249 terms

Pharmacology NCLEX-PN

STUDY
PLAY
Albuterol (Proventil HFA) two puffs and fluticasone propionate (Flovent Diskus) two puffs by metered-dose inhaler have been prescribed for a client with chronic obstructive pulmonary disease. The nurse caring for the client provides instructions regarding administration of the medication. Which statement by the client indicates an understanding of how to take these medications?

1. "I will take the two puffs of the fluticasone propionate first and then the two puffs of the albuterol."

2. "I will take the two puffs of the albuterol first and then the two puffs of the fluticasone propionate."

3."I will alternate a single puff of each, beginning with the fluticasone propionate."

4. "I will alternate a single puff of each, beginning with the albuterol."
2. "I will take the two puffs of the albuterol first and then the two puffs of the fluticasone propionate."
Disulfiram (Antabuse) is prescribed for a client who is seen in the psychiatric health care clinic. The nurse is collecting data on the client and is providing instructions regarding the use of this medication. Which is most important for the nurse to determine before administration of this medication?

1. A history of hyperthyroidism

2. A history of diabetes insipidus

3. When the last full meal was consumed

4. When the last alcoholic drink was consumed
4. When the last alcoholic drink was consumed
A nurse is caring for a client with liver disease. Laboratory studies are performed, and the client's serum calcium level is 13 mg/dL. The nurse checks to see that which medication is available in the stock medication supply area on the clinical nursing unit that may be needed to treat this calcium imbalance?

1. Vitamin D

2. Calcium chloride

3. Calcium gluconate

4. Calcitonin (Cibacalcin)
4. Calcitonin (Cibacalcin)
A client with carcinoma is admitted to the hospital for a chemotherapy treatment with intravenous bleomycin sulfate. The plan of care mentions observing for interstitial pneumonitis as the priority of care. Which assessment finding most closely correlates to symptoms of interstitial pneumonitis, requiring reporting?

1. Productive cough with thick, yellow sputum

2. Distended neck veins with pink, frothy sputum

3. Barking cough upon exertion

4. Lung wheezing and shortness of breath
4. Lung wheezing and shortness of breath
Tacrolimus (Prograf) is prescribed for a client. Which of the following disorders, if noted on the client's record, indicates that the medication needs to be administered with caution?

1. Ulcerative colitis

2. Diabetes insipidus

3. Renal insufficiency

4. Coronary artery disease
3. Renal insufficiency
A nurse employed in the emergency department is preparing to administer syrup of ipecac to a 7-month-old child. The nurse prepares 5 mL of the syrup and administers one half glass of water following administration of the ipecac syrup. Which response would the nurse expect?

1. Vomiting

2. Diarrhea

3. Increased level of consciousness

4. Elevated blood pressure
1. Vomiting
A nurse is reinforcing dietary instructions to a client who has been prescribed cyclosporine (Sandimmune). Which food item would the nurse instruct the client to avoid?

1. Red meats

2. Orange juice

3. Grapefruit juice

4. Green, leafy vegetables
3. Grapefruit juice
A client is being treated for acute congestive heart failure with intravenously administered bumetanide. The vital signs are as follows: blood pressure, 100/60 mm Hg; pulse, 96 beats/min; and respirations, 24 breaths/min. After the initial dose, which of the following is the priority assessment?

1. Monitoring weight loss

2. Monitoring temperature

3. Monitoring blood pressure

4. Monitoring potassium level
3. Monitoring blood pressure
A nurse is reinforcing discharge instructions to a client receiving sulfisoxazole. Which of the following should be included in the list of instructions?

1. Restrict fluid intake.

2. Maintain a high fluid intake.

3. If the urine turns dark brown, call the health care provider (HCP) immediately.

4. Decrease the dosage when symptoms are improving to prevent an allergic response.
2. Maintain a high fluid intake.
Docetaxel (Taxotere) is prescribed for a client with metastatic breast cancer. In addition, dexamethasone (Decadron) is prescribed to be administered before initiation of the docetaxel. The nurse tells the client that the dexamethasone is prescribed to:

1. Enhance the effects of the docetaxel.

2. Reduce the severity of fluid retention.

3. Prevent thromboembolic disorders.

4. Prevent neutropenia.
2. Reduce the severity of fluid retention.
Streptokinase (Streptase) is being administered to a client following an acute inferior myocardial infarction. The nurse plans care, knowing that the primary purpose of streptokinase is to:

1. Reduce myocardial oxygen demand.

2. Inhibit further clot formation.

3. Prevent platelet aggregation.

4. Dissolve the thrombus.
4. Dissolve the thrombus.
A client is seen in the clinic for complaints of skin itchiness that has been persistent over the past several weeks. Following data collection, it has been determined that the client has scabies. Lindane is prescribed, and the nurse is asked to provide instructions to the client regarding the use of the medication. The nurse tells the client to:

1. Apply a thick layer of cream to the entire body.

2. Apply the cream as prescribed for 2 days in a row.

3. Apply to the entire body and scalp, excluding the face.

4. Leave the cream on for 8 to 12 hours and then remove by washing.
4. Leave the cream on for 8 to 12 hours and then remove by washing.
A nurse is assisting in caring for a pregnant client who is receiving intravenous magnesium sulfate for the management of preeclampsia and notes that the client's deep tendon reflexes are absent. On the basis of this data, the nurse reports the finding and makes which determination?

1. The magnesium sulfate is effective.

2. The infusion rate needs to be increased.

3. The client is experiencing cerebral edema.

4. The client is experiencing magnesium toxicity.
4. The client is experiencing magnesium toxicity.
A client who is human immunodeficiency virus (HIV) seropositive has been taking zalcitabine (ddC) as a component of treatment. The nurse tells the client that which laboratory test will need to be monitored while taking this medication?

1. Glucose level

2. Platelet count

3. Red blood cell count

4. Liver function studies
4. Liver function studies
The nurse administering medications to a group of clients notes a prescription to give a subcutaneous dose of heparin sodium. The nurse should do which of the following to give this medication safely?

1. Aspirate with the plunger before injecting.

2. Massage the site after injection.

3. Give the injection using a 25- to 27-gauge, ⅝-inch needle.

4. Withdraw medication using a ⅝-inch needle and then change to a 1-inch needle.
3. Give the injection using a 25- to 27-gauge, ⅝-inch needle.
The nurse is analyzing the laboratory results of a client with leukemia who has received a regimen of chemotherapy. Which laboratory value would the nurse specifically note as a result of the massive cell destruction that occurred from the chemotherapy?

1. Anemia

2. Decreased platelets

3. Increased uric acid level

4. Decreased leukocyte count
3. Increased uric acid level
The client has begun medication therapy with pancrelipase (Pancrease MT). The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed?

1. Weight loss

2. Relief of heartburn

3. Reduction of steatorrhea

4. Absence of abdominal pain
3. Reduction of steatorrhea
Sodium hypochlorite (Dakin's solution) is prescribed for a client with a leg wound containing purulent drainage. The nurse is assisting in developing a plan of care for the client and includes which of the following in the plan?

1. Ensure that the solution is freshly prepared before use.

2. Soak a sterile dressing with solution and pack into the wound.

3. Allow the solution to remain in the wound following irrigation.

4. Apply the solution to the wound and on normal skin tissue surrounding the wound.
1. Ensure that the solution is freshly prepared before use.
A client with multiple sclerosis is receiving baclofen (Lioresal). The nurse monitoring this client should look for which of the following to indicate a primary therapeutic response from the medication?

1. Decreased muscle spasms

2. Increased range of motion of all extremities

3. Increased muscle tone and strength

4. Decreased nausea
1. Decreased muscle spasms
A client with cancer is receiving cisplatin. Which finding indicates that the client is experiencing an adverse effect of the medication?

1. Tinnitus

2. Increased appetite

3. Excessive urination

4. Yellow halos in front of the eyes
1. Tinnitus
The nurse provides medication instructions to an older hypertensive client who is taking 20 mg of lisinopril (Prinivil, Zestril) orally daily. The nurse evaluates the need for further teaching when the client states which of the following?

1. "I can skip a dose once a week."

2. "I need to change my position slowly."

3. "I take the pill after breakfast each day."

4. "If I get a bad headache, I should call my doctor immediately."
1. "I can skip a dose once a week."
A nurse provides instructions to a client who has been prescribed betaxolol (Betoptic) eye drops for the treatment of glaucoma. The nurse instructs the client regarding the administration of the medication and about the importance of returning to the clinic for monitoring of the:

1. Temperature

2. Blood pressure and apical pulse

3. Pupil dilation

4. Presence of Trousseau's sign
2. Blood pressure and apical pulse
A nurse is reviewing medications with the client receiving colchicine for the treatment of gout. The nurse determines that the medication is effective if the client reports a decrease in:

1. Blood glucose

2. Blood pressure

3. Joint inflammation

4. Headaches
3. Joint inflammation
A nurse is providing instructions to the parents of a child with iron deficiency anemia regarding the administration of a liquid oral iron supplement. The nurse tells the mother to:

1. Administer the iron through a straw.

2. Administer the iron at mealtimes.

3. Add the iron to food for easy administration.

4. Mix the iron with cereal to administer.
1. Administer the iron through a straw.
A nurse is caring for a client with chronic congestive heart failure who is taking digoxin (Lanoxin) 0.125 mg daily. Before administering the medication, the nurse reviews the serum digoxin level that was drawn earlier in the day. The result is 1 ng/mL. Which of the following actions should the nurse take based on this laboratory result?

1. Obtain another serum digoxin level to verify the results.

2. Administer the dose of the medication as scheduled.

3. Check the client's last pulse rate.

4. Notify the health care provider.
2. Administer the dose of the medication as scheduled.
A client has a prescription to receive albuterol (Proventil HFA) two puffs and beclomethasone dipropionate (Qvar) two puffs by metered-dose inhaler. The nurse plans to give these medications most effectively by:

1. Alternating a single puff of each hourly, beginning with the beclomethasone dipropionate

2. Alternating a single puff of each hourly, beginning with the albuterol

3. Administering the beclomethasone dipropionate before the albuterol

4. Administering the albuterol before the beclomethasone dipropionate
4. Administering the albuterol before the beclomethasone dipropionate
A urinary analgesic is prescribed for a client with a urinary tract infection. The nurse tells the client that it is best to take the medication:

1. With meals

2. At bedtime

3. One hour before meals

4. In the morning before breakfast
1. With meals
A nurse tells a client with leukemia that allopurinol (Zyloprim) has been added to the medication list. The client is currently receiving busulfan (Myleran). When the client asks the purpose of the new medication, the nurse responds that the allopurinol is intended to prevent:

1. Alopecia

2. Diabetes

3. Arthritis

4. Hyperuricemia
4. Hyperuricemia
Clients who are given a prescription for sildenafil (Viagra) should be taught that a potentially fatal medication interaction can occur with which medication?

1. Acetylsalicylic acid (aspirin)

2. Nitroglycerin (Nitrostat)

3. Warfarin (Coumadin)

4. Acetaminophen (Tylenol)
2. Nitroglycerin (Nitrostat)
A client has a prescription to take guaifenesin (Humibid) every 4 hours, as needed. The nurse determines that the client understands the most effective use of this medication if the client states that he or she will:

1. Watch for irritability as a side effect.

2. Take the tablet with a full glass of water.

3. Take an extra dose if the cough is accompanied by fever.

4. Crush the sustained-release tablet if immediate relief is needed.
2. Take the tablet with a full glass of water.
A nursing student is assigned to care for a 30-week gestational woman who is admitted to the maternity unit in preterm labor. Betamethasone is prescribed to be administered to the mother. The nursing instructor asks the student about the purpose of the medication. Which statement by the student indicates an understanding of the purpose of this medication?

1. "This medication will stop the premature uterine contractions."

