Pharmacology ATI
A nurse is planning care for a client who is receiving furosemide IV for peripheral edema. Which
following interventions should the nurse include in the plan of care? (select all that apply.)
A. Assess for tinnitus.
B. Report urine output 50 ml/hr.
C. Monitor blood potassium levels. D. Elevate the head of the bed slowly before ambulation.
E. Recommend eating a banana daily. - ANSWER- A, C, D, E
An adverse effect of furosemide is ototoxicity, manifestations of tinnitus should be reported to provider. A urine output of 50 ml/hr is expected, less than 30 ml/hr is a sign of dehydration and should be reported to provider. A decrease in blood potassium levels is an adverse effect of furosemide. Slowly elevate the head of the bed to prevent client from developing orthostatic hypotension which is a manifestation of hypovolemia. A banana is high in potassium and will prevent hypokalemia.
A nurse is providing information to a client who has a new prescription for hydrochlorothiazide. Which of the following information should the nurse include?
A. Take the medication with food.
B. Plan to take the medication at bedtime.
C. Expect increased swelling of the ankles.
D. Fluid intake should be limited in the morning. - ANSWER- A
The client should take hydrochlorothiazide with or after meals to prevent GI upset. The client should take hydrochlorothiazide in the morning or no later than 1400, and not at bedtime, to prevent nocturia. The client should expect decreased swelling of the ankles. The client should maintain an adequate fluid intake (1,500 ml) throughout the day unless contraindicated.
A nurse is monitoring a client who is receiving spironolactone. Which of the following findings should the nurse report to the provider?
A. Blood sodium 144 mEq/L
B. Urine output 120 ml in 4 hr
C. Blood potassium 5.2 mEq/L
D. Blood pressure 140/90 mmHg - ANSWER- C
Blood sodium, urine output, and blood pressure are all within expected reference ranges. Blood potassium of 5.2 mEq/L indicates hyperkalemia; because spironolactone causes potassium retention, withold the medication and notify the provider.
A nurse is caring for a client who has increased intracranial pressure and is receiving mannitol. Which of the following findings should the nurse report to the provider? A. Blood glucose 150 mg/dL
B. Urine output 40 ml/hr
C. Dyspnea
D. Bilateral equal pupil size - ANSWER- C
Blood glucose, urine output, and pupil size are all within expected reference ranges. Dyspnea is a
manifestation of HF, an adverse effect of mannitol. Stop the medication and notify the provider.
A nurse is planning care for a client who has a new prescription for torsemide. The nurse should plan to monitor for which of the following conditions as potential adverse reactions of this medication? (select all that apply.)
A. Respiratory acidosis
B. Hypokalemia
C. Hypotension
D. Ototoxicity
E. Ventricular dysrhythmias - ANSWER- B, C, D, E
Monitor for metabolic acidosis not respiratory acidosis. Monitor for hypokalemia, hypotension, ototoxicity (because it is a loop diuretic), and ventricular dysrhythmias (which is a manifestation of hypokalemia, an adverse effect of torsemide.)
A nurse is teaching clients about the use of insulin to treat type 1 diabetes mellitus. For which of the following types of insulin should the nurse tell the clients to expect a peak effect 1-5 hrs after
administration?
A. Insulin glargine
B. NPH insulin
C. Regular insulin
D. Insulin lispro - ANSWER- C
Insulin glargine (long-acting) doesn't have a peak effect time. NPH insulin has a peak effect around 6-14 hrs. Regular insulin has a peak effect around 1-5 hrs. Insulin lispro has a peak effect around 30 min - 2.5 hrs.
A nurse is caring for a client who has been taking acarbose for type 2 diabetes mellitus. Which of
the following laboratory tests should the nurse plan to monitor?
A. WBC
B. Amylase
C. Platelet count
D. Liver function tests - ANSWER- D
Infection is not an adverse effect of acarbose. Sitagliptin and Exenatide can cause rare pancreatitis so check amylase and lipase if client reports uncontrolled abdominal pain, but not associated with acarbose. Acarbose doesn't effect platelet levels but can cause iron deficiency anemia so monitor hemoglobin. Acarbose can cause liver toxicity when taken long-term so monitor liver function.
