A patient newly diagnosed with hypothyroidism is prescribed Levothyroxine (Synthroid) 0.25 mg PO daily. After 6 weeks of treatment the nurse determines that the medication was effective if the:
1) Thyroid stimulating hormone (TSH) level is 2 microunits/mL
2) Total t4 level is 2 mcg/dL
1) Thyroid stimulating hormone (TSH) level is 2 microunits/mL
A nurse providing teaching to a client who has just been prescribed prazosin (Minipress) which of the following client statement indicates understanding of teaching:
1) I will not use a salt substitute while taking meds
2) I will move slowly from sitting to standing to prevent falls
2) I will move slowly from sitting to standing to prevent falls
A nurse is providing teaching to a patient who is prescribed phenytoin (Dilantin). Which statement by the patient indicates further teaching:
1) I should expect a rash to develop
2) I may develop hair or face or chest
1) I should expect a rash to develop
A nurse is receiving a telephone prescription for an antibiotic from a client’s provider. Which of the following is the nurse required to do:
3) Read the prescription back to the provider after transcribing
4) Write the trade name for the prescribed medicine
3) Read the prescription back to the provider after transcribing
A nurse is providing teaching to an adolescent and her family regarding a new prescription of phenytoin (Dilantin) for a newly diagnosed seizure disorder. Which of the following client statements indicates the understanding of the teaching:
1) I will keep a seizure frequency chart
2) I will skip a dose if I am experiencing nausea
1) I will keep a seizure frequency chart
A nurse is caring for a client who has heart failure and is receiving furosemide (Lasix) and digoxin (Lanoxin). Routine laboratory results reveal a potassium level of 2.6 mEq/L. Which of the following actions should the nurse take first:
1) Apply a cardiac monitor
2) Provides foods high in potassium
1) Apply a cardiac monitor
A nurse administers ceftazidime (Fortaz) to a client who has a severe penicillin allergy. Which of the following client findings requires an incident report:
1) The client is also taking linsinophrel (Prinivil)
2) The client reports shortness of breath
2) The client reports shortness of breath
A nurse is providing teaching to a female client who has been newly diagnosed with a seizure disorder and has begun phenytoin (Dilantin). The nurse should tell the client that phenytoin can decrease the effectiveness of which of the following:
1) Ethunyl estradiol/desogestrel (Cyclessa)
2) Fluroxetine (Prozac)
1) Ethunyl estradiol/desogestrel (Cyclessa)
A nurse providing teaching to a client who is diagnosed with migrane headaches. The client is prescribed ergotamine (Ergostat) sublingual (SL). Which of the following should the nurse include in her instructions:
1) Take 1SL tablet three times a day before meals
2) Take 1SL tablet at onset of migrane
2) Take 1SL tablet at onset of migrane
A nurse is reviewing a client’s daily laboratory findings before administering 0.125 mg of digoxin (Lanoxin). The client’s serum digoxin level is 0.7 mg/mL. Which of the following actions should the nurse take:
1) Give the medication
2) Request a dose increase
1) Give the medication
A nurse is planning to provide medication education for a client who will begin a course of therapy with metronidazole (Flagyl). Which of the following should the nurse instruct the client to avoid during the course of therapy:
3) Coffee
4) Beer
4) Beer
A nurse is teaching a client who has heart failure about a new prescription for captopril (Capoten). Which of the following statements by the client indicates a need for further teaching:
3) I will take the medication 1 hr before my meals
4) I will use a salt substitute with my meals
4) I will use a salt substitute with my meals
A client is experiencing acute angle closure glaucoma and IV mannitol (Osmitrol) 25% is prescribed. Which of the following client findings should the nurse recognize as being the best indication that the medication is achieving it’s therapeutic effect:
3) Decrease in intraocular pressure
4) Lung fluids clear to auscultation
3) Decrease in intraocular pressure
A nurse is educating a client who has a new prescription for simvastatin (Zacor). Which of the following instructions should the nurse include in the teaching plan: (Select all that apply):
1) Report muscle pain to provider
2) Do not take the medication with grapefruit juice
3) Take the medication in the early morning
4) Minimize intake of alcoholic beverages
5) Expect therapy with this medication to be life long
1) Report muscle pain to provider
2) Do not take the medication with grapefruit juice
4) Minimize intake of alcoholic beverages
5) Expect therapy with this medication to be life long
A client taking IV heparin and oral warfarin (coumadin) for deep thrombosis. The client aPTT is 4x the normal value and his INR is 2. Which of the following actions should the nurse plan to take:
1) Decrease the heparin
2) Increase the warfarin
1) Decrease the heparin
The nurse is caring for a client who is in labor. The client is receiving oxytocin (pitocin) by continuous IV infusion, piggy backed into a maintenance IV solution. The external FHR monitor indicates late decelerations. Which of the following actions should the nurse take first:
1) Turn the client to side lying position
2) Discontinue the client’s IV meds
2) Discontinue the client’s IV meds
A nurse is providing teaching to a client taking bupropion (Zyban) as an aid to quit smoking. For which of the following side effects should the nurse assess the client:
3) Insomnia
4) Tinnitus
3) Insomnia
A nurse is teaching a client about the use of risedronate (Actonel) to treat osteoporosis. Which of the following client statements indicates a need for further teaching:
3) I need to set up or stand after taking the risedronate
4) I need to take the risedronate with food
4) I need to take the risedronate with food
