Pharm 2019 A
,A nurse is instructing a client on the application of nitroglycerin transdermal patches. Which of the
following statements by the client indicates an understanding of the teaching?
"I should apply a patch every 5 minutes if I develop chest pain." "I will take
the patch off right after my evening meal."
"I will leave the patch off at least 1 day each week."
"I should discard the used patch by flushing it down the toilet." - Answer "I will take the patch off right
after my evening meal."
Clients should remove the patch each evening for a medication free time of 12 to 14 hr before applying a
new patch to avoid developing a tolerance to the medication's effects.
A nurse receives a verbal order from the provider to administer morphine five milligrams every 4 hours
subcutaneously for severe pain as needed. The nurse should identify which of the following entries as the
correct format for the medication administration record (MAR)?
MSO4 5 mg subcut every 4 hr PRN severe pain Morphine 5 mg
subcut every 4 hr PRN severe pain MSO4 5 mg SQ every 4 hr
PRN severe pain
Morphine 5.0 mg subcutaneously every 4 hr PRN severe pain - Answer Morphine 5 mg subcut every 4 hr
PRN severe pain
The nurse should identify this entry as the correct format for the MAR. The medication name is
spelled out and there are not any abbreviations from The Joint Commission's "Do Not Use" list
included in the transcription.
A nurse is caring for a client who is taking acetazolamide for chronic open angle glaucoma. For which of
the following adverse effects should the nurse instruct the client to monitor and report
Tingling of fingers
Constipation Weight
gain
Oliguria - Answer Tingling of fingers
The nurse should instruct the client to report the adverse effect of paresthesia, a tingling sensation in the
extremities, when taking acetazolamide.
A nurse administers a dose of metformin to a client instead of the prescribed dose of metoclopramide.
Which of the following actions should the nurse take first?
Report the incident to the charge nurse. Notify
the provider.
Check the client's blood glucose.
, Fill out an incident report. - Answer check blood sugar
The first action the nurse should take using the nursing process is to assess the client. The client is at risk
for hypoglycemia. The nurse should monitor the client's blood glucose and provide the client with a
snack to reduce the risk for hypoglycemia.
A nurse is caring for a client who has cancer and is taking oral morphine and docusate sodium. The
nurse should instruct the client that taking the docusate sodium daily can minimize which of the
following adverse effects of morphine?
Constipation
Drowsiness
Facial flushing
Itching - Answer constipation
Constipation is a common adverse effect of morphine that can be minimized by taking docusate
sodium, a stool softener that promotes easier evacuation of stool by increasing water and fat in the
intestine.
A nurse is assessing a client's vital signs prior to the administration of PO digoxin. The client's BP is
144/86 mm Hg, heart rate is 55/min, and respiratory rate is 20/min. The nurse should withhold the
medication and contact the provider for which of the following findings?
Diastolic BP
Systolic BP Heart
rate
Respiratory rate - Answer HR
Digoxin slows the conduction rate through the SA and AV nodes, thereby decreasing the heart rate.
The nurse should withhold the medication and notify the provider for a heart rate of 55/min because
this is an early indication of digoxin toxicity.
A nurse is caring for a client who received 0.9% sodium chloride 1 L over 4 hr instead of over 8 hr as
prescribed. Which of the following information should the nurse enter as a complete documentation of
the incident?
IV fluid infused over 4 hr instead of the prescribed 8 hr. Client tolerated fluids well, provider notified.
0.9% sodium chloride 1 L IV infused over 4 hr. Vital signs stable, provider notified. 1 L of 0.9%
sodium chloride completed at 0900. Client denies shortness of breath.
IV fluid initiated at 0500. Lungs clear to auscultation. - Answer 0.9% sodium chloride 1 L IV infused over
4 hr. Vital signs stable, provider notified
The nurse should document the type and amount of fluid, how long it took to infuse, provider
notification, and the client's physical status.
,A nurse is instructing a client on the application of nitroglycerin transdermal patches. Which of the
following statements by the client indicates an understanding of the teaching?
"I should apply a patch every 5 minutes if I develop chest pain." "I will take
the patch off right after my evening meal."
"I will leave the patch off at least 1 day each week."
"I should discard the used patch by flushing it down the toilet." - Answer "I will take the patch off right
after my evening meal."
Clients should remove the patch each evening for a medication free time of 12 to 14 hr before applying a
new patch to avoid developing a tolerance to the medication's effects.
A nurse receives a verbal order from the provider to administer morphine five milligrams every 4 hours
subcutaneously for severe pain as needed. The nurse should identify which of the following entries as the
correct format for the medication administration record (MAR)?
MSO4 5 mg subcut every 4 hr PRN severe pain Morphine 5 mg
subcut every 4 hr PRN severe pain MSO4 5 mg SQ every 4 hr
PRN severe pain
Morphine 5.0 mg subcutaneously every 4 hr PRN severe pain - Answer Morphine 5 mg subcut every 4 hr
PRN severe pain
The nurse should identify this entry as the correct format for the MAR. The medication name is
spelled out and there are not any abbreviations from The Joint Commission's "Do Not Use" list
included in the transcription.
A nurse is caring for a client who is taking acetazolamide for chronic open angle glaucoma. For which of
the following adverse effects should the nurse instruct the client to monitor and report
Tingling of fingers
Constipation Weight
gain
Oliguria - Answer Tingling of fingers
The nurse should instruct the client to report the adverse effect of paresthesia, a tingling sensation in the
extremities, when taking acetazolamide.
A nurse administers a dose of metformin to a client instead of the prescribed dose of metoclopramide.
Which of the following actions should the nurse take first?
Report the incident to the charge nurse. Notify
the provider.
Check the client's blood glucose.
, Fill out an incident report. - Answer check blood sugar
The first action the nurse should take using the nursing process is to assess the client. The client is at risk
for hypoglycemia. The nurse should monitor the client's blood glucose and provide the client with a
snack to reduce the risk for hypoglycemia.
A nurse is caring for a client who has cancer and is taking oral morphine and docusate sodium. The
nurse should instruct the client that taking the docusate sodium daily can minimize which of the
following adverse effects of morphine?
Constipation
Drowsiness
Facial flushing
Itching - Answer constipation
Constipation is a common adverse effect of morphine that can be minimized by taking docusate
sodium, a stool softener that promotes easier evacuation of stool by increasing water and fat in the
intestine.
A nurse is assessing a client's vital signs prior to the administration of PO digoxin. The client's BP is
144/86 mm Hg, heart rate is 55/min, and respiratory rate is 20/min. The nurse should withhold the
medication and contact the provider for which of the following findings?
Diastolic BP
Systolic BP Heart
rate
Respiratory rate - Answer HR
Digoxin slows the conduction rate through the SA and AV nodes, thereby decreasing the heart rate.
The nurse should withhold the medication and notify the provider for a heart rate of 55/min because
this is an early indication of digoxin toxicity.
A nurse is caring for a client who received 0.9% sodium chloride 1 L over 4 hr instead of over 8 hr as
prescribed. Which of the following information should the nurse enter as a complete documentation of
the incident?
IV fluid infused over 4 hr instead of the prescribed 8 hr. Client tolerated fluids well, provider notified.
0.9% sodium chloride 1 L IV infused over 4 hr. Vital signs stable, provider notified. 1 L of 0.9%
sodium chloride completed at 0900. Client denies shortness of breath.
IV fluid initiated at 0500. Lungs clear to auscultation. - Answer 0.9% sodium chloride 1 L IV infused over
4 hr. Vital signs stable, provider notified
The nurse should document the type and amount of fluid, how long it took to infuse, provider
notification, and the client's physical status.
