CMSP Exam 186 Questions with Verified Answers,100% CORRECT

CMSP Exam 186 Questions with Verified Answers A nurse in a clinic receives a telephone call from a client who has tuberculosis and was prescribed rifampin 3 days ago. The client reports, "My saliva and tears are red. What should I do?" Which of the following responses by the nurse is appropriate? - CORRECT ANSWER This is an expected adverse effect of the medication A nurse is reinforcing teaching with a client who has multiple sclerosis and a new prescription for dantrolene. Which of the following statements indicates that the client understands the instructions? - CORRECT ANSWER I know that I'll have to get the blood tests to make sure my liver is okay. A nurse is caring for a client who has bipolar disorder and is receiving lithium carbonate. The nurse should plan to monitor which of the following laboratory values? - CORRECT ANSWER BUN A nurse is caring for a client who is immunosuppressed. The nurse should identify which of the following immunizations is contraindicated for this client? - CORRECT ANSWER Varicella A nurse is assisting with the care of a group of clients. For which of the following client situations should the nurse complete an incident report? - CORRECT ANSWER A client receiving packed RBCs through an 18-gauge IV catheter A nurse in a long-term care facility is collecting data from a client who has new prescription for glyburide. The client reports feeling anxious and having profuse sweating. Which of the following findings should the nurse expect? - CORRECT ANSWER Decreased blood glucose level A nurse is collecting data from a client who has schizophrenia and takes chlorpromazine. The nurse should monitor the client for which of the following findings as an adverse effect of this medication. - CORRECT ANSWER Tardive dyskinesia (adverse reaction) A nurse is caring for a client who has a history of an anaphylactic reaction to oxacillin. The provider prescribes amoxicillin (clavulanic acid) for the client. Which of the following actions should the nurse take? - CORRECT ANSWER Request a prescription for a different antibiotic A nurse is caring for a client who is requesting assistance with smoking cessation. Which of the following medications should the nurse plan to administer. - CORRECT ANSWER Bupropion (Bupropion hydrochloride) A nurse is preparing to administer medications to an infant. Which of the following identifiers should the nurse use in identifying the infant? (select all that apply ) - CORRECT ANSWER Medical identification number-Admitting the diagnosis of the infant-Guardian or parent-Date of birth A nurse is planning care for a client who has angina and a new prescription for nitroglycerin ointment. Which of the following actions should the nurse plan to take? - CORRECT ANSWER Cover the administration area with plastic wrap A nurse is collecting follow-up data from a client who has taken simvastatin for 3 months. Which of the following findings is the priority for the nurse to report - CORRECT ANSWER Muscle pain A nurse is caring for a client who is postoperative. For which of the following findings should the nurse administer ondansetron? - CORRECT ANSWER Clients report nausea A nurse is caring for a client who has a prescription for lisinopril 20 mg daily. Which of the following findings should indicate to the nurse that the medication is effective? - CORRECT ANSWER Blood pressure 118/60 mmHg A nurse is reinforcing teaching about the Ipledge program with a female client who has a new prescription for isotretinoin. The nurse should tell the client that which of the following is a requirement of the program? - CORRECT ANSWER Seuxally active female client must use two forms of birth control during treatment A nurse is collecting data from a client who has a history of alcohol use disorder. Which of the following findings indicate the client is experiencing alcohol withdrawal? - CORRECT ANSWER Tremor A nurse is checking the forearm of a client who received a tuberculin skin test 48 hr ago. Which of the following findings at the injection site should indicate to the nurse a positive result. Ulceration excoriation, bleeding, firmness - CORRECT ANSWER Excoriation A nurse is caring for a client who has a new prescription for penicillin G. For which of the following adverse effects should the nurse plan to monitor - CORRECT ANSWER Urticaria A nurse in a provider's office is collecting data from a client who continues to have migraine headache after taking sumatriptan orally 2 hr ago. Which of the following findings is the priority for the nurse to report? - CORRECT ANSWER Tingling sensation A nurse is assisting in the care of a client who is to receive a transfusion of packed RBCs. Which of the following actions should the nurse take? - CORRECT ANSWER Obtain 0.9 % sodium chloride solution for IV infusion A nurse is administering the first dose of ramipril to a client who has hypotension. The client reports feeling dizzy and lightheaded. Which of the following should the nurse administer? - CORRECT ANSWER Naloxone A nurse is contributing to the plan of care for a client who reports taking kava for the last 6 months. Which of the following laboratory values should the nurse expect to monitor? - CORRECT ANSWER Serum potassium A nurse in a mental health facility is collecting data from a client who is taking lithium. Which of the following findings should the nurse report to the provider as an indication of lithium toxicity? - CORRECT ANSWER Slurred speech A nurse is reinforcing teaching with a client who is to start therapy with insulin lispro and insulin glargine. Which of the following should the nurse include in the teaching? - CORRECT ANSWER Take insulin lispro right before a meal A charge nurse is evaluating a newly licensed nurse caring for a client who is using a PCA device. Which of the following actions by the nurse requires intervention by the charge nurse? - CORRECT ANSWER The nurse administers PCA dose for the client A nurse is collecting data from a client who has a new prescription for amoxicillin. Which of the following findings indicates that the client is having an allergic reaction to the medication - CORRECT ANSWER Wheezing A charge nurse working in a long-term care facility is reinforcing teaching about incident reporting with a group of newly licensed nurses. Which of the following situations requires the creation of an incident report? - CORRECT ANSWER A nurse cannot administer a medication because the medication is not available A nurse is collecting data from a client who has been taking diazepam several times per day but recently ran out of medication. Which of the following findings should nurse recognize as a manifestation of withdrawal from diazepam? - CORRECT ANSWER Tremors A nurse in a provider's office is collecting data from a client who has salicylism after taking an excessive amount of aspirin. Which of the following manifestations should the nurse