2023 ACTUAL EXAM QUESTIONS WITH DETAILED VERIFIED ANSWERS /A+ GRADE ASSURED

2023 ACTUAL EXAM QUESTIONS WITH DETAILED VERIFIED ANSWERS /A+ GRADE ASSURED A nurse is providing instructions to the parent of an adolescent client who has a new prescription for Albuterol, PO. Which of the following instructions should the nurse include? A. "You can take this medication to abort an acute asthma attack." B. "Tremors are an adverse effect of this medication." C. "Prolonged use of this medication can cause hyperglycemia." D. "This medication can slow skeletal growth rate." - ANS B (Tremors can occur due to excessive stimulation of beta2 receptors of skeletal muscles) A nurse is teaching a client who has a prescription for long term use of oral prednisone for treatment of chronic asthma. The nurse should instruct the client to monitor for which of the following adverse effects of this medication? A.Weight gain B.Nervousness C.Bradycardia D.Constipation - ANS A (Weight gain and fluid retention are adverse effects of oral prednisone due to the effect of sodium and water retention) A nurse is caring for a client who states she has been taking Phenylephrine nasal drops for the past 10 days for Sinusitis. The nurse should assess the client for which of the following adverse effects of this medication? A. Sedation B. Nasal congestion C. Productive cough D. Constipation - ANS B (When used for over 5 days, rebound nasal congestion can occur when taking nasal sympathomimetic medications, such as phenylephrine) A nurse is teaching a client who has a new prescription for Dextromethorphan to suppress a cough. The nurse should instruct the client to monitor for which of the following adverse effects of this medication? A. Diarrhea B. Anxiety C. Sedation D. Palpitations - ANS C (Dextromethorphan can cause sedation. Advise the client to avoid activities that require alertness) A nurse is teaching the family of a child who has Cystic Fibrosis and a new prescription for Acetylcysteine. Which of the following information should the nurse include in the instructions? A. "Expect this medication to suppress your cough." B. "Expect this medication to smell like rotten eggs." C. "Expect this medication to cause euphoria." D. "Expect this medication to turn your urine orange." - ANS B (Acetylcysteine has a sulfur content that causes a rotten egg odor) A nurse is teaching a client who has a new prescription for Diphenhydramine for allergic Rhinitis. The nurse should instruct the client to monitor for which of the following adverse reactions of this medication? (Select all that apply.) A. Dry mouth B. Nonproductive cough C. Skin rash D. Drowsiness E. Urinary hesitation - ANS a, d, e (A. Dry mouth is an anticholinergic manifestation that can occur when a client takes diphenhydramine D. Drowsiness is an adverse reaction of this medication. Diphenhydramine is administered to treat insomnia. E. Urinary retention is an anticholinergic manifestation that can occur when a client takes diphenhydramine.) A nurse is teaching a client about the use of Fluticasone to treat Perennial Rhinitis. Which of the following statements by the client indicates an understanding of the teaching? A. "I should use the spray every 4 hours while I am awake." B. "It can take as long as 3 weeks before the medication takes a maximum effect." C. "This medication can also be used to treat motion sickness." D. "I can use this medication when my nasal passages are blocked. - ANS B (The client can see some benefits of the medication within a few hours, but the maximum benefits can take up to 3 weeks.) A nursing is planning care for a client who is receiving Furosemide IV for peripheral edema. Which of the 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 serum potassium levels. D. Elevate the head of bed slowly before ambulation. E. Recommend eating a banana daily - ANS a, c, d, e (A. An adverse effect of furosemide is ototoxicity. manifestations of tinnitus should be reported to the provider C. A decrease in serum potassium levels is an adverse effect of furosemide, and the nurse should notify the provider. D. Slowly elevating the head of the bed will prevent the client from developing orthostatic hypotension, which is a manifestation of hypovolemia. E. A banana is high in potassium. The nurse should encourage the client to eat foods high in potassium to 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. - ANS A (The client should take hydrochlorothiazide with or after meals to prevent gastrointestinal upset) A nurse is monitoring a