BSN 315 Pharm II Exam Questions for HESI – With Correct and Verified Answers. Graded A+

BSN 315 Pharm II Exam Questions for HESI – With Correct and Verified Answers. Graded A+ A client with a history of chronic obstructive pulmonary disease (COPD) receives a new prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed? a. Primes the inhaler with 7 pumps. b. Attaches spacer device to the inhaler. c. Rinses the after each use. d. Stores the medication at room temperature. - Correct Answer Primes the inhaler with 7 pumps." "A client with atrial fibrillation receives a new prescription for dabigatran. Which instruction should the nurse include in this client's teaching plan? a. Keep an antidote available in the event of hemorrhage. b. Continue obtaining scheduled laboratory bleeding tests. c. Eliminate spinach and other green vegetables in the diet. d. Avoid use of nonsteroidal anti-inflammatory drugs (NSAID) - Correct Answer Avoid use of nonsteroidal anti-inflammatory drugs (NSAID)" "The healthcare provider prescribes the antibiotic tetracycline HI for an adult client that arrived at an outpatient clinic. Which instruction should the nurse include in the teaching plan for this client? a. Protect the skin from sunlight while taking the drug. b. Take with orange juice to enhance Gl absorption. c. Take with milk or antacids to prevent gastrointestinal (G) irritation. d. Return to the clinic weekly to obtain serum drug levels. - Correct Answer Protect the skin from sunlight while taking the drug." "A client with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in this client's plan of care? Cover your skin before going outside. Limit intake of high-potassium foods. Replace salt with a salt substitute. Monitor skin for excessive bruising. - Correct Answer Limit intake of high-potassium foods." "A client with peptic ulcer disease receives a new prescription for cimetidine. Which statement provided by the client requires additional instruction by the nurse? a. Notify the healthcare provider of lethargy. b. Monitor for any signs of sexual dysfunction. c. Decrease cigarette use to a pack per day. d. Take the medication an hour after antacids - Correct Answer Decrease cigarette use to a pack per day" "A client with chemotherapy induced nausea receives a prescription for metoclopramide. Which adverse effect is most important for the nurse to report? a. Diarrhea. b. Involuntary movements. c. Unusual irritability. d. Nausea. - Correct Answer Involuntary movements." "The nurse admits a client with a diagnosis of stage 4 cancer. The client has a prescription to wear a subcutaneous morphine sulfate patch for pain. The client is short of breath and difficult to arouse. While performing a head to toe assessment. the nurse discovers four patches on the client's body. Which action should the nurse take first? a. Monitor blood pressure. b. Administer a narcotic reversal drug. c. Remove the morphine patches. d. Apply oxygen face mask. - Correct Answer Remove the morphine patches." "The nurse is providing instructions about a client's new medications. How should the nurse explain the purpose of probenecid, a uricosuric drug? a. Decreases pain and burning during urination. b. Prevents the formation of kidney stones. c. Increases the strength of the urine stream. d. Promotes excretion of uric acid in the urine. - Correct Answer Promotes excretion of uric acid in the urine." "A client taking atorvastatin develops an increased serum creatine phosphokinase (CK) level. The nurse should assess the client for the onset of which problem? a. Excessive bruising. b. Muscle tenderness. c. Peripheral edema. d. Nausea and vomiting. - Correct Answer Muscle tenderness." "A client receives a new prescription for levothyroxine. Which statement made by client indicates to the nurse the education was effective? a. Take medication on an empty stomach. b. Avoid the use of iron supplements c. Administer levothyroxine at bedtime Consume foods that are high in iodine. - Correct Answer Take medication on an empty stomach." "A client with Parkinson's disease who is taking carbidopa/levodopa reports the urine appears to be darker in color. Which action should the nurse take? a. Explain the color change is normal. b. Measure the client's urinary output. c. Obtain a specimen for a urine culture. d. Encourage an increase in oral intake. - Correct Answer Explain the color change is normal." "A client receives a prescription for ciprofloxacin 400 mg intravenously (IV) every 12 hours to be infused over an hour. The IV bag contains ciprofloxacin 400 mg in dextrose 5% in water (D;W) 200 mL. The nurse should program the infusion pump to deliver how many mL/hr? (Enter numerical value only.) - Correct Answer 200mL/hr" "A female client who is a vegetarian has a new prescription for warfarin. The client states she eats leafy green vegetables every day. How should the nurse respond? a. Suggest that the client replace the leafy vegetables with a protein source such as nuts or beans. b. Confirm that her diet choices will help the medication be more effective in preventing blood clots. c. Commend the client for her healthy lifestyle and encourage her to continue her current diet habits. d. Advise the client that the healthcare provider needs to be made aware of her current diet. - Correct Answer Advise the client that the healthcare provider needs to be made aware of her current diet." "A female client with multiple sclerosis reports having less fatigue and improved memory since she began using the herbal supplement, ginkgo biloba. Which information is most important for the nurse to include in the teaching plan for this client? a. Anxiety and headaches increase with the use of ginkgo biloba. a. Nausea and diarrhea can occur when using this supplement. b. Ginkgo biloba use should be limited and not taken during pregnancy. c. Aspirin and non-steroidal anti-inflammatory drugs interact with ginkgo. - Correct Answer Aspirin and non-steroidal anti-inflammatory drugs interact with ginkgo." "While assessing a client who takes acetaminophen for chronic pain, the nurse observes that the client's skin looks yellow in color. Which action should the nurse take in response to this finding? a. Check the client's capillary glucose level. b. Use a pulse oximeter to assess oxygen saturation. c. Report the finding to the healthcare provider. d. Advise the client to reduce the medication dose. - Correct Answer Report the finding to the healthcare provider." "The nurse is preparing a discharge teaching plan for a client who is taking ciprofloxacin hydrochloride tablets, which were prescribed