2. "This medication will delay delivery."

3. "This medication will promote fetal lung maturity."

4. "This medication will prevent membrane rupture."
3. "This medication will promote fetal lung maturity."
A child is hospitalized with Rocky Mountain spotted fever (RMSF). The health record reveals documentation that the child was bitten by a tick 2 weeks ago. The child presents with complaints of headache, fever, and anorexia, and the nurse notes a rash on the palms of the hands and soles of the feet. The nurse reviews the health care provider's prescriptions and anticipates that which of the following will be prescribed?

1. Doxycycline (Vibramycin)

2. Amphotericin B

3. Ganciclovir (Cytovene)

4. Amantadine (Symmetrel)
1. Doxycycline (Vibramycin)
Baclofen (Lioresal) is prescribed for the client with multiple sclerosis. The nurse evaluates that the medication is having the intended effect if which of the following is noted in the client?

1. Increased muscle tone

2. Increased range of motion

3. Decreased muscle spasms

4. Decreased local pain and tenderness
3. Decreased muscle spasms
The nurse is applying a topical corticosteroid to a client with eczema. The nurse would monitor for the potential for increased systemic absorption of the medication if the medication were being applied to which of the following body areas?

1. Back

2. Axilla

3. Soles of the feet

4. Palms of the hands
2. Axilla
A client who has developed atrial fibrillation that is not responding to medication therapy has begun taking warfarin (Coumadin). The nurse is performing dietary discharge teaching with the client. The nurse would plan to teach the client to avoid which of the following foods while taking this medication?

1. Cherries

2. Potatoes

3. Spaghetti

4. Broccoli
4. Broccoli
When discussing the rationale for levothyroxine (Synthroid) with a client with hypothyroidism, the nurse should emphasize that the client can anticipate what primary expected outcome?

1. Alleviating depression

2. Increasing energy levels

3. Increasing blood glucose levels

4. Achieving normal thyroid hormone levels
4. Achieving normal thyroid hormone levels
Metoclopramide (Reglan) four times daily has been prescribed for a client with reflux esophagitis, and the nurse provides instructions to the client regarding administration of the medication. Which statement by the client indicates an understanding of the use of the medication?

1. "I need to take the medication 1 hour after each meal and at bedtime."

2. "I need to take the medication with every meal and at bedtime."

3. "I need to take the medication 30 minutes before meals and at bedtime."

4. "I need to take the medication every 6 hours spaced evenly around the clock."
3. "I need to take the medication 30 minutes before meals and at bedtime."
The client with non-Hodgkin's lymphoma is receiving daunorubicin (DaunoXome). Which of the following would indicate to the nurse that the client is experiencing a toxic effect related to the medication?

1. Fever

2. Diarrhea

3. Complaints of nausea and vomiting

4. Crackles on auscultation of the lungs
4. Crackles on auscultation of the lungs
The health care provider has prescribed silver sulfadiazine (Silvadene) for the client with a partial-thickness burn, which has cultured positive for gram-negative bacteria. The nurse is reinforcing information to the client about the medication. Which statement made by the client indicates a lack of understanding about the treatments?

1. "The medication is an antibacterial."

2. "The medication will help heal the burn."

3. "The medication will permanently stain my skin."

4. "The medication should be applied directly to the wound."
3. "The medication will permanently stain my skin."
A client has been given a prescription for chloral hydrate (Somnote) for short-term use. The nurse includes which of the following nursing interventions in caring for this client?

1. Instruct the client to call for help to get out of bed.

2. Leave the lights on in the client's room.

3. Perform a neurological assessment every 4 hours.

4. Monitor the vital signs every 4 hours.
1. Instruct the client to call for help to get out of bed.
A client with chronic renal failure is receiving epoetin alfa (Epogen, Procrit). Which laboratory result would indicate a therapeutic effect of the medication?

1. Hematocrit of 32%

2. Platelet count of 400,000 cells/mm3

3. White blood cell count of 6000 cells/mm3

4. Blood urea nitrogen (BUN) level of 15 mg/dL
1. Hematocrit of 32%
Cinoxacin (Cinobac), a urinary antiseptic, is prescribed for the client. The nurse reviews the client's medical record and should contact the health care provider (HCP) regarding which documented finding to verify the prescription? Refer to chart.

1. Renal insufficiency

2. Chest x-ray: normal

3. Blood glucose, 102 mg/dL

4. Folic acid (vitamin B6) 0.5 mg, orally daily
1. Renal insufficiency
A nurse is teaching a mother how to administer ear drops to an infant. The nurse plans to demonstrate by pulling the ear:

1. Down and back and directing the solution onto the eardrum

2. Down and back and directing the solution toward the wall of the canal

3. Up and back and directing the solution onto the eardrum

4. Up and back and directing the solution toward the wall of the canal
2. Down and back and directing the solution toward the wall of the canal
A health care provider tells the nurse that a potassium-sparing diuretic is being prescribed for the client with congestive heart failure. The nurse reviews the health care provider's prescriptions, expecting that which of the following medications will be prescribed?

1. Furosemide (Lasix)

2. Ethacrynic acid (Edecrin)

3. Spironolactone (Aldactone)

4. Hydrochlorothiazide (HydroDIURIL)
3. Spironolactone (Aldactone)
A health care provider has written a prescription for calcium carbonate for the client with hypocalcemia. The nurse preparing to administer the medication schedules the medication to be given:

1. Just before meals

2. With meals

3. Two hours after meals

4. At bedtime with a snack
3. Two hours after meals
A nurse is assigned to care for a client with herpes simplex virus (HSV) who is receiving acyclovir (Zovirax). The nurse is monitoring for adverse effects of the medication. Which of the following laboratory results would the nurse specifically monitor to identify an adverse effect associated with the use of this medication?

1. White blood cell count

2. Red blood cell count

3. Blood urea nitrogen (BUN)

4. Platelet count
3. Blood urea nitrogen (BUN)
The clinic nurse is performing an admission assessment on a client. The nurse notes that the client is taking azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect that the client is being treated for:

1. Acne

2. Eczema

3. Hair loss

4. Herpes simplex
1. Acne
A nurse reviews the laboratory results of a client with trigeminal neuralgia who is being treated with carbamazepine (Tegretol) 400 mg orally daily. The client's white blood cell (WBC) count is 3000 cells/mm3, blood urea nitrogen (BUN) is 15 mg/dL, sodium is 140 mEq/L, and uric acid is 5 ng/dL. The nurse would notify the health care provider that:

1. The BUN is elevated, indicating nephrotoxicity.

2. The WBC is low, indicating a blood dyscrasia.

3. The sodium level is low, indicating an electrolyte imbalance.

4. The uric acid level is elevated, indicating the risk for renal calculi.
2. The WBC is low, indicating a blood dyscrasia.
The nurse caring for the older adult client understands that dosages of many medications are reduced in this population because:

1. Body fat is decreased.

2. Pancreatic enzymes are increased.

3. Serum albumin levels are decreased.

4. Glomerular filtration rate is increased.
3. Serum albumin levels are decreased.
A nurse is caring for a client taking tolbutamide (Orinase) who has just been diagnosed with a urinary tract infection. The health care provider plans to treat the infection with sulfamethoxazole. The nurse expects that because of medication interactions, the health care provider will prescribe a:

1. Higher dose of the tolbutamide

2. Higher dose of the sulfamethoxazole

3. Lower dose of the tolbutamide

4. Lower dose of the sulfamethoxazole
3. Lower dose of the tolbutamide
A client with acquired immunodeficiency syndrome (AIDS) has a low T4 count. The nurse initiates prophylactic treatment as prescribed with aerosolized pentamidine isethionate (NebuPent) and monitors for which expected outcome?

1. The client has a respiratory rate and depth within normal limits for activity level.

2.Strict standard precautions were maintained.

3. The client shows no weight loss.

4. The client maintains serum sodium, potassium, calcium, and chloride values within normal ranges.
1. The client has a respiratory rate and depth within normal limits for activity level.
A client with benign prostatic hyperplasia is being administered finasteride (Proscar). Which of the following should be included in the plan of care?

1. Breast enlargement and breast lumps are not significant findings while taking this medication.

2. Taking this medication eliminates the need for screening exams for prostate cancer.

3. A pregnant caregiver should not be exposed to the crushed tablets of finasteride.

4. Testicular pain is common with this medication and does not require health care provider notification.
3. A pregnant caregiver should not be exposed to the crushed tablets of finasteride.
A nurse is preparing to administer eardrops to an infant. The nurse plans to:

1. Pull up and back on the ear and direct the solution onto the eardrum.

2. Pull down and back on the ear and direct the solution onto the eardrum.

3. Pull down and back on the ear and direct the solution toward the wall of the canal.

4. Pull up and back on the ear lobe and direct the solution toward the wall of the canal.
3. Pull down and back on the ear and direct the solution toward the wall of the canal.
A nurse is reviewing the laboratory results for a client receiving tacrolimus (Prograf). Which laboratory result would indicate to the nurse that the client is experiencing an adverse effect of the medication?

1. Blood glucose of 200 mg/dL

2. Potassium level of 3.8 mEq/L

3. Platelet count of 300,000 cells/mm3

4. White blood cell count of 6000 cells/mm3
1. Blood glucose of 200 mg/dL
Auranofin (Ridaura) has been prescribed for a client with rheumatoid arthritis. The nurse who is collecting data 2 weeks later interprets that the client may be experiencing the signs of medication toxicity based on what data collection findings. Select all that apply.

1. Reports loss of appetite

2. Observes several mouth lesions

3. Rash noted on trunk and neck

4. Reports a metallic taste in the mouth

5. Purplish blotches noticed on the skin
2. Observes several mouth lesions

3. Rash noted on trunk and neck

4. Reports a metallic taste in the mouth

5. Purplish blotches noticed on the skin
A client with advanced ovarian cancer is being treated with paclitaxel (Taxol). The nurse monitors the client closely for which side effect of the medication?

1. Bradycardia

2. Constipation

3. Fatigue

4. Hypertension
1. Bradycardia
A client is receiving tacrolimus (Prograf) to prevent organ rejection. The nurse expects to administer the dose with which of the following medications that is also normally prescribed?

1. Prednisone

2. Erythromycin

3. Fluconazole (Diflucan)

4. Carbamazepine (Tegretol)
1. Prednisone
A client is being treated for depression with amitriptyline hydrochloride. During the initial phases of treatment, the most important nursing intervention is:

1. Prescribing the client a tyramine-free diet

2. Checking the client for anticholinergic effects

3. Monitoring blood levels frequently because there is a narrow range between therapeutic and toxic blood levels of this medication

4. Getting baseline postural blood pressures before administering the medication and each time the medication is administered
4. Getting baseline postural blood pressures before administering the medication and each time the medication is administered
Megestrol acetate (Megace), an antineoplastic medication, is prescribed for the client with metastatic endometrial carcinoma. The nurse reviews the client's history and contacts the registered nurse if which diagnosis is documented in the client's history?

1. Gout

2. Asthma

3. Thrombophlebitis

4. Myocardial infarction
3. Thrombophlebitis
A client with a partial right adrenalectomy is placed on corticosteroid replacement therapy. Which of the following would indicate that the client is experiencing an adverse effect related to the pharmacological treatment?

