ATI PN PHARMACOLOGY COMPREHENSIVE EXAM A 2022/2023

ATI PN PHARMACOLOGY COMPREHENSIVE EXAM A 2022/2023 ATI PN PHAM   ATI PN PHARMACOLOGY COMPREHENSIVE EXAM A 2022/2023 A nurse is reinforcing teaching with a client who is using phenylephrine nasal spray three times daily and reports rebound congestion. which of the following instructions should the nurse include to reduce the effects of rebound congestion? discontinue use in the left nostril, then in the right nostril A nurse is monitoring a client who has type 2 diabetes mellitus and is receiving repaglinide. Which of the following laboratory tests should the nurse plan to review to obtain information about the long- term therapeutic effect of this medication? Glycosylated HBA1C A nurse is reinforcing teaching with a client who is to start therapy using a nitroglycrin transdermal patch. which of the following instructions should the nurse include? place the path on different site for each application At 0800 a nurse assists with initiating a 1,000 mL IV infusion for a client, which is running at 125 mL/hr. How much fluid is left in the IV bag at 1300? (Round the answer to the nearest whole number. Use aleading zero if it applies' Do not use a trailing zero.) 375 A nurse is caring for a client who has chronic kidney disease and has been receiving epoetin for 2 weeks. Which of the following findings should indicate to the nurse that the client's medication is having the desired therapeutic effect? hemoglobin rises 0.5g/dl A nurse is collecting data from a client who is postoperative and taking morphine for pain. Which of the following findings is the priority for the nurse to report to the provider? oxygen saturation 87% A nurse is reinforcing teaching with a client who has a new prescription for propranolol. which of the following information should the nurse include in the teaching? if your pulse rate is less than 50 beats per minute, notify your provider. A nurse is contributing to the plan of care for a client who has schizophrenia and a new prescription for clozapine. The nurse should include in the plan to monitor the client for which of the following adverse effects of this medication? agranulocytocis A nurse is reviewing medication prescriptions for a group of clients' The nurse should recognize that which of the following prescriptions can result in a medication administration error? furosemide 10.0 mg po daily A nurse is reinforcing teaching with a client who has a prescription for alendronate. Which of the following client responses indicates to the nurse an understanding of the teaching? i will take the medication with 8 ounces of water A nurse is reviewing the history of a client who is to start taking cefotetan to treat a bacterial infection' which of the following information from the client's medical record should the nurse report to the provider before the client begins receiving this medication? penicillin allergy A nurse is preparing to administer a PRN medication to a group of clients. which of the following clients should the nurse administer medication to first? a client who is attending postoperative physical therapy and requests pain medication A nurse is monitoring a client who is receiving a transfusion of packed RBCs. The client's temperature increases to 39.1" C (102.4° F). Which of the following actions should the nurse take first? stop the transfusion A nurse is reinforcing teaching about comfort measures with the parent of a 10-year-old child who has a viral infection. The nurse should plan to tell the parent that aspirin is contraindicated because of the risk for which of the following conditions? Reye syndrome A nurse is reinforcing teaching with a client who has HIV and a new prescription for zidovudine. Which of the following client statements should indicate to the nurse an understanding of the teaching? i will be sure to have my blood tested for anemia A nurse is reinforcing teaching with a female client who has a new prescription for isotretinoin. Which of the following information should the nurse include in the teaching? (Select all that apply) [-] you will need to have liver enzymes monitored after 1 month [-] you can nosebleed while taking this medication [-you should report any thoughts of harming yourself [-] you will need to have two negative pregnancy test prior to starting this medication A nurse is reinforcing teaching with a client who has bipolar disorder and a new prescription for lithium. which of the following instructions should the nurse include in the teaching? maintain consistent sodium intake A client comes to an urgent care clinic and announces with great enthusiasm, "I am an expert at all things medical as they apply to me. and I require zolpidem." The client's pupils are dilated. along with an elevated heart rate and blood pressure level. The nurse should suspect intoxication with which of the following substances? cocaine A nurse is caring for a client who has a new prescription for sumatriptan. The nurse notes that the client takes fluoxetine. The nurse should notify the provider that the combination of these medications will place the client at risk for which of the following adverse effects? tremors A nurse is collecting data from a female client who has been taking propylthiouracil (PTU) for 2 months to treat Graves' disease. Which of the following findings should the nurse recognize as an indication that the medication is effective? pulse 82/min A nurse is reinforcing teaching with a client who has a new prescription for etanercept to treat rheumatoid arthritis. which of the following instructions about self- administering this medication should the nurse include? discard any solution that are cloudy A nurse is assisting with the care of a client who has a methicillin-resistant Staphylamctus aureus (MRSA) infection and is receiving vancomycin via IV infusion. which of the following changes in the client's condition should the nurse identify as the priority finding to report to the provider? hypotension A nurse is caring for a client who has hyperthyroidism and has been taking methimazole. Which of the following findings