ATI PN Pharmacology Practice Quiz 40 Q & A

1. A nurse is caring for a client who has a new prescription for ergotamine. The nurse should recognize that ergotamine is administered to treat which of the following conditions? a. Raynaud's phenomenon b. Ulcerative colitis c. Anemia d. Migraine headaches - Migraine headaches *RATIONALE* Ergotamine prevents or stops a migraine headache by blocking alpha-adrenergic receptors in the cranial peripheral vascular smooth muscle, which causes vasoconstriction of dilated cerebral blood vessels. 2. A nurse is caring for a client who has a new prescription for amphotericin B. The nurse should plan to monitor the client for which of the following adverse effects? a. Hyperkalemia b. Hypertension c. Constipation d. Nephrotoxicity - Nephrotoxicity *RATIONALE* Amphotericin B is an antifungal medication used to treat severe fungal infections; however, it can cause nephrotoxicity. The nurse should monitor the client's creatinine every 3 to 4 days and increase fluid intake. The dosage of amphotericin B should be reduced if the client's creatinine is 3.5 mg/dL or greater. 3. A nurse is preparing to administer heparin 8,000 units subcutaneously every 8 hr. Available is heparin 10,000 units/1 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero, if it applies. Do not use a trailing zero.) - 0.8 mL *RATIONALE* 8,000 units x 1 mL/10,000 units = X mL. Reassess to determine whether the amount to give makes sense. If there are 10,000 units/1 mL and the amount prescribed is 8,000 units, it makes sense to administer 0.8 mL. The nurse should administer 0.8 mL heparin subcutaneously every 8 hr. 4. A nurse is providing teaching to a client who has chronic kidney failure with an AV fistula for hemodialysis and a new prescription for epoetin alfa. Which of the following therapeutic effects of epoetin alfa should the nurse include in the teaching? a. Reduces blood pressure b. Inhibits clotting of fistula c. Promotes RBC production d. Stimulates growth of neutrophils - Promotes RBC production *RATIONALE* Epoetin alfa stimulates erythropoiesis in the bone marrow to increase RBC production and reduce anemia. Anemia is common in clients who have chronic kidney failure, since erythropoietin is produced by the kidney. 5. A nurse is caring for a client who has a new prescription for enalapril. The nurse should monitor the client for which of the following adverse effects of this medication? a. Ecchymosis b. Jaundice c. Hypotension d. Hypokalemia - Hypotension *RATIONALE* Enalapril, an angiotensin-converting enzyme (ACE) inhibitor, can cause hypotension and postural hypotension, especially during the first 3 hr following the initial dosage. 6. A nurse is caring for a client who has a prescription for clopidogrel. The nurse should monitor the client for which of the following adverse effects? a. Insomnia b. Hypotension c. Bleeding d. Constipation - Bleeding *RATIONALE* Clopidogrel is an antithrombotic medication that inhibits platelet aggregation. It is used to prevent stenosis of coronary stents, myocardial infarctions, and strokes. The nurse should monitor for coffee ground emesis, black tarry stools, ecchymosis, or any indication of bleeding. 7. A nurse is caring for a client who has a new diagnosis of oral candidiasis after taking tertracycline for 7 days. The nurse should recognize that candidiasis is a manifestation of which of the following adverse effects? a. Allergic response b. Superinfection c. Renal toxicity d. Hepatic toxicity - Superinfection *RATIONALE* A superinfection can develop from the overgrowth of fungus due to the antibacterial effect of tetracycline. The nurse should monitor the client for manifestations of a superinfection, such as soreness of the mouth and a swollen tongue. 8. A nurse is providing teaching to a newly licensed nurse about ceftriaxone. The nurse should include a severe allergy to which of the following medications as a contraindication to ceftriaxone? a. Gentamicin b. Clindamycin c. Piperacillin d. Sulfamethoxazole-trimethoprim - Piperacillin *RATIONALE* Clients who have a severe allergy to piperacillin, which is a penicillin, can have a cross sensitivity to ceftriaxone, a third-generation cephalosporin. Ceftriaxone is contraindicated for the client who has an allergy to cephalosporins or a severe allergy to penicillin. 9. A nurse is administering subcutaneous epinephrine for a client who is experiencing anaphylaxis. The nurse should monitor the client for which of the following adverse effects? a. Hypotension b. Hyperthermia c. Hypoglycemia d. Tachycardia - Tachycardia *RATIONALE* Adverse effects of epinephrine, an adrenergic agonist, can include tachycardia and dysrhythmias as the result of cardiac stimulation. 10. A nurse is administering subcutaneous heparin to a client who is at risk for deep vein thrombosis. Which of the following actions should the nurse take? a. Administer the medication into the client's abdomen. b. Inject the medication into a muscle. c. Massage the site after administering the medication. d. Use a 22-gauge needle to administer the medication. - Administer the medication into the client's abdomen. *RATIONALE* The heparin should be administered subcutaneously into the client's abdomen using a 25-gauge or smaller needle to decrease the risk of hemorrhage. The nurse should apply firm pressure to the injection site after administration. 11. A nurse is providing teaching to a client who has cirrhosis and a new prescription for lactulose. The nurse should instruct the client that lactulose has which of the following therapeutic effects? a. Increases blood pressure b. Prevents esophageal bleeding c. Decreases heart rate d. Reduces ammonia levels - Reduces ammonia levels *RATIONALE* Lactulose is a laxative that promotes the excretion of ammonia in a client who has hepatic encephalopathy from cirrhosis of the liver. 