PHARMACOLOGY EXAM 3

Question 1

Which adverse response to isoniazid (INH) in a client with tuberculosis would cause the nurse to determine that prompt intervention is needed?
A. Orange feces
B. Yellow sclera
C. Temperature of 96.8°F (36°C)
D. Weight gain of 5 pounds (2.3 kilograms)

Answer 1

Yellow sclera

Question 2

Which purpose would the nurse identify as the reason for prescribing vitamin B 6 when a chemotherapy protocol prescribed for a client with tuberculosis includes vitamin B 6 and isoniazid (INH)?
A. To improve the nutritional status of the client
B. To enhance the tuberculostatic effect of INH
C. To accelerate the destruction of dormant tubercular bacilli
D. To counteract the peripheral neuritis that INH may cause

Answer 2

To counteract the peripheral neuritis that INH may cause

Question 3

Which explanation would the nurse provide to a client with tuberculosis who asks why vitamin B 6 (pyridoxine) is given with isoniazid?
A. “It will improve your immunologic defenses.”
B. “The tuberculostatic effect of isoniazid is enhanced.”
C. “Isoniazid interferes with the synthesis of this vitamin.”
D. “Destruction of the tuberculosis organisms is accelerated.”

Answer 3

“Isoniazid interferes with the synthesis of this vitamin.”

Question 4

A health care provider has prescribed isoniazid for a client. Which instruction will the nurse give the client about this medication?
A. Prolonged use can cause dark, concentrated urine.
B. The medication is best absorbed when taken on an empty stomach.
C. Take the medication with aluminum hydroxide to minimize gastrointestinal (GI) upset.
D. Drinking alcohol daily can cause medication-induced hepatitis.

Answer 4

Drinking alcohol daily can cause medication-induced hepatitis

Question 5

When caring for a client on isoniazid therapy for tuberculosis, the nurse would focus on which diagnostic testing for this client?
A. Creatinine
B. Hearing tests
C. Electrocardiogram
D. Liver function tests

Answer 5

Liver function tests

Question 6

A client diagnosed with tuberculosis is taking isoniazid. To prevent a food and medication interaction, the nurse will advise the client to avoid which food item?
A. Hot dogs
B. Red wine
C. Sour cream
D. Grapefruit juice

Answer 6

Red wine

Question 7

Isoniazid (INH) is prescribed as a prophylactic measure for a client whose spouse has active tuberculosis (TB). Which statements made by the client indicate that there is a need for further teaching? Select all that apply. One, some, or all responses may be correct.
A. ‘I plan to start taking vitamin B 6 with breakfast.’
B. ‘I’ll still be taking this medication 6 months from now.’
C. ‘I sometimes allow our children to sleep in our bed at night.’
D. ‘I know I also have tuberculosis because the skin test was positive.’
E. ‘I plan to attend a wine tasting event this evening.’

Answer 7

‘I sometimes allow our children to sleep in our bed at night.’
‘I know I also have tuberculosis because the skin test was positive.’
‘I plan to attend a wine tasting event this evening.’

Question 8

Pyridoxine (vitamin B 6) and isoniazid (INH) are prescribed as part of the medication protocol for a client with tuberculosis. Which response indicates that vitamin B 6 is effective?
A. Weight gain
B. Improvement of stomatitis
C. Absence of paresthesias
D. Absence of night sweats

Answer 8

Absence of paresthesias

Question 9

The chemotherapy protocol prescribed for a client with tuberculosis includes vitamin B 6 and isoniazid (INH). Which would the nurse identify as the reason for prescribing vitamin B 6?
A. To improve the nutritional status of the client
B. To enhance the tuberculostatic effect of INH
C. To accelerate the destruction of dormant tubercular bacilli
D. To counteract the peripheral neuritis that INH may cause

Answer 9

To counteract the peripheral neuritis that INH may cause

Question 10

A parent of three young children has contracted tuberculosis. Which medication would the nurse anticipate being prescribed for members of the family who have been exposed?
A. Isoniazid
B. Multiple-puncture test
C. Bacille Calmette-Guérin
D. Tuberculin purified protein derivative

Answer 10

Isoniazid

Question 11

The nurse is caring for a client who is receiving isoniazid for tuberculosis (TB). Which assessment finding would indicate the client is having a possible adverse response to this medication?
A. Yellowing of the sclera
B. Tinnitus and decreased hearing
C. Headache and sore throat
D. Urinary frequency

Answer 11

Yellowing of the sclera

Question 12

A client who is taking isoniazid for tuberculosis asks the nurse about the possible side effects of this medication. The nurse informs the client to report which side effect of this medication to the primary health care provider (HCP)?
A. Extremity tingling and numbness
B. Confusion and light-headedness
C. Double vision and visual halos
D. Photosensitivity and photophobia

Answer 12

Extremity tingling and numbness

Question 13

Which action would the nurse take when administering tetracycline?
A. Administer the medication with meals or a snack.
B. Provide orange or other citrus fruit juice with the medication.
C. Administer the medication at least an hour before ingestion of milk products.
D. Offer antacids 30 minutes after administration if gastrointestinal side effects

Answer 13

Administer the medication at least an hour before ingestion of milk products.

Question 14

Which effect has resulted in the avoidance of tetracycline use in children under 8 years old?
A. Birth defects
B. Allergic responses
C. Severe nausea and vomiting
D. Permanent tooth discoloration

Answer 14

Permanent tooth discoloration

Question 15

How would the nurse reply when a client prescribed a tetracycline class medication asks why milk and antacids should be avoided before and after dosing?
A. ‘Taking these together can lead to kidney impairment.’
B. ‘The pairing of these substances leads to tooth staining.’
C. ‘Severe diarrhea can occur when taking these substances together.’
D. ‘This can lead to decreased absorption of the medication you need.’

Answer 15

‘This can lead to decreased absorption of the medication you need.’

Question 16

A pregnant client with an infection tells the nurse that she has taken tetracycline for infections in the past and prefers to take it now. Which response would the nurse give regarding the avoidance of tetracycline administration during pregnancy?
A. ‘It affects breast-feeding adversely.’
B. ‘Tetracycline causes fetal allergies.’
C. ‘It alters the development of fetal teeth buds.’
D. ‘It increases fetal tolerance to the medication.’

Answer 16

‘It alters the development of fetal teeth buds.’

Question 17

A mother complains that her child’s teeth have become yellow in color. The nurse understands that with prolonged use, which medication may be responsible?
A. Tetracycline
B. Promethazine
C. Chloramphenicol
D. Fluoroquinolones

Answer 17

Tetracycline

Question 18

A child is prescribed tetracycline. The nurse understands which possible medication-related reaction is associated with this medication?
A. Kernicterus
B. Gray syndrome
C. Reye syndrome
D. Staining of teeth

Answer 18

Staining of teeth

Question 19

Which information would the nurse provide to a client diagnosed with chlamydia and prescribed doxycycline? Select all that apply. One, some, or all responses may be correct.
A. Report worsening symptoms.
B. Refrain from sexual relations.
C. Use barrier protection devices.
D. Contact partners to be tested.
E. Take the entire course of antibiotics.

Answer 19

Report worsening symptoms.
Refrain from sexual relations.
Use barrier protection devices.
Contact partners to be tested.
Take the entire course of antibiotics.

Question 20

The nurse is preparing to administer doxycycline to a client to treat syphilis. Which lab results should the nurse review before administering this medication?
A . Pregnancy test
B. Hematocrit
C. Sodium level
D. Arterial blood gas

Answer 20

Pregnancy test

Question 21

The nurse is providing medication teaching for a client who has been prescribed tetracycline. The client regularly takes calcium supplements to prevent osteoporosis. Which statement is appropriate for the nurse to make?
A. Take your calcium two hours before you take the antibiotic
B. You can take the calcium with the antibiotic to decrease an upset stomach
C. Try taking the antibiotic and calcium with orange juice
D. It is best to take the antibiotic and calcium on an empty stomach

Answer 21

Take your calcium two hours before you take the antibiotic

Question 22

The nurse in the urgent-care clinic is reviewing discharge instructions with a client who is prescribed doxycycline. Which statement by the client indicates understanding of the instructions?
A. “I will not wear my contact lenses while taking this medication.”
B. “I will carry glucose tablets with me in case I experience low blood sugar.”
C. “I will take this medication with an antacid to prevent an upset stomach.”
D. “I will apply sunscreen when outside to prevent a sunburn.”

Answer 22

“I will apply sunscreen when outside to prevent a sunburn.”

Question 23

The health care provider has prescribed tetracycline for a 28-year-old female client with severe acne. When teaching the client about this medication, which information is important for the nurse to include?
A. It may cause staining of the teeth.
B. It may decrease the effectiveness of oral contraceptives.
C. It should be taken with food or milk.
D. It may cause hearing loss

Answer 23

It may decrease the effectiveness of oral contraceptives.

Question 24

The nurse is educating an older adult client about newly prescribed levofloxacin for the treatment of pneumonia. The nurse should teach the client that which side effect is a priority for the client to report to the provider?
A . Joint tenderness
B. Diarrhea
C. Dizziness
D. Difficulty sleeping

Answer 24

Joint tenderness

Question 25

The nurse is reviewing discharge instructions with a client who has been prescribed ciprofloxacin following a minor burn injury. Which statement by the client requires additional teaching? A. "I will protect my skin from the sun with sunscreen and clothing." B. "I will not take ciprofloxacin prior to sun exposure." C. "After healing, I should have no scarring from this burn." D. "I can take ibuprofen for the pain related to this burn."

Answer 25

"I will not take ciprofloxacin prior to sun exposure."

Question 26

The nurse teaches a teenage client about the administration of levofloxacin to treat a sinus infection. The nurse concludes the teaching is effective when the client makes which statement? A. 'I should take the medication at mealtime.' B. 'I should take the medication just before a meal.' C. 'I should take the medication 1 hour before a meal.' D. 'I should take the medication 30 minutes after a meal.'

Answer 26

'I should take the medication 1 hour before a meal.'

Question 27

Levofloxacin is prescribed for a woman who has been experiencing urinary frequency and burning for the past 24 hours. The nurse concludes the teaching has been effective when the client states she will make which change in her routine? A. Limit her fluid intake. B. Strain her urine for calculi. C. Monitor her urine output. D. Take mineral supplements 2 hours before or after levofloxacin

Answer 27

Take mineral supplements 2 hours before or after levofloxacin

Question 28

A 5-year-old child is given fluoroquinolones. Which potential adverse effect unique to pediatric clients would the nurse anticipate? A. Tendon rupture B. Cartilage erosion C. Staining of developing teeth D. Central nervous system toxicity

Answer 28

Tendon rupture

Question 29

Which action will the nurse take after stopping the antibiotic infusion of a client who becomes restless and flushed, and begins to wheeze during the administration of an antibiotic? A. Check the client’s temperature. B. Take the client’s blood pressure. C. Obtain the client’s pulse oximetry. D. Assess the client’s respiratory status.

Answer 29

Assess the client’s respiratory status.

Question 30

Which explanation would the nurse include when teaching a client scheduled for a bowel resection about the purpose of preoperative antibiotics? A. "They prevent incisional infection." B. "Antibiotics prevent postoperative pneumonia." C. "These medications limit the risk of a urinary tract infection." D. "They are given to eliminate bacteria from the gastrointestinal (GI) tract."

Answer 30

"They are given to eliminate bacteria from the gastrointestinal (GI) tract."

Question 31

A client with advanced cancer of the bladder is scheduled for a cystectomy and ileal conduit. Which intervention would the nurse anticipate the health care provider will prescribe to prepare the client for surgery? A. Intravesical chemotherapy B. Instillation of a urinary antiseptic C. Administration of an antibiotic D. Placement of an indwelling catheter

Answer 31

Administration of an antibiotic

Question 32

A client with burns develops a wound infection. The nurse plans to teach the client that local wound infections are primarily treated with which antibiotic formulation? A. Oral B. Topical C. Intravenous D. Intramuscular

Answer 32

Topical

Question 33

Which issue related to antibiotic use is an increased risk for the older adult? A. Allergy B. Toxicity C. Resistance D. Superinfection

Answer 33

Toxicity

Question 34

Which client would benefit most from the administration of prophylactic antibiotics? Select all that apply. One, some, or all responses may be correct. A. Chickenpox infection B. Fever of unknown origin C. Preoperative hip replacement D. Congenital bicuspid aortic valve E. Current chemotherapy treatment

Answer 34

Preoperative hip replacement Congenital bicuspid aortic valve Current chemotherapy treatment

Question 35

The nurse is preparing to administer an intravenous piggyback antibiotic that has been newly prescribed. Shortly after initiation, the client becomes restless and flushed and begins to wheeze. After stopping the infusion, which priority action will the nurse take? A. Notify the primary health care provider immediately about the client’s condition. B. Take the client’s blood pressure. C. Obtain the client’s pulse oximetry. D. Assess the client’s respiratory status

Answer 35

Assess the client’s respiratory status

Question 36

An infant is prescribed an antibiotic after cardiac surgery. Which instruction would the nurse emphasize to the parents regarding administration of the medication? A. Give the antibiotic between feedings. B. Ensure that the antibiotic is administered as prescribed. C. Shake the bottle thoroughly before giving the antibiotic. D. Keep the antibiotic in the refrigerator after the bottle has been opened

Answer 36

Ensure that the antibiotic is administered as prescribed.

Question 37

A client being discharged home is prescribed an antibiotic with a dosage three times higher than it was administered when the client was in the hospital (IV route). Which route of administration should the nurse anticipate will be prescribed for the greatest first-pass effect? A. Oral. B. Sublingual. C. Intravenous. D. Subcutaneous.

Answer 37

Oral.

Question 38

The nurse is assessing a client who is receiving antibiotic therapy for an infection. Which finding should indicate to the nurse that the client may be experiencing an allergic reaction to a medication? A. Xerostomia B. Hypertension C. Pruritus D. Lymphadenopathy

Answer 38

Pruritus

Question 39

The nurse is caring for a client with sepsis receiving broad-spectrum antibiotics. Which finding might indicate to the nurse the need for a dosage adjustment? A. Elevated creatinine level B. Elevated heart rate C. Decreased white blood cell count D. Decreased platelet count

Answer 39

Elevated creatinine level

Question 40

The nurse in an ambulatory clinic is speaking with the parents of a 2-year-old child diagnosed with acute otitis media. Which information is most important for the nurse to include in the instructions to the parents? A. The child may be given acetaminophen or ibuprofen drops for pain. B. The child must complete the entire course of the prescribed antibiotic. C. The child should return to the clinic to evaluate effectiveness of the treatment. D. The child may be given a decongestant to relieve pressure on the tympanic membrane.

Answer 40

The child must complete the entire course of the prescribed antibiotic.

