HESI PRACTICE EXAM 3 PHARMACOLOGY,100% CORRECT

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A client with mild parkinsonism is started on oral amantadine (Symmetrel). What statement accurately describes the action of this medication? A 52-year-old client is admitted to the hospital for poss... ible duodenal ulcers. The healthcare provider prescribes ranitidine hydrochloride (Zantac) 150 mg BID PO. Which data would indicate that this medication is effective? A 78-year-old client with congestive heart failure receives the cardiac glycoside digoxin (Lanoxin) 0.25 mg PO daily. Which observation by the nurse indicates that the medication has been effective? Minocycline (Minocin) 50 mg every 8 hours is prescribed for an adolescent girl diagnosed with acne. The nurse discusses self-care with the client while she is taking the medication. Which teaching points should be included in the discussion? (Select all that apply.) The nurse is assessing a stuporous client in the emergency department who is suspected of overdosing with opioids. Which agent should the nurse prepare to administer if the client becomes comatose? The healthcare provider prescribes captopril (Capoten) 37.5 mg. The medication is available in 25 mg tablets. What should the nurse administer? A client who is HIV positive is receiving epoetin (Epogen) for management of anemia secondary to zidovudine (AZT) therapy. Which laboratory finding is most important for the nurse to report to the healthcare provider? A 75-year-old male client taking hydrochlorothiazide (HCTZ) is admitted to the hospital having "palpitations" and "skipped heart beats." What is the most likely cause of these symptoms given the client's medication history? Which parameter is most important for the nurse to check prior to administering a subcutaneous injection of heparin? A. Heart rate B. Urinary output C. Activated partial thromboplastin time (aPTT) D. Prothrombin time (PT) and international normalized A client is prescribed a cholinesterase inhibitor, and a family member asks the nurse how this medication works. Which pharmacophysiologic explanation should the nurse use to describe this class of drug? In developing a nursing care plan for a 9-month-old infant with cystic fibrosis, the nurse writes a nursing diagnosis of Alteration in nutrition: less than body requirements, related to inadequate digestion of nutrients. Which intervention would best meet this child's needs? When providing client teaching about the administration of methylphenidate (Ritalin) to the mother of a child diagnosed with attention-deficit/hyperactive disorder (ADHD), what instruction should the nurse include in the teaching plan? Alteration of which laboratory finding represents achievement of a therapeutic goal for heparin administration? The charge nurse is reviewing the admission history and physical data for four clients newly admitted to the unit. Which client is at greatest risk for adverse reactions to medications? A. 30-year-old man with a fracture B. 7-year-old child with an ear infection C. 75-year-old woman with liver disease D. 50-year-old man with an upper respiratory tract infection The healthcare provider prescribes ipratropium (Atrovent) for a client. An allergic reaction to what other medication would cause the nurse to question the prescription for Atrovent? 68-year-old client has been diagnosed with open-angle glaucoma. The healthcare provider prescribes pilocarpine (IsoptoCarpine) eye drops. What action of this drug makes it a useful treatment for the client's condition? The nurse is preparing to apply a surface anesthetic agent for a client. Which action should the nurse implement to reduce the risk of systemic absorption? A. Apply the anesthetic to mucous membranes. B. Limit the area of application to inflamed areas. C. Avoid abraded skin areas when applying the anesthetic. D. Spread the topical agent over a large surface area. C. Avoid abraded skin areas when applying the anesthetic The healthcare provider prescribes the anticonvulsant carbamazepine (Tegretol) for a client with a seizure disorder. The nurse should instruct the client to notify the healthcare provider if which condition occurs? chemotherapeutic regimen with doxorubicin HCl (Adriamycin) is being planned for a client recently diagnosed with cancer. What diagnostic test results should the nurse review prior to initiating this treatment? A client who is HIV positive is receiving combination therapy with the antiviral medication zidovudine (Retrovir). What instruction should the nurse include in this client's teaching plan? A 67-year-old client is discharged from the hospital with a prescription for digoxin (Lanoxin) 0.25 mg daily. Which instruction should the nurse include in this client's discharge teaching plan? Benztropinemesylate (Cogentin) and levodopa (Dopar) are prescribed for a client with Parkinson's disease. After a few days of therapy, the client complains of a "dry mouth" and "dizziness." What response by the nurse would be most appropriate? Vancomycin (Vancocin) is prescribed for a client who has a history of endocarditis and is to undergo minor dental surgery. The nurse knows that this drug Which assessment finding could indicate to the nurse that a client is experiencing an adverse effect of the gastrointestinal stimulant metoclopramide HCl (Reglan)? Methylphenidate HCl (Concerta) 18 mg PO is prescribed for daily administration to a 10-year-old child with attention-deficit/hyperactive disorder (ADHD). In preparing a teaching plan for the parents of this newly diagnosed ADHD child, which instruction is most important for the nurse to provide the parents? The nurse is preparing to administer amphotericin B (Fungizone) IV to a client. What laboratory data are most important for the nurse to assess before initiating an IV infusion of this medication? A client with angina pectoris is instructed to take sublingual nitroglycerin tablets PRN for chest pain. Which instruction should the nurse include in the client's teaching plan? A. Take one tablet every 3 minutes, up to five tablets. B. Take one tablet at the onset of angina and stop activity. C. Replace nitroglycerin tablets yearly to maintain freshness. D. Allow 30 minutes for a tablet to provide relief from angina. A client with cancer who has been receiving fentanyl (Duragesic) for several weeks reports to the nurse that the medication is not effectively controlling the pain. Which intervention should the nurse initiate? A 55-year-old male client was diagnosed with schizophrenia 5 years earlier. He has had numerous hospitalizations since diagnosis because of noncompliance with the prescribed medication regime. Which drug might work best for this particular client? Prolixin, an antipsychotic drug that can be given IM, has a delayed onset (24 to 96 hours) and a long duration of action (up to 3 or 4 weeks), so would be the drug of choice for a noncompliant psychotic client. In administering the antiinfective agent chloramphenicol (Chloromycetin) IV to a client, the nurse observes the client closely for signs of bone marrow depression. Which laboratory data would be most important for the nurse to monitor? The healthcare provider has prescribed a low-molecular-weight heparin, enoxaparin (Lovenox), 30 mg IVP BID for a client following hip replacement. Prior to administering the first dose, which intervention is most important for the nurse to implement? The nurse has completed diabetic teaching for a client who has been newly diagnosed with diabetes mellitus. Which statement by this client would indicate to the nurse that further teaching is needed? A. "Regular insulin can be stored at room temperature for 30 days." B. "My legs, arms, and abdomen are all good sites to inject my insulin." C. "I will always carry hard candies to treat hypoglycemic reactions." D. "When I exercise, I should plan to increase my insulin dosage." A client with schizophrenia has been taking the antipsychotic agent clozapine (Clozaril) for the past 3 weeks. Which nursing assessment finding would have the greatest implications for this client's care? The apical heart rate of an infant