Vati Pharmacological and Parenteral Therapies Quiz Answers Elaborated further Correctly Fall 2022 (With Rationale)

 Vati Pharmacological and Parenteral Therapies Quiz Answers Elaborated further Correctly Fall 2022 (With Rationale) A client with a digoxin level of 2.4 ng/ml has a heart rate of 39. The health care provider prescribes atropine sulfate. Which of the following best describes the intended action of atropine for this client? a. To dry oral and tracheobronchial secretions. b. To reduce peristalsis and urinary bladder tone. c. To accelerate the heart rate by interfering with vagal impulses. d. To stimulate the SA node and sympathetic fibers to increase the rate. To accelerate the heart rate by interfering with vagal impulses. Atropine accelerates the heart rate by interfering with vagal impulses. It is given IVP at doses of 0.5mg to 1.0mg per dose; every 3 to 5 minutes; up to 2.0mg. Doses less than 0.5mg may cause a paradoxical slowing of the heart rate. When Atropine is given to a client with history of an MI it should be used with great caution; increasing the heart rate also increases myocardial oxygen consumption! A client is prescribed digoxin 1mg by mouth QID. The client states that the objects in his room have a yellowish tinge and he is nauseated. Select the most appropriate nursing action at this time. a. Administer the medication and observe the client for further nausea. b. Hold the medication and count the apical pulse before the next dose is to be given. c. Count the apical pulse; if it is regular and above 60, administer the drug as ordered. d. Hold the drug and call the health care provider. d. Hold the drug and call the health care provider. This client is showing signs of digitalis toxicity. The most appropriate action is to hold the drug and call the health care provider. Severe arrhythmia may develop if action is not taken. A client diagnosed with preterm labor has been prescribed nifedipine. The client asks the nurse why this particular medication has been prescribed. Which of the following statements by the nurse is correct? a. To promote development of your baby's lungs b. To decrease the intensity of your pain c. To relax your muscles of your uterus d. To lower your blood pressure b. To relax your muscles of your uterus The use of nifedipine for the treatment of preterm labor is an unlabeled use of the drug. Nifedipine, a calcium channel blocker, is more commonly used to treat high blood pressure and heart disease. Smooth muscle tissue, like the uterus, needs calcium to contract. Nifedipine blocks the passage of calcium into certain tissues, relaxing the uterine muscles and smooth muscles of blood vessels throughout the body. A client is admitted to the hospital with a diagnosis of diabetic ketoacidosis (DKA). An intravenous infusion of regular insulin has been started. Which of the following nursing interventions is most appropriate for this client? a. Add the prescribed dose of NPH insulin to the IV infusion b. Monitor blood glucose levels every 4 hours c. Obtain an arterial blood gas every 2 hours d. Ensure glucagon is readily available Ensure glucagon is readily available Regular insulin is the only insulin that may be given by the IV route. In addition if a dose of NPH is prescribed for the client in DKA who is receiving an infusion of regular insulin, the order should be verified with the health care provider as the client may experience a rapid drop in blood sugar during peak effect of the NPH. A nurse is evaluating a client's understanding of lithium. Which statement by the client indicates a need for further education? a. "I should have my blood level drawn as directed." b. "I will contact my provider if I develop diarrhea." c. "I will drink 8-12 glasses of water a day." d. "I should take the medication on an empty stomach." d. "I should take the medication on an empty stomach." Lithium should be taken with meals or milk to decrease gastric upset. A nurse is caring for a client taking captopril. Which finding would require immediate attention for this client? a. Sodium 133 b. Blood pressure 96/48 c. Potassium 5.8 d. Pulse 56 b. Potassium 5.8 A potassium of 5.8 is elevated- normal is 3.5-5. One effect of Capoten is elevation of potassium levels because this drug inhibits the formation of angiotensin II and blocks the release of aldosterone. The blocking of the aldosterone