Rasmussen Pharm Exam 1 Complete Solutions Latest Grade A

1. A patient asks the nurse about drug interactions with OTC preparations. What is the nurse's best response? A. "Discuss this with the health care provider." B. "There are not many interactions, so don't worry about it." C. "Read the labels carefully, and check with your health care provider." D. "Avoid over-the-counter preparations." - C. "Read the labels carefully, and check with your health care provider." The patient should always check with the healthcare provider prior to starting new medications, and since this is referring to OTCs, the patient should also read labels for interactions and contraindications. 2. A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication? A. One B. Two C. Three D. Four - •A. One. Medications with long half-lives remain at their therapeutic levels between doses for long periods of time. The nurse should expect to administer this medication once a day. 3. A nurse educator is reviewing medication metabolism at an in-service presentation. Which of the following factors should the educator include as a reason to administer lower medication dosages? A. Increased renal excretion B. Increased medication-metabolizing enzymes C. Liver failure D. Hypertension - C. Liver failure. Liver failure decreases metabolism and thus increases the concentration of a medication. This requires decreasing the dosage. 4. A nurse is teaching a client about transdermal patches. Which of the following statements should the nurse identify as an indication that the client understands? • A. "It doesn't' matter if I clean the site before I apply the patch." B. "I will rotate the application sites weekly." C. "I will apply the patch to an area of skin with no hair." Rasmussen Pharm Exam 1 Complete Solutions Latest Grade A D. "I will place the new patch on the site of the old patch." - C. "I will apply the patch to an area of skin with no hair. "The client should apply the patch to a hairless area of skin to promote absorption of the medication. 5. A nurse is preparing a client's medications. Which of the following actions should the nurse take in following legal practice guidelines? (Select all that apply.) • A. Teach the client about the medication. B. Determine the dosage. C. Monitor for adverse effects. D. Lock compartments for controlled substances. E. Determine the client's insurance status. - A. Teach the medication as part of the rights of medication administration. • C. Monitor for adverse effects as part of the rights of medication administration. • D. Lock controlled substances in a drawer, cart, or other compartment to prevent misuse. 6. A nurse is preparing to administer digoxin to a client who states, "I don't want to take that medication. I do not want one more pill." Which of the following responses should the nurse make? • A. "Your physician prescribed it for you, so you really should take it." B. "Well, let's just get it over quickly then." C. "Okay, I'll just give you your other medications." D. "Tell me your concerns about taking this medication." - "Tell me your concerns about taking this medication." D. Although clients have the right to refuse a medication, this response is correct in determining the reason for refusal by asking about the client's concerns. Then information can be provided about the risk of refusal and facilitate an informed decision. At that point, if the client still exercises their right to refuse a medication, notify the provider and document the refusal and the actions taken. 7. A nurse is reviewing a client's prescribed medications. Which of the following situations represents a contraindication to medication administration? • A. The client drank grapefruit juice, which could reduce a medication's effectiveness. B. The medication has orthostatic hypotension as an adverse effect. C. A medication is approved for ages 12 and older, and the client is 8 years old. D. An antianxiety medication that has an adverse effect of drowsiness is prescribed as a preoperative sedative. - C. Age is one factor that can be a contraindication to medication administration. Contraindications are findings that indicate the client should not receive a medication and are different from instances where an undesirable effect or more monitoring are needed. 8. A nurse is assessing a client before administering medications. Which of the following data should the nurse obtain? (Select all that apply.) • A. Use of herbal products B. Daily fluid intake C. Ability to swallow D. Allergies - A. CORRECT: Inquire about the client's use of herbal products, which often contain caffeine, prior to medication administration because caffeine can affect medication biotransformation. • C. CORRECT: Determine the client's ability to swallow to see what route or formulation of the medication the client requires. • D. CORRECT: Inquire about food allergies during the preassessment to identify any potential reactions or interactions. 9. A nurse is working with a newly licensed nurse who is administering medications to clients. Which of the following actions should the nurse identify as an indication that the newly hired nurse understands medication error prevention? • A. Taking all medications out of the unit-dose wrappers before entering the client's room B. Checking the prescription when a single dose requires administration of multiple tablets C. Administering a medication, then looking up the usual dosage range D. Relying on another nurse to clarify a medication prescription - B. Checking the prescription when a single dose requires administration of multiple tablets. If a single dose requires multiple tablets, it is possible that an error has occurred in the prescription or transcription of the medication. This action could prevent a medication error. 10. A nurse is caring for a client experiencing IV extravasation. The facility requires the administration of an antidote for the prescribed IV solution. After stopping the IV infusion, which of the following actions should the nurse take first? • A. Remove the IV catheter. B. Withdraw the solution from the IV access. C. Administer the antidote to the vesicant. D. Insert a new IV access in a different extremity. - B. Withdraw the solution from the IV access. According to evidence-based practice, the nurse should first withdraw the solution from the IV access. This reduces the amount of vesicant in the body, and lowers the risk of tissue damage. 