A nurse is teaching a client about methotrexate therapy for rheumatoid arthritis

ATI PROCTORED PRACTICE B

1 nurse is caring for a client who has schizophrenia and is to start therapy with Resperidone. For which of the following manifestations should the nurse monitor to determine whether the treatment is effective? Improved social interactions -Clients who have schizophrenia typically have difficulty interacting with others and maintaining relationships. Manifestations can include dull affect and speech deficiency. Risperidone is an atypical antipsychotic that can minimize these manifestations, improving social interactions with others.

2 nurse is collecting data from a client who has bacterial pneumonia and is taking Ceftriaxone. Which of the following findings indicates a therapeutic effect of the medication? Clear, bilateral breath sounds -The nurse should identify that wheezing and crackles are findings of bacterial pneumonia. A decrease in these manifestations indicates a therapeutic effect of the medication.

3 nurse on a medical-surgical unit is preparing to administer medication to a client. Which of the following question should the nurse ask the client to verify the client's identity? "What is your name and date of birth?" -Acceptable client identifiers include the client's name, telephone number, facility identification number, date of birth, and other client-specific identifiers. The nurse must use at least two identifiers to verify the client's identity and should compare the information to what is on the client's wristband or in the medical record.

4 nurse is reviewing a client's medical history before administering hydromorphone for post operative pain. The nurse should notify the provider of which of the following findings before administering this medication? Benign prostatic hyperplasia -A client who has benign prostatic hyperplasia is at increased risk for developing acute urinary retention while taking opioids. Therefore, the nurse should notify the provider about this finding before administering hydromorphone.

5 nurse is collecting data from a client who is taking lithium to treat bipolar disorder. Which of the following findings should the nurse report to the provider? Slurred speech -The nurse should recognize that slurred speech is an indication of toxicity and should be reported to the provider.

6 nurse in a provider's office is reviewing the immunization records of a 12-month old- infant who is immunocompromised. Which of the following vaccines should the nurse identify as contraindicated for this client?

Measles, mumps, rubella (MMR) -Although most infants should receive the MMR vaccine between the ages of 12 months and 15 months, the nurse should identify that the MMR vaccine is composed of live viruses and is contraindicated for an infant who is immunocompromised.

7 nurse is collecting data from a client who recently began taking Niacin to treat hyperlipidemia. The client reports experiencing facial flushing after taking the medication. The nurse should expect the provider to make which of the following recommendations? Take aspirin 30 minutes before taking the medication -The nurse should expect a recommendation of aspirin 30 min prior to each dose to minimize facial flushing. The nurse should inform the client that this manifestation is often transient and diminishes over time.

8 nurse is collecting data from a client who has angina and has a new prescription for sublingual nitroglycerin. Which of the following manifestations should the nurse expect as an adverse effect of this medication? Headache -The nurse should expect the client to have headaches as a common adverse effect of taking sublingual nitroglycerin because it causes vasodilation.

9 nurse in a community health clinic is preparing to administer the varicella vaccine to a young adult female client who has not previously had chickenpox or its vaccine. The nurse should withhold the vaccine and collect additional data when the client makes which one of the following statements? "I am allergic to neomycin" -A hypersensitivity to neomycin is a contraindication for receiving the varicella vaccine.

10 nurse is caring for a patient who has kidney failure and has been taking Epoetin alfa. Which of the following is a therapeutic effect for this medication? Increased Hgb -Epoetin alfa is used to elevate erythrocyte count for clients who have kidney failure. An increased Hgb is the desired therapeutic effect of this medication.

11 nurse is reinforcing teaching with a client who has a new prescription for a fluticasone inhaler. Which of the following client statements indicates an understanding of the teaching "I will rinse my mouth after I use this inhaler" -The client should rinse his mouth after using inhaled glucocorticoids to avoid the development of oral thrush. Therefore, the nurse should identify this statement as indicating an understanding of the teaching.

12 nurse is assisting with the care of a client who is in preterm labor and is receiving magnesium sulfate by continuous IV infusion. Which of the following findings indicates magnesium toxicity?

