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Pharmacology

1. A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long halflife of 4 days. How many times per day should the nurse expect to administer this medication?

A. One

B. Two

C. Three

D. Four

2. A nurse educator is reviewing medication metabolism at an in-service presentation. Which of the following

factors should the educator include as a reason to administer lower medication dosages? (Select all that

apply.)

A. Increased renal excretion

B. Increased medication-metabolizing enzymes

C. Liver failure

D. Peripheral vascular disease

E. Concurrent use of medication the same pathway metabolizes

3. A nurse is preparing to administer eye drops to a client. Which of the following actions should the nurse

take? (Select all that apply.)

A. Have the client lie on one side.

B. Ask the client to look up at the ceiling.

C. Tell the client to blink when the drops enter the eye.

D. Drop the medication into the client's conjunctival sac.

E. Instruct the client to close the eye gently after instillation.

4. A nurse is teaching a client about transdermal patches. Which of the following statements should the nurse

identify as an indication that the client understands?

A. "I will clean the site with an alcohol swab before I apply the patch."

B. "I will rotate the application sites weekly."

C. "I will apply the patch to an area of skin with no hair."

D. "I will place the new patch on the site of the old patch."

5. A nurse reviewing a client's medical record notes a new prescription for verifying the trough level of the

client's medication. Which of the following actions should the nurse take?

A. Obtain a blood specimen immediately prior to administering the next dose of medication.

B. Verify that the client has been taking the medication for 24hr before obtaining a blood specimen.

C. Ask the client to provide a urine specimen after the next dose of medication.

D. Administer the medication, and obtain a blood specimen 30 min later.

6. A nurse is preparing a client's medications. Which the of following actions should the nurse take in

following legal practice guidelines? (Select all that apply.)

A. Teach the client about the medication.

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B. Determine the dosage.

C. Monitor for adverse effects.

D. Lock compartments for controlled substances.

E. Determine the client's insurance status.

7. A nurse is preparing to administer digoxin to a client who states, "I don't want to take that medication. I do

not want one more pill." Which of the following responses should the nurse make?

A. "Your physician prescribed it for so you really should take it."

B. "Well, let's just get it over quickly then." you,

C. "Okay, I'll just give you your other medications."

D. "Tell me your concerns about taking this medication."

8. A nurse is reviewing a client's prescribed medications. Which of the following situations represents a

contraindication to medication administration?

A. The client drank grapefruit juice, which could reduce a medication's effectiveness.

B. The medication has orthostatic hypotension as an adverse effect.

C. A medication is approved for ages 12 and older, and the client is 8 years old.

D. An antianxiety medication that has an adverse effect of drowsiness is prescribed as a preoperative sedative.

9. A nurse is assessing a client before administering medications. Which of the following data should the

nurse obtain? (Select all that apply.)

A. Use of herbal products

B. Daily fluid intake

C. Ability to swallow

D. Previous surgical history

E. Allergies

10. A nurse is working with a newly licensed nurse who is administering medications to clients. Which of the

following actions should the nurse identify as an indication that the newly hired nurse understands medication

error prevention?

A. Taking all medications out of the unit-dose wrappers before entering the client's room

B. Checking the prescription when a single dose requires administration of multiple tablets

C. Administering a medication, then looking up the usual dosage range

D. Relying on another nurse to clarify a medication prescription

11. A nurse in a clinic is caring for a group of clients. The nurse should contact the provider about a potential

contraindication to a medication for which of the following clients? (Select all that apply.)

A. A client at 8 weeks of gestation who asks for an influenza immunization

B. A client who takes prednisone and has a possible fungal infection

C. A client who has chronic liver disease and is taking hydrocodone / acetaminophen

D. A client who has peptic ulcer disease, takes sucralfate, and has started taking OTC aluminum hydroxide

E. A client who has a prosthetic heart valve, takes warfarin, and reports a suspected pregnancy

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12. A nurse is preparing to administer an IM dose of penicillin to a client who has a new prescription. The

client states when they took penicillin 3 years ago, they developed a rash. Which of the following actions

should the nurse take?

A. Administer the prescribed dose.

B. Withhold the medication.

C. Ask the provider to change the prescription to an oral form.

D. Administer an oral antihistamine the same time.

13. A nurse is providing discharge instructions for a client who has a new prescription for an antihypertensive

medication. Which of the following statements should the nurse give?

A. "Be sure to limit your potassium intake while taking the medication."

B. "You should check your blood pressure every 8 hours while taking this medication."

C. "Your medication dosage will be increased if you develop tachycardia."

D. "Change positions slowly when you move from sitting to standing."

14. A nurse is reviewing a client's health record and notes that the client experienced permanent

extrapyramidal effects caused by a previous medication. The nurse should recognize that the medication

affected which of the following systems in the client?

A. Cardiovascular

B. Immune

C. Central nervous

D. Gastrointestinal

15. A nurse is caring for a client who is taking oral oxycodone. The client is also taking ibuprofen in three

recommended doses daily. The nurse should identify that an interaction between these two medications will

cause which of the following findings?

A. A decrease in blood levels of ibuprofen, possibly leading to a need for increased doses of this medication

B. A decrease in blood levels of oxycodone, possibly leading to a need for increased doses of this medication.

C. An increase in the expected therapeutic effect of both medications

D. An increase in expected adverse effects for both medications

16. A nurse is preparing to administer medications to a 4-month-old infant. Which of the following

pharmacokinetic principles should the nurse consider when administering medications to this client? (Select

all that apply.)

A. Infants have a more rapid gastric emptying time.

B. Infants have immature liver function.

C. Infants' blood-brain barrier is poorly developed.

D. Infants have an increased ability to absorb topical medications.

E. Infants have an increased number of protein-binding sites.

17. A nurse in a provider's office is reviewing the medical record of a client who is pregnant and at the first

prenatal visit. Which of the following immunizations can the nurse administer safely to this client?

A. Varicella vaccine

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B. Rubella vaccine

C. Inactivated influenza vaccine

D. Measles vaccine

18. A nurse on a medical-surgical unit administers a hypnotic medication to an older adult client at 2100. The

next morning, the client is drowsy and wants to sleep instead of eating breakfast. Which of the following

factors should the nurse identify as a possible reason for the client's drowsiness?

A. Reduced cardiac function

B. First-pass effect

C. Reduced hepatic function

D. Increased gastric motility

19. A nurse is caring for a client who has increased liver enzymes and is taking herbal supplements. Which of

the following herbal supplements should the nurse report to the provider as the potential cause?

A. Glucosamine

B. Saw palmetto

C. Kava

D. St. John's Wort

2. A nurse is caring for a client who requests information on the use of feverfew. Which of the tallowing

responses should the nurse make?

A. "It is used to treat skin infections."

B. "It can decrease the frequency of migraine headaches."

C. "It can lessen the nasal congestion in the common cold."

D. "It can relieve nausea of morning sickness during pregnancy."

20. A nurse is reviewing a client's current medications. The client states, "I also take ginkgo biloba." Which of

the following medications has the potential to interact with ginkgo biloba?

A. Acetaminophen

B. Warfarin

C. Digoxin

D. Lisinopril

21. A nurse is caring for a client who asks about the potential adverse effects of smoking cannabis. Which of

the following manifestations should the nurse include in the response? (Select all that apply.)

A. Decreased heart rate

B. Dry mouth

C. Hallucinations

D. Hypertension

E. Increased urination

22. A nurse is teaching about the use of medical marijuana with a group of newly licensed nurses. Which of

the following statements indicates an understanding of the teaching?

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A. A health care provider must write a prescription for medical marijuana.

B. Medical marijuana is a Schedule V controlled substance in the United States.

C. Pharmacies must obtain certification prior to dispensing medical marijuana.

D. The FDA does not recognize the marijuana plant as a form of medicine.

23. A nurse working in an emergency department is caring for a client who has benzodiazepine toxicity. Which

of the following actions is the nurse's priority?

A. Administer flumazenil.

B. Identify the client's level of orientation.

C. Infuse IV fluids.

D. Prepare the client for gastric lavage.

24. A nurse is teaching a client who has a new prescription for escitalopram for treatment of generalized

anxiety disorder. Which of the following statements by the client indicates understanding of the teaching?

A. "I should take the medication on an empty stomach."

B. "I will follow a low-sodium diet while taking this medication."

C. "I need to discontinue this medication slowly."

D. "I should not crush this medication before swallowing."

25. A nurse is providing teaching to a client who has a new prescription for buspirone to treat anxiety. Which

of the following information should the nurse include?

A. "Take this medication on an empty stomach."

B. "Expect optimal therapeutic effects within 24 hr."

C. "Take this medication when needed for anxiety."

D. "This medication has a low risk for dependency."

26. A nurse is teaching a client who has obsessive-compulsive disorder and has a new prescription for

paroxetine. Which of the following instructions should the nurse include?

A. "It can take several weeks before you feel like the medication is helping."

B. "Take the medication just before bedtime to promote sleep."

C. "You should take the medication when needed for obsessive urges."

D. "Monitor for weight gain while taking this medication."

27. A nurse is caring for a client who takes paroxetine to treat posttraumatic stress disorder and reports that

they grind their teeth during the night. The nurse should identify which of the following interventions to

manage bruxism? (Select all that apply.)

A. Concurrent administration of buspirone

B. Administration of a different SSRI

C. Use of a mouth guard

D. Changing to a different class of antidepressant medication

E. Increasing the dose of paroxetine

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28. A nurse is teaching the guardians of a child who has a new prescription for desipramine. The nurse should

include that which of the following adverse effects is the priority to report to the provider?

A. Constipation

B. Suicidal thoughts

C. Photophobia

D. Dry mouth

2. A nurse is teaching an adolescent client who has a new prescription for clomipramine for OCD. Which of

the following instructions should the nurse include to minimize an adverse effect of his medication?

A. Wear sunglasses when outdoors.

B. Check your temperature daily.

C. Take this medication in the morning.

D. Add extra calories to your diet.

29. A nurse is caring for a school-age child who has a new prescription for atomoxetine. The nurse should

monitor the client for which of the following manifestations as an adverse effect of this medication?

