PN HESI PHARM

PN HESI PHARM A client with diabetes mellitus takes insulin daily and is prescribed propranolol (Inderal). Which information should the nurse provide to this client? A sign of hypoglycemia is that propranolol slows a rapid heart rate. 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) 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." 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." 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? Cigarette smoking history A mother brings her 3-month-old infant to the well-baby clinic because the baby has developed oral thrush. Which pharmacological agent should the practical nurse (PN) expect to be prescribed for the thrush? Nystatin (Mycostatin) 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? "I will take the antacid after meals and the Pepcid at bedtime." A mother brings her 18-month-old child to the clinic because the child has had "bad diarrhea" for the last 3 days. She states, "I bought some of this liquid at the pharmacy and gave my daughter a halfounce." The practical nurse (PN) sees that the bottle contains loperamide (Imodium AD). What intervention is most important for the PN to implement initially? Ask the mother when the child last voided. A client who received a prescription for cyclosporine ophthalmic emulsion (Restasis) for dry eyes asks the practical nurse (PN) if it is safe to continue using artificial tears. What information should the PN provide? Allow a 15-minute interval between the administration of Restasis and artificial tears. The health care provider prescribes morphine sulfate grain 1/8 IM stat. Morphine is available in 8 mg/mL. How many milliliters should the practical nurse (PN) administer? 1 mL Upgrade to remove ads Only $3.99/month 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 78-year-old client with congestive heart failure (CHF) receives the cardiac glycoside digoxin (Lanoxin) 0.25 mg PO daily. Which observation by the nurse indicates that the medication has been effective? Clear breath sounds bilaterally. The healthcare provider orders 1000 mL of 0.5% normal saline to run over 8 hours. The drop factor is 15 gtt/mL. The nurse plans to adjust the flow rate to how many gtt/min? (Round to the nearest whole number.) 31 A client asks the practical nurse (PN) if glipizide (Glucotrol) is an oral insulin. What answer should the PN provide? "No, it is not an oral insulin and can be used only when some beta cell function is present." 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 Drink a full glass of water with the medication and drink additional fluids throughout the day 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? Penicillins 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? Observe the client for changes in behavior weekly. 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. Which question should the practical nurse (PN) ask an older client before beginning treatment with gentamicin sulfate (Garamycin)? Are you hard of hearing?" 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? Avoid ingesting any alcoholic (ethanol) beverage. Upgrade to remove ads Only $3.99/month Which finding indicates that the desired effect of phenazopyridine (Pyridium), used in the management of urinary tract infections (UTIs), has been achieved? Client denies pain when voiding. The practical nurse (PN) is evaluating a client in the immediate postoperative period who is receiving morphine via a patient-controlled analgesia (PCA) pump. What finding should the PN consider the highest priority in this client? The rate and depth of the client's respirations The nurse prepares to administer ophthalmic drops to a client before cataract surgery. List the steps in the order they should be implemented from first step to final step. Wash hands and apply clean gloves. Place the dominant hand on the client's forehead. Drop prescribed number of drops into the conjunctival sac. Ask the client to close the eye gently. Which change in data indicates to the practical nurse (PN) that the desired effect of the angiotensin II receptor antagonist losartan (Cozaar) is achieved? Blood pressure reduced from 160/90 to 130/80 mmm Hg 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? Take one tablet at the onset of angina and stop activity. A 6-month-old infant with congestive heart failure (CHF) is receiving digoxin elixir. Which observation by the practical nurse (PN) warrants immediate intervention? Apical heart rate of 60 beats/min A 12-year-old boy is admitted from the emergency room with status epilepticus. His parents report that his seizure disorder has been managed with phenytoin (Dilantin) 50 mg PO bid for the past year. What drug should the practical nurse (PN) expect to be prescribed for administration in the event of another series of seizures? Diazepam (Valium) A nurse who is working in a men's health clinic is reviewing the medical records of several clients who have received prescriptions for sildenafil (Viagra). Which client history data should alert the nurse that close monitoring for adverse effects of Viagra is necessary Duodenal ulcer prophylaxis with cimetidine (Tagamet) A 78-year-old client with congestive heart failure is taking furosemide (Lasix) 40 mg PO twice daily. The nurse plans to monitor this client for development of which complication? Select all that apply. Muscle cramps Hypertension Lethagy Oliguria 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? Immediately before the next antibiotic dose is given Upgrade to remove ads Only $3.99/month A client diagnosed with essential hypertension asks the practical nurse (PN), "What type of decongestant should I take for this cold?" Which response is best for the PN to provide? "Contact your health care provider before taking anything." 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)? "I will take it at 8 PM every evening." 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? Hypokalemia 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? Do not take the medication if the heart beat is irregular or slow. 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? Guaiac-positive stool A 59-year-old client with heart failure is taking furosemide (Lasix) 40 mg twice daily. The practical nurse (PN) plans to monitor this client for development of which complication? Hypokalemia Alteration of which laboratory finding represents achievement of a therapeutic goal for heparin administration? Partial thromboplastin time Which instruction should the practical nurse (PN) reinforce when teaching a client who is receiving phenytoin (Dilantin) for seizure control? Brush and floss teeth daily. The practical nurse (PN) gives a client NPH insulin 15 units subcutaneously before breakfast (7:30 AM). At what time should the PN be particularly alert for signs or symptoms of a potential hypoglycemic reaction? 