PHARMcology 1.A nurse is reviewing the medication administration...

PHARMcology

1.A nurse is reviewing the medication administration record for a client who has cancer and is receiving morphine via a PCA pump. Which of the following prescriptions should the nurse clarify with the provider?

Ondansetron

Nalbuphine

Acetaminophen

Insulin glargine

2.A nurse is providing discharge dietary teaching to a client who has a new prescription for theophylline. Which of the following instructions should the nurse include?

Limit your sodium intake

Restrict milk products

Avoid caffeinated beverages

Take the medication with meals

3. A nurse is monitoring a client who has a head injury and is receiving mannitol 25% via IV infusion. The nurse should identify which of the following as an adverse effect of the medication and report to the provider?

Crackles on auscultation

Increase in urinary output

Intracranial pressure reading of 12 mm hg

Glasgow comma scale rating of 15

4.A nurse is monitoring the laboratory values of a client who is receiving heparin, which of the following values should the nurse report to the provider?

Hematocrit 45%

PT 11 seconds

Platelets 300,000/mm

aPTT 50 seconds

5. A nurse is planning to administer a controlled substance to a client who is experiencing pain. Which of the following actions should the nurse plan to take first?

Identify the client using two identifiers

Document the administration of the medication

Compare the amount of medication available to the inventory record

Remove the medication from the medication dispensing cabinet

6. A nurse is assessing a client who has heart failure and is taking furosemide. Which of the findings should indicate to the nurse that the client is experiencing fluid volume deficit?

Distended neck veins

Shortness of breath

Weight gain

Elevated hematocrit level

7. A nurse is caring for a client who has a prescription for amoxicillin. Which of the following findings indicates the client is experiencing an allergic reaction?

Nausea

Insomnia

Laryngeal edema

Cardiac dysrhythmia

9. A nurse is caring for a client who is receiving intravenous therapy and observes redness and inflammation along the vein. The nurse should identify this finding as which of the following complications of IV therapy?

Phlebitis

Extravasation

Venous spasm

Infiltration

10. A nurse is caring for a client who has pancreatic cancer and reports severe pain. Which of the following medications should the nurse expect to administer?

Hydromorphone

Caldolor

Aspirin

Meloxicam

11. A nurse is preparing to administer lidocaine via continuous IV infusion at 4mg/min. Available is lidocaine2g dextrose 5% in water 500ml. The nurse should set the IV pump to deliver how many ml/hr?(nearest whole number)

12. A nurse is providing teaching to a client who wants to stop smoking and has purchased a transdermal smoking patch. Which of the following information should the nurse provide?

The transdermal patch can cause insomnia

Leave the patch in place for 8hr each day

Rotate the application site every week

The transdermal patch releases nicotine rapidly into the bloodstream

13. A nurse is teaching a client who has active pulmonary tuberculosis about management of medication for the disease. Which of the following statements is appropriate for the nurse to make?

You should anticipate taking medication to treat your disease for at least the next 3 years

You should report monthly to have your blood drawn to monitor kidney function while taking medication

You will need to take two or more medications to treat your disease

You will need to undergo tuberculin skin tests every 6 months while taking medication for your disease

15. A nurse is caring for an older adult client who is taking prednisone for long term treatment of rheumatoid arthritis. The nurse should monitor the client for which of the following adverse effects of this drug?

Bone loss

Hemolytic anemia

Liver toxicity

Hypoglycemia

16. A nurse is preparing administer nitroglycerin topical ointment to a client. Which of the following actions should the nurse plan to take?

Cover the medication on the clients skin with a sterile gauze pad

Apply the medication to the same site for three consecutive days

Measure the dosage of medication using the applicator paper

Spread the medication over a 12.7cm (5in) area of the clients skin

17. A nurse in the emergency department is admitting a client who has diabetic ketoacidosis and blood glucose level of  800mg/dl. Which of the following interventions should the nurse initiate first?

Subcutaneous insulin injections

Potassium chloride 10mEq/hr

Bicarbonate by IV infusion

0.9% sodium chloride 15ml/kg/hr

18. A nurse is providing discharge teaching to a client who has a new prescription for furosemide. Which of the following instructions should the nurse include in the teaching?

This medication should be taken on an empty stomach

Take the medication before going to bed

Increase the amount of potassium in your diet

Weigh yourself on the same day each week

19. A nurse is reviewing the plan of care with a client who has a new prescription for lovastatin . Which of the following statements by the client would indicate to the nurse a need for further assessment?