A. Kidney toxicity

B. Liver damage

C. Seizure activity

D. Adrenal insufficiency

30. A nurse is teaching the caregiver of a school-age child about transdermal methylphenidate. Which of the

following instructions should the nurse include?

A. Apply one patch twice per day.

B. Leave the patch on for 9 hr.

C. Apply the patch to the child's waist.

D. Use opened tray within 6 months.

31. A nurse is teaching the guardians and their school-age child about a new prescription for

lisdexamfetamine. Which of the following information should the include in the teaching? (Select all that

apply.)

A. An adverse effect of this medication is CNS stimulation.

B. Administer the medication before bedtime.

C. Monitor blood pressure while taking this medication.

D. Therapeutic effects of this medication will take 1 to 3 weeks to fully develop.

E. This medication raises the levels of dopamine in the brain.

32. A nurse is providing teaching to a group of new parents about medications. The nurse should include that

aspirin is contraindicated for children who have a viral infection due to the risk of developing which of the

following adverse effects?

Reye's syndrome

Visual disturbances

Diabetes mellitus

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Wilms' tumor

33. A nurse is providing teaching to a client who has chronic kidney failure with an AV fistula for hemodialysis

and a new prescription for epoetin alfa. Which of the following therapeutic effects of epoetin alfa should the

nurse include in the teaching?

Reduces blood pressure

Inhibits clotting of fistula

Promotes RBC production

Stimulates growth of neutrophils

34. A nurse is caring for a client who has peptic ulcer disease and reports a headache. Which of the following

medications should the nurse plan to administer?

Ibuprofen

Naproxen

Aspirin

Acetaminophen

35. A nurse is preparing to administer heparin 8,000 units subcutaneously every 8hr. Available is heparin

10,000 units/1mL. How many mL should the nurse administer per dose? (Round the answer to the nearest

tenth. Use a leading zero if it applies. Do not use a trailing zero.)

 0.8 mL

36. A nurse is preparing to administer an enteral tube feeding through an NG tube at 250 mL over 4 hr. The

nurse should set the pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use

a leading zero if it applies. Do not use a trailing zero.)

 250/4 = 62.5} 63 mL/hr

37. A nurse is preparing to administer amoxicillin 250 mg liquid supspension PO every 8 hr to an older adult

client. The amount available is amoxicillin 50 mg/mL. How many mL should the nurse administer per dose?

(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

5 mL

38. A nurse is caring for a client who has a prescription for clopidogrel. The nurse should monitor the client for

which of the following adverse effects?

Insomnia

Hypotension

Bleeding

Constipation

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39. A nurse is teaching a newly licensed nurse about contraindications to ceftriaxone. The nurse should

include a severe allergy to which of the following medications as a contraindication to ceftriaxone?

Gentamicin

Clindamycin

Piperacillin

Sulfamethoxazole-trimethoprim

40. A nurse is providing teaching to a newly licensed nurse about metoclopramide. The nurse should include in

the teaching that which of the following conditions is a contraindication to this medication?

Hyperthyroidism

Intestinal obstruction

Glaucoma

Low blood pressure

41. A nurse is assessing a client who has a new prescription for chlorpromazine to treat schizophrenia. The

client has a mask-like facial expression and is experiencing involuntary movements and tremors. Which of the

following medications should the nurse anticipate administering?

Amantadine

Bupropion

Phenelzine

Hydroxyzine

42. A nurse is administering subcutaneous epinephrine for a client who is experiencing anaphylaxis. The nurse

should monitor the client for which of the following adverse effects?

Hypotension

Hyperthermia

Hypoglycemia

Tachycardia

43. A nurse is providing teaching to a client who has a urinary tract infection and new prescriptions for

phenazopyridine and ciprofloxacin. Which of the following statements by the client indicates the need for

further teaching?

"If the phenazopyridine upsets my stomach, I can take it with meals."

"The phenazopyridine will relieve my discomfort, but the ciprofloxacin will get rid of the infection."

"I need to drink 2 liters of fluid per day while I am taking the ciprofloxacin."

"I should notify my provider immediately if my urine turns an orange color."

44. A nurse is caring for an older adult client who has a prescription for zolpidem at bedtime to promote sleep.

The nurse should plan to monitor the client for which of the following adverse effects?

Ecchymosis

Decreased urine output

Increased blood pressure

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Dizziness

45. A nurse is reviewing laboratory values for a client who reports fatigue and cold intolerance. The client has

an increased thyroid stimulating hormone (TSH) level and a decreased total T3 and T4 level. The nurse should

anticipate a prescription for which of the following medications?

Methimazole

Somatropin

Levothyroxine

Propylthiouracil

46. A nurse is providing teaching to a client who has a new prescription for hydrochlorothiazide 50 mg PO daily

to treat hypertension. Which of the following instructions should the nurse include in the teaching?

"Take hydrochlorothiazide as needed for edema ."

"Check your weight once each week."

"Take the hydrochlorothiazide on an empty stomach."

"Take the hydrochlorothiazide in the morning."

47. A nurse is caring for a client who is at 28 weeks of gestation and is experiencing preterm labor. Which of

the following medications should the nurse plan to administer?

Oxytocin

Nifedipine

Dinoprostone

Misoprostol

48. A nurse is providing teaching to a client who has cirrhosis and a new prescription for lactulose. The nurse

should instruct the client that lactulose has which of the following therapeutic effects?

Increases blood pressure

Prevents esophageal bleeding

Decreases heart rate

Reduces ammonia levels

49. A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression.

Which of the following diagnostic tests should the nurse plan to perform prior to starting the client on this

medication?

Hearing examination

Glucose tolerance test

Electrocardiogram

Pulmonary function tests

50. A nurse is providing teaching to a client who has gout and a new prescription for allopurinol. The nurse

should instruct the client to discontinue taking the medication for which of the following adverse effects?

Nausea

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Metallic taste

Fever

Drowsiness

51. A nurse is assessing a client who is receiving IV gentamicin three times daily. Which of the following

findings indicates that the client is experiencing an adverse effect of this medication?

Hypoglycemia

Proteinuria

Nasal congestion

Visual disturbances

52. A nurse is providing teaching for a client who is withdrawing om alcohol and has a new prescriptio fr n for

propranolol. Which of the following information should the nurse include in the teaching?

A. Increases the risk for seizure activity

B. Provides a form of aversion therapy

C. Decreases cravings

D. Can increase blood pressure

53. A charge nurse is planning a staff education session to discuss medications used during the care of a client

experiencing alcohol withdrawal . Which of the following medications should the charge nurse include the

discus (Select all that apply.)

A. Lorazepam

B. Diazepam

C. Disulfiram

D. Naltrexone

E. Acamprosate

54. A nurse is teaching a client who has a new prescription for clonidine to assist with maintenance of

abstinence from opioids. The nurse should instruct the client to monitor for which of the following adverse

effects?

A. Diarrhea

B. Dry mouth

C. Insomnia

D. Hypertension

55. A nurse is teaching a client who has tobacco use disorder about nicotine replacement therapy. Which of

the following statements by the client indicates understanding of the teaching?

A. "I should avoid eating right before I chew a piece of nicotine gum."

B. "I will need to stop using the nicotine gum after 1 year."

C. "I know that nicotine gum is a safe alternative to smoking if I become pregnant."

D. "I must chew the nicotine gum quickly for about 15 minutes."

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56. A nurse in an acute mental health facility is caring for a client who is experiencing withdrawal from opioid

use and has a new prescription for clonidine. Which of the following actions should the nurse identify as the

priority?

A. Administer the clonidine on the prescribed schedule.

B. Provide ice chips at the client's bedside.

C. Educate the client on the effects of clonidine.

D. Obtain baseline vital signs.

57. A nurse in the post-anesthesia recovery unit is caring for a client who received a nondepolarizing

neuromuscular blocking agent and has muscle weakness. The nurse should expect a prescription for which of

the following medications?

A. Neostigmine

B. Naloxone

C. Dantrolene

D. Vecuronium

58. A nurse is providing information to a client who has early Parkinson's disease and a new prescription for

pramipexole. The nurse should instruct the client to monitor for which of the following adverse effects of this

medication?

A. Hallucinations

B. Increased salivation

C. Diarrhea

D. Discoloration of urine

59. A nurse is teaching a client who has a new prescription for levodopa / carbidopa for Parkinson's disease.

Which of the following instructions should the nurse include?

A. Increase intake of protein-rich foods.

B. Expect muscle twitching to occur.

C. Take this medication with food.

D. Anticipate relief of manifestations in 24 hr.

60. A nurse is preparing to administer a medication to a client who has absence seizures. The nurse should

expect to administer which of the following medications to the client? (Select all that apply.)

A. Phenytoin

B. Ethosuximide

C. Gabapentin

D. Carbamazepine

E. Valproic acid

F. Lamotrigine

61. A nurse is reviewing a new prescription for oxcarbazepine with a client who has partial seizures. Which of

the following instructions should the nurse include? (Select all that apply.)

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A. "Use caution if given a prescription for a diuretic medication."

B. "Consider using an alternate form of contraception if you are using oral contraceptives."

C. "Chew gum to increase saliva production."

D. "Avoid driving until you see how the medication affects you."

E. "Notify your provider if you develop a skin rash."

62. A nurse in the operating room is caring for a client who received a dose of succinylcholine. During the

operation, the client suddenly develops rigidity and a rise in body temperature. The nurse should expect a

prescription for which of the following medications?

A. Neostigmine

B. Naloxone

C. Dantrolene

D. Vecuronium

63. A nurse in the post-anesthesia care unit is caring for a client who is experiencing malignant hyperthermia.

Which of the following actions should the nurse take? (Select all that apply.)

A. Place a cooling blanket on the client.

B. Administer oxygen at 100%.

C. Administer iced 0.9% sodium chloride.

D. Administer potassium chloride IV.

E. Monitor core body temperature.

64. A nurse is teaching a client who has a new prescription for baclofen to treat muscle spasms. Which of the

following statements by the client indicates an understanding of the teaching? (Select all that apply.)