should indicate to the nurse that the medication has had a therapeutic effect? decreased T4 A nurse is reinforcing teaching with the parent o fa preschooler who has otitis media. The child has had a low-grade fever and irritability for 2 days. Which of the following instructions should the nurse include in the teaching? give acetaminophen as needed for discomfort and fever. A nurse is collecting data from a client who has Parkinson's disease and is taking levodopa/ carbidopa' The nurse should identify which of the following findings as an adverse effect of this medication? dark urine A nurse is caring for a client who has a history of psychosis and is taking chlorpromazine. Which of the following actions should the nurse take to counteract the adverse effects of this medication? inform the client to apply sunblock before going outside A nurse is reinforcing teaching with a client about the adverse effects of simvastatin, For which of the following adverse effects should the nurse instruct the client to notify the provider? muscle pain A nurse is reinforcing teaching with a client who has a new prescription for theophylline. The nurse should instruct the client that which of the following is an expected outcome of this medication? dilates bronchioles A nurse is reinforcing teaching with a client following placement of a cast for a fractured ankle. The client is to take oxycodone for pain management The nurse should instruct the client that which of the following over-the-counter medications is contraindicated while taking oxycodone? Diphenhydramine A nurse is reinforcing teaching with a client who has a new prescription for ethinyl estradiol/norethindrone, an oral contraceptive. which of the following client statements should indicate to the nurse an understanding of the teaching? "I will take the medication at the same time each day." A nurse is caring for a client who has a new prescription for eplerenone to treat hypertension. The nurse should monitor for which of the following adverse effects of this medication? Hyperkalemia A nurse is reinforcing teaching with a client who has hypertension and a new prescription for spironolactone. Which of the following instructions should the nurse include in the teaching? Restrict foods high in potassium. A nurse is collecting data from a client who is receiving digoxin for treatment of heart failure. The nurse should identify which of the following findings as adverse effects of this medication? (Select all that apply.) [] blurred vision [] Nausea [] Dysrythmias A nurse is reinforcing teaching with a client who has a new prescription for colchicine to manage gouty arthritis, which of the following manifestations should the nurse include as an adverse effect of this medication? abdominal pain A nurse is caring for a client who has multiple sclerosis and a new prescription for baclofen. Which of the following findings indicates to the nurse that the medication is having a therapeutic effect? Decreased muscle spasticity A nurse is planning to administer metoprolol to a client who has heart failure and a heart rate of 48/min. Which of the following actions should the nurse take? withhold the clients medicaion A nurse is caring for a client who is receiving 0.9% sodium :chloride,000 mL to infuse over 8 hr. The drop factor on the manual IV tubing is 15 gtt/mL. The nurse should ensure that the manual IV infusion is set to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) 31 A nurse is collecting data from a client who is taking ferrous sulfate orally. Which of the following findings reported by the client should indicate to the nurse that the medication is having a therapeutic effect? Increased tolerance to exercise A nurse is planning to reinforce teaching about newborn immunizations with a client who is 24 hr postpartum. Which ofthe following information should the nurse plan to include? your baby will receive the first hepatitis B vaccine before discharge. A nurse is reinforcing teaching with a client who has a new prescription for regular insulin. which of the following statements by the client indicates an understanding of the teaching? "I should ensure that the Insulin is clear prior to drawing it up." A nurse is reinforcing teaching with a client who has a new prescription for omeprazole oral capsules. Which of the following instructions should the nurse include? swallow the medication whole A nurse is caring for a client who is taking phenylephrine' The nurse should plan to monitor the client for which of the following manifestations as an adverse effect of this medication? increased HR A nurse is preparing to administer diphenhydramine 50 mg P0 at 2200 to a client who has difficulty swallowing pills and capsules. Available is diphenhydramine syrup 12.5 mg/5 mL PO. Which of the following nursing actions requires the completion of an incident report? administer 25 ml syrup A nurse is reinforcing teaching with a client who has seizures and a new prescription for valproic acid. The nurse should instruct the client to report which of the following adverse effects of valproic acid to the provider immediately? abdominal pain A nurse is collecting data from the parent of a toddler who is about to receive the varicella immunization. The nurse should identify that an anaphylactic reaction to which of the following substances is a contraindication for receiving this immunization? Gelatin A nurse is collecting data from a client who is asking about taking celecoxib for treatment of joint pain. The nurse should identify that which of the following findings is a contraindication to receiving celecoxib? History of myocardial infraction A nurse is instilling timolol eyedrops for a client who has glaucoma. Which of the following actions should the nurse take after instilling the eyedrops? press the nasolacrimal duct A nurse is reinforcing teaching with a newly licensed nurse about using metoprolol to treat hypertension. Which of the following conditions should the nurse include as a contraindication for this medication? bradycardia A nurse is caring for a client who has tuberculosis and will begin taking