A client has just started treatment with rifampin for tuberculosis. Which statement indicates that the client has a good understanding of his medication? Show "My urine will look orange because of the medication." The nurse is caring for a client with Reye syndrome who is receiving pancuronium bromide. What is the most important intervention for the nurse to include in the plan of care? Applying artificial tears as needed How should the nurse proceed when instilling neomycin and polymyxin B sulfates and hydrocortisone optic suspension, two drops in the right ear? Verify the proper client and route The client tells the nurse that she frequently experiences nausea and vomiting after receiving radiation and chemotherapy. The nurse adapts the plan of care to include antiemetics. What is the most appropriate time for the administration of the medication? Thirty minutes before therapy begins While administering medication, the client tells the nurse, "I've never seen this pill before." The nurse should: check the medication orders.
A client has been prescribed sertraline. Which adverse effects are most important for the nurse to communicate to this client? Select all that apply. Dry mouth, sleep disturbances, and agitation A client with chronic obstructive bronchitis asks the nurse why he is receiving diuretic therapy. What is the nurse's best response? To reduce fluid volume and reduce oxygen demand The nurse makes initial rounds for his clients. Five medication are scheduled for administration at the same time to five different clients. Which medication should the nurse administer first after initial rounds? Morphine sulfate to a client with a myocardial infarction reporting chest pain The nurse initiates the treatment for a delayed hypersensitivity reaction. What is the most appropriate treatment? Corticosteroids The effectiveness of selective serotonin reuptake inhibitor (SSRIs) therapy, in a client with post traumatic stress disorder (PTSD), can be verified when the client states: "I'm sleeping better now." A client diagnosed with uncomplicated rheumatoid arthritis is receiving naproxen. Which medication would require further intervention by the nurse prior to administration? Dabigatran The nurse is preparing to administer IV insulin to a client diagnosed with diabetic ketoacidosis (DKA). What will the nurse monitor while the client is receiving this intervention? Hypokalemia and hypoglycemia An unresponsive 41 lb (18.6 kg) child, with supraventricular tachycardia, is prescribed oral amiodarone 5 mg/kg. It comes as a solution of 150 mg/3 ml. How many milliliters should be given? Record your answer using one decimal place. 1.9 ml A 20-month-old toddler has been treated with permethrin for scabies. The toddler's mother asks, "Is this medication working? My child is still itching." Which response, by a nurse, is most appropriate? Pruritus can be present for weeks after treatment Which oral medication would the nurse anticipate being prescribed to prevent further thrombus formation? Warfarin A client has been receiving oxytocin to augment her labor. The nurse notes that contractions are lasting 100 seconds. Which immediate action should the nurse take? Stop the infusion The nurse is providing discharge instructions for a client who is receiving chemotherapeutic medications. Which intervention is most important to prevent hemorrhagic cystitis? Increasing fluid intake A nurse is teaching a client about tricyclic antidepressants. The nurse determines that teaching has been effective when the client states: "Improvement in my mood will take up to 28 days." The nurse is performing discharge teaching for a school-aged child who experienced an asthma attack. What is the most important information the nurse can provide this client about the prescription for budesonide? Rinse the mouth after using this medication. A depressed client, who is taking fluoxetine, tells the nurse that he has difficulty sleeping at night, is often sleepy during the day, and does not feel like doing anything. What is the nurse's best response? Ask the prescriber whether the medication can be given early in the day A neonate is admitted to the neonatal intensive care unit with persistent pulmonary hypertension. Which medication should the nurse anticipate for this neonate? Inhaled nitric oxide A nurse is caring for a child taking prednisone following a heart transplant. His pre-surgical weight was 25.6 lb (11.6 kg). The practitioner orders the child to receive 2 mg/kg/day divided every six hours. The oral solution comes prepared as 5 mg/5ml. How many milliliters will the child receive with each dose? Record your answer using one decimal place. 