A. "I will stop taking this medication right away if I develop dizziness."

B. "I know the doctor will gradually increase my dose of this medication for a while."

C. "I should increase fiber to prevent constipation from this medication."

D. "I won't be able to drink alcohol while I'm taking this medication."

E. "I should take this medication on an empty stomach each morning."

65. A nurse is reviewing the medical record of a client who reports urinary incontinence and asks about a

prescription for oxybutynin. The nurse should recognize that oxybutynin is contraindicated in the presence of

which of the following conditions?

A. Bursitis

B. Sinusitis

C. Depression

D. Glaucoma

66. A nurse is assessing a client who has a prescription for bethanechol to treat urinary retention. The nurse

should identify that which of the following findings is a manifestation of muscarinic stimulation?

A. Dry mouth

B. Hypertension

C. Excessive perspiration

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D Fecal impaction

67. A nurse is providing instructions to a client who has been experiencing insomnia and has a new

prescription for temazepam. The nurse should inform the client that which of the following manifestations

are adverse effects of temazepam? (Select all that apply.)

A. Incoordination

B. Hypertension

C. Pruritus

D. Sleep driving

E. Amnesia

68. A nurse is caring for a client who is receiving moderate sedation with diazepam IV. The client is

oversedated. Which of the following medications should the nurse expect to administer to this client?

A. Ketamine

B. Naltrexone

C. Flumazenil

D. Fluvoxamine

69. A nurse is teaching a client who has a new prescription for ramelteon. The nurse should instruct the client

to avoid which of the following foods at the time of medication administration?

A. Baked potato

B. Fried chicken

C. Whole-grain bread

D. Citrus fruits

70. A nurse is caring for a client who is to undergo a surgical procedure. Which of the following preexisting

conditions can be a contraindication for the use of ketamine as an intravenous anesthetic?

A. Peptic ulcer disease

B. Breast cancer

C. Diabetes mellitus

D. Schizophrenia

71. A nurse is providing instructions to a client who has a new prescription for zolpidem. Which of the

following instructions should the nurse include?

A. "Notify the provider if you plan to become pregnant."

B. "Take the medication 1hr before you plan to go to sleep."

C. "Allow at least 6hr for sleep when taking zolpidem."

D. "To increase the effectiveness of zolpidem, take it with a bedtime snack."

72. A nurse is reviewing the health record of a client who asks about using propranolol to treat hypertension.

The nurse should recognize which of the following conditions is a contraindication for taking propranolol?

A. Asthma

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B. Glaucoma

C. Hypertensio n

D. Tachycardia

73. A nurse is teaching a client who has a new prescription for verapamil to control hypertension. Which of

the following instructions should the nurse include?

A. Increase the amount of fiber in the diet.

B. Drink grapefruit juice daily to increase vitamin C intake.

C. Decrease the amount of calcium in the diet.

D. Withhold food for 1hr after the medication is taken.

74. A nurse is caring for a client who has a new prescription for captopril for hypertension. The nurse should

monitor the client for which of the following as an adverse effect of this medication?

A. Hypokalemia

B. Hypernatremia

C. Neutropenia

D. Bradycardia

75. A nurse in an acute care facility is caring for a client who is receiving IV nitroprusside for hypertensive

crisis. Which of the following conditions should the nurse monitor the client for as an adverse effect of this

medication?

A. Intestinal ileus

B. Neutropenia

C. Delirium

D. Hyperthermia

76. A nurse is planning to administer a first dose of captopril to a client who has hypertension. Which of the

following medications can intensify first dose hypotension? (Select all that apply.)

A. Simvastatin

B. Hydrochlorothiazide

C. Phenytoin

D. Clonidine

E. Aliskiren

77. A nurse is assessing a client who is taking amiodarone to treat atrial fibrillation. Which of the following

findings is a manifestation of amiodarone toxicity?

A. Light yellow urine

B. Report of tinnitus

C. Productive cough

D. Blue-gray skin discoloration.

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78. A nurse is caring for a client who received IV verapamil to treat supraventricular tachycardia (SVT). The

client's pulse rate is now 98 / min and the blood pressure is 74/44 mg Hg. The nurse should expect a

prescription for which of the following IV medications?

A. Calcium gluconate

B. Sodium bicarbonate

C. Potassium chloride

D. Magnesium sulfate

79. A nurse is assessing a client who is taking digoxin to treat heart failure. Which of the following findings is

a manifestation of digoxin toxicity?

A. Bruising

B. Report of metallic taste

C. Muscle pain

D. Report of anorexia

90. A nurse is assessing a client who has taken procainamide to treat dysrhythmias for the last 12 months. The

nurse should assess the client for which of the following manifestations as an adverse effect of this

medication? (Select all that apply.)

A. Hypertension

B. Widened QRS complex

C. Narrowed QT interval

D. Easy bruising

E. Swollen joints

91 A nurse is preparing to administer propranolol to a client who has a dysrhythmia. Which of the following

actions should the nurse plan to take?

A. Hold propranolol for an apical pulse greater than 100 / min.

B. Administer propranolol to increase the client's blood pressure.

C. Assist the client when sitting up or standing after taking this medication.

D. Check for hypokalemia frequently due to the risk for propranolol toxicity.

92. A nurse is providing teaching to a client who is starting simvastatin. Which of the following information

should the nurse include in the teaching?

A. Take this medication in the evening.

B. Change position slowly when rising from a chair.

C. Maintain a steady intake of green leafy vegetables.

D. Consume no more than 1 L/day of fluid.

93. A nurse is collecting data from a client who is taking gemfibrozil. Which of the following assessment

findings should the nurse identify as an adverse effect of this medication?

A. Mental status changes

B. Tremor

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C. Jaundice

D. Pneumonia

94. A nurse is teaching a client who is taking digoxin and has a new prescription for colesevelam. Which of the

following instructions should the nurse include in the teaching?

A. "Take digoxin with your morning dose of colesevelam."

B. "Your sodium and potassium levels will be monitored periodically while taking colesevelam."

C. "Watch for bleeding or bruising while taking colesevelam."

D. "Take colesevelam with food and at least one glass of water."

95. A nurse is completing a nursing history for a client who takes simvastatin. The nurse should identify which

of the following disorders as a contraindication to adding ezetimibe to the client's medications?

A. History of severe constipation

B. History of hypertension

C. Active hepatitis C

D. Type 2 diabetes mellitus

96. A nurse is caring for a client who has a new prescription for alirocumab to reduce cholesterol. The nurse

should monitor for which of the following findings as an adverse effect of alirocumab? (Select all that apply.)

A. Muscle aches

B. Vasculitis

C. Hearing loss

D. Urticaria

E. Jaundice

97. A nurse is planning to administer subcutaneous al enoxaparin 40 mg using a prefilled syringe of enoxaparin

40 mg / 0.4 mL to an adult client following hip arthroplasty. Which of the following actions should the nurse

plan to take?

A. Expel the air bubble from the prefilled syringe before injecting.

B. Insert the needle completely into the client's tissue.

C. Administer the injection in the client's thigh.

D. Aspirate carefully after inserting the needle into the client's skin.

98. A nurse is caring for a client who is receiving heparin by continuous IV infusion. The client begins vomiting

blood. After the heparin has been stopped, which of the following medications should the nurse prepare to

administer?

A. Vitamin K

B. Atropine

C. Protamine

D. Calcium gluconate

99. A nurse is planning to administer IV alteplase to a client. Which of the following interventions should the

nurse plan to take?

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A. Administer IM enoxaparin along with the alteplase dose.

B. Obtain the client's weight.

C. Administer aminocaproic acid IV prior to alteplase infusion.

D. Prepare to administer alteplase within 8hr of manifestation onset.

100. A nurse is monitoring a client who takes aspirin daily. The nurse should identify which of the following

manifestations as adverse effects of aspirin? (Select all that apply.)

A. Hypertension

B. Coffee-ground emesis

C. Tinnitus

D. Paresthesias of the extremities

E. Nausea

101. A nurse is caring for a client who has atrial fibrillation and a new prescription for dabigatran. Which of

the following medications is prescribed concurrently to treat an adverse effect of dabigatran?

A. Vitamin K

B. Protamine

C. Omeprazole

D. Probenecid

102. A nurse is teaching a client who has angina pectoris and is learning how to treat acute anginal attacks.

The clients asks, "What is my next step if I take one tablet, wait 5 minutes, but still have anginal pain?" Which

of the following responses should the nurse make?

A. "Take two more sublingual tablets at the same time." % 3D

B. "Call the emergency response team."

C. "Take a sustained-release nitroglycerin capsule."

D. "Wait another 5 minutes then take a second sublingual tablet."

103. A nurse is teaching a client who has a new prescription for nitroglycerin transdermal patch for angina

pectoris. Which of the following instructions should the nurse include?

A. Remove the patch each evening.

B. Cut each patch in half if angina attacks are under control.

C. Take off the nitroglycerin patch for 30 min if a headache occurs.

D. Apply a new patch every 48 hr.

104. A nurse is taking a medication history from a client who has angina and is to begin taking ranolazine. The

nurse should report which of the following medications in the client's history that can interact with

ranolazine? (Select all that apply.)

A. Digoxin

B. Simvastatin od

C. Verapamil

D. Amlodipine

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E. Nitroglycerin transdermal patch

105. A nurse is caring for a client who is prescribed isosorbide mononitrate for chronic stable angina and

develops reflex tachycardia. Which of the following medications should the nurse expect to administer?

A. Furosemide

B. Captopril

C. Ranolazine

D. Metoprolol

106. A nurse is teaching a client who has angina how to use nitroglycerin transdermal ointment. The nurse

should include which of the following instructions?

A. "Remove the prior dose before applying a new dose."

B. "Rub the ointment directly into your skin until it is no longer visible."

C. "Cover the applied ointment with a clean gauze pad."

D. "Apply the ointment to the same skin area each time."

107. A nurse in a provider's office is monitoring blood electrolytes for four clients who take digoxin. Which of

the following electrolyte values increases a client's risk for digoxin toxicity?