because of a suspected anthrax exposure. Which instruction(s) should be included in the teaching plan? (Select all that apply.) a. Limit exposure to sunlight and avoid tanning beds. b. Increase fluid intake while taking the medication. c. Crush and mix the tablets with pudding if you have trouble swallowing the tablets. d. Use nonsteroidal anti inflammatory drugs (NSAID) to relieve mild joint aches and pains caused by the medication. e. Report any tendon pain or swelling to the healthcare provider immediately. - Correct Answer Limit exposure to sunlight and avoid tanning beds. Increase fluid intake while taking the medication. Report any tendon pain or swelling to the healthcare provider immediately." "When should the nurse instruct the client and family that glucagon needs to be administered? a. Before meals to prevent hyperglycemia b. At the onset of signs of diabetic ketoacidosis c. When unable to eat during sick days. When signs of severe hypoglycemia occur - Correct Answer When signs of severe hypoglycemia occur" "A client receives a prescription for dalteparin 2500 units subcutaneously 2 hours before a scheduled procedure. The medication is available in a 5000 units/0.2 mL. prefilled syringe. How many mL should the nurse administer? (Enter numeric value only.) - Correct Answer 500/5000=0.1mL" "A client in the surgical recovery area asks the nurse to bring the largest possible dose of pain medication available. Which action should the nurse implement first? a. Review the history for a past use of recreational drugs. b. Determine when the last dose was administered. c. Ask the client to rate the current level of pain using a pain scale. d. Encourage the client to use diversional thoughts to manage pain. - Correct Answer Ask the client to rate the current level of pain using a pain scale." "The nurse is planning care for a client with major depression who is receiving a new prescription for duloxetine. Which information is most important for the nurse to obtain? a. Recent use of other antidepressants. b. Family history of mental illness. c. Weight change in the last month d. Liver function laboratory results. - Correct Answer Liver function laboratory results." "The nurse administers naloxone to a client with opioid-induced respiratory depression. One hour later, nursing assessment reveals that the client has a respiratory rate of 4 breaths/minute, oxygen saturation of 75%, and is unable to be aroused. Which action should the nurse implement? a. Initiate cardiopulmonary resuscitation (CPR). b. Administer a second dose of naloxone. c. Prepare to assist with chest tube insertion. d. Determine Glasgow Coma Scale score. - Correct Answer Administer a second dose of naloxone." "A client with hepatic encephalopathy is receiving lactulose. Which assessment provides the nurse with the best information to evaluate the client's therapeutic response to the drug? a. Serum hepatic enzymes. b. Fingerstick glucose. c. Serum electrolytes and ammonia. d. Stool color and character. - Correct Answer Serum electrolytes and ammonia." "A client with a seizure disorder is seen at the clinic for a follow-up visit and a prescription renewal for phenytoin. Which assessment finding warrants immediate intervention bv the nurse? a. Chronic insomnia. b. Blood pressure 100/78 mm Hg. c. Double vision. d. Puffy, bleeding gums. - Correct Answer Double vision." "Prior to administering the evening dose of carbamazepine, the nurse notes that the client's morning carbamazepine level was 8.4 mca/L (35.6 mcmol/L). Which action should the nurse take? Reference Range: Carbamazepine level [Reference Range: 4 to 12 mcg/mL or 16.9 to 50.8 mcmol/L] a. Withhold this dose of the Carbamazepine b. Administer the carbamazepine as prescribed. c. Notify the healthcare provider of the carbamazepine level. Assess the client for side effects of carbamazepine - Correct Answer Notify the healthcare provider of the carbamazepine level." "Before administering a newly prescribed dose of terbinafine HCL to a client with a fungal toenail infection, which assessment finding is most important for the nurse to address? Reference Range : White Blood Cell (WBC) [Reference Range: 5000 to 10,000/mm3 (5 to 10 x 109/L)] a. Toenails appear thick and yellow. b. White blood cell count of 8,500/mm}(8.5 x 10°/L). c. Employed as a construction worker. d. Reported history of alcoholism. - Correct Answer Reported history of alcoholism." "To control asthma, a client in a residential treatment facility uses a fluticasone propionate and salmeterol discus inhalation system, which provides an inhaled powdered form of these combined medications. Which instruction should the nurse provide to this client's caregivers? a. Offer the discus to the client for use during an acute asthma attack. b. Clients using the discus may experience decreased blood pressure. c. When using the discus, have the client breathe out rapidly into the mouthpiece. d. Explain that the client should not use the discus more than twice daily. - Correct Answer Explain that the client should not use the discus more than twice daily." "A client who is taking an oral contraceptive receives a new prescription for erythromycin. Which instruction should the nurse provide to the client? a. Stop the oral contraceptive immediately. b. Avoid prolonged exposure to direct sunlight c. Take the medications at least 12 hours apart. d. Use an additional form of contraception. - Correct Answer Use an additional form of contraception." "Which intervention is most important for the nurse to implement for a client who is receiving insulin lispro? a. Provide meals at the same time this insulin is given. b. Keep an oral liquid or glucose source available. c. Assess for hypoglycemia between meals. d. check blood glucose levels every six hours. - Correct Answer Provide meals at the same time this insulin is given." "A female client with trichomoniasis (Trichomonas vaginalis) receives a prescription for metronidazole (Flagyl). Which instruction is most important for the nurse to include this client's teaching plan? A. Avoid alcohol consumption. B. Complete the medication regimen. C. Use a barrier contraceptive method. D. Treat partner(s) concurrently. - Correct Answer Avoid alcohol consumption." "The nurse is evaluating a client's understanding of the prescribed antilipemic drug lovastatin (Mevacor). Which client statement indicates that further teaching is needed? A. "My bowel habits should not be affected by this drug." B. "This medication should be taken once a day only." C. "I will still need to follow a low-cholesterol diet." D. "I