I take metformin for my diabetes

I was just  diagnosed with hepatitis B

I should avoid drinking grapefruit juice

I am trying to decrease my dietary fat intake

20. A nurse is assessing a client who is receiving heparin via continuous IV. The client has an aPTT of 90seconds. The nurse should monitor the client for which of the following changes in their vital signs?

Decreased respiratory rate

Increase pulse rate

Decreased temperature

Increased blood pressure

21. A client who has Grave disease is prescribed methimazole. Which of the following effects should the nurse expect to see after the client has taken the medication for 2 months?

Increase in pulse rate

Warmer skin

Weight loss

Increased sleeping

22. A nurse is providing teaching to a client who is to receive a series of allergy tests. The nurse should instruct the client to avoid which of the following medications for up to 4 weeks before the procedure?

Albuterol

Acetaminophen

Diphenhydramine

Pseudoephedrine hydrochloride

23. A nurse is teaching a client who has a prescription for ferrous gluconate. Which of the following statements by the client indicates an understanding of the teaching?

I should take this medication with 8 ounces of milk

I should take an antacid with this medication to prevent stomach upset

I should stay upright for at least 15minutes after taking this medication

I should notify my provider if my stools turn black

24. A nurse is assessing a client who is receiving intravenous therapy. The nurse should identify which of the following findings as a manifestation of fluid volume excess?

Decreased bowel sounds

Thready pulse

Distended neck veins

Bilateral muscle weakness

25. A charge nurse is teaching a newly licensed nurse about administering heparin to a client. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

I will massage the site after the injecting the heparin

I will check the clients INR before administering the heparin

I will aspirate before administering the heparin

I will apply pressure for 1 minute after the injection

26. A nurse is caring for a client who is receiving 0.9% sodium chloride solution to treat dehydration. Which of the following findings should the nurse identify as an adverse effect of the solution?

Pink, froth sputum

Increased bowel sounds

Decreased skin turgor

Dark amber urine

27. A nurse is assessing a client who has heart failure and is taking digoxin. Which of the following findings should the nurse identify as an early indication of medication toxicity?

Visual disturbances

Sudden weight gain

Insomnia

Potassium 4.4mEq/L

28. A nurse is providing teaching to a client who has a new prescription for bumetanide for heart failure. Which of the following instructions should the nurse include in the teaching?

You should decrease your intake of foods high in potassium

You should monitor for hearing difficulties

You should take this medication on an empty stomach

You should take the medication at bedtime.

29.A nurse is mixing regular insulin and NPH insulin in the same syringe prior to administering it to a client who has diabetes mellitus. Which of the following actions should the nurse take first?

Inject air into the NPH vial

Withdraw the NPH insulin from the vial

Withdraw the regular insulin from the vial

Inject air into the regular insulin vial

30. A nurse is assessing a client who has asthma and a prescription for albuterol. The nurse should monitor the client for which of the following adverse effects?

Drowsiness

Constipation

Fever

Tachycardia

31. A nurse is transcribing a new prescription for a client which states, Diphenhydramine 50mg NOW. Which of the following actions should the nurse take?

Notify the pharmacy to send the medication immediately

Administer the medication withing 90min

Contact the provider to clarify the prescription

Inform the client there is a prescription available if needed

32. A nurse is preparing to administer digoxin to a client who has heart failure. The nurse should withhold the medication for which of the following findings?

BP 160/90mm Hg

Weight gain of 0.7kg (1.5lB) in 24 hr

Pulse rate 56/min

Urinary output 30 ml/hr

33. a nurse is caring for a client who has major depression  and a new prescription for citalopram. Which of the following adverse effects is the priority for the nurse to report to the provider?

Weight loss

Bruxism

Insomnia

Confusion

34. A nurse is caring for a client who has heart failure and is taking hydrochlorothiazide. The nurse should monitor the client for which of the following manifestations as an adverse effect of the medication?

Hypermagnesemia

Hypokalemia

Hypocalcemia

Hypernatremia

35. A nurse is reviewing the medication list of a client who has erectile who has erectile dysfunction and is requesting a prescription for sildenafil. The nurse should identify that which of the following medications is a contraindication for receiving this medication?

Furosemide

Indomethacin

Albuterol

Nitroglycerin

36. A nurse is reviewing the laboratory results of a client who is taking amitriptyline. Which of the following laboratory values should the nurse report to the provider?

Hct 44%

Total bilirubin 1.5mg/dl

WBC count 5,000/mm3

Potassium 4.2mEq/L

37. a nurse is caring for a client who has a peripheral IV catheter and a prescription for IV fluid replacement. The nurse should cover the insertion site with which of the following types of dressing?