A. Calcium 9.2 mg/dL

B. Calcium 10.3 mg/dL

C. Potassium 3.4 mEq/L

D. Potassium 4.8 mEq?L

108. A nurse is caring for a client who has a new prescription for digoxin and takes multiple other medications.

The nurse should recognize that concurrent use of which of the following medications places the client at risk

for digoxin toxicity?

A. Phenytoin

B. Verapamil

C. Warfarin

D. Aluminum hydroxide

109. A nurse is administering a dopamine infusion at a low dose to a client who has severe heart failure.

Which of the following findings is an expected effect of this medication?

A. Lowered heart rate

B. Increased urine output

C. Decreased conduction through the AV node

D. Vasoconstriction of renal blood vessels

110. A nurse is providing teaching to a client who has a new prescription for digoxin. The nurse should instruct

the client to monitor and report which of the following adverse effects that is a manifestation of digoxin

toxicity? (Select all that apply.)

A. Fatigue

19

B. Constipation

C. Anorexia

D. Rash

E. Blurred vision

111. A nurse is teaching a client who has a new prescription for digoxin to treat heart failure. Which of the

following instructions should the nurse include in the teaching?

A. Contact provider if heart rate is less than 60 / min.

B. Check pulse rate for 30 seconds and multiply result by 2.

C. Increase intake of sodium.

D. Take with food if nausea occurs.

112. A nurse is caring for a client who has a new prescription for phenelzine for the treatment of depression.

Which of the following indicates that the client has developed an adverse effect of this medication?

A. Orthostatic hypotension

B. Hearing loss

C. Gastrointestinal bleeding

D. Weight loss

113. A nurse is providing teaching to a client who has a new prescription for amitriptyline for treatment of

depression. Which of the following should the nurse include in the teaching? (Select all that apply.)

A. Expect therapeutic effects in 24 to 48 hr.

B. Discontinue the medication after a week of improved mood.

C. Change positions slowly to minimize dizziness.

D. Decrease dietary fiber intake to control diarrhea.

E. Chew sugarless gum to prevent dry mouth.

114. A nurse is providing discharge teaching to a client who has a new prescription for fluoxetine for

posttraumatic stress disorder. Which of the following statements should the nurse include in the teaching?

A. "You can have a decreased desire for intimacy while taking this medication."

B. "You should take this medication at bedtime to help promote sleep."

C. "You will have fewer urinary adverse effects if you urinate just before taking this medication."

D. "You'll need to wear sunglasses when outdoors due to the light sensitivity caused by this medication."

115. A nurse is caring for a client who has depression and a new prescription for venlafaxine. The nurse

should monitor the client for which of the following manifestations as an adverse effect of this medication?

(Select all that apply.)

A. Mydriasis

B. Dizziness

C. Decreased libido

D. Alopecia

E. Hypotension

20

116. A nurse is caring for a client who has been taking sertraline for the past 2 days. Which of the following

assessment findings should alert the nurse to the possibility that the client is developing serotonin syndrome?

A. Bruising

B. Fever

C. Tinnitus

D. Rash

117. A nurse is reviewing laboratory findings and notes that a client's lithium level is 2.1 mEg/L. Which of the

following is an appropriate action by the nurse?

A. Perform immediate gastric lavage.

B. Prepare the client for hemodialysis.

C. Administer an additional oral dose of lithium.

D. Request a stat repeat of the laboratory test.

118. A nurse is caring for a client who has a new prescription for lithium carbonate. When teaching the client

about ways to prevent lithium toxicity, the nurse should advise the client to do which of the following?

A. Avoid the use of acetaminophen for headaches.

B. Restrict intake of foods rich in sodium.

C. Decrease fluid intake to less than 1,500 mL daily.

D. Limit aerobic activity in hot weather.

119. A nurse is assessing a client who takes lithium carbonate for the treatment of bipolar disorder. The nurse

should identify which of the following findings is a possible indication of toxicity to this medication?

A. Severe hypertension

B. Coarse tremors

C. Constipation

D. Muscle spasms

120. A nurse is caring for a client who has a new prescription for valproic acid. The nurse should instruct the

client to have which of the following blood laboratory tests completed periodically? (Select all that apply.)

A. Thrombocyte count

B. Glucose

C. Amylase

D. Liver function tests

E. Potassium

121. A nurse is preparing a teaching plan for a client who has bipolar disorder and a new prescription for

carbamazepine. Which of the following instructions should the nurse include in the teaching?

A. "This medication can safely be taken during pregnancy."

B. "Eliminate grapefruit juice from your diet."

C. "You will need to have a complete blood count and carbamazepine levels drawn periodically."

D. "Notify your provider if you develop a rash."

21

E. "Avoid driving for the first few days after starting this medication."

122. A nurse is teaching a client, who has schizophrenia, strategies to cope with anticholinergic effects of

fluphenazine. Which of the following should the nurse suggest to the client to minimize anticholinergic

effects?

A. Take the medication in the morning to prevent insomnia.

B. Chew sugarless gum to moisten the mouth

C. Use cooling measures to decrease fever

D. Take an antacid to relieve nausea

123. A nurse is assessing a client who recently began taking haloperidol. Which of the following findings is the

priority to report to the provider?

A. Shuffling gait

B. Neck spasms

C. Drowsiness

D. Sexual dysfunction

124. A nurse is providing discharge teaching to a client who has a new prescription for clozapine. Which of the

following statements should the nurse include in the teaching?

A. "You should have a high-carbohydrate snack between meals and at bedtime."

B. "You are likely to develop hand tremors if you take this medication for a long period of time."

C. "You may experience temporary numbness of your mouth after each dose."

D. "You should have your white blood cell count monitored every week."

125. A nurse is providing teaching for a client who Is to begin taking risperidone. Which of the following

instructions should the nurse include?

A. "Add extra snacks to your diet to prevent weight loss."

B. "Notify the provider if you have trouble sleeping."

C. "You may begin to have mild seizures while taking this medication."

D. "This medication is likely to increase your libido."

126. A nurse is following up with a client who takes chlorpromazine for the treatment of schizophrenia. The

nurse should expect to find the greatest improvement in which of the following manifestations? (Select all

that apply.)

A. Disorganized speech

B. Bizarre behavior

C. Impaired social interactions

D. Hallucinations

E. Decreased motivation

127. A nursing is planning care for a client who is receiving furosemide IV for peripheral edema. Which of the

following interventions should the nurse include in the plan of care? (Select all that apply.)

22

A. Assess for tinnitus.

B. Report urine output 50 mL/hr.

C. Monitor blood potassium levels.

D. Elevate the head of bed slowly before ambulation

E. Recommend eating a banana daily.

128. A nurse is providing information to a client who has a new prescription for hydrochlorothiazide. Which of

the following information should the nurse include?

A. Take the medication with food.

B. Plan to take the medication at bedtime.

C. Expect increased swelling of the ankles.

D. Fluid intake should be limited in the morning.

129. A nurse is monitoring a client who is receiving spironolactone. Which of the following findings should the

nurse report to the provider?

A. Blood sodium 144 mEq /L

B. Urine output 120 mL in 4hr

C. Blood potassium 5.2 mEq /L

D. Blood pressure 140/90 mm Hg

130. A nurse is caring for a client who has increased intracranial pressure and is receiving mannitol. Which of

the following findings should the nurse report to the provider?

A. Blood glucose 150 mg/dL

B. Urine output 40 mL/hr

C. Dyspnea

D. Bilateral equal pupil size

131. A nurse is planning care for a client who is has a new prescription for torsemide. The nurse should plan

to monitor for which of the following conditions as potential adverse reactions of this medication? (Select all

that apply.)

A. Respiratory acidosis

B. Hypokalemia

C. Hypotension

D. Ototoxicity

E. Ventricular dysrhythmias

132. A nurse is teaching clients about the use of insulin to treat type 1 diabetes mellitus. For which of the

following types of insulin should the nurse tell the clients to expect a peak effect 1 to 5hr after administration?

A. Insulin glargine

B. NPH insulin

C. Regular insulin

D. Insulin lispro

23

133. A nurse is caring for a client who has been taking acarbose for type 2 diabetes mellitus. Which of the

following laboratory tests should the nurse plan to monitor?

A. WBC

B. Amylase

C. Platelet count

D. Liver function tests ed son

134. A nurse is providing teaching to a client who has type 2 diabetes mellitus and is starting repaglinide.

Which of the following statements by the client indicates understanding of the administration of this

medication?

A. "I'll take this medication after I eat."

B. "I'll take this medicine 30 minutes before I eat."

C. "I'll take this medicine just before I go to bed."

D. "I'll take this medication at least 1 hour before I eat."

135. A nurse is providing teaching for a client who has a new prescription for metformin. Which of the

following findings should the nurse instruct the client to report as an adverse effect of metformin?

A. Somnolence

B. Constipation

C. Fluid retention

D. Weight gain

136. A nurse is providing teaching to a client who has a prescription for pramlintide for type 1 diabetes

mellitus. Which of the following should the nurse include in the teaching? (Select all that apply.)

A. "Take oral medications 30 min before injection."

B. "Use upper arms as preferred injection sites."

C. "Mix pramlintide with the breakfast dose of insulin."

D. "Inject pramlintide just before a meal."

E. "Discard open vials after 28 days."

137. A nurse is caring for a client who is taking propylthiouracil. Which of the following findings should the

nurse monitor for as an adverse effect of this medication?

A. Bradycardia

B. Insomnia

C. Heat intolerance

D. Weight loss

138. A nurse is teaching a client who has Grave's disease and a new prescription for propranolol. Which of the

following client statements indicates effective teaching?

A. "Propranolol helps increase blood flow to my thyroid gland."

B. "Propranolol is used to prevent excess glucose in my blood."

C. "Propranolol will decrease my tremors and fast heart beat."

24

D. "Propranolol promotes a decrease of thyroid hormone in my body."

139. A nurse is caring for an older adult client who has hypothyroidism and a new prescription for

levothyroxine. Which of the following dosage schedules should the nurse expect for this client?