will take the medication every day before breakfast." - Correct Answer "I will take the medication every day before breakfast."" "An older client who had a colon resection yesterday is receiving a constant dose of hydromorphone (Dilaudid) via a patient-controlled analgesia (PCA) pump. Which assessment finding is most significant and requires that the nurse intervene? A. The client is drowsy and complains of pruritus. B. Pupils are 3 mm; PERRLA. C. The area around the sutures is reddened and swollen. D. Respirations decrease to 14 breaths/min. - Correct Answer Respirations decrease to 14 breaths/min." "After receiving five doses of filgrastim, the nurse notes that the client's white blood cell count has increased from 2,500/mm? (2.5 x 109L) to 5,000/mm? (5 x 109/L). Which action should the nurse implement? White Blood Cell (WBC) Reference Range: 5000 to 10,000/mm3 (5 to 10 x 109/L)] a. Review the client's culture and sensitivity reports. b. Implement neutropenic precautions. c. Assess the client's vital signs. d. Inform the client that the medication has been effective. - Correct Answer Inform the client that the medication has been effective." "A client is receiving a secondary infusion of azithromycin 500 mg in 500 mL. of normal saline (NS) to be infused over 2 hours. The intravenous (IV) Administration set delivers 10 gtU/mL. How many gtt/min should the nurse regulate the infusion? (Enter numerical value only. If rounding is required, round to the nearest whole number) - Correct Answer 42gtt/min" "The nurse is caring for a client who is taking diclofenac, a nonsteroidal anti-inflammatory (NSAID) drug for rheumatoid arthritis. During a clinic visit, the client appears pale and reports increasing fatigue. Which of the client's serum laboratory values is most important for the nurse to review? a. Sodium. b. lot protein c. Hemoglobin. d. Glucose - Correct Answer Hemoglobin" "A client with benign prostatic hyperplasia receives a new prescription of tamsulosin. Which intervention should the nurse perform to monitor for an adverse reaction? a. Assess urine output. b. Monitor blood pressure. c. Obtain daily weights. d. Perform a bladder scan. - Correct Answer Monitor blood pressure." "A client with nasal congestion receives a prescription for phenylephrine 10 mg by mouth every 4 hours. Which client condition should the nurse report the healthcare provider before administering the medication? a. Bronchitis. b. Hypertension. c. Diarrhea. d. Edema. - Correct Answer Hypertension." "After taking orlistat for one week, a female client tells the home health nurse that she is experiencing increasingly frequent oily stools and flatus. Which action should the nurse take? a. Obtain a stool specimen to evaluate for occult blood and fat content. b. Ask the client to describe her dietary intake history for the last several davs c. Instruct the client to increase her intake of saturated fats over the next week d. Advise the client to stop taking the drug and contact her healthcare provider. - Correct Answer Ask the client to describe her dietary intake history for the last several days" "The nurse is administering the muscle relaxant baclofen by mouth (PO) to a client diagnosed with multiple sclerosis. Which intervention should the nurse implement? a. Evaluate muscle strength every 4 hours. b. Ensure the client knows to stop baclofen before using other antispasmodics. c. Advise the client to move slowly and cautiously when rising and walking. d. Monitor intake and output every 8 hours. - Correct Answer Advise the client to move slowly and cautiously when rising and walking." "A client who receives multiple antihypertensive medications experiences syncope due to a drop in blood pressure to 70/40 mm Hg. Which is the rationale for the nurse's decision to hold the client's scheduled antihypertensive medications? a. The antagonistic interaction among the various blood pressure medications has reduced their effectiveness. b. The additive effect of multiple medications has caused the blood pressure to drop too low. c. The synergistic effect of the multiple medications has resulted in drug toxicity and resulting hypotension. d. Increased urinary clearance of the multiple medications has produced diuresis and lowered the blood pressure. - Correct Answer The synergistic effect of the multiple medications has resulted in drug toxicity and resulting hypotension." "When administering medications to a group of clients, which client should the nurse closely monitor for development of acute kidney injury (AK)? a. Vancomycin. b. Lorazepam. c. Digoxin. d. Sucralfate. - Correct Answer Vancomycin." "A client is receiving intravenous (IV) vancomycin and the nurse plans to draw blood for a peak and trough to determine the serum level of the drug. Which collection times provide the best determination of these levels? a. Immediately after completion of the IV dose and 30 minutes before the next administration of the medication. b. One hour after completion of the IV dose and one hour before the next administration of the medication. c. Two hours after completion of the IV dose and two hours before the next administration of the medication. d. Thirty minutes into the administration of the IV dose and 30 minutes before the next administration of the medication. - Correct Answer Immediately after completion of the IV dose and 30 minutes before the next administration of the medication" "A client has a new prescription for zolpidem, a hypnotic. The client tells the home health nurse that he plans to take a dose of the medication during the day because he is exhausted and needs to take a short afternoon nap prior to an evening activity in his home. Which action should the nurse take? a. Explain that the client needs to allow for sleep time of at least two hours. b. Advise the client to take the medication with the noon meal. c. Remind the client to drink plenty of fluids when taking the medication. Encourage the client to wait until bedtime to take the medication - Correct Answer Encourage the client to wait until bedtime to take the medication." "A client who is taking albendazole reports experiencing fatigue, nausea, and dark urine. The nurse observes a yellowing of the client's skin and sclera. Which laboratory result should the nurse review? a. Liver function test. b. Thyroid function test c. Basic metabolic panel. d. Renal function panel. - Correct Answer Liver function test." "An elderly client with heart failure comes to the emergency room because of nausea, vomiting, and anorexia. Based on the client's signs and symptoms, which data from the