Pharm CMS Practice Questions and Answers, CMS Practice Questions from ATI book Edition 8.0 Complete Solution

Pharm CMS Practice Questions and Answers, CMS Practice Questions from ATI book Edition 8.0 Complete Solution . A nurse educator is reviewing medication metabolism at an in-service presentation. Which of the following factors should the educator include as a reason to administer lower medication dosages? (select all that apply) A. increased renal excretion B. increased medication-metabolizing enzymes C. liver failure D. peripheral vascular disease E. concurrent use of medication the same pathway metabolizes Answer- C. Liver failure E. Concurrent use of medication the same pathway metabolizes A nurse is preparing to administer eye drops to a client. Which of the following actions should the nurse take? (select all that apply) A. Have the client lie on one side B. Ask the client to look up at the ceiling C. Tell the client to blink when the drops enter the eyes D. Drop the medication into the clients conjunctival sac E. Instruct the client to close the eye gently after instillation Answer- B. Ask the client to look up at the ceiling D. Drop the medication into the clients conjunctival sac E. Instruct the client to close the eye gently after instillation A nurse is teaching a client about transdermal patches. Which of the following statements should the nurse identify as an indication that the client understands? A. "I will clean the site with an alcohol swab before i apply the patch" B. "I will rotate the application sites weekly" C. "I will apply the patch to an area of skin with no hair" D. "I will place the new patch on the site of the old patch" Answer- C. "I will apply the patch to an area of skin with no hair" A nurse reviewing a client's medical record notes a new prescription for verifying the trough level of the client's medication. Which of the following actions should the nurse take? A. Obtain a blood specimen immediately prior to administering the next dose of medication. B. Verify that the client has been taking the medication for 24 hr before obtaining a blood specimen. C. Ask the client to provide a urine specimen after the next dose of medication. D. Administer the medication,and obtain a blood specimen 30 min late Answer- A. Obtain a blood specimen immediately prior to administering the next dose of medication. A nurse is preparing a client's medications. Which of the following actions should the nurse take in following legal practice guidelines? (Select all that apply) A. Teach the client about the med B. Determine the dosage C. Monitor for adverse effects D. Lock compartments for controlled substances E. Determine the clients insurance status Answer- A. Teach the client about the med C. Monitor for adverse effects D. Lock compartments for controlled substances The nurse is preparing to administer digoxin to a client who states, "I don't want to take that medication. I do not want one more pill." Which of the following responses should the nurse make? A. Your physician prescribes it for you, so you really should take it B. Well, lets just get it over quickly then C. Okay, ill just give you your other medications D. Tell me your concerns about taking this medication Answer- D. Tell me your concerns about taking this medication The nurse is reviewing a client's prescribed medications. Which of the following situations represents a contraindication to med administrations? A. The client drank grapefruit juice, which could reduce a medications effectiveness B. The medication has orthostatic hypotension as an adverse effect C. A medication is approved for ages 12 and older, and the client is 8 years old D. An antianxiety medication has an adverse effect of drowsiness is prescribed as a preoperative sedative Answer- C. A medication is approved for ages 12 and older, and the client is 8 years old The nurse is assessing a client before administering medications. Which of the following data should the nurse obtain? (select all the apply) A. Use of herbal products B. Daily fluid intake C. Ability to swallow D. Previous surgical history E. Allergies Answer- A. Use of herbal products C. Ability to swallow E. Allergies A nurse is working with a newly hired nurse who is administering medications to clients. Which of the following actions by the newly hired nurse indicates an understanding of medication error prevention. A. Taking all medications out of the unit- dose wrappers before entering the clients room B. Checking with the provider when a single dose requires administration of multiple tablets C. Administering a medication, then looking up the usual dosage range. D. Relying on another nurse to clarify a medication prescription. Answer- B. Checking with the provider when a single dose requires administration of multiple tablets A nurse is caring for a client experiencing IV extravasation. The facility requires the administration of an antidote for the prescribed IV solution. After stopping the IV infusion, which of the following actions should the nurse take first? A. Remove the IV catheter B. Withdraw the solution from the IV access C. Administer the antidote to the vesicant D. Insert a new IV access in a different extremity Answer- B. Withdraw the solution from the IV access A nurse is preparing to initiate IV therapy for an older adult client. Which of the following actions should the nurse plan to take?A. Use a disposable razor to