A nurse is providing teaching to a client who has type 2 diabetes mellitus and is starting repaglinide. Which of the following statements by the client indicates understanding of the administration of this medication?
A. "I'll take this medication after I eat."
B. "I'll take this medicine 30 minutes before I eat."
C. "I'll take this medicine just before I go to bed."
D. "I'll take this medication at least 1 hour before I eat." - ANSWER- B
This med peaks within 1 hr, taking it after meals wouldn't be effective helping client process the carbs consumed during the meal. This med causes a rapid, short-lived release of insulin; client should take it 30 mins before meal so that insulin is available when food is digested. This med is only effective for 4 hrs, taking it at bed wouldn't help manage mealtime carb intake. With the rapid onset the risk of hypoglycemia would be high if taken an hour before eating.
A nurse is providing teaching for a client who has a new prescription for metformin. Which of the following findings should the nurse instruct the client to report as an adverse effect of metformin?
A. Somnolence
B. Constipation
C. Fluid retention
D. Weight gain - ANSWER- A
Somnolence can indicate lactic acidosis, a very serious adverse effect of metformin. Diarrhea, not constipation is an adverse effect of metformin. Fluid retention is an adverse effect of pioglitazone. Anorexia and weight loss, not weight gain are adverse effects of metformin.
A nurse is providing teaching to a client who has a prescription for pramlintide for type 1 diabetes mellitus. Which of the following should the nurse include in the teaching? (select all that apply.)
A. "Take oral medications 30 minutes before injection."
B. "Use upper arms as preferred injection sites."
C. "Mix pramlintide with the breakfast dose of insulin."
D. "Inject pramlintide just before a meal."
E. "Discard open vials after 28 days." - ANSWER- D, E
Oral meds should be taken 1 hr before or 2 hrs after injections. Thigh and abdomen are preferred injection sites. Pramlintide shouldn't be mixed with insulin. It is important to eat a meal after injection to prevent hypoglycemia. Unused med in the open vial should be discarded after 28 days. A nurse is caring for a client who is taking propylthiouracil. Which of the following findings should the nurse monitor for as an adverse effect of this medication?
A. Bradycardia
B. Insomnia
C. Heat intolerance
D. Weight loss - ANSWER- A
Bradycardia is an adverse effect of propylthiouracil (Monitor for bradycardia). Drowsiness, rather than insomnia is an adverse effect of propylthiouracil. Cold intolerance rather than heat intolerance is an adverse effect of porpylthiouracil. Weight gain, rather than weight loss is an adverse effect of propylthiouracil.
A nurse is teaching a client who has Grave's disease and a new prescription for propanolol. Which of the following client statements indicates effective teaching?
A. "Propanolol helps increase blood flow to my thyroid gland."
B. "Propanolol is used to prevent excess glucose in my blood."
C. "Propanolol will decrease my tremors and fast heart beat."
D. "Propanolol promotes a decrease of thyroid hormone in my body." - ANSWER- C
Propanolol lowers blood pressure, but does not increase blood flow to the thyroid gland. Propanolol does not help prevent hyperglycemia. Propanolol is a beta-andrenergic antagonist that
decreases heart rate and controls tremors. Propanolol does not promote a decrease of thyroid hormone.
A nurse is caring for an older adult client who has hypothyroidism and a new prescription for levothyroxine. Which of the following dosage schedules should the nurse expect for the client?
A. The client will start at a high dosage, and the amount will be tapered as needed.
B. The client will remain on the initial dosage during the course of treatment.
C. The client's dosage will be adjusted daily based on blood levels. D. The client will start on a low dosage, which can be gradually increased. - ANSWER- D
Starting a new med at a high dosage can cause harm. The dosage will change periodically throughout treatment. The dosage will be based on blood levels, but daily monitoring is not required. Expect that levothyroxine will be started at a low dosage and gradually increased over several weeks. This is especially important in older adult clients to prevent toxicity.
A nurse is caring for a client who is taking somatropin to stimulate growth. The nurse should plan to monitor the client's urine for which of the following?
