DQ QUZZES PHARMA - MODERATE (122) Flashcards
A nurse is teaching a client about the proper placement of a nitroglycerin patch. Which of the following statements by the client indicates an understanding of the teaching?
A. “I’ll apply the patch over areas of my body with little fatty tissue.”
B. “I can place the patch on any area of my body without hair.”
C. “I’ll put the patch on the same site as the previous patch.”
D. “I have to apply the patch directly over my heart.”
Correct Answer: B.
“I can place the patch on any area of my body without hair.”
The nitroglycerin transdermal patch should be applied to skin that is free from hair because hair creates a physical barrier to absorption.
Incorrect Answers:
C. Placing the nitroglycerin patch on the same site as a previous patch should be avoided because it can cause skin irritation.
D. The nitroglycerin patch does not have to be applied directly over the heart. Various topical locations are acceptable.
A nurse is teaching a client who will be taking dexamethasone daily for pain due to spinal edema. The nurse should identify which of the following client statements as an indication that the teaching has been effective?
A. “I should eat a snack at bedtime to avoid low blood glucose.”
B. “I should stay away from people who are ill.”
C. “I should increase my fluid intake to about 3 quarts per day.”
D. “I’ll call my provider if I am experiencing too much sedation.”
Correct Answer: B.
“I should stay away from people who are ill.”
This medication is a glucocorticoid that decreases inflammation by affecting the client’s immune system. As a result, the client is susceptible to infection and should avoid large crowds as well as people who are ill.
Incorrect Answers:
A. This medication does not have an adverse effect of lowering blood glucose levels. It can increase blood glucose levels; as a result, the client might require glucose monitoring.
C. This medication does not have adverse effects on the kidneys such as renal calculi and kidney disease. (An increase in fluids is usually recommended to avoid these adverse effects.) However, this medication can cause fluid retention.
D. This medication should not cause sedation. Other pain medications such as morphine and fentanyl do cause sedation.
A nurse is teaching a client who has a new prescription for warfarin. Which of the following statements should the nurse identify as an indication that the client understands the instructions?
A. “I’ll use a safety razor to shave each day.”
B. “I’ll be sure to eat lots of spinach.”
C. “I’ll avoid contact sports like football.”
D. “I’ll take ibuprofen if I get a headache.”
Correct Answer: C.
“I’ll avoid contact sports like football.”
The most common adverse effect of taking anticoagulants is bleeding. Therefore, the client should avoid any activities that have a high risk of causing injury, such as contact sports.
Incorrect Answers:
A. The client should use an electric razor, not a safety razor, to shave. Safety razors contain a sharp blade that could cause bleeding.
B. Dark green, leafy vegetables are high in vitamin K and can reduce anticoagulation if the client eats an excessive amount. The client should keep vitamin K intake consistent.
D. The client should not take ibuprofen because NSAIDs interact with anticoagulants to increase their effects and raise the risk of bleeding. Acetaminophen can also increase the risk of bleeding. The client should contact the provider for help with relieving headaches.
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
Correct Answer: C.
Bleeding
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.
Incorrect Answers:
A. Clopidogrel can cause dizziness and headaches but does not cause insomnia.
B. Clopidogrel can cause hypertension but does not cause hypotension.
D. Clopidogrel can cause diarrhea but does not cause constipation.
A nurse working in a mental health facility is admitting a client with opioid use disorder who is experiencing withdrawal. The nurse should anticipate a prescription for which of the following medications from the provider?
A. Methylnaltrexone
B. Methadone
C. Naloxone
D. Hydromorphone
Correct Answer: B.
Methadone
The nurse should anticipate a prescription from the provider for methadone for a client who is experiencing opioid withdrawal. Methadone is an opioid medication that is used for pain management and treatment of withdrawal manifestations in clients who have opioid use disorder.
Incorrect Answers:
A. Methylnaltrexone is an opioid antagonist that is used to treat opioid-induced constipation for clients who have not responded to other laxatives.
C. Naloxone is an opioid antagonist that is used to treat opioid overdose. Naloxone is used cautiously in clients who have opioid use disorder because it can cause acute opioid withdrawal.
D. Hydromorphone is a strong opioid that is used to treat moderate to severe pain.
A nurse is teaching a client who has a new ezetimibe prescription for hyperlipidemia. Which of the following client statements should indicate to the nurse that the teaching was effective?
A. “I should let my doctor know if I have yellowing of my eyes.”
B. “This medication will stop my liver from making cholesterol.”
C. “I should expect to experience some bruising when I begin this medication.”
D. “I will take this medication at the same time as my gemfibrozil.”
Correct Answer: A.
“I should let my doctor know if I have yellowing of my eyes.”
The nurse should include in the teaching that jaundice can be an adverse effect of ezetimibe as a result of hepatitis. The client should notify the provider if this occurs.
Incorrect Answers:
B. Ezetimibe is a medication that is used to reduce plasma cholesterol by blocking the absorption of cholesterol in the intestinal tract. It is indicated for clients who have hyperlipidemia.
C. Some of the adverse effects of ezetimibe can include myopathy, hepatitis, pancreatitis, and thrombocytopenia. The client should notify the provider if adverse effects occur.
D. Both ezetimibe and fibrates can raise the cholesterol content of bile, which can increase the client’s risk of gallstones. Therefore, the combination of these medications is not recommended.
A nurse is providing teaching about sodium phosphate to a client who has a new prescription for sodium phosphate. The client is scheduled for a colonoscopy and is currently taking furosemide for hypertension. Which of the following client statements should indicate to the nurse that the teaching has been effective?
