LPN PHARM

[COMPANY NAME] [Company address] LPN PHARM LPN PHARM A client is being treated for hyperthyridism with propylthiouracil (PTU). The LPN/LVN knows that the action of this drug is to: inhibit synthesis of T3 and T4 by the thyroid gland A female client with RA takes ibuprofen (motrin) 600mg PO 4xday. To preven GI bleeding, misoprostol (cytotec) 100mcg PO is prescribed. Which information is most important for the nurse to include in client teaching? use contraception during intercourse Dobutamine (Dobutrex) is an emergency drug most commonly prescribed for a client with which condition? Heart failure Which medications should the nurse caution the client about taking while receiving an opioid analgesic? Benzodiasepines Which client should the LPN/LVN identify as being at the highest risk for complications during the use of an opioid analgesic? A young adult with inflammatory bowel disease Which change in data indicates to the nurse the desired effect of the angiotensin II receptor antagonist valsartan (Diovan) has been achieved Blood pressure reduced from 160/90 to 130.80 A client with heart failure is prescribed spironolactone (Aldactone). Which information is most important for the LPN/LVN to provide to the client about diet modifications? Refrain for eating foods high in potassium The nurse is assessing the effectiveness of high dose aspirin therapy for an 88-year-old client with arthritis. The client reports that she can't hear the nurse's questions because her ears are ringing. What action should the nurse implement? Notify the healthcare provider of this finding immediately The healthcare provider prescribes naproxen (Naproxen) twice daily for a client with osteoarthritis of the hands. The client tells the nurse that the drug does not seem to be effective after three weeks. Which is the best response for the nurse to provide? Another type of nonsteroidal antiinflammatory drug may be indicated An older client with a decreased percentage of lean body mass is likely to receive a prescription that is adjusted based on which pharmacokinetic process? Distribution ) A peak and trough level must be drawn for a client receiving antibiotic therapy. What is the optimum time for the LPN/LVN to obtain the trough level? Immediately before the next antibiotic dose is given. A client with Parkinson's disease is taking carbidopa-levodopa (Sinemet). Which observation by the nurse should indicate that the desired outcome of the medication is being achieved? Lessening of tremors A client with congestive heart failure (CHF) is being discharged with a new prescription for the angiotensin-converting enzyme (ACE) inhibitor captopril (Capoten). The LPN/LVN discharge instruction should include reporting which problem to the healthcare provider? Dizziness A client is receiving metroprolol (Lopressor SR). What assessment is most important for the LPN/LVN to obtain? Blood pressure A client with coronary artery disease who is taking digoxin (Lanoxin) receives a new prescription for atorvastatin (Lipitor). Two weeks after initiation of the Lipitor prescription, the nurse assesses the client. Which finding requires the most immediate intervention? Vomiting Upon admission to the emergency center, an adult client with acute status asthmaticus is prescribed this series of medications. In which order should the nurse administer the prescribed medications? (Arrange from first to last.) Albuterol (Proventil) puffs Salmeterol (Serevent Diskus). Prednisone (Deltasone) orally Gentamicin (Garamycin) IM An antacid (maalox) is prescribed for a client with PUD. The LPN/ LVN knows that the purpose of this medication is to Maintain a gastric pH of 3.5 or above Which dosing schedule should the nurse teach the client to observe for a controlled-release oxycodone prescription? Every 12 hours In teaching a client who had a liver transplant about cyclosporine (Sandimmune), the nurse should encourage the client to report which adverse response to the healthcare provider? Presence of hand tremors. Which antidiarrheal agent should be used with caution in clients taking high dosages of aspirin for arthritis? Bismuth subsalicylate (Pepto Bismol). A client receiving albuterol (Proventil) tablets complains of nausea every evening with her 9 p.m. dose. What action should the LPN/LVN take to alleviate this side effect? Administer the dose with a snack A client is receiving digoxin for the onset of supraventricular tachycardia (SVT). Which laboratory findings should the LPN/LVN identify that places this client at risk? Hypokalemia. ) Following heparin treatment for a PE, a client is being discharged with a prescription for warfarin. In conducting discharge teaching, the nurse advises the client to have which diagnostic test monitored regularly? Prothrombin time (PT/INR) A 43-year-old female client is receiving thyroid replacement hormone following a thyroidectomy. What adverse effects associated with thyroid hormone toxicity should the nurse instruct the client to report promptly to the healthcare provider? Tachycardia and chest pain. Following the administration of sublingual nitroglycerin to a client experiencing an acute anginal attack, which assessment finding indicates to the LPN/LVN that the desired effect has been achieved? Client states chest pain is relieved An adult client is given a prescription for a scopolamine patch (Transderm Scop) to prevent motion sickness while on a cruise. Which information should the nurse provide to the client? Apply the patch at least 4 hours prior to departure. Which action is most important for the nurse to implement prior to the administration of the antiarrhythmic drug adenosine (Adenocard)? Apply continuous cardiac monitoring A client is receiving clonidine (catapres) 0.1mg/24hr via transdermal patch. Which assessment finding indicates that the desired effect of the medication has been achieved? Blood pressure has changed from 180/120 to 140/70 A client's dose of isosorbide dinitrate (Imdur) is increased from 40 mg to 60 mg PO daily. When the client reports the onset of a headache prior to the next scheduled dose, which action should the LPN/LVN implement? Administer the 60 mg dose of Imdur and a PRN dose of acetaminophen (Tylenol). A category X drug is prescribed for a young adult female client. Which instruction is most important for the LPN/LVN to teach