A. Bilirubin
B. Protein
C. Potassium
D. Calcium - ANSWER- D
A nurse is planning care for a client who is receiving furosemide IV for peripheral edema. Which
following interventions should the nurse include in the plan of care? (select all that apply.)
A. Assess for tinnitus.
B. Report urine output 50 ml/hr.
C. Monitor blood potassium levels. D. Elevate the head of the bed slowly before ambulation.
E. Recommend eating a banana daily. - ANSWER- A, C, D, E
An adverse effect of furosemide is ototoxicity, manifestations of tinnitus should be reported to provider. A urine output of 50 ml/hr is expected, less than 30 ml/hr is a sign of dehydration and should be reported to provider. A decrease in blood potassium levels is an adverse effect of furosemide. Slowly elevate the head of the bed to prevent client from developing orthostatic hypotension which is a manifestation of hypovolemia. A banana is high in potassium and will prevent hypokalemia.
A nurse is providing information to a client who has a new prescription for hydrochlorothiazide. Which of the following information should the nurse include?
A. Take the medication with food.
B. Plan to take the medication at bedtime.
C. Expect increased swelling of the ankles.
D. Fluid intake should be limited in the morning. - ANSWER- A
The client should take hydrochlorothiazide with or after meals to prevent GI upset. The client should take hydrochlorothiazide in the morning or no later than 1400, and not at bedtime, to prevent nocturia. The client should expect decreased swelling of the ankles. The client should maintain an adequate fluid intake (1,500 ml) throughout the day unless contraindicated.
A nurse is monitoring a client who is receiving spironolactone. Which of the following findings should the nurse report to the provider?
A. Blood sodium 144 mEq/L
B. Urine output 120 ml in 4 hr
C. Blood potassium 5.2 mEq/L
D. Blood pressure 140/90 mmHg - ANSWER- C
Blood sodium, urine output, and blood pressure are all within expected reference ranges. Blood potassium of 5.2 mEq/L indicates hyperkalemia; because spironolactone causes potassium retention, withold the medication and notify the provider.
A nurse is caring for a client who has increased intracranial pressure and is receiving mannitol. Which of the following findings should the nurse report to the provider? A. Blood glucose 150 mg/dL
B. Urine output 40 ml/hr
C. Dyspnea
D. Bilateral equal pupil size - ANSWER- C
Blood glucose, urine output, and pupil size are all within expected reference ranges. Dyspnea is a
manifestation of HF, an adverse effect of mannitol. Stop the medication and notify the provider.
A nurse is planning care for a client who has a new prescription for torsemide. The nurse should plan to monitor for which of the following conditions as potential adverse reactions of this medication? (select all that apply.)
A. Respiratory acidosis
B. Hypokalemia
C. Hypotension
D. Ototoxicity
E. Ventricular dysrhythmias - ANSWER- B, C, D, E
Monitor for metabolic acidosis not respiratory acidosis. Monitor for hypokalemia, hypotension, ototoxicity (because it is a loop diuretic), and ventricular dysrhythmias (which is a manifestation of hypokalemia, an adverse effect of torsemide.)
A nurse is teaching clients about the use of insulin to treat type 1 diabetes mellitus. For which of the following types of insulin should the nurse tell the clients to expect a peak effect 1-5 hrs after
administration?
A. Insulin glargine
B. NPH insulin
C. Regular insulin
D. Insulin lispro - ANSWER- C
Insulin glargine (long-acting) doesn't have a peak effect time. NPH insulin has a peak effect around 6-14 hrs. Regular insulin has a peak effect around 1-5 hrs. Insulin lispro has a peak effect around 30 min - 2.5 hrs.
A nurse is caring for a client who has been taking acarbose for type 2 diabetes mellitus. Which of
the following laboratory tests should the nurse plan to monitor?
A. WBC
B. Amylase
C. Platelet count
D. Liver function tests - ANSWER- D
Infection is not an adverse effect of acarbose. Sitagliptin and Exenatide can cause rare pancreatitis so check amylase and lipase if client reports uncontrolled abdominal pain, but not associated with acarbose. Acarbose doesn't effect platelet levels but can cause iron deficiency anemia so monitor hemoglobin. Acarbose can cause liver toxicity when taken long-term so monitor liver function.