medical history has the most significance when planning this client's care? a. Coronary artery bypass procedure was performed in 1995. b. Digoxin and furosemide daily since 1996. c. Colonoscopy performed for routine screening six months ago. d. Suffered with depression following death of spouse in 1999. - Correct Answer Digoxin and furosemide daily since 1996." "Which nursing action has the highest priority when administering a dose of codeine with acetaminophen to a client? a. Advise the client that the medication should start to work in about 30 minutes. b. Instruct the client to request assistance when ambulating to the bathroom. c. Administer a stool softener/laxative at the same time as the analgesic. d. Tell the client to notify the nurse if the pain is not relieved. - Correct Answer Instruct the client to request assistance when ambulating to the bathroom." "Rivastigmine, a cholinesterase inhibitor, is prescribed for a female client with earl stage Alzheimer's Disease. The client's daughter tells the nurse that she plans to start administering the drug when her mother's symptoms are no longer manageable, in hopes that her mother will not have to go to a nursing home. How should the nurse respond? a. Confirm that the daughter is aware of the progressive nature of the disease. b. Assess the client's current mental status before deciding to support the decision c. Explain that the drug should be used early in the course of the disease process. d. Affirm the decision to use the medication when the symptoms start to worsen - Correct Answer Confirm that the daughter is aware of the progressive nature of the disease." "A client who received a renal transplant three months ago is readmitted to the acute care unit with signs of graft rejection. While taking the client's history, the nurse determines that the client has been self-administering St. John's Wort, an herbal preparation. on the advice of a friend. Which information is most significant about this finding? a. Wort can decrease plasma concentrations of cyclosporine. b. Ingestion of Wort can reduce the client's intake of sodium. c. The client probably used this herb to treat depression. Adding the herb can decrease the need for corticosteroids - Correct Answer Wort can decrease plasma concentrations of cyclosporine." "A client with anemia secondary to chronic kidney disease (CKD) started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is effective? Reference Range: Hemoglobin (Hgb) [Reference Range: Male: 14 to 18 g/dL (8.7 to 11.2 mmol/L)] a. Food diary shows increased consumption of iron-rich foods. b. Hemoglobin level increased to 12 g/dL (7.45 mmol/L). c. Reports of increased energy levels and decreased fatigue. d. Takes concurrent iron therapy without adverse effects. - Correct Answer Reports of increased energy levels and decreased fatigue." "The nurse is planning to administer the antiulcer gastrointestinal (GI) agent sucralfate to a client with peptic ulcer disease. Which action should the nurse include in this client's plan of care? a. Administer sucralfate once a day, preferably at bedtime. b. Monitor for electrolyte imbalance. c. Give sucralfate on an empty stomach. d. Assess for secondary Candida infection. - Correct Answer Give sucralfate on an empty stomach." "Prior to administering oral doses of calcitriol and calcium carbonate to a client with hypoparathyroidism, the nurse notes that the client's total calcium mg/dL (3.5 mmol/L). Which action should the nurse implement? Reference Range : Total Calcium [Reference Range: Adult 9 to 10.5 mg/dL or 2.25 to 2.62 mmol/L] a. Administer both prescribed medications as scheduled. b. Hold both medications until contacting the healthcare provider. c. Hold the, calcitriol but administer the calcium carbonate as scheduled. d. Hold the calcium carbonate, but administer the calcitriol as scheduled. - Correct Answer Hold both medications until contacting the healthcare provider." "A client with open-angle glaucoma asks the nurse how long the prescribed eye drops will need to be used. Which response made by the nurse is accurate? a. Until the excess pressure is reduced. b. For long-term control of normal eye pressure. c. For long-term control of pain and swelling. d. Until a smaller angle can be restored. - Correct Answer For long-term control of normal eye pressure." "The nurse initiates an infusion of piperacillin-tazobactam for a client with an urinary tract infection. Five minutes into the infusion, the client reports not feeling well. Which client manifestation should the nurse identify as a reason to stop the infusion? a. Hypertension. b. Bradycardia. c. Scratchy throat. d. Pupillary constriction - Correct Answer Scratchy throat." "The nurse prepares to administer a scheduled dose of labetalol by mouth to a client with hypertension. The client's vital signs are temperature 99° F (37.2°C), heart rate 48 beats/minute, respirations 16 breaths/minute, and blood pressure (B/P) 150/90 mm Hg. Which action should the nurse take? a. Administer the dose and monitor the client's BP regularly. b. Apply a telemetry monitor before administering the dose. c. Withhold the scheduled dose and notify the healthcare provider. d. Assess for orthostatic hypotension before administering the dose. - Correct Answer Withhold the scheduled dose and notify the healthcare provider." "An older adult with iron deficiency anemia is being discharged with a prescription for ferrous sulfate enteric-coated tablets. To promote best absorption of the medication, which information should the nurse include in the discharge instructions? a. Take the tablet with a daily multivitamin. b. Wait 2 hours after meals to take the tablet. c. Bedtime is the best time to take the tablet. d. Crush the tablets and mix with pudding. - Correct Answer Wait 2 hours after meals to take the tablet." "The nurse administers risedronate to a client with osteoporosis at 0700. The client asks for a glass of milk to drink with the medication. Which action should the nurse take? a. Withhold the medication until the client's breakfast tray is available on the unit. b. Assign an unlicensed assistive personnel (UP) to bring the client a glass of low fat milk. c. Instruct the client that it is necessary to take nothing but water with the medication. d. Consult with a pharmacist about scheduling the dose one hour after the client eats. - Correct Answer Instruct the client that it is necessary to take nothing but water with the medication." "A client with psychosis who is receiving an antipsychotic medication is continually rubbing the back of the neck. Which