PHARMACOLOGY EXAM 2 Flashcards
The nurse is caring for a client who is receiving aspirin therapy. Which clinical indicator would be related to this therapy?
A. Urinary calculi
B. Atrophy of the liver
C. Prolonged bleeding time
D. Premature erythrocyte destruction
Prolonged bleeding time
A client develops tinnitus. Which of the client’s medications would the nurse suspect is the cause of this new development?
A. Digoxin 0.25 mg, one tablet daily
B. Aspirin 325 mg, two tablets every 4 hours
C. Captopril 25 mg, one tablet three times daily
D. Diphenhydramine 25 mg, one tablet every 4 to 8 hours prn
Aspirin 325 mg, two tablets every 4 hours
A client with arthritis takes large doses of aspirin. Which symptom would the nurse include when teaching the client about the clinical manifestations of aspirin toxicity?
A. Feelings of drowsiness
B. Disturbances in hearing
C. Intermittent constipation
D. Metallic taste in the mouth
Disturbances in hearing
Which medication would the nurse anticipate the health care provider will prescribe to relieve the pain experienced by a client with rheumatoid arthritis?
A. Aspirin
B. Hydromorphone
C. Meperidine
D. Alprazolam
Aspirin
A client who takes four 325-mg tablets of buffered aspirin four times a day for severe arthritis complains of dizziness and ringing in the ears. Which complication would the nurse conclude that the client probably is experiencing?
A. Salicylate toxicity
B. Allergic reaction
C. Withdrawal symptoms
D. Aspirin tolerance
Salicylate toxicity
A health care provider prescribes aspirin for a client with severe arthritis. Which advice will the nurse provide to the client?
A. Take the medicine with meals.
B. See a dentist if bleeding gums develop.
C. Switch to acetaminophen if tinnitus occurs.
D. Avoid spicy foods while taking the medication.
Take the medicine with meals.
Aspirin is prescribed on a regular schedule for a client with rheumatoid arthritis. The nurse understands that the medication is being used primarily for which property?
A. Analgesic
B. Antipyretic
C. Anti-inflammatory
D. Antiplatelet
Anti-inflammatory
A client has been given a prescription for acetylsalicylic acid. The nurse recalls that this medication has which property?
A. Sedative
B. Hypnotic
C. Analgesic
D. Antibiotic
Analgesic
A client is admitted to the emergency department with crushing chest pain. A diagnosis of acute coronary syndrome is suspected. Which medication is indicated to prevent progression to a myocardial infarction?
A. Aspirin
B. Atropine
C. Gabapentin
D. Epinephrine
Aspirin
The client with chronic arterial insufficiency of the legs refuses the prescribed dose of aspirin (ASA). The client states, ‘My legs are not painful.’ Which action will the nurse take?
A. Explain the reason for the medication and encourage the client to take it.
B. Withhold the medication at this time and return to check with the client again in 30 minutes.
C. Withhold the medication and tell the client to ask for it if the legs become uncomfortable.
D. Request that the client take the medication and explain that it prevents the client from being uncomfortable in the next few hours.
Explain the reason for the medication and encourage the client to take it.
A health care provider prescribes aspirin therapy for a client with arthritis. The nurse will advise the client to report which adverse effects? Select all that apply. One, some, or all responses may be correct.
A. Ongoing nausea
B. Constipation
C. Easy bruising
D. Decreased pulse
E. Ringing in the ears
Ongoing nausea
Easy bruising
Ringing in the ears
Aspirin is prescribed for a client with rheumatoid arthritis. Which clinical indicators of aspirin toxicity will the nurse teach the client to report? Select all that apply. One, some, or all responses may be correct.
A. Bradycardia
B. Joint pain
C. Blood in the stool
D. Ringing in the ears
E. Increased urine output
Blood in the stool
Ringing in the ears
Which would the nurse include in the client’s medication teaching on the administration of aspirin 650 mg every 6 hours as needed for arthritic pain? Select all that apply. One, some, or all responses may be correct.
A. ‘Report persistent abdominal pain.’
B. ‘Do not chew enteric-coated tablets.’
C. ‘Take the aspirin with meals or a snack.’
D. ‘See a dentist if bleeding gums develop.’
E. ‘Switch to acetaminophen if tinnitus occurs.’
‘Report persistent abdominal pain.’
‘Do not chew enteric-coated tablets.’
‘Take the aspirin with meals or a snack.’
The nurse is planning care for a toddler who has ingested aspirin. Which assessment warrants close monitoring because an increase would result in further complications?
A. Blood pressure
B. Abdominal girth
C. Body temperature
D. Serum glucose level
Body temperature
The nurse is assessing the effectiveness of high dose aspirin therapy for an 88-year-old client with arthritis. The client reports hearing non-stop ringing in the ears. Which action should the nurse implement?
A. Refer the client to an audiologist for evaluation of her hearing.
B. Advise the client that this is a common side effect.
C. Notify the healthcare provider of the finding immediately.
D. Face the client directly and speak in a low, monotone voice.
Notify the healthcare provider of the finding immediately.