client who is receiving spironolactone. Which of the following findings should the nurse report to the provider? A. Serum Sodium 144 mEq/L B. Urine output 120 mL in 4 hr C. Serum Potassium 5.2 mEq/L D. Blood Pressure 140/90 mm Hg - ANS C (Serum potassium of 5.2 mEq/L indicates hyperkalemia. Because spironolactone causes potassium retention, the nurse should withhold 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 - ANS C (Dyspnea is a manifestation of heart failure, an adverse effect of mannitol. The nurse should stop the medication and notify the provider.) A nurse is planning caring for a client who is has a new prescription for Torsemide. The nurse should plan to monitor for which of the following adverse reactions of this medications? (Select all that apply.) A. Respiratory acidosis B. Hypokalemia C. Hypotension D. Ototoxicity E. Ventricular dysrhythmias - ANS b, c, d, e (B. The nurse should plan to monitor for hypokalemia, which is an adverse effect of a loop diuretic. C. The nurse should plan to monitor for hypotension. D. The nurse should plan to monitor the client for ototoxicity. E. The nurse should plan to monitor for ventricular dysrhythmias, which is a manifestation of hypokalemia, an adverse effect of torsemide) A nurse is reviewing the health record of a client who asks about using Propranolol to treat hypertension. The nurse should recognize which of the following conditions is a contraindication for taking propranolol? A. Asthma B. Glaucoma C. Hypertension D. Tachycardia - ANS A (Propranolol is a nonselective beta adrenergic blocker that blocks both beta1 and beta2 receptors. Blockade of beta2 receptors in the lungs causes bronchoconstriction, so it is contraindicated in clients who have asthma) A nurse is teaching a client who has a new prescription for Verapamil to control Hypertension. Which of the following instructions should the nurse include? A. Increase the amount of dietary fiber in the diet. B. Drink grapefruit juice daily to increase vitamin C intake. C. Decrease the amount of calcium in the diet. D. Withhold food for 1 hr after the medication is taken - ANS A (Increasing dietary fiber intake can help prevent constipation, an adverse effect of verapamil) A nurse is caring for a client who has a new prescription for Captopril for hypertension. The nurse should monitor the client for which of the following adverse effects of this medication? A. Hypokalemia B. Hypernatremia C. Neutropenia D. Bradycardia - ANS C (Neutropenia is a serious adverse effect that can occur in clients taking an ACE inhibitor. The nurse should monitor the client's CBC and teach the client to report indications of infection to the provider.) A nurse in an acute care facility is caring for a client who is receiving IV Nitroprusside for hypertensive crisis. The nurse should monitor the client for which of the following adverse reactions to this medication? A. Intestinal ileus B. Neutropenia C. Delirium D. Hyperthermia - ANS C (Delirium and other mental status changes can occur in thiocyanate toxicity when IV nitroprusside is infused at a high dosage. monitor thiocyanate level during therapy to remain below 10 mg/dL.) A nurse is planning to administer a first dose of Captopril to a client who has hypertension. Which of the following medications can intensify first dose hypotension? (Select all that apply.) A. Simvastatin B. Hydrochlorothiazide C. Phenytoin D. Clonidine E. Aliskiren - ANS b, d, e (B.hydrochlorothiazide, a thiazide diuretic, is often used to treat hypertension. Diuretics can intensify first dose orthostatic hypotension caused by captopril and can continue to interact with antihypertensive medications to causehypotension. The nurse should monitor clients carefully for hypotension, especially after the first dose of captopril and keep the client safe from injury D. Clonidine, a centrally acting alpha2 agonist, is an antihypertensive medication that can interact with captopril to intensify first dose orthostatic hypotension. The nurse should monitor clients carefully for hypotension, especially after the first dose of captopril, and keep the client safe from injury. E. Aliskiren, a direct renin inhibitor, is an antihypertensive medication that can interact with captopril to intensify its first dose orthostatic hypotension. The nurse should monitor clients carefully for hypotension, especially after the first dose of captopril, and keep the client safe from injury) A nurse in a provider's office is monitoring serum electrolytes for four older adult clients