NURSING 201PHARMESAN 3V EXAM REVIEW FOR NCLEX Q& As BEST EXAM SOLUTION GUARANTEED SUCCESS 100% VERIFIED ANSWERS LATEST UPDATE 2023/2024 RATED A+ SCORE

A nurse is caring for a client who is taking phenytoin. For which of the following adverse effects should the nurse monitor and report to the provider? Tachycardia +. c. Elevated blood pressure d. Tinnitus Rationale: phenytoin (Dilantin, Phenytek) : Classification: antiarrhythmics, anticonvulsants. Pharmacologic: Hydantoins. Pregnancy category: D. Indications: treatment/prevention of tonic-clonic (grand mal) seizures and complex partial seizures via enhancing inhibitory effects of GABA and decreases neuron firing. Also used as an antiarrhythmic, particularly for ventricular arrhythmias associated with digoxin toxicity & prolonged QT interval. Adverse effects: CNS effects (nystagmus, sedation, ataxia, double vision, cognitive impairment) notify providers if these occur, Gingival hyperplasia (softening and overgrowth of gum tissue, tenderness, and bleeding gums; maintain good oral hygiene), Skin rash (stop med if this occurs), Cardiovascular effects (dysrhythmias, hypotension), Endocrine and other effects (coarsening of focal features, hirsutism, and interference with vitamin D metabolism), and Interfering with vitamin K-dependent clotting factors causing bleeding in newborns. • . A nurse is assessing a client who is receiving via continuous IV infusion for labor augmentation. The nurse notes six contractions in a 10-minute period with a nonreassuring FHR. Which of the following actions should the nurse take first? a. Administer Terbutaline 0.25 mg subcutaneously b. Discontinue the oxytocin IV infusion c. Turn the client on the left side d. Apply oxygen at 10 L / min via face mask Rationale: Pharmacology 7.0 Chapter 32 page 253: Oxytocin (Pitocin): hormone, oxytocics, pregnancy category X. Uterine stimulants increase the strength, frequency, and length of uterine contractions. (contractions lasting longer than 60 secs, and occurring more frequently than every 2 to 3 min, stop the infusion, and notify the provider. Practice question from RN Pharmacology Practice Questions A: the priority question is for the nurse to place the client in lateral position. . A nurse is administering Lactated Ringer solution at 100ml/hr. The drop factor of the manual IV tubing is 15 gtt/ml. The nurse should set the manual IV infusion to deliver how many drops per minute? Round the answer to the nearest whole number? mL/ min x drop factor (gtt/min) 1 hr. = 60 min 100 mL/60 min x 15 gtt/mL = 25 gtt/min • . A client who has active tuberculosis and is taking rifampin reports that this urine and sweat have developed a red orange tinge. Which of the following actions should the nurse take? page 376 Adverse effects: Hepatotoxic sxs (jaundice, anorexia, fatigue, nausea vomiting, Metabolizes, warfarin, HIV drugs. and PO contraceptives NI: give it 1 or 2 hours before or after meals. a. Prepare the client for dialysis - no need to, orange pee is expected b. Instruct the client to increase the fluid intake c. Check the client’s liver function tests results d. Document this as an expected finding - Rationale: Pharmacology 7.0 Chapter 47 page 376: Rifampin: Broad spectrum antibiotic for gram-positive and gram- negative bacteria. Is given in combination with at least one other antituberculosis medication to help prevent antibiotic resistance. Inform clients of expected orange color of urine, saliva, sweat & tears. Adverse effects: hepatotoxicity (jaundice, anorexia, and fatigue), mild GI discomfort, and pseudomembranous colitis. Contraindicated in clients who have liver dysfunction. . A nurse is teaching a client about self-administration of enoxaparin . Which of the following instructions should the nurse include? (Select all that apply)