isoniazid. Which of the following actions should the nurse take? determine the client daily alcohol intake A nurse is caring for a client who has a prescription for an IM injection of penicillin G benzathine. The client asks why the injection must be given IM instead of through the IV line. Which of the following responses should the nurse make? "Your medication can't be given IV because it is not water soluble." A nurse is caring for a client who has a 10-year history of alcohol use disorder and is experiencing acute alcohol withdrawal. The nurse should identify which of the following interventions as the priority? implement seizure precautions. A nurse is reinforcing teaching with a client who experiences migraine headaches and has a new prescription for sumatriptan. The nurse should instruct the client to report which of the following manifestations to the provider as an adverse effect of this medication? chest tightness A nurse is reinforcing teaching with a client who is receiving enalapril 20 mg P0 daily, The nurse should instruct the client to monitor for which of the following adverse effects of this medication? Dry cough A nurse is caring for a client who has genital herpes. which of the following medications should the nurse expect to administer? acyclovir A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus about adverse effects of metformin. The nurse should instruct the client to monitor for which of the following findings as manifestations of lactic acidosis? (Select all that apply.) [] muscle pain [] hyperventilation [] Dizziness A nurse in a provider's office is reviewing the immunization records of a 12- month-old infant who is immunocompromised. which of the following vaccines should the nurse identify as contraindicated for this client? Measles, mumps, and rubella (MMR) A nurse is reinforcing teaching with a client who has type 1 diabetes mellitus and is learning to self- administer NPH insulin' Which of the following client actions indicates an understanding of the teaching? The client wipes the cap with alcohol prior to filling the syringe. A nurse is caring for a client who is having an acute asthma attack. Which of the following medications albuterol A nurse is collecting data from a client who received morphine IV for pain relief. Which of the following findings is the nurse's priority to report to the provider? respiration rate 11/min A nurse is caring for a client who has a new prescription for risperidone to manage schizophrenia. which of the following laboratory tests should the nurse plan to obtain prior to administering the first dose? fasting blood glucose level A nurse is performing the third check before administering hydromorphone to a client. After opening the unit-dose packet, the client tells the nurse they do not want to take the medication now. Which of the following actions should the nurse take? Dispose of the medication with a second nurse as a witness. A nurse is caring for a client who is taking disulfiram and consumed alcohol 12 hr ago. which of the following adverse reactions is the priority finding to report to the provider? respiratory depression A nurse is caring for a client who has schizophrenia and is to start therapy with risperidone. For which of the following manifestations should the nurse monitor to determine whether the treatment is effective? improved social interactions A nurse is preparing to administer phenobarbital 3 mg/kg P0 twice a day to a school-age child who weighs 44 lb, Available is phenobarbital elixir 20 mg/5 mL, How many mL should the nurse plan to administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) 15 A nurse is reviewing a client's medical history before administering hydromorphone for postoperative pain' The nurse should notify the provider of which of the following findings before administering this medication Benign prostatic hyperplasia A nurse erroneously administered zolpidem to the wrong client. Which of the following actions should the nurse take? document the notification of the clients provider A nurse is reinforcing discharge teaching with a client who has a prescription for a metered—dose inhaler (MDI). Which of the following information should the nurse include in the teaching? "Take a slow, deep breath lasting 3 to 5 seconds after releasing the medication." A nurse is caring for a client who has kidney failure and has been taking epoetin. Which of the following is a therapeutic effect of this medication? increased HGB A nurse is reinforcing teaching with a client who has a new prescription for vitamin B12 intranasal to treat malabsorption syndrome. Which of the following instructions should the nurse include in the teaching? massage your nose gently after medication administration A nurse is collecting data from a client who has hyperthyroidism and a new prescription for propylthiouracil. The nurse should monitor the client for which of the following manifestations as an adverse effect of this medication? sore throat A nurse is collecting data from a client who has multiple sclerosis and a new prescription for baclofen. Which of the following findings should the nurse identify as an adverse effect of this medication? drowsiness A nurse is reinforcing teaching with a client who is to start therapy with a nitroglycerin transdermal patch. which of the following statements by the client indicates an understanding of the teaching? while using this patch i will be careful when rising from a chair A nurse is reviewing the medical record of a client who has a new prescription for dimenhydrinate to treat motion sickness. which of the following conditions in the client's medical record should the nurse report to the provider? Benign prostatic hyperplasia A nurse in a community health clinic is preparing to administer the varicella vaccine to a young adult female client who has not previously had chickenpox or its vaccine, The nurse should withhold the vaccine and collect additional data when the client makes which of the following statements? i am allergic to neomycin A nurse is caring for a client who is receiving methylprednisolonet which of the