PN PHARM

PN PHARM PN PHARM A client with Parkinson's disease is taking carbidopa-levodopa (Sinemet). Which observation by the nurse would indicate that the desired outcome of the medication is being achieved? Lessening of tremors A client is prescribed a peak and trough level test for the antibiotic vancomycin (Vancocin). What time should the specimen be collected to obtain the trough serum drug concentration? Trough levels are drawn when the blood level is at its lowest, which is typically just before the next dose is given A 67-year-old client is discharged from the hospital with a prescription for digoxin (Lanoxin) 0.25 mg daily. Which instruction should the practical nurse (PN) reinforce? Monitoring the pulse rate for 1 minute is very important when taking digoxin (Lanoxin). The client should be further instructed to report pulse rates lower than 60, greater than 110 beats/min, or irregular, and to withhold the dosage until consulting with the health care provider in such cases. Which instruction should the practical nurse (PN) reinforce when teaching a client who is receiving phenytoin (Dilantin) for seizure control? Brushing and flossing the teeth daily prevents gingival hyperplasia (gum disease) that is common with long-term phenytoin (Dilantin) The nurse reviews medications at discharge with a client who suffers from severe anxiety disorder. Which statement made by the client indicates an understanding of the medication phenobarbital (Luminal)? Phenobarbital (Luminal) should be taken at the same time every day to maintain blood levels and enhance compliance. Because of the sedative effects, it is best to take it before bedtime The H2 receptor blocker famotidine (Pepcid) is prescribed for a client who has been taking antacids for chronic gastritis. Which client statement indicates to the practical nurse (PN) that teaching was effective regarding concurrent use of these medications? When taken at the same time, antacids block the absorption of H2 receptor blockers A healthy 58-year-old client asks the practical nurse (PN) about taking the pneumococcal vaccine (Pneumovax). Which statement should the PN offer to the client that provides the most accurate information about this vaccine? The immunization is administered once to older adults or persons with a history of chronic illness. In planning care for a client diagnosed with bacterial pneumonia, which intervention should the practical nurse implement? Obtain the sputum specimen before administering prescribed antibiotics. Phenytoin (Dilantin) is prescribed for a client who has a seizure disorder. Which statement by the client indicates to the practical nurse that the instruction about this drug has been effective? "I know that I should never stop taking this medication abruptly." Abruptly discontinuing the medication can precipitate seizures. A female client who started taking an oral sulfonamide for a urinary tract infection the previous day reports to the nurse that the medication is causing slight anorexia. She also states that she continues to experience urinary frequency, so she takes the medication with a small sip of cranberry juice and limits her fluid intake. What information should the practical nurse provide? The PN should emphasize the need to take sulfonamides with a full glass of water and to increase fluid intake to prevent crystalluria. A 74-year-old female client asks the practical nurse (PN) if she should get a flu shot. Which response should the PN provide? "Yes. Normal aging decreases your immunity, making you more susceptible to contagious diseases such as the flu." A client with angina pectoris is instructed to take sublingual nitroglycerin tablets PRN for chest pain. Which information should the practical nurse (PN) reinforce with this client? Nitroglycerin tablets should be taken at the onset of angina, and the client should stop activity and rest A health care provider prescribes cefadroxil (Duricef) for a client with a postoperative infection. It is most important for the practical nurse (PN) to consider that a cross allergy is possible with what drug allergy? Cross allergies exist between penicillins and cephalosporins such as cefadroxil (Duricef), so checking for penicillin allergy is a wise precaution before administering this drug. 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? The nurse should be alert for symptoms related to hypokalemia in clients taking thiazide diuretics. Which outcome(s) should the practical nurse (PN) expect a client to have who is receiving pregabalin (Lyrica)? (Select all that apply.) A decrease in joint pain resulting from osteoarthritis Improved range of motion during physical therapy exercises Amitriptyline hydrochloride (Elavil) is prescribed for an adult female client who is clinically depressed. Five days after beginning the drug, the client is admitted to the hospital because of suicide ideation. She tells the practical nurse (PN) that the drug is not working because she is not feeling any better. Which explanation should the PN provide? "It takes 2 to 4 weeks for antidepressant medications to become effective." A first-day postoperative client vomits 30 minutes after receiving an IV dose of hydromorphone (Dilaudid). What initial intervention is best for the practical nurse (PN) to implement? Because the emesis appears to be directly related to the administration of the opiate analgesic, the first action should be to reduce the client's nausea Administer a PRN dose of ondansetron (Zofran) IV A 6-month-old infant with congestive heart failure (CHF) is receiving digoxin elixir. Which observation by the practical nurse (PN) warrants immediate intervention? heart rate of 60 beats/min (A) is much lower than normal for a 6-month-old and warrants immediate intervention. The normal heart rate for a 6-month-old is 80 to 150 beats/min when awake, and a rate of 70 beats/min while sleeping is considered within normal limits. Benztropine mesylate (Cogentin) and carbidopa-levodopa (Sinemet) 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 "Chew gum to relieve the dry mouth and move slowly when assuming a standing position to reduce the dizziness." A client receiving ephedrine (Ephedrine) nose