A nurse is providing teaching to a client who has type 2 diabetes mellitus and is starting repaglinide. Which of the following statements by the client indicates understanding of the administration of this medication?
A. "I'll take this medication after I eat."
B. "I'll take this medicine 30 minutes before I eat."
C. "I'll take this medicine just before I go to bed."
D. "I'll take this medication at least 1 hour before I eat." - ANSWER- B
This med peaks within 1 hr, taking it after meals wouldn't be effective helping client process the carbs consumed during the meal. This med causes a rapid, short-lived release of insulin; client should take it 30 mins before meal so that insulin is available when food is digested. This med is only effective for 4 hrs, taking it at bed wouldn't help manage mealtime carb intake. With the rapid onset the risk of hypoglycemia would be high if taken an hour before eating.
A nurse is providing teaching for a client who has a new prescription for metformin. Which of the following findings should the nurse instruct the client to report as an adverse effect of metformin?
A. Somnolence
B. Constipation
C. Fluid retention
D. Weight gain - ANSWER- A
Somnolence can indicate lactic acidosis, a very serious adverse effect of metformin. Diarrhea, not constipation is an adverse effect of metformin. Fluid retention is an adverse effect of pioglitazone. Anorexia and weight loss, not weight gain are adverse effects of metformin.
A nurse is providing teaching to a client who has a prescription for pramlintide for type 1 diabetes mellitus. Which of the following should the nurse include in the teaching? (select all that apply.)
A. "Take oral medications 30 minutes before injection."
B. "Use upper arms as preferred injection sites."
C. "Mix pramlintide with the breakfast dose of insulin."
D. "Inject pramlintide just before a meal."
E. "Discard open vials after 28 days." - ANSWER- D, E
Oral meds should be taken 1 hr before or 2 hrs after injections. Thigh and abdomen are preferred injection sites. Pramlintide shouldn't be mixed with insulin. It is important to eat a meal after injection to prevent hypoglycemia. Unused med in the open vial should be discarded after 28 days. A nurse is caring for a client who is taking propylthiouracil. Which of the following findings should the nurse monitor for as an adverse effect of this medication?
A. Bradycardia
B. Insomnia
C. Heat intolerance
D. Weight loss - ANSWER- A
Bradycardia is an adverse effect of propylthiouracil (Monitor for bradycardia). Drowsiness, rather than insomnia is an adverse effect of propylthiouracil. Cold intolerance rather than heat intolerance is an adverse effect of porpylthiouracil. Weight gain, rather than weight loss is an adverse effect of propylthiouracil.
A nurse is teaching a client who has Grave's disease and a new prescription for propanolol. Which of the following client statements indicates effective teaching?
A. "Propanolol helps increase blood flow to my thyroid gland."
B. "Propanolol is used to prevent excess glucose in my blood."
C. "Propanolol will decrease my tremors and fast heart beat."
D. "Propanolol promotes a decrease of thyroid hormone in my body." - ANSWER- C
Propanolol lowers blood pressure, but does not increase blood flow to the thyroid gland. Propanolol does not help prevent hyperglycemia. Propanolol is a beta-andrenergic antagonist that
decreases heart rate and controls tremors. Propanolol does not promote a decrease of thyroid hormone.
A nurse is caring for an older adult client who has hypothyroidism and a new prescription for levothyroxine. Which of the following dosage schedules should the nurse expect for the client?
A. The client will start at a high dosage, and the amount will be tapered as needed.
B. The client will remain on the initial dosage during the course of treatment.
C. The client's dosage will be adjusted daily based on blood levels. D. The client will start on a low dosage, which can be gradually increased. - ANSWER- D
Starting a new med at a high dosage can cause harm. The dosage will change periodically throughout treatment. The dosage will be based on blood levels, but daily monitoring is not required. Expect that levothyroxine will be started at a low dosage and gradually increased over several weeks. This is especially important in older adult clients to prevent toxicity.
A nurse is caring for a client who is taking somatropin to stimulate growth. The nurse should plan to monitor the client's urine for which of the following?
A. Bilirubin
B. Protein
C. Potassium
D. Calcium - ANSWER- D