Question 41

The nurse in an urgent care clinic is preparing discharge instructions for the parents of a 15-month-old child with a first episode of otitis media. Which information is the priority to include? A. Explain that the child should complete the full 10 days of antibiotics B. Describe the tympanocentesis most likely needed to clear the infection C. Offer information on recommended immunizations around the child's second birthday D. Provide a written handout describing the care of myringotomy tubes

Answer 41

Explain that the child should complete the full 10 days of antibiotics

Question 42

A nurse is assessing a 9-year-old child after several days of treatment for a documented strep throat. Which statement is incorrect and suggests that further teaching is needed? A. "Sometimes I take my medicine with fruit juice." B. "Sometimes I take the pills in the morning and other times at night." C. "I am feeling much better than I did last week." D. "My mother makes me take my medicine right after school."

Answer 42

"Sometimes I take the pills in the morning and other times at night."

Question 43

Which of the following instructions is most important for the nurse to include when discharging a client with an infection caused by staphylococcus? A. Schedule follow-up blood cultures B. Monitor for signs of recurrent infection C. Visit the provider in a few weeks D. Complete the full course of the antibiotic

Answer 43

Complete the full course of the antibiotic

Question 44

Which statement indicates that a female client who is receiving rifampin for tuberculosis understands the teaching? Select all that apply. One, some, or all responses may be correct. A. "This medication may be hard on my liver, so I must avoid alcoholic drinks while taking it." B. "This medication may reduce the effectiveness of the oral contraceptive I am taking." C. "I cannot take an antacid within 2 hours before taking my medicine." D. "My health care provider must be called immediately if my eyes and skin become yellow."

Answer 44

"This medication may be hard on my liver, so I must avoid alcoholic drinks while taking it." "This medication may reduce the effectiveness of the oral contraceptive I am taking." "My health care provider must be called immediately if my eyes and skin become yellow."

Question 45

Which class is contraindicated in clients who take rifampin? A. Loop diuretics B. Oral contraceptives C. Proton pump inhibitor D. Intermediate-acting insulin

Answer 45

Oral contraceptives

Question 46

A client who takes rifampin tells the nurse, 'My urine looks orange.' Which action would the nurse take? A. Explain that this is expected. B. Check the liver enzymes. C. Ask the provider to order a urinalysis. D. Ask what foods were eaten.

Answer 46

Explain that this is expected.

Question 47

A client with tuberculosis is started on rifampin. The nurse evaluates that the teaching about rifampin is effective when the client makes which statement? A. 'I need to drink a lot of fluid while I take this medication.' B. 'My sweat will turn orange from this medication.' C. 'I should have my hearing tested while I take this medication.' D. 'Most people who take this medication develop a rash.'

Answer 47

'My sweat will turn orange from this medication.'

Question 48

A client is diagnosed with pulmonary tuberculosis, and the health care provider prescribes a combination of rifampin and isoniazid. The nurse evaluates that the teaching regarding the medications is effective when the client reports which action as most important? A. 'Report any changes in vision.' B. 'Take the medicine with my meals.' C. 'Call my doctor if my urine or tears turn red-orange.' D. 'Continue taking the medicine even after I feel better.'

Answer 48

'Continue taking the medicine even after I feel better.'

Question 49

Which statement by the client indicates to the nurse a need for further teaching on rifampin therapy? A. 'I can expect my skin to turn yellow.' B. 'I can expect my sweat to change color.' C. 'I can expect my urine to turn red-orange.' D. 'I can expect my contact lenses to stain orange.'

Answer 49

'I can expect my skin to turn yellow.'

Question 50

Clients who take rifampin should not take medications from which class? A. Loop diuretics B. Oral contraceptives C. Proton pump inhibitor D. Intermediate-acting insulin

Answer 50

Oral contraceptives

Question 51

A client is prescribed rifampin after being exposed to active tuberculosis. Which finding would the nurse immediately report to the health care provider? Select all that apply. One, some, or all responses may be correct. A. Reddish-orange color urine B. Yellow-colored teeth stains C. Orange-colored sweat and tears D. Small, red, pinpoint areas on the arms E. Numbness, tingling, and burning of extremities

Answer 51

Small, red, pinpoint areas on the arms

Question 52

The nurse is assessing a client who is taking rifampin for the treatment of tuberculosis. Which finding reported by the client should the nurse immediately report to the healthcare provider? A. Blurred vision B. Orange-tinged tears C. Dark amber urine D. Diarrhea

Answer 52

Dark amber urine

Question 53

A client diagnosed with tuberculosis is prescribed rifampin and isoniazid. Which information should the nurse include when reinforcing information about these medications? A. "You can take the medication with food." B. "You may experience an increase in appetite." C. "You may notice an orange-red color to your urine." D. "You may have occasional problems sleeping."

Answer 53

"You may notice an orange-red color to your urine."

Question 54

A client begins treatment with rifampin for suspected pulmonary tuberculosis. Which information should the nurse include when teaching the client about this drug? A. "It is important to stay upright for 30 minutes after taking this drug." B. "Check your radial pulse before taking the drug." C. "Avoid prolonged exposure to the sun while taking this drug." D. "You may notice an orange-red color to your urine."

Answer 54

"You may notice an orange-red color to your urine."

Question 55

Which response will be given by a nurse caring for a client with chronic hepatitis B who asks "Are there any medications to help me get rid of this problem?"? A. "Sedatives can be given to help you relax." B. "We can give you immune serum globulin." C. "Vitamin supplements are frequently helpful and hasten recovery." D. "There are medications to help reduce viral load and liver inflammation."

Answer 55

"There are medications to help reduce viral load and liver inflammation."

Question 56

The nurse is preparing to administer the next dose of prescribed vancomycin to the client being treated for sepsis. Which of the following laboratory results would be the priority for the nurse to review? A. Peak serum drug level B. Serum potassium level C. Serum creatinine level D. White blood cell count

Answer 56

Serum creatinine level

Question 57

The nurse is caring for a client with osteomyelitis who is receiving IV infusion of prescribed vancomycin. Which statement by the client would be a priority for the nurse to report to the healthcare provider? A. I fell some burning at the catheter site B. I feel a little nauseous C. I have a ringing in my ears D. I have a headache

Answer 57

I have a ringing in my ears

Question 58

The nurse is caring for a client who is prescribed erythromycin 500 mg orally every six hours for the treatment of pneumonia. The nurse should monitor the client for which common side effect? A. Esophagitis B. Tendon rupture C. Orange-red discoloration of urine D. Nausea and vomiting

Answer 58

Nausea and vomiting

Question 59

Which assessment would the nurse perform before administering a dose of vancomycin to a client? Select all that apply.One, some, or all responses may be correct. A. Creatinine B. Trough level C. Hearing ability D. Intravenous site E. Blood urea nitrogen

Answer 59

Creatinine Trough level Hearing ability Intravenous site Blood urea nitrogen

Question 60

Which reason will the nurse explain is the purpose for neomycin being prescribed to a client with cirrhosis? A. Prevents an infection B. Limits abdominal distention C. Minimizes intestinal edema D. Reduces the blood ammonia level

Answer 60

Reduces the blood ammonia level

Question 61

Which action would the nurse take when a client develops a maculopapular rash on the upper extremities and audible wheezing during the admistinration of intravenous vancomycin? A. Stop the infusion. B. Decrease the flow rate. C. Reassess in 15 minutes. D. Notify the health care provider.

Answer 61

Stop the infusion.

Question 62

Neomycin is prescribed preoperatively for a client with colon cancer. The client asks why this is necessary. Which response would the nurse provide? A. 'It kills cancer cells that may be missed during surgery.' B. 'This medication is helpful in decreasing the inflammatory response associated with surgical procedures.' C. 'It kills intestinal bacteria to decrease the risk for infection.' D. 'This medication alters the body flora to prevent the occurrence of superinfections.'

Answer 62

'It kills intestinal bacteria to decrease the risk for infection.'

Question 63

A client with pulmonary tuberculosis develops tinnitus and vertigo. Which antitubercular medication would the nurse suspect is causing these symptoms? A. Isoniazid B. Rifampin C. Streptomycin D. Ethambutol

Answer 63

Streptomycin

Question 64

A client with tuberculosis takes combination therapy with isoniazid, rifampin, pyrazinamide, and streptomycin. The client says, 'I’ve never had to take so much medication for an infection before.' How would the nurse respond? A. 'The bacteria causing this infection are difficult to destroy.' B. 'Streptomycin prevents the side effects of the other medications.' C. 'You only need to take the medications for a couple of weeks.' D. 'Aggressive therapy is needed because the infection is well advanced.'

Answer 64

'The bacteria causing this infection are difficult to destroy.'

Question 65

A client with an infection is receiving vancomycin. Which laboratory blood test result would the nurse report? A. Hematocrit: 45% B. Calcium: 9.0 mg/dL (2.25 mmol/L) C. White blood cells (WBC): 10,000 mm 3 (10 × 10 9/L) D. Blood urea nitrogen (BUN): 30 mg/dL (10.2 mmol/L)

Answer 65

Blood urea nitrogen (BUN): 30 mg/dL (10.2 mmol/L)

Question 66

A client with a history of tuberculosis reports difficulty hearing. Which medication would the nurse consider is causing this response? A. Streptomycin B. Pyrazinamide C. Isoniazid D. Ethambutol

Answer 66

Streptomycin

Question 67

A client receiving intravenous vancomycin reports ringing in both ears. Which initial action would the nurse take? A. Notify the primary health care provider. B. Consult an audiologist. C. Stop the infusion. D. Document the finding and continue to monitor the client.

Answer 67

Stop the infusion.

Question 68

The nurse is caring for a client who is receiving intermittent intravenous piggyback (IVPG) doses of vancomycin every 12 hours. The primary health care provider prescribes trough levels of the antibiotic. The nurse schedules the blood sample to be obtained at which time? A. Just before the medication is administered B. Between 30 and 60 minutes after the infusion is completed C. Six hours after the dose is completely infused D. In the morning before the client eats breakfast

Answer 68

Just before the medication is administered

Question 69

After receiving streptomycin sulfate for 2 weeks as part of the medical regimen for tuberculosis, the client reports feeling dizzy and having some hearing loss. Which part of the body is the medication affecting? A. Pyramidal tracts B. Cerebellar tissue C. Peripheral motor end plates D. Eighth cranial nerve’s vestibular branch

Answer 69

Eighth cranial nerve’s vestibular branch

Question 70

Which action would the nurse take to avoid red man syndrome when preparing to administer a vancomycin infusion? A. Infuse slowly. B. Change the intravenous (IV) site. C. Reduce the dosage. D. Administer vitamin K.

Answer 70

Infuse slowly.

Question 71

The clinic nurse is planning care for a client with chlamydia. Which treatment would the nurse anticipate implementing? A. Administration of 250 mg of acyclovir orally in a single dose B. Administration of 1 g of azithromycin orally in a single dose C. Administration of 250 mg of ceftriaxone intramuscularly in a single dose D. Administration of 2.4 million units of benzathine penicillin G intramuscularly in a single dose

Answer 71

Administration of 1 g of azithromycin orally in a single dose

Question 72

Use of which medication would the nurse identify as a potential risk for hearing impairment in a child? A. Amoxicillin B. Gentamicin C. Clindamycin D. Ciprofloxacin

Answer 72

Gentamicin

Question 73

The nurse teaches an adolescent about the side effects of azithromycin. The nurse determines the teaching has been understood when the adolescent identifies which problem as the most common side effect of this medication? A. Tinnitus B. Diarrhea C. Dizziness D. Headache

Answer 73

Diarrhea

Question 74

Which assessment would the nurse perform before administering a dose of vancomycin to a client? Select all that apply. One, some, or all responses may be correct. A. Creatinine B. Trough level C. Hearing ability D. Intravenous site E. Blood urea nitrogen

Answer 74

Creatinine Trough level Hearing ability Intravenous site Blood urea nitrogen

Question 75

The nurse is caring for a client who has been prescribed vancomycin intravenous infusion for the treatment of methicillin-resistant staphylococcus aureus. Which of the following laboratory values should be immediately reported to the healthcare provider? A. Vancomycin trough of 15 mcg/dl B. Blood urea nitrogen level of 18 mg/dl C. Creatinine level of 1.1 mg d/l D. White blood cell count of 11,500 per microliter

Answer 75

Vancomycin trough of 15 mcg/dl

Question 76

The home health nurse is teaching a female client about self-administering vancomycin. Which statement by the client demonstrates understanding of the teaching? A. I need to call my provider if my urine changes B. Muscle tingling and weakness is an expected side effect of this medication C. Ringing in the ears is common when taking vancomycin D. I should avoid eating food with active cultures in it

Answer 76

I need to call my provider if my urine changes

Question 77

An older adult client is to receive intravenous (IV) gentamicin for urosepsis. Before administering the medication, for which finding should the nurse notify the health care provider (HCP)? A. The client has a history of acid reflux disease. B. The client has a history of retinopathy. C. The client has a history of chronic kidney disease. D. The client has a history of urinary retention.

Answer 77

The client has a history of chronic kidney disease.

Question 78

A hospitalized infant is receiving gentamicin. While monitoring for drug toxicity, the nurse should focus on which laboratory result? A. Platelet counts B. Serum creatinine C. Thyroxin levels D. Growth hormone levels

Answer 78

Serum creatinine

Question 79

The nurse receives an order to administer intravenous gentamicin to a client. For which finding should the nurse contact the health care provider to clarify the order? A. Low serum albumin B. Low serum blood urea nitrogen C. High gastric pH D. High serum creatinine

Answer 79

High serum creatinine

Question 80

The health care provider prescribes peak and trough levels after initiation of intravenous antibiotic therapy. The client asks why these blood tests are necessary. Which reason would the nurse provide? A. 'They determine if the dosage of the medication is adequate.' B. 'They detect if you are having an allergic reaction to the medication.' C. 'The tests permit blood culture specimens to be obtained when the medication is at its lowest level.' D. 'These allow comparison of your fever to changes in the antibiotic level.'

Answer 80

'They determine if the dosage of the medication is adequate.'

Question 81

When the nurse is administering a course of aminoglycoside treatment to a client with Klebsiella infection, which adverse effects prompt the nurse to hold treatment and contact the health care provider? Select all that apply. One, some, or all responses may be correct. A. Vertigo B. Tinnitus C. Dizziness D. Heartburn E. Persistent headache

Answer 81

Vertigo Tinnitus Dizziness Persistent headache

Question 82

Which condition would the nurse monitor for in the client on aminoglycoside therapy and skeletal muscle relaxants? A. Stroke B. Respiratory arrest C. Myocardial infarction D. Abdominal discomfort

Answer 82

Respiratory arrest

Question 83

When would the nurse have the laboratory obtain a blood sample to determine the peak level of an antibiotic administered by intravenous piggyback (IVPB)? A. Halfway between two doses of the medication B. Between 30 and 60 minutes after a dose C. Immediately before the medication is administered D. Anytime it is convenient for the client and the laboratory

Answer 83

Between 30 and 60 minutes after a dose

Question 84

A peak and trough level is prescribed for a client receiving antibiotic therapy. When should the nurse should obtain the trough level? A. Sixty minutes after the antibiotic dose is administered. B. Immediately before the next antibiotic dose is given. C. Upon completion of the prescribed antibiotic regime. D. An hour before the next antibiotic dose is given.