drops PRN complains of wakefulness. What action should the nurse take to minimize the client's insomnia? Administer the dose a few hours before bedtime. Which finding indicates that the desired effect of phenazopyridine (Pyridium), used in the management of urinary tract infections (UTIs), has been achieved? Pyridium is a urinary analgesic that relieves the symptoms (C) of UTI but does not treat the underlying cause. Which assessment finding indicates that the expected outcome of administering donepezil (Aricept) to a client with Alzheimer's disease has been accomplished? Aricept is used to improve cognitive functioning in those diagnosed with Alzheimer's disease. Improvement in cognitive functioning is most clearly assessed when the client exhibits increased memory, attention, reasoning, and problem solving Upgrade to remove ads The practical nurse (PN) is obtaining the medical history of a female client starting a new prescription for conjugated estrogens (Premarin) 0.625 mg PO daily. Before taking the first dose of the medication, which information is most important for the PN to obtain from the client? Smoking cigarettes while on Premarin increases the client's risk for cardiovascular complications A client is receiving the antipsychotic medication haloperidol (Haldol). In evaluating the effectiveness of this medication, which action provides the practical nurse with the most reliable information? Changes in client behavior noted on a weekly basis provide the best evidence of the medication's effectiveness. A client has been diagnosed with open-angle glaucoma. The health care provider prescribes pilocarpine (Isopto Carpine) eye drops. What action of this drug makes it a useful treatment for the client's condition? Pilocarpine, a cholinergic agent, causes pupillary constriction (miosis), which facilitates outflow of aqueous humor, causing a decrease in intraocular pressure The health care provider has prescribed the low-molecular-weight heparin enoxaparin (Lovenox), 30 mg IVP bid for a client following hip replacement. Before administering the first dose, which intervention is most important for the practical nurse (PN) to implement? Lovenox is a low-molecular-weight heparin that can only be administered subcutaneously, so the PN should contact and ask the registered nurse (RN) to call the health care provider to clarify the route of administration Oral metronidazole (Flagyl) is prescribed for a client diagnosed with vaginal trichomoniasis, a protozoan infection. What precautions should the practical nurse (PN) instruct the client to follow while taking this medication? A disulfiram-like (Antabuse) reaction can occur if the client ingests ethanol (alcohol) while taking metronidazole (Flagyl). An antacid (Maalox) is prescribed for a client with peptic ulcer disease. What is the therapeutic action of this medication that is effective in treating the client's ulcer? The objective of antacids is to neutralize gastric acids and keep a pH of 3.5 or above 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. What complication is assessed through frequent laboratory testing, which the nurse should explain to this mother? Myelosuppression A client is receiving benztropine (Cogentin) and olanzapine (Seroquel) to control psychotic behavior. When reinforcing teaching to the client and/or significant others about these medications, what should the practical nurse (PN) explain about the use of benztropine (Cogentin)? The benztropine (Cogentin) is used to control extrapyramidal symptoms. The practical nurse (PN) is preparing to administer dalteparin (Fragmin) subcutaneously to an immobile client who has been receiving the medication for 5 days. Which finding indicates that the PN should hold the prescribed dose? Fragmin is a low-molecular-weight heparin (LMWH) anticoagulant used to prevent DVT in the at-risk client. If the client develops overt signs of bleeding such as guaiac-positive stool while receiving an anticoagulant, the medication should be held and coagulation studies completed. Alteration of which laboratory finding represents achievement of a therapeutic goal for heparin administration? Heparin therapy is guided by changes in the partial thromboplastin time (PTT) A client has a positive skin test for tuberculosis. What prophylactic drug should the practical nurse (PN) expect to be prescribed for this client? Isoniazid (INH) is highly specific for Mycobacterium tuberculosis and is the drug of choice for clients with positive PPD skin tests A client asks the practical nurse (PN) if glipizide (Glucotrol) is an oral insulin. What answer should the PN provide? Glipizide (Glucotrol) is an oral hypoglycemic agent that enhances pancreatic production of insulin When caring for a client on digoxin (Lanoxin) therapy, the practical nurse (PN) should be alert for digoxin (Lanoxin) toxicity. Which finding is likely to predispose this client to developing digoxin toxicity? Hypokalemia predisposes the client on digoxin to digoxin toxicity and is usually presented as abdominal pain, anorexia, nausea, vomiting, visual disturbances, bradycardia, and atrioventricular (AV) dissociation. A 43-year-old female client is receiving thyroid replacement hormone following a thyroidectomy. What adverse effects associated with thyroid hormone toxicity should the practical nurse (PN) reiterate to the client to report promptly to the health care provider? Thyroid replacement hormone increases the metabolic rate of all tissues, so common signs and symptoms of toxicity include tachycardia and chest pain A client is receiving clonidine (Catapres) 0.1 mg/24 hour via transdermal patch. Which assessment finding indicates that the desired effect of the medication is achieved? Blood pressure change from 180/120 to 140/70 mm Hg Catapres acts as a centrally acting analgesic and antihypertensive agent. (D) indicates a reduction in hypertension. A client is receiving methylprednisolone (Solu-Medrol) 40 mg IV daily. The practical nurse (PN) anticipates an increase in which laboratory value as the result of this medication? Solu-Medrol is a corticosteroid with glucocorticoid and mineralocorticoid actions. These effects can lead to hyperglycemia