who take digoxin. Which of the following electrolyte values increases a client's risk for Digoxin toxicity? A. Calcium 9.2 mg/dL B. Calcium 10.3 mg/dL C. Potassium 3.4 mEq/L D. Potassium 4.8 mEq/ - ANS C (Potassium 3.4 mEq/L is below the expected reference range and puts a client at risk for digoxin toxicity. Low Potassium can cause fatal dysrhythmias, especially in older clients who take Digoxin. The nurse should notify the provider, who might prescribe a potassium supplement or a potassium sparing diuretic for the client) A nurse is caring for an older adult client who has a new prescription for Digoxin and takes multiple other medications. The nurse should recognize that concurrent use of which of the following medications places the client at risk for Digoxin toxicity? A. Phenytoin B. Verapamil C. Warfarin D. Aluminum hydroxide - ANS B (Verapamil, a calcium channel blocker, can increase digoxin levels. If these medications are given concurrently, the digoxin dosage might be decreased and the nurse should monitor digoxin levels carefully) A nurse is administering a Dopamine infusion at a low dose to a client who has severe heart failure. Which of the following findings is an expected effect of this medication? A. Lowered heart rate B. Increased myocardial contractility C. Decreased conduction through the AV node D. Vasoconstriction of renal blood vessel - ANS B (The nurse should expect dopamine to cause increased myocardial contractility, which also increases cardiac output. This occurs with the stimulation of beta1 receptors and is a positive inotropic effect of dopamine when it is administered at a low dose) A nurse is providing teaching to a client who has a new prescription for Digoxin. The nurse should instruct the client to monitor and report which of the following adverse effects that is a manifestation Digoxin toxicity? (Select all that apply.) A. Fatigue B. Constipation C. Anorexia D. Rash E. Diplopia - ANS a, c, e (A. Fatigue and weakness are early CNS findings that can indicate digoxin toxicity. C. GI disturbances, such as anorexia, are manifestations of digoxin toxicity. E. Visual changes, such as diplopia and yellow tinged vision, are manifestations of digoxin toxicity) A nurse is teaching a client who has a new prescription for digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching? A. Contact provider if heart rate is less than 60/min. B. Check pulse rate for 30 seconds and multiply result by 2. C. Increase intake of sodium. D. Take with food if nausea occur - ANS A (The client should contact the provider for a heart rate less than 60/min) A nurse is teaching a client who has Angina Pectoris and is learning how to treat acute Anginal attacks. The clients asks, "What is my next step if I take one tablet, wait 5 minutes, but still have Anginal pain?" Which of the following responses should the nurse make? A. "Take two more sublingual tablets at the same time." B. "Call the emergency response team." C. "Take a sustained release nitroglycerin capsule." D. "Wait another 5 minutes then take a second sublingual tablet." - ANS B (The next step is to call 911 and then take a second sublingual tablet. If the first tablet does not work, the client might be having a myocardial infarction. The client can take a third tablet if the second one has not relieved the pain after waiting an additional 5 minutes.) A nurse is teaching a client who has a new prescription for Nitroglycerin transdermal patch for Angina Pectoris. Which of the following instructions should the nurse include? A. Remove the patch each evening. B. Cut each patch in half if angina attacks are under control. C. Take off the nitroglycerin patch for 30 min if a headache occurs. D. Apply a new patch every 48 hr - ANS A (In order to prevent tolerance to nitroglycerin, the client should remove the patch for 10 to 12 hr during each 24 hr period) A nurse is taking a medication history from a client who has Angina and is to begin taking Ranolazine. The nurse should report which of the following medications in the client's history that can interact with Ranolazine? (Select all that apply.) A. Digoxin B. Simvastatin C. Verapamil D. Amlodipine E. Nitroglycerin transdermal patch - ANS a, b, c (A. Concurrent use with ranolazine increases serum levels of digoxin, so digoxin toxicity can result. B. Concurrent use with ranolazine increases serum levels of simvastatin, so liver toxicity can result. C. Verapamil is an inhibitor of CYP3A4, which can increase levels of ranolazine and lead to the dysrhythmia torsades