nursing intervention is best for the nurse to implement? a. Obtain an extra pillow for the client to use at night. b. Obtain a prescription for physical therapy services. c. Provide the client a heating pad to place on the neck. d. Give a PRN prescription for benztropine. - Correct Answer Give a PRN prescription for benztropine." "Before administering a laxative to a bedfast client, it is most important for the nurse to perform what assessment? A. Observe the skin integrity of the client's rectal and sacral areas B. assess the client strength in moving and turning in the bed C. evaluate the client's ability to recognize the urge to defecate D. determine the frequency and consistency of bowel movements - Correct Answer Determine the frequency and consistency of bowel movements" "In explaining the benefits of the combination anti-infective drug code TMPSMZ (Bactrim) to a client receiving the medication for a urinary tract infection, more rationale to the nurse provide? A. Each drug could cause damage to the kidneys if taken separately B. One drug reduces the risk of side effects caused by the drug C. while one drug provide relief, the other fights the infection D. the two drugs work together to reduce resistance of the bacterial infection of symptoms - Correct Answer The two drugs work together to reduce resistance of the bacterial infection of symptoms" "In explaining the benefits of the combination anti-infective drug code TMPSMZ (Bactrim) to a client receiving the medication for a urinary tract infection, more rationale to the nurse provide? A. Each drug could cause damage to the kidneys if taken separately B. One drug reduces the risk of side effects caused by the drug C. while one drug provide relief, the other fights the infection D. the two drugs work together to reduce resistance of the bacterial infection of symptoms - Correct Answer The two drugs work together to reduce resistance of the bacterial infection of symptoms" "Client being treated with Haldol for schizophrenia is complaining of jaw tightness and a stiff neck. Which interventions should the nurse implement? A. give PRN dose of diphenhydramine Benadryl B. assess client other sensory hallucinations C. massage neck until muscles begin to relax D. obtain a 12 lead EKG - Correct Answer Give PRN dose of diphenhydramine Benadryl" "Which intervention is most important for the nurse implement for a client is receiving Lispro Humalog insulin? A. Check blood glucose levels every six hours B. Provide meals at the same time that insulin is given C. Assess for hypoglycemia between meals D. Keeping oral liquid or glucose source available - Correct Answer Provide meals at the same time that insulin is given" "Client takes nonsteroidal anti-inflammatory drugs every day for rheumatoid arthritis is being treated for anemia which intervention is most important for the nurse to include any plan of care A. Observe for gastrointestinal bleeding B. Monitor liver function test results C. Protect skin from bruising D. Offered dietary selections rich in iron - Correct Answer Observe for gastrointestinal bleeding" "A client receives a prescription for theophylline (Theo-Dur) PO to be initiated in the morning after the dose of theophylline IV is complete. The nurse determines that a theophylline level drawn yesterday was 22 mcg/mL. Based on this information, which action should the nurse implement? A. Hold the theophylline dose and notify the health care provider. B. Start the client on a half-dose of theophylline PO. C. The theophylline dose can be initiated as planned. D. The client is not ready to be weaned from the IV to the PO route - Correct Answer Hold the theophylline dose and notify the health care provider" "The nurse is reviewing a client's laboratory results before a procedure in which a neuromuscular blocking agent is a standing order. Which finding should the nurse report to the health care provider? A. Hypokalemia B. Hyponatremia C. Hypercalcemia D. Hypomagnesemia - Correct Answer Hypokalemia" "The nurse is preparing a child for transport to the operating room for an emergency appendectomy. The anesthesiologist prescribes atropine sulfate (Atropine), IM STAT. What is the primary purpose for administering this drug to the child at this time? A. Decrease the oral secretions B. Reduce the child's anxiety C. Potentiate the opioid effects D. Prevent possible peritonitis - Correct Answer Decrease the oral secretions" "When caring for a client on digoxin (Lanoxin) therapy, the nurse knows to be alert for digoxin (Lanoxin) toxicity. Which finding would predispose this client to developing digoxin toxicity? A. Low serum sodium level B. High serum sodium level C. Low serum potassium level D. High serum potassium level - Correct Answer Low serum potassium level" "A client is receiving anti-infective drug therapy for a postoperative infection. Which complaint should alert the nurse to the possibility that the client has contracted a superinfection? A. "My mouth feels sore" B. "I have a headache." C. "My ears feel plugged up." D. "I feel constipated" - Correct Answer "My mouth feels sore"" ".During the initial nursing assessment history, a client tells the nurse that he is taking tetracycline hydrochloride (Sumycin) for urethritis. Which medication taken concurrently with Sumycin could interfere with its absorption? A. Sucralfate (Carafate) B. Hydrochlorothiazide (Diuril) C. Acetaminophen (Tylenol) D. Phenytoin (Dilantin) - Correct Answer Sucralfate (Carafate)" "Following the administration of sublingual nitroglycerin, which assessment finding indicates that the medication was effective? A. Decrease in level of chest pain B. Clear bilateral breath sounds C. Increase in blood pressure D. Increase in urinary output - Correct Answer Decrease in level of chest pain" "Alteration of which laboratory finding represents the achievement of a therapeutic goal for heparin administration? A. Prothrombin time (PT) B. Fibrin split products C. Platelet count D. Partial thromboplastin time (PTT) - Correct Answer Partial thromboplastin time (PTT)" "The nurse is assessing a stuporous client in the emergency department who is suspected of overdosing with opioids. Which agent should the nurse prepare to administer if the client becomes comatose? A. Naloxone hydrochloride (Narcan) B. Atropine Sulfate C. Vitamin K D. Romazicon - Correct Answer Naloxone hydrochloride (Narcan)" "A client with HIV who was recently diagnosed with tuberculosis (TB) asks the nurse, "Why do I need to take all of these medications for TB?" What information should the nurse provide? A. Antiretroviral medications