A client who recently had a heart attack has been prescribed low-dose (81 mg) aspirin at bedtime. The client states “Why am I supposed to take a ‘baby aspirin’ instead of a regular 325 mg tablet?” Which statement represents the nurse’s best response?
A. “Taking a higher dose will affect your hearing.”
B. “The higher dose will cause you to have heartburn.”
C. “Taking 325 mg of aspirin daily will increase your risk of bleeding.”
D. “The higher doses may interfere with your normal sleep patterns.”
“Taking 325 mg of aspirin daily will increase your risk of bleeding.”
The nurse is assessing a client with suspected aspirin overdose. Which assessment findings would support this diagnosis? Select all that apply.
A. Respiratory rate of 28
B. Tinnitus
C. Hypoglycemia
D. Jaundice
E. Serum pH 7.31
F. Headache
Respiratory rate of 28
Tinnitus
Serum pH 7.31
Headache
A toddler ingested half a bottle of aspirin tablets. Which finding should the nurse expect to see in this child?
A. Dyspnea
B. Hypothermia
C. Edema
D. Epistaxis
Epistaxis
The nurse is preparing to administer aspirin 81 mg to a client who had a stroke. The client states, “I do not want to take that.” Which statements should the nurse make to the client? Select all that apply.
A. “If you don’t take aspirin every day, you might die.”
B. “Can you tell me what concerns you have about the aspirin?”
C. “Do you experience any nausea when you take the aspirin?”
D. “Do you take your other medications as prescribed by your provider?”
E. “Would you like to take the aspirin at another time of day?”
“Can you tell me what concerns you have about the aspirin?”
“Do you experience any nausea when you take the aspirin?”
“Do you take your other medications as prescribed by your provider?”
“Would you like to take the aspirin at another time of day?”
The nurse is caring for a client that is taking prednisone and aspirin for rheumatoid arthritis. Which action by the nurse is appropriate for this client?
A. Assess the client’s pain level once a shift
B. Monitor the client’s temperature every two hours
C. Test the client’s stool for occult blood
D. Apply a hot pack to a warm, acutely inflamed joint
Test the client’s stool for occult blood
A client with a history of heart disease has been prescribed prophylactic aspirin daily. Which action should the nurse implement to help prevent aspirin toxicity?
A. Monitor serum albumin
B. Measure daily protein intake
C. Assess serum potassium level
D. Teach the client that tinnitus is an expected side effect
Monitor serum albumin
How would the nurse instruct a client with arthritis to take aspirin when the client states that the aspirin causes stomach irritation?
A. An hour before a meal
B. With food and a full glass of water
C. With sodium bicarbonate
D. At the same time as the other medications
With food and a full glass of water
Which medication increases the risk for upper gastrointestinal (GI) bleeding? Select all that apply. One, some, or all responses may be correct.
A. Aspirin
B. Ibuprofen
C. Ciprofloxacin
D. Acetaminophen
E. Methylprednisolone
Aspirin
Ibuprofen
Methylprednisolone
When, during the first 24 hours postoperatively, will analgesics be administered to a client who undergoes an abdominal cholecystectomy for gangrene of the gallbladder?
A. If repositioning is ineffective
B. When the pain becomes severe
C. In gradually increasing dosages
D. As prescribed by the health care provider
As prescribed by the health care provider
Which action would the nurse take when a client refuses to take deep breaths and cough, saying, “It’s too painful.” after an abdominal cholecystectomy?
A. Give pain medication regularly as soon as possible.
B. Obtain a prescription to increase the client’s pain medication.
C. Schedule coughing and deep-breathing exercises after analgesic has taken effect.
D. Substitute incentive spirometry for coughing and deep breathing.
Schedule coughing and deep-breathing exercises after analgesic has taken effect.
An adolescent is admitted with partial- and full-thickness burns of the arms and upper torso. Which are the primary purposes of administering pain medication via the intravenous route, rather than the intramuscular route? Select all that apply. One, some, or all responses may be correct.
A. Adolescents are afraid of injections.
B. It decreases the risk of tissue irritation.
C. Severe pain is reduced more effectively.
D. Impaired peripheral circulation is bypassed.
E. It provides for more prolonged relief of pain.
It decreases the risk of tissue irritation.
Severe pain is reduced more effectively.
Impaired peripheral circulation is bypassed.
Which action is the nurse’s responsibility when administering prescribed opioid analgesics? Select all that apply. One, some, or all responses may be correct.
A. Count the client’s respirations.
B. Document the intensity of the client’s pain.
C. Withhold the medication if the client reports pruritus.
D. Verify the number of doses in the locked cabinet before administering the prescribed dose.
E. Discard the medication in the client’s toilet before leaving the room if the medication is refused.
Count the client’s respirations.
Document the intensity of the client’s pain.
Verify the number of doses in the locked cabinet before administering the prescribed dose.
A pain scale of 1 to 10 is used by the nurse to assess a client’s degree of pain. The client rates the pain as an 8 before receiving an analgesic and a 7 after being medicated. Which conclusion would the nurse make regarding the client’s response to pain medication?
A. The client has a low pain tolerance.
B. The medication is not adequately effective.
C. The medication has sufficiently decreased the pain level.
D. The client needs more education about the use of the pain scale.
The medication is not adequately effective.