5.8 mL A definitive diagnosis of pulmonary embolism has been made for a client. Which medication would the nurse anticipate for this client? Heparin The nurse is caring for a client receiving digoxin. Which symptoms would the nurse anticipate with a digoxin level of 2.3 ng/dl (0.08 nmol/l)? Select all that apply. Seeing halos around bright objects, Photophobia, Drowsiness, Nausea The home health nurse is speaking to the wife of a client with neurocognitive disorder due to Alzheimer's disease. The client has been taking donepezil. The nurse is most concerned when the caregiver states: "Yesterday, I managed to weigh my husband, and he has lost 8 lbs this month." Explanation: A client has been prescribed corticosteroids. The nurse would also anticipate an order for: blood glucose checks every 6 hours. Explanation: What is lactulose given for? constipation and encephalopathy A client with a large cerebral intracranial hemorrhage was given mannitol to decrease intracranial pressure (ICP). What therapeutic effect should the nurse anticipate from mannitol? Increased urine output Mannitol promotes osmotic diuresis by increasing the pressure gradient in the renal tubules, thus increasing urine output. Fixed and dilated pupils are symptoms of increased ICP or cranial nerve damage, seen in herniation associated with a deteriorating cerebellar hemorrhage. Rebound cerebral hypertension is caused by? ongoing Mannitol use Which nifedipine-related side effect should the nurse be most concerned with when caring for a new stroke admission? Hypotension Explanation: The nurse reviews information about how to take the prescribed tetracycline. Which statement, by the client, allows the nurse to determine that the client understands the information? "I can take tetracycline one hour before or two hours after meals with plenty of water."
Explanation: A client is experiencing status asthmaticus. For which would the nurse anticipate an immediate order? Inhaled Beta-2 adrenergic agonist Explanation: The nurse receives an order to administer morphine to a client with an acute myocardial infarction. What is the purpose of this medication? To decrease myocardial oxygen demand Explanation: The nurse is teaching a client with iron-deficiency anemia about ferrous gluconate therapy. Which statement, if made by the client, would indicate a correct understanding of the teaching? "I will take the medication on an empty stomach with orange juice." Explanation: During a home health visit, a nurse assesses a client's medication and notes that the client has two prescriptions for fluid retention. One prescription reads, "Lasix, 40 milligrams one tablet daily." The next prescription reads, "Furosemide, 40 milligrams one tablet daily." Which instruction should be given to the client? Call the health care provider for verification Explanation: Which medication would the nurse expect the provider to prescribe as prophylaxis against Pneumocystis carinii pneumonia for a client with leukemia? Co-trimoxazole Explanation: Oral nystatin suspension is indicated for? thrush Prednisone increases risk for? Infection Vincristine is what type of med? Anti-eoplastic agent Where is the best site for the nurse to assess a client's pulse prior to administering digoxin? At the left fifth intercostal space, midclavicular line Explanation: Where is the best site for the nurse to assess a client's pulmonic sounds? At the left second intercostal space in the midclavicular line. A client with suspected myasthenia gravis is to undergo a test with edrophonium. The client asks if edrophonium can be used to treat myasthenia gravis. What is the nurse's best response? The short half-life of edrophonium makes it impractical for long-term use Explanation: A client with a subarachnoid hemorrhage is prescribed a 1,000 mg loading dose of IV phenytoin. What information is most important when administering this dose? Rapid phenytoin administration can cause cardiac arrhythmias. Explanation: A child with diabetic ketoacidosis is being treated for a blood glucose level of 738 mg/dl (41.0 mmol/L). The nurse should anticipate an order for: normal saline with regular insulin. Explanation: A depressed client has been taking a selective serotonin reuptake inhibitor (SSRI) in the evening, and is upset because he cannot perform sexually due to erectile problems. What is the nurse's best response? Engage in sexual activity prior to taking the drug Explanation: The nurse is aware that antihypertensives should be used cautiously in clients already taking: thioridazine.