this client? Use a reliable form of birth control. A healthcare provider prescrives cephalexin monhydrate (Keflex) for a client with a postoperative infection. It is most important for the LPN/ LVN to assess for what additional drug allergy before administering this prescription? Penicillins A client is admitted to the coronary care unit with a medical diagnosis of acute myocardial infarction. which medication prescription decreases both preload and afterload nitroglycerin Which instructions should the nurse give to a femail client who just recieved a prescription for oral metronidazole (flagyl) for treatment of trichomonas vaginalis (select all that apply) A. increase fluid intake, especially cranberry juice D. Avoid drinking alcohol while taking this medication E. Use condoms until treatment is completed F. Ensure that all sexual partners are treated at the same time A client is taking hydromorphone (Dilaudid) PO q4h at home. Following surgery, Dilaudid IV q4h PRN and butorphanol tartrate (Stadol) IV q4h PRN are prescribed for pain. The client received a dose of the Dilaudid IV four hours ago, and is again requesting pain medication. What intervention should the nurse implement? Administer only the Dilaudid q4h PRN for pain Which nursing diagnosis is important to include in the plan of care for a client recieving the angiotensin II receptor antagonist irbesartan (avapro)? Risk for injury A client is being treated for osteoporosis with alendronate (fosamax), and the nurse has completed discharge teaching regarding medication administration. Which morning schedule would indicated to the LPN/LVN that the client teaching has been effective? . take medication, go for a30 minutes morning walk, then eat breakfast A client is admitted to the hospital for diagnostic testing for possible myasthenia gravis. The nurse prepares for intravenous administration of edrophonium chloride (Tensilon). What is the expected outcome for this client following administration of this pharmacologic agent Decreased muscle weakness When assessing an adolescent who recently overdosed on acetaminophen (tylonel), it is most important for the nurse to assess for pain in which area of the body . abdomen The nurse is transcribing a new prescription for spironolactone (aldactone) for a client who receives an angiotensin-converting enzyme inhibitor. Which action should the nurse implement verify both prescriptions with the HCP A client who was prescribed atorvastatin (Lipitor) one month ago calls the triage nurse at the clinic complaining of muscle pain and weakness in his legs. Which statement reflects the correct drug-specific teaching the nurse should provide to this client? Make an appointment to see the healthcare provider, because muscle pain may be an indication of a serious side effect The nurse is reviewing the use of the patient-controlled analgesia (PCA) pump with a client in the immediate postoperative period. The client will receive morphine 1mg IV/hour basal rate with 1mg IV every 15minutes per PCA to toal 5mg IV max per hour. WHat assessment has the highest priority before initating the PCA pump? The rate and depth of the client's respirations Which nursing intervention is most important when caring for a client receiving the antimetabolite cytosine arabinoside (Arc-C) for chemotherapy? Inspect the client's oral mucosa for ulcerations A medication that is classified as a beta-1 agonist is most commonly prescribed for a client with which condition? Heart failure. The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with congestive heart failure. Which intervention should the nurse implement prior to adminstering the digoxin? assess the serum potassium level A client asks the nurse if glipizide (Glucotrol) is an oral insulin. Which response should the LPN/LVN provide? No it is not an oral insulin and can be used only when some beta cell function is present While taking a nursing history, the client states, "I am allergice to penicillin." what related allergy to another type of anti-infective agent should the nurse ask the client about when taking nursing history . Cephalosporins The nurse is assessing a client who is experiencing anaphylaxis from an insect sting. Which prescription should the nurse prepare to administer to this client Epinephrine A postoperative client has been recieving a continuous IV infusion of meperidine (demerol) 35mg/hr for four days. The client has a PRN prescription for Demorol 100mg PO Q3H. The nurse notes that the client has become increasingly restless, irritable and confused, stating that there are bugs all over the walls. What action should the nurse take FIRST? . Decrease the IV infusion rate of the demerol per protocol The nurse is preparing the 0900 dose of losartan (Cozaar), an angiotensin II receptor blocker (ARB), for a client with hypertension and heart failure. The nurse reviews the client's laboratory results and notes that the client's serum potassium level is 5.9 mEq/L. What action should the nurse take first? Withhold the scheduled dose. After abdominal surgery, a male client is prescribed low molecular weight heparin (LMWH). during administration of the medication, the client asks the nurse why he is receiving this medication. Which is the best response for the nurse to provide This medication is a blood thinner given to prevent blood clot formation A client is receiving ampicillin sodium (Omnipen) for a sinus infection. The LPN/LVN should instruct the client to notify the healthcare provider immediately if which symptom occurs? Rash. In evaluating the effects of lactulose (Cephulac), which outcome should indicate that the drug is performing as intended? Two or three soft stools per day. A client who has been taking levodopa PO TID to control the symptoms of Parkinsons disease has a new prescription for sustained release levodopa/carbidopa (sinemet 25/100 PO BID. The client took his levodopa at 0800. Which instruction should the nurse include in the teaching plan for this client? You can begin taking the sinemet this evening, but do not take anymore levodopa Which method of medication administration provides the client with the greatest first-pass effect? Oral A client with hyperlipidemia recieves a prescription for niacin (niaspan). which client teaching is most important for the nurse to provide expected duration of flushing