The nurse is caring for a client with deep partial-thickness burns who is receiving an opioid for pain management. Which mode of medication administration is preferred for this client?
A. Oral
B. Rectal
C. Intravenous
D. Intramuscular
Intravenous
The nurse is preparing an education session for a client prescribed opioids for intractable cancer pain. The nurse should include strategies to help prevent which common side effect associated with long-term use of opioids?
A. Sedation.
B. Constipation.
C. Urinary retention.
D. Respiratory depression.
Constipation
A staff nurse is assisting a charge nurse with checking controlled substances at the change of shift. The charge nurse is urgently called to a client’s room and has to leave the medication room. Which action will the staff nurse take?
A. Continue performing the check while the charge nurse assists the client
B. Leave the medication room to find another nurse to assist with the check
C. Stop the check and sign out of the medication dispensing system
D. Pause the check until the charge nurse returns to the medication room
Stop the check and sign out of the medication dispensing system
A nurse is providing care to a client post-cholecystectomy. Which observation indicates the client may require PRN pain medication?
A. Slow gait when ambulating to the restroom
B. Guarding when the abdomen is palpated
C. Muscle tension when repositioning in bed
D. Refusal to eat the provided meals
Muscle tension when repositioning in bed
The nurse is assessing a client who is taking prescribed opioids for pain. Which finding should indicate to the nurse that the client is having a side effect of the medication?
A. Decreased skin turgor
B. No bowel movement for four days
C. Hypertension
D. Increased respiratory effort
No bowel movement for four days
A nurse is performing pain assessments on several clients. Which client would benefit the most from the administration of intravenous PRN pain medication?
A. A client eating breakfast verbalizing a headache
B. A client with a fractured arm pending discharge
C. A client post-abdominal surgery sitting in a chair
D. A client pending bedside debridement of a wound
A client pending bedside debridement of a wound
A client is diagnosed with rheumatoid arthritis (RA). Which types of drugs might the nurse expect to be ordered as a combination drug therapy regimen? Select all that apply.
A. Glucocorticoids
B. Biological-response modifiers
C. Antimicrobial agents
D. Diuretics
E. Anti-inflammatory drugs
Glucocorticoids
Biological-response modifiers
Anti-inflammatory drugs
The nurse is caring for a client who is actively dying and has been receiving high doses of opioid analgesics. The client has become unresponsive to verbal stimuli. What action should the nurse take?
A. Stop giving the analgesic
B. Give an extra dose of the analgesic
C. Decrease the analgesic dosage by half
D. Continue the analgesic at the current dose
Continue the analgesic at the current dose
Morphine has been prescribed for a client in a hospice home care program. Which information will the nurse provide regarding this pain management regimen?
A. Medication addiction is a concern with this medication.
B. Request the medication before the pain becomes severe.
C. Dosages of the medication will be given automatically at regular intervals around the clock.
D. Intermittent administration of the medication is possible after an intermittent lock is inserted.
Dosages of the medication will be given automatically at regular intervals around the clock.
A client, admitted to the cardiac care unit with a myocardial infarction, complains of chest pain. Which intervention will be most effective in relieving the client’s pain?
A. Nitroglycerin sublingually
B. Oxygen per nasal cannula
C. Lidocaine hydrochloride 50-mg intravenous (IV) bolus
D. Morphine sulfate 2 mg IV
Morphine sulfate 2 mg IV
A client who had a myocardial infarction receives 15 mg of morphine sulfate for chest pain. Fifteen minutes after receiving the medication, the client complains of feeling dizzy. Which action will the nurse take?
A. Determine if this is an allergic reaction.
B. Elevate the client’s head and keep the extremities warm.
C. Place the client in the supine position and take the vital signs.
D. Tell the client that this is not a typical sensation after receiving morphine sulfate.
Place the client in the supine position and take the vital signs.
A client receives intrathecal morphine to control severe postoperative pain. Which action will the nurse include as part of the client’s initial 24-hour postoperative care plan?
A. Monitoring of respiratory rate hourly
B. Assessing the client for tachycardia
C. Administering naloxone every 3 to 4 hours
D. Observing the client for signs of central nervous system (CNS) excitement
Monitoring of respiratory rate hourly
Which relationship reflects the relationship of naloxone to morphine sulfate?
A. Aspirin to warfarin
B. Amoxicillin to infection
C. Enoxaparin to dalteparin
D. Protamine sulfate to heparin
Protamine sulfate to heparin
The nurse is caring for a client hospitalized with a myocardial infarction. Which analgesic is the medication of choice for this client?
A. Ketorolac
B. Meperidine
C. Flurazepam
D. Morphine sulfate
Morphine sulfate
Which response to morphine would need to be reported immediately to the health care provider?
A. Nausea
B. Headache
C. Drowsiness
D. Bradycardia
Bradycardia
A client receiving morphine is being monitored by the nurse for adverse effects of the medication. Which clinical findings warrant immediate follow up by the nurse? Select all that apply. One, some, or all responses may be correct.
A. Polyuria
B. Unconsciousness
C. Bradycardia
D. Dilated pupils
E. Bradypnea
Unconsciousness
Bradycardia
Bradypnea
A health care provider prescribes morphine for a client being treated for myocardial infarction. Which physiological response will occur if the client experiences the intended therapeutic effect of morphine?