Answer 84

Immediately before the next antibiotic dose is given.

Question 85

Which therapy is indicated for a client admitted to the hospital after general paresis develops as a complication of syphilis? A. Penicillin therapy B. Major tranquilizers C. Behavior modification D. Electroconvulsive therapy

Answer 85

Penicillin therapy

Question 86

Which statement by a client prescribed ampicillin indicates that teaching by the nurse was effective? A. "I will miss eating grapefruit." B. "I must increase my fluid intake." C. "I can stop taking this medication any time." D. "I should take this medication just after eating."

Answer 86

"I must increase my fluid intake."

Question 87

Which rationale will the nurse give for the need to take penicillin G and probenecid for syphilis? A. "Each medication attacks the organism during different stages of cell multiplication." B. "The penicillin treats the syphilis, and the probenecid relieves the severe urethritis." C. "Probenecid delays excretion of penicillin, thus maintaining blood levels for longer periods." D. "Probenecid decreases the potential for an allergic reaction to penicillin, which treats the syphilis."

Answer 87

"Probenecid delays excretion of penicillin, thus maintaining blood levels for longer periods."

Question 88

The nurse is preparing a client for discharge from the emergency department. Which client statement provides evidence that the client understands medication teaching for high-dose ampicillin? A. 'I should take this medication with meals.' B. 'This medicine may cause constipation.' C. 'I must avoid dairy products while taking this medicine.' D. 'I must increase my intake of fluids while taking this medication.'

Answer 88

'I must increase my intake of fluids while taking this medication.'

Question 88

Which statement by a client prescribed ampicillin 250 mg by mouth every 6 hours indicates to the nurse that teaching has been effective? A. "I should drink a glass of milk with each pill." B. "I should drink at least six glasses of water every day." C. "The medicine should be taken with meals and at bedtime." D. "The medicine should be taken 1 hour before or 2 hours after meals."

Answer 88

"The medicine should be taken 1 hour before or 2 hours after meals."

Question 88

A client has an anaphylactic reaction after receiving intravenous penicillin. Which would the nurse conclude is the cause of this reaction? A. An acquired atopic sensitization occurred. B. There was passive immunity to the penicillin allergen. C. Antibodies to penicillin developed after a previous exposure. D. Genes encoded for allergies cause a reaction on an initial penicillin exposure.

Answer 88

Antibodies to penicillin developed after a previous exposure.

Question 89

Which information would the nurse include in the teaching plan on ampicillin? A. 'Take the ampicillin with meals.' B. 'Store the ampicillin in a light-resistant container.' C. 'Notify the health care provider if diarrhea develops.' D. 'Continue the medication until a negative culture is obtained.'

Answer 89

'Notify the health care provider if diarrhea develops.'

Question 90

The nurse provides teaching about ampicillin. Which client statement indicates that additional teaching is needed? A. 'I should take this on an empty stomach with a full glass of water.' B. 'This medicine will work best if I space the time out evenly.' C. 'I can stop this medication after I am symptom-free for 48 hours.' D. 'If I get worse, I will notify my primary health care provider.'

Answer 90

'I can stop this medication after I am symptom-free for 48 hours.'

Question 91

Which assessment findings during the administration of intravenous penicillin prompt the nurse to stop the infusion? Select all that apply. One, some, or all responses may be correct. A. Hives B. Itching C. Nausea D. Skin rash E. Shortness of breath

Answer 91

Hives Itching Skin rash Shortness of breath

Question 92

When a female client with a new infant is prescribed amoxicillin for a urinary tract infection, which instruction would the nurse include when teaching about the use of this medication? A. 'Take this medication on an empty stomach.' B. 'Report signs of allergic reaction such as skin rash or itching.' C. 'Stop taking the medication as soon as you void without burning.' D. 'Breast-feeding should stop until you have finished with this medication.'

Answer 92

'Report signs of allergic reaction such as skin rash or itching.'

Question 93

Which substance history of a severe allergic reaction results in avoidance of the cephalosporins such as cefazolin, cefditoren, cefotetan, and ceftriaxone? Select all that apply. One, some, or all responses may be correct. A. Milk B. Aspirin C. Calcium D. Penicillin E. Strawberries

Answer 93

Milk Aspirin Calcium Penicillin

Question 94

Which medication is considered first-line therapy for an infant with congenital syphilis? A. Vidarabine B. Pyrimethamine C. Intravenous (IV) penicillin D. Trimethoprim-sulfamethoxazole

Answer 94

Intravenous (IV) penicillin

Question 95

A client is prescribed ampicillin sodium (Omnipen) for a sinus infection. The nurse should instruct the client to notify the healthcare provider immediately if which symptom occurs? A. Rash. B. Nausea. C. Headache. D. Dizziness.

Answer 95

Rash

Question 96

While taking a medical history, the client states, "I am allergic to penicillin." What related allergy to another type of antiinfective agent should the nurse ask the client about when taking the nursing history? A. Aminoglycosides. B. Cephalosporins. C. Sulfonamides. D. Tetracyclines.

Answer 96

Cephalosporins

Question 97

The nurse is monitoring a client who received a first dose of intravenous ampicillin. Which finding should indicate to the nurse that the client may be experiencing an allergic reaction? A. Abdominal pain B. Increase in blood pressure C. Hypotensive bowel sounds D. Hives on the extremities

Answer 97

Hives on the extremities

Question 98

The nurse is providing education to the parent of a pediatric client receiving amoxicillin clavulanate suspension. Which of the following statements is appropriate? A. Use the measuring device provided by the pharmacy B. You should take this medication on an empty stomach C. Avoid shaking the medication before opening D. Take the medication with a glass of juice

Answer 98

Use the measuring device provided by the pharmacy

Question 99

A nurse is administering an intravenous piggyback infusion of penicillin. Which client statement would require the nurse's immediate attention? A. "I am itching all over." B. "I have soreness and aching in my muscles." C. "I have cramping in my stomach." D. "I have a burning sensation when I urinate."

Answer 99

"I am itching all over."

Question 100

A 2 year-old child is being treated with amoxicillin suspension, 200 milligrams per dose, for acute otitis media. The child weighs 33 lb (15 kg) and the daily dose range is 20 to 40 mg/kg of body weight, in three divided doses every eight hours. Using principles of safe drug administration, what should a nurse do next? A. Recognize that antibiotics are over-prescribed B. Call the health care provider to clarify the dose C. Hold the medication because the dosage is too low D. Give the medication as ordered

Answer 100

Give the medication as ordered

Question 101

The nurse is preparing to administer ceftriaxone to a client. Which of the following findings from the client’s medical record should cause the nurse to question this prescription? A. White blood cells in the urine B. History of hypertension C. Allergy to cephalexin D. Current tobacco smoker

Answer 101

Allergy to cephalexin

Question 102

At 6 weeks’ gestation a client is found to have gonorrhea. For which medication would the nurse anticipate preparing a teaching plan? A. Ceftriaxone B. Levofloxacin C. Sulfasalazine D. Trimethoprim/sulfamethoxazole

Answer 102

Ceftriaxone

Question 103

Which fact about ceftriaxone medication therapy will the nurse emphasize when teaching a client diagnosed with gonorrhea? A. Cures the infection B. Prevents complications C. Controls its transmission D. Reverses pathologic changes

Answer 103

Cures the infection

Question 104

During an assessment the client mentions taking cefotetan and drinking a few cocktails at dinner. Which symptoms might be explained by this medication–alcohol interaction? Select all that apply. One, some, or all responses may be correct. A. Pruritus B. Diaphoresis C. Hypotension D. Hypertension E. Stomach cramps F. Chest pain

Answer 104

Pruritus Diaphoresis Hypotension Stomach cramps

Question 105

A nurse receives a prescription to administer intravenous cefepime to a client with a bacterial infection. The client has a history of lung cancer and is on a continuous cisplatin infusion. How will the nurse administer the prescribed medication? A. Piggyback the cefepime onto the cisplatin infusion B. Wait for the cisplatin infusion to finish before administering cefepime C. Infuse the cefepime via IV push at the proximal port D. Initiate a new intravenous line for the cefepime infusion

Answer 105

Initiate a new intravenous line for the cefepime infusion

Question 106

A child with pinworms is prescribed mebendazole. Which expected response to the medication would the nurse teach the parents watch for? A. Blood B. Constipation C. Yellow stools D. Passage of worms

Answer 106

Passage of worms

Question 107

The nurse is caring for a pregnant client who has contracted a trichomonal protozoan infection. For which oral medication would the nurse anticipate preparing to provide education? A. Penicillin G B. Acyclovir C. Nystatin D. Metronidazole

Answer 107

Metronidazole

Question 108

A client with giardiasis is taking metronidazole (Flagyl) 2 grams PO. Which information should the nurse include in the client's instruction? A. Notify the clinic of any changes in the color of urine. B. Encourage the use of over-the-counter cough/cold syrup when a cough/cold develops. C. Stop the medication after the diarrhea resolves. D. Take the medication with food.

Answer 108

Take the medication with food.

Question 108

Which instruction) should the nurse give to a female client who just received a prescription for oral metronidazole (Flagyl) for treatment of trichomonas vaginalis? (Select all that apply.) A. Increase fluid intake, especially cranberry juice. B. Do not abruptly discontinue the medication; taper use. C. Check blood pressure daily to detect hypertension. D. Avoid drinking alcohol while taking this medication. E. Use condoms until treatment is completed. F. Ensure that all sexual partners are treated at the same time.

Answer 108

Increase fluid intake, especially cranberry juice. Avoid drinking alcohol while taking this medication. Use condoms until treatment is completed. Ensure that all sexual partners are treated at the same time.

Question 109

The nurse is teaching the client with bacterial vaginosis who has been prescribed metronidazole tablets. What statement is appropriate? A. You may continue to experience symptoms after you stop the medication B. You should avoid drinking alcohol while taking this medication C. Call your healthcare provider if you experience diarrhea D. Your sexual partner will need to be treated as well

Answer 109

You should avoid drinking alcohol while taking this medication

Question 110

The nurse is educating a client prescribed metronidazole. Which of the following findings should the nurse include in the education as reportable to the healthcare provider? A. Pinpoint red spots on the skin B. Nausea after beginning the medication C. Metallic taste D. Occasional diarrhea

Answer 110

Pinpoint red spots on the skin

Question 110

Which explanation would the nurse provide to a client with gastric ulcer disease who asks the nurse why the health care provider has prescribed metronidazole? A. To augment the immune response B. To potentiate the effect of antacids C. To treat Helicobacter pylori infection D. To reduce hydrochloric acid secretion

Answer 110

To treat Helicobacter pylori infection

Question 111

Which education would the nurse provide the parents of an infant receiving the first diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP) at 2 months of age? A. Give the baby aspirin if there is pain. B. Call the clinic if marked drowsiness occurs. C. Apply ice to the injection site if there is swelling. D. Provide heat at the injection site if redness occurs.

Answer 111

Call the clinic if marked drowsiness occurs.

Question 112

Which health history would the nurse consider a contraindication to administering the second diphtheria/tetanus/pertussis (DTaP) immunization to a 4-month-old infant? A. Allergy to eggs B. Lactose intolerance C. Infectious dermatitis D. High fever after the first dose

Answer 112

High fever after the first dose

Question 113

The nurse is planning to administer a series of vaccines to a 4-year-old child including the DTap, IPV, MMR, and VAR. Before administering the vaccines, what information should the nurse be aware of? Select all that apply. A. Either the deltoid muscle of the arm or anterolateral thigh muscle can be used B. A 20 gauge needle is used to administer the varicella (VAR) vaccine intramuscularly (IM) C. A 5/8 inch needle length is often used for subcutaneous (SubQ) injections D. The vaccines contain the preservative thimerosal E. Multiple immunizations should be administered a minimum of 1 inch apart F. The vaccines all contain weakened live viruses

Answer 113

Either the deltoid muscle of the arm or anterolateral thigh muscle can be used A 5/8 inch needle length is often used for subcutaneous (SubQ) injections Multiple immunizations should be administered a minimum of 1 inch apart

Question 114

Which vaccine is contraindicated for a child undergoing chemotherapy? A. Influenza (Hib) B. Hepatitis B (Hep B) C. Measles, mumps, rubella (MMR) D. Diphtheria, tetanus, acellular pertussis (DTaP)

Answer 114

Measles, mumps, rubella (MMR)

Question 115

Which education would the nurse provide parents about the side effects of the Haemophilus influenzae (Hib) vaccine? A. Lethargy B. Urticaria C. Generalized rash D. Low-grade fever

Answer 115

Low-grade fever

Question 116

A 6-month-old infant is to receive scheduled immunizations. The parents ask why two influenza vaccines are given: Haemophilus influenzae type B (Hib) and pneumococcal conjugate vaccine (PCV). Which response by the nurse is appropriate? A. 'PCV prevents influenza.' B. 'Hib is given to prevent pneumonia.' C. 'Hib and PCV prevent different bacterial diseases.' D. 'They are given together to protect against viral and bacterial diseases.'

Answer 116

'Hib and PCV prevent different bacterial diseases.'

Question 117

The nurse is teaching parents about the side effects of immunization vaccines. Which expected side effect associated with the Haemophilus influenzae (Hib) vaccine would the nurse include in the teaching? A. Urticaria B. Lethargy C. Low-grade fever D. Generalized rash

Answer 117

Low-grade fever

Question 118

Which parent education would the nurse give about why the MMR vaccine is administered at 12 to 15 months of age? A. There is an increased risk of side effects in infants. B. Maternal antibodies provide immunity for about 1 year. C. It interferes with the effectiveness of vaccines given during infancy. D. There are rare instances of these infections occurring during the first year of life.

Answer 118

Maternal antibodies provide immunity for about 1 year.

Question 119

Which vaccine is used to prevent human papilloma virus infection? A. Varivax B. RotaTeq C. Gardasil D. Hepatitis A vaccine

Answer 119

Gardasil

Question 120

Which action would the nurse take when a client arrives for an influenza vaccination and reports a low-grade fever with a cough? A. Administer aspirin with the vaccine. B. Check the temperature and current history. C. Hold the vaccine and notify the health care provider. D. Reschedule administration of the vaccine for the next month.

Answer 120

Check the temperature and current history.

Question 121

The parent of a newborn asks the nurse why, except for hepatitis B vaccine, the immunization schedule does not start until the infant is 2 months old. Which response would the nurse provide? A. 'A newborn’s spleen can’t produce efficient antibodies.' B. 'Infants younger than 2 months are rarely exposed to infectious disease.' C. 'The immunization will attack the infant’s immature immune system and cause the disease.' D. 'Maternal antibodies interfere with the development of active antibodies by the infant when immunized.'

Answer 121

'Maternal antibodies interfere with the development of active antibodies by the infant when immunized.'