expect? - CORRECT ANSWER Tinnitus A nurse is reinforcing teaching with a client who has a new prescription for enalapril. The nurse should determine that the teaching was effective when the client states she will report which of the following adverse effects to the provider? - CORRECT ANSWER Blurred Vision A nurse is preparing to administer a dose of digoxin to a client. Which of the following findings should indicate to the nurse to withhold the medication? - CORRECT ANSWER Heart rate 52/min A nurse is caring for a client who is receiving gemfibrozil. Which of the following laboratory values should the nurse plan to monitor? - CORRECT ANSWER Liver Enzymes A nurse is collecting the data from a client who has been taking carbamazepine. Which of the following is an adverse effect of carbamazepine and should be reported to the provider? - CORRECT ANSWER Sore throat A nurse is caring for a client who has hypertension and has been taking hydrochlorothiazide. Which of the following laboratory values should the nurse evaluate? - CORRECT ANSWER Serum electrolyte levels A nurse is reinforcing teaching with a client about the administration trimethoprim. Which of the following should the nurse include? - CORRECT ANSWER Do not eat for 1 hour after ingestion A nurse is preparing to administer erythromycin PO to a client who has an infection. The nurse checks the client's medical record and notes that the client has a severe allergy to penicillin. Which of the following actions should the nurse take? - CORRECT ANSWER Request a different medication from the provider A nurse is caring for a client who started taking amitriptyline 6 days ago. The client reports that the medication is not helping. Which of the following responses should the nurse make? - CORRECT ANSWER You will need to wait a couple of weeks to feel the therapeutic effect of the medication A nurse is collecting data from a client who has cancer and receiving morphine for pain control. Which of the following medications should the nurse administer to counteract an adverse effect of morphine? - CORRECT ANSWER Docusate sodium A nurse is reinforcing teaching with a newly licensed nurse about age-related changes that affect medication administration for older patients. - CORRECT ANSWER Renal excretion time slows for medication A nurse is caring for a client who has chronic hypertension. The client's morning vital sign include BP 148 over 80 mm Hg, heart rate 54 a min, and respiratory rate 18 amin. which of the following medications should the nurse plan to withhold? - CORRECT ANSWER Atenolol A nurse in a provider's office is reviewing the laboratory results of a client who is taking omeprazole for GERD and thiazide diuretic for hypertension. Which of the following laboratory findings should the nurse report to the provider? - CORRECT ANSWER Magnesium 1.0 mEq/L A nurse is caring for an older adult client who has heart failure and prescription for a repeat dose of furosemide 40 mg orally. Which of the following actions is the nurses' priority? - CORRECT ANSWER Record the client's urinary output A nurse is reinforcing a teaching with a parent of a child who is to receive the measles, mumps, and rubella (MMR) vaccine. The nurse should instruct the parent to monitor for which of the following adverse effects? - CORRECT ANSWER Vomiting and rashes A nurse is talking with a client who has been taking levothyroxine to treat hypothyroidism. The nurse should instruct the client to avoid taking which of the following over-the-counter medications within 4 hour of taking levothyroxine? - CORRECT ANSWER Oral antihistamines A nurse is preparing to administer acetaminophen 650 mg rectally. Which of the following actions should the nurse take? - CORRECT ANSWER Have the client lie on his left side for 5 min after insertion A nurse is reinforcing teaching with a client who has a new prescription for prednisone to treat rheumatoid arthritis. Which of the following statements should indicate to the nurse that the client understand the teaching - CORRECT ANSWER "I will report a sore throat to my provider" A nurse is caring for a client who has been taking epoetin alfa for 3 months. Which of the following laboratory tests should the nurse monitor to determine the effectiveness of the medication? - CORRECT ANSWER Hgb A nurse in an urgent care clinic is collecting the data from a client who reports itching for the past 5 days. Which of the following medications should the nurse expect the provider to prescribe? - CORRECT ANSWER Diphenhydramine A nurse is reviewing the medical record of a client who has a new prescription for celecoxib to treat osteoarthritis. Which of the following should the nurse recognize as a contraindication for medication? - CORRECT ANSWER Sulfonamide allergy A nurse is caring for an adolescent who has sickle cell anemia and is experiencing a vaso-occlusive crisis. Which of the following interventions is the nurse's priority? - CORRECT ANSWER Administer analgesics on a schedule A nurse administered ketorolac 30 mg IM to a client who is postoperative. Which of the following information should the nurse document? (Select all that apply) - CORRECT ANSWER Site of injection-Medication expiration date-Time of administration-Dose of medication administered A client has a new prescription for spironolactone (Aldactone). Which of the following laboratory values should the nurse recognize as a reason to withhold the morning dose of the medication and notify the provider? a. Serum sodium 138 mEq/L b. Serum potassium 5.2 mEq/L c. Serum creatinine 1.2 mEq/L d. Serum chloride 106 mEq/L - CORRECT ANSWER b. Serum potassium 5.2 mEq/L A nurse is caring for a client who is prescribed daily doses of both digoxin (Lanoxin) and furosemide (Lasix). The client's potassium level is 3.2 mEq/L. For which of the following medication interaction is the client at risk? a. Toxic levels of furosemide b. Toxic levels of digoxin c. Sub-therapeutic levels of furosemide d. Sub-therapeutic levels of digoxin - CORRECT ANSWER b. Toxic levels of digoxin Propranolol (Inderal) is contraindicated for a client who has which of the following conditions? a. Asthma b. Diabetes c. Angina d. Dementia - CORRECT ANSWER a. Asthma A nurse is reinforcing teaching for a client who has a prescription for verapamil (Calan). Which of the following statements by the clients indicates a need for further teaching? a. "I should increase the amount of fiber in my diet since the medication causes constipation." b. "I should eliminate grapefruit juice from my diet while taking verapamil." c. "I should decrease the amount of calcium in my diet while taking the medication." d. I should take the medication with food if it causes an upset stomach." - CORRECT ANSWER c. "I should decrease the amount of calcium in my diet while taking the medication." A nurse is caring for a client with prescription for nifedipine (Procardia) to treat angina pectoris. The nurse should plan to monitor the client for