A nurse is caring for a client who is receiving haloperidol (Haldol). For which of the following adverse effects should the nurse be observing:
1) Vomiting
2) Akathesia
2) Akathesia
A nurse is caring for a client who is receiving oprelvekin (Interleukin ll). which should the nurse document to indicate the effectiveness of the therapy:
1) Increased platelet count
2) Increased RBC count
1) Increased platelet count
A nurse is administering baclofen (Lioresal) for a client with a spinal cord injury. Which of the following should the nurse document as a therapeutic outcome:
1) Increase in seizure threshold
2) Decrease flexor & extension spasticity
2) Decrease flexor & extension spasticity
A nurse is assessing a client who is receiving epoetin alfa (Procit) to treat anemia. For which should the nurse monitor related to this medication:
1) Paresthesias
2) Increased BP
2) Increased BP
A nurse is planning teaching for a client who has depression and is to start a new prescription for tranylcypromine (Parnate). Which should be included in teaching:
1) Avoid eating citrus fruits while taking this medication
2) Move slowly when changing to a standing position
2) Move slowly when changing to a standing position
Provide teaching new prescription: exenatide (Byetta) for Type 2 Diabetes. What should the nurse monitor and report:
1) Abdominal pain
2) Increased thirst
1) Abdominal pain
A nurse is reviewing lab results, for a patient who has chronic asthma and is taking prednisone (Deltasome) every other day. Which of the following lab values should the nurse report to the doctor:
3) Blood glucose 200 mg/dL
4) BUN 14 mg/dL
3) Blood glucose 200 mg/dL
A nurse is caring for a client receiving zidovudine (Retrovir) for which of the following lab results should the nurse prepare to monitor:
3) Serum creatine
4) Hemoglobin
4) Hemoglobin
A client informs the nurse at the primary care providers office that he received a prescription for timolol (timoptic) to treat glaucoma. Which of the following in the client’s history should concern you:
3) The client has a history of bradycardia
4) The client reports that he is taking loratadine (Claritan)
3) The client has a history of bradycardia
A mom of a newborn asks the nurse when her newborn should receive his 1st diptheria, tetanus, and pertusis vaccine (DTAP). Which of the following should the nurse say:
1) Birth
2) 2 months
2) 2 months
A nurse is preparing to administer warfarin (coumadin) to a client diagnosed with atrial fibrillation. Which action should the nurse take before administering warfarin:
1) Check INR results
2) Monitor the aPTT level
1) Check INR results
A nurse caring for a client diagnosed with sickle cell anemia who is taking hydroxyurea (Droxia). Which findings should the nurse report- select all that apply:
1) hemoglobin 4.2 g/dL
2) Hematocrit 42%
3) RBC 4,700,000/ mm3
4) Platelets 75,000/mm3
5) Neutrophils 1,400 /mm3
1) hemoglobin 4.2 g/dL
4) Platelets 75,000/mm3
5) Neutrophils 1,400 /mm3
A nurse assesses a patient with chronic back pain who is receiving 650 mg acetaminophen (Tylenol) every 4 hours for pain. PCP has prescribed oxycodone/acetaminophen (Percocet) every 4 to 6 hours PRN for breakthrough pain. Which action should the nurse take:
3) Place the client on seizure precautions
4) Notify the PCP
4) Notify the PCP
A nurse is teaching a patient who has a peptic ulcer disease and is to start a new prescription for sucralfate (Carafate). The nurse explains to the patient this medication:
3) Forms a protective barriers over ulcers
4) Treats ulcers by eradicating H. pylor
3) Forms a protective barriers over ulcers
Which of the following statements made by a client after a teaching session about Warfarin (Coumadin) indicates a need for further teaching:
1) I may take aspirin as needed for pain
2) I should limit the amount of green, leafy vegetables
1) I may take aspirin as needed for pain
A nurse is caring for a patient who has pneumonia. The patient tells the nurse that she is pregnant, but has not told her provider. Which of the following medication orders should the nurse question:
1) Acetaminophen (Tylenol)
2) Doxycycline (Doxycin)
2) Doxycycline (Doxycin)
A nurse is providing teaching to a patient who has hypertension and is to start a new prescription for lisinopril (Zestril). For which of the following should the nurse instruct the client to monitor and report to the PCP:
3) Facial Flushing
4) Dry cough
4) Dry cough
A nurse caring for the following patient with acute ST elevation myocardial infarction. The patient is receiving nitroglycerin (Nitro-bid IV) by continuous IV infusion to maintain a systolic blood pressure between 130-150 mmHg:
1) Increase the dose when the Systolic BP is 120 mmHg
2) Increase the dose when the Systolic BP is 160 mmHg
2) Increase the dose when the Systolic BP is 160 mmHg
Older adult taking procainamide (Pronestyl) is admitted to ER with an acute myocardial infarction and ventricular premature beats. Which finding should indicate to the nurse to withhold medication and notify PCP:
1) Drowsiness
2) A QRS widening increase than 50%
2) A QRS widening increase than 50%
A nurse is caring for a client who is taking tamoxifen (Nolvadex) for treatment of breast cancer. The nurse should inform the client that which of the side effects can develop:(Select all that apply)
1) Bradycardia
2) Menstrual irregularities
3) Petechia
4) Hot flashes
5) Vaginal discharge
2) Menstrual irregularities
4) Hot flashes
5) Vaginal discharge
A nurse is providing teaching to a patient with chronic asthma, is prescribed beclomethsdone (QVAR). What instructions should be included in the nursing care plan:
1) Use inhaler as soon as asthma attack begins
2) Take extra Vitamin B & C when using medication
1) Use inhaler as soon as asthma attack begins
A client with history of hypertension tells the nurse that he uses over-the counter oral decongestant for nasal congestion. The nurse should advise client that decongestions?