remove excess hair on the extremity B. Select the back of the client's hand to insert the IV catheter C. Distend the veins by using a blood pressure cuff D. Direct the client to raise their arm above their heart Answer- C. Distend the veins by using a blood pressure cuff A nurse assessing the IV catheter insertion site for a client receiving a non vesicant solution and notes swelling at the site with decreased skin temperature. Which of the following actions should the nurse take? (select all that apply) A. Stop the infusion B. Start a new IV access distal to this site C. Apply warm compresses to the insertion site D. Elevate the client's arm E. Obtain a specimen for culture at the insertion site Answer- A. Stop the infusion C. Apply warm compresses to the insertion site D. Elevate the client's arm A nurse in a clinic is caring for a group of clients. The nurse should contact the provider about a potential contraindication to a medication for which of the following clients? SELECT ALL THAT APPLY. A. A client at 8 weeks of gestation who asks for an influenza immunization. B. A client who takes prednisone and has a possible fungal infection. C. A client who has chronic liver disease and reports he is taking hydrocodone. D. A client who has peptic ulcer disease and takes sucralfate and tells the nurse she has started taking over-the-counter aluminum hydroxide. E. A client who has a prosthetic heart valve who takes warfarin and reports a suspected pregnancy. Answer- B. A client who takes prednisone and has a possible fungal infection. C. A client who has chronic liver disease and reports he is taking hydrocodone. E. A client who has a prosthetic heart valve who takes warfarin and reports a suspected pregnancy. A nurse is preparing to administer an IM dose of penicillin to a client who has a new prescription. The client states she took penicillin 3 years ago and developed a rash. Which of the following is an appropriate nursing action? A. Administer the prescribed dose. B. Withhold the medication. C. Ask the provider to change the prescription to an oral form. D. Administer an oral antihistamine at the same time. Answer- B. Withhold the medication A nurse is providing discharge instructions for a client who has a new prescription for an antihypertensive medication. Which of the following is an appropriate statement by the nurse? A. "Be sure to limit your potassium intake while taking the medication. "B. "You should check your blood pressure every 8 hr while taking this medication. "C. "Your medication dosage will be increased if you develop tachycardia. "D. "Change positions slowly when you move from sitting to standing." Answer- D. "Change positions slowly when you move from sitting to standing." A nurse is reviewing a client's health record and notes that the client experiences permanent extrapyramidal effects caused by a previous medication. The nurse recognizes that the medication affected the client's: A. cardiovascular system. B. immune system. C. central nervous system. D. gastrointestinal system. Answer- C. central nervous system. A nurse is caring for a client who is taking oral oxycodone. The client states he is also taking ibuprofen in three recommended doses daily. The interaction between these two medications will cause which of the following? A. A decrease in serum levels of ibuprofen, possibly leading to a need for increased doses of the medication. B. A decrease in serum levels of oxycodone, possibly leading to a need for increased doses of this medication. C. An increase in the expected therapeutic effect of both medications. D. An increase in expected adverse effects for both medications. Answer- C. An increase in the expected therapeutic effect of both medications. A nurse is preparing to administer meds to a 4-month-old infant. Which of the following pharmacokinetic principles should the nurse consider when administering? (select all that apply) A) Infants have a more rapid gastric emptying time B) Infants have immature liver function C) Infants' blood-brain barrier is poorly developed D) Infants have an increased ability to absorb topical medications E) Infants have an increased number of protein binding sites Answer- B) Infants have immature liver function C) Infants' blood-brain barrier is poorly developed D) Infants have an increased ability to absorb topical medications A nurse in a provider's office is reviewing the medical record of a client who is pregnant and is at her first prenatal visit. Which of the following immunizations may the nurse administer safely to the client? A. Varicella vaccine B. Rubella vaccine C. Inactivated influenza vaccine D. Measles vaccine Answer- C. Inactivated influenza vaccine A nurse on a medical-surgical unit administers a hypnotic medication to an older adult client at 2100. The next morning, the client is drowsy and wants to sleep instead of eating breakfast. Which of the following factors should the nurse identify as a possible reason for the client's drowsiness? A. Reduced cardiac function B. First-pass effect C. Reduced hepatic function D. Increased gastric motility Answer- C. Reduced hepatic function A nurse working in an emergency department is caring for a client who has benzodiazepine toxicity due to an overdose. Which of the following actions is the nurses priority? A. administer flumazenil B. identify the clients level of orientation C. infuse IV fluids D. prepare the client for gastric