which of the following findings? a. Weight loss b. Reflex tachycardia c. Grand mal seizures d. Urinary Retention - CORRECT ANSWER b. Reflex tachycardia A nurse is caring for a client on a medical unit who takes regular doses of propranolol (Inderal) for hypertension. Before administering the client's morning dose of propranolol, which of the following should the nurse plan to monitor? (SATA) a. Urinary output b. Pulse rate c. Temperature d. Blood pressure e. Deep tendon reflexes - CORRECT ANSWER b. Pulse rate d. Blood pressure 7. A nurse is reinforcing teaching for a client who is prescribed digoxin (Lanoxin). Which of the following should the nurse instruct the client to report to the provider? (SATA) a. Fatigue b. Constipation c. Anorexia d. Rash e. Diplopia - CORRECT ANSWER a. Fatigue c. Anorexia e. Diplopia A nurse is caring for a client who is prescribed isosorbide mononitrate (Imdur) for chronic stable angina. The nurse should plan to monitor the client for which of the following findings? a. Bradycardia b. Fever c. Hypertension d. Headache - CORRECT ANSWER d. Headache A nurse is obtaining a medication history from a client who is to start a new prescription for warfarin (Coumadin). Which of the following over-the-counter medications should the nurse instruct the client to avoid? a. Ranitidine (Zantac) b. Docusate sodium (Colace) c. Acetaminophen d. Aspirin - CORRECT ANSWER d. Aspirin A nurse is caring for a client who has angina pectoris and is prescribed a nitroglycerin patch (Nitro-Dur) once daily. Which of the following are true regarding the administration of transdermal nitroglycerin? (SATA) a. Apply the patch at the same time each morning b. Leave the patch in place for 24 hr before replacing. c. Put patch on a hairless area of skin. d. Rotate the sites of administration with each application. e. Cut patches in half to allow for smaller doses of prescribed medication. - CORRECT ANSWER a. Apply the patch at the same time each morning c. Put patch on a hairless area of skin. e. Cut patches in half to allow for smaller doses of prescribed medication. After instilling an eye drop that has a systematic effect, the nurse should press on which of the following to prevent absorption into the circulation? a. The bony orbit b. The nasolacrimal duct c. The conjunctival sac d. The outer cantus of the eye - CORRECT ANSWER b. The nasolacrimal duct A nurse is caring for a client who has just been diagnosed with primary open-angle glaucoma (POAG) during a screening examination. Which of the following data collection finding should the nurse expect? a. Sudden loss of central vision b. Intraocular pressure 19 mm Hg c. No reports of pain d. Intact peripheral vision - CORRECT ANSWER c. No reports of pain A nurse is preparing to administer timolol (Timoptic) ophthalmic drops into the eye of a client who has glaucoma. For which of the following adverse effects should this client be monitored? a. Hypertension b. Bradycardia c. Seizures d. Jaundice - CORRECT ANSWER b. Bradycardia A nurse is caring for a client who has a prescription for tizanidine (Zanaflex) for relief of muscle spasm following a back injury. Which of the following lab values should the nurse expect to monitor while the client is taking this medication? a. Serum creatinine b. Liver enzymes c. WBC count d. RBC count - CORRECT ANSWER b. Liver enzymes A nurse is reinforcing teaching to a client with asthma about how to use cromolyn (Intal). Which of the following should the nurse include in the teaching? (Select all that apply) a. Take the medication 15 min before exercising. b. Follow a fixed-dosage schedule for long-term control of asthma. c. Expect to lose weight while taking the medication. d. Observe for adverse effects such as tremors, restlessness, and palpitations. e. Do not crush or chew tablets. - CORRECT ANSWER a. Take the medication 15 min before exercising. b. Follow a fixed-dosage schedule for long-term control of asthma. A nurse is reinforcing teaching for a client with a prescription for a beclomethasone (QVAR) inhaler to be used for the long-term management of asthma. Which of the following dietary supplements should the client be sure to consume in sufficient amounts to prevent a deficiency while taking the QVAR inhaler? a. Iron and Protein b. Calcium and Vitamin D c. Vitamin B¹² and folic acid d. Vitamin E and K - CORRECT ANSWER b. Calcium and Vitamin D A nurse is caring for a client who is prescribed oral prednisone (Deltasone) for the treatment of chronic asthma. The nurse should plan to monitor the client for which of the following findings? a. Weight loss b. Infection c. Hypoglycemia d. Angina Pain - CORRECT ANSWER b. Infection A nurse is caring for a client who states she has been taking phenylephrine (Neo-Synephrine) nasal drops for the past 10 days for her upper respiratory symptoms. The nurse should plan to monitor the client for which of the following findings? a. Sedation b. Nasal congestion c. Productive cough d. Constipation - CORRECT ANSWER b. Nasal congestion A nurse is caring for a preschool-age child who may have taken an overdose of diphenhydramine (Benadryl). To identify antihistamine toxicity, the nurse should plan to monitor the child for which of the following? a. Hallucinations b. Bradycardia c. Pinpoint pupils d. Pallor - CORRECT ANSWER a. Hallucinations A nurse is reinforcing teaching for a client who has hypertension and is prescribed hydrochlorothiazide (HydroDIURIL) twice daily. Which of the following instructions should the nurse include in the client's teaching? a. "You should avoid foods high in potassium." b. "Take the second dose of the day by early afternoon." c. "Watch for ankle swelling that may appear late in the evening." d. "Limit your daily fluid intake to 1½ L." - CORRECT ANSWER b. "Take the second dose of the day by early afternoon." A nurse is reinforcing teaching to a client who is prescribed lovastatin (Mevacor). Which of the following should be included in the teaching? a. Take the medication with the evening meal. b. Change position slowly when rising from a chair. c. Maintain a steady intake of green leafy vegetables. d. Consume no more than 1L of fluid/day. - CORRECT ANSWER a. Take the medication with the evening meal. A nurse is reinforcing teaching for a client who is to begin taking a new prescription for niacin (Niacor). The nurse should instruct the client to expect which of the following? a. Facial flushing b. Frontal headache c. Blurred vision d. Dry mouth - CORRECT ANSWER a. Facial flushing A nurse is caring for a client who takes a daily dose of warfarin (Coumadin). The client begins vomiting blood. Which of the following medications should the nurse prepare to give to reverse the effects of warfarin? a. Vitamin K b. Atropine sulfate c. Protamine sulfate d. Calcium gluconate - CORRECT ANSWER a. Vitamin K A nurse is caring for a client who has been taking a daily dose of warfarin for the past two weeks following an acute myocardial infarction. The