de pointes.) A nurse is caring for a client who is prescribed Isosorbide Mononitrate for chronic stable Angina and develops reflex tachycardia. Which of the following medications should the nurse expect to administer? A. Furosemide B. Captopril C. Ranolazine D. Metoprolol - ANS D (metoprolol, a beta adrenergic blocker, is used to treat hypertension and stable angina pectoris, and is often prescribed to decrease heart rate in clients who have tachycardia) A nurse is teaching a client who has angina how to use nitroglycerin transdermal ointment. The nurse should include which of the following instructions? A."Remove the prior dose before applying a new dose." B."Rub the ointment directly into your skin until it is no longer visible." C."Cover the applied ointment with a clean gauze pad." D."Apply the ointment to the same skin area each time. - ANS A (The client should remove the prior dose before applying a new dose to prevent toxicity) A nurse is assessing a client who is taking Amiodarone to treat Atrial Fibrillation. Which of the following findings is a manifestation of Amiodarone toxicity? A. Light yellow urine B. Report of tinnitus C. Productive cough D. Blue gray skin discoloration - ANS C (Productive cough can indicate pulmonary toxicity or heart failure. The nurse should assess for cough, chest pain, and shortness of breath) A nurse is caring for a client who received IV Verapamil to treat supraventricular tachycardia (SVT). The client's pulse rate is now 98/min and his blood pressure is 74/44 mg hg. The nurse should anticipate a prescription for which of the following IV medications? A. Calcium gluconate B. Sodium bicarbonate C. Potassium chloride D. Magnesium sulfate - ANS A (Reverse severe hypotension caused by Verapamil with Calcium gluconate, given slowly IV. The calcium counteracts vasodilation caused by verapamil. Other measures to increase blood pressure can include IV fluid therapy and placing the client in a modified Trendelenburg position.) A nurse is assessing a client who is taking Digoxin to treat heart failure. Which of the following findings is a manifestation of digoxin toxicity? A. Bruising B. Report of metallic taste C. Muscle pain D. Report of anorexia - ANS D (Anorexia, blurred vision, stomach pain, and diarrhea are manifestations of digoxin toxicity) A nurse is caring for a client who has angina and asks about obtaining a prescription for sildenafil to treat erectile dysfunction. Which of the following medications is contraindicated with Sildenafil? A. Aspirin B. Isosorbide C. Clopidogrel D. Atorvastatin - ANS B (Isosorbide is an organic nitrate that manages pain from angina. Concurrent use of it is contraindicated because fatal hypotension can occur. The client should avoid taking a nitrate medication for 24 hr after taking isosorbide.) A nurse is teaching a client about Terbutaline. Which of the following statements by the client indicates understanding of the teaching? A. "This medication will stop my contractions." B. "This medication will prevent vaginal bleeding." C. "This medication will promote blood flow to my baby." D. "This medication will increase my prostaglandin production - ANS A (Terbutaline blocks beta2 adrenergic receptors, which causes uterine smooth muscle relaxation) A nurse is caring for a client who has Preeclampsia and is receiving Magnesium Sulfate IV continuous infusion. Which of the following findings should the nurse report to the provider? A. 2+ deep tendon reflexes B. 2+ pedal edema C. 24 mL/hr urinary output D. Respirations 12/mi - ANS C (Urine output less than 25 to 30 mL/hr is associated with magnesium sulfate toxicity and should be reported to the provider) A nurse is caring for a client who has a new prescription for Oxytocin to stimulate uterine contractions. Which of the following interventions should the nurse make? (Select all that apply.) A. Use an infusion pump for medication administration. B. Obtain vital signs frequently and with every dosage change. C. Stop infusion if uterine contractions occur every 4 min and last 45 seconds. D. Increase medication infusion rate rapidly. E. Monitor fetal heart rate continuously - ANS a, b, e (A. Oxytocin must be administered by an infusion pump to ensure precise dosage. B. Vital signs are monitored to assess for hypertension, an adverse effect of oxytocin. E. Continuous FHR monitoring is required to assess for fetal distress) A nurse is caring for a client who is in labor and receiving IV Opioid analgesics. Which of the following actions should the nurse