A. Increased respiratory rate
B. Decreased workload of the heart
C. Dilation of coronary arteries
D. Diminished metabolites within the ischemic heart muscle
Decreased workload of the heart
After surgery the client has a prescription for morphine sulfate via intravenous (IV) route every 3 hours as needed for pain. The client’s preoperative blood pressure was 128/76 mm Hg. Postoperative assessments reveal that the client’s blood pressure ranges between 90/60 mm Hg and 100/70 mm Hg. Which action will the nurse take if the client requests medication for pain?
A. Administer morphine as prescribed.
B. Obtain a prescription for a vasoconstrictor.
C. Give half the prescribed amount of morphine.
D. Withhold morphine until the blood pressure stabilizes.
Withhold morphine until the blood pressure stabilizes.
An adolescent client has orders for morphine sulfate for severe pain and acetaminophen-codeine compound for moderate pain after a spinal fusion. The pain assessment reveals the client is rigid and crying in pain. Which information would influence the nurse’s choice of analgesic?
A. One dose of morphine may be given, but the drug should be restricted thereafter because it is addictive.
B. Adolescents tend to exaggerate their discomfort, particularly when they are immobilized by surgery or injury.
C. Spinal fusion causes considerable pain during the early postoperative days, and morphine is the more effective analgesic.
D. The acetaminophen-codeine compound is preferred because morphine can cause respiratory depression or respiratory arrest.
Spinal fusion causes considerable pain during the early postoperative days, and morphine is the more effective analgesic.
Which client should the nurse identify as being at highest risk for complications during the use of an opioid analgesic?
A. An older client with Type 2 diabetes mellitus.
B. A client with chronic rheumatoid arthritis.
C. A client with a open compound fracture.
D. A young adult with inflammatory bowel disease.
D. A young adult with inflammatory bowel disease.
Which medications should the nurse caution the client about taking while receiving an opioid analgesic?
A. Antacids.
B. Benzodiazepines.
C. Antihypertensives.
D. Oral antidiabetics.
Benzodiazepines.
A nurse is preparing to administer morphine to a client with chronic pain. Which assessment finding would prompt the nurse to withhold the medication?
A. Heart rate of 117 beats/min
B. Urine output of 35 ml/hr
C. Oxygen saturation of 92%
D. Respiratory rate of 11 breaths/min
Respiratory rate of 11 breaths/min
The nurse is teaching a client who is postoperative cesarean section about prescribing morphine via a patient-controlled device. Which statement should the nurse include in client teaching about the medication?
A. It is normal for this medication to cause burning at the IV site
B. You will probably experience some itching each time you administer a dose
C. Tell your family members to press the administration button if you are feeling tired
D. Let a staff member know if you experience any trouble breathing
Let a staff member know if you experience any trouble breathing
The nurse is caring for an 81-year-old client with colorectal cancer. Previously, the client’s pain was managed with acetaminophen with codeine. However, the client is now experiencing frequent, severe pain and intravenous morphine has been prescribed. What should the nurse recognize about this order?
A. Inappropriate due to the potential of respiratory depression
B. Inappropriate and demonstrates lack of knowledge related to pain control
C. Appropriate despite the risk of diarrhea and abdominal upset
D. Appropriate pain management and should be available around the clock
Appropriate pain management and should be available around the clock
The nurse is caring for a client with acute pain and realizes a medication error has occurred. The client received twice the ordered dose of morphine an hour ago. Which nursing problem is the priority at this time?
A. Chronic pain
B. Respiratory depression
C. Constipation
D. Tolerance
Respiratory depression
The nurse is caring for a 1-year-old child after heart surgery. The child weighs 22 pounds (10 kg). The health care provider has given an order for morphine sulfate 4 mg IV every 3 to 4 hours as needed for pain. What should the nurse do next?
A. Administer the prescribed dose as ordered.
B. Verify that the dose is appropriate for this child.
C. Give half of the dose first, wait 30 minutes, then give the other half.
D. Check with the pharmacist to clarify the dose.
Verify that the dose is appropriate for this child.
A client with a myocardial infarction is admitted to the cardiac intensive care unit. Which pain relief medication would the nurse expect to find on the plan of care for this client?
A. Morphine
B. Diazepam
C. Midazolam
D. Oxycodone
Morphine
A client in the coronary care unit develops ‘viselike’ chest pain radiating to the neck. Assessment reveals a blood pressure of 124/64 mm Hg, an irregular apical pulse of 64 beats per minute, and diaphoresis. Cardiac monitoring is instituted, and morphine sulfate 4 mg intravenous (IV) push stat is prescribed. Which intervention is the priority nursing care for this client?
A. Relief of pain
B. Client teaching
C. Cardiac monitoring
D. Maintenance of bed rest
Relief of pain
A client with a known history of opioid addiction has a surgical repair of multiple stab wounds to the abdomen. After surgery, the client’s pain is not relieved by the prescribed morphine injections. Which phenomenon is the client experiencing when they fail to achieve pain relief?
A. Tolerance
B. Habituation
C. Physical addiction
D. Psychological dependence
Tolerance
At which time would the nurse plan to administer morphine 2 mg by mouth every 2 hours as needed to a client who has burns on 55% of the body surface and requires dressing changes?
A. 15 minutes before the dressing change
B. 60 minutes before the dressing change
C. Along with a stool softener each time it is administered
D. Only if the client rates pain between 8 and 10 on the pain scale
60 minutes before the dressing change
Which adverse effect of morphine indicates the need for naloxone administration?
A. Blurred vision
B. Urinary retention
C. Mental confusion
D. Respiratory depression
Respiratory depression
A client who receives morphine by patient-controlled analgesia has a respiratory rate of 6 breaths/minute. Which intervention is needed?
A. Nasotracheal suction
B. Mechanical ventilation
C. Naloxone administration
D. Cardiopulmonary resuscitation
Naloxone administration
A client takes morphine sulfate for severe metastatic bone pain. The nurse will assess the client for which adverse effect?
A. Diarrhea
B. Addiction
C. Respiratory depression
D. Diuresis
Respiratory depression
Which medication would the nurse anticipate will be prescribed to relieve anxiety and apprehension in a client with pulmonary edema?
A. Morphine
B. Phenobarbital
C. Hydroxyzine
D. Chloral hydrate
Morphine
A terminally ill client is receiving a morphine drip that exceeds the typical recommended dosage. The client’s spouse tells the nurse that the client is again uncomfortable and needs the morphine increased. The prescription states to titrate the morphine to comfort level. Which action will the nurse take?
A. Add a placebo to the morphine to appease the spouse.
B. Discuss with the spouse the risk for morphine addiction.
C. Assess the client’s pain before increasing the dose of morphine.
D. Check the client’s heart rate before increasing the morphine to the next level.
Assess the client’s pain before increasing the dose of morphine.
Which member of the health care team would the nurse ask to serve as a witness when wasting unused morphine?
A. Nursing supervisor
B. Licensed practical nurse (LPN)
C. Client’s health care provider
D. Designated nursing assistant
Licensed practical nurse (LPN)
A client has increased intracranial pressure and is unconscious with a heart rate of 60 beats/min, respirations 16 breaths/min, and blood pressure 142/64 mm Hg. The nurse reviews the treatment plan and questions which prescription?
A. Mannitol
B. Dexamethasone
C. Chlorpromazine
D. Morphine
Morphine
A client who has been diagnosed with a myocardial infarction receives digoxin, fluoxetine, morphine, and docusate sodium. Which medication would the nurse identify as a risk factor for straining due to constipation?
A. Digoxin
B. Morphine
C. Docusate
D. Fluoxetine
Morphine
A client is admitted to the emergency department after experiencing a seizure. Which action would the nurse take first?
A. Ask the emergency provider for a prophylactic anticonvulsant.
B. Obtain a history of seizure type and incidence.
C. Ask the client to remove any dentures and eyeglasses.
D. Observe the client for increased restlessness and agitation.
Obtain a history of seizure type and incidence.
Which statement by the nurse reflects teaching for a client recently initiated on anticonvulsants? Select all that apply. One, some, or all responses may be correct.
A. ‘It is important to take the medication at the same time every day with meals.’
B. ‘It is important to not drink excessive amounts of caffeine-containing beverages or alcohol.’
C. ‘Avoid driving or hazardous activities until any side effects such as drowsiness can be determined.’
D. ‘Some anticonvulsants interfere with vitamin and mineral absorption, so you may need a supplement.’
E. ‘Oral hygiene, such as gum massage and tooth brushing, is important to combat the gingival hyperplasia that some anticonvulsant medication can cause.’
‘It is important to take the medication at the same time every day with meals.’
‘It is important to not drink excessive amounts of caffeine-containing beverages or alcohol.’
‘Avoid driving or hazardous activities until any side effects such as drowsiness can be determined.’
‘Some anticonvulsants interfere with vitamin and mineral absorption, so you may need a supplement.’
‘Oral hygiene, such as gum massage and tooth brushing, is important to combat the gingival hyperplasia that some anticonvulsant medication can cause.’
Status epilepticus develops in an adolescent with a seizure disorder who is taking antiseizure medication. Which reason would the nurse identify as the most common reason for the development of status epilepticus?
A. The provider failed to account for a growth spurt.
B. The amount prescribed is insufficient to cover activities.
C. The prescribed antiseizure medication probably is not taken consistently.
D. The client is prescribed a medication that is ineffective in preventing seizures.
The prescribed antiseizure medication probably is not taken consistently.
A client has a tonic-clonic seizure caused by an overdose of aspirin. Which action would the nurse take next?
A. Check reflexes every 2 hours.
B. Insert a urinary retention catheter.
C. Monitor vital signs every 15 minutes.
D. Prepare a setup for a central venous pressure (CVP) line.
Monitor vital signs every 15 minutes.
During the admission process, the client reports heavy alcohol use for at least one year. What effect does the nurse anticipate the hospitalized client will experience when alcohol consumption stops?