client's most recent INR is 1 to 2. If the client has been taking the warfarin as prescribed, the nurse should expect which of the following changes to the client's prescription? a. The warfarin will be continued at the same dose. b. The warfarin will be discontinued. c. The warfarin dosage will be increased. d. The warfarin dosage will be decreased. - CORRECT ANSWER c. The warfarin dosage will be increased. When caring for a client taking aspirin to reduce the risk for a myocardial infarction, the nurse should monitor for which of the following adverse effects? (Select all that apply) a. Petechiae b. Hypertension c. Tinnitus d. Bruising e. Black stools - CORRECT ANSWER a. Petechiae d. Bruising e. Black stools Which of the following interventions should the nurse implement when preparing to administer filgrastim (Neupogen) for the first time to a client who has undergone a bone marrow transplant? a. Administer intramuscularly in a large muscle mass to prevent injury. b. Give orally with a meal or snack to prevent severe gastrointestinal upset. c. Shake vial gently to mix well before withdrawing dose. d. Discard vial after removing one dose of the medication. - CORRECT ANSWER d. Discard vial after removing one dose of the medication. A nurse is caring for a client who has been receiving epoetin alfa (Epogen) three times a week for several weeks. At a visit to the clinic, the client's Hgb has increased from 7 g/dL to 8.5 g/dL in the past week. Which of the following actions should the nurse expect to take regarding today's dose of epoetin alfa? a. To increase today's dose. b. To administer the ordered dose. c. To withhold today's dose. d. To discontinue the medication. - CORRECT ANSWER c. To withhold today's dose. A nurse is monitoring a client who is receiving sargramostim (Leukine) following a bone marrow transplant. For which of the following adverse reactions should the nurse monitor the client? a. Constipation b. Bone pain c. Insomnia d. Hair loss - CORRECT ANSWER b. Bone pain A nurse is reinforcing teaching for a client who has peptic ulcer disease on how to properly selfadminister ranitidine (Zantac). Which of the following client statements indicates effective teaching by the nurse? a. "I should call my doctor if my stools look black and sticky." b. "I will take ranitidine regularly until my burning symptoms disappear." c. "I need to take ranitidine on my empty stomach." d. "I can take ibuprofen if I have minor aches and pains." - CORRECT ANSWER a. "I should call my doctor if my stools look black and sticky." A nurse is reinforcing teaching for a client who is newly diagnosed with peptic ulcer disease and has prescription for several different medications. The nurse should recognize that which of the following medications is used as a mucosal protectant to promote healing of the ulcer? a. Bismuth (Pepto-Bismol) b. Sucralfate (Carafate) c. Ranitidine hydrochloride (Zantac) d. Metronidazole (Flagyl) - CORRECT ANSWER b. Sucralfate (Carafate) A nurse is reinforcing teaching for a client who is beginning a prescription of conjugated estrogens (Premarin) for symptoms of menopause. For which of the following should the nurse plan to monitor the client? a. Lower leg pain and swelling b. Shortened stature c. Vulvar and vaginal atrophy d. Weight loss - CORRECT ANSWER a. Lower leg pain and swelling A nurse is reinforcing teaching for a client who is about to begin a prescription for an oral contraceptive. The nurse should tell the client that the oral contraceptives work by doing which of the following? (SATA) a. Thickening the cervical mucus to slow sperm passage b. Inducing maturation of ovarian follicle c. Increasing development of the corpus luteum d. Altering the endometrial lining to prevent implantation e. Inhibiting ovulation - CORRECT ANSWER a. Thickening the cervical mucus to slow sperm passage d. Altering the endometrial lining to prevent implantation e. Inhibiting ovulation A nurse is caring for a male client who has a new prescription for testosterone cypionate (DepoTestosterone) IM every 2 to 4 weeks for hypogonadism. The nurse should plan to monitor which of the following laboratory values? a. Serum creatinine b. Cholesterol levels c. BUN d. Serum potassium - CORRECT ANSWER b. Cholesterol levels A nurse is reinforcing teaching for a client who takes sildenafil (Viagra) several times weekly and has a new prescription for oral erythromycin (E-Mycin) to treat a respiratory tract infection. The nurse should instruct the client about an increased risk for which of the following findings due to an interaction between the two medications? a. Priapism b. Urinary frequency c. Weight gain d. Insomnia - CORRECT ANSWER a. Priapism A nurse is reinforcing teaching for a female client who has a new prescription for hydroxychloroquine (Plaquenil) for rheumatoid arthritis. The nurse evaluates that the client understand the teaching when she states, "While taking hydroxychloroquine I should a. go to the dentist more frequently b. call my doctor if I develop blurred vision." c. have a Pap test twice a year." d. let my doctor know if my urine becomes darker." - CORRECT ANSWER b. call my doctor if I develop blurred vision." A client who has osteoporosis is started on alendronate (Fosamax). The nurse should instruct the client to do which of the following? (SATA) A. Take the medication in the morning after arising and before eating. B. Chew tablets to increase bioavailability. C. Drink 8oz of water with each tablet D. Take the medication with an antacid if heartburn occurs E. Avoid lying down after taking the medication - CORRECT ANSWER A. Take the medication in the morning after arising and before eating. C. Drink 8oz of water with each tablet E. Avoid lying down after taking the medication A nurse is caring for a client who has been prescribed calcitonin-salmon to treat osteoporosis. When evaluating the client's therapy, the nurse should recognize that which of the following serum calcium levels is within the expected range? a. 8.6 mg/dl b. 9.6 mg/dl c. 10.6 mg/dl d. 11.6 mg/dl - CORRECT ANSWER b. 9.6 mg/dl A nurse is caring for an older adult client who is taking large doses of aspirin four times daily for severe rheumatoid arthritis pain. For which of the following should the nurse monitor the client? a. Hepatotoxicity b. Renal impairment c. Reye's syndrome d. Ischemic stoke - CORRECT ANSWER b. Renal impairment A nurse is caring for a toddler who was just admitted for an acetaminophen overdose. Which of the following medications should the nurse anticipate being administered to this client? a. Acetylcysteine (Mucomyst) b. Pegfilgrastim (Neulasta) c. Misoprostol (Cytotec) d. Naltrexone (Re Via) - CORRECT ANSWER a. Acetylcysteine (Mucomyst) A nurse is caring for postoperative client who is prescribed ketorolac (Toradol) for pain management. The nurse should recognize that which of the following is true regarding the administration of ketorolac? a. Ketorolac is prescribed