receiving digoxin (Lanoxin) for congestive heart failure slows to 80 beats/min. What intervention should the nurse implement first? A client with viral influenza is receiving vitamin C 1000 mg PO daily and acetaminophen elixir 650 mg PO every 4 hours PRN. The nurse calls the healthcare provider to report that the client has developed diarrhea. Which change in prescriptions should the nurse anticipate? What nursing intervention has the highest priority during IV administration of mechlorethamineHCl (nitrogen mustard) and actinomycin (Actinomycin-D)? client is receiving oral griseofulvin (Grisactin) for a persistent tinea corporis infection. What response by the client indicates an accurate understanding of the drug teaching conducted by the nurse? A 42-year-old client is admitted to the emergency department after taking an overdose of amitriptyline (Elavil) in a suicide attempt. Which drug should the nurse plan to administer to reverse the cardiac and central nervous system effects of amitriptyline (Elavil)? The healthcare provider prescribes the H2 antagonist famotidine (Pepcid) 20 mg in the morning and at bedtime. What statement regarding the action of H2 antagonists offers the correct rationale for administering the medication at female client is receiving sulfisoxazole (Gantrisin) for a urinary tract infection. What client teaching should the nurse include? Prior to administering a scheduled dose of digoxin (Lanoxin), the nurse reviews the client's current serum digoxin level, which is 1.3 ng/dl. Which action should the nurse implement? A. Administer Digibind to counteract the toxicity. B. Withhold the drug and notify the health care provider immediately. C. Withhold the dose and notify the health care provider during rounds that the dose was held. D. Give the dose of digoxin if the client's heart rate is within a safe range. A 19-year-old male client who sustained a severe head injury is intubated and placed on assisted mechanical ventilation. To facilitate optimal ventilation and prevent the client from "fighting" the ventilator, the healthcare provider administers pancuronium bromide (Pavulon) IV with adjunctive narcotic analgesia. What medication should the nurse maintain at the client's bedside? The nurse is administering the early morning dose insulin aspart (NovoLog) 5 units subcutaneously to a client with diabetes mellitus type 1. The client's fingerstick serum glucose is 140 mg/dl. Considering the onset of NovoLog, when should the nurse ensure that the client's breakfast is available? What nursing intervention has the highest priority during IV administration of mechlorethamineHCl (nitrogen mustard) and actinomycin (Actinomycin-D)? . A client with mild parkinsonism is started on oral amantadine (Symmetrel). What statement accurately describes the action of this medication? The nurse is reviewing a client's laboratory results before a procedure in which a neuromuscular blocking agent is a standing order. Which finding should the nurse report to the healthcare provider? The nurse is evaluating a client's understanding of the prescribed antilipemic drug lovastatin (Mevacor). Which client statement indicates that further teaching is needed? Which class of antineoplastic chemotherapy agents resembles the essential elements required for DNA and RNA synthesis and inhibits enzymes necessary for cellular function and replication? A. Alkylating agents B. Antimetabolites C. Antitumor antibiotics D. Plant alkaloids Which assessment finding could indicate to the nurse that a client is experiencing an adverse effect of the gastrointestinal stimulant metoclopramide HCl (Reglan)? A female client with myasthenia gravis is taking a cholinesterase inhibitor and asks the nurse what can be done to remedy her fatigue and difficulty swallowing. What action should the nurse implement? A. Explore a plan for development of coping strategies for the symptoms with the client. B. Explain to the client that the dosage is too high, so she should skip every other dose of medication. C. Advise the client to contact her health care provider because of the development of tolerance to the medication. D. Develop a teaching plan for the client to self-adjust the dose of medication in response to symptoms. A client who is HIV positive is receiving epoetin (Epogen) for management of anemia secondary to zidovudine (AZT) therapy. Which laboratory finding is most important for the nurse to report to the healthcare provider? A female client who has started taking long-term corticosteroid therapy tells the nurse that she is careful to take her daily dose at bedtime with a snack of crackers and milk. What is the best response by the nurse? A 45-year-old female client is receiving alprazolam (Xanax) for anxiety. Which client behaviors would indicate that the drug is effective? A. Personal hygiene is maintained by the client for the first time in a week. B. The client has an average resting heart rate of 120 beats/min. C. The staff observes the client sitting in the day room reading a book. D. The nurse records that the client lost 2 lb of body weight in the past week. 55-year-old male client was diagnosed with schizophrenia 5 years earlier. He has had numerous hospitalizations since diagnosis because of noncompliance with the prescribed medication regime. Which drug might work best for this particular client? The nurse notes that a client receiving phenytoin (Dilantin) 300 mg PO daily has a serum phenytoin level of 14 mcg/ml. What intervention should the nurse implement? Make sure that the client is performing thorough oral care. Amoxicillin 500 mg PO every 8 hours is prescribed for a client with an infection. The drug is available in a suspension of 125 mg/5 ml. How many milliliters should the nurse administer with each dose? A client has a positive skin test for tuberculosis. What prophylactic drug should the nurse expect to administer to this client? A client with acute lymphocytic leukemia is to begin chemotherapy today. The healthcare provider's prescription specifies that ondansetron (Zofran) is to be administered IV 30 minutes prior to the infusion of cisplatin (Platinol). What is the rationale for administering Zofran prior to the chemotherapy induction? When caring for a client on digoxin (Lanoxin) therapy, the nurse knows to be alert for digoxin (Lanoxin) toxicity. Which finding would predispose this client to developing digoxin toxicity? A client with viral influenza is receiving vitamin C 1000 mg PO daily and acetaminophen elixir 650 mg PO every 4 hours PRN. The nurse calls the healthcare provider to report that the client has developed diarrhea. Which change in prescriptions should the nurse anticipate? A 26-year-old primigravida client is experiencing increasing discomfort and anxiety during the active phase of labor. She requests something for pain. Which analgesic should the nurse anticipate administering? A. Butorphanol (Stadol) B. Hydromorphone (Dilaudid) C. Morphine sulfate D. Codeine sulfate A. Butorphanol (Stadol) A client receives an antihypertensive agent daily. Which action is most important for the nurse to implement prior to administering the medication? A. Verify the expiration date. B. Obtain the client's blood pressure. C. Determine the client's history of adverse reactions. D. Review the client's medical record for a change in drug route. An older client who had a colon resection yesterday is receiving a constant dose of meperidine (Demerol) via PCA pump. Which assessment finding is most significant and requires that the nurse intervene? Clients receiving disulfiram (Antabuse) for treatment of alcoholism should be cautioned about the importance of avoiding alcohol, particularly during concurrent treatment with cephalosporin antibiotics, because an Antabuse reaction may be initiated. Which symptom would indicate that the client is experiencing a reaction to disulfiram (Antabuse)? female client is receiving sulfisoxazole (Gantrisin) for a urinary tract infection. What instruction should the nurse include in the teaching plan for this client? A client who is receiving phenytoin (Dilantin) begins to exhibit nystagmus