A. Bradycardia
B. Somnolence
C. Withdrawal
D. Tachypnea
Withdrawal
Which adverse response would a nurse assesses for when carbidopa-levodopa is prescribed for a client with Parkinson disease? Select all that apply. One, some, or all responses may be correct.
A. Nausea
B. Lethargy
C. Bradycardia
D. Polycythemia
E. Emotional changes
Nausea
Emotional changes
Carbidopa-levodopa is prescribed for a client with Parkinson’s disease. Which instruction will the nurse include when teaching the client about this medication?
A. ‘Take this medication between meals.’
B. ‘Blood levels of the medication should be monitored weekly.’
C. ‘It can cause happy feelings followed by feelings of depression.’
D. ‘You may experience dizziness when moving from sitting to standing.’
‘You may experience dizziness when moving from sitting to standing.’
The nurse administers carbidopa-levodopa to a client with Parkinson’s disease. Which activity describes the mechanism of action of this medication?
A. Increase in acetylcholine production
B. Regeneration of injured thalamic cells
C. Improvement in myelination of neurons
D. Replacement of a neurotransmitter in the brain
Replacement of a neurotransmitter in the brain
A client with Parkinson disease is admitted to the hospital. Which medication is prescribed to improve the physical manifestations of Parkinson disease?
A. Carbidopa-levodopa
B. Isocarboxazid
C. Dopamine
D. Pyridoxine (vitamin B 6)
Carbidopa-levodopa
Which would the nurse include when teaching a client with Parkinson disease about carbidopa-levodopa?
A. Multivitamins should be taken daily.
B. A high-protein diet should be followed.
C. The medication should be taken with meals.
D. Alcohol consumption should be in moderation.
The medication should be taken with meals.
A client with Parkinson’s disease is taking carbidopa-levodopa (Sinemet). Which observation by the nurse would indicate that the desired outcome of the medication is being achieved?
A. Decreased blood pressure.
B. Lessening of tremors.
C. Increased salivation.
D. Increased attention span.
Lessening of tremors.
A nurse is providing education on the use of carbidopa/levodopa to a client with Parkinson’s disease. What will the nurse include in the teaching?
A. This medication will stop the progression of your condition
B. Notify your healthcare provider if your urine appears dark
C. Eat plenty of whole-grain foods when taking this medication
D. Avoid eating meals that are high in protein
Avoid eating meals that are high in protein
The nurse is caring for a client with Parkinson’s disease. Which finding indicates that the client might be experiencing an adverse side effect from the dopamine-enhancing drugs?
A. Urinary retention
B. Hallucinations
C. Kidney failure
D. Hypertensive urgency
Hallucinations
Which mechanism of action would the nurse identify for levodopa therapy prescribed to a client diagnosed with Parkinson disease?
A. Blocks the effects of acetylcholine
B. Increases the production of dopamine
C. Restores the dopamine levels in the brain
D. Promotes the production of acetylcholine
Restores the dopamine levels in the brain
Which symptom of levodopa toxicity will a client taking levodopa be taught as a reason to contact the primary health care provider?
A. Nausea
B. Dizziness
C. Twitching
D. Constipation
Twitching
The daughter of a client with Alzheimer’s disease asks the nurse, “Will the medication my mother is taking cure her dementia?” What is the best response by the nurse?
A. “It will help your mother live independently again.”
B. “It is used to halt the progression of Alzheimer’s disease.”
C. “It will not improve dementia but can help control emotional responses.”
D. “It will provide a steady improvement in memory.”
“It will not improve dementia but can help control emotional responses.”
The nurse is completing a health history of a client diagnosed with Alzheimer’s disease. The nurse reviews a list of the client’s medications and supplements routinely taken at home. Which treatment should be a cause for concern by the nurse?
A. Donepezil
B. Ginkgo biloba
C. Omega-3 fatty acids
D. Coconut oil
Coconut oil
Donepezil is prescribed for a client who has mild dementia of the Alzheimer type. Which information would the nurse include when discussing this medication with the client and family?
A. Fluids should be limited to 4 large glasses per day.
B. Constipation should be reported to the primary health care provider immediately.
C. Blood tests that reflect liver function will be performed routinely.
D. The client’s medication dosage may be self-adjusted according to the client’s response.
Blood tests that reflect liver function will be performed routinely.
A client with a diagnosis of dementia of the Alzheimer type has been taking donepezil 10 mg/day for 3 months. The client’s partner calls the clinic and reports that the client has increasing restlessness and agitation accompanied by nausea. Which advice would the nurse give the partner?
A. Give the medication with food.
B. Administer the medication at bedtime.
C. Omit 1 dose today and start with a lower dose tomorrow.
D. Bring the partner to the clinic for testing and a physical examination.
Bring the partner to the clinic for testing and a physical examination.
The nurse teaches a client’s family about the administration of donepezil for treatment of dementia of the Alzheimer type. Which side effect identified by the caregiver indicates to the nurse that further teaching is needed?
A. Nausea
B. Dizziness
C. Headache
D. Constipation
Constipation
The caregiver of a client with Alzheimer’s disease asks the nurse for information about different treatment options that can help with memory or behavior problems. Which of the following responses by the nurse are correct? Select all that apply.