postoperatively to lower the dosage of opioids needed. b. Client's who take ketorolac avoid the adverse reactions of NSAIDS. c. Ketorolac is available as a timed-release transdermal patch. d. Client's maybe prescribed ketorolac for long-term relief of chronic pain, such as arthritis - CORRECT ANSWER a. Ketorolac is prescribed postoperatively to lower the dosage of opioids needed. A nurse is monitoring a client who received regular doses of meperidine (Demerol) for postoperative pain for 36 hr. For which of the following should the nurse monitor the client? a. Hypothermia b. Bradycardia c. Delirium d. Watery diarrhea - CORRECT ANSWER c. Delirium A nurse is caring for a client who has been receiving morphine for postoperative pain for the past few days. For which of the following should the nurse monitor the client? (Select all that apply) a. Dilated pupils b. Urinary retention c. Orthostatic hypotension d. Constipation e. Nausea - CORRECT ANSWER b. Urinary retention c. Orthostatic hypotension d. Constipation e. Nausea A nurse is caring for a client with severe pain whose prescription for morphine IV bolus has been changed to transdermal fentanyl (Duragesic). The nurse should understand which of the following information when administering a fentanyl transdermal patch? a. Apply a hot pack to the area containing the patch to enhance therapeutic effect. b. Administer a short-term opioid for pain for the first 24hr after patch application. c. Have the client replace the patch daily. d. Remove the patch for immediate relief of the respiratory depression and do not give any further treatment. - CORRECT ANSWER b. Administer a short-term opioid for pain for the first 24hr after patch application. A nurse is caring for a client who has back pain and has been prescribed nalbuphine (Nubain). The nurse should know that agonist-antagonist opioids, such as nalbuphine, differ from pure opioid agonists in that they... a. have a greater risk for abuse due to an increase in euphoria. b. cause a higher incidence of respiratory depression. c. may not be reversed with an opioid antagonist. d. may cause abstinence syndrome in clients physically dependent to opioids. - CORRECT ANSWER d. may cause abstinence syndrome in clients physically dependent to opioids. A nurse is caring for a hospitalized client who has cancer and has a variety of prescribed adjuvant medications which may be administered along with opioids for pain. When the client describes having "burning pain shooting down my leg." Which of the following adjuvants should the nurse administer? a. Etidronate (Didronel) b. Gabapentin (Neurontin) c. Methylphenidate (Ritalin) d. Hydroxyzine (Vistaril) - CORRECT ANSWER b. Gabapentin (Neurontin) A nurse is caring for a client who has cancer and is receiving opioids along with prednisone (Deltasone) daily for pain control. While the client is taking prednisone, the nurse should plan to monitor the client for which of the following findings? a. Hypoglycemia b. GI Bleeding c. Weight loss d. Asthma - CORRECT ANSWER b. GI Bleeding A nurse is caring for a client who has severe pain in his right foot. Which of the following laboratory values tell the nurse that the client is having a flare-up of gout? a. Increased serum creatinine b. Decreased creatinine kinase c. Decreased total protein d. Increased uric acid - CORRECT ANSWER d. Increased uric acid A nurse is caring for a client who has migraine headaches and is planning to ask her provider for a prescription for ergotamine is contraindicated for clients who have which of the following conditions? a. Seizure disorders b. Angle closure glaucoma c. Coronary artery disease d. Peptic ulcer disease - CORRECT ANSWER c. Coronary artery disease A nurse is reinforcing teaching to a client with migraine headaches who has a new prescription for sumatriptan (Imitrex). The nurse should plan to monitor the client for which of the following? a. Nausea and vomiting b. Pressure in the chest c. Fever and sore throat d. Bleeding and bruising - CORRECT ANSWER b. Pressure in the chest Match the time of NPH insulin (Humulin N) onset: a. Less than 15 min b. 30 min to 1 hr c. 1 to 2 hr d. 1 hr - CORRECT ANSWER c. 1 to 2 hr A nurse is caring for a group of clients who need insulin injections. The nurse should recognize that he can mix. Which of the following insulin in the same syringe with another insulin? (SATA) a. Insulin detemir (Levemir) b. Insulin lispro (Humalog) c. Insulin glargine (Lantus) d. Insulin aspart (Novolog) - CORRECT ANSWER b. Insulin lispro (Humalog) d. Insulin aspart (Novolog) A nurse is caring for a client who has type 2 diabetes mellitus and a prescription for rosiglitazone (Avandia). For which of the following findings should the nurse monitor the client? a. Edema b. Palpitations c. Seizures d. Urinary retention - CORRECT ANSWER a. Edema A nurse is reinforcing teaching for a client newly diagnosed who has type 2 diabetes mellitus. Which of the following should the nurse include the teaching? (SATA) a. Check blood glucose levels less frequently when feeling ill. b. Take an extra dose of the oral hypoglycemic agent the next day if a dose is missed. c. Carry a fast-acting glucose source at all times. d. Eat a snack prior to planned exercise. e. Inspect feet surfaces daily - CORRECT ANSWER c. Carry a fast-acting glucose source at all times. d. Eat a snack prior to planned exercise. e. Inspect feet surfaces daily A nurse is caring for a client who is taking levothyroxine (Synthroid). For which of the following should the nurse monitor to identify levothyroxine toxicity? a. Hair loss b. Lethargy c. Weight loss d. Cold intolerance - CORRECT ANSWER c. Weight loss A nurse is reinforcing teaching for a client with hyperthyroidism who has a new prescription for propranolol (Inderal). The nurse should teach the client that propranolol should perform which of the following actions? a. Increase blood flow to the thyroid gland b. Prevent thyroid hormone synthesis c. Suppress tachycardia d. Promote conversion of T4 to T3 - CORRECT ANSWER c. Suppress tachycardia A nurse is reinforcing teaching for a client who is prescribed strong iodide solution (Lugol's solution) prior to thyroid surgery. For which of the following adverse effects should the nurse monitor the client? a. Blurred vision b. Metallic taste c. Absence seizures d. Frontal headache - CORRECT ANSWER b. Metallic taste A client taking hydrocortisone for adrenocortical insufficiency (Addison's disease) is admitted to the hospital for a total hip arthroplasty. Which is the following actions is the highest priority? a. Administration of supplemental doses of hydrocortisone b. Instruction on coughing and deep breathing c. Insertion of an indwelling urinary catheter d. Requesting a referral for physical therapy - CORRECT ANSWER a. Administration of supplemental doses of hydrocortisone A nurse is preparing to administer scheduled immunizations to a 2-month-old infant. Which of the following instructions should