take? A. Instruct the client to self ambulate every 2 hr. B. Offer oral hygiene every 2 hr. C. Anticipate medication administration 2 hr prior to delivery. D. Monitor fetal heart rate every 2 hr - ANS B (Oral hygiene should be offered on a regular basis to a client receiving opioid analgesics due to the adverse effects of dry mouth, nausea, and vomiting) A nurse is reviewing a new prescription for Terbutaline with a client who has a history of preterm labor. Which of the following client statements indicates understanding of the teaching? A. "I can increase my activity now that I've started on this medication." B. "I will increase my daily fluid intake to 3 quarts." C. "I will report increasing intensity of contractions to my doctor." D. "I am glad this will prevent preterm labor." - ANS C (The client should report increasing intensity, frequency, or duration of contractions to the provider because these are manifestations of preterm labor) A nurse is providing teaching for a client who has gout and a new prescription for Allopurinol. For which of the following adverse effects should the client be taught to monitor? (Select all that apply.) A. Stomatitis B. Insomnia C. Nausea D. Rash E. Increased gout pain - ANS c, d, e (C. Nausea and vomiting are adverse effects that can be caused by allopurinol. D. Rash and other hypersensitivity reactions can be caused by allopurinol. The client should be taught to contact the provider for any manifestation of hypersensitivity so that the medication can be discontinued. E. An increase in gout attacks can occur during the first few months in a client who is taking allopurinol.) A nurse is caring for a client who has a new prescription for Adalimumab for Rheumatoid Arthritis. Based on the route of administration of Adalimumab, which of the following should the nurse plan to monitor? A. The vein for thrombophlebitis during IV administration B. The subcutaneous site for redness following injection C. The oral mucosa for ulceration after oral administration D. The skin for irritation following removal of transdermal patch - ANS B (Adalimumab is administered subcutaneously, and injection site redness and swelling are common. It is appropriate for the nurse to assess the site for redness following injection.) A nurse is preparing to administer Belimumab for a client who has Systemic Lupus Erythematosus. Which of the following actions should the nurse plan to take? A.Warm the medication to room temperature over 1 hr before administering. B. Administer the medication by IV bolus over 5 min. C. Dilute the medication in 5% dextrose and water solution. D. Monitor the client for hypersensitivity reactions - ANS D (Belimumab can cause severe infusion reactions and can cause anaphylaxis. The nurse should carefully monitor the client during infusion of this medication and be prepared to slow or stop the medication if a reaction occurs.) A nurse is caring for a client who has a new diagnosis of Fibromyalgia. Which of the following medications should the nurse anticipate being prescribed for this client? A. Colchicine B. Hydroxychloroquine C. Auranofin D. Duloxetine - ANS D (Duloxetine is a serotonin norepinephrine reuptake inhibitor used to treat fibromyalgia. Other uses for this medication include treating depression and diabetic peripheral neuropathy) A nurse is evaluating teaching for a client who has Rheumatoid Arthritis and a new prescription for Methotrexate. Which of the following statements by the client indicates understanding of the teaching? A. "I will be sure to return to the clinic at least once a year to have my blood drawn while I'm taking methotrexate." B. "I will take this medication on an empty stomach." C. "I'll let the doctor know if I develop sores in my mouth while taking this medication. D. "I should stop taking oral contraceptives while I'm taking methotrexate." - ANS C (Ulcerations in the mouth, tongue, or throat are often the first signs of methotrexate toxicity and should be reported to the provider immediately) A nurse is providing teaching to a client who is taking Raloxifene to prevent Postmenopausal Osteoporosis. The nurse should advise the client that which of the following are adverse effects of this medication? (Select all that apply.) A. Hot flashes B. Lump in breast C. Swelling or redness in calf D. Shortness of breath E. Difficulty swallowing - ANS a, c, d (A. Raloxifene can cause hot flashes or increase existing hot flashes. C. Raloxifene increases the risk for thrombophlebitis, which can cause swelling or redness in