3) Can constrict blood vessels
4) Are less effective than antihistamines
3) Can constrict blood vessels
A nurse is providing teaching for a patient with acute cystitis and is prescribed phenazopyridine HCL (Pyridium). Which side effect will be normal for the patient to see:
1) Urine will turn red-orange color
2) A mild fever
1) Urine will turn red-orange color
A patient has been prescribed trimethoprim/sulfamethoxazole (Bactrum DS). Which of the following should the nurse report:
3) Photosensitivity
4) Vesicular, crusty rash
4) Vesicular, crusty rash
A client has been taking propylthiouracil (PTU) for 4 weeks- what should an outcome be:
3) Decrease heart rate
4) Increase body temp
3) Decrease heart rate
A nurse instructing on appropriate placement of the client’s nitroglycerin transdermal patch (Minitran) understands teaching with this statement:
1) I should apply the patch to an area of body with minimal fat tissue
2) I will take the patch off right after my evening meal
2) I will take the patch off right after my evening meal
A nurse is to administer a new prescription for amoxicillin/clavulanic acid (Augmentin) IV bolus. The client tells the nurse allergy to penicillin. Which should be done first:
3) Withhold the medication
4) Inform the pharmacist of allergy to penicillin
3) Withhold the medication
A nurse providing discharge teaching for patient has a prescription for morphine. The nurse should:
3) Increase fiber intake
4) Increase dosage to relieve pain
3) Increase fiber intake
A nurse is monitoring a patient who has been prescribed amphoterian B (Fungizone) intermittent IV bolus for histoplasmosis. What adverse effects should you notify PCP:
1) Bradycardia
2) Fever
2) Fever
A patient has been receiving aspirin for treatment of arthritis. Which symptom should indicate the client beginning to exhibit salicylism:
3) Excessive bruising
4) Tinnitus
4) Tinnitus
A nurse is caring for a patient who has cancer and is experiencing breakthrough pain every 6 to 8 hours. The client report pain level of 8 on a scale of 0 to 10. Which of the following analgesics should the nurse anticipate administering:
3) Celecoxib (Celebrax)
4) Hydromorpine (Dilaudid)
4) Hydromorpine (Dilaudid)
A nurse is caring for a school age child prescribed methylphenidate (Ritalin) for ADHD. The nurse has initiated interventions to minimize adverse effects. Which of the following indicates a successful intervention:
1) Increase BP
2) Maintains age- appropriate weight
2) Maintains age- appropriate weight
A nurse is instructing a client who experiences migraines and is starting oral sumatriptan (Imitrex) therapy. Which of the following should the nurse include in teaching:
1) Take the medication 1x daily to prevent migrane attacks
2) Use the medication as soon as migrane symptoms appear
2) Use the medication as soon as migrane symptoms appear
Nurse caring for postoperative patient with PCA of morphine sulfate. The nurse assesses a respiratory rate of 10/ min and is unable to arouse the patient with verbal or tactile stimulation. Which of the following actions should the nurse first take:
3) Administer naloxone (Narcan) IV to the client
4) Notify the primary of the findings
3) Administer naloxone (Narcan) IV to the client
A patient diagnosed with acute bronchitis is beginning a short course of prednisone (Deltasone) therapy. The patient asks the nurse to give him the required vaccinations because he is joining the peace corp. The nurse appropriately responds by stating, “You should”:
1) Wait until you have completed your medication therapy before receiving the vaccinations
2) Wait until after you have taken this medication for a few days
1) Wait until you have completed your medication therapy before receiving the vaccinations
A nurse is providing teaching to a client regarding the administration of ferrous sulfate (Feosol). Which of the following instructions should the nurse include in her teaching:
3) Take the tablet on an empty stomach
4) Call your provider if you begin to bruise easily
3) Take the tablet on an empty stomach
A nurse is providing teaching to a client who has a new prescription for phenytoin (Dilantin). Which of the following statements by the client indicates an understanding of the teaching:
3) I should let my dentist know that I’m taking this medication
4) I should expect to experience some unusual type movement when taking Dilantin
3) I should let my dentist know that I’m taking this medication
A nurse is caring for an older adult patient who is taking ranitidine (Zantac) for GERD. For which of the following findings should the client be instructed to monitor and report to provider:
3) Clay colored stools
4) Green sputum
4) Green sputum
A nurse is assessing a patient who is taking oral contraceptives. Which of the following medications will interfere with the effectiveness of the oral contraceptives:
1) Warfarin (Coumadin)
2) carbamazepine (Tegretol)
2) carbamazepine (Tegretol)
A nurse is teaching a patient with tuberculosis about the adverse effects of isoniazid (INH). The nurse restricts the client to notify the PCP immediately if which of the following occurs:
3) Yellowish skin tones
4) Headache
3) Yellowish skin tones
A nurse is reinforcing teaching to a 17 year old female patient who has severe acne regarding the use of isotretinoin (Accutane). Which of the following side effects is the priority side effect to report to the PCP:
3) Back pain
4) Feelings of isolation
4) Feelings of isolation
A nurse caring for a client who was admitted to the hospital with congestive heart failure (CHF) and is taking digoxin (Lanoxin) 0.25 mg daily .he patient refused breakfast and is complaining of nausea and generalized weakness. Which of the following actions should the nurse perform 1st:
1) Check the patient’s vital signs
2) Request a dietitian consult
1) Check the patient’s vital signs
A nurse is caring for a patient who is hospitalized with active pulmonary tuberculosis and is to be started on ethambutol (myambutol) therapy. The nurse should understand that which of the following should be monitored:
1) Visual Activity
2) Skin color
1) Visual Activity
A clinic nurse is giving instructions to a mother on the proper technique of applying ointment to her pre-school-age child. Who has conjunctivitis. Which should the nurse include in the instructions:
3) Discard the first bead of ointment before each application
4) Instruct your client to squeeze his eyes shut following application
3) Discard the first bead of ointment before each application
A nurse enters an older adult patient’s room to insert a saline lock. The client ask the nurse, ‘Why do need that, I am drinking plenty of fluids?” Which of the following responses by the nurse is appropriate?”
