VATI Pharmacology Pre-Assessment Exam 2024

A nurse is providing teaching to a client who has gout and a new prescription for allopurinol. Which of the following statements by the client indicates an understanding of the teaching? A. "If I get a rash from this medication, I will take my usual antihistamine." B. "I need to increase my fluid intake while taking this medication." C. "I should take this medicine on an empty stomach." D. "If I get a fever while taking this medication, I will take some aspirin." - B. "I need to increase my fluid intake while taking this medication." Clients who have gout should increase their fluid intake to 2 to 3L per day to prevent toxicity of allopurinol and decrease uric acid levels. A nurse is providing instructions to a client who has a new prescription for sublingual nitroglycerin to treat angina pectoris. Which of the following instructions should the nurse include? A. "Place the tablet under your tongue, and then take a small sip of water." B. "The medication can take up to 15 minutes to take effect." C. "Avoid taking the medication prior to exercising." D. "Stop taking the medication and notify your provider if you develop a headache." - A. "Place the tablet under your tongue, and then take a small sip of water." A client who takes a sublingual medication should place it under his tongue. A sip of water can help the medication dissolve. The nurse should tell the client that the medication takes effect rapidly in 1-3 min. The nurse should tell the client that the medication can be used to terminate an ongoing anginal attack as well as to prevent anginal pain prior to exertion. Therefore the client might need the medication prior to exercising. Headache is a common adverse effect of this medication that often dissipates with prolonged use. The client should continue to take the medication and take aspirin or acetaminophen for headache. A nurse is teaching a client who has a new prescription for phenytoin. The nurse should instruct the client to monitor for and report which of the following adverse effects of this medication? A. Metallic taste B. Diarrhea C. Skin rash D. Anxiety - C. Skin rash Phenytoin is an antiepileptic medication used to treat partial seizures and generalized tonic-clonic seizures. Phenytoin can cause a rash that can progress to Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). If a rash develops, the client should notify the provider immediately and stop the use of phenytoin. Adverse effects of clarithromycin include an altered taste. Phenytoin can cause gingival hyperplasia. Adverse effects of phenytoin include constipation. Adverse effects of phenytoin include suicidal tendencies and aggression. A nurse is caring for a client who has atrial fibrillation and receives digoxin daily. Before administering this medication, which of the following actions should the nurse take? A. Offer the client a light snack B. Measure the client's blood pressure C. Measure the client's apical pulse D. Weigh the client - C. Measure the client's apical pulse Digoxin decreases the heart rate, so the nurse should count the apical pulse for at least 1 min before administering. The nurse should hold the medication and notify the provider if the client's heart rate is below 60/min or if a change in heart rhythm is detected. A nurse is providing discharge teaching to a client who has a new prescription for lithium. Which of the following information should the nurse include in the teaching? A. Follow a low-sodium diet. B. Limit daily fluid intake. C. Obtain a daily weight. D. Avoid foods that have a high tyramine content. - C. Obtain a daily weight Clients who are taking lithium should monitor their daily weight due to the risk of fluid imbalance. Clients who are taking lithium should avoid a low-sodium diet due to the risk of hyponatremia. Clients who are taking lithium should drink plenty of fluids. Clients who are taking a monoamine oxidase inhibitor (MAOI), rather than lithium, should avoid foods that have a high tyramine content. A nurse is preparing to administer an intramuscular (IM) injection of meperidine to a client. Which of the following is the priority assessment the nurse should complete? A. Apical pulse rate B. Blood pressure C. Level of consciousness D. Respiratory rate - D. Respiratory rate Airway, breathing, and circulation are the priority focus of the nurse at this time. Meperidine can cause respiratory depression and the client's respiratory rate should be monitored prior to administering this medication. A nurse is caring for a client who has thromboplebitis and is receiving a continuous heparin infusion. Which of the following medications should the nurse have available to reverse heparin's effects? A. Vitamin K B. Protamine sulfate C. Acetylcysteine D. Deferasirox - B. Protamine sulfate Protamine sulfate reverses the effects of heparin by binding with heparin to form a heparin-protamine complex that has no anticoagulant properties. Vitamin K reverses the effects of warfarin, not heparin, by promoting the synthesis of coagulation factors VI, IX, X, and prothrombin. Acetylcysteine, a mucolytic, reduces the risk of hepatotoxicity after acetaminophen overdose. It does not reverse the effects of heparin toxicity. A chelating agent such as deferasirox binds to iron to reduce iron toxicity from supplemental iron therapy. It