3:30 to 7:30 PM 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. Upgrade to remove ads Only $3.99/month The practical nurse (PN) administers two newly prescribed medications, isosorbide dinitrate (Isordil), a nitrate, and hydrochlorothiazide (HCTZ), a diuretic, to a client. Which follow-up observation is most important for the PN to perform? Monitor the client's blood pressure. Which outcome would indicate that the drug lactulose (Cephulac) has had a therapeutic effect? Two or three soft stools per day 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? Tachycardia and chest pain A client is receiving ampicillin sodium (Omnipen) for a sinus infection. The practical nurse (PN) should reinforce that the client notify the health care provider immediately if which symptom occurs? Rash Before administering an antiinfective agent to a client with a urinary tract infection, which nursing intervention is most important? Obtain a clean-catch urine specimen. A client who is receiving chemotherapy asks the practical nurse (PN), "Why is so much of my hair falling out each day?" Which response by the PN best explains the reason for alopecia? Chemotherapy affects the cells of the body that grow rapidly, both normal and malignant." A male client who is being discharged to his home accompanied by his wife asks the practical nurse (PN) to give him a dose of hydrocodone (Vicodin) before he leaves the hospital. How should the PN respond to this client's request? Ask him to describe the location and severity of the pain and to rate it on a scale from 1 to 10. 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 A client who has a dry, nonproductive cough and congested nasal passages reports that he usually drinks two or three beers nightly. The health care provider recommends the over-the-counter (OTC) expectorant guaifenesin (Robitussin). Which information should the practical nurse provide to this client? Notify the health care provider if the cough lasts more than 7 days. 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—low serum potassium level Upgrade to remove ads Only $3.99/month The practical nurse (PN) is implementing the plan of care for a client receiving the glucocorticoid methylprednisolone (Solu-Medrol). Which nursing diagnosis is related to this medication Risk for infection Which assessment finding requires nursing intervention before the administration of a prescribed dose of digoxin (Lanoxin) to an adult? Apical pulse rate of 50 beats/min The health care provider prescribes the anticonvulsant carbamazepine (Tegretol) for an adolescent client with a seizure disorder. The nurse should instruct the client to notify the health care provider if which condition occurs? Develops a sore throat When reinforcing teaching about childhood safety precautions to parents, the practical nurse (PN) should know that inducing vomiting is recommended for which child who may have ingested a possible poison? 16-month-old who drank 2 ounces of acetaminophen (Tylenol) elixir 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? Clarify the prescription with the RN and health care provider. 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 The nitrate isosorbide dinitrate (Isordil) has been prescribed for a client with angina. Which instruction should the practical nurse (PN) reinforce in this client's teaching? "Do not get up quickly. Always rise slowly." 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 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? Serum glucose A male client with diverticulitis requests medication for severe pain, but when the practical nurse (PN) arrives in his room to administer a narcotic analgesic, the client is talking and laughing with his visiting family. Which action should the PN implement? Administer analgesia indicated by the reported pain level. 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? Maintenance of a gastric pH of 3.5 or above 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 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 Which outcome would the nurse expect a client to have who is receiving cyclobenzaprine (Flexeril)? Improved range of motion during physical therapy exercises Phenazopyridine (Pyridium) is commonly prescribed for clients with urinary tract infections. What statement should the nurse include when teaching clients about the administration of phenazopyridine (Pyridium)? Take this medication with food to decrease gastric irritation. 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. The nurse is caring for a client who was newly prescribed NovoLog (Aspart) 7 units subcutaneously prior to each meal. Which nursing intervention has the highest priority when planning this client's care? Administer Novolog (Aspart) 15 minutes prior to the meal Daily doses of calcium citrate malate (Calcium) and vitamin D are prescribed for a 70-year-old female client. Which instruction should the nurse provide to this client regarding taking the prescribed medications? Divide the medication over the course of the day and take it in small doses 1 hour after meals and at bedtime. An 83-year-old female client is recovering from a myocardial infarction. The cardiologist prescribes docusate sodium and casanthranol (Peri-Colace) one tablet PO bid. What therapeutic effect does this medication provide for this client? Maintaining soft stools to prevent straining on defecation 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? The outflow of aqueous humor in the eyes is increased. Which assessment finding indicates that the expected outcome of administering donepezil (Aricept) to a client with Alzheimer's disease has been accomplished? Increased ability to solve simple problems A client with type 2 diabetes mellitus takes metformin (Glucophage) daily. The client is scheduled for major surgery requiring general anesthesia the next day. The practical nurse (PN) knows that the client's diabetes should be managed by which approach while the client is NPO during the perioperative period? Regular insulin subcutaneously per sliding scale 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? Administer a PRN dose of ondansetron (Zofran) IV.