Question 122

Which immunizations would the nurse determine are safe for a child who is receiving prednisone? Select all that apply. One, some, or all responses may be correct. A. Rubeola B. Pertussis C. Varicella D. Inactivated poliovirus E. Tetanus immune globulin

Answer 122

Pertussis Inactivated poliovirus Tetanus immune globulin

Question 123

Which are the characteristics of reactions associated with immunizations for a 2-month-old infant? A. Local or systemic and usually mild B. Often serious, possibly requiring hospitalization C. Sometimes causing ulceration at the injection site D. May be responsible for permanent neurological damage

Answer 123

Local or systemic and usually mild

Question 124

A teenager with a deep laceration of his leg does not remember the date of the last tetanus immunization received. The nurse explains that tetanus immunoglobulin and tetanus toxoid are required. Which explanation underlies the nurse’s statement? A. Neither medication is effective alone. B. Both eliminate the need for additional medications. C. Antibodies provide protection, whereas the toxoid stimulates a response. D. Tetanus toxoid minimizes the risks related to the tetanus immunoglobulin.

Answer 124

Antibodies provide protection, whereas the toxoid stimulates a response.

Question 125

There is an order to administer an intramuscular influenza vaccine to an adult client. What actions should the nurse take before administration of the injection? Select all that apply. A. Ask if the client ever had an adverse reaction to the flu vaccine B. Have the client sign the vaccination consent form C. Check the expiration date on the vaccination bottle D. Provide the client with the a vaccine information statement E. Record the site and time of injection F. Record the client's reaction to the injection

Answer 125

Ask if the client ever had an adverse reaction to the flu vaccine Have the client sign the vaccination consent form Check the expiration date on the vaccination bottle Provide the client with the a vaccine information statement

Question 126

Which information will the nurse include when teaching about tetanus immune globulin prescribed to a client with a puncture wound? A. "It will take about a week to become effective." B. "Immune globulin provides lifelong passive immunity." C. "It provides immediate, passive, short-term immunity." D. "Immune globulins stimulate the production of antibodies."

Answer 126

"It provides immediate, passive, short-term immunity."

Question 127

Tetanus immune globulin is prescribed after a client steps on a rusty nail. Which action would the nurse associate with this medication? A. Provides antibodies B. Stimulates plasma cells C. Produces active immunity D. Facilitates long-lasting immunity

Answer 127

Provides antibodies

Question 128

A client has a prescription for nitrofurantoin 50 mg orally every evening to manage recurrent urinary tract infections. Which instruction would the nurse give to the client? A. 'Increase your intake of fluids.' B. 'Strain your urine for crystals and stones.' C. 'Stop taking the medication if your urinary output increases.' D. 'This may turn your urine green.'

Answer 128

'Increase your intake of fluids.'

Question 129

A client has received a prescription for nitrofurantoin to treat a urinary tract infection. Which of the following statements made by the client indicates the need for additional teaching about the medication? A. "I will be sure to finish taking the antibiotics, even if I start feeling better." B. "I will spend extra time in the sun to get plenty of vitamin D." C. "I'll call my primary health care provider immediately if I develop a rash after taking the medication." D. "I will take the medication with food."

Answer 129

"I will spend extra time in the sun to get plenty of vitamin D."

Question 130

Trimethoprim/sulfamethoxazole is prescribed for a child with a urinary tract infection. Which statement by the parent indicates the nurse’s instructions about administration have been understood? A. 'Mealtime is a good time to give the medication.' B. 'I’ll make sure to give each pill with 6 to 8 oz of fluid.' C. 'It must be taken with orange juice to ensure acidity of urine.' D. 'The medication has to be taken every 4 hours to maintain a blood level.'

Answer 130

I’ll make sure to give each pill with 6 to 8 oz of fluid.'

Question 131

A sulfonamide preparation is prescribed for a child with a urinary tract infection. Which nursing responsibility is a priority when administering this medication? A. Weighing the child daily B. Giving the medication with milk C. Taking the child’s temperature frequently D. Administering the medication at the prescribed times

Answer 131

Administering the medication at the prescribed times

Question 132

A child infected with human immunodeficiency virus (HIV) is admitted with Pneumocystis jiroveci pneumonia and receives trimethoprim/sulfamethoxazole. Which common side effects would the nurse anticipate? Select all that apply. One, some, or all responses may be correct. A. Jaundice B. Vomiting C. Headache D. Crystalluria E. Photosensitivity

Answer 132

Vomiting Crystalluria Photosensitivity

Question 133

Trimethoprim-sulfamethoxazole is prescribed for a client with cystitis. Which instruction would the nurse include when providing medication teaching? A. 'Drink eight to ten glasses of water daily.' B. 'Take this medication with orange juice.' C. 'Take the medication with meals.' D. 'Take the medication until symptoms subside.'

Answer 133

'Drink eight to ten glasses of water daily.'

Question 134

The nurse is teaching a client with diabetes about newly prescribed trimethoprim and sulfamethoxazole (TMP-SMX) to treat a urinary tract infection. Which statement by the client indicates understanding? A. I will stop taking this medication if I develop a rash." B. This antibiotic will kill mature bacteria in my urinary tract." C. I should avoid dairy products when taking this medication." D. "My blood sugar will not be affected by this medication."

Answer 134

I will stop taking this medication if I develop a rash."

Question 135

The nurse is preparing to administer trimethoprim and sulfamethoxazole (TMP-SMX) to a client. When assessing client allergies, the client reports that they are allergic to glipizide. What action by the nurse is most appropriate? A. Prepare to administer the medication B. Report the allergies to the healthcare provider C. Review the health record to see if the client is on glipizide D. Assess the client blood sugar

Answer 135

Report the allergies to the healthcare provider

Question 136

A client is prescribed trimethoprim/sulfamethoxazole for recurrent urinary tract infections. Which statement by the nurse about this medication is correct? A. "You can stop the medication after five days." B. "Be sure to take the medication with food." C. "It is safe to take with oral contraceptives." D. "Drink at least eight glasses of water a day."

Answer 136

"Drink at least eight glasses of water a day."

Question 137

A client is prescribed trimethoprim/sulfamethoxazole for recurrent urinary tract infections. Which information should the nurse include during client teaching? A. "A harmless skin rash may appear." B. "Drink at least eight large glasses of water a day." C. "Be sure to take the medication with food." D. "Stop the medication when your symptoms disappear."

Answer 137

"Drink at least eight large glasses of water a day."

Question 138

After teaching a client about sulfonamide use for a urinary tract infection, which client statement would the nurse review for correction? A. 'I will avoid the sunlight.' B. 'I will increase my fluid intake.' C. 'I will let my doctor know if I develop a rash.' D. 'I will stop taking the medication when my symptoms subside.'

Answer 138

'I will stop taking the medication when my symptoms subside.'

Question 139

Which finding in a client with hypothyroidism and hypertension who reports taking an extra dose of levothyroxine indicates the need to obtain a thyroid function panel? Select all that apply. One, some, or all responses may be correct. A. Tremors B. Diaphoresis C. Nervousness D. Temperature 101°F E. Heart rate 116 beats/min

Answer 139

Tremors Diaphoresis Nervousness Temperature 101°F Heart rate 116 beats/min

Question 140

Which clinical manifestation exhibited by a client taking levothyroxine for hypothyroidism for 3 months would cause a nurse to suspect that a decrease in dosage is needed? Select all that apply. One, some, or all responses may be correct. A. Tremors B. Bradycardia C. Somnolence D. Heat intolerance E. Decreased blood pressure

Answer 140

Tremors Heat intolerance

Question 141

An infant with congenital hypothyroidism receives levothyroxine for 3 months. Which finding would indicate to the nurse that the medication is effective? A. The infant is alert and interactive. B. The skin is cool to the touch. C. The baby’s fine tremor has ceased. D. The baby’s thyroid stimulating hormone level has increased.

Answer 141

The infant is alert and interactive.

Question 142

A client is taking thyroxine to manage hypothyroidism. Which developments indicate to the nurse that the dosage should be reduced? Select all that apply. One, some, or all responses may be correct. A. Diaphoresis B. Weight gain C. Tachycardia D. Nervousness E. Cold intolerance

Answer 142

Diaphoresis Tachycardia Nervousness

Question 143

When a female client becomes hypothyroid, levothyroxine is prescribed. The client asks whether she can become pregnant while taking levothyroxine. How will the nurse respond? A. 'If you become pregnant, thyroid abnormalities will develop in the fetus.' B. 'Yes, but you will have a high-risk pregnancy.' C. 'This medication causes infertility for the length of time that it is taken.' D. 'This medicine will not interfere with your ability to become pregnant.'

Answer 143

'This medicine will not interfere with your ability to become pregnant.'

Question 144

Which finding in a client with hypothyroidism and hypertension who reports taking an extra dose of levothyroxine indicates the need to obtain a thyroid function panel? Select all that apply. One, some, or all responses may be correct. A. Tremors B. Diaphoresis C. Nervousness D. Temperature 101°F E. Heart rate 116 beats/min

Answer 144

Tremors Diaphoresis Nervousness Temperature 101°F Heart rate 116 beats/min

Question 145

A nurse is providing care to a client diagnosed with a myocardial infarction. The client has a history of hypothyroidism and hypertension. Which prescribed medication will the nurse clarify before administering it to the client? A. Morphine B. Levothyroxine C. Aspirin D. Labetalol

Answer 145

Levothyroxine

Question 146

The nurse is preparing to administer 0600 medications to a client. The client is prescribed levothyroxine 125 mcg PO daily for hypothyroidism. The medication package states levothyroxine tablet 0.125 mg. Which action is appropriate? A. Administer the medication B. Call the pharmacy and ask them to deliver the correct dose C. Hold the medication until the healthcare provider arrives D. Call the healthcare provider and request that the time of administration be changed

Answer 146

Administer the medication

Question 147

The nurse is reinforcing teaching about levothyroxine for a client newly-diagnosed with hypothyroidism. Which information should the nurse make sure to reinforce about this medication? A. The medication must be stored in a dark container. B. The medication should be taken in the morning. C. The medication will decrease the client's heart rate. D. The medication may decrease the client's energy level.

Answer 147

The medication should be taken in the morning.

Question 148

The nurse understands that the prescribed levothyroxine is effective when the client with hypothyroidism makes which statement? A. "I still feel lethargic and fatigued." B. "I have to change my sheets in the morning because I sweat a lot at night." C. "I have been having daily, formed bowel movements." D. "I was reprimanded at work after becoming angry with my boss."

Answer 148

"I have been having daily, formed bowel movements."

Question 149

The nurse is providing instructions to a client with a new prescription for levothyroxine 50 mcg daily to treat hypothyroidism. Which of the following is important for the nurse to include in the discharge instructions? A. It can be taken with an antacid if stomach upset occurs. B. It should be taken in the morning. C. It must be stored in a dark container. D. It may decrease the client's energy level.

Answer 149

It should be taken in the morning.

Question 150

A client has been diagnosed with hypothyroidism. Which medication should the nurse administer to treat the client's bradycardia? A. Epinephrine B. Adenosine C. Levothyroxine D. Atropine

Answer 150

Levothyroxine

Question 151

Which medication will the nurse expect the health care provider to prescribe to a client who had a thyroidectomy and is pale with spasms of the hand when taking the blood pressure? A. Calcium B. Magnesium C. Bicarbonate D. Potassium chloride

Answer 151

Calcium

Question 152

Which alteration is the likely cause of thyrotoxic crisis (thyroid storm) in a client who has had treatment with propylthiouracil for hyperthyroidism followed by thyroid ablation with 131I? A. Deficiency of iodine B. Decreased serum calcium C. Increased sodium retention D. Excessive hormone replacement

Answer 152

Excessive hormone replacement

Question 153

Which mineral deficiency would a nurse suspect in a client who reports tingling in the fingers and around the mouth and exhibits carpopedal spasm and tremors after a surgical thyroidectomy ? A. Potassium B. Calcium C. Magnesium D. Sodium

Answer 153

Calcium

Question 154

A client with thyroid cancer is scheduled for a thyroidectomy. Which information will the nurse teach the client? A. The dietary intake of carbohydrates must be restricted. B. Thyroxine replacement therapy will be required indefinitely. C. Chemotherapy will be used in conjunction with the surgery. D. A tracheostomy is required for clients having this procedure.

Answer 154

Thyroxine replacement therapy will be required indefinitely.

Question 155

A client is admitted to the hospital for a subtotal thyroidectomy. When discussing postoperative medication therapy with the client, which advice will the nurse include in the teaching? A. 'You will be taking iodine daily to increase the formation of thyroid hormone.' B. 'After your body adjusts to postsurgical status, you will be weaned off this medication.' C. 'The propylthiouracil that is prescribed will stimulate the secretion of thyroid-stimulating hormone.' D. 'If you develop palpitations, nervousness, or tremors, the dose of thyroid hormone may need to be decreased.'

Answer 155

'If you develop palpitations, nervousness, or tremors, the dose of thyroid hormone may need to be decreased.'

Question 156

A client is experiencing both tingling of the extremities and tetany. The nurse will review the client’s laboratory report to check for which electrolyte abnormality? A. Hypokalemia B. Hypocalcemia C. Hyponatremia D. Hypochloremia

Answer 156

Hypocalcemia

Question 157

At 9 am, the nurse administers 10 units of insulin aspart subcutaneously to a client with a blood sugar of 322 mg/dL. At approximately what time should the nurse expect the insulin to peak? A. At 9:30 am B. At 10:00 am C. At noon D. This insulin does not peak because it acts over 24 hours.

Answer 157

At 10:00 am

Question 158

Which insulin will the nurse prepare for the emergency treatment of ketoacidosis? A. Glargine B. NPH insulin C. Insulin aspart D. Insulin detemir

Answer 158

Insulin aspart

Question 159

At the client's request, the nurse performs a fingerstick to test the client's blood glucose and the results are 322 mg/dL (17.9 mmol/L). Following the insulin sliding scale orders, the nurse administers 3 units of insulin lispro at 11:00 AM. When does the nurse anticipate the insulin lispro will begin to act? A. 3:00 pm B. 11:15 am C. 1:00 pm D. 12:00 PM

Answer 159

11:15 am

Question 160

Which insulin would the nurse conclude has the fastest onset of action? A. NPH insulin B. Insulin lispro C. Regular insulin D. Insulin glargine

Answer 160

Insulin lispro

Question 161

A client with diabetes mellitus is scheduled to receive an intravenous (IV) administration of 25 units of insulin in 250 mL normal saline. Which type of insulin would the nurse recognize as compatible with IV solutions? A. NPH insulin B. Insulin lispro C. Insulin detemir D. Insulin glargine

Answer 161

Insulin lispro

Question 162

The nurse is caring for a client with diabetes mellitus. The client reports feeling hungry and thirsty. The client's most recent blood glucose level was 175 mg/dL. Which type of insulin should the nurse anticipate being prescribed for this client? A. Glucagon B. Lispro C. Exenatide D. Sitagliptin

Answer 162

Lispro

Question 163

An adolescent with diabetes had a 6:30 AM fasting blood glucose level of 180 mg/dL (10.0 mmol/L). Which nursing action is a priority? A. Encourage the adolescent to start exercising. B. Ask the adolescent to obtain an immediate glucometer reading. C. Inform the adolescent that a complex carbohydrate such as cheese should be eaten. D. Tell the adolescent that the prescribed dose of rapid-acting insulin should be administered.