Explanation: The health care provider is preparing to write a plan of care for a client with borderline personality disorder. Which medication would the nurse anticipate for this client? Selective serotonin reuptake inhibitors (SSRIs), along with an atypical antipsychotic, are used to treat mood instability and impulsivity Selective serotonin reuptake inhibitors and atypical antipsychotics are used to treat dysphoria, mood instability, and impulsivity in clients with borderline personality disorder. This is the best choice of medications for a client with borderline personality disorder. Monoamine oxidase inhibitors have food restrictions, and clients with borderline personality disorder would not comply with such restrictions. Anti-psychotics are indicated for? psychotic behaviors such as illusions, ideas of reference, and paranoid thinking. Anxiolytics may be prescribed for? Anxiolytics may be prescribed for Clients with borderline personality disorder experience symptoms other than anxiety. What adverse reaction might the nurse observe after administering enteric-coated erythromycin to a client? Nausea and vomiting Erythromycin is an antibiotic. Common adverse effects include nausea, vomiting, diarrhea, abdominal pain, and anorexia. It should be given with a full glass of water and after meals, or with food, to lessen gastrointestinal symptoms. A client with joint pain, tenderness and swelling has been admitted to the hospital. A disease modifying anti-rheumatic drug (DMARD) is prescribed by the health care provider. Which medication should the nurse expect to administer? Methotrexate Methotrexate is considered a first-line DMARD for most clients with rheumatoid arthritis (RA). NSAIDs, such as aspirin, cannot be tolerated. Prednisone may be used to control inflammation when NSAIDs cannot be used. Ferrous sulfate is used to treat? RA Which medication will the nurse administer to a client who experienced a thrombotic stroke two days ago? Aspirin Explanation: Alteplase is used to? potent medication that breaks down blood clots. It is approved by the U.S. Food and Drug Administration (FDA) for treatment within three hours of the onset of ischemic stroke. When alteplase is given, the client should have a brain scan 24-hours post infusion, and prior to the initiation of anti-platelet therapy. A client is receiving spironolactone to treat hypertension. Which instruction should the nurse provide? Avoid salt substitutes Explanation: A client who is receiving acetaminophen for osteoarthritis reports continuing pain. The health care provider prescribes celecoxib. What important information regarding this medication, should the nurse share with this client? Report black and tarry stools to the health care provider
Explanation: A nurse is assessing a client with bipolar disorder. The client tells the nurse his family health care provider prescribed lithium. Which symptom would indicate that the client is developing lithium toxicity? Lethargy Explanation: One hour after receiving pyridostigmine bromide for myasthenia gravis, a client reports difficulty swallowing and excessive respiratory secretions. What medication would the nurse anticipate to reverse the effects of pyridostigmine bromide? Atropine Explanation: Acyclovir is what type of drug? Antiviral The nurse is teaching the family of a client with a psychiatric disorder about traditional antipsychotic drugs and their effect on symptoms. Which symptom would be most responsive to these types of drugs? Delusions Explanation: Negative symptoms are more responsive to the new atypical antipsychotics, such as clozapine risperidone, and olanzapine. A nurse is reviewing the health care provider's orders for a client admitted with systemic lupus erythematosus (SLE). Which medication would the nurse expect to find in this client's plan of care? Hydroxychloroquine Explanation: Ketoconazole is what type of drug? Antifungal Dimenhydrinate is what type of drug? Antiemetic The nurse is preparing to administer vasopressin to a client who has undergone a hypophysectomy. What is the purpose of the medication? To replace antidiuretic hormone Explanation: Somatropin (growth hormone) is used to treat? Growth failure A nurse is about to give a client with type 2 diabetes mellitus her insulin before breakfast on her first day postpartum. Which client statement indicates an understanding of insulin requirements immediately postpartum? "I will need less insulin now than during my pregnancy." Explanation: A client with acute pulmonary edema has been taking an angiotensin-converting enzyme (ACE) inhibitor. The nurse explains that this medication has been ordered to: reduce blood pressure. Explanation: Negative inotropic agents are prescribed to? Decrease contractility Vasodilators are prescribed to? Increase cardiac output What is the most important assessment for the nurse to make when administering tamsulosin to a client with benign prostatic hyperplasia (BPH)? Voiding pattern