Sterile gauze bandage

Transparent membrane dressing

Hydrocolloid dressing

Adhensive bandage

38. A nurse is monitoring for an infusion reaction for a client who is receiving a dose of IV amphotericin B. which of the following findings should indicate to the nurse that the client is experiencing an acute infusion reaction?

Pedal edema

Hyperglycemia

Fever

Dry cough

39. A nurse is monitoring a client who receiving a blood transfusion . which of the followings indicates that the nurse should administer epinephrine?

Confusion

Urticaria

Bounding pulse

Distended jugular vein

40. A nurse recently administered filgrastim intravenously to client who has cancer and is receiving cytotoxic chemotherapy. For which of the following data , discovered after the medication was administered, should the nurse file an incident report?

The clients absolute neutrophil count was 2500/mm3 before the medication was administered

The client had chemotherapy 12 hr before the medication was administered

The nurse flushed the clients IV line with dextrose 5% in water before and the medication was administered.

The medication vial salt at room temperature for 2hr before it was administered

41. A nurse is caring for a group of clients . For which of the following situations should the nurse complete an incident report?

A client receive 0900 medications at 0930

A client received a blood transfusion with dextrose 5% in water

A client received an infusion of lipids through a central line

A client who has asthma was administered tiotropium inhalation

42. A nurse is applying a nitroglycerin transdermal patch for a client who has angina. Which of the following actions should the nurse take?

Apply a 4x4 dressing over the patch

Apply the patch to the same site every 24hr

Apply the patch to a hairless area of the skin

Apply the patch to a bony prominence on the chest.

43. A nurse is reviewing the laboratory data of a client who is receiving filgrastim. Which of the following laboratory values should the nurse monitor to evaluate the effectiveness of the treatment?

BUN

Potassium level

INR

WBC count

44. A nurse is preparing to initiate IV therapy for a client . Which of the following sites should the nurse use to place the peripheral IV catheter?

Dominant distal dorsal vein

Nondominant dorsal venous arch

Dominant antecubital basilic vein

Nondominant forearm basilic vein

45. A nurse is teaching a client who is pregnant and has iron deficiency anemia about taking ferrous sulfate elixir. Which of the following instructions should the nurse include in the teaching?(SATA)

Increase your fiber intake to prevent constipation

Increase your intake of daily products to increase the absorption of this medication

Stop taking the medication if your stools become green or black

Take the medication with an antacid if it upsets your stomach

Drink the elixir using a straw to prevent staining your teeth

46. A nurse is preparing to administer clindamycin to a client who states the forgot to report to the provider that she is allergic to penicillin. Which of the following actions should the nurse take

Obtain a prescription for an alternative antibiotic

Administer the clindamycin using a desensitization schedule

Give the client the prescribed dose of the clindamycin

Premedicate the client with epinephrine before administering the antibiotic

47. A nurse is caring for a client who has diabetes insipidus and is receiving desmopressin by intermittent IV bolus. Which of the following manifestations should indicate to the nurse a therapeutic response to the medication?

Increase in WBC count

Decrease in blood pressure

Decrease in urine output

Increase in serum glucose

48 A nurse is planning to administer medications to an older adult client who has dysphagia. Which of the following actions should the nurse plan to take?

Administer more than one pill to the client at a time

Place the medications on the back of the clients tongue

Tilt the clients head back when administering the medications

Mix the medications with a semisolid food for the client

49.A nurse is caring for a client who has diabetes mellitus and is pioglitazone. The nurse should plan to monitor the client for which of the following adverse effects?

Tinnitus

Fluid retention

Insomnia

Orthostatic hypotension

50. a nurse is caring for a client who is taking azathioprine to treat rheumatoid arthritis. Which of the following laboratory values indicates and adverse effect of this medication?

BUN 15mg/dl

HCT 45%

Platelets 250,000/mm3

WBC 3,000/mm3

51. A nurse is preparing to titrate a continuous nitroprusside infusion for a client . The nurse should plan to titrate the infusion according to which of the following assessment?

Stroke volume

Blood pressure

Cardiac output

Urine output

52. A nurse is reviewing medication prescriptions for a client. For which of the following entries on the clients medication administration record should the nurse request clarification?

Acetaminophen 500mg every 4hr PRN for fever

Morphine 4mg IV every 4hr PRN for pain

Levothyroxine 100mcg PO every morning

Simvastatin 40mg PO at bed time

53. A nurse is caring for a client who is receiving a continuous IV infusion of magnesium sulfate for preterm labor. The nurse should discontinue the infusion and prepare to administer calcium gluconate if the demonstrates which of the following findings?(SATA)

Absence of deep tendon reflexes

Decreased level of consciousness

Systolic blood pressure 130mm Hg

Report of chills

Urine output 80ml in 4hr

54. A nurse is reviewing a clients laboratory results before administering furosemide 40mg IV. For which of the following values should the nurse withhold the medication and contact the provider?