A. The client will start at a high dosage, and the amount will be tapered as needed.

B. The client will remain on the initial dosage during the course of treatment.

C. The client's dosage will be adjusted daily based on blood levels.

D. The client will start on a low dosage, which can be gradually increased.

140. A nurse is caring for a client who is taking for somatropin to stimulate growth. The nurse should plan to

monitor the client's urine for which of the following?

A. Bilirubin

B. Protein

C. Potassium

D. Calcium

141. A nurse is reviewing the medical record of a client who takes desmopressin for diabetes insipidus. Which

of the following findings is an adverse effect of desmopressin?

A. Hypovolemia

B. Hypercalcemia

C. Agitation

D. Headache

142. nurse is admitting a client for a total hip ar A throplasty. The client takes hydrocortisone for Addison's

disease. Which of the following actions the nurse's priority?

A. Administering a supplemental dose of hydrocortisone

B. Instructing the client about coughing and deep breathing

C. Collecting additional information about the client's history of Addison's disease

D. Inserting an indwelling urinary catheter

143. A nurse is teaching a client about terbutaline. Which of the following statements by the client indicates

understanding of the teaching?

A. "This medication will stop my contractions."

B. "This medication will prevent vaginal bleeding."

C. "This medication will promote blood flow to my baby."

D. "This medication will increase my prostaglandin production."

144. A nurse is caring for a client who has preeclampsia and is receiving magnesium sulfate IV continuous

infusion. Which of the following findings 2 should the nurse report to the provider?

A. 2+ deep tendon reflexes

B. 2+ pedal edema

C. 24 mL/hr urinary output

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D. Respirations 12/min

145. A nurse is caring for a client who has a new prescription for oxytocin to stimulate uterine contractions.

Which of the following actions should the nurse take? (Select all that apply. )

A. Use an infusion pump for medication administration.

B. Obtain vital signs frequently and with every dosage change.

C. Stop infusion if uterine contractions occur every 4 min and last 45 seconds.

D. Increase medication infusion rate rapidly.

E. Fetal heart rate continuously monitor.

146. A nurse is caring for a client who and is receiving oxytocin. The nurse should monitor the client for which

of the following as complications of oxytocin? (Select all that apply.)

A. Uterine rupture

B. Uterine tachysystole

C. Placental abruption

D. Hyponatremia

E. Placenta previa

147. A nurse is reviewing a new prescription for terbutaline with a client who has a history of preterm labor.

Which of the following client statements indicates understanding of the teaching?

A. "I can increase my activity now that I've started on this medication."

B. "I will increase my daily fluid intake to 3 quarts."

C. "I will report increasing intensity of contractions to my doctor."

D. "I am glad this will prevent preterm labor."

148. A nurse is reviewing the health care record of a client who is asking about conjugated equine estrogens.

The nurse should inform the client this medication is contraindicated in which of the following conditions?

A. Atrophic vaginitis

B. Dysfunctional uterine bleeding

C. Osteoporosis

D. Thrombophlebitis

149. A nurse is providing teaching to a female client who is taking testosterone to treat advanced breast

cancer. The nurse should tell the client that which of the following are adverse effects of this medication?

(Select all that apply.)

A. Deepening voice

B. Weight gain

C. Low blood pressure

D. Dry mouth

E. Facial hair

26

150. A nurse is explaining the mechanism of action of combination oral contraceptives to a group of clients.

The nurse should tell the clients that which of the following actions occur with the use of combination oral

contraceptives? (Select all that apply.)

A. Thickening the cervical mucus

B. Inducing maturation of ovarian follicle

C. Increasing development of the

D. Altering the endometrial lining

E. Inhibiting ovulation

151. A nurse is providing teaching to a client who will start alfuzosin for treatment of benign prostatic

hyperplasia. The nurse should instruct the client that which of the following is an adverse effect of this

medication?

A. Bradycardia

B. Edema

C. Hypotension

D. Tremor

152. A nurse is caring for a client who has angina and asks about obtaining a prescription for sildenafil to treat

erectile dysfunction. Which of the following medications is contraindicated with sildenafil?

A. Aspirin

B. Isosorbide

C. Clopidogrel

D. Atorvastatin

153. A nurse is providing teaching to a newly licensed nurse about caring for a client who has a prescription for

gemfibrozil. The nurse should instruct the newly licensed nurse to monitor which of the following laboratory

tests?

Platelet count

Electrolyte levels

Thyroid function

Liver function

154. A nurse is caring for a client who has a new prescription for ergotamine. The nurse should recognize that

ergotamine is administered to treat which of the following conditions?

Raynaud's phenomenon

Migraine headaches

Ulcerative colitis

Anemia

155. A nurse is reviewing the laboratory values for a client who is receiving a continuous IV heparin infusion

and has an aPTT of 90 seconds. Which of the following actions should the nurse prepare to take?

27

Administer vitamin K

Reduce the infusion rate

Give the client a low-dose aspirin

Request an INR

156. A nurse is providing teaching to a client who has rhematoid arthritis and a prescription for long-term

prednisone therapy. The nurse should instruct the client to monitor for which of the following adverse effects?

Stress fractures

Orthostatic hypotension

Gingival ulcerations

Weight loss

157. A nurse is caring for a client who has a new prescription for tamoxifen. The nurse should recognize that

tamoxifen has which of the following therapeutic effects?

Antiestrogenic

Antimicrobial

Androgenic

Anti-inflammatory

158. A nurse is caring for a client who has a new prescription for amphotericin B. The nurse should plan to

monitor the client for which of the following adverse effects?

Hyperkalemia

Hypertension

Constipation

Nephrotoxicity

159. A nurse is administering subcutaneous heparin to a client who is at risk for deep vein thrombosis. Which

of the following actions should the nurse take?

Administer the medication into the client's abdomen.

Inject the medication into a muscle.

Massage the site after administering the medication.

Use a 22-gauge needle to administer the medication.

160. A nurse is reviewing the laboratory results for a client who has a prescription for filgrastim. The nurse

should recognize that an increase in which of the following values indicates a therapeutic effect of this

medication?

Erythrocyte count

Neutrophil count

Lymphocyte count

Thrombocyte count

28

161. A nurse is providing teaching to a client who has ulcerative colitis and a new prescription for

sulfasalazine. The nurse should instruct the client to monitor for which of the following adverse effects of this

medication?

Jaundice

Constipation

Oral candidiasis

Sedation

162. A nurse is planning care for a client who has a seizure disorder and a new prescription for valproic acid.

Which of the following laboratory values should the nurse plan to monitor? (Select all that apply.)

BUN

PTT

Aspartate aminotransferase (AST)

Urinalysis

Alanine aminotransferase (ALT)

163. A nurse is caring for a client who has a new diagnosis of oral candidiasis after taking tetracycline for 7

days. The nurse should recognize that candidiasis is a manifestation of which of the following adverse effects?

Allergic response

Superinfection

Renal toxicity

Hepatotoxicity

164. A nurse is preparing to administer furosemide 4 mg/kg/day PO divided into 2 equal doses daily to a

toddler who weighs 22 lb. How many mg should the nurse administer per dose? (Round the answer to the

nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

40mg

STEP 1: What is the unit of measurement the nurse should calculate? kg

STEP 2: Set up an equation and solve for X.

2.2 lb/1 kg = client's weight in lb/X kg

2.2 lb/1 kg = 22 lb/X kg

X = 10 kg

STEP 3: Round if necessary.

STEP 4: Reassess to determine whether the conversion to kg makes sense. If 1 kg = 2.2 lb, it makes sense that

22 lb = 10 kg.

STEP 5: What is the unit of measurement the nurse should calculate? mg

29

STEP 6: Set up an equation and solve for X.

mg x kg / day = X

4 mg x 10 kg = 40 mg/day

STEP 7: Round if necessary.

165. A nurse is caring for a client who has a prescription for chlorothiazide to treat hypertension. The nurse

should plan to monitor the client for which of the following adverse effects?

Thrombophlebitis

Hyperactive reflexes

Muscle weakness

Hypoglycemia

166. A nurse on a medical unit is preparing to administer alendronate 40 mg PO for an older adult client who

has Paget's disease of the bone. Which of the following actions should be the nurse's priority?

Administer the medication to the client before breakfast in the morning.

Ambulate the client to a chair prior to administering the medication.

Give the medication to the client with water rather than milk.

Teach the client how to take the medication at home.

167. A nurse is caring for a client who has been taking isoniazid and rifampin for 3 weeks for the treatment of

active pulmonary tuberculosis (TB). The client reports his urine is an orange color. Which of the following

statements should the nurse make?

"Stop taking the isoniazid for 3 days and the discoloration should go away."

"Rifampin can turn body fluids orange."

"I'll make an appointment for you to see the provider this afternoon."

"Isoniazid can cause bladder irritation."

168. A nurse is preparing to administer lactated Ringer's (LR) 1,000 mL IV to infuse over 8 hr. The drop factor

of the manual IV tubing is 10 gtt/mL. The nurse should set the manual IV infusion to deliver how many

gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing

zero.)

 21 gtt/min

Ratio and Proportion and Desired Over Have

STEP 1: What is the unit of measurement the nurse should calculate? gtt/min

STEP 2: What is the volume the nurse should infuse? 1,000 mL

STEP 3: What is the total infusion time? 8 hr

30

STEP 4: Should the nurse convert the units of measurement? Yes (hr does not equal min)

1 hr/60 min = 8 hr/X min

X = 480 min

STEP 5: Set up an equation and solve for X.

Volume (mL)/Time(min) X Drop Factor (gtt/mL) = X

1,000 mL/480 min x 10 gtt/mL = X gtt/min

X = 20.833

STEP 6: Round if necessary. 20.833 = 21

169. A nurse is caring for a client who has a new prescription for enalapril. The nurse should monitor the client

for which of the following adverse effects of this medication?