Answer 163

Tell the adolescent that the prescribed dose of rapid-acting insulin should be administered.

Question 164

Which time for medication scheduling would a nurse teach to a client prescribed the oral pancreatic enzymes pancrelipase? A. At bedtime B. With meals C. One hour before meals D. On arising each morning

Answer 164

With meals

Question 165

The nurse is reviewing discharge instructions with the parent of an infant with cystic fibrosis. Which statement indicates the parents know how to administer the pancreatic enzyme replacement? A. 'We should give the medication with feedings.' B. 'We should put crushed enteric-coated pills in the formula.' C. 'We need to give the medication every 6 hours, even during the night.' D. 'We should feed the granules from the capsule in applesauce every morning.'

Answer 165

'We should give the medication with feedings.'

Question 166

When would the nurse plan to administer pancrelipase to a child with cystic fibrosis? A. With meals and snacks B. In the morning and at bedtime C. On awakening and every 3 hours while the child is awake D. After each bowel movement and after postural drainage is performed

Answer 166

With meals and snacks

Question 167

A 12-year-old child with cystic fibrosis is prescribed four pancrelipase capsules five times a day. The nurse explains to the child they would take the medication with meals and snacks to accomplish which goal? A. Enhance oxygenation B. Limit excretion of fats C. Facilitate nutrient utilization D. Prevent iron-deficiency anemia

Answer 167

Facilitate nutrient utilization

Question 168

The nurse is giving instructions to the parents of a child who has cystic fibrosis. Which information should the nurse emphasize about administration of pancreatic enzymes? A. Administer each time a high-carbohydrate meal is eaten B. Crush the tablet and sprinkle on food three times a day C. Dispense once daily with breakfast D. They are to be taken with every meal or snack

Answer 168

They are to be taken with every meal or snack

Question 169

The nurse evaluates that teaching for the oral pancreatic enzymes pancrelipase is understood when the client identifies which time for medication scheduling? A. At bedtime B. With meals C. One hour before meals D. On arising each morning

Answer 169

With meals

Question 170

Which mechanism of action explains how glyburide decreases serum glucose levels? A. Stimulates the pancreas to produce insulin B. Accelerates the liver’s release of stored glycogen C. Increases glucose transport across the cell membrane D. Decreases absorption of glucose from the gastrointestinal system

Answer 170

Stimulates the pancreas to produce insulin

Question 171

A client asks the nurse if glipizide (Glucotrol) is an oral insulin. Which response should the nurse provide? A. "Yes, it is an oral insulin and has the same actions and properties as intermediate insulin." B. "Yes, it is an oral insulin and is distributed, metabolized, and excreted in the same manner as insulin." C. "No, it is not an oral insulin and can be used only when some beta cell function is present." D. "No, it is not an oral insulin, but it is effective for those who are resistant to injectable insulins."

Answer 171

"No, it is not an oral insulin and can be used only when some beta cell function is present."

Question 172

A nurse is reviewing prescribed medications for a client diagnosed with diabetic ketoacidosis. Which medication will the nurse clarify with the healthcare provider? A. Regular insulin B. Potassium C. 0.9% sodium chloride D. Glipizide

Answer 172

Glipizide

Question 173

A nurse is educating a client with diabetes type 2 about newly prescribed glipizide. Which statement by the nurse best describes the action of glipizide? A. “This medication absorbs the excess carbohydrates from your intestinal tract.” B. “This medication will inhibit the release of glucose stored in the liver.” C. “This medication will stimulate your pancreas to release insulin.” D. “This medication works by increasing the ability of the cells to uptake glucose.”

Answer 173

“This medication will stimulate your pancreas to release insulin.”

Question 174

Which statement made by a client prescribed metformin extended release to control type 2 diabetes mellitus indicates the need for further education? A. "I will take the medication with food." B. "I must swallow my medication whole and not crush or chew it." C. "I will notify my doctor if I develop muscular or abdominal discomfort." D. "I will stop taking metformin for 24 hours before and after having a test involving dye."

Answer 174

"I will stop taking metformin for 24 hours before and after having a test involving dye."

Question 175

The nurse prepares to administer extended-release metformin to an older adult who has asked that it be crushed because it is difficult to swallow. Which rationale will prompt the nurse to ask the provider for a different form of metformin? A. This medication has a wax matrix frame that is difficult to crush. B. The medication has an unpleasant taste, which most clients find intolerable if crushed. C. If crushed, this medication irritates mucosal tissue and can cause oral and esophageal ulcer formation. D. Extended-release formulations are designed to be released slowly and crushing the tablet will prevent this from occurring.

Answer 175

Extended-release formulations are designed to be released slowly and crushing the tablet will prevent this from occurring.

Question 176

The health care provider prescribes metformin as monotherapy for the client with type 2 diabetes. The nurse will teach the client to monitor for which adverse effect? A. Weight gain B. Constipation C. Lactic acidosis D. Hypoglycemia

Answer 176

Lactic acidosis

Question 177

A health care provider prescribes oral antacids and intravenous ranitidine for a client with burns and crushing injuries caused by an accident. The client asks how these medications work. Which explanation would the nurse provide? A. 'These medications work together to decrease bowel irritability.' B. 'They limit acidity in the gastrointestinal tract.' C. 'They are very effective in clients with multiple trauma.' D. 'These medications decrease nausea and vomiting.'

Answer 177

'They limit acidity in the gastrointestinal tract.'

Question 178

A health care provider prescribes famotidine for a client with dyspepsia. Which statement is important to include in a teaching session about famotidine? A. Lowers the stress level B. Neutralizes gastric acidity C. Reduces gastrointestinal peristalsis D. Decreases secretions in the stomach

Answer 178

Decreases secretions in the stomach

Question 179

Famotidine is prescribed for a client with peptic ulcer disease. Which mechanism of action is a characteristic of this medication? A. Increases gastric motility B. Neutralizes gastric acidity C. Facilitates histamine release D. Inhibits gastric acid secretion

Answer 179

Inhibits gastric acid secretion

Question 180

The nurse is providing medication teaching for a client prescribed famotidine for the treatment of gastroesophageal reflux disease (GERD). Which statement by the client indicates an understanding of the teaching? A. I will take this medication once a day in the morning B. I will no longer have discomfort at night once I begin this medication C. This medication will both prevent and treat heartburn D. My treatment will be done in one week

Answer 180

This medication will both prevent and treat heartburn

Question 181

The nurse is counseling a client with gastroesophageal reflux disease (GERD) who has been taking prescribed famotidine for two days. Which statement would require immediate follow up by a healthcare provider? A. I take digoxin for my heart failure B. I use calcium carbonate if I have symptoms after meals C. I use alendronate for my osteoporosis D. I’m still having some symptoms of heartburn.

Answer 181

I take digoxin for my heart failure

Question 182

The nurse administers cimetidine to a 75-year-old client diagnosed with a gastric ulcer. The nurse should monitor the client for which adverse reaction? A. Mental status change B. Increased liver enzymes C. Constipation D. Hearing loss

Answer 182

Mental status change

Question 183

A nurse administers cimetidine to a 79-year-old male with a gastric ulcer. Which parameter may be affected by this drug and should be closely monitored by the nurse? A. Blood pressure B. Liver enzymes C. Mental status D. Hemoglobin

Answer 183

Mental status

Question 184

Which mechanism is specifically responsible for the action of the medication ranitidine? A. Inhibiting proton pumps B. Promoting the release of gastrin C. Regenerating the gastric mucosa D. Inhibiting the histamine at H 2 receptors

Answer 184

Inhibiting the histamine at H 2 receptors

Question 185

Which administration instruction would the nurse give a client prescribed ranitidine 150 mg daily to treat peptic ulcer disease (PUD)? A. As needed B. With meals C. At bedtime D. Before meals

Answer 185

At bedtime

Question 186

Which information would the nurse include when teaching a client about the administration of ranitidine? A. Ranitidine increases gastrointestinal peristalsis. B. Ranitidine reduces gastric acidity in the stomach. C. Ranitidine neutralizes the acid that is present in the stomach. D. Ranitidine stops the production of hydrochloric acid in the stomach.

Answer 186

Ranitidine reduces gastric acidity in the stomach.

Question 187

Which concern would prompt the nurse to contact the health care provider when a client with gastric ulcers receives a prescription for ranitidine 150 mg twice a day? A. Ranitidine can increase the risk for gastrointestinal bleeding. B. An administration route is not specified. C. Ranitidine is contraindicated for gastric ulcers. D. Ranitidine should be given with an adjuvant.

Answer 187

An administration route is not specified.

Question 188

Which medication is classified as an H 2 receptor antagonist? Select all that apply. One, some, or all responses may be correct. A. Nizatidine B. Ranitidine C. Famotidine D. Lansoprazole E. Metoclopramide

Answer 188

Nizatidine Ranitidine Famotidine

Question 189

Which nursing intervention would prevent stimulation of the pancreas in a client with acute pancreatitis? A. Maintain the gastric pH at a level of less than 3.5. B. Encourage the resumption of activities of daily living. C. Administer the histamine H 2-receptor antagonist as prescribed. D. Ensure that the nasogastric tube remains in the fundus of the stomach.

Answer 189

Administer the histamine H 2-receptor antagonist as prescribed.

Question 190

The nurse is administering a histamine H 2 antagonist to a client who has extensive burns. Which complication will it prevent? A. Colitis B. Gastritis C. Stress ulcer D. Metabolic acidosis

Answer 190

Stress ulcer

Question 191

The nurse in a primary care clinic is reviewing the medical record of a client with chronic gastroesophageal reflux disease (GERD). Which findings are risk factors for developing GERD? Select all that apply. A. Being overweight or obese B. Diabetes mellitus type 2 C. Helicobacter pylori infection D. Taking a calcium channel blocker E. Smoking F. Essential hypertension

Answer 191

Being overweight or obese Helicobacter pylori infection Taking a calcium channel blocker Smoking

Question 192

Which independent nursing action would be included in the plan of care for a client after an episode of ketoacidosis? A. Monitoring for signs of hypoglycemia resulting from treatment B. Withholding glucose in any form until the situation is corrected C. Giving fruit juices, broth, and milk as soon as the client is able to take fluids orally D. Regulating insulin dosage according to the client’s urinary ketone levels

Answer 192

Monitoring for signs of hypoglycemia resulting from treatment

Question 193

Which manifestation would the nurse include when teaching a client about ketoacidosis? Select all that apply. One, some, or all responses may be correct. A. Confusion B. Hyperactivity C. Excessive thirst D. Fruity-scented breath

Answer 193

Confusion Excessive thirst Fruity-scented breath

Question 194

Which purpose of insulin would a nurse identify when caring for a client prescribed insulin added to a solution of 10% dextrose in water after an intravenous solution containing potassium inadvertently was infused too rapidly? A. Glucose with insulin increases metabolism, which accelerates potassium excretion. B. Increased potassium causes a temporary slowing of the pancreatic production of insulin. C. Increased insulin accelerates the excretion of glucose and potassium, thereby decreasing the serum potassium level. D. Potassium follows glucose into the cells of the body, thereby raising the intracellular potassium level.

Answer 194

Potassium follows glucose into the cells of the body, thereby raising the intracellular potassium level.

Question 195

Which rationale accurately explains why insulin is prescribed for clients in acute renal failure? A. It promotes transfer of potassium into cells to lower serum potassium levels. B. Insulin is required because the alpha cells of the pancreas cease to function with renal failure. C. It is necessary to manage the elevated blood glucose levels that accompany renal failure. D. Insulin reduces the accumulated toxins by lowering the metabolic rate.

Answer 195

It promotes transfer of potassium into cells to lower serum potassium levels.

Question 196

Intravenous fluids and insulin are prescribed to treat a client’s diabetic ketoacidosis. The client develops peripheral paresthesias and shortness of breath. The cardiac monitor shows the appearance of a U wave. Which complication would the nurse suspect? A. Hypokalemia B. Hypoglycemia C. Hypernatremia D. Hypercalcemia

Answer 196

Hypokalemia

Question 197

Which rationale explain why intravenous (IV) potassium is prescribed in addition to regular insulin for clients in diabetic ketosis? A. Potassium loss occurs rapidly from diaphoresis present during coma. B. Potassium is carried with glucose to the kidneys to be excreted in the urine in increased amounts. C. Potassium is quickly used up during the rapid series of catabolic reactions stimulated by insulin and glucose. D. Serum potassium levels will decrease as potassium ions shift from the extracellular fluid to the intracellular fluid compartment.

Answer 197

Serum potassium levels will decrease as potassium ions shift from the extracellular fluid to the intracellular fluid compartment.

Question 198

The nurse adds 20 mEq of potassium chloride to the intravenous solution of a client with diabetic ketoacidosis. Which purpose would this medication serve? A. Treats hyperpnea B. Prevents flaccid paralysis C. Prevents hypokalemia D. Treats cardiac dysrhythmias

Answer 198

Prevents hypokalemia

Question 199

A client is diagnosed with acute kidney failure secondary to dehydration. An intravenous (IV) infusion of 50% glucose with regular insulin is prescribed to address which purpose? A. To correct hyperkalemia B. To increase urinary output C. To prevent respiratory acidosis D. To increase serum calcium levels

Answer 199

To correct hyperkalemia

Question 200

An adolescent with type 1 diabetes mellitus is admitted to the intensive care unit in ketoacidosis with a blood glucose level of 170 mg/dL (9.4 mmol/L). A continuous insulin infusion is started. Which adverse reaction to the infusion is most important for the nurse to monitor? A. Hypokalemia B. Hypovolemia C. Hypernatremia D. Hypercalcemia

Answer 200

Hypokalemia

Question 201

Which information would the nurse provide to a client with type 1 diabetes who requests information about the differences between penlike insulin delivery devices and syringes? A. "The penlike devices have a shorter injection time." B. "Penlike devices provide a more accurate dose delivery." C. "The penlike delivery system uses a smaller-gauge needle." D. "Penlike devices cost less by having reusable insulin cartridges."

Answer 201

"Penlike devices provide a more accurate dose delivery."

Question 202

Which is the priority short-term goal when teaching a client with type 1 diabetes who is placed on an insulin pump to control the diabetes? A. "The client will adhere to the medical regimen." B. "The client will remain normoglycemic for 3 weeks." C. "The client will demonstrate correct use of the insulin pump." D. "The client will list three self-care activities that are necessary to control the diabetes."

Answer 202

"The client will demonstrate correct use of the insulin pump."