and diplopia. Which physiologic manifestation is consistent with these findings? The nurse gives a client NPH insulin 15 units subcutaneously before breakfast (7:30 AM). At what time should the nurse be particularly alert for signs or symptoms of a potential hypoglycemic reaction? The nurse is reviewing a client's laboratory results before a procedure in which a neuromuscular blocking agent is a standing order. Which finding should the nurse report to the healthcare provider? A male client who resides in a long-term care facility has a seizure disorder that has been managed with phenobarbital (Nembutal) for several years. Lately, he has become more difficult to arouse, and frequently tells the nurse that he wants to take a nap. What intervention should the nurse implement? The nurse knows that certain antipsychotic drugs cause extrapyramidal symptoms. Which extrapyramidal symptom is a permanent and irreversible adverse effect of long-term phenothiazine administration? Phenazopyridine (Pyridium) is commonly prescribed for clients with urinary tract infections. What statement should be included by the nurse when teaching clients about the administration of phenazopyridine (Pyridium)? A 46-year-old female client is instructed to take Lugol's solution (strong iodine solution) in preparation for thyroidectomy surgery. Which food should the nurse instruct this client to remove from her diet? A client is receiving pyridostigmine bromide (Mestinon) to control the symptoms of myasthenia gravis. Which client behavior would indicate that the drug therapy is effective? What medication is useful in treating digoxin (Lanoxin) toxicity? What intervention is most important for a nurse to implement prior to administering atropine PO? The nurse is preparing a child for transport to the operating room for an emergency appendectomy. The anesthesiologist prescribes atropine sulfate (Atropine) IM STAT What is the primary purpose for administering this drug to the child at this time? A client receives a prescription for theophylline (Theo-Dur) PO to be initiated in the morning. The nurse determines that a theophylline level drawn yesterday was 15 mcg/ml. Based on this information, what should the nurse tell the nurse on the next shift about initiating the new prescription? A male client who has chronic back pain is on long-term pain medication management and asks the nurse why his pain relief is not as effective as it was 2 months ago. How should the nurse respond? A child is being treated with mebendazole (Vermox) for pinworms. What type of diet should the mother be instructed to feed the child while receiving this medication? A high-fat diet increases the absorption of mebendazole (Vermox), which boosts the effectiveness of the medication in eliminating the pinworms A client with a dislocated shoulder is being prepared for a closed, manual reduction using conscious sedation. Which medication should the nurse explain as a sedative used during the procedure? During administration of theophylline (Theo-Dur), the nurse should monitor for signs of toxicity. What symptom would cause the nurse to suspect Theo-Dur toxicity? The nurse performs a client assessment prior to the administration of a prescribed dose of dipyridamole and aspirin (Aggrenox) PO. The nurse notes that the client's carotid bruit is louder than previously assessed. What action should the nurse implement? A client who is experiencing an acute attack of gouty arthritis is prescribed Colchicine USP 1 mg PO daily. Which information is most important for the nurse to provide the client? An older male client with Tourette syndrome takes haloperidol (Haldol) to control tics and vocalizations. He has become increasingly drowsy over the past 2 days and reports becoming dizzy when changing from a supine to sitting position. What action should the nurse take? Before administering an antiinfective agent to a client with a urinary tract infection, which nursing intervention is most important? The healthcare provider prescribes cisplatin (Platinol) to be administered in 5% dextrose and 0.45% normal saline with mannitol (Osmitrol) added. Which assessment parameters would be most helpful to the nurse in evaluating the effectiveness of the Osmitrol therapy? During therapy with isoniazid (INH), it is most important for the nurse to monitor which lab value closely? The nurse is preparing to administer the disease-modifying antirheumatic drug (DMARD) methotrexate (Rheumatrex) to a client diagnosed with rheumatoid arthritis. Which intervention is most important to implement prior to administering this medication Have another nurse check the prescription. Which instruction should the nurse include in the teaching plan for a client who is receiving phenytoin (Dilantin) for seizure control? A.Maintain consistent sodium intake. B. Use sunscreen when outdoors. C. Return for monthly urinalysis. D. Brush and floss teeth daily. The nurse plans to draw blood samples for the determination of peak and trough levels of gentamicin sulfate (Garamycin) in a client receiving IV doses of this medication. When should the nurse plan to obtain the peak level? A. Thirty minutes after the dose is administered B. Immediately before giving the next dose C. When the next electrolyte levels are drawn D. Sixty minutes after the dose is administered A. Thirty minutes after the dose is administered A 4-year-old child is receiving chemotherapy for acute lymphocytic leukemia. Which laboratory result should the nurse examine to assess the child's risk for infection? Which assessment finding could indicate to the nurse that a client is experiencing an adverse effect of the gastrointestinal stimulant metoclopramide HCl (Reglan)? A primigravida at 34 weeks of gestation is admitted to labor and delivery in preterm labor. She is started on a terbutaline sulfate (Brethine) continuous IV infusion via pump. This therapy is ineffective and the baby is delivered vaginally. What complication should the nurse monitor for in this infant during the first few hours after delivery? In developing a nursing care plan for a 9-month-old infant with cystic fibrosis, the nurse writes a nursing diagnosis of Alteration in nutrition: less than body requirements, related to inadequate digestion of nutrients. Which intervention would best meet this child's needs? When providing nursing care for a client receiving pyridostigmine bromide (Mestinon) for myasthenia gravis, which nursing intervention has the highest priority? A. Monitor the client frequently for urinary retention. B. Assess respiratory status and breath sounds often. C. Monitor blood pressure each shift to screen for hypertension. D. Administer most medications after meals to decrease gastrointestinal irritation. Which question should the nurse ask an older client prior to the initiation of treatment with intravenous infusions of gentamicin sulfate (Garamycin)? A client with dysphagia has been diagnosed with duodenal ulcers and is being discharged from the hospital with a prescription for the gastric acid pump inhibitor lansoprazole (Prevacid) 15 mg PO daily. The medication comes in capsule form. What instruction should the nurse include in the discharge teaching plan for this client? A 78-year-old client with congestive heart failure receives the cardiac glycoside digoxin (Lanoxin) 0.25 mg PO daily. Which observation by the nurse indicates that the medication has been effective? During the initial nursing assessment history, a client tells the nurse he is taking tetracycline hydrochloride (Sumycin) for urethritis. What medication taken concurrently with Sumycin could interfere with its absorption? A mother brings her 18-month-old child to the community health center because the child has had "bad diarrhea" for the last 3 days. She states, "I bought some of this liquid at the pharmacy and gave my daughter a half-ounce." The nurse sees the bottle contains loperamide (Imodium AD). What intervention is most important for the nurse to implement initially? An 83-year-old female client is recovering from a myocardial infarction. The cardiologist prescribes docusate sodium and casanthranol (Peri-Colace) 1 tab PO BID. What therapeutic effect does this medication provide for this client? A 6-year-old boy is admitted to the emergency department with status epilepticus. His parents report that his seizure disorder has been managed with phenytoin (Dilantin) 50 mg PO BID for the past year. What drug should the nurse plan to administer in the emergency department? A client is receiving acyclovir sodium (Zovirax) IV for a severe herpes simplex infection. What intervention should the nurse implement during this drug therapy? . The healthcare provider prescribes carbamazepine (Tegretol) for a child whose tonic/clonic seizures have been poorly controlled. The nurse informs the mother that the child must have blood tests every week. The mother asks why so many blood tests are necessary. What complication is assessed through frequent lab testing that the nurse should explain to this mother? A 19-year-old male client who sustained a severe head injury is intubated and placed on assisted mechanical ventilation. To facilitate optimal ventilation and prevent the client from "fighting" the ventilator, the healthcare provider administers pancuronium bromide (Pavulon) IV with adjunctive narcotic analgesia. What medication should the nurse maintain at the client's bedside? Which outcome would the nurse expect a client to have who is receiving cyclobenzaprine (Flexeril)? A client taking linezolid (Zyvox) at home for an infected foot ulcer calls the home care nurse to report the onset of watery diarrhea. What intervention should the nurse implement? Which statement indicates that client teaching regarding the administration of the chemotherapeutic agent daunorubicinHCl (Cerubidine) has been effective? A. "I should use an astringent mouthwash after every meal." B. "I will eat high-fiber foods and drink lots of water." C. "I expect my urine to be red for the next few days." D. "I should use sunscreen when I spend time outdoors." client who is HIV positive is receiving combination therapy with the antiviral medication zidovudine (Retrovir). What instruction should the nurse include in this client's teaching plan? A client who is receiving chlorpromazine HCl (Thorazine) to control his psychotic behavior also has a prescription for benztropine (Cogentin). When teaching the client and/or significant others about these medications, what should the nurse explain about the use of benztropine (Cogentin) in the treatment plan for this client? A psychiatric client is discharged from the hospital with a prescription for haloperidol (Haldol). Which instruction should the nurse include in the discharge teaching plan for this client? A. Take with antacids to reduce gastrointestinal irritation. B. Use sunglasses and sunscreen when outdoors. C. Eat foods low in fiber and salt. D. Count the pulse before each dose. A 42-year-old client is admitted to the emergency department after taking an overdose of amitriptyline (Elavil) in a suicide attempt. Which drug should the nurse plan to administer to reverse the cardiac and central nervous system effects of amitriptyline (Elavil)? A. Sodium bicarbonate B. Naloxone (Narcan) C. Phentolaminemesylate (Regitine) D. Atropine sulfate (Atropine) The nurse notes that the hemoglobin of a client receiving darbepoetin alfa (Aranesp) has increased from 6 g/dl to 10 g/dl over the first 2 weeks of treatment. What action should the nurse take? A 3-year-old is admitted to the emergency department after ingesting an unknown amount of phenobarbital (Luminal) elixir prescribed for his brother's seizure disorder. What nursing intervention should the nurse implement first? . The healthcare provider prescribes ipratropium (Atrovent) for a client. An allergic reaction to what other medication would cause the nurse to question the prescription for Atrovent? A client receiving ephedrine (Ephedrine) nose drops PRN complains of wakefulness. What action should the nurse take to minimize the client's insomnia? A 2-month-old infant is scheduled to receive the first DPT immunization. What is the preferred injection site to administer this immunization? The nurse is assessing a stuporous client in the emergency department who is suspected of overdosing with opioids. Which agent should the nurse prepare to administer if the client becomes comatose? A child with cystic fibrosis is receiving ticarcillin disodium (Ticar) for Pseudomonas pneumonia. What adverse effect should the nurse assess for and report promptly to the healthcare provider? A client is receiving antiinfective drug therapy for a postoperative infection. Which complaint should alert the nurse to the possibility that the client has contracted a superinfection? An older client is receiving a water-soluble drug that is above the average dose for a young adult. Which action should the nurse implement first? 75-year-old male client taking hydrochlorothiazide (HCTZ) is admitted to the hospital having "palpitations" and "skipped heart beats." What is the most likely cause of these symptoms given the client's medication history? A client is taking famotidine (Pepcid). Which client statement should the nurse further assess because it may indicate that the client is experiencing a side effect of this drug? The nurse is preparing a plan of care for a client receiving the glucocorticoid methylprednisolone (Solu-Medrol). Which nursing diagnosis reflects a problem related to this medication that should be included in the care plan? A. Ineffective airway clearance B. Risk for infection C. Deficient fluid volume D. Impaired gas exchange A female client who has started taking long-term corticosteroid therapy tells the nurse that she is careful to take her daily dose at bedtime with a snack of crackers and milk. What is the best response by the nurse? Two hours after taking the first dose of penicillin, a client arrives at the emergency department complaining of feeling ill, exhibiting hives, having difficulty breathing, and exhibiting hypotension. These findings are consistent with which client response that requires immediate action? The nurse is preparing a teaching plan for a client who has received a new prescription for levothyroxine sodium (Synthroid). Which instruction should be included? A. "Take this medication with a high-protein snack at bedtime." B. "You may change at any time to a less expensive generic brand." C. "Take your pulse daily, and if it exceeds 100 beats/min, contact the health care provider." D. "Return to the clinic weekly for serum blood glucose testing." Which class of antineoplastic chemotherapy agents resembles the essential elements required for DNA and RNA synthesis and inhibits enzymes necessary for cellular function and replication? When developing a written nursing care plan for a client receiving chemotherapy for treatment of cancer, the nurse writes, "Assess each voiding for hematuria." Administration of which type of chemotherapeutic agent would prompt the nurse to add this intervention? For which client(s) should the nurse withhold the initial dose of a COX-2 inhibitor until notifying the healthcare provider? (Select all that apply.) A female client is receiving tamoxifen (Nolvadex) following surgery for breast cancer. She reports the onset of hot flashes to the nurse. What intervention should the nurse implement?Which factor is most important to ensure compliance when planning to teach a client about a drug regimen? A. Genetics B. Client age C. Client education D. Absorption rate A client receiving a continuous infusion of heparin intravenously starts to hemorrhage from an arterial access site. What medication should the nurse anticipate administering to prevent further heparin-induced hemorrhaging? Dopamine (Intropin) 5 mcg/kg/min is prescribed for a client weighing 105 kg. The nurse mixes 400 mg of dopamine in 250 ml D5W for intravenous administration via an infusion pump. What is the hourly rate the nurse should set on the pump? A lidocaine intravenous infusion at 4 mg/min via infusion pump is prescribed for a client having premature ventricular contractions (PVCs). The available premixed infusion contains 2 mg/ml of D5W. How