the calf. D. Raloxifene increases the risk for pulmonary embolism, which can cause shortness of breath.) A nurse is teaching a client who has Osteoporosis and a new prescription for Alendronate. Which of the following instructions should the nurse provide? (Select all that apply.) A. Take medication in the morning before eating. B. Chew tablets to increase bioavailability. C. Drink an 8 oz glass of water with each tablet. D. Take medication with an antacid if heartburn occurs. E.Avoid lying down after taking this medication - ANS a, c, e (A. Take alendronate first thing in the morning before eating to increase absorption C. Clients should drink at least 240 mL (8 oz) water with alendronate tablets. E. Clients should sit upright or stand for at least 30 min after taking alendronate.) A nurse is caring for a client who has a new prescription for Calcitonin salmon for Osteoporosis. Which of the following tests should the nurse tell the client to expect before beginning this medication? A. Skin test for allergy to the medication B. ECG to rule out cardiac dysrhythmias C. Mantoux test to rule out exposure to tuberculosis D. Liver function tests to assess risk for medication toxicity - ANS A (Anaphylaxis can occur if the client is allergic to calcitonin salmon. A skin test to determine allergy might be done before starting this medication. The nurse also should ask the client about previous allergies to fish) A nurse is caring for a young adult client whose serum Calcium is 8.8 mg/dL. Which of the following medications should the nurse anticipate administering to this client? A. Calcitonin salmon B. Calcium carbonate C. Zoledronic acid D. Ibandronate - ANS B (The client's serum calcium level is below the expected reference range. Calcium carbonate is an oral form of calcium used to increase serum calcium to the expected reference range.) A nurse is providing instruction to a client who has a new prescription for Calcitonin salmon for postmenopausal Osteoporosis. Which of the following instructions should the nurse include in the teaching? A. Swallow tablets on an empty stomach with plenty of water. B. Watch for skin rash and redness when applying calcitonin salmon topically. C. Mix the liquid medication with juice and take it after meals. D. Alternate nostrils each time calcitonin salmon is inhale - ANS D (Calcitonin salmon can be administered Im or subcutaneously, but is commonly administered intranasally for postmenopausal osteoporosis. The client should alternate nostrils daily.) A nurse is assessing a client who has salicylism. Which of the following findings should the nurse expect? (Select all that apply.) A. Dizziness B. Diarrhea C. Jaundice D. Tinnitus E. Headache - ANS A, d, e (A. The client who has salicylism can have dizziness, which is an expected finding. D. The client who has salicylism can have tinnitus, which is an expected finding. E. The client who has salicylism can have a headache, which is an expected finding) A nurse is admitting a toddler to the hospital after an Acetaminophen overdose. Which of the following medications should the nurse anticipate administering to this client? A. Acetylcysteine B. Pegfilgrastim C. Misoprostol D. Naltrexone - ANS A (The nurse should administer acetylcysteine, which is the antidote for acetaminophen overdose.) A nurse is teaching a client about the a new prescription for Celecoxib. Which of the following information should the nurse include in the teaching? A. Increases the risk for a myocardial infarction B. Decreases the risk of stroke C. Inhibits COX 1 D. Increases platelet aggregation - ANS A (The client who takes celecoxib has an increased risk for a myocardial infarction secondary to suppressing vasodilation) A nurse is taking a history for a client who reports that he is taking Aspirin about four times daily for a sprained wrist. Which of the following prescribed medications taken by the client is contraindicated with aspirin? A. Digoxin B. Metformin C. Warfarin D. Nitroglycerin - ANS C (The effect of warfarin and other anticoagulants is increased by aspirin, which inhibits platelet aggregation. This client would have an increased risk for bleeding. Use of aspirin generally is contraindicated for clients who take warfarin.) A nurse in an emergency department is performing an admission assessment for a client who has severe Aspirin toxicity. Which of the following findings should the nurse expect? A. Body temperature 35° C (95° F) B. Lung crackles C. Cool, dry skin D. Respiratory depression - ANS D (Respiratory