decrease the efficacy of the TB drugs. B. Multiple drugs prevent the development of resistant organisms. C. Duration of the medication regimen is shortened. D. Potential adverse drug reactions are minimized. - Correct Answer Multiple drugs prevent the development of resistant organisms." "Two hours after taking the first dose of penicillin, a client arrives at the emergency department complaining of feeling ill, exhibiting hives, having difficulty breathing, and experiencing hypotension. These findings are consistent with which client response that requires immediate action? A. Severe acute anaphylactic response B. Side reaction that should resolve C. Idiosyncratic reaction D. Cumulative drug response - Correct Answer Severe acute anaphylactic response" "Which question should the nurse ask a client prior to the initiation of treatment with IV infusions of gentamicin sulfate (Garamycin)? A. "Are you having difficulty hearing?" B. "Have you ever been diagnosed with cancer?" C. "Do you have any type of diabetes mellitus?" D. "Have you ever had anemia?" - Correct Answer "Are you having difficulty hearing?"" "A male client who has chronic back pain is on long-term pain medication management and asks the nurse why his pain relief therapy is not as effective as it was 2 months ago. How should the nurse respond? A. The phenomenon occurs when opiates are used for more than 6 months to relieve pain. B. Withdrawal occurs if the drug is not tapered slowly while being discontinued. C. Pharmacodynamics tolerance requires increased drug levels to achieve the same effect. D. A consistent dosage with around-the-clock administration is the most effective. - Correct Answer Pharmacodynamics tolerance requires increased drug levels to achieve the same effect." "The nurse is providing discharge instructions to a client who has received a prescription for an antibiotic that is hepatotoxic. Which information should the nurse include in the instructions? A. Avoid ingesting any alcohol or acetaminophen (Tylenol). B. Schedule a follow-up visit for a liver biopsy in 1 month. C. Activities that are strenuous should be avoided. D. Notify the health care provider of any increase in appetite. - Correct Answer Avoid ingesting any alcohol or acetaminophen (Tylenol)" "A client with mild Parkinsonism is started on oral amantadine (Symmetrel). Which statement accurately describes the action of this medication? A. Viral organisms that cause Parkinsonism are eliminated. B. Acetylcholine in the myoneural junction is enhanced. C. Dopamine in the central nervous system is increased. D. Norepinephrine release is reduced within the periphery. - Correct Answer Dopamine in the central nervous system is increased." "A female client who has started long-term corticosteroid therapy tells the nurse that she is careful to take her daily dose at bedtime with a snack of crackers and milk. Which is the best response by the nurse? A. Advise the client to take the medication in the morning, rather than at bedtime. B. Teach the client that dairy products should not be taken with her medication. C. Tell the client that absorption is improved when taken on an empty stomach. D. Affirm that the client has a safe and effective routine for taking the medication. - Correct Answer Advise the client to take the medication in the morning, rather than at bedtime." "A female client with myasthenia gravis is taking a cholinesterase inhibitor and asks the nurse what can be done to remedy her fatigue and difficulty swallowing. What action should the nurse implement? A. Explore a plan for development of coping strategies for the symptoms with the client. B. Explain to the client that the dosage is too high, so she should skip every other dose of medication. C. Advise the client to contact her health care provider because of the development of tolerance to the medication. D. Develop a teaching plan for the client to self-adjust the dose of medication in response to symptoms - Correct Answer Develop a teaching plan for the client to self-adjust the dose of medication in response to symptoms" "A female client is receiving tetracycline (Vibramycin) for acne. Which client teaching should the nurse include? A. Oral contraceptives may not be effective. B. Drinking cranberry juice will promote healing. C. Breast tenderness may occur as a side effect. D. The urine will turn a red-orange color. - Correct Answer Oral contraceptives may not be effective" "A client receives an antihypertensive agent daily. Which action is most important for the nurse to implement prior to administering the medication? A. Verify the expiration date. B. Obtain the client's blood pressure. C. Determine the client's history of adverse reactions. D. Review the client's medical record for a change in drug route. - Correct Answer Obtain the client's blood pressure." "The charge nurse is reviewing the admission history and physical data for four clients newly admitted to the unit. Which client is at greatest risk for adverse reactions to medications? A. 30-year-old man with a fracture B. 7-year-old child with an ear infection C. 75-year-old woman with liver disease D. 50-year-old man with an upper respiratory tract infection - Correct Answer 75-year-old woman with liver disease" "The health care provider has prescribed a low-molecular-weight heparin, enoxaparin (Lovenox) prefilled syringe, 30 mg/0.3 mL IV every 12 hours, for a client following hip replacement. Prior to administering the first dose, which intervention is most important for the nurse to implement? A. Assess the client's IV site for signs of inflammation. B. Evaluate the client's degree of mobility. C. Instruct the client regarding medication side effects. D. Contact the health care provider to clarify the prescription. - Correct Answer Contact the health care provider to clarify the prescription." "The nurse is preparing a plan of care for a client receiving the glucocorticoid methylprednisolone (Solu-Medrol). Which nursing diagnosis reflects a problem related to this medication that should be included in the care plan? A. Ineffective airway clearance B. Risk for infection C. Deficient fluid volume D. Impaired gas exchange - Correct Answer Risk for infection" "The nurse is reviewing prescribed medications with a female client who is preparing for discharge. The client asks the nurse why the oral dose of an opioid analgesic is higher than the IV dose that she received during hospitalization. Which response is best for the nurse to provide? A. A higher dose of analgesic medication may be needed after discharge. B. An error in the dose calculation