Pharm- ENWE Study Guide Test.
a nurse is assessing a client who has numerous bruises on his upper extremities. The client reports that
he has taken warfarin (Coumadin) daily for the past 3 months. Which of the following statements by the
client indicates the client needs further teaching? - CORRECT ANSWER "I have started taking ginger root
to treat my joint stiffness."
Ginger root can interfere with the blood clotting effect of warfarin and place the client at risk for
bleeding.
Clients who are taking warfarin can take acetaminophen for mild to mod pain relief. but no more tha
1g/day and no more than 2-3 days at a time.
Green leafy veggies contain Vit K which can interfere with warfarin but pts do not need to constrict their
intake of vit k but instead control it.
Clients need their INR tested every 2-4 weeks.
A nurse is talking with a client who is about to start taking allopurinol (Zyloprim) to treat gout. Which of
the following statements indicates that the client understands how to take this medication? - CORRECT
ANSWER "I need to drink at least 3 quarts of water a day."
Clients taking allopurinol must drink enough fluids to produce 2000 ml of urine per day.
The pts need to report a rash or a fever to the provider immediately.
Pts. need to take this after a meal.
A client is receiving pancreatic enzymes as a digestive aid. The nurse should tell the client expect which
of the following gastrointestinal changes? - CORRECT ANSWER "decreased fat in stools"
Clients who have CF or pancreatitis need to supplement meals with oral pancreatic enzymes to reduce
the fat content in their stools.
A nurse is caring for a client who is hospitalized with deep vein thrombosis and has been on IV heparin
for 5 days. The provider prescribes warfarin without discontinuing the heparin. The client asks the nurse
why both anticoagulants are necessary. Which of the following is an appropriate nursing response? -
CORRECT ANSWER "The Coumadin takes several days to work so the IV heparin will be used until the
coumadin reaches a therapeutic level."
, Heparin and warfarin are both anticoagulants. Warfarin takes 1-5 days for therapeutic levels to be
reached.
A nurse is caring for a client who is receiving a unit of packed RBC. The nurse notices the client's face is
flushing and he begins to report low back pain. Which of the following actions is the nurse's priority? -
CORRECT ANSWER "Stop the transfusion"
the client will need antihistamines, will need vital signs to be monitored, will need the venous access
maintained with 0.9% sodium chloride but these are all not priority action.
A nurse is teaching a client about the side effects of taking tamoxifen (Nolvadex) to treat breast cancer.
Which client statement indicates understanding of the possible effects? - CORRECT ANSWER "I will call
my doctor if i notice any unusual menstrual bleeding"
Tamoxifen, an estrogen receptor blocker can cause uterine cancer. The client should watch for abnormal
uterine bleeding, pelvic pain or pressure and have regular gynecologic exams.
- more likely to cause weight loss.
more likely to cause vision loss.
more likely to cause sleepiness and dizziness.
A home health nurse is reviewing the medication list of an older adult client who reports falling a couple
of times over the past week. Which of the following meds should the nurse suspect is contributing to the
client's falls? - CORRECT ANSWER "Alprazolam"- CNS depressant- dizziness and lightheadedness
causes sedation too
A nurse is teaching a client who is about to start therapy with alendronate (Fosamax) to treat
osteoporosis. Which of the following adverse effects should the nurse instruct the client to report? -
CORRECT ANSWER "Jaw pain, blurred vision, dysphagia"
alendronate can cause osteonecrosis of the jaw= jaw pain
- cause ocular inflammation= blurred vision.
- cause headache
- cause esophagitis- dysphagia
a nurse is assessing a client who has numerous bruises on his upper extremities. The client reports that
he has taken warfarin (Coumadin) daily for the past 3 months. Which of the following statements by the
client indicates the client needs further teaching? - CORRECT ANSWER "I have started taking ginger root
to treat my joint stiffness."
Ginger root can interfere with the blood clotting effect of warfarin and place the client at risk for
bleeding.
Clients who are taking warfarin can take acetaminophen for mild to mod pain relief. but no more tha
1g/day and no more than 2-3 days at a time.
Green leafy veggies contain Vit K which can interfere with warfarin but pts do not need to constrict their
intake of vit k but instead control it.
Clients need their INR tested every 2-4 weeks.
A nurse is talking with a client who is about to start taking allopurinol (Zyloprim) to treat gout. Which of
the following statements indicates that the client understands how to take this medication? - CORRECT
ANSWER "I need to drink at least 3 quarts of water a day."
Clients taking allopurinol must drink enough fluids to produce 2000 ml of urine per day.
The pts need to report a rash or a fever to the provider immediately.
Pts. need to take this after a meal.
A client is receiving pancreatic enzymes as a digestive aid. The nurse should tell the client expect which
of the following gastrointestinal changes? - CORRECT ANSWER "decreased fat in stools"
Clients who have CF or pancreatitis need to supplement meals with oral pancreatic enzymes to reduce
the fat content in their stools.
A nurse is caring for a client who is hospitalized with deep vein thrombosis and has been on IV heparin
for 5 days. The provider prescribes warfarin without discontinuing the heparin. The client asks the nurse
why both anticoagulants are necessary. Which of the following is an appropriate nursing response? -
CORRECT ANSWER "The Coumadin takes several days to work so the IV heparin will be used until the
coumadin reaches a therapeutic level."
, Heparin and warfarin are both anticoagulants. Warfarin takes 1-5 days for therapeutic levels to be
reached.
A nurse is caring for a client who is receiving a unit of packed RBC. The nurse notices the client's face is
flushing and he begins to report low back pain. Which of the following actions is the nurse's priority? -
CORRECT ANSWER "Stop the transfusion"
the client will need antihistamines, will need vital signs to be monitored, will need the venous access
maintained with 0.9% sodium chloride but these are all not priority action.
A nurse is teaching a client about the side effects of taking tamoxifen (Nolvadex) to treat breast cancer.
Which client statement indicates understanding of the possible effects? - CORRECT ANSWER "I will call
my doctor if i notice any unusual menstrual bleeding"
Tamoxifen, an estrogen receptor blocker can cause uterine cancer. The client should watch for abnormal
uterine bleeding, pelvic pain or pressure and have regular gynecologic exams.
- more likely to cause weight loss.
more likely to cause vision loss.
more likely to cause sleepiness and dizziness.
A home health nurse is reviewing the medication list of an older adult client who reports falling a couple
of times over the past week. Which of the following meds should the nurse suspect is contributing to the
client's falls? - CORRECT ANSWER "Alprazolam"- CNS depressant- dizziness and lightheadedness
causes sedation too
A nurse is teaching a client who is about to start therapy with alendronate (Fosamax) to treat
osteoporosis. Which of the following adverse effects should the nurse instruct the client to report? -
CORRECT ANSWER "Jaw pain, blurred vision, dysphagia"
alendronate can cause osteonecrosis of the jaw= jaw pain
- cause ocular inflammation= blurred vision.
- cause headache
- cause esophagitis- dysphagia