Ecchymosis

Jaundice

Hypotension

Hypokalemia

170. A nurse is preparing to administer prochlorperazine 2.5 mg IV. Available is prochlorperazine injection 5

mg/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading

zero if it applies. Do not use a trailing zero.)

 0.5 mL

Ratio and Proportion

STEP 1: What is the unit of measurement the nurse should calculate? mL

STEP 2: What is the dose the nurse should administer? Dose to administer= Desired 2.5 mg

STEP 3: What is the dose available? Dose available = Have 5 mg

STEP 4: Should the nurse convert the units of measurement? No

STEP 5: What is the quantity of the dose available? 1 mL

STEP 6: Set up an equation and solve for X.

Have/Quantity = Desired/X

5 mg/1 mL = 2.5 mg/X mL

31

X = 0.5

171. A nurse is providing teaching to a newly licensed nurse about administering morphine via IV bolus to a

client. Which of the following information should the nurse include in the teaching?

Respiratory depression can occur 7 min after the morphine is administered.

The morphine will peak in 10 min.

Withhold the morphine if the client has a respiratory rate less than 16/min.

Administer the morphine over 2 min.

172. A nurse is providing teaching to a parent of a child who has asthma and a new prescription for a cromolyn

sodium metered dose inhaler. Which of the following statements by the parent indicates the need for further

teaching?

"I will give my child a dose as soon as wheezing starts."

"My child should rinse out his mouth after using the inhaler."

"My child should exhale completely before placing the inhaler in his mouth."

"If my child has difficulty breathing in the dose, a spacer can be used."

173. A nurse is preparing a discharge teaching plan for a 6-year-old client who has asthma and several

prescription medications using metered dose inhalers (MDIs). Which of the following interventions should the

nurse include in the plan?

Add a spacer to each MDI.

Instruct the child to inhale more rapidly than usual when using an MDI.

Request that the provider change the child's medications from inhaled to oral formulations.

Administer oxygen by facemask along with the MDI.

174. A nurse is administering oral hydroxyzine to a client. Which of the following adverse effects should the

nurse instruct the client to expect?

Diarrhea

Anxiety

Nausea and vomiting

Dry mouth

175. A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40 mg daily, but the

client reports that she has been taking extra doses to promote weight loss. Which of the following findings

should indicate to the nurse that the client is dehydrated?

Urine specific gravity 1.035

Distended neck veins

BUN 18 mg/dL

Bounding radial pulses

32

176. A nurse is preparing a discharge teaching plan for a client who is to begin long-term oral prednisone for

asthma. Which of the following instructions should the nurse include in the plan?

Stop taking the medication if a rash occurs.

Take the medication on an empty stomach to enhance absorption.

Schedule the medication on alternate days to decrease adverse effects.

Treat shortness of breath with an extra dose of the medication.

177. A nurse is providing teaching to a client who has hypertension and type 1 diabetes mellitus and a new

prescription for metoprolol. Which of the following statements by the client indicates an understanding of the

teaching?

"I might have difficulty recognizing when my blood sugar is low."

"I will have less risk for developing an infection while I take this medication."

"I should be concerned about losing excess weight while I take this medication."

"I could have more problems with high blood sugars while taking this medication."

178. A nurse is preparing to administer ampicillin 500 mg in 50 mL of dextrose 5% in water (D5W) to infuse

over 15 min. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should set the manual IV infusion

to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies.

Do not use a trailing zero.)

33 gtt/min

STEP 1: What is the unit of measurement the nurse should calculate? gtt/min

STEP 2: What is the quantity of the drop factor that is available? 10 gtt/min

STEP 3: What is the total infusion time? 15 min

STEP 4: What is the volume the nurse should infuse? 50 mL

STEP 5: Should the nurse convert the units of measurement? No

STEP 6: Set up an equation and solve for X.

Quantity/1 mL x Conversion (hr)/ Conversion(min) x Volume (mL)/Time (min) = X gtt/min

10 gtt/1 mL x 50 mL/15 min = X gtt/min

X = 33.3333

STEP 7: Round if necessary. 33.3333 = 33 gtt/min

179. A nurse is planning to administer epoetin alfa to a client who has chronic kidney failure. Which of the

following data should the nurse plan to review prior to administration of this medication?

Blood pressure

33

Temperature

Blood glucose levels

Total protein level

180. A nurse is planning care for a female client who has severe irritable bowel syndrome with diarrhea (IBS-D)

and a new prescription for alosetron. Which of the following interventions should the nurse include in the plan

of care?

The client must sign an agreement with the provider before beginning alosetron.

The client must stop taking alosetron if diarrhea continues 1 week after beginning the medication.

The client should expect to have a slower heart rate while taking alosetron.

The client should use a barrier birth control method because alosetron interacts with oral contraceptives.

181. A nurse is caring for a client and realizes after administering the 0900 medications that she administered

digoxin 0.25 mg PO to the client instead of the prescribed digoxin 0.125 mg PO. Which of the following actions

should the nurse take first?

Notify the provider.

Contact the nursing supervisor.

Assess the client's apical pulse.

Complete an incident report.

182. A nurse is providing discharge teaching to a client who has angina pectoris and a new prescription for

verapamil. The client tells the nurse, "My brother takes verapamil for high blood pressure. Do you think the

provider made a mistake?" Which of the following responses should the nurse make?

"Verapamil is used to treat both high blood pressure and angina."

"You should talk to your provider to make sure the prescription is correct for you."

"Are you concerned that you might have high blood pressure?"

"Your provider has prescribed verapamil so that you will not develop high blood pressure."

183. A nurse is providing discharge teaching to a client who had a kidney transplant and has a prescription for

oral cyclosporine. Which of the following statements by the client indicates an understanding of the teaching?

"I will be able to stop taking this medication 6 months after my surgery."

"I am likely to develop higher blood pressure while taking this medication."

"I am likely to lose my hair while taking this medication."

"I am taking this medication to boost my immune system."

184. A nurse is preparing to administer an IV fluid bolus of 1 L 0.9% sodium chloride over 2 hr to a client who is

dehydrated. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest

whole number. Use a leading zero if it applies. Do not use a trailing zero.)

 500 mL/hr

STEP 1: What is the unit of measurement the nurse should calculate? mL/hr

STEP 2: What is the volume the nurse should infuse? 1 L

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STEP 3: What is the total infusion time? 2 hr

STEP 4: Should the nurse convert the units of measurement? Yes (L does not equal mL)

1 L/1 L = 1,000 mL/X mL

X = 1,000 mL

STEP 5: Set up an equation and solve for X.

Volume (mL)/Time (hr) = X mL/hr

1,000 mL/2 hr = X mL/hr

X = 500

185. A nurse is providing discharge teaching to a client who has venous thrombosis and a prescription for

warfarin. Which of the following instructions should the nurse include in the teaching?

Take ibuprofen as needed for headache or other minor pains.

Carry a medic alert ID card.

Report to the laboratory weekly to have blood drawn for aPTT.

Increase intake of dark green vegetables.

186. A nurse is preparing to administer ampicillin 50 mg/kg/day PO divided into 4 equal doses for a toddler

who weighs 33 lb. Available is ampicillin 125 mg/5 mL oral solution. How many mL should the nurse

administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a

trailing zero.)

7.5 mL

STEP 1: What is the unit of measurement the nurse should calculate? mL

STEP 2: What is the dose the nurse should administer? Dose to administer = Desired 187.5 mg

STEP 3: What is the dose available? Dose available = Have 125 mg

STEP 4: Should the nurse convert the units of measurement? No

STEP 5: What is the quantity of the dose available? 5 mL

STEP 6: Set up an equation and solve for X.

Desired x Quantity/Have = X

187.5 mg x 5 mL/125 mg = X mL

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7.5 mL = X

187. A nurse is preparing to administer iron dextran IV to a client. Which of the following actions should the

nurse plan to take?

Administer a small test dose before giving the full dose.

Infuse the medication over 30 seconds.

Monitor the client closely for hypertension after the infusion.

Administer cyanocobalamin as an antidote if iron dextran toxicity occurs.

188. A nurse is caring for a client who has congestive heart failure and is taking digoxin. The client reports

nausea and refuses to eat breakfast. Which of the following actions should the nurse take first?

Encourage the client to eat the toast on the breakfast tray.

Administer an antiemetic.

Inform the client's provider.

Check the client's apical pulse.

189. A nurse is administering ciprofloxacin and phenazopyridine to a client who has a severe urinary tract

infection (UTI). The client asks why both medications are needed. Which of the following responses should the

nurse make?

"Phenazopyridine decreases adverse effects of ciprofloxacin hydrochloride."

"Combining phenazopyridine with ciprofloxacin hydrochloride shortens the course of therapy."

"The use of phenazopyridine allows for a lower dosage of ciprofloxacin hydrochloride."

"Ciprofloxacin hydrochloride treats the infection, and the phenazopyridine treats pain."

190. A nurse is providing teaching to a client who has postmenopausal osteoporosis and a new prescription for

intranasal calcitonin-salmon. Which of the following statements by the client indicates an understanding of

the teaching?

"I will administer a spray into each nostril daily."

"I should expect nasal bleeding for the first week."

"I will need to depress the side arms to activate the pump."

"I should expect to take this medication for a short-term course of treatment."

191. A nurse is caring for a client who has heart failure and is taking oral furosemide 40 mg daily. For which of

the following adverse effects should the client be taught to monitor and notify the provider if it occurs?

Nasal congestion

Tremors

Tinnitus

Frontal headache

192. A nurse is teaching a client who has chronic stable angina pectoris and a prescription for sublingual

nitroglycerin tablets. Identify the sequence of instructions that the nurse should tell the client to use if he

experiences chest pain. (Move the steps into the box on the right, placing them in the selected order of

performance. Use all the steps.)

36

3 Wait 5 min.

1 Stop activity.

4 Call 911 if the pain is not relieved.

2 Place a tablet under the tongue.

193. A hospice nurse is caring for a client who has cancer and is taking naproxen 250 mg three times daily PO

and gabapentin 1,800 mg three times daily PO to manage pain. The client tells the nurse, "I'm having pain that

keeps me from doing what I'd like most of the time." Which of the following additions should the nurse

anticipate to the client's medication regimen?