does not reverse the effects of heparin toxicity. A nurse is teaching a client about taking an expectorant to treat a cough. The nurse should explain that this type of medication has which of the following actions? A. Reduces inflammation B. Suppresses the urge to cough C. Dries mucous membranes D. Stimulates secretions - D. Stimulates secretions Expectorants act by increasing secretions to improve a cough's productivity. Glucocorticoids reduce inflammation. Antitussives suppress the cough stimulus. Anticholinergic medications dry mucous membranes and reduce secretions. A nurse is caring for a client who has HIV-1 infection and is prescribed zidovudine as part of antiretroviral therapy. The nurse should monitor the client for which of the following adverse effects of this medication? A. Cardiac dysrhythmia B. Metabolic alkalosis C. Renal failure D. Aplastic anemia - D. Aplastic anemia Severe myelosuppression that results in anemia (decreased red blood cells), agranulocytosis (decreased white blood cells), and thrombocytopenia (decreased platelets) is a life-threatening adverse reaction to zidovudine therapy. Consequently, zidovudine must be used cautiously in clients already experiencing myelosuppression, and the client must be monitored with a CBC performed every few weeks for early detection of marrow failure, which may lead to aplastic anemia. Zidovudine has no documented adverse effects on the heart. Lactic acidosis, not metabolic alkalosis, is an adverse effect of zidovudine. Zidovudine is not known as a nephrotoxic agent. A nurse is caring for a client who has a prescription for digoxin 0.25 mg PO daily. Available is digoxin 0.125 mg/tab. How many tablets should the nurse administer? - 2 tablets A nurse is caring for four clients. After administering morning medications, she realizes that the nifedipine prescribed for one client was inadvertently administered to another client. Which of the following actions should the nurse take first? A. Notify the client's provider. B. Check the client's vital signs. C. Fill out an occurrence form. D. Administer the medication to the correct client. - B. Check the client's vital signs. The first action the nurse should take using the nursing process is to assess the client. The nurse should know that the action of nifedipine is to lower blood pressure. Immediately upon realizing the error, the nurse should check the client's vital signs (especially the client's blood pressure) to ensure that the client is not hypotensive as a result. Only after ensuring that the client is safe and has stable vital signs should the nurse take other actions. A nurse on a medical unit is planning care for an older adult client who takes several medications. Which of the following prescribed medications places the client at risk for orthostatic hypotension? (Select all that apply.) A. Furosemide B. Telmisartan C. Duloxetine D. Clopidogrel E. Atorvastatin - A. Furosemide B. Telmisartan C. Duloxetine Furosemide is correct. This medication is used to reduce edema and hypertension, and an adverse effect is orthostatic hypotension. Telmisartan is correct. This medication is used to control hypertension, and an adverse effect is orthostatic hypotension. Duloxetine is correct. This medication is used to treat depression and anxiety disorder, and an adverse effect is orthostatic hypotension. A nurse is preparing to administer amipicillin and gentamicin sulfate via IV infusion. Which of the following resources should the nurse consult first regarding medication compatibility? A. Nurse manager B. Hospital pharmacist C. Health care proivder D. Medication sales representative - B. Hospital pharmacist The greatest risk to the client is injury form medication error; therefore, the nurse should consult the hospital pharmacist first. The pharmacist will have information about medications, including adverse effects, recommended dosages, and drug incompatibilities. A nurse is caring for a client who has a prescription for potassium chloride (KCl) 20 mEq PO daily. The nurse reviews the client's most recent laboratory results and finds the client's potassium level is 5.2 mEq/L. Which of the following actions should the nurse take? A. Give the ordered KCL as prescribed. B. Omit the KCL dose and document it was not given. C. Call the prescribing physician and inform her of the client's serum potassium level results. D. Call the lab to verify the client's results. - C. Call the prescribing physician and inform her of the client's serum potassium level results. As a potassium level of 5.2 mEq/L is above the expected reference range, the nurse should hold the medication and notify the provider of the client's serum potassium level. A nurse is assessing a client after administering IV vancomycin. Which of the following findings is the nurse's priority to report to the provider? A. Localized redness at the catheter insertion site. B. Client report of a headache C. Client report of tinnitus D. Audible inspiratory stridor - D. Audible inspiratory stridor When using the airway, breathing, circulation approach to client care the nurse determines the priority finding is inspiratory strider. The client is at risk for bronchospasms, hypotension and circulatory collapse due to anaphylaxis. The nurse should contact the rapid response team, discontinue the vancomycin, and administer epinephrine.