Explanation: A nurse is teaching a client who received a dose of Rho(D) immune globulin at 28 weeks' gestation to prevent Rh isoimmunization. Which statement most accurately describes isoimmunization? Rh-positive fetal blood crosses into maternal blood, stimulating maternal antibodies. Explanation: The alpha-adrenergic blocker tamsulosin relaxes the smooth muscle of the bladder neck and prostate, so the urinary voiding symptoms of BPH are reduced in many clients. These drugs do not affect the size of the prostate, renal function, or the production or metabolism of testosterone. reduce blood pressure. Explanation: The nurse understands that certain medications protect the ischemic myocardium by blocking catecholamines and sympathetic nerve stimulation. Which class of medications serve this function? Beta-adrenergic blockers Explanation: CCB are indicated for? reduce workload of heart by reducing contractility and vasodilation, lowering after load
Opioids reduce? myocardial oxygen demand, promote vasodilation & decrease anxiety Nitrates reduce? myocardial oxygen consumption by decreasing left ventricular end-diastolic pressure and systemic vascular resistance Which instruction should the nurse give to a client with prostatitis who is receiving double strength co-trimoxazole? Drink six to eight glasses of fluid daily while taking this medication Explanation: The nurse is providing information to a client who is taking chlorpromazine. What is the most important information for the nurse to provide? Schedule routine medication checks Explanation: The nurse is teaching the parents of a child with growth hormone deficiency how to administer growth hormone to their child. At what time should the nurse suggest administration of this medication? At bedtime Explanation: The nurse and occupational therapist are planning an outdoor volleyball game and picnic for eight mental health clients. What action should the nurse take for the two clients taking nortriptyline for depression? Provide protective clothing and apply sunscreen before going out Explanation: Tricyclic antidepressants (Pamelor) are administer at? Night. may cause drowsiness and can cause HTN A client, hospitalized for pulmonary embolism, is being discharged on warfarin therapy. The client asks the nurse to explain how warfarin works. What is the nurse's best response? It inhibits the formation of blood clots. Explanation: The home health nurse is speaking to the wife of a client with neurocognitive disorder due to Alzheimer's disease. The client has been taking donepezil. The nurse is most concerned when the caregiver states: "Yesterday, I managed to weigh my husband, and he has lost 8 lbs this month." Explanation: A client with suspected myasthenia gravis is to undergo a test with edrophonium. The client asks if edrophonium can be used to treat myasthenia gravis. What is the nurse's best response? The short half-life of edrophonium makes it impractical for long-term use Explanation: A client is prescribed a tricyclic antidepressant after other medications were ineffective. What outcome would indicate that this medication is effective? Helped prevent the re-experience of the trauma Explanation: A client with sickle cell disease is discussing his therapeutic regimen. Which statement by the client indicates further teaching is needed? "I should take one baby aspirin daily to help prevent sickle cell crisis." Explanation: Which nursing intervention would help to decrease the adverse effects of radiation therapy on the gastrointestinal tract? Encouraging fluids and a soft diet Radiation therapy can cause adverse effects such as nausea and vomiting, anorexia, mucosal ulceration, and diarrhea. What is the most important information for the nurse to include when teaching a client about metronidazol? Mixing this drug with alcohol causes severe nausea and vomiting. When mixed with alcohol, metronidazole causes a disulfiram-like effect involving nausea, vomiting, and other unpleasant symptoms. Urine may turn reddish brown, not greenish, from the drug. 31s "You may experience nausea and some dizziness." Common side effects of nifediine are feelings of dizziness, nausea and headache. A 12-year-old child sustains a moderate burn injury. The mother reports that the child last received a tetanus injection when he was five years old. Which immunization would the nurse anticipate an for this child? Tetanus prophylaxis is given to all clients with moderate to severe burn injuries if it has been longer than five years since the last immunization, or if there is no history of immunization. The correct dosage is 0.5 ml IM, one time, if the child was immunized within 10 years. If it has been