following laboratory values should the nurse plan to monitor? (select all that apply.) [] white blood cell count []serum potassium is correct []blood glucose A nurse is reinforcing teaching with a client who has rheumatoid arthritis and a new prescription for methotrexate. which of the following information should the nurse include in the teaching? increase fluid intake A nurse is collecting data from a client who is taking tobramycin, which of the following findings should the nurse report to me provider immediately? oliguria A nurse is collecting data from a client who is taking lithium to treat bipolar disorder. which of the following findings should me nurse report to the provider? slurred speech A nurse is reviewing the medication administration record of a client who has a history of Stevens-Johnson syndrome when taking sulfamethoxazole- trimethoprim. Which of the following medications should the nurse identify as contraindicated for this client? furosemide A nurse is collecting data from a client who is taking oral amoxicillin to treat a respiratory infection The nurse should monitor the client for which of the following manifestations as an adverse effect of the medication? diarrhea A nurse is evaluating a client who is receiving amphotericin 8 Via intermittent IV bolus. Which of the following findings indicates an adverse reaction to this medication? hypotension A nurse is preparing to administer cefazolin 1 g in 100 mL 0.9% sodium chloride to infuse over 30 min. The drop factor of the manual IV tubing is 15 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) 50 A nurse is monitoring a client who is 2 hr postoperative and has a prescription for opioid analgesics. which of the following actions provides the nurse with the priority data to determine the client's need for analgesia? ask the client to rate their pain A nurse is reinforcing dietary teaching with a client who has a new prescription for phenelzine, which of the following foods should the nurse include in the teaching as an appropriate land choice? yogurt A nurse is reinforcing teaching with a client who recently began taking furosemides Which oi the following instructions should the nurse include in the teaching? increase dietary potassium while taking the medication A nurse is reinforcing teaching with a client who has a new prescription for tirnoiai eye drops to treat glaucoma. which of the following client statements indicates an understanding of the teaching? i will look up when putting the medication into my eyes A nurse is reinforcing teaching with a client who has a new prescription for a flulicasone inhaler. which of the following client statements indicates an understanding of the teaching? i will rinse my mouth after i use this inhaler A nurse is collecting data from a client who has been taking digoxin for I month The nurse should identify which of the following findings as a manifestation of digoxin toxicity? vomiting A nurse is reinforcing teaching with a client who is newly diagnosed with hypertension and is taking metoprolol. The nurse should instruct the client to report which of the following manifestations to the provider as an adverse effect of this medication? peripheral edema A nurse is collecting data from a client who has angina and a new prescription for sublingual nitroglycerin. which of the following manifestations should the nurse expect as an adverse effect of this medication? headache A nurse is reviewing the medication administration record for a client who has a new prescription for tobramycin ta treat a pulmonary infection which. of the following medications should the nurse identify as increasing the risk for ototoxicity while taking tobramycin.' furosemide A nurse is collecting data from a client who has bacterial pneumonia and is taking ceftriaxone' which of the following findings indicates a therapeutic effect of the medication? clear bilateral breath sounds a client who has terminal cancer reports pain as 5 on a scale of 0 to 10. The client has e prescription for morphine I5 mg orally every 4 hr. The clients adult children express concern that the client is receiving too much of the 'The dose should remain constant to prevent breakthrough pain." A nurse on a medical-surgical unit is preparing to administer medications to a client which of the following questions should the nurse ask the client to verify the client's identity? what is your phone number A nurse is collecting data prior to administering digoxin to a client. For which of the following findings should the nurse withhold this medication and notify the provider? apical pulse of 52 A nurse is reinforcing teaching with a client who has a prescription for scopolarnine transderrnal patches to prevent motion sickness. which of the following statements by the client indicates an understanding of the teaching? i should place the patch behind my ear A nurse is collecting data from a client who is taking exenatide to treat diabetes mellitus. For which of the following findings should the nurse withhold the exenatide dose and notify the provider immediately? abdominal pain A nurse is monitoring a client when has been receiving long-term hydrochlurothialide therapy for recurring episodes of heart failure. which of the following findings should me nurse identify as an adverse effect of this medication? hypokalemia A nurse is collecting data from a client who has been taking levodopa/carlaidopa. which of the following findings should indicate to the nurse that the medication is effective? the client who is able to wash their face A nurse is assisting with collecting data (or a client who is in preterm labor and is receiving magnesium sulfate via continuous iv infusion. which of the following findings should the nurse identify as an indication of magnesium toxicity? hyporeflexia 1. 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 2. 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 3. 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 4. 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 5. 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. 1/15 e. Do not crush or chew tablets. 