PN VATI PHARMACOLOGY NURSING 100% A GRADE

PN VATI PHARMACOLOGY 100% A GRADE 1. A nurse is caring for a client who has bipolar disorder and new prescription for lithium, laboratory values should the nurse plan to monitor for potential adverse effect. Ans.: Serum Sodium. The nurse should monitor the sodium level while client is taking lithium. 2. A nurse is reinforcing teaching with a client who is prescribed disulfiram to treat alcohol use disorder. Which of the following information should the nurse include in the teaching? Answer: Avoid using aftershave or cologne while taking this medication. The nurse should identify that disulfiram causes a build up of acetaldehyde in the blood. Within 10 min. of consuming or touching alcohol., the client can experience manifestation such as nausea, tachycardia, flushing, hypotension, confusion, and weakness. The severity of the manifestation depends on the amount of alcohol present. Therefore, the nurse should instruct the client to avoid using alcohol-based products, such as aftershave. 3. A nurse is reinforcing teaching with a client who is starting phenytoin therapy to help manage a seizure disorder. Which of the following instructions should the nurse include? Answer: “Brush and floss your teeth after each meal. “Phenytoin cause gingival hyperplasia, an overgrowth of gum tissue. To minimize gum injury and discomfort the client should brush and floss after each meal, massage her gums, take folic acid supplement, and schedule dental examination regularly. 4. A nurse is collecting data for four clients prior to administering morning medication. Which of the following findings indicates the nurse should withhold the prescribed medication? Answer: Apical pulse of 48/ min for a client receiving metoprolol The heart rate is below expected range of 60 to 100/ min. Metoprolol is a selective beta blocker that will lower the heart rate further. The nurse should withhold the medication and contact the provider for a client who has a heart rate of less than 50 / min. 5. A nurse is preparing to administer vaccines to an adolescent during well child visit. The nurse should check for an allergy to eggs prior to administering which of the following vaccines? Answer: Inactivated Influenza Vaccine 6. A nurse is collecting data for a client who is scheduled to receive an initial dose of tobramycin. Which of the following findings should the nurse report to the provider? Answer: The clients creatine level is 2. 2 mg/dL The creatine level is above the expected range for adult of 0.5 to 1.3 mg/dL. Indicating impaired kidney function which increase the risk of nephrotoxicity Therefore the nurse should monitor the Creatine clearance, BUN, and. urinalysis results to prevent kidney injury. 7. A nurse is reinforcing teaching with a client who has a prescription for Rosuvastatin to treat high cholesterol levels. For which of the following adverse effects should the nurse instruct the client to monitor and report to the provider immediately? ANSWER: Muscle weakness When using urgent vs. nonurgent approach in client care, the nurse should determine that the priority finding to report is muscle weakness because it can be manifestation of rhabdomyolysis a rare but potentially fatal adverse effect of CoA reductase inhibitor therapy. 8. A nurse is client who has diabetes mellitus. The client received a dose of regular insulin prior to an episode of vomiting and now is unable to eat. For which of the following manifestation should the nurse monitor. Answer: Confusion A client who has hypoglycemia can become confused due to lack of glucose in the brain. 9. A nurse is reinforcing teaching with a client who has a new prescription for spironolactone. Which of the following information should the nurse include in the teaching? Answer: Avoid salts substitute containing potassium while taking this medication. Spironolactone is a potassium sparing diuretics. Eating foods that contain large amount of potassium or using salt substitute that contain potassium can increase the risk of developing HYPERKALEMIA. 10. A nurse is administering prescribed ear drops into an older adult client’s right ear. Which of the following actions should the nurse take? Answer: Initial drop holding the dropper 1 cm. above the ear canal. 11. A nurse is reviewing a young adult client’s medical history before administering the varicella vaccine, for which of the following findings in the client’s medical history should the nurse withhold the immunization and notify the provider. Answer: Allergy to Gelatin Having reaction to gelatin or neomycin is a contraindication for receiving varicella because it contains both substances. The nurse should also be extremely cautious when administering the measles, mumps, and rubella MMR vaccine to a client who is allergic to GELATIN. 12. A nurse is planning to reinforce teaching with a newly hired nurse about physiologic changes in older adult clients that can alter pharmacokinetics. Which of the following should the nurse include as an age- related change? Answer: Decrease kidney function An older adult client can experience decreased kidney function, which can lead to medication toxicity, therefore an older adult client might require a reduced dosage of medications to decrease the risk of adverse effect . 13. A nurse in the clinic is planning to administer an immunization to a client who just turned 60 years old. Which the following immunization should the nurse plan to administer Answer: Herpes Zoster vaccine The nurse should identify the client that at age 60 years or older should receive the herpes zoster immunization according to CDC GUIDELINES. The vaccine helps to prevent herpes zoster or shingles which is a serious viral disease that can cause severe pain and other serious complications. 14. The nurse is collecting data from a client who has a heart failure and is scheduled to receive a dose of digoxin. For which of the following findings should the nurse withhold the dose and notify the provider. Answer: Heart rate 50 / min. Prior going to digoxin, the nurse should monitor the client’s apical pulse for 1 min. If her heart rate is slower than 60/ min. or if the nurse notes any changes in the heart rhythm or quality of her palpitations. 15. A nurse is reinforcing discharge teaching with a client who has a new prescription for warfarin. The nurse should instruct the client that which of the following medications is contraindicated with warfarin therapy. Answer: Cimetidine Cimetidine can increase the anticoagulant effects of warfarin by inhibiting certain liver enzymes and is therefore contraindicated. 16. A nurse is reinforcing teaching with the client who has type 1 diabetes mellitus about the use of over- the-counter supplement. The nurse should include in the teaching that which of the following supplement can cause hypoglycemia. Answer: Ginger root. Ginger root can lower the blood glucose and increase the effect of insulin and other diabetic medications, the nurse should instruct the client to avoid the supplement. 17. A nurse is reinforcing teaching with a client who is starting to take amitriptyline. Which of the following client statements indicate understanding of teaching? Answer: I should take the medication at bedtime The nurse should instruct the client to take the medication at bedtime because it can cause drowsiness. The client should also avoid activities that require alertness until the effect of the medication are known. 18. A nurse is collecting data from a client who is taking prednisone for RA. Which of the following findings should the nurse identify as adverse effect of the medication? Select all that apply Answer: Weight gain, Susceptibility to infection, Gastrointestinal ulceration. Weight gain is common adverse effect of prednisone, secondary to fluid retention. The nurse should monitor a client who takes prednisone for peripheral edema and hypertension by checking daily weight as well as intake and output. The nurse should monitor the client for viral or bacterial infection while taking prednisone because prednisone is effective in preventing rejection in clients who have organ transplant. The nurse should monitor the client for upper and lower gastrointestinal discomfort and should administer prednisone with meals to prevent gastrointestinal irritation. 19. 350ml/60 x10 =58 20. A nurse is collecting data from a client who is receiving morphine to relieve postoperative pain. The client’s respiratory rate is 9/min. The nurse should notify the provider and expect a stat prescription for which of the following medication? Answer: Naloxone Morphine is opioid analgesic, naloxone is a opiate antagonist. reverses the effect of opioids 21. A nurse is reviewing the medical history of a client who requires ophthalmic medication to treat glaucoma. Which of the following factors in the client history is a contraindicated for using beta adrenergic blocking eye drops to treat this disorder?