1. Hypoglycemia

2. Hypotension

3. Dry mouth

4. Tarry stools
4. Tarry stools
A nurse is assisting in preparing to administer acetylcysteine (Mucomyst) to a client with an overdose of acetaminophen (Tylenol). The nurse prepares to administer the medication by:

1. Administering the medication subcutaneously in the deltoid muscle

2. Administering the medication by the intramuscular route in the gluteal muscle

3. Administering the medication by the intramuscular route, mixed in 10 mL of normal saline

4. Mixing the medication in a flavored ice drink and allowing the client to drink the medication through a straw
4. Mixing the medication in a flavored ice drink and allowing the client to drink the medication through a straw
A client with breast cancer has been given a prescription for cyclophosphamide. The nurse determines that the client understands the proper use of the medication if the client states that she needs to:

1. Decrease dietary intake of magnesium.

2. Increase dietary intake of potassium.

3. Take the medication with large meals.

4. Increase fluid intake to 2 to 3 L/day.
4. Increase fluid intake to 2 to 3 L/day.
A nurse is caring for a client with Paget's disease who has an elevated serum calcium level of 12.3 mEq/L. The nurse checks to see that which of the following medications is available in the stock medication supply area for possible use to reverse this elevation?

1. Calcium gluconate

2. Calcium chloride

3. Calcitonin (Calcimar)

4. Vitamin D
3. Calcitonin (Calcimar)
A nurse prepares to administer digoxin (Lanoxin) to a 3-year-old with a diagnosis of congestive heart failure and notes that the apical heart rate is 120 beats per minute. Which nursing action is appropriate?

1. Administer the digoxin.

2. Recheck the apical heart rate in 15 minutes.

3. Notify the registered nurse.

4. Hold the medication.
1. Administer the digoxin.
A client with aldosteronism has been instructed on spironolactone (Aldactone) treatment. Which client statement indicates that the client needs further teaching about the medication?

1. "This medication will make me void frequently."

2. "This medication will decrease my blood glucose."

3. "My blood pressure should get back to normal."

4. "My potassium level will increase."
2. "This medication will decrease my blood glucose."
A nurse is reviewing the laboratory results of a client receiving chemotherapy. The nurse prepares to initiate neutropenic precautions when the nurse notes which of the following laboratory results?

1. A white blood cell (WBC) count of 2000 cells/mm3

2. A platelet count of 200,000 cells/mm3

3. A clotting time of 10 minutes

4. An ammonia level of 20 mcg/dL
1. A white blood cell (WBC) count of 2000 cells/mm3
A client is diagnosed with hypothyroidism, and levothyroxine (Synthroid) is prescribed. The nurse notes that the client is presently taking warfarin sodium (Coumadin) and anticipates that the health care provider will prescribe which of the following?

1. An increased dosage of warfarin sodium

2. A decreased dosage of warfarin sodium

3. An increased dosage of levothyroxine

4. A decreased dosage of levothyroxine
2. A decreased dosage of warfarin sodium
A nurse is caring for a client with a diagnosis of chronic renal failure who is receiving dialysis. Epoetin alfa (Epogen) has been prescribed for the client. The nurse prepares to administer the medication by:

1. The subcutaneous route

2. Shaking the vial before drawing up the medication

3. Obtaining the medication from the medication freezer

4. Mixing the medication with 0.1 mL of heparin before administration to prevent clotting
1. The subcutaneous route
A client who exhibits fatigue, lack of energy, constipation, and depression is diagnosed with hypothyroidism. The health care provider prescribes levothyroxine (Synthroid). To increase the likelihood of medication compliance in the early course of treatment, the nurse plans to alert the client that:

1. Diarrhea as an early side effect diminishes with time.

2. Weight gain or edema formation is greatest in the first month.

3. The full therapeutic effect may take 1 to 3 weeks.

4. The full therapeutic effect may take up to 4 months.
3. The full therapeutic effect may take 1 to 3 weeks.
A nurse is caring for a client who is receiving an intravenous (IV) infusion of an antineoplastic medication. During the infusion, the client complains of pain at the insertion site. During an inspection of the site, the nurse notes redness and swelling and that the rate of infusion of the medication has slowed. The nurse should take which appropriate action?

1. Notify the registered nurse.

2. Administer pain medication to reduce the discomfort.

3. Apply ice and maintain the infusion rate, as prescribed.

4. Elevate the extremity of the IV site, and slow the infusion.
1. Notify the registered nurse.
Nalidixic acid (NegGram) is prescribed for the client with a urinary tract infection. Reviewing the client's record, the nurse notes that the client is taking warfarin (Coumadin) on a daily basis. Which of the following prescriptions would the nurse anticipate because the client is taking this oral anticoagulant?

1. An increase in the anticoagulation dosage

2. A reduction in the anticoagulation dosage

3. The need to discontinue the warfarin during therapy

4. The need to administer an alternative medication to treat the urinary tract infection
2. A reduction in the anticoagulation dosage
A nurse reinforces discharge instructions to a postoperative client who is taking warfarin sodium (Coumadin). Which statement, if made by the client, reflects the need for further teaching?

1. "I will take my pills every day at the same time."

2. "I will be certain to avoid alcohol consumption."

3. "I have already called my family to pick up a Medic-Alert bracelet."

4. "I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated."
4. "I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated."
A nurse is applying a topical glucocorticoid to a client with eczema. The nurse monitors for systemic absorption of the medication if the medication is being applied to which of the following body areas?

1. Back

2. Axilla

3. Soles of the feet

4. Palms of the hands
2. Axilla
Alendronate (Fosamax) is prescribed for a client with osteoporosis. The client taking this medication is instructed to:

1. Take the medication at bedtime.

2. Take the medication in the morning with breakfast.

3. Lie down for 30 minutes after taking the medication.

4. Take the medication with a full glass of water after rising in the morning.
4. Take the medication with a full glass of water after rising in the morning.
A client with coronary artery disease complains of substernal chest pain. After checking the client's heart rate and blood pressure, a nurse administers nitroglycerin, 0.4 mg, sublingually. After 5 minutes, the client states, "My chest still hurts." Select the appropriate actions that the nurse should take. Select all that apply.

1. Call a code blue.

2. Contact the registered nurse.

3. Contact the client's family.

4. Assess the client's pain level.

5. Check the client's blood pressure.

6. Administer a second nitroglycerin, 0.4 mg, sublingually.
2. Contact the registered nurse.

4. Assess the client's pain level.

5. Check the client's blood pressure.

6. Administer a second nitroglycerin, 0.4 mg, sublingually.
Collagenase (Santyl) is prescribed for a client with a severe burn to the hand. The nurse is preparing to provide instructions to the client and spouse regarding the wound treatment. Which of the following should the nurse include in the instructions?

1. Apply twice a day and leave the wound open to the air.

2. Apply twice a day and cover the wound with a sterile dressing.

3. Apply once a day and leave the wound open to the air.

4. Apply once a day and cover the wound with a sterile dressing.
4. Apply once a day and cover the wound with a sterile dressing.
Levothyroxine sodium (Synthroid) is prescribed for a client with hypothyroidism. When would the nurse encourage the client to take the medication?

1. In the morning

2. At bedtime

3. At lunchtime

4. At dinnertime
1. In the morning
A client is taking trihexyphenidyl for the treatment of Parkinson's disease. The nurse would monitor for which adverse effect of this medication?

1. Diarrhea

2. Urinary retention

3. Urinary incontinence

4. Excessive perspiration
2. Urinary retention
A client with heart failure is being discharged to home and will be taking furosemide (Lasix). The nurse determines that teaching has been effective if the client states which of the following?

1. "I will check my ankles every day for swelling."

2. "I will take my pulse every day."

3. "I will measure my urine output."

4. "I will weigh myself every day."
4. "I will weigh myself every day."
A child is hospitalized with a diagnosis of lead poisoning. The nurse assisting in caring for the child would prepare to assist in administering which of the following medications?

1. Activated charcoal

2. Sodium bicarbonate

3. Syrup of ipecac syrup

4. Dimercaprol (BAL in Oil)
4. Dimercaprol (BAL in Oil)
A client who is receiving carbamazepine (Tegretol) daily has a white blood cell (WBC) count of 2800 cells/mm3, blood urea nitrogen (BUN) of 17 mg/dL, sodium of 141 mEq/L, and uric acid of 5 mg/dL. The nurse makes which interpretation, based on these laboratory values?

1. The uric acid level is elevated, indicating the risk for renal calculi.

2. The sodium level is low, indicating an electrolyte imbalance.

3. The BUN is elevated, indicating nephrotoxicity.

4. The WBC count is low, indicating a blood dyscrasia.
4. The WBC count is low, indicating a blood dyscrasia.
A nurse is reviewing the health care provider's prescription sheet for the preoperative client, which states that the client must be on nothing per mouth (NPO) status after midnight. The nurse would clarify whether which of the following medications should be given to the client and not withheld?

1. Conjugated estrogen (Premarin)

2. Atenolol (Tenormin)

3. Cyclobenzaprine (Flexeril)

4. Ferrous sulfate
2. Atenolol (Tenormin)
A nurse is reviewing instructions to a client with otitis media who is receiving amoxicillin (Amoxil) 500 mg orally every 8 hours. Which of the following statements by the client would indicate an understanding of the adverse effects related to the medication?

1. "If I get diarrhea, I need to call the doctor."

2. "I may become dizzy from the medication."

3. "Constipation means that the medication needs to be stopped."

4. "A headache may mean that I need to discontinue the medication."
1. "If I get diarrhea, I need to call the doctor."
A nurse has completed client teaching about heart failure and prescribed medications that include digoxin (Lanoxin) and furosemide (Lasix). The nurse documents that the teaching goals have been met if the client states to report a:

1. Sudden increase in appetite

2. Weight gain of 2 to 3 pounds in a few days

3. Cough that accompanies a cold

4. High urine output during the day
2. Weight gain of 2 to 3 pounds in a few days
A potassium-sparing diuretic is prescribed for a client with heart failure. Which of the following foods would the nurse instruct the client to avoid?

1. Bananas

2. Cranberry juice

3. Plums

4. Cheddar cheese
1. Bananas
A nurse in the emergency department is preparing to instill fluorescein into the eye of a client with the complaint of eye pain. The nurse understands the rationale for the use of this medication is to:

1. Paralyze the ciliary muscles.

2. Promote mydriasis of the pupil.

3. Increase outflow of aqueous humor.

4. Provide visualization of injury to the cornea.
4. Provide visualization of injury to the cornea.
Saquinavir (Invirase) is prescribed for the client who is human immunodeficiency virus (HIV) seropositive. The nurse provides medication instructions and determines that the client needs further instructions if the client states he will:

1. Avoid sun exposure.

2. Eat high-calorie foods.

3. Eat foods that are high in fat.

4. Take the medication on an empty stomach.
4. Take the medication on an empty stomach.
A nurse is caring for a client who has been prescribed gabapentin (Neurontin) and is monitoring for adverse effects of the medication. Which of the following findings would indicate a potential adverse effect?

1. Tremors

2. Slurred speech

3. Dysarthria

4. Weight gain
2. Slurred speech
The client with acquired immunodeficiency syndrome and Pneumocystis jiroveci infection has been receiving pentamidine isethionate (Pentam 300). The client develops a temperature of 101° F. The nurse does further monitoring of the client, knowing that this sign would most likely indicate:

1. The dose of the medication is too low.

2. The client is experiencing toxic effects of the medication.

3. The client has developed inadequacy of thermoregulation.

4. The result of another infection caused by leukopenic effects of the medication.
4. The result of another infection caused by leukopenic effects of the medication.
A daily dose of prednisone is prescribed for a client. A nurse reinforces instructions to the client regarding administration of the medication and instructs the client that the best time to take this medication is:

1. At noon

2. At bedtime

3. Early morning

4. Anytime, at the same time, each day
3. Early morning
A nurse is caring for a client who has just had rotator cuff repair. The client asks the nurse how soon he can resume his tai chi classes. The nurse makes which statement to the client?

1. "You will never be able to do tai chi again!"

2. "Tai chi is good for you so you can start any time."

3. "Tai chi uses only your leg muscles, so it would be all right."

4. "You shouldn't be doing any exercises that require the use of your upper arms until you have been cleared to do so by the health care provider."
4. "You shouldn't be doing any exercises that require the use of your upper arms until you have been cleared to do so by the health care provider."
A client has just been given a prescription for methocarbamol (Robaxin), and the nurse provides instructions to the client. Which statement by the client indicates the need for further instructions?

1. "This medication can cause nasal congestion."

2. "This medication is intended to relieve muscle spasms."

3. "The medication may turn the urine brown or green."

4. "Blurred vision is a common but unimportant effect."
4. "Blurred vision is a common but unimportant effect."
A client is scheduled for an intravenous pyelogram and has been instructed to take liquid magnesium citrate on the day before the scheduled procedure. The client asks the nurse about the administration procedure for this medication. Which of the following instructions will the nurse provide to the client?

1. "Take the medication on ice."

2. "Mix the medication with apple juice only."

3. "Mix the medication with a full glass of water."

4. "Drink the medication at room temperature."
1. "Take the medication on ice."
Entacapone (Comtan) is prescribed for a client with a diagnosis of Parkinson's disease. The nurse provides medication instructions to the client and tells the client that a frequent side effect is:

1. An elevation in blood pressure

2. Joint pains

3. Urine discoloration to dark yellow or orange

4. Pruritus
3. Urine discoloration to dark yellow or orange
A client is diagnosed with an acute myocardial infarction and is receiving tissue plasminogen activator, alteplase (Activase, tPA). Which action is a priority nursing intervention?

1. Monitor for renal failure.

2. Monitor psychosocial status.

3. Monitor for signs of bleeding.

4. Have heparin sodium available.
3. Monitor for signs of bleeding.
A nurse is providing care for a client with a diagnosis of germ cell cancer of the testes who has been prescribed ifosfamide (Ifex). The nurse anticipates that the client will also be prescribed which additional antineoplastic medication?

1. Mesna (Mesnex)

2. Melphalan (Alkeran)

3. Prednisone

4. Cisplatin (Platinol-AQ)
1. Mesna (Mesnex)
A client is receiving diazepam (Valium) for its skeletal muscle relaxant effects. The nurse should monitor this client for which side effect of this medication?

1. Urinary retention

2. Headache

3. Incoordination

4. Increased salivation
3. Incoordination
A nurse is caring for a client diagnosed with Parkinson's disease who is prescribed benztropine mesylate (Cogentin) daily. The nurse reinforces instructions to both the client and the spouse regarding the side effects of this medication and the need to report which side effect if it occurs?

1. Inability to urinate

2. Decreased appetite

3. Shuffling, unsteady gait

4. Irregular bowel movements
1. Inability to urinate
A licensed practical nurse (LPN) is reviewing the medical record of a newly assigned client and notes that the client is receiving cyclobenzaprine hydrochloride (Flexeril) for the treatment of muscle spasms. The LPN questions the prescription if which of the following disorders is noted in the admission history?

1. Angle-closure glaucoma

2. Hypothyroidism

3. Chronic bronchitis

4. Recurrent pneumonia
1. Angle-closure glaucoma
A client has self-administered his first injection of regular insulin at 7:30 AM, before breakfast. This client should be instructed to most closely monitor for signs of hypoglycemia at which time?

1. 7:30 AM

2. 11:00 AM

3. 2:30 PM

4. 7:00 PM
2. 11:00 AM
Saquinavir (Invirase) is prescribed for the client who is human immunodeficiency virus seropositive. The nurse reinforces medication instructions and tells the client to:

1. Avoid sun exposure.

2. Eat low-calorie foods.

3. Eat foods that are low in fat.

4. Take the medication on an empty stomach.
1. Avoid sun exposure.
Trimethoprim-sulfamethoxazole (TMP-SMZ) is prescribed for a client. A nurse should instruct the client to report which symptom if it developed during the course of this medication therapy?

1. Nausea

2. Diarrhea

3. Headache

4. Sore throat
4. Sore throat
A client is being given a transcutaneous electrical nerve stimulation (TENS) unit to use for relief of chronic pain. Choose the instructions that the nurse provides to the client about the TENS unit. Select all that apply.

1. Using this unit will help relieve the pain.

2. Hospitalization is required for this treatment.

3. The unit needs to be prescribed by the health care provider.

4. The unit works after attaching electrodes to the skin.

5. The unit will decrease the amount of pain medication needed.

6. The electrodes attached to the unit are placed on the skin around the area of pain.
1. Using this unit will help relieve the pain.

3. The unit needs to be prescribed by the health care provider.

4. The unit works after attaching electrodes to the skin.

5. The unit will decrease the amount of pain medication needed.

6. The electrodes attached to the unit are placed on the skin around the area of pain.
A client with a closed head injury is receiving phenytoin (Dilantin), an anticonvulsant medication. Which of the following would indicate that the client is experiencing side effects related to this medication? Select all that apply.

1. Ataxia

2. Sedation

3. Constipation

4. Bleeding gums

5. Hyperglycemia

6. Decreased platelet count
3. Constipation

4. Bleeding gums

5. Hyperglycemia

6. Decreased platelet count
In monitoring a client's response to disease-modifying antirheumatic drugs (DMARDs), which findings would the nurse interpret as acceptable responses? Select all that apply.

1. Symptom control during periods of emotional stress

2. Normal white blood cell counts, platelet, and neutrophil counts

3. Radiological findings that show nonprogression of joint degeneration

4. An increased range of motion in the affected joints 3 months into therapy

5. Inflammation and irritation at the injection site 3 days after injection is given

6. A low-grade temperature upon rising in the morning that remains throughout the day
1. Symptom control during periods of emotional stress

2. Normal white blood cell counts, platelet, and neutrophil counts

3. Radiological findings that show nonprogression of joint degeneration

4. An increased range of motion in the affected joints 3 months into therapy
A licensed practical nurse (LPN) is reviewing the medication list of the client with a history of glaucoma. The LPN would consult with the registered nurse if which of the following medications is prescribed for this client?

1. Pilocarpine (Pilopine HS)

2. Pilocarpine hydrochloride (Isopto Carpine)

3. Atropine sulfate (Isopto Atropine)

4. Carteolol hydrochloride
3. Atropine sulfate (Isopto Atropine)
Atenolol hydrochloride (Tenormin) is prescribed for a hospitalized client. The nurse should perform which of the following as a priority action before administering the medication?

1. Listen to the client's lung sounds.

2. Check the client's blood pressure.

3. Check the recent electrolyte levels.

4. Assess the client for muscle weakness.
2. Check the client's blood pressure.
A client with narcolepsy has been prescribed dextroamphetamine (Dexedrine). The client complains to the nurse that he cannot sleep well anymore at night and does not want to take the medication any longer. Before making any specific comment, the nurse plans to investigate whether the client takes the medication at which of the following proper time schedules?

1. After dinner each day

2. Just before going to bed

3. Two hours before bedtime

4. At least 6 hours before bedtime
4. At least 6 hours before bedtime
A nurse caring for a client taking tamsulosin (Flomax) determines that which of the following findings indicates the need for follow-up?

1. Vertigo

2. Nasal congestion

3. Blood pressure of 135/85 mm Hg

4. Pulse rate of 120 beats per minute
4. Pulse rate of 120 beats per minute
A nurse is reinforcing medication instructions to a client with human immunodeficiency virus (HIV) who will be taking saquinavir (Invirase). The nurse instructs the client to take the medication:

1. On an empty stomach

2. Two hours before breakfast

3. Within 2 hours after a full meal

4. At bedtime
3. Within 2 hours after a full meal
Letrozole (Femara) is prescribed for a postmenopausal client with advanced breast cancer. The nurse provides instructions to the client regarding the medication and tells the client that a frequent side effect is:

1. Skeletal pain

2. Weakness

3. Diarrhea

4. Nervousness
1. Skeletal pain
A nurse is reviewing the health care provider's prescriptions for an adult client who has been admitted to the hospital following a back injury. Carisoprodol (Soma) is prescribed for the client to relieve the muscle spasms; the health care provider has prescribed 350 mg to be administered four times a day. When preparing to give this medication, the nurse determines that this dosage is:

1. The normal adult dosage

2. A lower than normal dosage

3. A higher than normal dosage

4. A dosage requiring further clarification
1. The normal adult dosage
A client taking carbamazepine (Tegretol) asks the nurse what to do if he misses one dose. The nurse responds that the carbamazepine should be:

1. Withheld until the next scheduled dose

2. Withheld and the health care provider is notified immediately

3. Taken as long as it is not immediately before the next dose

4. Withheld until the next scheduled dose, which should then be doubled
3. Taken as long as it is not immediately before the next dose
A client who has just been diagnosed with glaucoma has been given a prescription for a miotic medication. When teaching the client about medication effects, the nurse plans to tell the client that the medication will:

1. Reshape the lens to eliminate blurred vision.

2. Interrupt the drainage of aqueous humor from the eye.

3. Lower intraocular pressure and enhance blood flow to the retina.

4. Dilate the pupil to reduce intraocular pressure.
3. Lower intraocular pressure and enhance blood flow to the retina.
A client with suspected opioid overdose has received a dose of nalmefene. The client subsequently becomes restless, starts to vomit, and complains of abdominal cramping. The blood pressure increases from 110/72 to 160/86 mm Hg. The nurse provides emotional support and reassurance while administering care to the client, knowing that:

1. The client may become suicidal.

2. These are signs of opioid withdrawal.

3. These effects will only last a few moments.

4. The client may otherwise sign out against medical advice.
2. These are signs of opioid withdrawal.
A health care provider has written a prescription for ranitidine (Zantac), once daily. The nurse should schedule the medication for which of the following times?

1. At bedtime

2. After lunch

3. With supper

4. Before breakfast
1. At bed time
A client has been prescribed allopurinol (Zyloprim). The nurse reinforces which information concerning the administration of the medication?

1. Take the medication 1 hour before eating.

2. Drink at least eight glasses of fluid every day.

3. Put ice on the upper and lower lips if they swell.

4. Use an antihistamine lotion if an itchy rash develops.
2. Drink at least eight glasses of fluid every day.
A 15-year-old child is scheduled to receive a series of the hepatitis B vaccine. The child arrives at the clinic for the first dose. The nurse collects data on the child before administering the vaccine and asks the child about a history of an allergy to:

1. Baker's yeast

2. Eggs

3. Penicillin

4. Sulfonamides
1. Baker's yeast
A nurse is performing an assessment on a pregnant client who has had a severe asthma attack. The nurse asks the client about prescription and herbal medications she is taking and the client tells the nurse that she has been taking the herb chamomile. The nurse refers to an herbal reference book and discovers that chamomile:

1. Is a known stimulant

2. Is always safe for women and children

3. Has no side effects or interactions with other medications

4. Should not be used by pregnant women and persons with asthma
4. Should not be used by pregnant women and persons with asthma
A client who is prescribed metronidazole (Flagyl) calls the clinic nurse to report dark discoloration of the urine. The nurse interprets that the client's report warrants which nursing action at this time?

1. Instruct the client to increase oral fluid intake.

2. Inform the client that this is a common side effect.

3. Arrange for the client to speak with the health care provider.

4. Advise the client to immediately discontinue the medication.
1. Instruct the client to increase oral fluid intake.
Cyclobenzaprine (Flexeril) is prescribed for a client to treat muscle spasms, and the nurse is reviewing the client's record. Which of the following disorders, if noted in the client's record, would indicate a need to contact the health care provider regarding the administration of this medication?

1. Glaucoma

2. Emphysema

3. Hyperthyroidism

4. Diabetes mellitus
1. Glaucoma
A client with myocardial infarction is a candidate for alteplase (Activase) therapy. The nurse assisting in the care of this client is aware that it will be necessary to monitor for which frequent adverse effect if the client receives this treatment?