3) We give all our medications IV in this unit
4) The provider has prescribed antibiotics therapy to be administered IV every 6 hours
4) The provider has prescribed antibiotics therapy to be administered IV every 6 hours
A nurse is caring for a patient who has erectile dysfunction and is interested in taking sildenafel (Viagra). The nurse informs the patient that sildenfil is contraindicated due to the fact that the client also takes which one of the following medications:
1) Isosorbide (Isordel)
2) Phenytoin (Dilatin)
1) Isosorbide (Isordel)
A nurse reported to the nurse manager that another staff member was observed signing out meperidine hydrochloride (Demerol), which was not administered to the patient. The nurse manager should know that potential opiate abuse by the employees may be manifested by which of the following symptoms:
1) Tremors
2) Rhinorrhea
1) Tremors
A nurse is caring for a patient who is taking clarithyromycin (Biaxin). The nurse includes a diagnosis of “risk for altered sensory perception” in the client’s plan of care. This is appropriate because many client’s on clarithromycin have an altered sense of which of the following:
1) Smell
2) Taste
2) Taste
A nurse is caring for a client who has asthma and is prescribed chewable mortelukast (Singular). The nurse should instruct the child’s parent to administer the medication:
1) Daily at bedtime
2) Before any activity
1) Daily at bedtime
A nurse is assessing a client who comes to the clinic for a seasonal influenza vaccine. The client says he read about an influenza vaccine that is given as a nasal spray and wants to receive it. Which of the following is a contradiction for the patient to receiving the live attenuated influenza vaccine (LAIV)?
1) Just turned 62
2) Smokes one pack of cigarettes a day
1) Just turned 62
A nurse is caring for a client who is receiving chlorpromazine (Thorazine) and is given a pass to attend a family outing on a sunny day. Which of the following is the most important for the nurse to include in the client’s teaching about the side effects of chlorpromazine?
1) Wear a hat and long sleeved shirt
2) Suck on hard candies
1) Wear a hat and long sleeved shirt
A nurse is reviewing a client’s admission record. The nurse notes that there are prescriptions for several medications. Which of the following factors should the nurse recognizes is of primary consideration when determining the schedule of administration:
1) Institutional policies regarding routine medication administration times
2) Specific characteristics of the medications
2) Specific characteristics of the medications
A client has a history of myocardial infarction (MI) is prescribed aspirin (Ecotrin) 325 mg. The nurse correctly understands that the aspirin is ordered due to its action as a:
3) Antiplatelet aggregate
4) Antipyretic
3) Antiplatelet aggregate
A home health nurse is reviewing the medication list of an older adult patient who reports falling a couple of times over the past week. Which of the following meds should the nurse suspect is contributing to the client’s falls:
1) Alprazolam (Xanax)
2) Acetaminophen (Tylenol)
1) Alprazolam (Xanax)
A nurse is caring for an older adult client who is hospitalized. Which of the following medication is likely to put the client at risk for orthostatic hypotension. (Select all that apply):
1) Furosemide (Lasix)
2) Telmisartan (Micardis)
3) Phenelzine sulfate (Nardil)
4) Clopidogrel (Plavix)
5) Atorvastatin (Lipitor)
1) Furosemide (Lasix)
2) Telmisartan (Micardis)
3) Phenelzine sulfate (Nardil)
A nurse is caring for a client who is receiving nifedipine (Procardia). The nurse checks the client’s blood pressure before administering medication and reports 98/58. Which of the following actions should the nurse first take:
3) Document the patient’s blood pressure
4) Recheck the client’s blood pressure
4) Recheck the client’s blood pressure
A nurse is caring for an older adult client who has rheumatoid arthritis and is taking aspirin (Bufferin) 650 mg every 4 hours. Which of the following diagnostic tests should the nurse monitor to evaluate the effectiveness of this medication:
3) Antinuclear antibody (ANA)
4) Erthrocyte sedimentation rate (ESR)
4) Erthrocyte sedimentation rate (ESR)
A nurse is caring for several patients who have bipolar disorder. The nurse should recognize that which of the following medications are appropriate for treating this condition (Select all that apply):
1) paraoxetine (Paxil)
2) lithium (Lethane)
3) tranylcypromine (Parnate)
4) valproic acid (Depakota)
5) phenytoin (Dilantin)
6) carbamazepine (Tegretol)
1) paraoxetine (Paxil)
2) lithium (Lethane)
4) valproic acid (Depakota)
6) carbamazepine (Tegretol)
A nurse is assessing a client who has numerous bruises on his upper extremities. The patient reports that he has taken warfarin (coumadin) daily for the past 3 months. Which of the following statements by the client indicates the client needs further teaching:
1) I have started taking ginger root to treat my joint stiffness
2) I take Tylenol whenever I have a headache
1) I have started taking ginger root to treat my joint stiffness
A nurse is caring for a client with nausea. The client is prescribed intravenous metaclopramide (Reglan) as needed. The nurse knows that Reglan is an effective antimetic because it
1) Promotes gastric emptying
2) Decrease gastric acid secretions
1) Promotes gastric emptying