19 nurse in reinforcing teaching with a client who experiences migraine headaches and has a new prescription for sumatriptan. The nurse should instruct the client to report which of the following manifestations to the provider as an adverse effect of this medication? Chest tightness -The nurse should instruct the client to report chest pain or tightness to the provider because this can be a manifestation of a vasospastic response.

20 nurse is collecting data from a client who has multiple sclerosis and a new prescription for baclofen. Which of the following findings should the nurse identify as an adverse effect of this medication? Drowsiness -The nurse should identify drowsiness as an adverse effect of baclofen. Other adverse effects include dizziness, weakness, and fatigue.

21 nurse is reviewing the medical record of a client who has a new prescription for dimenhydrinate to treat motion sickness. Which of the following disorders in the client's medical record should the nurse report to the provider? Benign prostatic hyperplasia -Clients who have benign prostatic hyperplasia might have urinary hesitancy and retention and, therefore, should not take dimenhydrinate due to the anticholinergic adverse effects of the medication.

22 nurse is caring for a client who is having and cute asthma attack. Which of the following medications should the nurse administer first? Albuterol -According to evidence-based practice, the nurse should administer a short-acting beta agonist with a rapid onset when a client is experiencing an acute asthma attack. Therefore, the nurse should administer the albuterol prior to the other medications for prompt relief of airway constriction.

23 nurse is caring for a client who is receiving methylprednisolone. Which of the following laboratory values should the nurse plan to monitor? ( Select all that apply) White blood cell count is (correct.) -Methylprednisolone can increase the client's risk for infection and cause leukocytosis. Serum potassium is (correct.) -Methylprednisolone can cause hypokalemia, as well as fluid and sodium retention. Creatine phosphokinase is (incorrect.) -Methylprednisolone does not damage the muscles and, therefore, does not cause release of creatine phosphokinase. Blood glucose is (correct.) -Methylprednisolone can cause increased blood glucose levels. Amylase is (incorrect.) -Methylprednisolone does not affect pancreatic function.

24 nurse is collecting data from a client who is taking exenatide to treat diabetes mellitus. For which of the following findings should the nurse withhold the exenatide dose and notify the provider immediately? Abdominal Pain -The greatest risk to this client is the development of pancreatitis as an adverse effect of exenatide; therefore, the nurse should withhold the medication and immediately notify the provider of the client's abdominal pain. Manifestations of pancreatitis include severe, persistent abdominal pain with possible emesis.

25 nurse is reinforcing discharge teaching with a client who has type 2 diabetes mellitus and a new prescription for metformin. The nurse should instruct the client to monitor for which of the following manifestations as adverse effects of this medication? (select all that apply) Muscle pain is (correct.)

• Clients taking metformin should monitor for muscle pain or hyperventilation as indications of lactic acidosis. Fatigue is (correct.) -Metformin can decrease vitamin B12 absorption, causing pernicious anemia. Therefore, clients taking metformin should monitor for manifestations of anemia, including fatigue and pallor. Absence of adequate vitamin B12 can also cause neurological damage. Weight gain is (incorrect.) -Unlike sulfonylurea medications, metformin does not cause weight gain, and can cause weight loss in some clients. Constipation is (incorrect.) -Metformin can cause GI manifestations such as diarrhea, nausea, and vomiting. Metallic taste is (correct.) -Metformin can cause GI manifestations such as a bitter or metallic taste.

26 nurse is reinforcing teaching with a client who has rheumatoid arthritis and a new prescription for methotrexate. Which of the following information should the nurse include in the teaching? Increase fluid intake -Clients who are taking methotrexate should increase fluid intake to reduce the risk for renal damage and to increase drug excretion.

27 nurse is collecting data from a client who has been taking digoxin for 1 month. The nurse should identify which of the following findings as a manifestation of digoxin toxicty? Vomiting -The nurse should identify vomiting as an early manifestation of digoxin toxicity.