1. Infection

2. Bleeding

3. Allergic reaction

4. Muscle weakness
2. Bleeding
Baclofen (Lioresal) is prescribed for a client with a spinal cord injury who is experiencing muscle spasms, and the nurse prepares a list of the associated side effects of the medication and reviews the list with the client. Which side effect, if identified by the client, indicates a need for further instruction?

1. Photosensitivity

2. Slurred speech

3. Nasal congestion

4. Tremors
1. Photosensitivity
A nurse notes that the result of the serum theophylline level of a client taking theophylline is 15 mcg/mL. The nurse interprets this result as:

1. Below the therapeutic range

2. In the middle of the therapeutic range

3. At the top of the therapeutic range

4. In excess of the therapeutic range
2. In the middle of the therapeutic range
A client diagnosed with gout has been started on medication therapy with allopurinol (Zyloprim). The nurse reinforces teaching with this client about which of the following points about this medication?

1. "Take the medication on an empty stomach."

2. "Development of a rash frequently occurs with this medication."

3. "The medication takes effect immediately."

4. "It is important to drink 3 L of fluid per day."
4. "It is important to drink 3 L of fluid per day."
A nurse is asked to prefill syringes containing NPH and regular insulin for a diabetic client who lives at home alone and has difficulty with seeing and accurately preparing dosages. Considering the stability of insulin, how many prefilled syringes will the nurse prepare for the client?

1. Three-day supply

2. Five-day supply

3. Seven-day supply

4. One-month supply
3.
The nurse is reviewing the history and physical examination of a client who will be receiving asparaginase (Elspar), an antineoplastic agent. The nurse consults with the registered nurse regarding the administration of the medication if which of the following is documented in the client's history?

1. Pancreatitis

2. Diabetes mellitus

3. Myocardial infarction

4. Chronic obstructive pulmonary disease
1. Pancreatitis
A nurse is monitoring a child who is receiving calcium disodium edetate (EDTA) for the treatment of lead poisoning. The nurse reviews the laboratory results of the child during treatment with this medication and is particularly concerned with monitoring which laboratory test result?

1. Blood urea nitrogen

2. Hemoglobin and hematocrit (H&H) level

3. Complete blood cell (CBC) count

4. Cholesterol level
1. Blood urea nitrogen
Warfarin sodium (Coumadin) is prescribed for a client. The nurse expects that the health care provider will prescribe which of the following to monitor for a therapeutic effect of the medication?

1. Platelet count

2. Red blood cell (RBC) count

3. Prothrombin time (PT)

4. Activated partial thromboplastin time (aPTT)
3. Prothrombin time (PT)
A client with acquired immunodeficiency syndrome has been started on therapy with zidovudine (AZT, Retrovir). The nurse reviews the health care provider's prescriptions, expecting to note that which laboratory test has been prescribed?

1. Blood glucose level

2. Blood urea nitrogen

3. Blood culture

4. Complete blood count (CBC)
4. Complete blood count (CBC)
A client has begun taking lansoprazole (Prevacid). The nurse monitors for which of the following intended effects of this medication?

1. Relief of abdominal pain

2. Decrease in intestinal gas

3. Relief of nighttime heartburn

4. Absence of nausea and vomiting
3. Relief of nighttime heartburn
Dantrolene sodium (Dantrium) is prescribed for a client experiencing flexor spasms, and the client asks the nurse about the action of the medication. The nurse responds, knowing that the therapeutic action of this medication is which of the following?

1. Depresses spinal reflexes

2. Acts directly on the skeletal muscle to relieve spasticity

3. Acts within the spinal cord to suppress hyperactive reflexes

4. Acts on the central nervous system (CNS) to suppress spasms
2. Acts directly on the skeletal muscle to relieve spasticity
A client taking an angiotensin-converting enzyme (ACE) inhibitor reviewed the medication information sheet and notes that the medication is used to treat hypertension. He states, "I have heart failure. Why am I taking this medicine?" The nurse responds by stating:

1. "There must be some mistake, I will check the medication prescriptions."

2. "The medication causes relaxation in your arteries and veins and decreases the heart's work."

3. "The medication makes your heart beat faster and this improves blood flow to your tissues."

4. "An additional medication will be added to the ACE inhibitor to strengthen your heart muscle."
2. "The medication causes relaxation in your arteries and veins and decreases the heart's work."
The nurse is caring for a female client receiving chemotherapy and notes that the client has developed myelosuppression. Which of the following laboratory values would support the client's diagnosis of myelosuppression?

1. Hemoglobin 9.4 g/dL, hematocrit 26%

2. Blood urea nitrogen (BUN) 15 mg/dL, creatinine 0.9 mg/dL

3. Protein 7 g/dL

4. Magnesium 1.8 mg/dL
1. Hemoglobin 9.4 g/dL, hematocrit 26%
A client with a history of simple partial seizures is taking clorazepate (Tranxene). The client asks the nurse whether there is a risk of addiction. The nurse's response is based on the understanding that clorazepate:

1. Is not habit forming either physically or psychologically

2. Leads to physical and psychological dependence with prolonged high dose therapy

3. Leads to physical tolerance, but only after 10 or more years of therapy

4. Can result in psychological dependence only, because of the nature of the medication
2. Leads to physical and psychological dependence with prolonged high dose therapy
A client has been prescribed oral erythromycin. The nurse reinforces which information regarding the administration of this medication?

1. Take with juice.

2. Schedule at bedtime.

3. Take on an empty stomach.

4. Ingest just before performing an activity.
3. Take on an empty stomach.
A nurse is caring for a client with myasthenia gravis who has received edrophonium (Enlon) intravenously to test for myasthenic crisis. The client asks the nurse how long the improvement in muscle strength will last. The nurse's response is based on the understanding that the effects have a duration of approximately:

1. 5 minutes

2. 15 minutes

3. 30 minutes

4. 60 minutes
3. 30 minutes
Fludrocortisone (Florinef) is prescribed for a client with Addison's disease. The nurse prepares to administer the medication, knowing that the primary action of this medication is to:

1. Enhance the reabsorption of sodium and chloride ions in the distal tubules of the kidney.

2. Promote the retention of potassium in the distal tubules of the kidney.

3. Promote the retention of hydrogen ions in the distal tubules of the kidney.

4. Promote the excretion of water in the distal tubules of the kidney.
1. Enhance the reabsorption of sodium and chloride ions in the distal tubules of the kidney.
A nurse is preparing a subcutaneous dose of bethanechol chloride (Urecholine) prescribed for a client with urinary retention. Before giving the dose, the nurse checks to see that which of the following medications is available on the emergency cart for use if needed?

1. Protamine sulfate

2. Vitamin K

3. Atropine sulfate

4. Acetylcysteine (Mucomyst)
3. Atropine sulfate
A newborn infant receives naloxone hydrochloride (Narcan) to reverse opiate-induced respiratory depression that occurred following labor and delivery. The nurse continues to monitor the respiratory status of a newborn infant following the administration of this medication because:

1. The newborn infant may demonstrate a reappearance of respiratory depression.

2. The newborn infant may have an underlying respiratory disorder.

3. The effects of naloxone are long lasting.

4. The use of naloxone in newborn infants is toxic.
1. The newborn infant may demonstrate a reappearance of respiratory depression.
A nurse has given a client taking ethambutol (Myambutol) information about the medication. The nurse determines that the client understands the instructions if the client states that he or she will immediately report:

1. Impaired sense of hearing

2. Problems with visual acuity

3. Gastrointestinal (GI) side effects

4. Orange-red discoloration of body secretions
2. Problems with visual acuity
Rifabutin (Mycobutin) is prescribed for a client with active Mycobacterium avium complex (MAC) disease and tuberculosis. The nurse monitors for which side effects of the medication? Select all that apply.

1. Signs of hepatitis

2. Flu-like syndrome

3. Low neutrophil count

4. Vitamin B6 deficiency

5. Ocular pain or blurred vision

6. Tingling and numbness of the fingers
1. Signs of hepatitis

2. Flu-like syndrome

3. Low neutrophil count

5. Ocular pain or blurred vision
After kidney transplantation, cyclosporine (Sand immune) is prescribed for a client. Which laboratory result would indicate an adverse effect from the use of this medication?

1. Decreased creatinine level

2. Decreased hemoglobin level

3. Elevated blood urea nitrogen level

4. Decreased white blood cell count
3. Elevated blood urea nitrogen level
Bethanechol chloride (Urecholine) is prescribed for a client with urinary retention. Which disorder would be a contraindication to the administration of this medication?

1. Gastric atony

2. Urinary strictures

3. Neurogenic atony

4. Gastroesophageal reflux
2. Urinary strictures
A client receiving nifedipine (Procardia) for angina complains of feeling listless, with generalized weakness and no energy. To support the client most effectively, the nurse must understand that these symptoms:

1. Are unrelated to taking the medication

2. Indicate underdosing of the medication

3. Are an expected effect of the medication

4. Indicate a toxic reaction to the medication
3. Are an expected effect of the medication
A nurse working in a pediatric clinic is preparing to administer childhood vaccinations to a 15-month-old child. Which vaccine should be added to the child's routine immunizations at this time because the child is older than 12 months of age?

1. Varicella

2. Hepatitis B

3. Hepatitis A

4. Pneumococcal vaccine (PVC)
1. Varicella
A nurse is caring for a client in the oncology unit who has developed stomatitis during chemotherapy. The nurse would plan which of the following measures to treat this complication?

1. Use lemon and glycerin swabs liberally on painful oral lesions.

2. Brush the teeth and use nonwaxed dental floss at least twice a day.

3. Rinse the mouth with dilute baking soda or saline solution.

4. Place the client on nothing-by-mouth (NPO) status for 12 hours, then resume liquids.
3. Rinse the mouth with dilute baking soda or saline solution.
A nurse is assigned to care for a client with a diagnosis of hepatic encephalopathy. Which prescribed medication does the nurse anticipate administering?

1. Phenolphthalein (Ex-Lax)

2. Lactulose syrup (Chronulac)

3. Magnesium hydroxide (Milk of Magnesia)

4. Psyllium hydrophilic mucilloid (Metamucil)
2. Lactulose syrup (Chronulac)
A nurse is planning to administer hydrochlorothiazide (HydroDIURIL) to a client. The nurse understands that which of the following are concerns related to the administration of this medication?

1. Hypouricemia, hyperkalemia

2. Increased risk of osteoporosis

3. Hypokalemia, hyperglycemia, sulfa allergy

4. Hyperkalemia, hypoglycemia, penicillin allergy
3. Hypokalemia, hyperglycemia, sulfa allergy
A licensed practical nurse (LPN) is assisting in the care of a client who is receiving oxytocin (Pitocin) to induce labor. The LPN plans to notify the registered nurse immediately if which of the following is noted?

1. The client complains of fatigue.

2. The client becomes drowsy.

3. There are early decelerations of fetal heart rate.

4. The uterus becomes hyperstimulated.
4. The uterus becomes hyperstimulated.
The client with non-Hodgkin's lymphoma is receiving daunorubicin (DaunoXome). Which of the following would indicate to the nurse that the client is experiencing a toxic effect related to the medication?

1. Fever

2. Diarrhea

3. Complaints of nausea and vomiting

4. Crackles on auscultation of the lungs
4. Crackles on auscultation of the lungs
The nurse is caring for a postrenal transplant client taking cyclosporine (Sandimmune, Gengraf, Neoral). The nurse notes an increase in one of the client's vital signs, and the client is complaining of a headache. What is the vital sign that is most likely increased?