many ml/hr should the nurse program the pump to deliver to this client? A client being treated for an acute myocardial infarction is to receive the tissue plasminogen activator (Alteplase). The nurse would be correct in providing which explanation to the client regarding the purpose of this drug? A client with HIV who was recently diagnosed with tuberculosis (TB) asks the nurse, "Why do I need to take all of these medications for TB?" What information should the nurse provide? A. Antiretroviral medications decrease the efficacy of the TB drugs. B. Multiple drugs prevent the development of resistant organisms. C. Duration of the medication regimen is shortened. D. Potential adverse drug reactions are minimized. A client experiencing dysrhythmias is given quinidine 200 mg PO every 6 hours. The nurse plans to observe this client for which common side effect associated with the use of this medication? In addition to nitrate therapy, a client is receiving nifedipine (Procardia) 10 mg PO every 6 hours. The nurse should plan to observe for which common side effect of this treatment regimen? A 59-year-old client with congestive heart failure is taking furosemide (Lasix) 40 mg twice daily. The nurse plans to monitor this client for development of which complication? The daughter of a female client with Alzheimer disease reports to the nurse that her mother has recently lost her appetite and refuses to eat. The client recently started taking rivastigmine tartrate (Exelon). What instructions are important for the nurse to provide the client's daughter? The nurse working in the community health clinic is assessing risk factors that can decrease medication effectiveness for clients with schizophrenia. Which client behavior is likely to decrease the effectiveness of psychotropic medications? A client is being discharged with a prescription for sulfasalazine (Azulfidine) to treat ulcerative colitis. Which instruction should the nurse provide to this client prior to discharge? A. Maintain good oral hygiene. B. Take the medication 30 minutes before a meal. C. Discontinue use of the drug gradually. D. Drink eight glasses of fluid a day. Daily doses of calcium citrate-malate (Citrucel) and vitamin D are prescribed for a 70-year-old female client. Which instruction should the nurse provide this client regarding taking the prescribed medications? A female client with trichomoniasis (T. vaginalis) receives a prescription for metronidazole (Flagyl). Which instruction is most important for the nurse to include this client's teaching plan? Which physiologic mechanism explains a drug's increased metabolism that is triggered by a disease process? A. Selectivity response B. Pharmacokinetics C. Pharmacodynamics D. Pharmacotherapeutics Methenaminemandelate (Mandelamine) is prescribed for a client with a urinary tract infection and renal calculi. What finding indicates to the nurse that the medication is effective? Which assessment datum indicates to the nurse that a dose of granisetron (Kytril) administered IV prior to chemotherapy has had the desired effect? The nurse who is working in a men's health clinic is reviewing the medical records of several clients who have received a prescription for sildenafil (Viagra). Which client history data should alert the nurse that close monitoring for adverse effects of Viagra is necessary? Which instructions should the nurse provide an adolescent female client who is initiating treatment with isotretinoin (Accutane) for acne vulgaris? (Select all that apply.) A male client asks the nurse why condoms should not be lubricated with the spermicide nonoxynol-9. Which response is best for the nurse to provide? A. The risk of female infertility and spontaneous abortion is linked with nonoxynol-9. B. Partners can develop intermittent interstitial cystitis if the spermicide is used after the expiration date. C. The spermicide decreases the amount of vaginal and penile sensitivity for up to 8 to 12 hours. D. Nonoxynol-9 provides no protection from STDs and has been linked to the transmission of HIV. The healthcare provider prescribes oral contraceptives for a client who wants to prevent pregnancy. Which information is the most important for the nurse to provide this client? A client with metastatic cancer reports severe, continuous pain. Which route of administration should the nurse use to provide the most effective continuous analgesia? The nurse is providing discharge instructions to a client who received a prescription for an antibiotic that is hepatotoxic. Which information should the nurse include in the instructions? Which response best supports the observations the nurse identifies in a client who is experiencing a placebo effect? A pediatric client is discharged home with multiple prescriptions for medications. Which information should the nurse provide that is most helpful to the parents when managing the medication regimens? A client receives doxacurium (Nuromax), a long-acting, nondepolarizing neuromuscular blocker, during surgical anesthesia. Which client situation should alert the nurse to evaluate the client for a prolonged muscle relaxation response to this medication? The nurse is preparing to administer a secondary infusion of a dobutamine solution to a client. The nurse notes that the solution is brown in color. Which action should the nurse implement? A. Verify the prescribed dose with the health care provider. B. Discard the solution and reorder from the pharmacy. C. Dilute the solution with more normal saline until it becomes lighter in color. D. Administer the drug if the solution's reconstitution time is less than 24 hours. Dopamine (Intropin) is administered to a client who is hypotensive. Which finding should the nurse identify as a therapeutic response? A. Gain in weight B. Increase in urine output C. Improved gastric motility D. Decrease in blood pressure A client with diabetes mellitus takes insulin daily and is prescribed propranolol (Inderal). Which information should the nurse provide this client? A client who arrives in the PACU after surgery is not awake from general anesthesia. What action should the nurse implement first? The nurse is reviewing prescribed medications with a female client who is preparing for discharge. The client asks the nurse why the oral dose of an opioid analgesic is higher than the intravenous (IV) dose that she received during hospitalization. Which response is best for the nurse to provide Amoxicillin 500 mg PO every 8 hours is prescribed for a client with an infection. The drug is available in a suspension of 125 mg/5 ml. How many milliliters should the nurse administer with each dose? During therapy with isoniazid (INH), it is most important for the nurse to monitor which laboratory value closely? A. Liver enzyme levels B. Blood urea nitrogen (BUN) level C. Serum electrolyte levels D. Complete blood count (CBC) A client who arrives in the postanesthesia care unit (PACU) after surgery is not awake from general anesthesia. Which action should the nurse implement first? A. Assess for deep tendon reflexes. B. Observe urinary output. C. Review the medication administration record (MAR). D. Administer naloxone (Narcan). A client with metastatic cancer who has been receiving fentanyl (Duragesic) for several weeks reports to the nurse that the medication is not effectively controlling the pain. Which intervention should the nurse initiate? A. Instruct the client about the indications of opioid dependence. B. Monitor the client for symptoms of opioid withdrawal. C. Notify the health care provider of the need to increase the dose. D. Administer naloxone (Narcan) per PRN protocol for reversal. A female client is receiving tamoxifen (Nolvadex) following surgery for breast cancer. She reports the onset of hot flashes to the nurse. Which intervention should the nurse implement? A. Instruct the client that hot flashes are a side effect that often occurs with the use of this medication. B. Encourage the client to verbalize her feelings and fears about the recurrence of her breast cancer. C. Help the client schedule an appointment for evaluation of the need to increase