A. “Music therapy has been found to help some clients.”
B. “Ginkgo biloba may help with memory.”
C. “Acupuncture may be very relaxing.”
D. “Donepezil (Aricept) may help slow cognitive decline.”
E. “Garlic may help with this disease.”
“Music therapy has been found to help some clients.”
Ginkgo biloba may help with memory.”
Donepezil (Aricept) may help slow cognitive decline.”
The nurse is preparing to administer newly prescribed intravenous phenytoin to a client. When reviewing the client’s medical record, which prescription should the nurse question?
A. Continuous infusion of dextrose 5% in 0.9% saline
B. NPH insulin 40 units before meals
C. Labetalol 100 mg orally twice per day Your Answer
D. Ketorolac 15 mg IV push as needed for pain
Continuous infusion of dextrose 5% in 0.9% saline
The nursing is preparing to administer phenytoin IV push to a client. The client has dextrose 5% in water infusing continuously. Which action is appropriate?
A. Pinch the line above the infusion port during the administration
B. Hold the medication and collaborate with the provider prior to administration
C. Stop the infusion and flush the port with normal saline prior to administration
D. Ask the pharmacy to mix the medication into an IV piggyback (IVPB) infusion
Stop the infusion and flush the port with normal saline prior to administration
The nurse is educating a client with seizure disorder about newly prescribed phenytoin. Which statement should the nurse include in the teaching?
A. Blood work will be required if you have a seizure while taking this medication
B. You will need to have routine visits with a dentist when taking this medication
C. It is normal to have a change in your gait when you first start this medication
D. Avoid grapefruit juice when taking this medication
You will need to have routine visits with a dentist when taking this medication
A nurse is providing care to a client who takes phenytoin for seizure prevention. The latest laboratory report shows a phenytoin level of 32 mcg/mL. Which action does the nurse take next?
A. Examine the oral cavity
B. Percuss the abdomen
C. Check the skin turgor
D. Assess the pupillary response
Assess the pupillary response
A newly admitted client reports taking phenytoin for several months. Which assessment should the nurse include in the admission report? Select all that apply.
A. Report of unsteady gait, rash and diplopia
B. Report of any seizure activity
C. Serum phenytoin levels
D. Report of anorexia, numbness and tingling of the extremities
Report of unsteady gait, rash and diplopia
Report of any seizure activity
Serum phenytoin levels
A nurse is teaching parents of a child recently prescribed the medication phenytoin for seizure control. Which side effect will the nurse include?
A. Hypertension
B. Insomnia
C. Gingival hyperplasia
D. Increased appetite
Gingival hyperplasia
The nurse is caring for a child diagnosed with seizures. While teaching the family and the child about the medication phenytoin, which concept should the nurse emphasize?
A. Omit the medication if the child is seizure-free
B. Serve a diet that is high in iron
C. A rash is normal with this medication
D. Maintain good oral hygiene and dental care
Maintain good oral hygiene and dental care
Which instruction about phenytoin will the nurse provide during discharge teaching to a client with epilepsy who is prescribed phenytoin for seizure control?
A. “Antiseizure medications will probably be continued for life.”
B. “Phenytoin prevents any further occurrence of seizures.”
C. “This medication needs to be taken during periods of emotional stress.”
D. “Your antiseizure medication usually can be stopped after a year’s absence of seizures.”
“Antiseizure medications will probably be continued for life.”
The nurse teaches the parents of a child prescribed long-term phenytoin therapy about care. Which statement indicates the teaching has been effective?
A. ‘We give the medication between meals.’
B. ‘We’ll call the clinic if her urine turns pink.’
C. ‘She’s eating high-calorie foods, and we encourage fluids, too.’
D. ‘We’ll have her massage her gums and floss her teeth frequently.’
‘We’ll have her massage her gums and floss her teeth frequently.’
A school-age child with a seizure disorder is prescribed divalproex/phenytoin. The nurse would include which instruction when teaching the parents about administering this medication?
A. ‘Crush the tablets and mix them with applesauce.’
B. ‘Take the child for regularly scheduled blood tests.’
C. ‘Stop the medication immediately if a rash develops.’
D. ‘Provide oral hygiene, especially gum massage and flossing.’
‘Take the child for regularly scheduled blood tests.’
The client with a seizure disorder receives intravenous (IV) phenytoin. The nurse will monitor closely for which condition?
A. Cardiac dysrhythmias
B. Hypoglycemia
C. Polycythemia
D. Paradoxical excitation
Cardiac dysrhythmias
A client with a seizure disorder will begin taking phenytoin. Which instructions will the nurse give to the client?
A. ‘Take the medication on an empty stomach.’
B. ‘Provide meticulous oral hygiene.’
C. ‘Taper off the medication if seizures are controlled for 3 months.’
D. ‘Stop taking the medication if you become pregnant.’
‘Provide meticulous oral hygiene.’
Warfarin is prescribed for the client who takes phenytoin for a seizure disorder. Which medication interaction complicates seizure therapy?
A. Warfarin inhibits the metabolism of phenytoin.
B. Warfarin decreases phenytoin absorption.
C. Phenytoin competes with warfarin for receptor occupation.
D. Warfarin promotes excretion of phenytoin.
Warfarin inhibits the metabolism of phenytoin.