results in sodium excretion and potassium retention. Hyperkalemia can result in cardiac arrhythmias and if untreated lead to cardiac arrest. A nurse is caring for a client taking captopril who has started experiencing a frequent dry cough. What action should the nurse take? a. Encourage the client to continue taking the medication as prescribed. b. Encourage the client to use over the counter cough syrup for the cough. c. Notify the provider of the client's symptom. d. Instruct the client to decrease the dosage of the medication. c. notify the provider of the client's symptom An adverse effect of ACE inhibitors is a cough related to inhibition of kinase II which results in an increase in bradykinin. The provider should be notified if a dry cough occurs so that the medication can be discontinued. A nurse is caring for a client receiving total parenteral nutrition (TPN). Which of the following outcomes best demonstrates that TPN therapy is effective? a. The client reports less frequent bowel movements. b. The client maintains an albumin level of 5.0 g/100mL. c. The client gains one kilogram per day. d. The client's urinary output increases by 800 mL per day. The client maintains an albumin level of 5.0 g/100mL While receiving TPN therapy, the client should maintain normal bowel function. Constipation is not a desired client outcome for effective TPN therapy. A client with Type 1 diabetes has the following values from the morning laboratory testing: fasting plasma glucose = 115 mg/dL and HgA1C = 7.5%. How would a nurse interpret these values with regard to the client's glucose control? a. Short term values normal, long-term values elevated b. Short term values normal, long term values normal c. Short term values elevated, long term values elevated d. Short term values elevated, long-term values normal Short term values normal, long-term values elevated Fasting plasma glucose is normal. Normal fasting plasma glucose range for the diabetic client is 90-130 mg/dl. HgA1C level is elevated. HgA1C normal level range is less than 7% with the optimal range being 4-6% in the diabetic. HgA1C level indicates the client's glucose average over the last 120 day period and is considered to be the best indicator of long term glycemic control. A nurse is reviewing the morning laboratory results while preparing to administer a client their dose of digoxin. Which result would the nurse need to report to the primary care provider? a. Sodium level of 133 mEq/l b. Calcium level of 11mg/dl c. Digoxin level of 0.5 ng/ml d. Potassium level of 3.4 mEq/l Potassium level of 3.4 mEq/l Serum potassium is important to monitor for the client on digoxin. Hypokalemia can lead to digoxin toxicity while hyperkalemia can lead to a low therapeutic level. The normal range for potassium is 3.5-5.0 mEq/l. A nurse is monitoring client compliance with the diabetes mellitus treatment regimen. Which of the following values best indicates compliance with the regimen? a. Fasting blood glucose level of 127 mg/dL b. Hemoglobin A1c of 5% c. Pre-meal glucose of 140 mg/dL d. Blood glucose level of 125 mg/dL Hemoglobin A1c of 5% Glycosylated hemoglobin (HbA1c) is the best indicator of average blood glucose levels for the past 120 days. This test assists in evaluating treatment effectiveness and compliance. The target value is 4-6%. The value given is within the normal range. A nurse is caring for a client prescribed omeprazole. What information should the nurse provide to the client regarding administration of this medication? a. Take the medication after a meal twice daily. b. You may crush the medication for easier swallowing. c. Take the medication at bedtime. d. Take the medication in the morning before breakfast. Take the medication in the morning before breakfast Clients should take omeprazole once a day prior to eating in the morning. A client has an order for an IV of 1000 ml of lactated ringers with 20 mEq of potassium/L to infuse at 40 ml/hr. The drip factor is 15 drops/ml. The nurse calculates the flow rate to be: ______ gtt/min. a. 9 drops/min b. 10 drops/min c. 11 drops/min d. 12 drops/min 10 drops/ min A nurse is to administer nitroglycerin to a client for the treatment of angina. Which of the following should the nurse first advise the client? a. A headache may occur. b. Dizziness may occur. c. To sit or lie down. d. To rise slowly To sit or lie down