the dose of medication. D. Notify the health care provider that the client needs immediate evaluation for medication toxicity. In addition to nitrate therapy, a client is receiving nifedipine (Procardia), 10 mg PO every 6 hours. The nurse should plan to observe for which common side effect of this treatment regimen? A. Hypotension B. Hyperkalemia C. Hypokalemia D. Seizures A female client is receiving tetracycline (Vibramycin) for acne. Which client teaching should the nurse include? A. Oral contraceptives may not be effective. B. Drinking cranberry juice will promote healing. C. Breast tenderness may occur as a side effect. D. The urine will turn a red-orange color. Which medication is useful in treating digoxin (Lanoxin) toxicity? A. Atropine sulfate (Atropine) B. Isoproterenol (Isuprel) C. Xylocaine (Lidocaine) D. Digoxin immune Fab (Digibind) A male client with prostatic carcinoma has arrived for his scheduled dose of docetaxel (Taxotere) chemotherapy. What symptom would indicate a need for an immediate response by the nurse prior to implementing another dose of this chemotherapeutic agent? A. A cough that is new and persistent B. Persistent nausea and vomiting C. Fingernail and toenail changes D. Increasing weakness and neuropathy The health care provider prescribes ipratropium (Atrovent) for a client. An allergic reaction to which other medication would cause the nurse to question the prescription for Atrovent? A. Albuterol (Proventil) B. Theophylline (Theo-24) C. Metaproterenol (Alupent) D. Atropine sulfate (Atropine) The nurse is administering the early morning dose of insulin aspart (NovoLog), 5 units subcutaneously, to a client with diabetes mellitus type 1. The client's fingerstick serum glucose level is 140 mg/dL. Considering the onset of insulin aspart (NovoLog), when should the nurse ensure that the client's breakfast be given? A. 5 minutes after subcutaneous administration B. 30 minutes after subcutaneous administration C. 1 to 2 hours after administration D. Any time because of a flat peak of action Alteration of which laboratory finding represents the achievement of a therapeutic goal for heparin administration? A. Prothrombin time (PT) B. Fibrin split products C. Platelet count D. Partial thromboplastin time (PTT) A client has a positive skin test for tuberculosis. Which prophylactic drug should the nurse expect to administer to this client? A. Isoniazid (INH) B. Carvedilol (Coreg) C. Acyclovir (Zovirax) D. Griseofulvin (Grisactin) An older client who had a colon resection yesterday is receiving a constant dose of hydromorphone (Dilaudid) via a patient-controlled analgesia (PCA) pump. Which assessment finding is most significant and requires that the nurse intervene? A. The client is drowsy and complains of pruritus. B. Pupils are 3 mm; PERRLA. C. The area around the sutures is reddened and swollen. D. Respirations decrease to 14 breaths/min. A client receiving a continuous infusion of heparin IV starts to hemorrhage from an arterial access site. Which medication should the nurse anticipate administering to prevent further heparin-induced hemorrhaging? A. Vitamin K1 (AquaMEPHYTON) B. Protamine sulfate C. Warfarin sodium (Coumadin) D. Prothrombin A primigravida at 34 weeks of gestation is admitted to labor and delivery in preterm labor. She is started on a terbutaline sulfate (Brethine) continuous IV infusion via pump. This therapy is ineffective, and the baby is delivered vaginally. For which complication should the nurse monitor in this infant during the first few hours after delivery? A. Hypokalemia B. Hypermagnesia C. Hypoglycemia D. Hypernatremia A client who is HIV-positive is receiving combination therapy with the antiviral medication zidovudine (Retrovir). Which instruction should the nurse include in this client's teaching plan? A. Take the drug as prescribed to cure HIV infections. B. Use the drug to reduce the risk of transmitting HIV to sexual contacts. C. Return to the clinic every 2 weeks for blood counts. D. Report to the health care provider immediately if dizziness is experienced. A client with mild parkinsonism is started on oral amantadine (Symmetrel). Which statement accurately describes the action of this medication? A. Viral organisms that cause parkinsonism are eliminated. B. Acetylcholine in the myoneural junction is enhanced. C. Dopamine in the central nervous system is increased. D. Norepinephrine release is reduced within the periphery. A client is receiving oral griseofulvin (Grisactin) for a persistent tinea corporis infection. Which response by the client indicates an accurate understanding of the drug teaching conducted by the nurse? A. "I'll wear sunscreen whenever I mow the lawn." B. "This is the worse bacterial infection I've ever had." C. "I will need to take the medication for 7 days." D. "My urine will probably turn brown due to this drug." . A client is experiencing an adverse effect of the gastrointestinal stimulant metoclopramide HCl (Reglan). Which assessment finding would require immediate intervention by the nurse? A. Complains of dizziness when first getting up B. Describes an unpleasant metallic taste in the mouth C. Demonstrates Parkinson's-like symptoms, such as cogwheel rigidity D. Refuses to drive after 6 pm because of an inability to see well at night Which instructions should the nurse provide to an adolescent female client who is initiating treatment with isotretinoin (Accutane) for acne vulgaris? (Select all that apply.) A. "Notify the health care provider immediately if you think you are pregnant." B. "If your acne gets worse, stop the medication and call the health care provider." C. "Take a daily multiple vitamin to prevent deficiencies and promote dermal healing." D. "Dermabrasion for deep acne scars should be postponed for 1 month after therapy is stopped." E. "If you begin crying more than usual and feel sad, stop the drug and call the health care provider." F. "Before, during, and after therapy, two effective forms of birth control must be used at the same time." A client with viral influenza is receiving vitamin C, 1000 mg PO daily, and acetaminophen elixir, 650 mg PO every 4 hours PRN. The nurse calls the health care provider to report that the client has developed diarrhea. Which change in prescriptions should the nurse anticipate? A. Change the acetaminophen to ibuprofen. B. Change the elixir to an injectable route. C. Decrease the dose of vitamin C. D. Begin treatment with an antibiotic. A client taking linezolid (Zyvox) at home for an infected foot ulcer calls the home care nurse to report the onset of watery diarrhea. Which intervention should the nurse implement? A. Schedule appointments to obtain blood samples for drug peak and trough levels. B. Reassure the client that this is an expected side effect that will resolve in a few days. C. Instruct the client to obtain a stool specimen to be taken to the laboratory for analysis. D. Advise the client to begin taking an over-the-counter antidiarrheal agent. A client who has trouble swallowing pills intermittently has been prescribed venlafaxine (Effexor XR) for depression. The medication comes in capsule form. What should the nurse include in the discharge teaching plan for this client? A. Capsule contents can be sprinkled on pudding or applesauce. B. Chew the medication thoroughly to enhance absorption. C. Take the medication with a large glass of water or juice. D. Contact the health care provider for another form of medication. A client who is HIV-positive is receiving epoetin alfa (Epogen) for the management of anemia secondary to zidovudine (AZT) therapy. Which laboratory finding is most important for the nurse to report to the health care provider? A. Hematocrit (HCT) of 58% B. Hemoglobin of 10.8 g/dL C. White blood cell count of 5000 mm3 D. Serum potassium level of 5 mEq/L The nurse is scheduling a client's antibiotic peak and trough levels with the laboratory personnel. What is the best schedule for drawing the trough level? A. Give the dose of medication, and call the laboratory to draw the trough STAT. B. Arrange for the laboratory to draw the trough 1 hour after