11. A nurse is preparing to administer an IM dose of penicillin to a client who has a new prescription. The client states when they took penicillin 3 years ago, they developed a rash. Which of the following actions should the nurse take? • A. Administer the prescribed dose. B. Withhold the medication. C. Ask the provider to change the prescription to an oral form. D. Administer an oral antihistamine at the same time. - B. Withhold the medication and notify the provider of the client's previous reaction to penicillin so that an alternative antibiotic can be prescribed. Allergic reactions to penicillin can range from mild to severe anaphylaxis, and prior sensitization should be reported to the provider. 12. A nurse is reviewing a client's health record and notes that the client experienced permanent extrapyramidal effects caused by a previous medication. The nurse should recognize that the medication affected which of the following systems in the client? • A. Cardiovascular B. Immune C. Central nervous D. Gastrointestinal - Central nervous. C. CORRECT: Realize that extrapyramidal effects are movement disorders that can be caused by a number of central nervous system medications (traditional/FGA antipsychotic medications). 13. A nurse is teaching a client who has a new prescription for levodopa/carbidopa for Parkinson's disease. Which of the following instructions should the nurse include? A. Increase intake of protein-rich foods. B. Expect muscle twitching to occur. C. Take this medication with food. D. Anticipate relief of manifestations in 24 hr. - C. The client should take this medication with food to reduce GI effects. 14. A nurse is caring for a client who is receiving moderate sedation with diazepam IV. The client is over sedated. Which of the following medications should the nurse expect to administer to this client? A. Ketamine B. Naltrexone C. Flumazenil D. Fluvoxamine - C. CORRECT: Flumazenil is a competitive benzodiazepine antagonist used to reverse the sedation and other effects of benzodiazepines. 15. A nurse is teaching a client who has obsessive-compulsive disorder and has a new prescription for fluoxetine. Which of the following instructions should the nurse include? A. "It can take several weeks before you feel like the medication is helping." B. "Take the medication just before bedtime to promote sleep." C. "You should take the medication when needed for obsessive urges." D. "Monitor for weight gain while taking this medication." - A. CORRECT: Fluoxetine can take 1 to 4 weeks before the client reaches full therapeutic benefit. 16. A nurse is caring for a client who has a new prescription for phenelzine, an MAOI, for the treatment of depression. Which of the following indicates that the client has developed an adverse effect of this medication? A. Orthostatic hypotension B. Hearing loss C. Gastrointestinal bleeding D. Weight loss - A. CORRECT: Orthostatic hypotension is an adverse of effect of MAOIs, including phenelzine 17. A nurse is providing teaching to a client who has a new prescription for amitriptyline for treatment of depression. Which of the following should the nurse include in the teaching? (Select all that apply.) A. Expect therapeutic effects in 24 to 48 hr. B. Discontinue the medication after a week of improved mood. C. Change positions slowly to minimize dizziness. D. Decrease dietary fiber intake to control diarrhea. E. Chew sugarless gum to prevent dry mouth. - C. CORRECT: Changing positions slowly helps prevent orthostatic hypotension, which is an adverse effect of amitriptyline. F. CORRECT: Chewing sugarless gum can minimize dry mouth, which is an adverse effect of amitriptyline. 18. A nurse is providing discharge teaching to a client who has a new prescription for fluoxetine for posttraumatic stress disorder. Which of the following statements should the nurse include in the teaching? A. "You can have a decreased desire for intimacy while taking this medication." B. "You should take this medication at bedtime to help promote sleep." C. "You will have fewer urinary adverse effects if you urinate just before taking this medication." D. "You'll need to wear sunglasses when outdoors due to the light sensitivity caused by this medication." - A. CORRECT: Decreased libido is a potential adverse effect of fluoxetine and other SSRIs 19. A nurse is caring for a client who has been taking sertraline for the past 2 days. Which of the following assessment findings should alert the nurse to the possibility that the client is developing serotonin syndrome? A. Bruising B. Fever C. Tinnitus D. Rash - B. CORRECT: Fever is a manifestation of serotonin syndrome, which can result from taking an SSRI such as sertraline. 20. A nurse is reviewing laboratory findings and notes that a client's lithium level is 20.1 mEq/L. Which of the following is an appropriate action by the nurse? • A. Hold the medication and notify the provider. B. Prepare the client for hemodialysis. C. Administer an additional oral dose of lithium. D. Request a stat repeat of the laboratory test. - A. CORRECT: Hold the medication and notify the provider is the appropriate action for a client who has severe toxicity, as evidenced by a plasma lithium level of 2.1 mEq/L. 21. A nurse is caring for a client who has a new prescription for lithium. When teaching the client about ways to prevent lithium toxicity, the nurse should advise the client to do which of the following? A. Avoid the use of acetaminophen for headaches. B. Restrict intake of foods rich in sodium. C. Decrease fluid intake to less than 1,500 mL daily. D. Limit aerobic activity in hot weather. - D. CORRECT: The client should avoid activities that have the potential to cause sodium/water depletion, which can increase the risk for toxicity. 22. A nurse is assessing a client who takes lithium for the treatment of bipolar disorder. The nurse should identify which of the following findings is a possible indication of toxicity to this medication? A. Severe hypertension B. Coarse tremors C. Constipation D. Muscle spasms - B. CORRECT: Coarse tremors are an indication of toxicity 23. A nurse is preparing a teaching plan for a client who has bipolar disorder and a new prescription for carbamazepine. Which of the following instructions should the nurse include in the teaching? (Select all that apply.) A. "This medication can safely be taken during pregnancy."