A nurse is caring for a patient with chronic renal failure and states she has heartburn. Prescribes aluminum hydroxide (Amphojel). The patient asks the nurse why cant i just take the antacide magadrate (Reopan) my husband has at home. The nurse explains to the client that aluminum hydroxide is the preferred antacid because it lowers which of the following:
1) Serum phosphorus levels
2) Serum potassium levels
1) Serum phosphorus levels
A nurse is planning teaching for a child who has been prescribed fluticasone propionate (Flovent) for treatment of chronic asthma. The nurse plans to teach the child to use a spacer to minimize the risk for which of the following:
1) Adrenal Suppression
2) Candidiasis of the mouth
2) Candidiasis of the mouth
A nurse is caring for a client who has hypovolemic shock. The client is being administered mannitol (Osmitrol) by IV bolus. Which of the following findings is the best indicator of the medication’s effectiveness:
1) Urine output 50 mL/hr
2) BUN 18 mg/dL
1) Urine output 50 mL/hr
A nurse is caring for a client taking atorvastatin (Lipitor). Which of the following should the nurse recognize should be monitored for this client:
1) CK
2) ESR
1) CK
A client is being treated for heart failure and is receiving digoxin (Lanoxin) and furosemide (Lasix). Based on the chart findings, which of the following actions should the nurse take first:
3) Obtain an order for serum digoxin level
4) Review the client’s blood pressure over the past 24 hours
3) Obtain an order for serum digoxin level
A nurse is teaching a client about the use of risedronate (Actonel) for the treatment of osteoporosis. Which of the following client statements indicates an understanding of the teaching:
3) I should take an antacid with the risedronate to avoid nausea
4) I should sit up for 30 minutes after taking the risedronate
4) I should sit up for 30 minutes after taking the risedronate
A nurse is teaching a client who has a prescription for pilocarpine (Pilocar) eye drops. Which of the following client statements should indicate to the nurse a need for additional teaching:
3) I will stop using the drops as soon as my vision improves
4) I know this medication can cause side effects in other areas of my body
3) I will stop using the drops as soon as my vision improves
A nurse is precepting a newly licensed nurse who us caring for four clients. Which of the following actions should be noted in an incident report? The nurse administers:
3) Regular insulin (Humulin R) to a client who has a blood glucose of 250 mg/dL
4) Isosorbide mononitrate (Imdur) to a client who has blood pressure 82/60 mmHg
4) Isosorbide mononitrate (Imdur) to a client who has blood pressure 82/60 mmHg
A nurse is caring for a client who has been receiving parenteral morphine sulfate following a thoracic procedure. Which of the following findings should the nurse recognize is the most reliable indicator that the client’s pain is being adequately managed:
3) The client is speaking with a family member
4) The client is able to breathe deeply and cough
4) The client is able to breathe deeply and cough
A nurse is caring for a 20 year old female who has been prescribed isotretinoin (Accutane) for severe nodulocystic acne vulgaris. Before the client can obtain a refill, the nurse should advise the client that which of the following tests will be required:
1) Hgb level
2) Pregnancy test
2) Pregnancy test
A nurse is caring for a client receiving heparin IV at 1,000 units/hr. Which of the following should the nurse recognize as an adverse reaction to this medication:
1) Paresthesias
2) Pink tinged urine
2) Pink tinged urine
A nurse is assessing a 5 year old child’s need for pain medication. Which of the following actions by the nurse will best determine whether the child needs for pain medication:
1) Ask the parents if they think the child is in pain
2) Have the child rate the pain using the FACES pain rating scale
2) Have the child rate the pain using the FACES pain rating scale
A nurse is providing teaching to a client who is prescribed an MAOI. Which of the following should the nurse instruct the client to avoid while taking this medication:
1) Red wine
2) Cottage cheese
1) Red wine
A nurse is obtaining a medication history from a client who is prescribed tobramycin sulfate. Which of the following medications should the nurse notify the provider concerning concurrent use:
1) Paroxetine (Paxil)
2) Ibuprofen (Motrin)
2) Ibuprofen (Motrin)
A nurse is caring for a client in the PACU. The client is 1 hour postoperative, is difficult to arouse, and is hypotensice. The nurse should administer which of the following:
3) Lorazepam (Ativan)
4) Naloxone (Narcan)
4) Naloxone (Narcan)
A nurse is providing discharge instructions for a client who has a prescription for colesevelam (WelChol). Which of the following indicates the client needs additional teaching:
3) I will mix the medication with 30 mL of water
4) I will increase my fiber intake while taking this medication
3) I will mix the medication with 30 mL of water
A nurse is providing teaching about insulin glargine (Lantus) to a client who has Type 1 diabetes mellitus. Which of the following should the nurse include in the instructions:
3) Do not mix this medication in a syringe with other insulins
4) Rotate the bottle gently prior to drawing up the insulin
3) Do not mix this medication in a syringe with other insulins
A client is being started on ferrous sulfate. To enhance absorption, the nurse should advise the client to take the medication with which of the following?