may have occurred when the prescribed dose was converted. C. The doses should be the same unless the pain is not well controlled. D. Oral taken drugs dissolves in the gut its not %100 absorbed unlike when it is administered as an IV. (that is the concept of the answer but it is not exactly the same choice). - Correct Answer Oral taken drugs dissolves in the gut its not %100 absorbed unlike when it is administered as an IV" "Amoxicillin, 500 mg PO every 8 hours, is prescribed for a client with an infection. The drug is available in a suspension of 125 mg/5 mL. How many milliliters should the nurse administer with each dose? - Correct Answer 20 mL = 500 x 5 / 125 = 20" "Minocycline (Minocin), 50 mg PO every 8 hours, is prescribed for an adolescent girl diagnosed with acne. The nurse discusses self-care with the client while she is taking the medication. Which teaching points should be included in the discussion? A. Report vaginal itching or discharge. B. Take the medication at 0800, 1500, and 2200 hours. C. Protect skin from natural and artificial ultraviolet light. D. Avoid driving until response to medication is known. E. Take with an antacid tablet to prevent nausea. F. Use a nonhormonal method of contraception if sexually active. - Correct Answer Report vaginal itching or discharge. Protect skin from natural and artificial ultraviolet light. Avoid driving until response to medication is known. Use a nonhormonal method of contraception if sexually active." "The health care provider prescribes carbamazepine (Tegretol) for a child whose tonic-clonic seizures have been poorly controlled. The nurse informs the mother that the child must have blood tests every week. The mother asks why so many blood tests are necessary. Which complication is assessed through frequent laboratory testing that the nurse should explain to this mother? A. Nephrotoxicity B. Ototoxicity C. Myelosuppression D. Hepatotoxicity - Correct Answer Myelosuppression" "A 67-year-old client is discharged from the hospital with a prescription for digoxin (Lanoxin), 0.25 mg daily. Which instruction should the nurse include in this client's discharge teaching plan? A. Take the medication in the morning before rising. B. Take and record radial pulse rate daily. C. Expect some vision changes caused by the medication. D. Increase intake of foods rich in vitamin K. - Correct Answer Take and record radial pulse rate daily." "A pediatric client is discharged home with multiple prescriptions for medications. Which information should the nurse provide that is most helpful to the parents when managing the medication regimens? A. Maintain a drug administration record. B. Fill all prescriptions at one pharmacy. C. Allow one person to give the medications. D. Give all medications in small volumes. - Correct Answer Maintain a drug administration record." "A client who is hypertensive receives a prescription for hydrochlorothiazide (HCTZ). When teaching about the side effects of this drug, which symptoms are most important for the nurse to instruct the client to report? A. Fatigue and muscle weakness B. Anxiety and heart palpitations C. Abdominal cramping and diarrhea D. Confusion and personality changes - Correct Answer Fatigue and muscle weakness" "When providing nursing care for a client receiving pyridostigmine bromide (Mestinon) for myasthenia gravis, which nursing intervention has the highest priority? A. Monitor the client frequently for urinary retention. B. Assess respiratory status and breathe sounds often. C. Monitor blood pressure each shift to screen for hypertension. D. Administer most medications after meals to decrease gastrointestinal irritation. - Correct Answer Assess respiratory status and breathe sounds often." ".A client is being discharged with a prescription for sulfasalazine (Azulfidine) to treat ulcerative colitis. Which instruction should the nurse provide to this client prior to discharge? A. Maintain good oral hygiene. B. Take the medication 30 minutes before a meal. C. Discontinue use of the drug gradually. D. Drink eight glasses of fluid a day. - Correct Answer D. Drink eight glasses of fluid a day." "Which parameter is most important for the nurse to check prior to administering a subcutaneous injection of heparin? A. Heart rate B. Urinary output C. Activated partial thromboplastin time (aPTT) D. Prothrombin time (PT) and international normalized ratio (INR) - Correct Answer Activated partial thromboplastin time (aPTT)" "The nurse plans to draw blood samples for the determination of peak and trough levels of gentamicin sulfate (Garamycin) in a client receiving IV doses of this medication. When should the nurse plan to obtain the peak level? A. Thirty minutes after the dose is administered B. Immediately before giving the next dose C. When the next electrolyte levels are drawn D. Sixty minutes after the dose is administered - Correct Answer Thirty minutes after the dose is administered" "A client receiving a continuous infusion of heparin IV starts to hemorrhage from an arterial access site. Which medication should the nurse anticipate administering to prevent further heparin-induced hemorrhaging? A. Vitamin K1 (AquaMEPHYTON) B. Protamine sulfate C. Warfarin sodium (Coumadin) D. Prothrombin - Correct Answer Protamine sulfate" "A client with acute lymphocytic leukemia is to begin chemotherapy today. The health care provider's prescription specifies that ondansetron (Zofran) is to be administered IV 30 minutes prior to the infusion of cisplatin (Platinol). What is the rationale for administering Zofran prior to the chemotherapy induction? A. Promotion of diuresis to prevent nephrotoxicity B. Reduction or elimination of nausea and vomiting C. Prevention of a secondary hyperuricemia D. Reduction in the risk of an allergic reaction - Correct Answer Reduction or elimination of nausea and vomiting" "The health care provider prescribes cisplatin (Platinol) to be administered in 5% dextrose and 0.45% normal saline with mannitol (Osmitrol) added. Which assessment parameters would be most helpful to the nurse in evaluating the effectiveness of the Osmitrol therapy? A. Oral temperature B. Blood cultures C. Urine output D. Liver enzyme levels - Correct Answer Urine output" "Which factor is most important to ensure compliance when planning to teach a client about a drug regimen? A. Genetics B. Client age C. Client education D. Absorption rate - Correct Answer Client education" ".A client being treated for an acute myocardial infarction is to receive the tissue plasminogen activator altaplase (Activase). The nurse would be correct in