the dose is given. C. Instruct the laboratory to draw the trough immediately before the next scheduled dose. D. Give the first dose of medication after the laboratory reports that the trough has been drawn. During administration of theophylline (Theo-Dur), the nurse should monitor for signs of toxicity. Which symptom would cause the nurse to suspect Theo-Dur toxicity? A. Dry mouth B. Urinary retention C. Restlessness D. Sedation The health care provider prescribes oral contraceptives for a client who wants to prevent pregnancy. Which information is the most important for the nurse to provide to this client? A. Take one pill at the same time every day until all the pills are gone. B. Use condoms and foam instead of the pill while on any antibiotics. C. Limit sexual intercourse for at least one cycle after starting the pill. D. Use another contraceptive if two or more pills are missed in one cycle. For which client(s) should the nurse withhold the initial dose of a cyclooxygenase 2 (COX-2) inhibitor until notifying the health care provider? (Select all that apply.) A. A middle-aged adult with a history of tinnitus while taking aspirin B. A middle-aged adult with a history of polycystic ovarian disease C. An older adult with a history of a skin rash while taking glyburide (DiaBeta) D. An adolescent with a history of an anaphylactic reaction to penicillin E. An older adult with a history of gastrointestinal upset while taking naproxen sodium (Naprosyn) F. An adolescent at 34 weeks of gestation experiencing 1+ pitting edema A client with metastatic cancer reports severe continuous pain. Which route of administration should the nurse use to provide the most effective continuous analgesia? A. Oral B. Intravenous C. Transdermal D. Intramuscular A chemotherapeutic regimen with doxorubicin HCl (Adriamycin) is being planned for a client recently diagnosed with cancer. What diagnostic test results should the nurse review prior to initiating this treatment? A. Electrocardiogram (ECG) B. Arterial blood gases (ABGs) C. Serum cholesterol level D. Pelvic ultrasound In administering the antiinfective agent chloramphenicol (Chloromycetin) IV to a client with bacterial meningitis, the nurse observes the client closely for signs of bone marrow depression. Which laboratory data would be most important for the nurse to monitor? A. Platelet count B. Blood urea nitrogen level C. Culture and sensitivity D. Serum calcium level A female client with trichomoniasis (Trichomonas vaginalis) receives a prescription for metronidazole (Flagyl). Which instruction is most important for the nurse to include this client's teaching plan? A. Avoid alcohol consumption. B. Complete the medication regimen. C. Use a barrier contraceptive method. D. Treat partner(s) concurrently. The nurse is reviewing prescribed medications with a female client who is preparing for discharge. The client asks the nurse why the oral dose of an opioid analgesic is higher than the IV dose that she received during hospitalization. Which response is best for the nurse to provide? A. A higher dose of analgesic medication may be needed after discharge. B. An error in the dose calculation may have occurred when the prescribed dose was converted. C. The doses should be the same unless the pain is not well controlled. D. Oral forms of drugs must pass through the liver first, where more of the dose is metabolized. . A lidocaine IV infusion at 4 mg/min via infusion pump is prescribed for a client having premature ventricular contractions (PVCs). The available premixed infusion contains 2 mg/mL of D5W. How many milliliters per hour should the nurse program the pump to deliver to this client? A. 20 B. 24 C. 60 D. 120 During the initial nursing assessment history, a client tells the nurse that he is taking tetracycline hydrochloride (Sumycin) for urethritis. Which medication taken concurrently with Sumycin could interfere with its absorption? A. Sucralfate (Carafate) B. Hydrochlorothiazide (Diuril) C. Acetaminophen (Tylenol) D. Phenytoin (Dilantin) A child with cystic fibrosis is receiving ticarcillin disodium (Ticar) for Pseudomonas pneumonia. For which adverse effect should the nurse assess and report promptly to the health care provider? A. Petechiae B. Tinnitus C. Oliguria D. Hypertension To evaluate whether the administration of an antihypertensive medication has caused a therapeutic effect, which action should the nurse implement? A. Ask the client about the onset of any dizziness since taking the medication. B. Measure the client's blood pressure while the client is lying, sitting, and then standing. C. Compare the client's blood pressure before and after the client takes the medication. D. Interview the client about any past or recent history of high blood pressure. The nurse is preparing a child for transport to the operating room for an emergency appendectomy. The anesthesiologist prescribes atropine sulfate (Atropine), IM STAT. What is the primary purpose for administering this drug to the child at this time? A. Decrease the oral secretions. B. Reduce the child's anxiety. C. Potentiate the opioid effects. D. Prevent possible peritonitis. Which nursing intervention has the highest priority during IV administration of mechlorethamineHCl (nitrogen mustard) and actinomycin (Actinomycin D)? A. Assess for extravasation at the IV site during infusion. B. Premedicate with antiemetics 30 to 60 minutes before infusion. C. Monitor cardiac rate and rhythm during the IV infusion. D. Check the granulocyte count daily for the presence of neutropenia. A female client who has started long-term corticosteroid therapy tells the nurse that she is careful to take her daily dose at bedtime with a snack of crackers and milk. Which is the best response by the nurse? A. Advise the client to take the medication in the morning, rather than at bedtime. B. Teach the client that dairy products should not be taken with her medication. C. Tell the client that absorption is improved when taken on an empty stomach. D. Affirm that the client has a safe and effective routine for taking the medication. A 3-year-old boy is admitted to the emergency department after ingesting an unknown amount of phenobarbital (Luminal) elixir prescribed for his brother's seizure disorder. Which nursing intervention should the nurse implement first? A. Administer syrup of ipecac. B. Take the child's vital signs. C. Draw a blood specimen for a phenobarbital level. D. Teach the mother safe medication storage practices. Two hours after taking the first dose of penicillin, a client arrives at the emergency department complaining of feeling ill, exhibiting hives, having difficulty breathing, and experiencing hypotension. These findings are consistent with which client response that requires immediate action? A. Severe acute anaphylactic response B. Side reaction that should resolve C. Idiosyncratic reaction D. Cumulative drug response The nurse is preparing to administer amphotericin B (Fungizone) IV to a client. What laboratory data is most important for the nurse to assess before initiating an IV infusion of this medication? A. Serum potassium level B. Platelet count C. Serum creatinine level D. Hemoglobin level Which question should the nurse ask a client prior to the initiation of treatment with IV infusions of gentamicin sulfate (Garamycin)? A. "Are you having difficulty hearing?" B. "Have you ever been diagnosed with cancer?" C. "Do you have any type of diabetes mellitus?" D. "Have you ever had anemia?" A client experiencing dysrhythmias is given quinidine (Quinidex), 300 mg PO every 6 hours. The nurse plans to observe this client for which common side effect associated with the use of this medication? A. Diarrhea B. Hypothermia C. Seizures D. Dysphagia A client with Tourette's syndrome takes haloperidol (Haldol) to control tics and vocalizations. The client has become increasingly drowsy over the past 2 days and reports becoming dizzy when changing from a supine to sitting position. Which action should the nurse take? A. Assess for poor skin turgor, sunken eyeballs, and concentrated urine output. B. Recognize that a sedative