Question 203

Which statement by the nurse is most appropriate regarding the greatest advantage of using an insulin pump? A. 'Independence is fostered.' B. 'Fear of daily injections is allayed.' C. 'Dietary restrictions are minimized.' D. 'Blood glucose monitoring can be eliminated.'

Answer 203

A. 'Independence is fostered.'

Question 204

The nurse is teaching a school-age child how to use an insulin pump. Which instruction by the nurse is most important for the child to understand? A. The needle must be changed every day. B. A blood glucose check is necessary once a day. C. The pump is an attempt to mimic the way a healthy pancreas works. D. Subcutaneous pockets near the abdomen are used to implant the pump.

Answer 204

The pump is an attempt to mimic the way a healthy pancreas works.

Question 205

Which advice will the nurse give the client to avoid lipodystrophy when self-administering insulin therapy? A. Exercise regularly. B. Rotate injection sites. C. Use the Z-track technique. D. Vigorously massage the injection site.

Answer 205

Rotate injection sites.

Question 206

The nurse identifies a nontender 5-cm indurated region on the upper arm of a client with type 1 diabetes. The client says to the nurse, 'That is where I give myself insulin shots.' The nurse concludes that the nodule is a result of which condition? A. Callus B. An allergy C. An infection D. Lipodystrophy

Answer 206

Lipodystrophy

Question 207

The nurse plans to teach a client with type 1 diabetes about the use of an insulin pump. Which information will the nurse include in client teaching? A. Insulin pumps mimic the way a healthy pancreas works. B. The insulin pump’s needle should be changed every day. C. Pumps are implanted in a subcutaneous pocket near the abdomen. D. The insulin pump’s advantage is that it only requires glucose monitoring once a day.

Answer 207

Insulin pumps mimic the way a healthy pancreas works.

Question 208

A nurse receives a prescription to administer regular insulin U-500 to a client with diabetes mellitus. How will the nurse administer this medication? A. Intravenously using an infusion pump B. Subcutaneously using an insulin pump C. Intramuscularly using a U-100 syringe D. Subcutaneously using a U-500 syringe

Answer 208

Subcutaneously using a U-500 syringe

Question 209

A nurse is educating a client on insulin administration. Which statement made by the client indicates further teaching is required? A. I will inject the insulin in the same site every day B. The best injection area is around my abdomen C. I will squeeze my skin together to inject the medication D. Gentle pressure should be applied to the site after injection

Answer 209

I will inject the insulin in the same site every day

Question 210

A child is prescribed insulin glargine before breakfast. Which instruction is most appropriate for the nurse to give the parents regarding a bedtime snack? A. 'Offer a snack to prevent hypoglycemia during the night.' B. 'Give the child a snack if signs of hyperglycemia are present.' C. 'Avoid a snack because the child is being treated with long-acting insulin.' D. 'Keep a snack at the bedside in case the child gets hungry during the night.'

Answer 210

'Offer a snack to prevent hypoglycemia during the night.'

Question 211

The nurse plans to teach a fifth-grader with type 1 diabetes how to self-administer lispro and glargine insulin. Which action would the nurse include in the teaching plan? A. Alternate the sites until the best one to use is found. B. Self-administer the injections after being taught the technique. C. Draw up the insulin glargine and then draw up the insulin lispro. D. Learn to use the needle and syringe by practicing on an insulin pad first.

Answer 211

Learn to use the needle and syringe by practicing on an insulin pad first.

Question 212

A client has type 2 diabetes controlled with oral antidiabetic medications. When admitted for elective surgery, the health care provider prescribes regular insulin. Which information would the nurse include when teaching the client about the addition of insulin? A. 'You will need a higher serum glucose level while on bed rest.' B. 'The stress of surgery may cause hypoglycemia.' C. 'With insulin, dosage can be adjusted to your changing needs during recovery from surgery.' D. 'The possibility of surgical complications is greater when a client takes oral hypoglycemics.'

Answer 212

'With insulin, dosage can be adjusted to your changing needs during recovery from surgery.'

Question 213

Which instruction about medications would the nurse include when teaching a client with type 1 diabetes who tells the nurse, "I take guaifenesin cough syrup when I have a cold."? A. "Substitute an elixir for the cough syrup." B. "Increase fluid intake and use a humidifier to control the cough." C. "The small amounts of sugar in medications are not a concern with diabetes." D. "Include the glucose in the cough syrup when calculating daily carbohydrate allowance."

Answer 213

"Include the glucose in the cough syrup when calculating daily carbohydrate allowance."

Question 214

Which instruction will the nurse provide to a client with type 2 diabetes who develops gout when teaching about the administration of allopurinol? A. "Allopurinol masks symptoms of hypoglycemia." B. "Increase your oral hypoglycemic medications." C. "Increase attention to diabetic foot care." D. "Monitor blood glucose levels more frequently."

Answer 214

"Monitor blood glucose levels more frequently."

Question 215

How will the nurse respond to a client with a new diagnosis of type 1 diabetes who becomes agitated and says, "I am scared of shots. If that is my only option, I’ll just have to go into a coma and die!" when told that lifelong insulin will be needed? A. "Injections are not the only option available for insulin." B. "It won’t be so bad; you will get used to it if you will only try." C. "This is one of those times when you need to act like an adult." D. "Clients have the right to refuse treatment, but I need you to sign this form that removes us from liability for your decision."

Answer 215

"Injections are not the only option available for insulin."

Question 216

Which response would a nurse give to a client diagnosed with type 1 diabetes who states "I hate shots. Why can’t I take the insulin in tablet form?"? A. "Your diabetic condition is too serious for oral insulin." B. "Insulin is poorly absorbed orally, so it is not available in a tablet." C. "Insulin by mouth causes a high incidence of allergic and adverse reactions." D. "Once your diabetes is controlled, your primary health care provider might consider oral insulin."

Answer 216

"Insulin is poorly absorbed orally, so it is not available in a tablet."

Question 217

The nurse is planning to teach an adolescent about diabetes and self-administration of insulin. Which would the nurse complete first? A. Establish realistic goals. B. Assess the adolescent’s intellectual ability. C. Determine what the adolescent knows about diabetes. D. Gather the equipment that will be needed for the demonstration.

Answer 217

Determine what the adolescent knows about diabetes.

Question 218

Which response by the nurse would be most appropriate to promote a sense of control in a 6-year-old child who is about to receive an injection? A. 'This won’t hurt, so you shouldn’t cry.' B. 'Which arm should I use to give you the medicine?' C. 'I know you’re grown up. You won’t cry, will you?' D. 'Close your eyes. You won’t even know what’s happening.'

Answer 218

'Which arm should I use to give you the medicine?'

Question 219

Which statement made by a client recently diagnosed with type 1 diabetes indicates that further education is necessary regarding the teaching plan? A. 'I will need to have my eyes and vision examined once a year.' B. 'I will need to check my blood sugar at home to evaluate my response to my treatment plan.' C. 'I can improve metabolic and cardiac risk factors of this disease if I follow a healthy diet and exercise routine.' D. 'Once I get my glucose levels under control, there is a good chance that I will be able to switch from insulin to an oral medication.'

Answer 219

'Once I get my glucose levels under control, there is a good chance that I will be able to switch from insulin to an oral medication.'

Question 220

A client who is taking an oral hypoglycemic daily for type 2 diabetes develops an infection with anorexia. Which advice will the nurse provide to the client? Select all that apply. One, some, or all responses may be correct. A. Avoid solid food. B. Continue to take the oral medication. C. Drink fluids throughout the day. D. Monitor capillary glucose levels. E. Do not take medication until tolerating food.

Answer 220

Continue to take the oral medication. Drink fluids throughout the day. Monitor capillary glucose levels.

Question 221

During a teaching session about insulin injections, a client asks the nurse, 'Why can’t I take the insulin in pills instead of taking shots?' How will the nurse respond? A. 'Insulin cannot be manufactured in pill form.' B. 'Insulin is destroyed by gastric juices, rendering it ineffective.' C. 'Your health care provider decides the route of administration.' D. 'Your health care provider will prescribe pills when you are ready.'

Answer 221

'Insulin is destroyed by gastric juices, rendering it ineffective.'

Question 222

A nurse is administering insulin glargine to a client with diabetes type I. The client asks the nurse why insulin is the only option for therapy. Which statement by the nurse is appropriate? A. Your body does not produce an adequate amount of insulin B. Insulin is better at controlling the disease than oral pills C. Your body has a resistance to insulin D. Oral pills take longer to produce therapeutic effects than insulin

Answer 222

Your body does not produce an adequate amount of insulin

Question 223

The client is newly diagnosed with type 1 diabetes mellitus. Which of these approaches would be the best strategy for the nurse to use when teaching insulin injection techniques? A. Give written pre and post tests B. Allow another diabetic to assist C. Ask questions during practice D. Observe a return demonstration

Answer 223

Observe a return demonstration

Question 224

The nurse is planning an evening snack for a child receiving NPH insulin. The nurse offers a snack for which reason? A. It encourages the child to stay on the diet. B. Energy is needed for immediate utilization. C. Extra calories will help the child gain weight. D. Nourishment helps counteract late insulin activity.

Answer 224

Nourishment helps counteract late insulin activity.

Question 225

Which purpose is served by an evening snack of milk, crackers, and cheese for a client who is receiving NPH insulin? A. Encouragement to stay on the diet B. Food to counteract late insulin activity C. Added calories to promote weight gain D. High carbohydrates to provide nourishment for immediate use

Answer 225

Food to counteract late insulin activity

Question 226

A client with type 1 diabetes self-administers neutral protamine Hagedorn (NPH) insulin every morning at 8:00 AM. The nurse evaluates that the client understands the action of the insulin when the client identifies which time range as the highest risk for hypoglycemia? A. 9:00 AM to 10:00 AM B. 10:00 AM to 11:00 AM C. Noon to 8:00 PM D. 8:00 PM to midnight

Answer 226

Noon to 8:00 PM

Question 227

The nurse teaches an adolescent about administration of intermediate-acting insulin and regular insulin. Which response indicates the adolescent understands when to administer the second dose of NPH insulin? A. At lunch B. At dinnertime C. 1 hour after lunch D. 1 hour after dinner

Answer 227

At dinnertime

Question 228

The nurse teaches an adolescent with type 1 diabetes about peak action of NPH insulin and the risk for hypoglycemia. The nurse determines teaching has been effective when the adolescent identifies insulin peak action within which time frame? A. 1to2hours B. 2to4hours C. 5 to 10 hours D. 4 to 12 hours

Answer 228

4 to 12 hours

Question 229

A child with type 1 diabetes is receiving 15 units of regular insulin and 20 units of NPH insulin at 7:00 AM each day. Which time would the nurse anticipate a hypoglycemic reaction from the NPH insulin to occur? A. Before noon B. In the afternoon C. Within 30 minutes D. During the evening

Answer 229

In the afternoon

Question 230

Why would lactulose be prescribed for a client with a history of cirrhosis of the liver? A. The desire to drink alcohol is decreased. B. Diarrhea is controlled and prevented. C. Elevated ammonia levels are lowered. D. Abdominal distension secondary to ascites is decreased.

Answer 230

Elevated ammonia levels are lowered.

Question 231

The nurse administers lactulose to a client with cirrhosis of the liver. Which laboratory test change leads the nurse to determine that the lactulose is effective? A. Decreased amylase B. Decreased ammonia C. Increased potassium D. Increased hemoglobin

Answer 231

Decreased ammonia

Question 232

In evaluating the effects of lactulose (Cephulac), which outcome would indicate that the drug is performing as intended? A. An increase in urine output. B. Two or three soft stools per day. C. Watery, diarrhea stools. D. Increased serum bilirubin.

Answer 232

Two or three soft stools per day.

Question 233

The nurse is preparing to administer a prescribed dose of lactulose to a client who has cirrhosis. Which lab value will the nurse monitor to evaluate the therapeutic effect of the medication? A. Glucose B. Ammonia C. Potassium D. Bicarbonate

Answer 233

Ammonia

Question 234

A client with cirrhosis of the liver asks the nurse about the purpose of taking lactulose. How should the nurse respond? A. "It is used to control portal hypertension." B. "It adds dietary fiber to your diet." C. "It helps to regenerate your liver." D. "It helps to reduce ammonia levels in your blood."

Answer 234

"It helps to reduce ammonia levels in your blood."

Question 235

A client is to receive metoclopramide intravenously 30 minutes before initiating chemotherapy for cancer of the colon. The nurse explains that metoclopramide is given for which purpose? A. To stimulate production of gastrointestinal (GI) secretions B. To stimulate peristalsis of the upper gastrointestinal (GI) tract C. To prolong excretion of the chemotherapeutic medication D. To increase absorption of the chemotherapeutic medication

Answer 235

To stimulate peristalsis of the upper gastrointestinal (GI) tract

Question 236

The nurse is providing teaching to the client taking metoclopramide. Serious side effects that should be reported to the provider are included in the teaching plan. Which of the following side effects is the priority? A. Involuntary muscle movements B. Report of increased fatigue C. Onset of headaches D. Difficulty with sleep

Answer 236

Involuntary muscle movements

Question 237

Which advantage does aluminum and magnesium hydroxide have over baking soda (sodium bicarbonate) for the treatment of heartburn? A. They can be used for short-term relief. B. Absorption by the stomach mucosa is markedly enhanced. C. There is no direct effect on the systemic acid–base balance when taken as directed. D. Fewer side effects, such as diarrhea or constipation, are experienced when they are used properly.

Answer 237

There is no direct effect on the systemic acid–base balance when taken as directed.

Question 238

The nurse is reviewing a plan of care for a client who was admitted with dehydration as a result of prolonged watery diarrhea. Which new prescription will the nurse question? A. Oral psyllium B. Oral potassium supplement C. Intravenous normal saline D. Magnesium citrate

Answer 238

Magnesium citrate

Question 239

Which effect may be experienced by a client who reports frequently taking calcium carbonate? A. Diarrhea B. Water retention C. Rebound hyperacidity D. Bone demineralization

Answer 239

Rebound hyperacidity

Question 240

Which mechanism of action explains how aluminum hydroxide decreases serum phosphorus? A. Binding with phosphorus in the intestine B. Promoting excretion of phosphorus C. Promoting excretion of excessive urinary phosphates D. Dissolving stones as they pass through the urinary tract

Answer 240

Binding with phosphorus in the intestine

Question 241

A client is prescribed aluminum hydroxide for peptic ulcer disease. Which statement by the client demonstrates an understanding of the action of the medication? A. It decreases the production of gastric secretions. B. It produces an adherent barrier over the ulcer. C. It helps maintain a gastric pH of 3.5 or above. D. It slows down the gastric motor activity.

Answer 241

It helps maintain a gastric pH of 3.5 or above.

Question 242

The nurse is educating a client with end-stage renal failure about newly prescribed aluminum hydroxide. Which statement should the nurse include in the teaching? A. “This medication binds with phosphates from food to decrease absorption.” B. “This medication is used to decrease urea to prevent urticaria.” C. “This medication will coat the lining of the stomach to decrease acid production.” D. “This medication treats hyperkalemia by exchanging sodium for potassium in the intestines.”