1. Pulse

2. Respirations

3. Blood pressure

4. Pulse oximetry
3. Blood pressure
A client with lung cancer is receiving a high dose of methotrexate (Rheumatrex). Leucovorin (citrovorum factor, folic acid) is also prescribed. The nurse who is assisting in planning care for the client understands that the purpose of administering the leucovorin is to:

1. Preserve normal cells.

2. Promote DNA synthesis.

3. Promote medication excretion.

4. Promote the synthesis of nucleic acids.
1. Preserve normal cells.
A nurse is providing instructions to a client who will be taking phenytoin (Dilantin) for seizure control. Which statement will the nurse make to the client regarding the administration of this medication?

1. "If you have difficulty swallowing the capsules, open them and mix the contents with applesauce."

2. "You need to cancel your next dentist visit and plan dentist appointments yearly rather than twice a year."

3. "If you miss a dose of medication, wait until the next dose and take both doses."

4. "If you develop a sore throat, it is necessary to notify the health care provider."
4. "If you develop a sore throat, it is necessary to notify the health care provider."
A nurse is employed in a newborn nursery. The nurse is aware that medication toxicity is more likely to occur in the neonate than in an adult because:

1. The lungs are not developed.

2. The kidneys are smaller than those of adults.

3. Cerebral function is not fully developed.

4. The liver is immature.
4. The liver is immature.
Which of these findings indicates a side effect associated with the use of latanoprost (Xalatan) eye drops?

1. Irregular pulse

2. Periorbital edema

3. Elevated blood pressure

4. Brown pigmentation of the iris
4. Brown pigmentation of the iris
A nurse is assisting in monitoring a preterm infant in the neonatal intensive care unit who received surfactant (Infasurf). The nurse monitors for which desired therapeutic outcome of this medication?

1. Decreased acrocyanosis

2. Improved cardiac output

3. Increased body temperature

4. Decreased tachypnea and nasal flaring
4. Decreased tachypnea and nasal flaring
A client with multiple sclerosis is receiving diazepam (Valium), and the home care nurse provides instructions to the client regarding the side effects of the medication. The nurse tells the client that which of the following is a side effect of this medication?

1. Insomnia

2. Incoordination

3. Inability to urinate

4. Increased salivation
2. Incoordination
A client is to receive medication via a client-controlled analgesia (PCA), and the nursing instructor asks the nursing student caring for the client to describe the use of the PCA. The instructor determines that the student needs instructions about the PCA if the student states that:

1. PCA enables the client to titrate analgesics.

2. PCA delivers predetermined amounts of analgesia at preset intervals.

3. Clients using PCA initiate the infusion by programming a pump.

4. A continuous intravenous (IV) solution is needed to keep the vein open between analgesia infusions.
3. Clients using PCA initiate the infusion by programming a pump.
A client with a history of prostatic hypertrophy has purchased the over-the-counter medication, diphenhydramine (Benadryl), to treat symptoms of a runny nose. The nurse explains to the client that this medication combined with prostatic hypertrophy could cause increased symptoms of:

1. Lowered heart rate

2. Excessive sweating

3. Urinary retention

4. Excessive drooling
3. Urinary retention
A nurse is collecting data from a client and the client's spouse reports that the client is taking donepezil hydrochloride (Aricept). Which disorder would the nurse suspect that this client may have based on the use of this medication?

1. Dementia

2. Schizophrenia

3. Seizure disorder

4. Obsessive-compulsive disorder
1. Dementia
A nurse performs an admission assessment on a client who visits a health care clinic for the first time. The client tells the nurse that propylthiouracil (PTU) is taken daily. The nurse continues to collect data from the client, suspecting that the client has a history of:

1. Myxedema

2. Graves' disease

3. Addison's disease

4. Cushing's syndrome
2. Graves' disease
When teaching a client who is being started on imipramine hydrochloride (Tofranil), the nurse would inform the client that the desired effects of the medication may:

1. Start during the first week of administration

2. Not occur for 2 to 3 weeks of administration

3. Start during the second week of administration

4. Not occur until after a month of administration
2. Not occur for 2 to 3 weeks of administration
A client with acquired immunodeficiency syndrome (AIDS) is receiving intravenous (IV) pentamidine isethionate (Pentam). The nurse assigned to care for the client monitors for signs of which toxic effect related to the administration of this medication?

1. Hypertension

2. Anorexia

3. Dizziness

4. Hypoglycemia
4. Hypoglycemia
An adult client with hypothyroidism is admitted to the hospital. When reviewing the client's health record, the nurse notes that the client is taking a maintenance dose of levothyroxine (Synthroid). The nurse checks the dosage that the client is taking, knowing that the normal adult maintenance dose of this medication is:

1. 0.025 to 0.05 mg daily

2. 0.075 to 0.1 mg daily

3. 0.05 to 0.075 mg daily

4. 0.1 to 0.2 mg daily
4. 0.1 to 0.2 mg daily
A nurse has given medication instructions to a client beginning therapy with carisoprodol (Soma). The nurse determines that the client understands the effects of the medication if the client states to:

1. Expect muscle spasticity as a side effect.

2. Take a missed dose when remembered, regardless of when the next dose is due.

3. Avoid alcohol while taking this medication.

4. Drive on city streets, but avoid highway driving.
3. Avoid alcohol while taking this medication.
A film-coated form of diflunisal has been prescribed for a client for the treatment of chronic rheumatoid arthritis. The client calls the clinic nurse because of difficulty swallowing the tablets. Which initial instruction should the nurse provide to the client?

1. "Crush the tablets and mix them with food."

2. "Notify the health care provider for a medication change."

3. "Open the tablet and mix the contents with food."

4. "Swallow the tablets with large amounts of water or milk."
4. "Swallow the tablets with large amounts of water or milk."
A nurse is assisting with caring for a client with cancer who is receiving cisplatin. Select the adverse effects that the nurse monitors for that are associated with this medication. Select all that apply.

1. Tinnitus

2. Ototoxicity

3. Hyperkalemia

4. Hypercalcemia

5. Nephrotoxicity

6. Hypomagnesemia
1. Tinnitus

2. Ototoxicity

5. Nephrotoxicity

6. Hypomagnesemia
An oral hypoglycemic medication, a sulfonylurea, is prescribed for a client with type 2 diabetes mellitus. The nurse plans to administer the medication, knowing that the primary action of this medication is which of the following?

1. Decrease glucose production by the liver.

2. Inhibit carbohydrate digestion.

3. Promote insulin secretion by the pancreas.

4. Decrease insulin resistance.
3. Promote insulin secretion by the pancreas.
A postoperative client has been receiving morphine sulfate every 3 to 4 hours for pain. The nurse should be sure to implement which measure to reduce the risk of adverse effects from this medication?

1. Monitor the client's temperature.

2. Encourage fluids.

3. Maintain the client in a supine position.

4. Encourage coughing and deep breathing.
4. Encourage coughing and deep breathing.
A client with epilepsy is taking the prescribed dose of phenytoin (Dilantin) to control seizures. A phenytoin blood level is drawn, and the results reveal a level of 35 mcg/ml. Which of the following symptoms would be expected as a result of this laboratory result?

1. Nystagmus

2. Tachycardia

3. Slurred speech

4. No symptoms, because this is a normal therapeutic level
3. Slurred speech
A health care provider initiates carbidopa/levodopa (Sinemet) therapy for the client with Parkinson's disease. A few days after the client starts the medication, the client complains of nausea and vomiting. The nurse tells the client that:

1. Taking an antiemetic is the best measure to prevent the nausea.

2. Taking the medication with food will help to prevent the nausea.

3. This is an expected side effect of the medication and will decrease over time.

4. The nausea and vomiting will decrease when the dose of levodopa is stabilized.
2. Taking the medication with food will help to prevent the nausea.
A nurse is caring for a client who is receiving lithium carbonate (Lithobid) for the treatment of bipolar disorder and monitors the client for signs of lithium toxicity. Which sign would alert the nurse to the potential for toxicity?

1. Vomiting

2. Headaches

3. Constipation

4. Increased urination
1. Vomiting
A client is receiving a daily dose of oral fluphenazine. The nurse would teach the client to do which of the following to minimize common side effects of this medication?

1. Have blood pressure checked once a week.

2. Monitor pulse daily.

3. Eat snacks at midmorning and bedtime.

4. Use hard, sour candy or sugarless gum.
4. Use hard, sour candy or sugarless gum.
Isotretinoin is prescribed for a client with severe acne. Before the administration of this medication, the nurse anticipates that which laboratory test will be prescribed?

1. Platelet count

2. Triglyceride level

3. Complete blood count

4. White blood cell count
2. Triglyceride level
A client experiencing spasticity because of a spinal cord injury has been prescribed dantrolene (Dantrium). Before administering the first dose, the nurse checks to see whether which baseline study has been done?

1. Liver function

2. Renal function

3. Otoscopic examination

4. Blood glucose measurements
1. Liver function
Heparin sodium is prescribed for the client. The nurse expects that the health care provider will prescribe which of the following to monitor for a therapeutic effect of the medication?

1. Hematocrit level

2. Hemoglobin level

3. Prothrombin time (PT)

4. Activated partial thromboplastin time (aPTT)
4. Activated partial thromboplastin time (aPTT)
Fluoxetine (Prozac) is prescribed for the client. The nurse reinforces instructions to the client regarding the administration of the medication. Which statement by the client indicates an understanding about administration of the medication?

1. "I should take the medication with my evening meal."

2. "I should take the medication at noon with an antacid."

3. "I should take the medication in the morning when I first arise."

4. "I should take the medication right before bedtime with a snack."
3. "I should take the medication in the morning when I first arise."
A nurse is caring for a client with a diagnosis of metastatic breast carcinoma. Tamoxifen citrate 10 mg orally twice daily is prescribed for the client, and the nurse provides instructions to the client regarding the medication. Which statement by the client would indicate an understanding of the medication?

1. "If hot flashes occur, I need to call the health care provider."

2. "If I have difficulty seeing, I need to call the health care provider."

3. "Pelvic pain and pressure from this medication are expected."

4. "Vaginal bleeding should not occur with this medication."
2. "If I have difficulty seeing, I need to call the health care provider."
A nurse is caring for a client with renal failure. The serum phosphate level is reported as 7 mg/dL. Which of the following medications should the nurse plan to administer as prescribed to the client?

1. Calcium gluconate

2. Calcium chloride

3. Aluminum hydroxide gel (AlternaGEL)

4. Calcitonin (Calcimar)
3. Aluminum hydroxide gel (AlternaGEL)
The nurse is assigned to care for a client with cytomegalovirus retinitis and acquired immunodeficiency syndrome who is receiving foscarnet. The nurse should check the latest results of which of the following laboratory studies while the client is taking this medication?

1. CD4 cell count

2. Serum albumin

3. Serum creatinine

4. Lymphocyte count
3. Serum creatinine
A client has been prescribed cyclobenzaprine (Flexeril) in the treatment of painful muscle spasms accompanying a herniated intervertebral disk. The nurse would withhold the medication and question the prescription if the client had concurrent prescriptions to take:

1. Furosemide (Lasix)

2. Valproic acid (Depakene)

3. Ibuprofen (Motrin)

4. Tranylcypromine (Parnate)
4. Tranylcypromine (Parnate)
A nurse is caring for a hospitalized client who has been taking clozapine (Clozaril) for the treatment of a schizophrenic disorder. Which laboratory study prescribed for the client will the nurse specifically review to monitor for an adverse effect associated with the use of this medication?

1. Platelet count

2. Cholesterol level

3. White blood cell count

4. Blood urea nitrogen level
3. White blood cell count
Prednisone is prescribed for a client with diabetes mellitus who is taking Humulin neutral protamine Hagedorn (NPH) insulin daily. Which of the following prescription changes does the nurse anticipate during therapy with the prednisone?

1. An additional dose of prednisone daily

2. A decreased amount of daily Humulin NPH insulin

3. An increased amount of daily Humulin NPH insulin

4. The addition of an oral hypoglycemic medication daily
3. An increased amount of daily Humulin NPH insulin
Atropine sulfate is prescribed for a client with gastrointestinal hypermotility, and the nurse reviews the client's record before administering the medication. Which of the following, if noted on the client's record, indicates the need to contact the health care provider before administering the medication?