lavage Answer- B. identify the clients level of orientation A nurse is teaching a client who has a new prescription for escitalopram for treatment of generalized anxiety disorder. Which of the following statements by the client indicates understanding of the teaching? A. I should take the medication on an empty stomach B. I will follow a low-sodium diet while taking this medication C. I need to discontinue this medication slowly D. I should not crush this medication before swallowing Answer- C. I need to discontinue this medication slowly A nurse is providing teaching to a client who has new prescription for buspirone to treat anxiety. Which of the following information should the nurse include? A. take the medication on an empty stomach B. Expect optimal therapeutic effects within 24 hr C. Take this medication when needed for anxiety D. This medication has a low risk for dependency Answer- D. This medication has a low risk for dependency A nurse is teaching a client who has obsessive-compulsive disorder and has a new prescription for paroxetine. Which of the following instructions should the nurse include? A. it can take several weeks before you feel like the medication is helping B. take the medication just before bedtime to promote sleep C. You should take the mediation when needed for obsessive urges D. Monitor for weight gain while taking this medication Answer- A. it can take several weeks before you feel like the medication is helping A nurse is caring for a client who takes paroxetine to treat post traumatic stress disorder and reports that he grinds his teeth during the night. The nurse should identify which of the following interventions to manage bruxism? (SATA) A. concurrent administration of buspirone B. Administration of different SSRI C. Use of mouth guard D. Changing to a different class of antidepressant medication E. increasing the dose of paroxetine Answer- A. concurrent administration of buspirone C. Use of mouth guard D. Changing to a different class of antidepressant medication A nurse is caring for a client who has a new prescription for phenelzine for the treatment for depression. Which of the following indicates that the client has developed an adverse effect of this medication? A. Orthostatic hypotension B. Hearing loss C. Gastrointestinal bleeding D. Weight loss Answer- A. Orthostatic Hypotension *Causes Blurry vision and Weight gain instead of Hearing loss and weight loss A nurse is providing teaching to a client who has a new prescription for amitriptyline for treatment of depression. Which of the following should the nurse include in the teaching? (SATA) A. expect therapeutic effects in 24 to 48 hr B. discontinue the medication after a week of improved mood C. change positions slowly to minimize dizziness D. Decrease dietary fiber intake to control diarrhea E. Chew sugarless gum to prevent dry mouth Answer- C. change positions slowly to minimize dizziness E. Chew sugarless gum to prevent dry mouth A nurse is providing discharge teaching to a client who has a new prescription for fluoxetine for post traumatic stress disorder. Which of the following statements should the nurse include in the teaching? A. You may have a decreased desire for intimacy while taking this medication B. you should take this medication at bedtime to help promote sleep C. you will have fewer urinary adverse effects if you urinate just before taking this medication D. you'll need to wear sunglasses when outdoors due to the light sensitivity caused by this medication Answer- A. You may have a decreased desire for intimacy while taking this medication A nurse is caring for a client who has depression and a new prescription for venlafaxine For which of the following adverse effects should the nurse monitor this client? (SATA). A. Cough B. Dizziness C. Decreased libido D. alopecia E. Hypotension Answer- A. Cough B. Dizziness C. Decreased Libido A nurse is caring for a client who has been taking sertraline for the past 2 days. Which of the following assessments findings should alert the nurse to the possibility that the client is developing serotonin syndrome? A. bruising B. Fever C. abdominal pain D. Rash B. Fever Answer- B. Fever A nurse is reviewing laboratory findings and notes that a clients plasma lithium is 2.1. Which of the following is an appropriate action by the nurse? A. perform immediate gastric lavage B. prepare the client for hemodialysis C. administer an additional oral dose of lithium D. request a stat repeat of the laboratory test Answer- A. perform immediate gastric lavage A nurse is caring for a client who has a new prescription for lithium carbonate. When teaching the client about ways to prevent lithium toxicity, the nurse should advise the client to do which of the following? A. avoid the use of acetaminophen for headaches B. restrict intake of foods rich in sodium C. decrease fluid intake to less than 1500 mL daily D. limit aerobic activity in hot water Answer- D. limit aerobic activity in hot water A nurse is caring for a client who has a new prescription for valproic acid the nurse should instruct the client that while taking this medication he will need to have which of the following laboratory tests completed periodically. SATA A. Thrombocyte count B. hematocrit C. Amylase D.Liver function tests E. potassium Answer- A. Thrombocyte count C. amylase D. liver function tests a nurse is assessing a client who takes lithium carbonate