providing which explanation to the client regarding the purpose of this drug? A. This drug is a nitrate that promotes vasodilation of the coronary arteries. B. This drug is a clot buster that dissolves clots within a coronary artery. C. This drug is a blood thinner that will help prevent the formation of a new clot. D. This drug is a volume expander that improves myocardial perfusion by increasing output. - Correct Answer This drug is a clot buster that dissolves clots within a coronary artery" "In addition to nitrate therapy, a client is receiving nifedipine (Procardia), 10 mg PO every 6 hours. The nurse should plan to observe for which common side effect of this treatment regimen? A. Hypotension B. Hyperkalemia C. Hypokalemia D. Seizures - Correct Answer Hypotension" ".Dopamine (Intropin) is administered to a client who is hypotensive. Which finding should the nurse identify as a therapeutic response? A. Gain in weight B. Increase in urine output C. Improved gastric motility D. Decrease in blood pressure - Correct Answer Increase in urine output" "A client taking linezolid (Zyvox) at home for an infected foot ulcer calls the home care nurse to report the onset of watery diarrhea. Which intervention should the nurse implement? A. Schedule appointments to obtain blood samples for drug peak and trough levels. B. Reassure the client that this is an expected side effect that will resolve in a few days. C. Instruct the client to obtain a stool specimen to be taken to the laboratory for analysis. D. Advise the client to begin taking an over-the-counter antidiarrheal agent. - Correct Answer Instruct the client to obtain a stool specimen to be taken to the laboratory for analysis." "To evaluate whether the administration of an antihypertensive medication has caused a therapeutic effect, which action should the nurse implement? A. Ask the client about the onset of any dizziness since taking the medication. B. Measure the client's blood pressure while the client is lying, sitting, and then standing. C. Compare the client's blood pressure before and after the client takes the medication. D. Interview the client about any past or recent history of high blood pressure. - Correct Answer Compare the client's blood pressure before and after the client takes the medication." "After starting an IV dose of sulfamethoxazole (Bactrim®), the nurse notes that the patient is having difficulty breathing, his face is flushed, and he complains of back pain. Which type of hypersensitivity reaction is this patient most likely experiencing? A. Cytotoxic B. Serum sickness C. Anaphylactic D. Infectious - Correct Answer Anaphylactic" ".A nurse is caring for a pregnant patient who needs treatment for rosacea. The patient asks the nurse about using topical corticosteroids for treatment. Which of the following information should the nurse provide this patient? A. The patient can safely use this type of medication B. The patient can only use this medication in areas away from the abdomen C. This medication causes teratogenic effects and should be avoided D. There is no safety evidence of this medication during pregnancy, so it should be avoided - Correct Answer There is no safety evidence of this medication during pregnancy, so it should be avoided" "Which of the following agents would increase sedation caused by morphine? A. ethanol B. diazepam C. chlorpromazine D. clomipramine E. All of the above - Correct Answer All of the above" "The nurse is scheduling a client's antibiotic peak and trough levels with the laboratory personnel. What is the best schedule for drawing the trough level? A. Give the dose of medication, and call the laboratory to draw the trough STAT. B. Arrange for the laboratory to draw the trough 1 hour after the dose is given. C. Instruct the laboratory to draw the trough immediately before the next scheduled dose. D. Give the first dose of medication after the laboratory reports that the trough has been drawn. - Correct Answer Instruct the laboratory to draw the trough immediately before the next scheduled dose" "Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which finding indicates the presence of systemic toxicity from this medication? A. tinnitus B. diarrhea C. constipation D. decreased respirations - Correct Answer tinnitus" ".Isotretinoin is prescribed for a client with severe acne. Before administration of this medication, the nurse anticipates that which laboratory test will be prescribed? A. K levels B. triglyceride levels C. Hemoglobin A1C D. total cholesterol level - Correct Answer total cholesterol level" "A client with severe acne is seen in the clinic and the HCP prescribes isotretinoin. The nurse reviews the client's medication record and would contact the HCP if the client is also taking which medication? A. digoxin B. phenytoin C. vitamin A D. furosemide - Correct Answer vitamin A" "The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse reminds the children that chemical sunscreens are most effective when applied at which times? A. immediately before swimming B. 5 minutes before exposure to the sun C. immediately before exposure to the sun D. at least 30 minutes before exposure to the sun - Correct Answer at least 30 minutes before exposure to the sun" "The nurse is teaching a client how to mix regular insulin and NPH insulin in the same syringe. Which action, if performed by the client, indicates the need for further teaching? A. withdraws the NPH insulin first B. withdraws the regular insulin first C. injects air into NPH insulin vial first D. injects an amount of air equal to the desired dose of insulin into each vial - Correct Answer withdraws the NPH insulin first" "The home care nurse visits a client recently diagnosed with diabetes mellitus who is taking Humulin NPH insulin daily. The client asks the nurse how to store the unopened vials of insulin. The nurse should tell the client to take which action? A. freeze the insulin B. refrigerate the insulin C. store the insulin in a dark, dry place D. keep the insulin at room temperature - Correct Answer refrigerate the insulin" "A nurse is preparing to administer a dose of warfarin to a patient. Based on the nurse's knowledge of this drug, the nurse knows to monitor for which of the following side effects? A. Black stools B. Constipation C. Abdominal bloating D. Back pain - Correct Answer Black stools" "Which of the following is considered a contraindication for administration of Furosemide [Lasix®]? A. 4+ pitting edema in the lower extremities B. Hypertension C. Facial swelling D. Decreased urine output - Correct Answer Decreased urine output"