Answer 242

“This medication binds with phosphates from food to decrease absorption.”

Question 243

The nurse is reinforcing teaching for a client with chronic kidney disease about the prescribed aluminum hydroxide. Which is the best statement by the nurse about this medication? A. "It decreases phosphate levels." B. "It increases urine output." C. "It reduces potassium levels." D. "It controls stomach acid secretions."

Answer 243

"It decreases phosphate levels."

Question 244

The nurse is teaching a client with chronic renal failure about their medications. The client questions the purpose of taking aluminum hydroxide. How should the nurse respond? A. "It increases your urine output." B. "It decreases your blood's phosphate levels." C. "It is taken to control gastric acid secretions." D. "It will reduce your blood's calcium levels."

Answer 244

"It decreases your blood's phosphate levels."

Question 245

The nurse recognizes that hormonal therapy (HT) increases the risk of which condition in postmenopausal women? A. Breast cancer B. Rapid weight loss C. Accelerated bone loss D. Vaginal tissue atrophy

Answer 245

Breast cancer

Question 246

A client who has a habit of smoking is on estrogen therapy. Which condition is the client at most risk of developing? A. Thrombosis B. Gastrointestinal upset C. Risk of developing cancer D. Decreased effectiveness of estrogen

Answer 246

Thrombosis

Question 247

Which points would the nurse include when counseling a woman on hormone therapy? Select all that apply. One, some, or all responses may be correct. A. The client should use appropriate sun protection. B. The client should monitor any deviations in body weight. C. The client should take the medication on an empty stomach. D. The client should discontinue the medication if adverse effects occur. E. The client should alternate the time of day the medication is taken.

Answer 247

The client should use appropriate sun protection. The client should monitor any deviations in body weight.

Question 248

A 25-year-old woman on estrogen therapy has a history of smoking. Which complication would the nurse anticipate in the client? A. Osteoporosis B. Hypermenorrhea C. Endometrial cancer D. Pulmonary embolism

Answer 248

Pulmonary embolism

Question 249

A registered nurse teaches a nursing student about caring for a client prescribed estradiol to treat low estrogen levels. Which statement by the student indicates to the nurse a need for additional learning? A. 'I should apply the emulsion once a day on the thighs.' B. 'I should avoid covering the medication with clothing after it is dried.' C. 'I should educate the client about the pharmacokinetic effects of estradiol.' D. 'I should advise the client to avoid applying sunscreen at the same time as the medication intake.'

Answer 249

'I should avoid covering the medication with clothing after it is dried.'

Question 249

Which conditions would the nurse identify as decreasing the effectiveness of estrogen therapy? Select all that apply. One, some, or all responses may be correct. A. Habit of smoking B. Use of anticoagulants C. Use of tricyclic antidepressants D. Presence of endometrial cancer E. Presence of thromboembolic disorders

Answer 249

Habit of smoking Use of anticoagulants

Question 249

Which finding in a menopausal client’s health history would prevent the health care provider from prescribing hormone replacement therapy? Select all that apply. One, some, or all responses may be correct. A. Smoking B. Cirrhosis C. Cholecystitis D. Breast cancer E. Deep vein thrombosis

Answer 249

Smoking Cirrhosis Cholecystitis Breast cancer Deep vein thrombosis

Question 249

The nurse is caring for a female client who is requesting hormonal contraceptives. Which of the following questions should the nurse ask to assess for contraindications? A. “Have you ever had a blood clot?” B. “How many children do you have?” C. “Do you drink alcohol?” D. Did you experience acne in adolescence?

Answer 249

“Have you ever had a blood clot?”

Question 250

Which vitamin would the nurse anticipate may become deficient in a client prescribed cholestyramine for the treatment of type II hyperlipoproteinemia? A. Niacin (vitamin B 3) B. Calciferol (vitamin D) C. Ascorbic acid (vitamin C) D. Cyanocobalamin (vitamin B 12)

Answer 250

Calciferol (vitamin D)

Question 251

Which prescription would the nurse anticipate for the client who takes a medication that interferes with fat absorption? A. High-fat diet B. Supplemental cod liver oil C. Total parenteral nutrition (TPN) D. Water-miscible forms of vitamins A and E

Answer 251

Water-miscible forms of vitamins A and E

Question 252

A client who takes daily megadoses of vitamins is hospitalized with joint pain, loss of hair, yellow pigmentation of the skin, and an enlarged liver due to vitamin toxicity. Which type of toxicity would the nurse suspect? A. Retinol (vitamin A) B. Thiamine (vitamin B 1) C. Pyridoxine (vitamin B 6) D. Ascorbic acid (vitamin C)

Answer 252

Retinol (vitamin A)

Question 253

A thin 24-year-old woman who runs 10 miles each week asks the nurse for advice about preventing osteoporosis. Which vitamin would the nurse recommend? A. Vitamin E B. Vitamin B C. Vitamin D D. Vitamin C

Answer 253

Vitamin D

Question 254

A client who has a long history of medication and alcohol abuse mentions taking ginkgo biloba. Which condition is this client taking ginkgo biloba to treat? A. Insomnia B. Depression C. Memory impairment D. Anxiety and nervousness

Answer 254

Memory impairment

Question 255

Which condition is contraindicated for St. John’s wort herbal therapy? A. Anxiety B. Seizures C. Dementia D. Cardiac disease

Answer 255

Dementia

Question 256

A primary health care provider prescribes venlafaxine for a client with a diagnosis of major depressive disorder who has been taking herbal medications. Which herbal supplement is contraindicated when taking venlafaxine? A. Ginseng B. Valerian C. Kava-kava D. St. John’s wort

Answer 256

St. John's wort

Question 257

A client reports to the nurse, 'I’ve been using St. John’s wort to try and feel more like myself again. I’m not sure whether it’s going to work.' Which symptom would the nurse further assess? A. Depression B. Sleep disturbances C. Diminished cognitive ability D. Sensory-perceptual disturbances

Answer 257

Depression

Question 258

Which condition contraindicates the use of ginseng herbal therapy? A. Pregnancy B. Schizophrenia C. Bipolar depression D. Alzheimer disease

Answer 258

Pregnancy

Question 259

Which action by a client taking alendronate requires correction? Select all that apply. One, some, or all responses may be correct. A. Taking medication twice a week B. Taking medication before rising C. Taking medication with breakfast D. Taking medication before bedtime E. Taking medication with apple juice

Answer 259

Taking medication twice a week Taking medication before rising Taking medication with breakfast Taking medication before bedtime Taking medication with apple juice

Question 260

A client is being treated for osteoporosis with alendronate (Fosamax), and the nurse has completed discharge teaching regarding medication administration. Which morning schedule would indicate to the nurse that the client teaching has been effective? A. Take medication, go for a 30 minute morning walk, then eat breakfast. B. Take medication, rest in bed for 30 minutes, eat breakfast, go for morning walk. C. Take medication with breakfast, then take a 30 minute morning walk. D. Go for a 30 minute morning walk, eat breakfast, then take medication.

Answer 260

Take medication, go for a 30 minute morning walk, then eat breakfast.

Question 261

The nurse is caring for a client with osteoporosis who has been prescribed alendronate. When providing care, which intervention would be a priority? A. Administer the alendronate 30 to 60 minutes before the client eats. B. Notify the health care provider if the client reports jaw pain. C. Encourage the client to increase their intake of vitamin D. D. Monitor the client's serum calcium levels.

Answer 261

Notify the health care provider if the client reports jaw pain.

Question 262

A client has been prescribed alendronate for osteoporosis. Which statements indicate that the client understands how to safely take this medication? Select all that apply. A. "I will notify my doctor if I experience worsening heartburn." B. "I will take the pill with an antacid to prevent stomach upset." C. "I will swallow the pill with a full glass of water." D. "I will stand or sit quietly for 30 minutes after taking the pill." E. "I will always eat breakfast before taking the pill."

Answer 262

"I will notify my doctor if I experience worsening heartburn." "I will swallow the pill with a full glass of water." "I will stand or sit quietly for 30 minutes after taking the pill."

Question 263

A client is prescribed alendronate. Which instruction should the nurse emphasize when teaching about this medication? A. "Take the medication with a full glass of milk two hours after meals." B. "It is recommended that you take this medication with calcium and a glass of juice." C. "Be sure to take this medication on an empty stomach." D. "You may take this medication after any meal, at the same time every day."

Answer 263

"Be sure to take this medication on an empty stomach."

Question 264

Which topic will the nurse include in the discharge teaching of a client who has had a total gastrectomy? A. Daily use of a stool softener B. Injections of vitamin B 12 for life C. Monthly injections of iron dextran D. Replacement of pancreatic enzymes

Answer 264

Injections of vitamin B 12 for life

Question 265

Which body function maintained by thiamine (vitamin B 1) and niacin (vitamin B 3) will the nurse monitor when prescribed for a client with alcoholism? A. Neuronal activity B. Bowel elimination C. Efficient circulation D. Prothrombin development

Answer 265

Neuronal activity

Question 266

Which medication therapy is indicated for management of Wernicke encephalopathy associated with Korsakoff syndrome? A. Traditional phenothiazines B. Judicious use of antipsychotics C. Intramuscular injections of thiamine D. Oral administration of chlorpromazine

Answer 266

Intramuscular injections of thiamine

Question 267

Which rationale will the nurse provide to a client with Crohn's disease who asks why the prescribed vitamins have to be given intravenously (IV) rather than by mouth? Select all that apply. One, some, or all responses may be correct. A. "They provide more rapid action results." B. "They decrease colon irritability." C. "Oral vitamins are less effective." D. "Intestinal absorption may be inadequate." E. "Allergic responses are less likely to occur."

Answer 267

"They provide more rapid action results." "Oral vitamins are less effective." "Intestinal absorption may be inadequate."

Question 268

Which B vitamin deficiency will result in Wernicke encephalopathy? A. B 3 (niacin) B. B 1 (thiamine) C. B 2 (riboflavin) D. B 6 (pyridoxine)

Answer 268

B 1 (thiamine)

Question 269

A client asks the nurse what she should do if she forgets to take her contraceptive pill 1 day. Which response by the nurse is appropriate? A. 'Take your pills as instructed.' B. 'Call your primary health care provider immediately.' C. 'Continue as usual, and there shouldn’t be a problem.' D. 'On the next day take 1 pill in the morning and 1 pill before bedtime.'

Answer 269

'On the next day take 1 pill in the morning and 1 pill before bedtime.'

Question 270

A 28-year-old woman who is a smoker seeks advice about oral contraceptives. Which response by the nurse is appropriate? A. 'Oral contraceptives can cause thrombophlebitis.' B. 'Oral contraceptives must be used with other methods.' C. 'Some oral contraceptives can be used without concern.' D. 'Some oral contraceptives are safe, but others are not safe.'

Answer 270

'Oral contraceptives can cause thrombophlebitis.'

Question 271

Which supplement would the nurse instruct a client taking oral contraceptives to increase? A. Calcium B. Vitamin C C. Vitamin E D. Potassium

Answer 271

Vitamin C

Question 272

Oral contraceptives are prescribed for a client who smokes heavily. Which side effect would the nurse warn the client might occur? A. Blood clots B. Cervical cancer C. Ovarian cancer D. Risk of coronary heart disease later in life

Answer 272

Blood clots

Question 273

A client is taking an estrogen-progestin oral contraceptive. Which adverse effects from the contraceptive would the nurse teach the client to report to the primary health care provider? Select all that apply. One, some, or all responses may be correct. A. Dizziness B. Chest pain C. Bloating D. Nausea E. Calf tenderness F. Breast tenderness

Answer 273

Dizziness Chest pain Calf tenderness

Question 274

A 31-year-old client is seeking contraceptive information. While obtaining the client’s history, which factor indicates to the nurse that oral contraceptives are contraindicated? A. Older than 30 years B. Current hypothyroidism C. Two multiple pregnancies D. Blood pressure 162/110

Answer 274

Blood pressure 162/110

Question 275

A biphasic antiovulatory medication of combined progestin and estrogen is prescribed for a client. Which instruction would the nurse include when teaching about this oral contraceptive? A. 'Report irregular vaginal bleeding.' B. 'Restrict sexual activity temporarily.' C. 'Have regular bimonthly Pap smears.' D. 'Increase dietary intake of calcium.'

Answer 275

'Report irregular vaginal bleeding.'

Question 276

A client comes in for a pregnancy test. She tells the nurse that pregnancy may have occurred because she missed her contraceptive pills for 1 week when she had the flu. Which response by the nurse is appropriate? A. 'That’s the trouble with using contraceptive pills. People frequently forget to take them.' B. 'You may be correct. The effect of contraceptive pills depends on them being taken on a regular schedule.' C. 'Let’s find out whether you really are pregnant. If you are, you may want to consider having an abortion.' D. 'Contraceptive pills are unpredictable. You could have become pregnant even if you had taken them regularly.'

Answer 276

You may be correct. The effect of contraceptive pills depends on them being taken on a regular schedule.'

Question 277

A client taking oral contraceptives for 3 months tells the nurse she has breakthrough bleeding between menstrual cycles. For which causative factor would the nurse first assess in the client? A. Illness B. Anorexia nervosa C. Ectopic pregnancy D. Nonadherence to protocol

Answer 277

Nonadherence to protocol

Question 278

The nurse is counseling a 34-year-old client who has requested a prescription for oral contraceptives. Which condition would warrant additional discussion? A. Anemia B. Depression C. Hypertension D. Dysmenorrhea

Answer 278

Hypertension

Question 279

The nurse would instruct a client to stop taking an oral contraceptive and notify the health care provider immediately for the presence of which clinical findings? Select all that apply. One, some, or all responses may be correct. One, some, or all responses may be correct. A. Nausea B. Headaches C. Weight loss D. Visual disturbances E. Increased menstrual flow

Answer 279

Headaches Visual disturbances

Question 280

A client is concerned about taking hormones for birth control. Which contraceptives, explained to the client by the nurse, have a hormonal component? Select all that apply. One, some, or all responses may be correct. A. Oral contraceptives B. Diaphragm C. Cervical cap D. Female condom E. Foam spermicide F. Transdermal agents

Answer 280

Oral contraceptives Transdermal agents

Question 281

The nurse provides client teaching on the use of oral contraceptives. Which statement made by the client indicates to the nurse that teaching was effective? A. 'I will take my pill at the same time every day.' B. 'I can stop the pill and try to get pregnant right away.' C. 'I may miss two periods and not worry about being pregnant.' D. 'I am so glad we won’t have to use condoms even if I miss just one pill during the

Answer 281

'I will take my pill at the same time every day.'