1. Biliary colic

2. Sinus bradycardia

3. Narrow-angle glaucoma

4. History of peptic ulcer disease
3. Narrow-angle glaucoma
A client with myasthenia gravis becomes increasingly weaker. The health care provider injects a dose of edrophonium (Enlon) to determine whether the client is experiencing a myasthenia crisis or a cholinergic crisis. The nurse expects that the client will have which of the following reactions if the client is in cholinergic crisis?

1. An improvement of the weakness

2. A temporary worsening of the condition

3. No change in the condition

4. Complaints of muscle spasms
2. A temporary worsening of the condition
The nurse plans to emphasize which statement when providing instructions about the use of indinavir (Crixivan) to a client?

1. Take the medication with a large meal.

2. Store the medication in the refrigerator.

3. Take the medication with a high-protein snack.

4. Moisture can affect the potency of the medication.
4. Moisture can affect the potency of the medication.
Which of the following precautions will the nurse specifically take during the administration of ribavirin (Virazole) to a child with respiratory syncytial virus (RSV)?

1. Wearing goggles

2. Wearing a gown

3. Wearing a gown and a mask

4. Handwashing before administration
1. Wearing goggles
A client with recurrent constipation has begun using psyllium (Metamucil). The nurse tells this client that this medication should be taken with:

1. Any cold beverage

2. Any hot beverage

3. Any type of gelatin

4. A full glass of liquid, followed by a second glass of liquid
4. A full glass of liquid, followed by a second glass of liquid
A nurse notes that a client in a long-term care facility is receiving a daily dose of furosemide (Lasix). The nurse writes in the care plan to monitor which of the following parameters on a daily basis?

1. Weight

2. Radial pulse

3. Hemoglobin

4. Serum creatinine clearance
1. Weight
A client is being treated for heart failure and is receiving digoxin (Lanoxin). The client's vital signs are blood pressure 85/50 mm Hg, pulse 96 beats per minute, respirations 26 breaths per minute. To evaluate therapeutic effectiveness of this medication, the nurse would expect which of the following changes in the client's vital signs?

1. Blood pressure 85/50 mm Hg, pulse 60 beats per minute, respirations 26 breaths per minute

2. Blood pressure 98/60 mm Hg, pulse 80 beats per minute, respirations 24 breaths per minute

3. Blood pressure 130/70 mm Hg, pulse 104 beats per minute, respirations 20 breaths per minute

4. Blood pressure 110/40 mm Hg, pulse 110 beats per minute, respirations 20 breaths per minute
2. Blood pressure 98/60 mm Hg, pulse 80 beats per minute, respirations 24 breaths per minute
A client with multiple sclerosis is receiving dantrolene (Dantrium) for relief of muscle spasticity. The nurse checks the results of which laboratory value periodically prescribed while the client is taking this medication?

1. Liver function studies

2. Creatinine

3. Blood urea nitrogen

4. Hematocrit level
1. Liver function studies
A nurse is collecting medication information from a client, and the client states that she is taking garlic as an herbal supplement. The nurse understands that the client is most likely treating which of the following conditions?

1. Eczema

2. Insomnia

3. Migraines

4. Hyperlipidemia
4. Hyperlipidemia
A licensed practical nurse (LPN) is assisting in the care of a client in preterm labor who is being started on intravenous magnesium sulfate to stop the contractions. The LPN checks to see that which of the following is available on the unit as an antidote to magnesium sulfate?

1. Magnesium oxide

2. Vitamin K

3. Aluminum hydroxide

4. Calcium gluconate
4. Calcium gluconate
A nurse is working in the primary care office and is conducting an interview with the parents of a child. The parents of the child state that syrup of ipecac is kept at home in case of an accidental poisoning. The nurse provides which appropriate instruction specific to the use of this medication?

1. "This medication is only appropriate for clients who are unconscious."

2. "This medication is administered routinely for potential accidental poisoning."

3. "Ipecac syrup should not be given unless the poison control center indicates to do so."

4. "This medication is safe and effective when given for suspicion of accidental poisoning."
3. "Ipecac syrup should not be given unless the poison control center indicates to do so."
A nurse is reviewing the health care provider's prescriptions of a client admitted to the hospital with a diagnosis of liver disease. Which medication prescription would the nurse question?

1. Lorazepam (Ativan)

2. Acetaminophen (Tylenol)

3. Furosemide (Lasix)

4. Omeprazole (Prilosec)
2. Acetaminophen (Tylenol)
A client taking fexofenadine (Allegra) is scheduled for allergy skin testing and tells the nurse in the health care provider's office that a dose was taken this morning. The nurse determines that:

1. The client should reschedule the appointment.

2. A lower dose of allergen will need to be injected.

3. A higher dose of allergen will need to be injected.

4. The client should have the skin test read a day later than usual.
1. The client should reschedule the appointment.
A nurse is providing instructions to an adolescent who is taking phenytoin (Dilantin) for the control of seizures. Which statement by the adolescent indicates a need for further teaching regarding the medication?

1. "The medication may cause oily skin."

2. "Drinking alcohol may affect the medication."

3. "If my gums become sore, I need to stop the medication."

4. "Birth control pills may not be effective when I take this medication."
3. "If my gums become sore, I need to stop the medication."
A client is taking Humulin NPH insulin daily every morning. The nurse reinforces instructions for the client and tells the client that the most likely time for a hypoglycemic reaction to occur is:

1. 2 to 4 hours after administration

2. 4 to 12 hours after administration

3. 16 to 18 hours after administration

4. 18 to 24 hours after administration
2. 4 to 12 hours after administration
A nurse is assigned to care for a client with a diagnosis of toxoplasmosis. The health care provider has prescribed sulfasalazine (Azulfidine). The nurse preparing to administer this medication understands that this medication is a(n):

1. Antibiotic

2. Sulfonamide

3. Opioid analgesic

4. Nonsteroidal anti-inflammatory
2. Sulfonamide
A client with diabetes mellitus visits a health care clinic. The client's diabetes mellitus previously had been well controlled with glyburide (DiaBeta) daily, but recently the fasting blood glucose level has been 180 to 200 mg/dL. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia?

1. Prednisone

2. Phenelzine (Nardil)

3. Atenolol (Tenormin)

4. Allopurinol (Zyloprim)
1. Prednisone
A health care provider (HCP) writes a prescription for digoxin (Lanoxin), 0.25 mg daily. The nurse teaches the client about the medication and tells the client that it is important to:

1. Count the radial and carotid pulses every morning.

2. Check the blood pressure every morning and evening.

3. Stop taking the medication if the pulse is higher than 100 beats per minute.

4. Withhold the medication and call the HCP if the pulse is less than 60 beats per minute.
4. Withhold the medication and call the HCP if the pulse is less than 60 beats per minute.
Vasopressin (Pitressin) is prescribed for the client with diabetes insipidus. During data collection, the nurse is particularly cautious in checking the client for which of the following preexisting conditions?

1. Depression

2. Endometriosis

3. Coronary artery disease

4. Pheochromocytoma
3. Coronary artery disease
A client informs the nurse that she has been taking acarbose (Precose) as prescribed. The nurse determines that a therapeutic effect of the medication has occurred if which of the following is noted?

1. A serum lipase of 100 units/L

2. A 2-hour postprandial serum glucose of 120 mg/dL

3. A sodium level of 140 mEq/L

4. A blood urea nitrogen (BUN) level of 15 mg/dL
2. A 2-hour postprandial serum glucose of 120 mg/dL
Which of the following herbal therapies would be prescribed for its use as an antispasmodic? Select all that apply.

1. Aloe

2. Kava

3. Ginger

4. Chamomile

5. Peppermint oil
4. Chamomile

5. Peppermint oil
Amantadine hydrochloride (Symmetrel) 100 mg orally twice daily has been prescribed for a client with Parkinson's disease, and the nurse teaches the client about the medication. Which statement by the client indicates that further teaching is necessary?

1. "I'll take this medication early in the morning and just before I go to bed."

2. "I can empty the capsules into food or fluid to make swallowing easier."

3. "I can get this medication in syrup form if I have difficulty swallowing."

4. "I should see improvement in my condition in about 7 days."
1. "I'll take this medication early in the morning and just before I go to bed."
A nurse is administering a dose of prochlorperazine to a client for nausea and vomiting. The nurse tells the client to report which of the following symptoms, which is a frequent side effect of this medication?

1. Excessive perspiration

2. Blurred vision

3. Diarrhea

4. Drooling
2. Blurred vision
A 1-year-old child has been prescribed digoxin (Lanoxin) to treat congestive heart failure (CHF). The nurse would plan on withholding the prescribed dose of the medication if:

1. A dose is missed by more than 1 hour.

2. The child has a fever greater than 101° F.

3. The child's pulse is less than 80 beats per minute.

4. The child's pulse is more than 100 beats per minute.
3. The child's pulse is less than 80 beats per minute.
The client with a gastric ulcer has a prescription for sucralfate (Carafate), 1 g by mouth four times daily. The nurse schedules the medication for which times?

1. With meals and at bedtime

2. Every 6 hours around the clock

3. One hour after meals and at bedtime

4. One hour before meals and at bedtime
4. One hour before meals and at bedtime
A licensed practical nurse employed in the ambulatory clinic is assisting a registered nurse with preparing to administer a dose of intravenous immune globulin (IVIG). The licensed practical nurse ensures that which medication is readily available before the medication is administered?

1. Protamine sulfate

2. Phytonadione (vitamin K)

3. Epinephrine (adrenalin)

4. Acetylcysteine (Mucomyst)
3. Epinephrine (adrenalin)
Bethanechol (Urecholine) is prescribed for the client with urinary retention, and an injectable form of bethanechol is available for use as prescribed. The nurse informs the client of the health care provider's prescription, knowing that the medication will be administered:

1. Intravenously

2. Intramuscularly

3. Intradermally

4. Subcutaneously
4. Subcutaneously
A nurse is providing instructions to a client who is taking codeine sulfate for severe back pain. The nurse tells the client to:

1. Increase fluid intake.

2. Maintain a low-fiber diet.

3. Avoid all exercise to prevent lightheadedness.

4. Avoid the use of stool softeners to prevent diarrhea.
1. Increase fluid intake.
A client is diagnosed with pulmonary embolism and is to be treated with streptokinase (Streptase). A nurse would report which priority data collection finding to the registered nurse before initiating this therapy?

1. Adventitious breath sounds

2. Temperature of 99.4° F orally

3. Blood pressure of 198/110 mm Hg

4. Respiratory rate of 28 breaths/min
3. Blood pressure of 198/110 mm Hg
A client with cancer is receiving daunorubicin (Cerubidine) intravenously. The nurse assigned to assist in caring for the client monitors for which commonly expected side effect?

1. Hypertension

2. Polycythemia

3. Hypovolemia

4. Nausea and vomiting
4. Nausea and vomiting
A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium level is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the client?

1. Calcium chloride

2. Calcium gluconate

3. Calcitonin (Miacalcin)

4. Large doses of vitamin D
3. Calcitonin (Miacalcin)
A client is taking ticlopidine hydrochloride (Ticlid). The nurse tells the client to avoid which of the following while taking this medication?

1. Vitamin C

2. Vitamin D

3. Acetaminophen (Tylenol)

4. Acetylsalicylic acid (aspirin)
4. Acetylsalicylic acid (aspirin)
A client who recently began medication therapy with levodopa (Larodopa) for Parkinson's disease complains of nausea. The nurse reminds the client to do which of the following to best manage this problem?