the nurse give the parent before discharge? a. Treat discomfort with liquid ibuprofen for the first 24 hr following the vaccinations. b. Apply warm compresses to injection site comfort. c. Call the provider if the injection site becomes slightly reddened. d. Gently move the involved extremity to decrease discomfort. - CORRECT ANSWER d. Gently move the involved extremity to decrease discomfort. A nurse is caring for a client who has a suspected bacterial infection in her urine. Which of the following prescribed laboratory tests will identify which micro-organism is responsible for the injection? a. Gram stain b. Culture c. Sensitivity d. Specific gravity - CORRECT ANSWER b. Culture A nurse is caring for a client for urgent care clinic who has pneumonia. The client is prescribed ampicillin (Pricipen). Two days later the client calls the clinic and reports to the nurse that she is experiencing itchy rash. Which of the following actions should the nurse take first? a. Collect data about previous allergic reactions. b. Ask the client to describe her symptoms. c. Tell the client not to take the next dose of antibiotic. d. Have the client come to the clinic to see her provider. - CORRECT ANSWER b. Ask the client to describe her symptoms. A nurse is caring for a client who is receiving vancomycin (Vancocin) for a severe infection. For which of the following should the nurse monitor the client in order to collect data about a possible adverse reaction to vancomycin? a. Visual acuity b. Hearing ability c. Presence of ataxia d. Deep tendon reflexes - CORRECT ANSWER b. Hearing ability A nurse is reinforcing teaching for a client who has a urinary tract infection and a new prescription for Primaxin. Which of the following adverse reaction should the nurse instruct the client to watch for? a. Oral thrush b. Chest pain c. Rapid pulse d. Peripheral neuropathy - CORRECT ANSWER a. Oral thrush A nurse is reinforcing teaching to a client prescribed tetracycline (Sumycin) to treat a gastrointestinal infection. Which of the following statements by the client indicates a need for further teaching? a. "I will be sure to wear long sleeves when out in the sun." b. "I will take the medication with full glass of milk." c. "I will finish all the medicine even if I am feeling better." d. "I will take the medication first thing in the morning.' - CORRECT ANSWER b. "I will take the medication with full glass of milk." A nurse is caring for a client who will receive gentamicin (Garamycin) intermittent IV bolus at noon. The infusion will take 30 min. When should the nurse plan to have a peak level of gentamicin drawn by the laboratory? a. 12:30 pm b. 1:00 pm c. 2:30 pm d. 3:00 pm - CORRECT ANSWER b. 1:00 pm A nurse is caring for a client with prescription for erythromycin (E-Mycin) to treat a urethral infection. The client also takes daily prescriptions for furosemide (Lasix) and warfarin (Coumadin). For which of the following manifestations of a drug interaction should the nurse monitor the client? a. Bradycardia b. Urinary retention c. Bleeding d. Hypernatremia - CORRECT ANSWER c. Bleeding A nurse is caring for a client who receives amikacin (Amikin) by intermittent IV bolus for a severe infection. Which of the following laboratory values should the nurse recognize as an adverse effect of amikacin? a. Elevated serum creatinine b. Elevated triglycerides c. Decrease serum potassium d. Decrease hematocrit - CORRECT ANSWER a. Elevated serum creatinine A nurse is caring for a group of clients who each have urinary tract infections. The nurse should know that trimethroprim-sulfamethoxazole is contraindicated in clients who have had a hypersensitivity reaction to which of the following medications? a. Digoxin (Lanoxin) b. Chlorothiazide (Diuril) c. Ranitidine (Zantac) d. Rosiglitazone (Avandia) - CORRECT ANSWER b. Chlorothiazide (Diuril) A nurse is reinforcing teaching for a client with prescription for trimethoprim-sulfamethoxazole (Bactrim). Which of the following precautions should the nurse reinforce to the client in order to minimize an adverse effect of the medication? a. Avoid prolonged sun exposure. b. Slip water or suck hard candy frequently. c. Stop taking the medication if ringing in the ears occurs. d. Increase the amount of fiber and liquids in the diet. - CORRECT ANSWER a. Avoid prolonged sun exposure. A nurse is caring for a client who has diabetes mellitus and pulmonary tuberculosis. The client has a new prescription for isoniazid (INH). Which of the following supplements should the nurse expect to administer to prevent an adverse effect of isoniazid? a. Ascorbic acid b. Pyridoxine c. Folic acid d. Cyanocobalamin - CORRECT ANSWER b. Pyridoxine A nurse is caring for a client who has a prescription for oral ketoconazole (Nizoral), which he will be taking for several months to treat a systemic fungal infection. Which of the following should the nurse to monitor? a. BUN and serum creatinine levels b. Hemoglobin and hematocrit levels c. Liver function tests d. Thyroid function tests - CORRECT ANSWER c. Liver function tests A nurse is monitoring a client with latent tuberculosis who has been taking twice-weekly isoniazid (INH) for the past 3 months. For which of the following findings should the nurse monitor the client? a. Jaundice b. Renal impairment c. Hypotension d. Palpitations - CORRECT ANSWER a. Jaundice A nurse is reinforcing teaching to a client who has HIV-positive and has a new prescription for efavirenz (Sustiva), an NNRTI medication. Which 0f the following adverse effects should the nurse teach the client to watch for? a. A rash, which may begin within two weeks b. Orthostatic hypotension, which may occur following the first dose c. Hair loss, which may start after 2 to 3 days d. Ankle edema, which may occur after several months of therapy - CORRECT ANSWER a. A rash, which may begin within two weeks A nurse is preparing to administer medication for a client who is receiving intermittent enteral feedings through a gastrostomy tube. Which of the following actions should the nurse take? a. Crush extended release tablets b. Administer sublingual tablets under the tongue c. Flush with 10 mL of warm water when completed d. Add medications to enteral feeding - CORRECT ANSWER b. Administer sublingual tablets under the tongue A health care provider prescribes furosemide (Lasix) 40 mg PO now. The nurse should recognize this as which types of order? a. Single order b. Stat order c. Routine order d. Standing order - CORRECT ANSWER b. Stat order A nurse is preparing to administer a client's morning insulin dosage. Which of the following actions should the nurse take first? a. Review the client's blood glucose level b. Verify the client's identity c. Ask another nurse to check the amount of insulin drawn into the syringe. d. Wash the injection site with soap and water - CORRECT ANSWER a. Review the client's blood glucose level A nurse is preparing to insert a miconazole vaginal suppository for a