depression due to increasing respiratory acidosis is an expected manifestation of severe aspirin toxicity.) A nurse is preparing to administer an Opioid agonist to a client who has acute pain. Which of the following complications should the nurse monitor? A. Urinary retention B. Tachypnea C. Hypertension D. Irritating cough - ANS A (The nurse should monitor for urinary retention because morphine can suppress awareness that the bladder is full.) A nurse is caring for a client who has end stage cancer and is receiving Morphine. The client's daughter asks why the provider prescribed Methylnaltrexone. Which of the following responses should the nurse make? A. "The medication will increase your mother's respirations." B. "The medication will prevent dependence on the Morphine C. "The medication will relieve your mother's constipation." D. "The medication works with the Morphine to increase pain relief. - ANS C (Methylnaltrexone is an opioid antagonist used for treating severe constipation that is unrelieved by laxatives in clients who are opioid dependent. The medication blocks the mu opioid receptors in the GI tract.) A nurse is preparing to administer Butorphanol to a client who has a history of substance use disorder. The nurse should identify which of the following information as true regarding Butorphanol? A. Butorphanol has a greater risk for abuse than morphine. B. Butorphanol causes a higher incidence of respiratory depression than morphine. C. Butorphanol cannot be reversed with an opioid antagonist. D. Butorphanol can cause abstinence syndrome in opioid dependent clients - ANS D (Opioid agonist/antagonist medications, such as butorphanol, can cause abstinence syndrome in opioid dependent clients. manifestations include abdominal pain, fever, and anxiety) A nurse is planning to administer Morphine IV to a client who is postoperative. Which of the following actions should the nurse take? A. Monitor for seizures and confusion with repeated doses. B. Protect the client's skin from the severe diarrhea that occurs with morphine. C. Withhold this medication if respiratory rate is less than 12/min. D. Give Morphine intermittent via IV bolus over 30 seconds or less - ANS C (The nurse should withhold all opioids if the respiratory rate is 12/min or less, and notify the provider.) A nurse is reviewing the medication administration record for a client who is receiving transdermal Fentanyl for severe pain. Which of the following medications should the nurse expect to cause an adverse effect when administered concurrently with Fentanyl? A. Ampicillin B. Diazepam C. Furosemide D. Prednisone - ANS B (Diazepam, a benzodiazepine, is a CNS depressant, which can interact by causing the client to become severely sedated when administered concurrently with an opioid agonist or agonist/antagonist.) A nurse is caring for a client who has cancer and is taking Morphine and Carbamazepine or pain. Which of the following effects should the nurse monitor for when giving the medications together? (Select all that apply.) A. Need for reduced dosage of the opioid B. Reduced adverse effects of the opioid C. Increased analgesic effects D. Enhanced CNS stimulation E. Increased opioid tolerance - ANS a, b, c (A. Dosage of the opioid can be reduced when adjuvant medications are added for pain. B. Adverse effects of the opioid can be reduced when adjuvant medications are added for pain. C. Analgesic effects are increased when adjuvant medications are added for pain) A nurse is planning care for a client who has brain cancer and is experiencing headaches. Which of the following adjuvant medications are indicated for this client? A.Dexamethasone B. Methylphenidate C. Hydroxyzine D.Amitriptyline - ANS A (Dexamethasone, a glucocorticoid, decreases inflammation and swelling. It is used to reduce cerebral edema and relieve pressure from the tumor.) A nurse is preparing to administer Pamidronate to a client who has bone pain related to cancer. Which of the following precautions should the nurse take when administering pamidronate? A. Inspect the skin for redness and irritation when changing the intradermal patch. B. Assess the IV site for Thrombophlebitis frequently during administration. C. Instruct the client to sit upright or stand for 30 min following oral administration. D. Watch for manifestations of anaphylaxis for 20 min after Im administration - ANS B (Pamidronate is administered by IV infusion. This medication is irritating to veins, and the nurse should assess for thrombophlebitis during administration)