A. “I can take my water pill as prescribed.”
B. “I can experience an imbalance in my electrolytes from this medication.”
C. “I should drink 8 ounces of bowel cleanser every 10 minutes until I drink a total of 4 liters.”
D. “I can experience rebound constipation after using this medication.”
Correct Answer: B.
“I can experience an imbalance in my electrolytes from this medication.”
Sodium phosphate can cause excess fluid loss as a result of cleansing the bowel of stool. Therefore, the client is at risk for electrolyte imbalance and should be monitored closely.
Incorrect Answers:
A. Sodium phosphate can increase the risk of dehydration. Therefore, taking a diuretic simultaneously can reduce water retention and increase urine output, causing dehydration. The nurse should notify the client’s provider for further instructions.
C. When taking sodium phosphate, the client should ingest 20 tablets with clear liquid in the evening and 20 tablets with clear liquid the next day.
D. Rebound constipation is not an adverse effect of this medication. However, the nurse should inform the client that diarrhea is an expected adverse effect of this medication as it cleanses the bowel.
A nurse is monitoring a client with pneumonia who has received penicillin G intramuscularly (IM). Which of the following findings should the nurse plan to evaluate first?
A. Pain at the injection site
B. Prolonged motor dysfunction
C. Laryngeal edema
D. Temperature 37.6C (99.7F)
Correct Answer: C.
Laryngeal edema
When using the urgent vs nonurgent approach to client care, the nurse should determine that the priority finding is laryngeal edema, which can indicate the client is experiencing an allergic reaction to penicillin G. The nurse should also consider that the client is experiencing an anaphylactic reaction, which can be life-threatening. Anaphylaxis is an immediate hypersensitivity reaction that requires the primary treatment of epinephrine in addition to respiratory support.
Incorrect Answers:
A. Pain at the site of injection is an expected finding when penicillin G is administered IM. Therefore, there is another finding that is the nurse’s priority.
B. Motor dysfunction after a penicillin G injection is nonurgent because it can occur when there is an accidental injection into a peripheral nerve. Sensory and motor dysfunction is reversible. Therefore, there is another finding that is the nurse’s priority.
D. This temperature is an expected finding for a client who is being treated for an infection. Therefore, there is another finding that is the nurse’s priority.
A nurse is monitoring a client who is receiving lactulose for cirrhosis. Which of the following laboratory values related to this medication should indicate to the nurse that the treatment is effective?
A. Increased aspartate aminotransferase (AST)
B. Decreased alanine aminotransferase (ALT)
C. Increased prothrombin time (PT)
D. Decreased serum ammonia
Correct Answer: D.
Decreased serum ammonia
The nurse should identify that lactulose is a laxative that can be used for chronic liver disorders such as cirrhosis. Lactulose improves the client’s condition by decreasing ammonia levels through enhancing intestinal secretion of ammonia so that it can be eliminated from the body.
Incorrect Answers:
A. An increase in AST can indicate that the client’s liver condition is worsening. Therefore, this can indicate that the treatment is ineffective.
B. A decrease in ALT can indicate that the client’s liver condition is improving. However, lactulose does not directly affect this laboratory value.
C. An increased PT can indicate that the client’s condition is worsening due to an increased blood-clotting time. The liver is directly related to clotting factors and the body’s ability to form a clot. Therefore, this can indicate that the treatment is ineffective.
A nurse is planning to administer diltiazem via IV bolus to a client who has atrial fibrillation. When assessing the client, the nurse should recognize that which of the following findings is a contraindication to administration of diltiazem?
A. Hypotension
B. Tachycardia
C. Decreased level of consciousness
D. History of diuretic use
Correct Answer: A.
Hypotension
Diltiazem can be a treatment option for essential hypertension. This medication will lower blood pressure and is contraindicated for a client who is hypotensive. The nurse should teach the client to self-monitor blood pressure and keep a record of the readings.
Incorrect Answers:
B. Diltiazem and other calcium channel blockers are contraindicated for use in certain conditions where bradycardia is present (e.g. second- or third-degree heart block). It is used to treat tachydysrhythmia such as atrial flutter and fibrillation and supraventricular tachycardia.
C. A decreased level of consciousness is not a contraindication for diltiazem use.
D. Diltiazem does not interact with diuretics, and a history of diuretic use is not a contraindication for diltiazem administration.
A nurse is preparing to administer warfarin to a client who has a new onset of atrial fibrillation. The client asks the nurse, “What should this medication do?” Which of the following responses should the nurse make?
A. “It helps your heart return to a normal rhythm.”
B. “It dissolves blood clots.”
C. “It can reduce your risk of having a stroke.”
D. “It helps to prevent bleeding in atrial fibrillation.”
Correct Answer: C.
“It can reduce your risk of having a stroke.”
The nurse should identify that atrial fibrillation increases the client’s risk of having a stroke due to clot formation in the atrium. Warfarin can prevent clot formation when used long-term, which will reduce the client’s risk of having a stroke.
Incorrect Answers:
A. The nurse should identify that conversion of rhythms is not an indication of warfarin because warfarin is anti-coagulant. Other medications such as amiodarone can assist with the conversion of arrhythmias to a normal sinus rhythm.
B. The nurse should identify that thrombolytic medications dissolve clots. Warfarin is an anticoagulant and cannot dissolve clots.
D. The nurse should identify that hemorrhage is an adverse effect of warfarin.