1) Calcium carbonate
2) Ascorbic acid
2) Ascorbic acid
A nurse in the PACU is caring for a client who has received midazolam (Versed) IV bolus prior to an endoscopy. Which of the following findings indicate to the nurse to administer flumazenil (Romazicon) IV?
3) Elevated temperature
4) Respiratory depression
4) Respiratory depression
A nurse is caring for an older adult client. The client received 0.9% sodium chloride 1 L over 4 hr instead of over 8 hour as prescribed. Which of the following entries is the appropriate documentation of this occurrence in the client’s medical record:
1) IV fluid infused over 4 hours instead of the prescribed 8 hours. Client tolerated fluids well
2) 0.9% sodium chloride 1 L IV infused over 4 hours. Vital signs stable
2) 0.9% sodium chloride 1 L IV infused over 4 hours. Vital signs stable
A nurse is obtaining the medication history of a client who is starting a new prescription for allopurinol (Zyloprim). Which of the following medications should the nurse contact the provider regarding a potential interaction:
3) Nifesipine (Adalat)
4) Warfarin (Coumadin)
4) Warfarin (Coumadin)
A nurse is caring for a client receiving filgrastim (Neupogen) for neutropenia. Which of the following laboratory values indicates that the treatment has been effective:
1) Hgb 15 g/dL
2) WBC 8,000/mm3
2) WBC 8,000/mm3
A client who has hypothyroidism and is breastfeeding tells the nurse that she is taking levothyroxine (Synthroid) and is concerned that it will be excreted in her breast milk. Which of the following responses by the nurse is appropriate?
3) You will need to take the medication after breastfeeding the infant each morning
4) You will need to decrease your medication while breastfeeding
3) You will need to take the medication after breastfeeding the infant each morning
At 0900 a nurse is preparing a client’s medications. Based on the chart findings, which of the following medications should the nurse give first:
1) Sodium polystyrene sulfate (Kayexalate)
2) Atenolol (Tenormin)
1) Sodium polystyrene sulfate (Kayexalate)
A nurse administers naloxone (Narcan) as prescribed for a client who is 8 hr. postoperative adverse effects after administration of opioid analgesia. Which of the following interventions should the nurse plan to take following naloxone administration? (Select all that apply)
1) Observes the client for bleeding
2) Assess the client for nausea and vomiting
3) Check the client’s pain level frequency
4) Monitor the client for bradycardia
5) Repeat the dose every 15 min until the client responds
1) Observes the client for bleeding
2) Assess the client for nausea and vomiting
A nurse is planning teaching for a client who has a new diagnosis of exercise-induces asthma. Which of the following medications should the nurse instruct the client to use prior to physical activity:
1) Cromolyn sodium (Intal)
2) Predisone (Deltasone)
1) Cromolyn sodium (Intal)
A nurse is providing teaching to a client who has just been prescribed prazosin (Minipress). Which of the following client statements indicates an understanding of the teaching:
1) I will not use salt substitute while taking this medication
2) I will move slowly from sitting to standing to prevent falls
2) I will move slowly from sitting to standing to prevent falls
A nurse is providing teaching to a client who is prescribed thrimethoprim/ sulfamethoxazole (Bactrim DS). Which of the following instructions should the nurse include in her teaching:
3) Drink 8 to 10 glasses of water daily
4) Rise slowly from bed in the morning
3) Drink 8 to 10 glasses of water daily
A client is receiving a heparin infusion for deep vein thrombosis. The nurse should discontinue the medication infusion for which client findings:
3) Hemoglobin 15 g/dL
4) Platelets 96,000/mm3
4) Platelets 96,000/mm3
A client newly diagnosed with hyperthyroidism is prescribed (Synthyroid) 0.25 mg PO daily. After 6 weeks of treatment, the nurse determines that the medication was effective if the:
1) Thyroid-stimulating hormone (TSH) level is 2 microunits/mL
2) Total t4 level is 3 mcg/dL
1) Thyroid-stimulating hormone (TSH) level is 2 microunits/mL
A nurse is caring for a client who has just been transferred from the PACU to the medical surgical unit following a colon resection. The client reports pain of an 8 on a scale from 0 to 10 and has a prescription for morphine sulfate 4 mg IV bolus PRN pain every 2 hr. Which of the following actions should the nurse take first:
1) Administer the morphine sulfate
2) Check the client’s PACU medication record
2) Check the client’s PACU medication record
A client who has diabetes mellitus insulin lispro and is prescribed metoprolol (Lopressor) for hypertension. Which of the following should the nurse observe for in this client as an early indicator of hypoglycemia:
1) Sweating
2) Tachycardia
1) Sweating
A nurse is caring for a client who has cancer and is taking oral morphine sulfate and docusate sodium (Colace). Which of the following side effects will be minimized by taking the docusate sodium on a daily basis?