client who has vulvovaginal candidiasis. Which of the following actions is appropriate for inserting this medication? - CORRECT ANSWER Insert the suppository a long the wall of vaginal canal A nurse is preparing to administer a client's daily dose of alendronate. Which of the following actions should the nurse plan to take? - CORRECT ANSWER Keep the client upright for 30 min after administration. A nurse is reinforcing teaching about the iPLEDGE program with a female client who has a new prescription for isotretinoin. The nurse should tell the client that which of the following is à requirement of the program? - CORRECT ANSWER Sexually active female clients must use two forms of birth control during treatment. A nurse is collecting data from a client who reports nausea and has vomited clear emesis. Which of the following medications should the nurse administer? - CORRECT ANSWER Promethazine A nurse is collecting data on a client prior to administering digoxin. For which of the following findings should the nurse withhold the medication? - CORRECT ANSWER Apical pulse 52/min A nurse is collecting data from a client who has been taking diazepam several times per day but recently ran out of the medication. Which of the following findings should the nurse recognize as a manifestation of withdrawal from diazepam? - CORRECT ANSWER Tremors A nurse is collecting data from a client who is taking chlorpromazine. Which of the following is the highest priority finding? - CORRECT ANSWER Sedation A nurse is monitoring a client following the administration of an oral glucose solution for the treatment of hypoglycemia. Which of the following findings indicates that the client is continuing to experience hypoglycemia? - CORRECT ANSWER Diaphoresis A nurse is reinforcing teaching with the family of a client who is to start therapy with risperidone. Which of the following therapeutic effects should the nurse instruct the family to expect? - CORRECT ANSWER Improved social interaction A nurse is preparing to administer phenobarbital 3 mg/kg/day PO in two divided doses to a client who weighs 145 lb. The amount available is phenobarbital 100 mg/tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) - CORRECT ANSWER 1 tablets A nurse is administering regular insulin 10 units and NPH insulin 15 units in one syringe to a client. Which of the following actions should the nurse take? - CORRECT ANSWER Draw the regular insulin into the syringe first. A nurse administered a dose of almotriptan to a client 30 min ago. Which of the following statements by the client indicates the medication is effective? - CORRECT ANSWER "My headache pain has decreased A nurse is collecting data from a client who received diphenhydramine for insomnia. Which of the following findings should the nurse identify as an idiosyncratic reaction? - CORRECT ANSWER Dizziness A nurse is reinforcing teaching with a newly licensed nurse about age-related changes that affect medication administration for older adult clients. Which of the following information should the nurse include? - CORRECT ANSWER Renal excretion time slows for medication. A nurse is caring for a client who has chronic hypertension. The client's morning vital signs include BP 140/80 mm Hg, heart rate 54/min, and respiratory rate 18/min. Which of the following medications should the nurse plan to withhold? - CORRECT ANSWER Atenolol A nurse is caring for a client who is receiving ampicillin via intermittent IV bolus. The client begins wheezing. Which of the following actions should the nurse take first? - CORRECT ANSWER Discontinue the medication. A nurse is caring for a client who started taking amitriptyline 6 days ago. The client reports that the medication is not helping. Which of the following responses should the nurse make? - CORRECT ANSWER "You will need to wait a couple of weeks to feel the therapeutic effect of the medication.' A nurse is caring for a client who is receiving a continuous IV of heparin. For which of the following adverse effects should the nurse monitor? - CORRECT ANSWER Ecchymosis A nurse is collecting data from a client who has taken an overdose of oxycodone. Which of the following findings should the nurse expect? - CORRECT ANSWER Sedation A nurse is reinforcing teaching with a client who had a recent myocardial infarction and has a new prescription for low-dose aspirin therapy. Which of the following instructions should the nurse include? - CORRECT ANSWER Ibuprofen can decrease the effectiveness of this medication A nurse is caring for a client who is receiving heparin therapy. If the client requires a reversal of the effects of heparin, which of the following medications should the nurse expect the provider to prescribe? - CORRECT ANSWER Protamine A nurse is assisting in the care of a client who is receiving morphine via a continuous epidural infusion. Which of the following findings should the nurse report to the provider immediately? - CORRECT ANSWER Respiratory rate 10/min A nurse is preparing to administer medications to a client through an enteral feeding tube. Which of the following actions should the nurse take? - CORRECT ANSWER Pinch the tube while connecting the syringe to it. A nurse is preparing to administer an IM injection to a client who has gonorrhea. Which of the following actions should the nurse take? - CORRECT ANSWER Use the Z track technique to administer the medication A nurse is preparing to administer the hepatitis B vaccine IM to a 2-month-old infant. Which of the following actions should the nurse take? - CORRECT ANSWER Administer the vaccine in the vasts lateralis. A nurse is reinforcing teaching with a client who has a new prescription for prednisone to treat rheumatoid arthritis. Which of the following statements should indicate to the nurse that the client understands the teaching? - CORRECT ANSWER will report a sore throat to my provider." A nurse is reinforcing teaching about the rights of medication administration to a newly licensed nurse. The nurse should include which of the following as rights of medication administration? (Select all that apply.) - CORRECT ANSWER Right medication Right time Right dose A nurse is preparing to administer an antibiotic via intermittent IV bolus for a client who has a continuous IV infusion. Which of the following steps should the nurse take first? - CORRECT ANSWER Check the IV site for signs of infiltration. A nurse is reinforcing teaching with a client who has a prescription for omeprazole. Which of the following instructions should the nurse include in the teaching? - CORRECT ANSWER "Notify your provider if you develop diarrhea. A nurse is reviewing the medical record of a client who has a new prescription for celecoxib to treat osteoarthritis. Which of the following should the nurse recognize as a contraindication for this medication? - CORRECT ANSWER Sulfonamide allergy A nurse is preparing to administer an insulin injection for a client. Which of the following