Question 282

A client is prescribed an oral contraceptive. As part of teaching, the nurse plans to inform the client of the possibility of which adverse effect? A. Cervicitis B. Ovarian cysts C. Fibrocystic breasts D. Breakthrough bleeding

Answer 282

Breakthrough bleeding

Question 283

The nurse teaches a client about side effects that necessitate discontinuation of oral contraceptives. Which statement made by the client indicates that the teaching was effective? A. 'I’ll stop taking the pills if I have chest pain.' B. 'I’ll stop taking the pills if I start to retain fluid.' C. 'I’ll stop taking the pills if I have white discharge from the vagina.' D. 'I’ll stop taking the pills if I have pain during the middle of my cycle.'

Answer 283

'I’ll stop taking the pills if I have chest pain.'

Question 284

A woman questions the nurse about the effectiveness of oral contraceptives. Which important factor about the effectiveness of oral contraceptives would the nurse include in the response? A. User motivation B. Simplicity of use C. Reliability record D. Identified risk factors

Answer 284

User motivation

Question 285

Which therapeutic effect would the nurse expect to identify when mannitol is administered to a client? A. Improved renal blood flow B. Decreased intracranial pressure C. Maintenance of circulatory volume D. Prevention of the development of thrombi

Answer 285

Decreased intracranial pressure

Question 286

Which assessment would the nurse perform specific to the safe administration of intravenous mannitol? A. Body weight daily B. Urine output hourly C. Vital signs every 2 hours D. Level of consciousness every 8 hours

Answer 286

Urine output hourly

Question 287

A 6-year-old child is receiving an intravenous solution of 10% glucose and mannitol to reduce cerebral edema. Which complication would the nurse monitor the child for? A. Overhydration B. Seizure activity C. Acute heart failure D. Hypovolemic shock

Answer 287

Hypovolemic shock

Question 288

A child is prescribed intravenous mannitol. The nurse understands mannitol belongs to which classification of diuretics? A. Loop B. Osmotic C. Potassium sparing D. Carbonic anhydrase inhibitor

Answer 288

Osmotic

Question 289

The nurse is caring for a 6-year-old child who has undergone craniotomy. The parents ask what effect mannitol has. Which response by the nurse is most appropriate? A. 'It relieves cerebral pressure.' B. 'It increases the bladder’s filtration rate.' C. 'It reduces glucose excretion in the urine.' D. 'It decreases the peripheral retention of fluid.'

Answer 289

'It relieves cerebral pressure.'

Question 290

A health care provider prescribes mannitol for a client with a head injury. Which mechanism of action is responsible for therapeutic effects of this medication? A. Decreasing the production of cerebrospinal fluid B. Limiting the metabolic requirements of the brain C. Drawing fluid from brain cells into the bloodstream D. Preventing uncontrolled electrical discharges in the brain

Answer 290

Drawing fluid from brain cells into the bloodstream

Question 291

A client is prepared for a supratentorial craniotomy with burr holes, and an intravenous infusion of mannitol is instituted. The nurse concludes that this medication is primarily given for which purpose? A. Lower blood pressure B. Prevent hypoglycemia C. Increase cardiac output D. Decrease fluid in the brain

Answer 291

Decrease fluid in the brain

Question 292

A nurse is preparing to administer intravenous mannitol to a client with increased intracranial pressure. Which action will the nurse perform prior to administering the medication? A. Connect an in-line filter to the infusion tubing B. Dilute the medication with lactated ringers C. Prepare an infusion warmer D. Ensure the client has a patent central line

Answer 292

Connect an in-line filter to the infusion tubing

Question 293

The nurse is administering an osmotic diuretic to a client with a traumatic brain injury. Which finding best indicates that the medication was effective? A. 250 mL clear, yellow urine output over four hours B. Clear bilateral lung sounds to posterior auscultation C. Intracranial pressure reading of 14 mmHg D. Bilateral ovoid pupils that are slow to constrict

Answer 293

Intracranial pressure reading of 14 mmHg

Question 294

A client with benign prostatic hypertrophy has been prescribed tamsulosin. Which statement by the nurse correctly describes how this medication works? A. "This medication will shrink your enlarged prostate gland." B. "This medication will eliminate your nocturia." C. "Your sexual desire will increase with this medication." D. "This medication will improve the flow of urine."

Answer 294

"This medication will improve the flow of urine."

Question 295

A nurse is providing instructions to a client receiving baclofen. Which of the following would be included in the teaching plan? A. Limit Fluid Intake B. Hold the medication if diarrhea occurs. C. Restrict alcohol intake. D. Notify the Physician if weakness occurs.

Answer 295

Restrict alcohol intake.

Question 296

A client diagnosed with multiple sclerosis is prescribed baclofen. Which assessment finding would indicate to the nurse that the client is experiencing a therapeutic response from the medication? A. Decreased Nausea B. Decreased muscle spasms C. Increased muscle tone and strength D. Increased range of motion to all extremities.

Answer 296

Decreased muscle spasms

Question 297

A nurse is monitoring a pt receiving baclofen (Lioresal) for side effects related to the medication. Which of the following would indicate that the pt is experiencing a side effect? A. Polyuria B. Diarrhea C. Drowsiness D. Muscular excitability

Answer 297

Drowsiness

Question 298

A health care provider prescribes bed rest, loperamide, and esomeprazole for a client who just had major surgery. After several days of this regimen, the client complains of diarrhea. Which treatment strategy would the nurse conclude is the cause of the diarrhea? A. Loperamide B. Esomeprazole C. Bed rest D. Diet alteration

Answer 298

Esomeprazole

Question 299

A client prescribed omeprazole for gastroesophageal reflux disease reports a new occurrence of significant diarrhea. Which response by the nurse is most appropriate? A. 'Stop taking your omeprazole.' B. 'This is a normal side effect of omeprazole.' C. 'We are going to collect a stool sample for testing.' D. 'Antidiarrheal medication can be used to decrease this.'

Answer 299

We are going to collect a stool sample for testing.'

Question 300

The nurse is preparing to administer prescribed IV pantoprazole to the hospitalized client. The medication has been stocked in tablet form. Which action by the nurse is appropriate? A . Administer the medication to the client in oral form B. Call the pharmacy to stock the correct form of the medication C. Request that the healthcare provider change the order to tablets D. Ask the pharmacist if it is safe to give the client oral pantoprazole

Answer 300

Call the pharmacy to stock the correct form of the medication

Question 301

The nurse is assessing a client who began taking omeprazole a month ago. Which finding by the nurse, indicates that the drug has had the desired effect? A. Blood pressure readings are lower B. Feelings of depression are not as severe C. Chronic pain level is markedly decreased D. Heartburn discomfort is lessened

Answer 301

Heartburn discomfort is lessened

Question 302

Which condition is treated with a proton pump inhibitor (PPI)? A. Diarrhea B. Vomiting C. Cardiac dysrhythmias D. Gastroesophageal reflux disease (GERD)

Answer 302

Gastroesophageal reflux disease (GERD)

Question 303

A 43-year-old female client is prescribed thyroid replacement hormone following a thyroidectomy. Which adverse effects should the nurse instruct the client to report immediately to the healthcare provider? A. Tinnitus and dizziness. B. Tachycardia and chest pain. C. Dry skin and intolerance to cold. D. Weight gain and increased appetite.

Answer 303

Tachycardia and chest pain.

Question 304

A client who receives NPH insulin every morning reports feeling nervous at 4:30 PM. The nurse observes that the client’s skin is moist and cool. Which condition is the client likely experiencing? A. Hyperosmolar hyperglycemic nonketotic state B. Ketoacidosis C. Glycogenesis D. Hypoglycemia

Answer 304

Hypoglycemia

Question 305

The nurse administers a tube of glucose gel to a client who is hypoglycemic. Which explanation would the nurse share regarding the reversal of hypoglycemia? A. It liberates glucose from hepatic stores of glycogen. B. It provides a glucose source that is rapidly absorbed. C. Insulin action is blocked as it competes for tissue sites. D. Glycogen is supplied to the brain as well as other vital organs.

Answer 305

It provides a glucose source that is rapidly absorbed.

Question 306

Several hours after administering insulin, the nurse assesses the client’s response to the insulin. Which client responses are indicative of a hypoglycemic reaction? Select all that apply. One, some, or all responses may be correct. A. Tremors B. Anorexia C. Confusion D. Glycosuria E. Diaphoresis

Answer 306

Tremors Confusion Diaphoresis

Question 307

A client with type 1 diabetes receives 30 units of neutral protamine Hagedorn (NPH) insulin at 7:00 AM. At 3:30 PM, the client becomes diaphoretic, weak, and pale. With which condition would the nurse determine that these physiological responses are associated? A. Diabetic coma B. Hyperosmolar hyperglycemic nonketotic syndrome C. Diabetic ketoacidosis D. Hypoglycemic reaction

Answer 307

Hypoglycemic reaction

Question 308

In addition to clients who are receiving insulin for type 1 diabetes, the nurse will assess for signs and symptoms of hypoglycemia in clients who have which diagnosis? A. Liver failure B. Anemia C. Hyperthyroidism D. Stage 3 hypertension

Answer 308

Liver failure

Question 309

The nurse is caring for a client with type 1 diabetes. Which signs or symptoms may indicate that the client has insulin-induced hypoglycemia? Select all that apply. One, some, or all responses may be correct. A. Excessive hunger B. Weakness C. Diaphoresis D. Excessive thirst E. Deep respirations

Answer 309

Excessive hunger Weakness Diaphoresis

Question 310

A client with diabetes presents to the emergency department with a 3-hour history of profound weakness and nervousness. According to the spouse, the client became confused shortly after self-administering the morning dose of 10 units of regular insulin and 25 units of NPH insulin. The client had a light breakfast and no additional intake since that time. Which condition would the nurse identify as the likely cause of the client’s signs and symptoms? A. Hyperglycemia B. Hyperinsulinemia C. Hypoglycemia D. Hypoinsulinemia

Answer 310

Hypoglycemia

Question 311

A client with type 1 diabetes experiences tremors, pallor, and diaphoresis. These signs and symptoms are manifestations of which cause? A. Overeating B. Viral infection C. Aerobic exercise D. Missed insulin dose

Answer 311

Aerobic exercise

Question 312

Which finding would lead the nurse to recheck the blood glucose level of a diabetic client before administering a mealtime insulin dose? Select all that apply. One, some, or all responses may be correct. A. Confusion B. Drowsiness C. Diaphoresis D. Nervousness E. Heart rate 110 beats/min

Answer 312

Confusion Drowsiness Diaphoresis Nervousness Heart rate 110 beats/min

Question 313

A nurse is assessing a client diagnosed with diabetic ketoacidosis. The client is on a prescribed regular insulin infusion at 0.1 units/kg/hr. The client appears restless and verbalizes tingling to the extremities. Which action does the nurse perform next? A. Check the client capillary blood glucose B. Stop the regular insulin infusion C. Increase the infusion to 0.15 units/kg/hr D. Give the client 4 oz of fruit juice

Answer 313

Check the client capillary blood glucose

Question 314

Which response would a nurse give to a client taking an oral hypoglycemic tablet daily who asks if an extra tablet should be taken before exercise? A. "You will need to decrease your exercise." B. "An extra tablet will help your body use glucose correctly." C. "When taking medicine, your diet will not be affected by exercise." D. "No, but you should observe for signs of hypoglycemia while exercising."

Answer 314

"No, but you should observe for signs of hypoglycemia while exercising."

Question 315

Which finding would lead the nurse to recheck the blood glucose level of a diabetic client before administering a mealtime insulin dose? Select all that apply. One, some, or all responses may be correct. A. Confusion B. Drowsiness C. Diaphoresis D. Nervousness E. Heart rate 110 beats/min

Answer 315

Confusion Drowsiness Diaphoresis Nervousness Heart rate 110 beats/min

Question 316

Which complication of diabetes would the nurse suspect when a health care provider prescribes one tube of glucose gel for a client with type 1 diabetes? A. Diabetic acidosis B. Hyperinsulin secretion C. Insulin-induced hypoglycemia D. Idiosyncratic reactions to insulin

Answer 316

Insulin-induced hypoglycemia

Question 317

The nurse is caring for a client who reports sweating, tachycardia, and tremors. The laboratory report of the client reveals serum cortisol less than normal and a blood glucose level of 60 mg/dL. Which medication would be administered to this client? A. Glucagon B. Kayexalate C. Hydrocortisone D. Insulin with dextrose in normal saline

Answer 317

Glucagon

Question 318

A client with type 2 diabetes takes one glyburide tablet daily. The client asks whether an extra tablet should be taken before exercise. Which response will the nurse provide? A. 'You will need to decrease how much you are exercising.' B. 'An extra pill will help your body use glucose when exercising.' C. 'The amount of medication you need to take is not related to exercising.' D. 'Do not take an extra pill because you may become hypoglycemic when exercising.'

Answer 318

'Do not take an extra pill because you may become hypoglycemic when exercising.'

Question 319

The nurse concludes that a client has a hypoglycemic reaction to insulin. Which clinical findings support this conclusion? Select all that apply. One, some, or all responses may be correct. A. Irritability B. Glycosuria C. Dry, hot skin D. Heart palpitations E. Fruity odor of breath

Answer 319

Irritability Heart palpitations

Question 320

A client with diabetes asks how exercise will affect insulin and dietary needs. Which effects of exercise would the nurse share? A. Increases the amount of insulin needed and increases the need for carbohydrates B. Increases the amount of insulin needed and decreases the need for carbohydrates C. Decreases the amount of insulin needed and increases the need for carbohydrates D. Decreases the amount of insulin needed and decreases the need for carbohydrates

Answer 320

Decreases the amount of insulin needed and increases the need for carbohydrates

Question 321

The health care provider prescribes an oral hypoglycemic medication for the client with type 2 diabetes. Which statement will the nurse need to consider when developing the teaching plan? A. Oral hypoglycemics work by decreasing absorption of carbohydrates. B. Oral hypoglycemics work by stimulating the pancreas to produce insulin. C. Clients taking oral hypoglycemics may subconsciously relax dietary rules to gain a sense of control. D. Serious adverse effects are not a problem for oral hypoglycemics.

Answer 321

Clients taking oral hypoglycemics may subconsciously relax dietary rules to gain a sense of control.

Question 322

The nurse is teaching a 10-year-old child with type 1 diabetes about insulin requirements. Which statement by the nurse correctly identifies when insulin needs decrease? A. 'Insulin needs often decrease when puberty is reached.' B. 'When there is an infection is present, the body requires less insulin.' C. 'Emotional stress can cause insulin needs to decrease.' D. 'Increased muscle activity such as exercise, cause insulin needs to decrease.'

Answer 322

'Increased muscle activity such as exercise, cause insulin needs to decrease.'

Question 323

The nurse is caring for a client with diabetes type I who received a prescribed dose of regular insulin 30 minutes prior to the meal. The client reports nausea and vomiting. Which action should the nurse take? A. Administer another dose of regular insulin B. Encourage the client to eat a small amount of carbohydrates C. Assess blood glucose level D. Notify the healthcare provider

Answer 323

Assess blood glucose level