Pharm Test 2 Flashcards
A client demonstrates understanding of inhaled corticosteroids by saying that he will do what?
A. Rinse his mouth with water after each use.
B. Do not use an albuterol inhaler when prescribed an inhaled corticosteroids.
C. Take two puffs to treat an acute asthma attack.
D. Immediately stop taking his oral montelukast when he starts using an inhaled corticosteroids.
A. Rinse his mouth with water after each use.
Inhaled corticosteroids can cause oral thrush and it is important to teach patients to rinse their mouth after each use. Montelukast should be continued to also prevent inflammation.
Which instruction will the nurse include when teaching a client about the proper use of metered-dose inhalers?
A. “Hold your breath for up to 10 seconds if you can after you inhale the medication.”
B. “Hold the inhaler in your mouth, take a deep breath, and then compress the inhaler.”
C. “After you inhale the medication once, repeat until you obtain relief.”
D. “Make sure that you puff out air repeatedly after you inhale the medication.”
A. “Hold your breath for up to 10 seconds if you can after you inhale the medication.”
Which client assessment would assist the nurse in evaluating therapeutic effects of a calcium channel blocker?
A. Client states that she has no angina chest pain.
B. Client states that she does not feel dizzy.
C. Client states that she feels stronger.
D. Client states that the swelling in her feet is reduced.
A. Client states that she has no angina chest pain.
A nurse is caring for a client who is starting lisinopril for hypertension. For which of the following adverse effects should the nurse monitor the client?
A. Blood clots
B. Anemia
C. Hyperkalemia
D. Hypernatremia
C. Hyperkalemia
Hyperkalemia is a risk for clients taking ACE inhibitors.
The nurse is planning care for a client who is prescribed hydroxychloroquine (Plaquenil) for rheumatoid arthritis. The nurse should encourage the client to make an appointment with which health care provider?
A. Psychologist
B. Ophthalmologist
C. Respiratory therapist
D. Cardiologist
B. Ophthalmologist
The risk of visual disturbances is a prominent adverse effect of hydroxychloroquine. Clients need to be taught to schedule and keep ophthalmology appointments to screen for the development of any visual problems.
A nurse is caring for a client who is starting niacin (Niaspan) to reduce cholesterol levels. The nurse should monitor the client for which of the following adverse effects?
A. Cold, clammy skin
B. Hearing loss
C. Myopathy
D. Hyperglycemia
D. Hyperglycemia
Hyperglycemia may occur as an adverse effect of niacin. The nurse should plan to monitor blood glucose periodically.
A nurse is providing teaching to a client who is starting atorvastatin (Lipitor). Which of the following should the nurse include in the teaching?
A. Consume no more than 1 L of fluid/day
B. The medication can be taken in the morning or the evening.
C. Maintain a steady intake of green leafy vegetables.
D. Change position slowly when rising from a chair.
B. The medication can be taken in the morning or the evening.
The client can take atorvastatin in the morning or the evening due to the medication’s longer half-life than compared to other statins in this class. Statin’s such as simvastatin have a shorter half-life and would need to be taken in the evening because most cholesterol is synthesized in the body at nighttime. Taking simvastatin in the evening increases medication effectiveness; however, due to the longer half-life of atorvastatin, this drug can be taken in the morning as well.
Beclomethasone (Beconase) has been prescribed for a client with allergic rhinitis. The nurse teaches the client that which is the most common side effect from continuous use?
A. Hallucinations
B. Sore throat
C. Dry nasal mucosa
D. Cough
C. Dry nasal mucosa
Dry nasal mucosa is a common reaction with continuous use of beclomethasone.
A nurse is evaluating a client’s understanding of the teaching about the use of fluticasone (Flonase) to treat perennial rhinitis. Which of the following statements by the client indicates he UNDERSTANDS the teaching?
A. “This medication can also be used to treat motion sickness.”
B. “I should use the spray every 4 hours while I am awake.”
C. “It may take as long as 3 weeks before the medication takes a maximum effect.”
D. “I can use this medication when my nasal passages are blocked.”
C. “It may take as long as 3 weeks before the medication takes a maximum effect.”
The client may see some benefits of the medication within a few hours, but the maximum benefits may not be seen for as long as 3 weeks.
Mr. Smith is a 65 year-old caucasian male who has a history of diabetes and hypertension. The nurse will anticipate administering which type of medication to treat the client’s hypertension?
A. Potassium Sparing Diuretic
B. ACE Inhibitor
C. Calcium Channel Blocker
D. Direct-acting vasodilator
B. ACE Inhibitor
Ace inhibitors are the treatment of choice for clients who are hypertensive and have a history of diabetes. The client is also caucasian and research shows that ACE inhibitors have reduced morbidity and mortality in this ethnicity group.