1) Constipation
2) Drowsiness
1) Constipation
A nurse caring for a client that has undergone a liver transplant and is taking cyclosporine (Sandimmune). Which of the following laboratory findings indicates an adverse effect of the medication:
1) WBC count 8,000/mm3
2) Serum creatine 2.5 mg/dL
2) Serum creatine 2.5 mg/dL
A nurse is providing teaching to a client who has a new pancrelipase (Pancrease). Which of the following should the nurse include in the teaching:
3) Take the medication with each meal and snack
4) Monitor blood glucose levels daily
3) Take the medication with each meal and snack
A client who is postoperative has received 2 mg of hydromorphine (Dilaudid) IV bolus every 2 hours. The client continue to rate his pain at a 7 on a scale from 0 to 10. which of the following client findings should the nurse attend to first:
1) Constipation
2) Hypotension
2) Hypotension
A nurse is instructing a client who has asthma. The client is currently taking albuterol (Proventil) every 4 hours PRM for bronchial spasms. He is to start a new prescription for montelukast (Singulair). Which of the following instructions should the nurse include: (Select all that apply)
1) Use montelukast to relieve an asthma attack
2) Do not take montelukast with food
3) Administer montelukast 30 min before sports activities
4) Report any increased need to use albuterol
5) Take montelukast once a day in the the evening
4) Report any increased need to use albuterol
5) Take montelukast once a day in the the evening
A nurse is caring for a client who is experiencing acute alcohol withdraw. For which of the following is the client prescribed chlordiazpoxide (Librium)
3) Lessen craving
4) Prevent delirium tremens
4) Prevent delirium tremens
A child is prescribed amoxicillin-clavulanic acid (Augmentin) for the treatment of an ear infection. The child’s mother asks the nurse why her child is receiving this combination of two medications. The nurse appropriately responds by stating that this medication is:
1) More effective
2) Known to decrease allergic reaction
1) More effective
A nurse is providing teaching to a client who has rheumatoid arthritis and is prescribed methotrexate (Rheumatrex). Which of the following statements by the client indicates an understanding of the teaching:
3) I should call my doctor if I develop sores in my mouth
4) I will have difficulty sleeping when I take this medication
3) I should call my doctor if I develop sores in my mouth
A nurse is caring for a client who is starting a new prescription for warfarin (Coumadin). Which of the following medications should the nurse plan to administer if the client experiences bleeding:
1) Vitamin K
2) Protamine sufate
1) Vitamin K
A nurse is evaluating a client who has been prescribed oral metformin (Glucophage) and glipizide (Glucotrol) 3 months ago to control diabetes mellitus. The nurse should identify which of the following laboratory findings as indicative of client compliance over time:
1) HbA1c 8.0%
2) HbA1c 6.5%
2) HbA1c 6.5%
An older adult client who has an infection is prescribed gentamicin (Garamycin). Which of the following client statements indicates a side effect of this medication and should be reported to the provider immediately:
1) I’m having difficulty reading the newspaper
2) I have to turn the volume up on the TV to hear it
2) I have to turn the volume up on the TV to hear it
A client is prescribed amitriptyline (Elavil). Which of the following adverse effects should the nurse instruct the client to report:
3) Urinary retention
4) Decreased libido
3) Urinary retention
A nurse is caring for a client who has heart failure and is prescribed enalapril (Vasotec) and spironolactone (Aldactone). For which of the following potential side effects should the nurse plan to monitor:
1) Hypokalemia
2) Hyperkalemia
2) Hyperkalemia
A nurse is monitoring a client receiving an IV infusion of magnesium sulfate for preterm labor. Which of the following indicates to the nurse that the client is experiencing magnesium toxicity:
3) Decreased level of consciousness
4) Agitation
3) Decreased level of consciousness
A nurse is administering donepezil (Aricept) to a client who has Alzheimer’s disease. Which of the following documented findings should the nurse report to the provider immediately:
3) Dizziness
4) Dyspnea
4) Dyspnea
Pharmacology ATI Proctored Exam A nurse is assessing a client who is receiving intravenous therapy. The nurse should identify which of the following findings as a manifestation of fluid volume excess? a) Decreased bowel sounds b) Distended neck veins c) Bilateral muscle weakness d) Thread pulse A nurse is teaching a guardian of a school-age child who has a new prescription for a fluticasone metered-dose inhaler. Which of the following information should the nurse include in the teaching? (SATA) a) “Soak the inhaler in water after use.” b) “Have your child take one inhalation as needed for shortness of breath.” c) “Shake the device prior to administration.” d) “A spacer will make it easier to use the device.” e) “Rinse your child’s mouth following administration.” A nurse is preparing to administer potassium chloride elixir 20 mEq/day PO to divide equally 12 hr. available is 6.7 mEq/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 trialing zero.) DOSAGE CALCULATION ✓ 7.5mL
A nurse is instructing a client who has a new prescription for a daily dose of lovastatin extended release. Which of the following information should the nurse include in the teaching? a) “You will need liver function tests before beginning therapy.” b) “Avoid consuming dairy products while taking this medication.” c) “You may crush the medication and mix it with applesauce.” d) “You should take the medication in the morning.” A nurse is assessing a client who is receiving a peripheral IV infusion and notes infiltration of fluid into the tissue surrounding the insertion site. Which of the following actions should the nurse take? a) Flush the IV catheter b) Apply pressure to the IV site c) Elevate the extremity d) Slow the infusion rate A nurse is preparing to administer 4,000 units of heparin subcutaneously to a client who has deep-vein thrombosis. Available is heparin 10,000 units. How many mL of heparin should the nurse administer? (Round to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.) DOSAGE CALCULATON ✓ 0.4mL A nurse us caring for a client who is in shock and is receiving an infusion of albumin. Which of the following findings should the nurse expect? a) Oxygen saturation 96% b) PaCO2 30 mm Hg c) Increase in BP d) Decrease in protein