A client who is receiving phenytoin asks why folic acid was prescribed. Which explanation would the nurse provide?
A. Phenytoin inhibits absorption of folate from foods.
B. Folic acid potentiates the action of phenytoin.
C. Absorption of iron from foods is improved.
D. Neuropathy caused by phenytoin is prevented.
Phenytoin inhibits absorption of folate from foods.
A client with a seizure disorder is receiving phenytoin and phenobarbital. Which client statement indicates that the instructions regarding the medications are understood?
A. ‘I will not have any seizures with these medications.’
B. ‘These medicines must be continued to prevent falls and injury.’
C. ‘Stopping the medications can cause continuous seizures and I may die.’
D. ‘By my staying on the medicines I will prevent postseizure confusion.’
‘Stopping the medications can cause continuous seizures and I may die.’
A client’s phenytoin level is 16 mcg/L. Which action will the nurse take?
A. Hold the medication and notify the health care provider.
B. Administer the next dose of the medication as prescribed.
C. Hold the next dose and then resume administration as prescribed.
D. Call the health care provider to obtain a prescription with an increased dose.
Administer the next dose of the medication as prescribed.
Which instruction would the nurse provide to parents of a school-age child who has been on long-term phenytoin therapy to prevent side effects?
A. Provide good oral hygiene.
B. Administer the medication between meals.
C. Watch for a reddish-brown discoloration of urine.
D. Supplement the diet with high-calorie foods.
Provide good oral hygiene.
The nurse educating a client who is postpartum about the use of ibuprofen for uterine cramping. Which statement should the nurse include in the teaching?
A. This medication could cause gastrointestinal discomfort
B. You may experience decreased vaginal discharge with this medication
C. Taking this medication could decrease your breast milk production
D. You could experience dizziness while taking this medication
This medication could cause gastrointestinal discomfort
A nurse is reviewing prescriptions for a client with a history of rheumatoid arthritis and peptic ulcer disease. The client has prescriptions for ibuprofen and ranitidine. Which action will the nurse perform?
A. Clarify the prescription for ibuprofen
B. Administer the ibuprofen 30 minutes before the ranitidine
C. Hold the ranitidine for 1 hour after meals
D. Question the prescription for ranitidine
Clarify the prescription for ibuprofen
The mother of a toddler with hemophilia A asks the nurse, ‘Can I give my child ibuprofen for fever or pain?’ How will the nurse respond?
A. ‘Ibuprofen is a good choice for fever or pain.’
B. ‘Give your child acetaminophen. Ibuprofen may cause bleeding.’
C. ‘No. I’ll explain why your child isn’t allowed pain medications.’
D. ‘You seem concerned about giving medications to your child.’
‘Give your child acetaminophen. Ibuprofen may cause bleeding.’
Which life-threatening complication may occur in clients taking high-dose or long-term ibuprofen?
A. Anaphylaxis
B. Gastrointestinal (GI) bleeding
C. Cardiac dysrhythmia
D. Disulfiram reaction
Gastrointestinal (GI) bleeding
A client with rheumatoid arthritis is to begin taking ibuprofen 800 mg by mouth three times a day. The nurse provides education about the medication’s side effects. The nurse concludes that the teaching was effective when the client makes which statements? Select all that apply. One, some, or all responses may be correct.
A. ‘I need to report any dark tarry stools.’
B. ‘I will need to stop taking this medication before any scheduled surgery.’
C. ‘I should change positions slowly.’
D. ‘I will take the medication on an empty stomach.’
E. ‘I need to stop taking low-dose aspirin while I take this medication.’
A. ‘I need to report any dark tarry stools.’
B. ‘I will need to stop taking this medication before any scheduled surgery.’
Which therapeutic outcomes are expected after administering ibuprofen? Select all that apply. One, some, or all responses may be correct.
A. Diuresis
B. Pain relief
C. Temperature reduction
D. Bronchodilation
E. Anticoagulation
F. Reduced inflammation
B. Pain relief
C. Temperature reduction
F. Reduced inflammation
The nurse administers acetaminophen to a child who complains of pain after abdominal surgery. The mother asks the nurse why her child isn’t being given ibuprofen. Which response by the nurse is most appropriate?
A. ‘It could prolong bleeding time.’
B. ‘It’s contraindicated for young children.’
C. ‘It can suppress the healing of the incision.’
D. ‘It becomes ineffective when given for long periods.’
‘It could prolong bleeding time.’
A nurse is reviewing analgesic prescriptions for a client with a history of liver cirrhosis. The prescriptions state to administer PRN for pain. Which medication is the nurse most likely to administer to this client?
A. Fentanyl
B. Acetaminophen
C. Ibuprofen
D. Ketorolac
Fentanyl
A nurse has removed a 2 ml vial of fentanyl from the medication dispensing system. After dosage calculations, the nurse determines only 1 ml will be administered to the client. Which action will the nurse perform with the remainder of the medication?
A. Request another nurse to witness wasting of the unused medication
B. Dispose of the unused medication in the sink
C. Store the unused of the medication in the medication cart
D. Return the unused medication to the dispensing system
Request another nurse to witness wasting of the unused medication