Oral meperidine

Parenteral naloxone

Parenteral diazepam

Oral oxycodone

194. A nurse is planning to administer diphenhydramine 50 mg via IV bolus to a client who is having an allergic

reaction. The client has an IV infusion containing a medication that is incompatible with diphenhydramine in

solution. Which of the following actions should the nurse take?

Choose an IV port for IV bolus injection of the diphenhydramine as near as possible to the client's hanging IV

bag.

Flush the IV tubing with 2 mL of 0.9% sodium chloride before and after administering diphenhydramine.

Allow the IV infusion to keep running while administering the diphenhydramine via IV bolus.

Aspirate to check for IV patency before administering the diphenhydramine.

195. A nurse is providing teaching to a client who has heart failure and is taking spironolactone. Which of the

following statements by the client indicates an understanding of the teaching?

"I will increase my intake of citrus fruits, bananas, and potatoes."

"I will use salt substitutes on my food."

"I will drink as much water as I can while taking this medication."

"I will watch for increased breast tissue growth while taking this medication."

196. A nurse is providing teaching to a client who has type 2 diabetes mellitus and a new prescription for

metformin. Which of the following adverse effects of metformin should the nurse instruct the client to watch

for and report to the provider?

Weight gain

Myalgia

Hypoglycemia

Severe constipation

197. A nurse is assessing a client who reports using several herbal and vitamin supplements daily, including

saw palmetto. The nurse should recognize that saw palmetto is a supplement used by clients to elicit which of

the following therapeutic effects?

Urinary health promotion

Immune system stimulation

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Decreased leg pain from arterial disease

Prevention of nausea caused by motion sickness

198. A nurse is caring for a client who is in preterm labor and has a new prescription for nifedipine. The client

states she is concerned because her father takes nifedipine for his angina pectoris. The nurse should explain to

the client that nifedipine works for clients who are pregnant by which of the following mechanisms?

It decreases the incidence of bacterial vaginosis, thus preventing uterine contractions.

It inhibits uterine contractions by blocking entry of calcium into uterine cells.

It decreases the activity within the CNS, which regulates all smooth muscle.

It stimulates beta2 receptors in the uterus, which results in decreased frequency of contractions.

199. A nurse is assessing a client who takes oral theophylline for relief of chronic bronchitis. The nurse should

recognize that which of the following findings indicates toxicity to theophylline?

Constipation

Tremors

Fatigue

Bradycardia

200. A nurse is caring for a client who was brought to the emergency department by friends who report the

client has overdosed on heroin. Which of the following findings should the nurse expect to assess?

Temperature 39.2° C (102.6° F)

Respiratory rate 30/min

Pinpoint pupils

Severe abdominal cramping

201. A nurse is providing discharge teaching to a client who has been hospitalized for major depressive

disorder and has a prescription for amitriptyline. Which of the following statements by the client indicates an

understanding of the teaching?

"I will take amitriptyline in the morning because I'm likely to have trouble falling asleep if I take it in the

evening."

"I will move slowly when I stand up because amitriptyline can cause my blood pressure to decrease."

"I can drink a glass of beer or wine with my evening meal because amitriptyline doesn't interact with alcohol."

"I will avoid foods high in fiber because amitriptyline can cause diarrhea."

202. A nurse is providing teaching to a client who is to start taking hydrochlorothiazide for hypertension. The

nurse instructs the client to eat foods rich in potassium. Which of the following statements by the client

indicates an understanding of the teaching?

"This medication will not work unless I have enough potassium."

"Potassium will increase the therapeutic effect of my blood pressure medication."

"Potassium will lower my blood pressure."

"This medication can cause a loss of potassium."

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203. A nurse is administering adenosine via IV bolus for a client who has developed paroxysmal atrial

tachycardia. For which of the following findings should the nurse assess the client during administration of

adenosine?

Seizures

Cinchonism

Dyspnea

Transient pallor of the face

204. A nurse is planning discharge teaching for a client who has major depressive disorder and a new

prescription for phenelzine. Which of the following foods should the nurse include in the plan as safe for the

client to consume while taking phenelzine?

Broiled beef steak

Macaroni and cheese

Pepperoni pizza

Smoked salmon

205. A nurse is caring for a client who has alcohol use disorder and is admitted with lower extremity fractures

following a motor-vehicle crash. A few hours after admission, the client develops restlessness and tremors.

Which of the following medications should the nurse anticipate administering to the client first?

Acamprosate

Naltrexone

Chlordiazepoxide

Disulfiram

206. A nurse is administering insulin glulisine 10 units subcutaneously at 0730 to an adolescent client who has

type 1 diabetes mellitus. The nurse should anticipate onset of action of the insulin at which of the following

times?

0800

0745

0900

1030

207. A nurse is providing teaching to the parents of a school-age child who has asthma about medications for

bronchospasm. Which of the following inhaled medications should the nurse instruct the parents to use to

relieve an acute asthma attack?

Salmeterol

Cromolyn

Fluticasone

Albuterol

208. A nurse is preparing to administer oxytocin to a client who is at 41 weeks of gestation and is experiencing

ineffective labor. Which of the following actions should the nurse plan to take?

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Place the oxytocin from a pre-filled syringe into the posterior fornix of the vagina every 10 min until effective

labor occurs.

Check the client's blood pressure and pulse every 15 min while induction of labor is occurring.

Stop the oxytocin for contractions that continue longer than 30 seconds.

Increase the dose of oxytocin to obtain uterine contractions that occur every 2 to 3 min.

209. A nurse is providing discharge teaching to a client who has heart failure and a prescription for digoxin

0.125 mg PO daily and furosemide 20 mg PO daily. Which of the following statements by the client indicates

an understanding of the teaching?

"I know that blurred vision is something I will expect to happen while taking digoxin."

"I will measure my urine output each day and document it in my diary."

"I will skip a dose of my digoxin if my resting heart rate is below 72 beats per minute."

"I will eat fruits and vegetables that have high potassium content every day."

210. A nurse is caring for a client who has a positive tuberculin skin test and is beginning a prescription for

isoniazid. The nurse should teach the client that which of the following laboratory values should be monitored

while taking isoniazid?

Thyroid Stimulating Hormone level (TSH)

Aspartate aminotransferase (AST)

Potassium

Sodium

211. A nurse is planning to administer diltiazem via IV bolus to a client who has atrial fibrillation. When

assessing the client, the nurse should recognize that which of the following findings is a contraindication to

administration of diltiazem?

Hypotension

Tachycardia

Decreased level of consciousness

History of diuretic u se

212. A nurse is preparing to administer chlorothiazide 20 mg/kg/day PO divided equally and administered

twice daily for a toddler who weighs 28.6 lb. The amount available is chlorothiazide oral suspension 250 mg/5

mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a

leading zero if it applies. Do not use a trailing zero.)

 2.6 mL

STEP 1: What is the unit of measurement the nurse should calculate? kg

STEP 2: Set up an equation and solve for X.

2.2 lb/1 kg = Client's weight in lb/X kg

2.2 lb/1 kg = 28.6 lb/X kg

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X = 13 kg

STEP 3: Round if necessary.

STEP 4: Reassess to determine whether the conversion to kg makes sense. If 1 kg = 2.2 lb, it makes sense that

28.6 lb = 13 kg.

STEP 5: What is the unit of measurement the nurse should calculate? mg

STEP 6: Set up an equation and solve for X.

mg x kg/day = X

20 mg x 13 kg = 260 mg/day

STEP 7: Round if necessary.

213. A nurse is preparing to administer dextrose 5% in 0.45% sodium chloride 400 mL IV to an older adult

client over 8 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the

nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

 50 mL/hr

STEP 1: What is the unit of measurement the nurse should calculate? mL/hr

STEP 2: What is the volume the nurse should infuse? 400 mL

STEP 3: What is the total infusion time? 8 hr

STEP 4: Should the nurse convert the units of measurement? No

STEP 5: Set up an equation and solve for X.

Volume (mL)/Time (hr) = X mL/hr

400 mL/8 hr = X mL/hr

X = 50 mL/hr

214. A nurse is assessing a client who has hypothyroidism and takes levothyroxine. Which of the following

findings should alert the nurse that the client is experiencing acute levothyroxine overdose?

Bradycardia

Cold intolerance

Tremor

Hypothermia

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215. A nurse is providing discharge teaching about lithium toxicity to a client who has a new prescription for

lithium. Which of the following statements by the client indicates an understanding of the teaching?

"I should take naproxen if I have a headache because aspirin can cause lithium toxicity."

"I can develop lithium toxicity if I eat foods with lots of sodium."

"I can develop lithium toxicity if I experience vomiting or diarrhea."

"I might need to take a daily diuretic along with my lithium to prevent lithium toxicity."

216. A nurse is preparing to administer heparin 900 units/hr via IV infusion. The amount available is heparin

25,000 units in 500 mL 5% dextrose in water. The nurse should set the IV pump to deliver how many mL/hr?

(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

18 mL/hr

STEP 1: What is the unit of measurement the nurse should calculate? mL/hr

STEP 2: What is the dose the nurse should administer? Dose to administer = Desired 900 units/hr

STEP 3: What is the dose available? Dose available = Have 25,000 units

STEP 4: Should the nurse convert the units of measurement? No

STEP 5: What is the quantity of the dose available? 500 mL

STEP 6: Set up an equation and solve for X.

Desired x Quantity/Have = X

900 units/hr x 500 mL/25,000 units = X mL/hr

18 mL/hr = X

217. A nurse is monitoring laboratory values for a male client who has leukemia and is receiving weekly

chemotherapy with methotrexate via IV infusion. Which of the following laboratory values should the nurse

report to the provider?