1. Take the medication with three glasses of water.

2. Eat a snack before taking the medication.

3. Take an antiemetic at the same time as the levodopa.

4. Lie down and rest after taking the dose.
2. Eat a snack before taking the medication.
A histamine (H2)-receptor antagonist will be prescribed for a client. The nurse understands that which medications are H2-receptor antagonists? Select all that apply.

1. Nizatidine (Axid)

2. Ranitidine (Zantac)

3. Famotidine (Pepcid)

4. Cimetidine (Tagamet)

5. Esomeprazole (Nexium)

6. Lansoprazole (Prevacid)
1. Nizatidine (Axid)

2. Ranitidine (Zantac)

3. Famotidine (Pepcid)

4. Cimetidine (Tagamet)
The nurse should instruct the client taking codeine sulfate to do which of the following?

1. Avoid the use of stool softeners to prevent diarrhea.

2. Avoid exercise to prevent lightheadedness.

3. Maintain a low-fiber diet.

4. Increase fluid intake.
4. Increase fluid intake.
A nurse is emphasizing discharge instructions to a mother of a child who has been prescribed tetracycline hydrochloride. The nurse stresses the importance of which instruction?

1. Mix the medication with water in a glass container.

2. Use a straw when the child is taking the medication.

3. Administer the medication 1 hour before bedtime.

4. Give the medication in combination with milk.
2. Use a straw when the child is taking the medication.
A nurse is reinforcing dietary instructions to a client who is currently prescribed probenecid (Benemid). Which food should the nurse encourage the client to continue to eat?

1. Spinach

2. Scallops

3. Shrimp

4. Liver
1. Spinach
An older client with rheumatoid arthritis has been instructed by the health care provider to take ibuprofen (Motrin) 300 mg orally four times daily. The nurse reading the medication prescription interprets that the prescribed dosage is:

1. The normal adult dosage

2. An unusual dosage for this diagnosis

3. Higher than the normal adult dosage

4. Lower than the normal adult dosage
1. The normal adult dosage
A nurse is providing care to a client diagnosed with multiple sclerosis and prescribed baclofen (Lioresal). Which information should the nurse plan to reinforce in the client instructions?

1. Stop taking the medication if diarrhea occurs.

2. Watch for urinary retention as a side effect.

3. Restrict fluid intake while taking this medication.

4. Notify the health care provider if fatigue occurs.
2. Watch for urinary retention as a side effect.
A client diagnosed with acute lymphocytic leukemia has been prescribed asparaginase (Elspar). Which finding represents possible drug toxicity?

1. Hair loss

2. Oral ulcerations

3. Prolonged blood clotting times

4. Decreased white blood cell count
3. Prolonged blood clotting times
A client diagnosed with testicular cancer is prescribed cisplatin (Platinol-AQ). The nurse monitors for which toxic effect of this medication?

1. Tinnitus

2. Leukocytosis

3. Nausea

4. Vomiting
1. Tinnitus
A nurse is caring for a client diagnosed with scabies who has just been prescribed crotamiton (Eurax). The nurse provides which instruction for application of this medication?

1. Apply the medication to the entire body and leave it on for 2 hours, followed by a cleansing bath.

2. Apply the application to the entire body and leave it on for 24 hours, followed by a cleansing bath.

3. Massage the medication into the skin of the upper trunk and extremities, avoiding any skin folds and creases; sponge bathe the medication off in 12 hours.

4. Massage the medication into the skin from the chin downward, and apply a second application in 24 hours, followed up with a cleansing bath 48 hours after the second application.
4. Massage the medication into the skin from the chin downward, and apply a second application in 24 hours, followed up with a cleansing bath 48 hours after the second application.
A nurse has obtained ribavirin (Virazole) in powder form from the pharmacy to give to a child with respiratory syncytial virus (RSV). The nurse understands that the medication will be administered by which of the following routes?

1. Inhalation

2. Intravenous

3. Subcutaneous

4. Oral in formula
1. Inhalation
A client with tuberculosis (TB) is prescribed rifampin (Rifadin). The nurse reinforces which information regarding this medication?

1. Orange discoloration of the skin is common.

2. Wear glasses instead of soft contact lenses.

3. Take the medication on an empty stomach.

4. A negative sputum culture warrants stopping the therapy.
2. Wear glasses instead of soft contact lenses.
A client is taking a monoamine oxidase (MAO) inhibitor. The nurse plans care, knowing that:

1. This classification of medications increases the amount of MAO in the liver.

2. Hypotensive crisis may be precipitated by foods that contain tyramine and tryptophan.

3. Symptomatology of drug toxicity includes headache, hypertension, and nausea and vomiting.

4. Increased salivation, bradycardia, constipation, and mild insomnia are an expected side effect.
3. Symptomatology of drug toxicity includes headache, hypertension, and nausea and vomiting.
A nurse is caring for a client who is receiving hydralazine (Apresoline). The nurse evaluates the effectiveness of the medication by monitoring which of the following client parameters?

1. Cardiac rate

2. Urine output

3. Blood pressure

4. Blood glucose level
3. Blood pressure
A client has received atropine sulfate intravenously during a surgical procedure. The nurse monitors the client for which of the following effects of the atropine sulfate in the postoperative period?

1. Diarrhea

2. Bradycardia

3. Urinary retention

4. Excessive salivation
3. Urinary retention
A nurse is monitoring a client taking an antipsychotic medication for signs of neuroleptic malignant syndrome (NMS). The nurse would expect to note which of the following if NMS occurred?

1. Bradycardia

2. Dysphagia

3. Hypotension

4. Hyperpyrexia
4. Hyperpyrexia
A nurse is caring for a client in preterm labor who is receiving terbutaline sulfate to stop uterine activity. During this medication therapy, the nurse implements nursing interventions to monitor which specific body organs that can be affected by this medication?

1. Kidneys and lungs

2. Heart and kidneys

3. Heart and lungs

4. Lungs and gastrointestinal tract
3. Heart and lungs
Iron dextran (InFeD) is prescribed to be administered intramuscularly to a client. The nurse prepares the medication and determines that the appropriate method of administration is:

1. Using the Z-track technique

2. Injecting into the deltoid muscle

3. Using a 5/8-inch needle on a large syringe

4. Applying heat to the injection site before administration
1. Using the Z-track technique
A client with acquired immunodeficiency syndrome (AIDS) is receiving intravenous (IV) pentamidine isethionate (Pentam). The nurse assigned to care for the client monitors for signs of which toxic effect related to the administration of this medication?

1. Hypertension

2. Anorexia

3. Dizziness

4. Hypoglycemia
4. Hypoglycemia
A client is receiving heparin sodium by continuous intravenous (IV) infusion. The licensed practical nurse (LPN) is concerned that the client received a bolus of medication when the tubing was removed from the IV pump during a gown change. The LPN immediately notifies the registered nurse or health care provider and then checks to see whether which medication is available in the medication cart?

1. Protamine sulfate

2. Enoxaparin (Lovenox)

3. Aminocaproic acid (Amicar)

4. Phytonadione (Vitamin K)
1. Protamine sulfate
A client returning to the medical nursing unit following cardiac catheterization has a stat prescription to receive a dose of procainamide. The licensed practical nurse assisting in caring for the client obtains which of the following pieces of equipment to adequately determine the client's response to this medication?

1. Glucometer

2. Pulse oximeter

3. Cardiac monitor

4. Noninvasive blood pressure cuff
3. Cardiac monitor
A client in pulmonary edema has a prescription to receive morphine sulfate intravenously. The licensed practical nurse assisting in caring for the client determines that the client experienced an intended effect of the medication if which of the following is noted?

1.
Increased pulse rate

2. Relief of apprehension

3. Decreased urine output

4. Increased blood pressure
2. Relief of apprehension
A client uses the alternative therapy of cascara sagrada known as Californian buckthorn for ongoing management of chronic constipation. The nurse monitors the client's laboratory results for which electrolyte imbalance related to long-term use of this medication?

1. Hypokalemia

2. Hyperkalemia

3. Hyponatremia

4. Hypernatremia
1. Hypokalemia
A client has been started on cyclobenzaprine (Flexeril) for the management of muscle spasms in the cervical spine. The client is experiencing drowsiness, dizziness, and dry mouth. The nurse interprets that these:

1. Are the common side effects of this medication

2. Represent an allergic reaction to the medication

3. Effects are related to the problem with the cervical spine

4. Effects are dose-related; the client should cut the medication dose in half.
1. Are the common side effects of this medication
A nurse is teaching a client about the use of ceftriaxone, an antibiotic, for treating cervical gonorrhea. Further teaching is necessary if the client makes which statement?

1. "I can expect to get this one shot."

2. "I will take the pills for twenty full days."

3. "I may experience some discomfort at the injection site."

4. "If I have a penicillin allergy, I may be allergic to this medication too."
2. "I will take the pills for twenty full days."
A nurse has provided instructions to a client receiving enalapril maleate (Vasotec). Which statement by the client indicates a need for further education?

1. "I need to notify the health care provider if nausea occurs."

2. "I need to notify the health care provider if a sore throat occurs."

3. "I need to rise slowly from a lying to sitting position."

4. "I know that several weeks of therapy may be required for the full therapeutic effect."
1. "I need to notify the health care provider if nausea occurs."
Enoxaparin sodium (Lovenox) is prescribed for the client following hip replacement surgery. The nurse prepares to have which of the following available in the event that an overdose of the medication occurs?

1. Protamine sulfate

2. Naloxone (Narcan)

3. Epinephrine (Adrenaline)

4. Phytonadione (vitamin K)
1. Protamine sulfate
A client receiving a blood transfusion begins to exhibit flushing, stridor, and a drop in blood pressure. The nurse would initially obtain which of the following medications from the emergency cart to have ready for use as prescribed?

1. Lidocaine (Xylocaine)

2. Theophylline (Theo-Dur)

3. Norepinephrine (Levophed)

4. Epinephrine (Adrenalin)
4. Epinephrine (Adrenalin)
A nurse is providing instructions to a client with glaucoma receiving acetazolamide (Diamox) daily. Which of the following statements by the client indicates an understanding of the adverse effects related to the medication?

1. "I need to call the doctor if I notice dark urine and stools."

2. "If I get really irritable, I need to stop the medication."

3. "Constipation will probably be a problem with this medication."

4. "If difficulty with swallowing occurs, I need to taper the medication."
1. "I need to call the doctor if I notice dark urine and stools."
A client has a history of seizures. The health care provider has prescribed amitriptyline three times daily. The nurse plans care, knowing that the client is at risk for injury because of which adverse effect of the amitriptyline?

1. Decreased mental acuity

2. Decreased seizure threshold

3. Decreased platelet aggregation

4. Depressed immunological system
2. Decreased seizure threshold
A nurse is providing instructions to the family of a client with Alzheimer's disease regarding tacrine (Cognex). Which statement by the family would indicate an understanding of the adverse effects related to this medication?

1. "I need to call the health care provider if constipation occurs."

2."Fever is a sign of an adverse effect of the medication."

3. "Increased urination may be an indication of an adverse effect."

4. "If difficulty voiding occurs, I need to call the health care provider immediately because the medication will need to be discontinued."
3. "Increased urination may be an indication of an adverse effect."
A nurse is asked to assist in preparing a heparin sodium infusion for a client with a diagnosis of thrombophlebitis. Which of the following is an unnecessary item?

1. Intravenous (IV) tubing

2. Protamine sulfate

3. Phytonadione (vitamin K)

4. IV infusion controller
2. Protamine sulfate
A nurse is assisting in developing a plan of care for a client receiving warfarin sodium (Coumadin). The nurse selects which problem as the priority in caring for this client?

1. Potential for injury

2. Potential for infection

3. Fluid volume overload

4. Potential for inability to tolerate activity
1. Potential for injury
YOU MIGHT ALSO LIKE...