28 nurse is collecting data prior to administering digoxin to a client. For which of the following findings should the nurse withhold this medication and notify the provider? Apical pulse 52/min -The nurse should check the client's apical pulse prior to administering digoxin because

35 nurse is reviewing the medication administration record for a client who has a new prescription for tobramycin to treat a pulmonary infection. Which of the following medications should the nurse identify as increasing the risk for ototoxicity while taking tobramycin? Furosemide -Tobramycin is an aminoglycoside antibiotic that can cause ototoxicity. Furosemide is a diuretic that also can cause ototoxicity. The client's risk for hearing loss is increased if receiving both of these medications at the same time.

36 nurse is reinforcing teaching about immunizations with a client who is pregnant. Which of the following vaccines should the nurse include in the teaching as safe to administer during pregnancy? Tetanus and diphtheria (Td) -The nurse should include that either the Td vaccine or the tetanus, diphtheria, and pertussis (Tdap) vaccine is safe for administration during pregnancy. Tdap is the preferred vaccine.

37 nurse is reinforcing teaching with a client who is receiving enalapril 20 mg PO daily. The nurse should instruct the client to monitor for which of the following adverse effects of this medication? Dry cough -The nurse should identify that a persistent dry or nonproductive cough is an adverse effect of enalapril. The underlying cause of the dry cough is the accumulation of bradykinin from the medication. The client should notify the provider of this adverse effect.

38 nurse is reinforcing teaching with a client who has a new prescription for vitamin B12 intranasal to treat malabsorption syndrome. Which of the following instructions should the nurse include in the teaching? "Massage your nose gently after medication administration." -The nurse should instruct the client to massage her nose gently to increase absorption of the medication.

39 nurse is collecting data from a client who is taking oral amoxicillin to treat respiratory infection. The nurse should monitor the client for which of the following manifestations as an adverse effect of the medication? Diarrhea -The nurse should monitor the client for diarrhea. A Clostridium difficile infection is an adverse effect of antibiotics, including amoxicillin.

40 nurse is caring for a client who is taking disulfiram and consumed alcohol 12 hr ago. Which of the following adverse reactions is the priority finding to report to the provider? Respiratory depression -When using the urgent vs. nonurgent approach to client care, the nurse should

determine that the priority finding is respiratory depression, which can indicate the client is experiencing acetaldehyde syndrome, a life-threatening event.

41 nurse is reinforcing teaching with a client who has a new prescription for timolol eye drops to treat glaucoma. Which of the following client statements indicates an understanding of the teaching? "I will look up when putting the medication into my eyes." -The nurse should instruct the client to look up during administration of eye drops to help protect the cornea and minimize blinking.

42 nurse is collecting data from a client who has hyperthyroidism and a new prescription for propylthiouracil. The nurse should monitor the client for which of the following manifestations as an adverse effect of this medication? sore throat -The nurse should monitor for sore throat and fever because these are early indications of agranulocytosis, which is an adverse effect of propylthiouracil.

43 nurse is reinforcing dietary teaching with a client who has a new prescription for phenelzine. Which of the following foods should the nurse include in the teaching as an appropriate food choice? Yogurt -Clients taking phenelzine should avoid consuming tyramine, which can cause high blood pressure. Yogurt contains little or no tyramine. Therefore, it is an appropriate food choice to include in the teaching.

44 nurse is reviewing the medical administration record of a client who has a history of Stevens-Johnson syndrome when taking sulfamethoxazole trimethoprim. Which of the following medications should the nurse identify as contraindicated for this client? Furosemide -A client who has a history of Stevens-Johnson syndrome when taking sulfonamides is at risk for an allergic reaction to furosemide because the two medications are chemically related. The client should also avoid thiazide diuretics and sulfonylurea-type oral hypoglycemic agents.

45 nurse is performing the third check before administering hydromorphone to a client. After opening the unit-dose packet, the client tells the nurse he does not want to take the medication now. Which of the following actions should the nurse make? Dispose of the medication with a second nurse as a witness. -The nurse is legally required to have a witness when disposing of a controlled substance.

46 nurse erroneously administered zolpidem to the wrong client. Which of the following actions should the nurse take when documenting the medication error? Document the notification of the client's provider. -In the medical record of the client who received the zolpidem, the nurse should

What information is important for the nurse to teach a client recently prescribed raloxifene?

Which of the following is a therapeutic action of raloxifene?