The nurse instructs the client to avoid which over-the-counter products when taking theophylline (Theo-Dur)?
A. acetaminophen (Tylenol)
B. St. John’s wort
C. diphenhydramine (Benadryl)
D. Echinacea
B. St. John’s wort
Which assessment findings in a client who is receiving calcitriol (Rocaltrol) should the nurse immediately report to the prescriber?
A. Diarrhea, abdominal pain, and stomatitis
B. Bone pain, joint stiffness, and fever
C. Photosensitivity, tinnitus, and bone pain
D. Muscle weakness, nausea, and vomiting
D. Muscle weakness, nausea, and vomiting
Diarrhea, stomatitis, and photosensitivity are not symptoms that would be associated with the effects of vitamin D therapy. Bone pain and fever are symptoms of vitamin D deficiency.
Mr. Bart is prescribed a cromolyn inhaler and uses it successfully to manage his COPD. He develops chronic renal insufficiency. Which of the following would you expect the physician to do?
A. Maintain the current dose of the medication.
B. Reduce the dosage of the medication.
C. Increase the dosage of the medication.
D. Tritrate the dosage of the medication upward.
B. Reduce the dosage of the medication.
What is the best information for the nurse to provide to the client who is receiving spironolactone (Aldactone) and furosemide (Lasix) diuretic therapy?
A. “This combination promotes diuresis but decreases the risk of hypokalemia.”
B. “Moderate doses of two different diuretics are more effective than a large dose of one.”
C. “This combination prevents dehydration and hypovolemia.”
D. “Using two drugs increases the osmolality of plasma and the glomerular filtration rate.”
A. “This combination promotes diuresis but decreases the risk of hypokalemia.”
A nurse is caring for a client who is taking gemfibrozil (Lopid). Which of the following assessment findings is an adverse reaction to the medication?
A. Jaundice
B. Mental status changes
C. Pneumonia
D. Tremor
A. Jaundice
Mental status changes do not occur as adverse effects of gemfibrozil. Tremor does not occur as an adverse effect of gemfibrozil. Pneumonia is not an adverse effect of taking gemfibrozil.
A client with increased intracranial pressure is receiving mannitol (Osmitrol). Which of the following findings should the nurse report to the provider?
A. Urine output 40 mL/hr
B. Symptoms of dyspnea or heart failure
C. Blood glucose 150 mg/dL
D. Headache
B. Symptoms of dyspnea or heart failure
Dyspnea can indicate heart failure, an adverse effect of mannitol. The nurse should stop the medication and notify the provider.
A client with HF has an order for lisnopril (Prinivil, Zestril) Which of the following conditions in the client’s history would lead a nurse to confirm the order with the provider?
A. A history of alcoholism, currently abstaining.
B. A history of angioedema after taking enalapril (Vasotec)
C. A history of seasonal allergies currently treated with antihistamines.
D. A history of hypertension previously treated with diuretics.
B. A history of angioedema after taking enalapril (Vasotec)
Client history of angioedema while taking a previous ACE inhibitor could result in severe angioedema when prescribing an additional ACE inhibitor.
Which laboratory value will the nurse report to the health care provider as a potential adverse response to furosemide (Lasix)?
A. Sodium level of 130 mEq/L
B. Potassium level 3.7 mEq/L
C. BUN level of 15 mg/dL
D. Fasting blood glucose of 80 mg/dL
A. Sodium level of 130 mEq/L
Furosemide (Lasix) is a loop diuretic and cause sodium and potassium (electrolyte) depletion. Normal sodium levels fall in the range of 135-145 mEq/L and the nurse should question giving furosemide if the client’s sodium level is below a normal value.
The nurse is providing discharge teaching to the client who was given a prescription for nifedipine (Adalat) for blood pressure management. Which instructions should the nurse include?
A. “Palpitations do not occur early in therapy”
B. “Increase water intake”
C. “Increase calcium intake”
D. “Weigh at the same time each day”
D. “Weigh at the same time each day”
A nurse is providing information to a client who has a new prescription for hydrochlorothiazide. Which of the following information should the nurse include?
A. Plan to take the medication at bedtime.
B. Take the medication with food.
C. Expect increased swelling of the ankles.
D. Fluid intake should be limited in the morning.
B. Take the medication with food.
The client should take hydrochlorothiazide in the morning or not later than 2:00pm and not at bedtime to prevent nocturia. The client should expect decreased swelling of the ankles. The client should maintain an adequate fluid intake throughout the day unless contraindicated because of heart failure.