Sodium 141mEq/L

INR 1.0

WBC count 8,000/mm3

Potassium 2.5mEq/L

55. A nurse is preparing to administer amphotericin B lipid complex via intermittent IV bolus to a client who has infective endocarditis. Which of the following actions should the nurse take?

Administer the medication over 2hr

Prime the tubing with 0.9% sodium chloride

Discard the medication if it is yellow

Use a gravity flow set

56. A nurse on a medical surgical unit is preparing to administer an influenza vaccine to a client. The client tells the nurse , I no longer want to receive the vaccine which of the following responses should the nurse make?

Influenza can be very serious to anyone who does not receive the vaccine

If I were you I would get the vaccine to keep my family safe

The influenza vaccine is strongly encouraged but I understand you would like to decline right now.

The influenza vaccine is mandatory for all clients before discharge so you will need to sign an against medical advice form

57. A nurse is completing a medication reconciliation for a client prior to his transfer to a long term care facility which of the following actions should the nurse take?

Include medications the client received in the acute setting but will no longer need after transfer

Remove duplicate medications of different dosages from the reconciliation list

Omit over the counter medications from the at home medication list

58. A nurse is providing teaching to a client who has a new prescription for paroxetine. The nurse should instruct the client to monitor for which of the following adverse effects?

Alopecia

Tinnitus

Drowsiness

Peripheral edema

59. A nurse realizes that they failed to administer a medication that was due 4hr ago to a client . Which of the following actions should the nurse take first?

File an incident report

Report the missed dosage to the clients provider

Assess the client for adverse reactions

Determine factors that led to the omission

60. A nurse is teaching a class about administering IV fluids to treat dehydration. The nurse should include in the teaching that which of the following laboratory values indicates effective treatment of dehydration?

Serum hematocrit 55%

BUN 28mg/dl

Urine specific gravity 1.020

Serum osmolarity 310 mOsm/L

61. A nurse is teaching a clients partner how to administer an otic medication to the client. Which of the following statements by the clients partner indicates an understanding of the teaching?

I will have my partner tilt their head back while I am instilling the drops

I will make sure the solution is cool prior to instilling the drops

I will have my partner lie down on their back while I am instilling the drops

I will pull the pinna upward and outward prior to instilling the drops

62. A nurse is reviewing the laboratory results of a client who has atrial fibrillation and a prescription for warfarin. After informing the provider that the INR is 2.5 the nurse should expect which of the following prescription?

Decrease the dose of the medication

Administer the current dose of the medication

Increase the dose of the medication

Withhold the medication

63.  A nurse is caring for a client who is receiving ceftriaxone intravenously. Which of the following manifestations should the nurse identify as an allergic reaction?

Polyuria

Nausea

Hypotension

Bradycardia

64.  A nurse is caring for a client who is in shock and is receiving an infusion of albumin. Which of the following findings should the nurse expect?

Decrease in protein

Oxygen saturation 96%

Increase in BP

PaCO2 30 mmHg

65. A nurse is reviewing the medical record of a client who is requesting an oral contraceptive. Which of the following findings is a contraindication for the use of oral contraceptive?

Client age of 36 years

Anxiety disorder

Ovarian cysts

History of deep vein thrombosis

66. A nurse is caring for a client who is taking lithium and reports starting program, The nurse should assess the client for which of the following electrolyte imbalances?

Hypokalemia Hyponatremia

Hypomagnesemia

Hypocalcemia

67. A nurse is caring for a client who requires a reinsertion of  a short peripheral venous catheter. In which of the following locations should the nurse place the catheter?

A vein that feels hard to the touch

A vein in the clients dominant arm

A vein on the client wrist

A vein proximal to the previous site

68. A nurse is preparing to administer acyclovir 10mg/kg IV to a client who weighs 132 LBs. Available is acyclovir IV injectable solution 50mg/ml. How many ml should the nurse administer?(nearest whole number)

69. A nurse in a providers office is preparing to teach a middle adult client who has a new diagnosis of metabolic syndrome and an HbA 1 c of 6.5%. Which of the following medication should the nurse plan to teach the client about first?

Metformin

Regular insulin

Exenatide

Insulin glargine

70. A nurse is teaching a client who has pernicious anemia to self administer nasal cyanocobalamin. Which of the following information should the nurse include in the teaching?

Administer the medication into one nostril once per week

Plan to self administer this medication for the next 6 months

Use a nasal decongestant 15 minute before the medication if you have a stuffy nose

Lie down for 1 hour after administering the medication