12. A nurse is providing teaching to a client who has rhematoid arthritis and a new prescription for long-term prednisone therapy. The nurse should instruct the client to monitor for which of the following adverse effects of this medication? a. Stress fractures b. Orthostatic hypotension c. Gingival ulcerations d. Weight loss - Stress fractures *RATIONALE* Prednisone can cause demineralization of the bones and can lead to osteoporosis and stress fractures. 13. A nurse is caring for a client who has peptic ulcer disease and reports a headache. Which of the following medications should the nurse plan to administer? a. Ibuprofen b. Naproxen c. Aspirin d. Acetaminophen - Acetaminophen *RATIONALE* Acetaminophen is an analgesic used for mild to moderate pain. It can be administered to a client who has peptic ulcer disease because it does not affect blood coagulation and does not increase the risk of gastrointestinal bleeding. 14. A nurse is planning care for a client who has a seizure disorder and a new prescription for valproic acid. Which of the following laboratory values should the nurse plan to monitor? (Select all that apply.) a. BUN b. PTT c. Aspartate aminotransferase (AST) d. Urinalysis e. Alanine aminotransferase (ALT) - PTT Aspartate aminotransferase (AST) Alanine aminotransferase (ALT) *RATIONALE* Valproic acid can alter coagulation; therefore, PT and PTT should be monitored. Valproic acid can cause life-threatening hepatotoxicity. The client should have baseline liver function tests (LFTs) before starting this medication and LFTs should be repeated at regular intervals during therapy. ALT is a liver enzyme that is measured as a component of liver function tests. Levels of the enzyme identify liver damage. 15. A nurse is reviewing laboratory values for a client who reports fatigue and cold intolerance. The client has an increased thyroid stimulating hormone (TSH) level and a decreased total T3 and T4 level. The nurse should anticipate a prescription for which of the following medications? a. Methimazole b. Somatropin c. Levothyroxine d. Propylthiouracil - Levothyroxine *RATIONALE* Levothyroxine replaces thyroid hormone for a client who has hypothyroidism. Laboratory values for hypothyroidism include an increased TSH level and decreased total T3 and T4 levels. Clinical manifestations for hypothyroidism include fatigue, cold intolerance, and a decreased body temperature and pulse. 16. A nurse is providing teaching to a client who has ulcerative colitis and a new prescription for sulfasalazine. The nurse should instruct the client to monitor for which of the following adverse effects of this medication? a. Jaundice b. Constipation c. Oral candidiasis d. Sedation - Jaundice *RATIONALE* Sulfasalazine can cause a yellow discoloration of the skin and yellow/orange discoloration of the urine. The nurse should instruct the client to notify the provider if these occur. 17. A nurse is preparing to administer amoxicillin 250 mg liquid suspension PO every 8 hr to an older adult client. The amount available is amoxicillin 50 mg/mL. How many mL 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.) - 5 mL *RATIONALE* 250 mg x 1 mL/50 mg = X mL. Reassess to determine whether the amount to give makes sense. If there are 50 mg/1 mL and the amount prescribed is 250 mg, it makes sense to administer 5 mL. The nurse should administer amoxicillin 5 mL PO. 18. A nurse is providing teaching to a client who has a urinary tract infection and new prescriptions for phenazopyridine and ciprofloxacin. Which of the following statements by the client indicates the need for further teaching? a. "Phenazopyridine can cause mild gastrointestinal upset. I can take this medication with meals to relieve this adverse effect." b. "The phenazopyridine will relieve my discomfort, but the ciprofloxacin will get rid of the infection." c. "I need to drink 2 liters of fluid per day while I am taking the ciprofloxacin." d. "I should notify my provider immediately if my urine turns an orange color." - "I should notify my provider immediately if my urine turns an orange color." *RATIONALE* Phenazopyridine is a urinary tract analgesic used to relieve pain and burning during urination. The medication can cause the client's urine to turn a reddish-orange color. This coloration is an expected effect of this medication, and although it can stain clothing, it does not need to be reported to the provider. 19. A nurse is providing teaching to a newly licensed nurse about metoclopramide. The nurse should include in the teaching that which of the following conditions is a contraindication to this medication? a. Hyperthyroidism b. Intestinal obstruction c. Glaucoma d. Low blood pressure - Intestinal obstruction *RATIONALE* Metoclopramide reduces nausea and vomiting by increasing gastric motility and promoting gastric emptying. It is contraindicated for a client who has an intestinal obstruction or perforation. 20. A nurse is providing teaching to a newly licensed nurse about caring for a client who has a prescription for gemfibrozil. The nurse should instruct the newly licensed nurse to monitor which of the following laboratory tests? a. Platelet count b. Electrolyte levels c. Thyroid function d. Liver function - Liver function *RATIONALE* Gemfibrozil reduces triglycerides by decreasing the liver's uptake of fatty acids. It can cause liver toxicity; therefore, the nurse should monitor the client's liver function.