BUN 18 mg/dL

Platelets 78,000/mm3

Hemoglobin 14.2 g/dL

Aspartate aminotransferase (AST) 35 units/L

218. A nurse is providing discharge teaching to a client who had a bleeding duodenal ulcer and is prescribed

omeprazole. Which of the following statements should the nurse include in the teaching?

"You will need to take this medication for the next 6 months."

"Taking this medication will decrease your risk for acquiring pneumonia."

"You should take this medication before breakfast every day."

"Watch for the serious adverse effects of tachycardia and heart palpitations while taking this medication."

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219. A nurse is preparing to administer digoxin 0.2 mg via IV bolus to a client. The amount available is digoxin

0.25 mg/1 mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a

leading zero if it applies. Do not use a trailing zero.)

0.8 mL

STEP 1: What is the unit of measurement the nurse should calculate? mL

STEP 2: What is the dose the nurse should administer? Dose to administer = Desired. 0.2 mg

STEP 3: What is the dose available? Dose available = Have. 0.25 mg

STEP 4: Should the nurse convert the units of measurement? No

STEP 5: What is the quantity of the dose available? 1 mL

STEP 6: Set up an equation and solve for X.

Desired x Quantity/Have = X

0.2 mg x 1 mL/0.25 mg = X mL

0.8 mL = X

220. A nurse is providing teaching to a client who has hypertension and a new prescription for oral clonidine.

Which of the following instructions should the nurse include in the teaching?

Discontinue the medication if a rash develops.

Expect increased salivation during the first few weeks of therapy.

Minimize fiber intake to prevent diarrhea.

Avoid driving until the client's reaction to the medication is known.

221. A nurse is preparing to administer codeine 30 mg PO every 4 hr PRN to a client for pain. The amount

available is codeine oral solution 15 mg/5 mL. How many mL should the nurse plan to administer per dose?

(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

10 mL

STEP 1: What is the unit of measurement the nurse should calculate? mL

STEP 2: What is the dose the nurse should administer? Dose to administer = Desired 30 mg

STEP 3: What is the dose available? Dose available = Have 15 mg

STEP 4: Should the nurse convert the units of measurement? No

STEP 5: What is the quantity of the dose available? 5 mL

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STEP 6: Set up an equation and solve for X.

Desired x Quantity/Have = X

30 mg x 5 mL/15 mg = X mL

10 mL = X

222. A home health nurse is visiting an older adult client who has Alzheimer's disease. His caregiver tells the

nurse she has been administering prescribed lorazepam, 1 mg three times per day, to the client for

restlessness and anxiety during the past few days. For which of the following adverse effects should the nurse

assess the client?

Low-grade fever

Sedation

Diuresis

Tonic-clonic seizures

A nurse is teaching a client who has a new prescription for beclomethasone. Which of the following

instructions should the nurse include?

"Rinse your mouth out after each use of this medication"

A nurse is providing instructions to a client who has a new prescription for albuteroll and beclomethasone

inhalers for the control of asthma. Which of the following instructions should the nurse include in the

teaching?

A. Take the albuterol at the same time each day.

B. Administer the albuterol inhaler prior to using the beclomethasone inhaler.

C. Use beclomethasone if experiencing an acute episode.

D. Avoid shaking the beclomethasone before use

A nurse is providing instructions to a client who has a new prescription for albuterol, PO. Which of the

following instructions should the nurse include?

A. "You can take this medication to abort an acute asthma attack."

B. "Tremors are an adverse effect of this medication."

C. "Prolonged use of this medication can cause hyperglycemia."

D. "This medication can slow skeletal growth rate."

A nurse is teaching a client who has a prescription for long-term use of oral prednisone for treatment of

chronic asthma. The nurse should instruct the client to monitor for which of the following manifestations as

an adverse effect of this medication?

A. Weight gain

B. Nervousness

C. Bradycardia

D. Constipation

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A nurse is caring for a client who has been taking phenylephrine nasal drops for the past 10 days for sinusitis.

The nurse should assess the client for which of the following manifestations as an adverse effect of this

medication?

A. Sedation

B. Nasal congestion.

C. Productive cough

D. Constipation

A nurse is teaching a client who has a new prescription for dextromethorphan to suppress a cough. The nurse

should instruct the client to monitor for which of the following manifestations as an adverse effect of this

medication?

A. Diarrhea

B. Anxiety

C. Sedation

D. Palpitations

A nurse is teaching the family of a child who has cystic fibrosis and a new prescription for acetylcysteine.

Which of the following information should the nurse include in the instructions?

A. "Expect this medication to suppress your child's cough."

B. "Expect this medication to smell like rotten eggs."

C. "Expect this medication to cause euphoria."

D. "Expect this medication to turn your child's urine orange."

A nurse is teaching a client who has a new prescription for diphenhydramine for allergic rhinitis. The nurse

should instruct the client to monitor for which of the following manifestations as an adverse effect of this

medication? (Select all that apply.)

A. Dry mouth

B. Nonproductive cough

C. Skin rash

D. Drowsiness

E. Urinary hesitation

A nurse is teaching a client about the use of fluticasone to treat perennial rhinitis. Which of the following

statements by the client indicates an understanding of the teaching?

A. "I should use the spray every 4 hours while I am awake."

B. "It can take as long as 3 weeks before the medication takes a maximum effect."

C. "This medication can also be used to treat motion sickness."

D. "I can use this medication when my nasal passages are blocked."

A nurse is implementing a plan of care for a client who has a wound infection. Which of the following actions

is the nurse's priority?

A. Administer antibiotic medication.

45

B. Obtain a wound specimen for culture.

C. Monitor the client for a superinfection.

D. Teach the client about wound care.

A nurse is teaching a client who has manifestations of a urinary tract infection. The nurse should instruct the

client that which of the following tests is needed to determine which microorganism is causing the infection?

A. Blood WBC

B. Blood creatinine

C. Urine culture

D. Urine specific gravity

A nurse is teaching a group of nurses about antimicrobial therapy. The nurse should that effective penetration

of antibiotics can be impeded by which of the following conditions? struct

A. Meningitis dh

B. An infected abscess

C. Endocarditis

D. Pneumonia

E. Pyelonephritis

A nurse is caring for a group of clients who are receiving antimicrobial therapy. The nurse should identify that

which of the following clients is at risk for medication toxicity?

A. A young adult client who has a sinus infection

B. An older adult client who has prostatitis

C. A client who is postpartum and has mastitis

D. A middle adult client who has a urinary tract infection

A nurse is teaching a group of nurses about the importance of prophylactic antimicrobial therapy. Which of

the following information should the nurse include in the teaching? (Select all that apply.)

A. Administer prophylactic antimicrobial therapy to clients who report exposure to a sexually transmitted

infection.

B. Administer prophylactic antimicrobial therapy to clients who are having orthopedic surgery.

C. Instruct clients who have a prosthetic heart valve about the need for prophylactic antimicrobial therapy

before dental work.

D. Consult the provider for prophylactic antimicrobial therapy for clients who have recurrent urinary tract

infections.

E. Instruct clients to request prophylactic antimicrobial therapy immediately when they have an upper

respiratory infection.

A nurse is preparing to administer nafcillin IM to an adult client who has an infection. Which of the following

actions should the nurse plan to take? (Select all that apply.)

A. Select a 25-gauge, ½-inch needle for the injection.

B. Administer the medication deeply into the ventrogluteal muscle.

C. Ask the client about an allergy to penicillin before administering the medication.

46

D. Monitor the client for 30 min following the injection.

E. Tell the client to expect a temporary rash to develop following the injection.

A nurse is assessing a client who has a severe infection and has been receiving cefotaxime for the past week.

Which of the following findings indicates potentially serious adverse reaction to this medication that the nurse

should report to the provider?

A. Diaphoresis

B. Epistaxis

C. Diarrhea

D. Alopecia

A nurse is obtaining a medication history from a client who is to receive imipenem-cilastatin IV to treat an

infection. Which of the following medications the client also receives increases the risk for a medication

interaction?

A. Regular insulin

B. Furosemide

C. Valproic acid

D. Ferrous sulfate

A nurse is caring for a client who has a cerebrospinal fluid infection with gram-negative bacteria. Which of the

following cephalosporin antibiotics should the nurse expect to administer IV to treat this infection?

A. Cefaclor

B. Cefazolin

C. Cefepime

D. Cephalexin

A nurse is preparing to administer penicillin V to a client who has a streptococcal infection. The client reports

difficulty swallowing tablets and doesn't "do well" with liquid or chewable medications because of the taste,

even when the nurse mixes the medication with food. The nurse should request a prescription for which of

the following medications?

A. Fosfomycin

B. Amoxicillin

C. Nafcillin

D. Cefaclor

A nurse is teaching a client about taking tetracycline to treat a Gl infection due to Helicobacter pylori. Which

of the following statements should the nurse identify as an indication that the client understands the

instructions?

A. "I will take this medication with 8 ounces of milk."

B. "I will let my doctor know if I start having diarrhea."

C. "I can stop taking this medication when I feel completely well."

D. "I can take this medication just before bedtime."

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A nurse is administering gentamicin by IV infusion at 0900. The medication will take 1 hr to infuse. When

should the nurse plan to obtain a blood sample for a peak blood level of gentamicin?

A. 1000

B. 1030

C. 1100

D. 1130

A nurse is caring for a client who is starting a course of gentamicin IV for a serious respiratory infection. For

which of the following manifestations should the nurse monitor as an adverse effect of this medication?

(Select all that apply.)

A. Pruritus

B. Hematuria

C. Muscle weakness

D. Difficulty swallowing

E. Vertigo

A nurse is caring for a client who has subacute bacterial endocarditis and is receiving several antibiotics,

including streptomycin IM. For which of the following manifestations should the nurse monitor as an adverse

effect of this medication?

A. Ataxia

B. Urinary retention

C. Constipation

D. Complex partial seizures

A nurse is caring for a client who is undergoing preparation for extensive colorectal surgery. Which of the

following oral antibiotics should the nurse expect to administer specifically to suppress normal flora in the Gl

tract?

A. Kanamycin

B. Gentamicin

C. Neomycin

D. Tobramycin