more than 10 years, or the child hasn't received tetanus immunization, the dosage is 250 units of tetanus immune globulin, one time. The nurse has instructed a client on self-administration of heparin injections. The nurse determines that teaching is effective when the client makes which statement? "Heparin slows the time it takes for the blood to clot." Explanation: Heparin Hospital: IV or Subq Onset: rapid (minutes) Duration: brief (hours) Eliminated: renal Monitor: aPTT & aPTT Antidote: Protamine Slows clot time Warfarin/Coumadin Start when therapeutic Heparin is reached PO Onset: slow (hours) up to 3 days/therapeutic Duration: prolonged (days) Eliminated: hepatic Monitor: PT/INR Antidote: Vit K Prevents further clot formation Which instruction should the nurse give to a client with prostatitis who is receiving double strength co-trimoxazole? Drink six to eight glasses of fluid daily while taking this medication Explanation: A nurse is teaching a client with bipolar disorder about the drug carbamazepine. The nurse determines teaching was effective when the client states: I need to have my blood counts checked periodically." Explanation: The nurse is caring for a newborn with unrepaired transposition of the great vessels. Which medication should the nurse anticipate giving first for treatment of this defect? Prostaglandin E1 Explanation: 23s Heparin Explanation: A client was admitted to the hospital because of a transient ischemic attack (TIA) secondary to atrial fibrillation. The nurse anticipates that the provider will prescribe: warfarin. Atrial fibrillation may lead to the formation of mural thrombi, which may embolize to the brain. Warfarin will prevent further clot formation and prevent clot enlargement. The home health nurse is visiting a client newly diagnosed with type 1 diabetes mellitus. The client reports nausea and abdominal pain. The nurse observes dehydration and dry skin. What question should the nurse ask the client? "Are you taking your insulin daily?" The nurse should ask if the client is taking their insulin, as a common cause of DKA is missed insulin. Classic symptoms of diabetic ketoacidosis (DKA) include polyuria, weight loss, nausea and vomiting, altered mental status, abdominal pain, and Kussmaul's respirations. A nurse is teaching a client who has HIV about the adverse effects of aquinavir. What information is important to include? Thrombocytopenia Saquinavir is an antiretroviral-protease inhibitor used in combination with other antiretroviral medications to help manage HIV. Adverse effects include hyperglycemia, bone loss, hypersensitivity reaction, hyperlipidemia, thrombocytopenia, and leukopenia. Liquid oral iron supplements have been prescribed for a child. What is the most important information for the nurse to provide to this child's parents? Give the medicine via a dropper or through a straw Liquid iron preparations may temporarily stain the teeth. The drug should be given by dropper or through a straw. Iron supplements should be given between meals, when the presence of free hydrochloric acid is greatest. If vomiting occurs, supplementation should not be stopped, but it should be administered with food. Constipation can be decreased by increasing intake of fruits and vegetables. A client who had a myocardial infarction asks the nurse why he is receiving morphine. Which benefits of morphine should the nurse explain to this client? Sedation Morphine is administered because it decreases myocardial oxygen demand. Morphine will also decrease pain and anxiety while causing sedation. Vasodilation and urinary retention are associated with morphine administration. What is the classification of nifedipine?Nifedipine is in a class of medications called calcium-channel blockers. It lowers blood pressure by relaxing the blood vessels so the heart does not have to pump as hard. It controls chest pain by increasing the supply of blood and oxygen to the heart.
Where is the best site for the nurse to assess a client's pulse prior to administering digoxin?A nurse should assess the apical pulse for a full minute before administering digoxin due to its positive inotropic action (it increases contractility, stroke volume, and, thus, cardiac output), negative chronotropic action (it decreases heart rate), and negative dromotropic action (it decreases electrical conduction ...
Which medication will the nurse administer to a client who experienced a thrombotic stroke two days ago?tPA (tissue plasminogen activator)
It can stop a stroke by breaking up the blood clot. It must be given as soon as possible and within 4½ hours after stroke symptoms start.
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What is the most important information for the nurse to teach this client concerning nifedipine?
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