effect is expected and continue monitoring the client. C. Have the caregiver hold the next two doses of the medication to reduce the drug toxicity. D. Determine whether the client's urine is pink or reddish brown, and report findings to the health care provider. . Which response best supports the observations that the nurse identifies in a client who is experiencing a placebo effect? A. Beneficial response or cure for disease B. Behavioral or psychotropic responses C. Malingering or drug-seeking behaviors D. Psychological response to inert medication The health care provider prescribes carbamazepine (Tegretol) for a child whose tonic-clonic seizures have been poorly controlled. The nurse informs the mother that the child must have blood tests every week. The mother asks why so many blood tests are necessary. Which complication is assessed through frequent laboratory testing that the nurse should explain to this mother? A. Nephrotoxicity B. Ototoxicity C. Myelosuppression D. Hepatotoxicity Methenaminemandelate (Mandelamine) is prescribed for a client with a urinary tract infection and renal calculi. Which finding indicates to the nurse that the medication is effective? A. The frequency of urinary tract infections decreases. B. The urine changes color and pain is diminished. C. The dipstick test changes from +1 to trace. D. The daily urinary output increases by 10%. The nurse is preparing to administer the disease-modifying antirheumatic drug (DMARD) methotrexate (Rheumatrex) to a client diagnosed with rheumatoid arthritis. Which intervention is most important to implement prior to administering this medication? A. Assess the client's liver function test results. B. Monitor the client's intake and output. C. Have another nurse check the prescription. D. Assess the client's oral mucosa. The health care provider has prescribed a low-molecular-weight heparin, enoxaparin (Lovenox) prefilled syringe, 30 mg/0.3 mL IV every 12 hours, for a client following hip replacement. Prior to administering the first dose, which intervention is most important for the nurse to implement? A. Assess the client's IV site for signs of inflammation. B. Evaluate the client's degree of mobility. C. Instruct the client regarding medication side effects. D. Contact the health care provider to clarify the prescription. The health care provider prescribes the H2 antagonist famotidine (Pepcid), 20 mg PO in the morning and at bedtime. Which statement regarding the action of H2 antagonists offers the correct rationale for administering the medication at bedtime? A. Gastric acid secreted at night is buffered, preventing pepsin formation. B. Hydrochloric acid secreted during the night is blocked. C. The drug relaxes stomach muscles at night to reduce acid. D. Ingestion of the medication at night offers a sedative effect, promoting sleep. When providing client teaching about the administration of methylphenidate (Ritalin) to a parent of a child diagnosed with ADHD, which instruction should the nurse include in the teaching plan? A. The doses should be given exactly 12 hours apart to sustain a therapeutic serum level. B. Doses should be scheduled at midmorning and midafternoon to achieve optimal benefit. C. Give the medication only on school days and when the child appears to be anxious. D. Offer the child the medication before the child eats breakfast and after the child eats lunch. A 6-year-old child is admitted to the emergency department with status epilepticus. His parents report that his seizure disorder has been managed with phenytoin (Dilantin), 50 mg PO bid, for the past year. Which drug should the nurse plan to administer in the emergency department? A. Phenytoin (Dilantin) B. Diazepam (Valium) C. Phenobarbital (Luminal) D. Carbamazepine (Tegretol) A client with chronic gouty arthritis is talking allopurinol (Zyloprim), 100 mg PO daily. Which laboratory serum level should the nurse report to the health care provider to determine the therapeutic outcome? A. Prothrombin time B. Uric acid level C. White blood cell count D. Creatinine level A 19-year-old male client who has sustained a severe head injury is intubated and placed on assisted mechanical ventilation. To facilitate optimal ventilation and prevent the client from "fighting" the ventilator, the health care provider administers pancuronium bromide (Pavulon) IV, with adjunctive opioid analgesia. What medication should the nurse maintain at the client's bedside? A. Dantrolene sodium (Dantrium) B. Neostigmine bromide (Prostigmin) C. Succinylcholine bromide (Anectine) D. Epinephrine (Adrenalin) A 67-year-old client is discharged from the hospital with a prescription for digoxin (Lanoxin), 0.25 mg daily. Which instruction should the nurse include in this client's discharge teaching plan? A. Take the medication in the morning before rising. B. Take and record radial pulse rate daily. C. Expect some vision changes caused by the medication. D. Increase intake of foods rich in vitamin K. An older client is receiving a water-soluble drug that is more than the average dose for a young adult. Which action should the nurse implement first? A. Obtain a prescription for lower medication dosages. B. Determine the drug's serum levels for toxicity. C. Start IV fluids to decrease the serum drug levels. D. Hold the next dosage and notify the health care provider. A client who is hypertensive receives a prescription for hydrochlorothiazide (HCTZ). When teaching about the side effects of this drug, which symptoms are most important for the nurse to instruct the client to report? A. Fatigue and muscle weakness B. Anxiety and heart palpitations C. Abdominal cramping and diarrhea D. Confusion and personality changes Dopamine (Intropin), 5 mcg/kg/min, is prescribed for a client who weighs 105 kg. The nurse mixes 400 mg of dopamine in 250 mL D5W for IV administration via an infusion pump. What is the hourly rate that the nurse should set on the pump? A. 5 mL/hr B. 10 mL/hr C. 15 mL/hr D. 20 mL/hr A male client who has chronic back pain is on long-term pain medication management and asks the nurse why his pain relief therapy is not as effective as it was 2 months ago. How should the nurse respond? A. The phenomenon occurs when opiates are used for more than 6 months to relieve pain. B. Withdrawal occurs if the drug is not tapered slowly while being discontinued. C. Pharmacodynamic tolerance requires increased drug levels to achieve the same effect. D. A consistent dosage with around-the-clock administration is the most effective. Which intervention is most important for a nurse to implement prior to administering atropine PO? A. Determine the presence of 5 to 35 bowel sounds/min. B. Assess the blood pressure, both lying and standing. C. Verify that the client's tendon reflexes are 2+. D. Have the client rate his or her pain on a 0 to10 scale. Minocycline (Minocin), 50 mg PO every 8 hours, is prescribed for an adolescent girl diagnosed with acne. The nurse discusses self-care with the client while she is taking the medication. Which teaching points should be included in the discussion? (Select all that apply.) A. Report vaginal itching or discharge. B. Take the medication at 0800, 1500, and 2200 hours. C. Protect skin from natural and artificial ultraviolet light. D. Avoid driving until response to medication is known. E. Take with an antacid tablet to prevent nausea. F. Use a nonhormonal method of contraception if sexually active. Methylphenidate HCl (Concerta) is prescribed for daily administration to a 10-year-old child with attention deficit-hyperactivity disorder (ADHD). In preparing a teaching plan for the parents of this child newly diagnosed with ADHD, which instruction is most important for the nurse to provide to the parents? A. Administer the medication in the morning before the child goes to school. B. Plan to implement periodic interruptions in the administration of the drug. C. Attempt to be consistent when setting limits on inappropriate behavior. D. Seek professional counseling if the child's behavior continues to be disruptive. [Show More]

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