6. 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 7. 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 8. 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 9. 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 10. 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.” 11. 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 12. 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 13. Propranolol (Inderal) is contraindicated for a client who has which of the following conditions? a. Asthma b. Diabetes c. Angina d. Dementia 14. 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.” 15. 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 16. 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 propanolol, which of the following should the nurse plan to monitor? (Select all that apply) a. Urinary output b. Pulse rate c. Temperature d. Blood pressure e. Deep tendon reflexes 17. 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? (Select all that apply.) a. Fatigue b. Constipation c. Anorexia d. Rash e. Diplopia 18. 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 19. 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 20. 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? (Select all that apply) 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. 21. 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. 22. 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 23. 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 24. 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. 25. 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 26. 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. 27. 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. 28. 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 29. A nurse is reinforcing teaching for a client who has peptic ulcer disease on how to properly self- administer 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.” 30. 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) 31. 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 32. 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? (Select all that apply.) 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 33. A nurse is caring for a male client who has a new prescription for testosterone cypionate (Depo- Testosterone) 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 34. 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 35. 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.” 36. A client who has osteoporosis is started on alendronate (Fosamax). The nurse should instruct the client to do which of the following? (Select all that apply.) 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 37. 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 38. 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 39. 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) 40. 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 opiods 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 41. A nurse is monitoring a client who received regular doses of meperidine (Demerol) for post- operative pain for 36 hr. For which of the following should the nurse monitor the client? a. Hypothremia b. Bradycardia c. Delirium d. Watery diarrhea 42. 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 43. 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 fetanyl 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 24 hr 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. 44. 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. 45. 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) 46. 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 nurtse should plan to monitor the client for which of the following findings? a. Hypoglycemia b. GI Bleeding c. Weight loss d. Asthma 47. 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 48. 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 49. 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 50. Match the time of NPH insulin (Humulin N) onset: a. Less than 15 min b. 0.5 to 1 hr c. 1 to 2 hr d. 1 hr 51. 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? (Select all that apply) a. Insulin detemir (Levemir) b. Insulin lispro (Humalog) c. Insulin glargine (Lantus) d. Insulin aspart (Novolog) 52. 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 53. 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? (Select all that apply) 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 54. 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 55. A nurse is reinforcing teaching for a client with hyperthyroidism who has a new prescription for propanolol (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 56. 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 57. 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 58. 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. 59. 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 60. 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 prescribe 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. 61. 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 62. 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 insstruct the client to watch for? a. Oral thrush b. Chest pain c. Rapid pulse d. Peripheral neuropathy 63. 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.’ 64. 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 65. 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 66. 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 67. 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) 68. 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. 69. 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 70. 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 71. 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 72. 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 73. 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 tables under the tongue c. Flush with 10 mL of warm water when completed d. Add medications to enteral feeding 74. 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 75. 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