for the treatment of bipolar disorder. The nurse should recognize which of the following findings as a possible indication of toxicity to this medication? A. severe hypertension B. coarse tremors C. Constipation D. Muscle spasms Answer- B. coarse tremors A nurse is preparing a teaching plan for a female client who has bipolar disorder and a new prescription for carbamazepine. Which of the following instructions should the nurse include in the teaching? (SATA) A. this medication can safely be taken during pregnancy B. Eliminate grapefruit C. You will need to have a complete blood count and carbamazepine levels drawn periodically D. Notify your provider if you develop your rash E. Avoid driving for the first few days after starting this medication Answer- B. Eliminate grapefruit C. You will need to have a complete blood count and carbamazepine levels drawn periodically D. Notify your provider if you develop your rash E. Avoid driving for the first few days after starting this medication A nurse is teaching a client who has schizophrenia strategies to cope with anticholinergic effects of fluphenazine. Which of the following should the nurse suggest to the client to minimize anticholinergic effects? A. take the medication in the morning to prevent insomnia B. chew sugarless gum to moisten the mouth C. use cooling measures to decrease fever D. take an antacid to relieve nausea Answer- B. chew sugarless gum to moisten the mouth A nurse is assessing a male client who recently began taking haloperidol. Which of the following findings is the highest priority to report to the provider? A. shuffling gait B. neck spasms C. drowsiness D. impotence Answer- B. neck spasms A nurse is providing discharge teaching to a client who has a new prescription for clozapine. Which of the following statements should the nurse include in the teaching? A. you should have high carbohydrate snack between meals and at bedtime B. you are likely to develop hand tremors if you take this medication for long period of time C. you may experience temporary numbness of your mouth after each dose D. you should have your white blood cell count monitored every week Answer- D. you should have your white blood cell count monitored every week A nurse is providing teaching for a male client who has schizophrenia and is taking risperidone. Which of the following instructions should the nurse include in the teaching? A. add extra snacks to your diet to prevent weight loss B. notify the provider if you develop breast enlargement C. you may begin to have mild seizures while taking this medication D. tHis medication is likely to increase your libido Answer- B. notify the provider if you develop breast enlargement A nurse is preparing to perform a follow up assessment on a ancient who takes chlorpromazine for the treatment of schizophrenia. The nurse should expect to find the greatest improvement in which of the following manifestations? SATA A. disorganized B. bizarre behavior C. impaired social interactions D. hallucinations E. decreased motivation Answer- A. disorganized B. bizarre behavior D. hallucinations A nurse is teaching the parents of child who has a new prescription for desipramine. The nurse should instruct the parents that which of the following adverse effects is the priority to report to the provider? A. constipation B. Suicidal thoughts C. photophobia D. dry mouth Answer- B. Suicidal thoughts A nurse is teaching an adolescent client who has a new prescription for clomipramine for OCD. which of the following instructions should the nurse include to minimize an adverse effect of his medication? A. wear sunglasses when outdoors .B. check your temperature daily C. take this medication in the morning D. add extra calories to your diet Answer- A. wear sunglasses when outdoors a nurse is caring for a school-age child who has a new prescription for atomoxetine. The nurse should monitor the client for which of the following adverse effects of this medication? A. kidney toxicity B. liver damage C. seizure activity D. adrenal insufficiency Answer- B. liver damage A nurse is teaching the parents of a school age child about transdermal methylphenidate. Which of the following instructions should the nurse include? A. apply one patch twice per day. B. leave the patch on for 9 hr C. apply the patch to the child's waist D. use opened tray within 6 months Answer- B. leave the patch on for 9 hr A nurse is teaching a school age child and his parents about a new prescription for lisdexamfetamine. Which of the following information should the nurse include the teaching? SATA A. an adverse effect of this medication is CNS stimulation B. administer the medication before bedtime C. monitor blood pressure while taking this medication D. therapeutic effects of this medication will take 1 to 3 weeks to fully develop E. this medication raises the levels of dopamine in the brain Answer- A. an adverse effect of this medication is CNS stimulation C. monitor blood pressure while taking this medication E. this medication raises the levels of dopamine in the brain A nurse is providing teaching for a client who is withdrawing from alcohol and has a new prescription for propranolol. Which of the following information should the nurse include in the teaching? A. increases the risk for seizure activity B. Provides a form of aversion therapy C. Decreases Cravings D. Can increase blood pressure Answer- C. Decreases Cravings