actions should the nurse take? - CORRECT ANSWER insert the needle into the right thigh at a 90* angle A nurse is caring for a client who has a prescription for morphine 4 mg IM stat. The medication is dispensed in a 5 mg/mL prefilled syringe. Which of the following actions should the nurse take? - CORRECT ANSWER Discard the excess medication with a second nurse as a witness. A nurse working in an urgent care clinic is collecting data from a client who takes montelukast. Which of the following is an expected therapeutic effect of this medication? - CORRECT ANSWER -Reduce bronchial inflammation A nurse is reinforcing teaching with a client who has a new prescription for furosemide. Which of the following should the nurse include as an adverse effect of the medication that the client should report to the provider? - CORRECT ANSWER Leg cramps A nurse is caring for a client who has a new diagnosis of schizophrenia. Which of the following medications should the nurse expect to administer? - CORRECT ANSWER Risperidone A nurse is reinforcing discharge teaching with a client who has a new diagnosis of type 2 diabetes mellitus and a prescription for exenatide. Which of the following instructions should the nurse include in the teaching? - CORRECT ANSWER "Inject the medication into the subcutaneous tissue of your abdomen." A nurse is reviewing the laboratory values of a client who is taking atorvastatin. The nurse should identify that a change in which of the following laboratory values indicates an adverse effect of the medication? - CORRECT ANSWER Creatine kinase A nurse is reinforcing teaching about the varicella vaccine with the guardian of a toddler. Which of the following statements should the nurse include in the teaching? - CORRECT ANSWER "The vaccine should be avoided in children who have leukemia." A nurse is preparing to mix PH insulin and regular insulin for administration. Which of the following actions should the nurse take? - CORRECT ANSWER Inject air into each vial. A nurse is monitoring a client who recently began taking lisinopril for hypertension. The nurse should identify that which of the following findings is an adverse effect of the medication to report to the provider? - CORRECT ANSWER Persistent cough A nurse is caring for a client who has cystic fibrosis. The client is taking pancrelipase and has a new onset of steatorrhea, Which of the following statements should the nurse make? - CORRECT ANSWER -You should take this medication with food A nurse is reinforcing teaching with a client who has a prescription for timolol ophthalmic solution to treat glaucoma. Which of the following statements by the client indicates an understanding of the teaching? - CORRECT ANSWER "I will apply pressure to the side of my nose after instilling the medication.' A nurse is caring for a client who has a prescription for cephalexin 1 g PO daily to be given in divided doses every 6 hr. Available is cephalexin 250 mg tablets. How many tablets should the nurse administer with each dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) - CORRECT ANSWER 4 tablets A nurse is caring for a client who is postoperative following arthroscopy and reports a pain level of 6 on a scale of O to 10 after receiving ketorolac 1 hr ago. Which of the following actions should the nurse take? - CORRECT ANSWER -tell the client they can have another dose of ketorolac in 3 hr. A nurse is reinforcing teaching with a client who has a new prescription for verapamil PO. Which of the following beverages should the nurse recommend avoiding while taking this medication? - CORRECT ANSWER Grapefruit juice A nurse is caring for a client who has hyperlipidemia and has been taking rosuvastatin for the past year. The client tells the nurse he has been experiencing muscle tenderness. Which of the following laboratory values should the nurse review? - CORRECT ANSWER -creatinine kinase A nurse is caring for a client who has been taking epoetin alfa for 3 months. Which of the following laboratory tests should the nurse monitor to determine the effectiveness of the medication? - CORRECT ANSWER HGb A nurse is reinforcing teaching with the family of a client who has a new prescription for donepezil. Which of the following therapeutic effects should the nurse inform the family to expect? - CORRECT ANSWER Improved cognitive function A nurse is collecting a medication history from the parent of a preschooler who comes to the clinic for routine immunizations. For which of the following findings should the nurse withhold the varicella immunization? - CORRECT ANSWER Receiving treatment for leukemia A nurse is reinforcing teaching with a client who has diabetes mellitus and takes insulin glargine and insulin aspart. Which of the following actions indicates that the client understands the instructions? - CORRECT ANSWER -the client administers insulin glargine at the same time every day A nurse who is preparing to administer medications to a client is unfamiliar with a medication that the client takes at home. Which of the following resources should the nurse consult? - CORRECT ANSWER Nursing drug guide A nurse is reviewing the laboratory values of a client who is taking warfarin for treatment of deep-vein thrombosis. Which of the following findings should indicate to the nurse that the medication is effective? - CORRECT ANSWER INR 2.5 A nurse is reinforcing teaching with a client who has a new prescription for phenytoin. Which of the following findings should the nurse include as an adverse effect of phenytoin? - CORRECT ANSWER Gingival hyperplasia A nurse is reinforcing teaching with a newly licensed nurse about the administration of metoprolol. Which of the following findings should the nurse identify as a contraindication for this medication? - CORRECT ANSWER Sinus bradycardia A nurse is caring for a client receiving gentamicin. For which of the following should the nurse monitor the client? - CORRECT ANSWER Tinnitus A nurse is preparing to administer medications to a client. Which of the following client identifiers should the nurse use to verify that the correct client is receiving the medication? (Select all that apply.) - CORRECT ANSWER Date of birth Name A nurse is collecting data from a client who has a new prescription for warfarin. Which of the following medications in the client's history should the nurse report to the provider? - CORRECT ANSWER Aspirin A nurse is caring for a client who has suspected acute opioid toxicity. Which of the following data should the nurse collect first? - CORRECT ANSWER Respiratory rate A nurse is reinforcing teaching with a client who has a new prescription for nitroglycerin. Which of the following statements indicates an understanding of the instructions? - CORRECT ANSWER "I will wear the patch for 12 hours per day." A nurse is preparing to administer digoxin to a client. For which of the following findings should the nurse withhold the medication? - CORRECT ANSWER Apical pulse 54/min