Detailed Answer Key RN 46 C9 Pharmacology

1.A nurse is caring for a client who has active pulmonary tuberculosis (TB) and is to be started on intravenous rifampin therapy. The nurse should instruct the client that this medication can cause which of the following adverse effects? A. Constipation Rationale: Rifampin does not cause constipation. More common gastrointestinal effects are diarrhea and nausea. B. Black colored stools Rationale:It is most commonly iron supplements that cause stools to turn black, not rifampin. C. Staining of teeth Rationale: Teeth may be stained from taking liquid iron preparations, not from taking rifampin. D. Body secretions turning a red-orange color Rationale: Rifampin is used in combination with other medicines to treat TB. Rifampin will cause the urine, stool, saliva, sputum, sweat, and tears to turn reddish-orange to reddish-brown. 2.A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first? A. Check the client's vital signs. Rationale:It is possible that the client's nausea is secondary to digoxin toxicity. By obtaining vital signs, the nurse can assess for bradycardia, which is a symptom of digoxin toxicity. The nurse should withhold the medication and call the provider if the client's heart rate is less than 60 bpm. B. Request a dietitian consult. Rationale: While the dietitian might be able to assist the client with making appropriate food choices, this is not the first action the nurse should take. C. Suggest that the client rests before eating the meal. Rationale: While this intervention might be appropriate, this is not the first action the nurse should take. D. Request an order for an antiemetic. Rationale: While this intervention might relieve the client's nausea, this is not the first action the nurse should take. 3.A nurse is caring for a client who has difficulty swallowing medications and is prescribed enteric-coated aspirin PO once daily. The client asks if the medication can be crushed to make it easier to swallow. Which of the following responses should the nurse provide? Created on:08/29/2018 Page 1Detailed Answer Key RN 46 C9 Pharmacology A. "Crushing the medication might cause you to have a stomachache or indigestion." Rationale: The pill is enteric-coated to prevent breakdown in the stomach and decrease the possibility of GI distress. Crushing the pill destroys that protection. B. "Crushing the medication is a good idea, and I can mix it in some ice cream for you." Rationale: Crushing the pill will destroy the enteric coating, and the client should be advised against this. The client should be told not to break, crush, or chew enteric-coated tablets. C. "Crushing the medication would release all the medication at once, rather than over time." Rationale: Crushing the pill will destroy the enteric coating, and the client should be advised against this, but the enteric coating does not prevent the release of medication. Sustained release preparations disburse the medication over time. D. "Crushing is unsafe, as it destroys the ingredients in the medication." Rationale: Many medications can safely be crushed to make them easier to swallow. The client should check with his provider for information about which medications can be safely crushed. 4.A nurse is caring for four clients for whom she has to administer oral medications in the morning. The nurse should administer which of the following medications before breakfast? A. Alendronate Rationale: The client must take alendronate first thing in the morning on an empty stomach and wait at least 30 minutes before eating, drinking, or taking other medications. B. Digoxin Rationale: Digoxin treats hearts failure and dysrhythmias. While it is important that the client get the morning dose in a timely manner, the nurse does not have to administer it before a meal. C. Mycostatin mouthwash Rationale:Any mouthwash or rinse is most effective after a meal. D. Divalproex Rationale: Divalproex, an anticonvulsant, helps control seizures and treats the manic phase of bipolar disorder. The client should take the dose on time, but not necessarily before a meal. 5.A nurse is caring for a client who has bipolar disorder and has been taking lithium for 1 year. Before administering the medication, the nurse should check to see that which of the following tests have been completed? A. Thyroid hormone assay Rationale: Thyroid testing is important because long-term use of lithium may lead to thyroid dysfunction. B. Liver function tests Rationale: