ATI PN PHARMACOLOGY PROCTORED EXAM 2020

A nurse is providing teaching to a client who has peptic ulcer disease and is to start a new prescription for sucralfate. Which of the following actions of sucralfate should the nurse include in the teaching? Decreases stomach acid secretion Neutralizes acids in the stomach Forms a protective barrier over ulcers Treat ulcers by eradication H. pylori Forms a protective barrier over ulcers Secretions by the parietal and chief cells, hydrochloric acid and pepsin, can further irritate the ulcerated areas. Sucralfate, a mucosal protectant, forms a gel-like substance that coats the ulcer, creating a barrier to hydrochloric acid and pepsin. A nurse is providing teaching to a client who has multiple sclerosis and a new prescription for methylprednisolone. Which of the following instructions should the nurse include? (Select all that apply.) Blood glucose levels will be monitored during therapy. Avoid contact with people who have known infections. Take the medication 1 hr before breakfast. Decrease dietary intake of foods containing potassium. Grapefruit juice can increase the effects of the medication. Blood glucose levels will be monitored during therapy. Avoid contact with people who have known infections. Grapefruit juice can increase the effects of the medication Blood glucose levels will be monitored during therapy is correct. The nurse should monitor the client for hyperglycaemia while providing methylprednisolone to the client. Glucocorticoids, such as methylprednisolone, increase serum glucose levels and can require management with insulin or antihyperglycemics. Avoid contact with people who have known infections is correct. The nurse should instruct the client to avoid exposure to infectious agents, such as contact with those who have active infections or illnesses. Glucocorticoids, such as methylprednisolone, depress the immune system, placing the client at an increased risk for developing an infection. Take the medication 1 hr before breakfast is incorrect. The nurse should instruct the client to take the medication with food or milk to decrease gastrointestinal upset. Decrease dietary intake of foods containing potassium is incorrect. The nurse should instruct the client to increase dietary intake of potassium-rich foods while taking this medication. Glucocorticoids, such as methylprednisolone, deplete potassium in the body, which manifests as hypokalemia. Grapefruit juice can increase the effects of the medication is correct. The nurse should instruct the client that grapefruit and grapefruit juice can increase the level of methylprednisolone in the body. A nurse is providing discharge teaching about handling medication to a client who is to continue taking oral transmucosal fentanyl raspberry-flavoured lozenges on a stick. Which of the following information should the nurse include in the teaching? Chew on the medication stick to release the medication. Leave the medication stick in one location of the mouth until melted. Allow the medication 1 hr for analgesia effects to begin. Store unused medication sticks in a storage container. Store unused medication sticks in a storage container. The nurse should instruct the client to store unused, used, or partially used medication sticks in the safe storage container that comes in the kit when the medication is initially prescribed. A nurse is reviewing the ECG of a client who is receiving IV furosemide for heart failure. The nurse should identify which of the following findings as an indication of hypokalaemia? Tall, tented T-waves Presence of U-waves Widened QRS complex ST elevation Presence of U-waves The nurse should identify the presence of U-waves as a manifestation of hypokalaemia, an adverse effect of furosemide. 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 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 planning care for a client who is receiving mannitol via continuous IV infusion. The nurse should monitor the client for which of the following adverse effects? Weight loss Increased intraocular pressure Auditory hallucinations Bibasilar crackles Bibasilar crackles Mannitol, an osmotic diuretic, can precipitate heart failure and pulmonary edema. Therefore, the nurse should recognize lung crackles as an indicator of a potential complication and stop the infusion. A nurse is providing teaching to a client who has a gastric ulcer and a new prescription for famotidine. Which of the following instructions should the nurse include? "Take the medication on an empty stomach for full effectiveness." "You may discontinue this medication when stomach discomfort subsides." "Report yellowing of the skin." "You will be taking this medication for 2 weeks." "Report yellowing of the skin." Famotidine can be hepatotoxic and cause jaundice. The nurse should instruct the client to monitor for and report yellowing of the skin or eyes to the provider. A nurse is assessing a client after administering a second dose of cefazolin IV. The nurse notes the client has anxiety, hypotension, and dyspnea. Which of the following medications should the nurse administer first? Diphenhydramine Albuterol inhaler Epinephrine Prednisone Epinephrine According to evidence-based practice, the nurse should administer epinephrine first to induce vasoconstriction and bronchodilation during anaphylaxis. A nurse is planning care for a client who has hypertension and is to start taking metoprolol. Which of the following interventions should the nurse include in the plan of care? Weigh the client weekly. Determine apical pulse prior to administering. Administer the medication 30 min prior to breakfast. Monitor the client for jaundice. Determine apical pulse prior to administering. Life-threatening bradycardia is an adverse effect that might affect this client. Therefore, the nurse should assess the client's apical pulse prior to administering the medication. If the client's pulse rate is less than 60/min, the nurse should withhold the medication and notify the provider. A nurse is preparing to administer ciprofloxacin 15 mg/kg PO every 12 hr to a child who weighs 44 lb. How many mg should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) ____ mg 300 mg A nurse in an emergency department is caring for a client whose family reports the client has taken large amounts of diazepam. Which of the following medications should the nurse anticipate administering? Ondansetron Magnesium sulfate Flumazenil Protamine sulfate Flumazenil The nurse should anticipate administering flumazenil, an antidote used to reverse benzodiazepines such as diazepam. A nurse is reviewing the laboratory results for a client who is receiving heparin via continuous IV infusion for deep-vein thrombosis. The nurse should discontinue the medication infusion for which of the following client findings? Potassium 5.0 mEq/ L aPTT 2 times the control Hemoglobin 15 g/dL Platelets 96,000/mm3 Platelets 96000/mm3 A platelet count of 96,000/mm3 is below the expected range of 150,000 to 400,000/mm3. A platelet count less than 100,000/mm3 while receiving heparin can indicate heparin-induced thrombocytopenia, a potentially fatal condition that requires stopping the infusion. A nurse is reviewing the medication administration record of a client who has hypocalcemia and a new prescription for IV calcium gluconate. The nurse should identify that which of the following medications can interact with calcium gluconate? Felodipine Guaifenesin Digoxin Regular insulin Digoxin The nurse should identify that calcium gluconate can cause hypercalcemia, which increases the risk of digoxin toxicity. 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. Check the client's blood glucose. 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 teaching a client who is to start taking hydrocodone with acetaminophen tablets for pain. Which of the following information should the nurse include in the teaching? The medication should be taken 1 hr prior to eating. It takes 48 hr for therapeutic effects to occur. Tablets should not be crushed or chewed. Decreased respirations might occur. Decreased respiration might occur. The nurse should instruct the client that hydrocodone with acetaminophen might cause respiratory depression, which is an adverse effect of the medication. The client should avoid taking over-the-counter medications or newly prescribed medications without consulting their provider to avoid increased respiratory depression. A nurse in an emergency department is caring for a client who has heroin toxicity. The client is unresponsive with pinpoint pupils and a respiratory rate of 6/min. Which of the following medications should the nurse plan to administer? Methadone Naloxone Diazepam Bupropion Naloxone The nurse should administer naloxone, an opioid antagonist, to a client who has heroin toxicity to reverse the respiratory depressive effects of the heroin. However, the nurse should not administer naloxone too quickly because naloxone can cause hypertension, tachycardia, nausea, vomiting, and might cause the client to enter a state of opioid withdrawal. A nurse is reviewing the medication list of a client who wants to begin taking oral contraceptives. The nurse should identify that which of the following client medications will interfere with the effectiveness of oral contraceptives? Carbamazepine Sumatriptan Atenolol Glipizide Carbamazepine Carbamazepine causes an accelerated inactivation of oral contraceptives because of its action on hepatic medication-metabolizing enzymes. 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 Heart Rate 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 at a clinic is providing follow-up care to a client who is taking fluoxetine for depression. Which of the following findings should the nurse identify as an adverse effect of the medication? Tingling toes Sexual dysfunction Absence of dreams Pica Sexual dysfunction Sexual dysfunction, including a decreased libido, impotence, and delayed orgasm, or anorgasmia, is a common adverse effect of fluoxetine and occurs in about 70% of clients who take this SSRI antidepressant. A nurse is teaching a client about warfarin. The client asks if they can take aspirin while taking the warfarin. Which of the following responses should the nurse make? "It is safe to take an enteric-coated aspirin." "Aspirin will increase the risk of bleeding." "Acetaminophen may be substituted for aspirin." "The INR lab work must be monitored more frequently if aspirin is taken." "Aspirin will increase the risk of bleeding." Aspirin inhibits platelet aggregation and can potentiate the action of the anticoagulant warfarin. Therefore, the client should avoid taking aspirin because it increases the risk for bleeding. A nurse is assessing a client who is postoperative following an outpatient endoscopy procedure using midazolam. The nurse should monitor for which of the following findings as an indication that the client is ready for discharge? The client's capnography has returned to baseline. The client can respond to their name when called. The client is passing flatus. The client is requesting oral intake. The client's capnography has returned to baseline. The nurse should identify that the client is ready for discharge when the capnography level indicates that gas exchange is adequate. A nurse is caring for the parent of a newborn. The parent asks the nurse when their newborn should receive the first diphtheria, tetanus, and pertussis vaccine (DTaP). The nurse should instruct the parent that their newborn should receive the immunization at which of the following ages? At birth 2 months 6 months 15 months 2 months The CDC recommends that newborns receive the first dose of the five-dose series of the DTaP immunization at 2 months of age. 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. 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 assessing a client who is taking propylthiouracil for the treatment of Graves' disease. Which of the following findings should the nurse identify as an indication that the medication has been effective? Decrease in WBC count Decrease in amount of time sleeping Increase in appetite Increase in ability to focus Increase in ability to focus A client who has Graves' disease can experience psychological manifestations such as difficulty focusing, restlessness, and manic-type behaviors. Propylthiouracil is a thyroid hormone antagonist that decreases the circulating T4 hormone, reducing the manifestations of hyperthyroidism. An increased ability to focus indicates that the medication has been effective. A nurse is preparing to administer medications to a client who tells the nurse, "I don't want to take my fluid pill until I get home today." Which of the following actions should the nurse take? Document the refusal and inform the client's provider. File an incident report with the risk manager. Contact the pharmacist to pick up the medication. Give the client the medication to take at home and document that it was administered. Document the refusal and inform the client's provider. The nurse has the responsibility to verify that the client understands the risks of refusing the medication so that an informed decision can be made. The nurse should then document the refusal in the client's medical record and notify the health care provider. A nurse is administering donepezil to a client who has Alzheimer's disease. Which of the following findings should the nurse report to the provider immediately? Dyspepsia Diarrhea Dizziness Dyspnea Dyspnea When using the airway, breathing, circulation approach to client care, the nurse should report the adverse effect of dyspnea, caused by bronchoconstriction, to the provider first. Bronchoconstriction, dyspepsia, diarrhea, and dizziness are caused by the increase in acetylcholine levels, which is a primary effect of donepezil. A nurse is assessing a client who has myasthenia gravis and is taking neostigmine. Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect? Tachycardia Oliguria Xerostomia Miosis Miosis Miosis, which is pupillary constriction, is a common adverse effect of neostigmine due to the excessive muscarinic stimulation that causes difficulty with visual accommodation. A nurse is teaching a client about cyclobenzaprine. Which of the following client statements should indicate to the nurse that the teaching is effective? "I will have increased saliva production." "I will continue taking the medication until the rash disappears." "I will taper off the medication before discontinuing it." "I will report any urinary incontinence." I will taper off the medication before discontinuing The client should taper off cyclobenzaprine before discontinuing it to prevent abstinence syndrome or rebound insomnia. A nurse is providing teaching to a client who is to begin taking oxybutynin for urinary incontinence. Which of the following adverse effects should the nurse include in the teaching? (Select all that apply.) Dry mouth Tinnitus Blurred vision Bradycardia Dry eyes Dry Mouth Blurred Vision Dry Eyes Dry mouth is correct. Oxybutynin is an anticholinergic agent that can cause dry mouth. Tinnitus is incorrect. Oxybutynin can cause several sensory adverse effects including increased intraocular pressure. The nurse should instruct the client to report eye pain, seeing colored halos around lights, and a decreased ability to perceive light changes. However, tinnitus is not an adverse effect associated with oxybutynin administration. Blurred vision is correct. Oxybutynin is an anticholinergic agent that can cause blurred vision due to an increase in intraocular pressure. Bradycardia is incorrect. Oxybutynin can cause several cardiovascular adverse effects such as a prolongation of the QT interval, palpitations, hypertension, and tachycardia.Dry eyes is correct. Oxybutynin is an anticholinergic agent that can cause dry eyes and mydriasis, or pupil dilation.