A nurse is discussing adverse reactions to pain medications in older adult clients with a newly licensed nurse. Which of the following findings should the nurse include as risk factors for an adverse drug reaction? (SATA) a) Polypharmacy b) Increased rate of absorption c) Decreased percentage of body fat d) Multiple health problems e) Decreased renal function A nurse is reviewing the laboratory data of a client prior to administering IV tobramycin. Which of the following laboratory values should the nurse report to the provider? a) Sodium 137 mEq/L b) Hct 4.3% c) Hgb 15 g/Dl d) Creatinine 2.5 mg/dL A nurse is preparing to administer enoxaparin to a client. Which of the following actions should the nurse take? a) Apply firm pressure to the injection site following administration b) Administer the medication into the client’s muscle c) Expel the air bubble from the syringe prior to injection d) Insert the syringe needle halfway into the client’s skin A nurse is reviewing a client’s 0800 laboratory values at 1100. The nurse notes that the client received heparin at 1000. Which of the following laboratory values warrants an incident report? a) aPTT 90 seconds b) Hgb 16 g/dL c) INR 1.6 d) WBC 6,000/mm3
A nurse is caring for a client who has breast cancer and reports pain. 1 hr after administration of prescribed morphine 10 mg IV. Which of the following medications should the nurse expect to administer? a) Naloxone IV b) Morphine tablet c) Lidocaine patch d) Fentanyl transmucosal A nurse is assessing a client who reports taking over-the-counter antacids. Which of the following findings should the nurse identify as a manifestation of hypercalcemia? a) Constipation b) Decreased urine output c) Positive Trousseau’s sign d) Headache A nurse is caring for a client who is to receive potassium replacement. The provider’s prescription reads. “Potassium chloride 30 mEq in 0.9% sodium chloride 100 mL IV over 30 min.” which of the following reasons should the nurse clarify this prescription with the provider. a) Potassium chloride should be diluted in dextrose 5% in water. b) The potassium infusion rate is too rapid c) Another formulation of potassium should be given IV d) The client should be treated by giving potassium by IV bolus A nurse is monitoring laboratory values for a client who has chronic heart failure and is receiving digoxin. Which of the following values should the nurse report to the provider? a) Sodium 1.38 mEq/dL b) Magnesium 1.5 mEq/L c) BUN level 10 mg/dL d) Potassium 2.9 mEq/L
A client who has active tuberculosis and is taking rifampin reports that his urine and sweat have developed a red tinge. Which of the following actions should the nurse take? a) Check the client’s liver function test results b) Instruct the client to increase his fluid intake c) Document this as an expected finding d) Prepare the client for dialysis A nurse accidently administers the medication metformin instead of metoprolol to a client. Which of the following actions should the nurse take? a) Monitor the client’s thyroid function levels b) Collect the client’s uric acid level c) Obtain the client’s HDL level d) Check the client’s glucose level A nurse is administering 4 mg of hydromorphone to a client by mouth every 4 hr. the medication is provided as hydromorphone 8 mg per tablets. Which of the following actions is appropriate for the nurse to take? a) Return the remaining medication to the facility’s pharmacy b) Store the remaining half of the pill in the automated medication dispensing system c) Place the remaining half of the pill in the unit dose package d) Dispose of the remaining medication while another nurse observes A nurse is caring for 4-year-old child following an orthopedic procedure. When assessing the child for pain. Which of the following pain scales should the nurse use? a) FACES b) Numeric c) CRIES d) Word graphic
A nurse is planning care for a client who requires treatment for high cholesterol. Which of the following prescriptions should the nurse expect to administer? a) Colchicine b) Cimetidine c) Colerain – Colesevelam (Welchol) d) Chlorpromazine A nurse is caring for a client who has heart failure. The nurse administered furosemide 60 mg IV bolus 30 min earlier. For which of the following findings should the nurse notify the provider? a) Potassium 3.8 mEq/L b) The client reports dizziness upon standing c) The client reports difficulty hearing d) BUN 15 mg/dL A nurse is planning teaching for a client who is trying to quit smoking. Which of the following instructions about nicotine replacement options should the nurse include? a) Change the nicotine patch every other day b) Do not drink beverages while sucking on a nicotine lozenge c) Chew nicotine gum for 10 min before spitting it out d) Administer 2 sprays of nicotine nasal spray in each nostril with each dose A nurse is caring for a client who has a prescription for total parental nutrition (TPN). Which of the following routes of administration should the nurse use? a) Subcutaneous b) Intravenous c) Central venous access device d) Midline catheter
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A nurse is preparing to administer filgrastim 5mcg/kg/day subcutaneous to a client who weighs 143 lb. How many mcg should the nurse administer per day? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) DOSAGE CALCULATION ✓ 325 mcg A nurse is preparing to initiate IV therapy for a client. Which of the following sites should the nurse use to place the peripheral IV catheter? a) Nondominant dorsal venous arch b) Dominant distal dorsal vein c) Nondominant forearm basilic vein d) Dominant antecubital vein A nurse is assessing a client who is taking an osmotic laxative which of the following findings should the nurse identify as an indication of fluid volume deficit? a) Nausea b) Weight gain c) Headache d) Oliguria A nurse is reviewing the laboratory results of a client who is taking amitriptyline which of the following laboratory values should the nurse report to the provider? a) Total bilirubin 1.5 mg/dL b) Potassium 4.2 mEq/L c) Hct 0.44% d) WBC count 5,000/mm3
A nurse is caring for a client who is taking lithium and reports starting a new exercise program. The nurse should assess the client for which of the following electrolyte imbalances? a) Hypocalcemia b) Hypokalemia c) Hyponatremia d) Hypomagnesemia A nurse is assessing a client after administering phenytoin IV bolus for a seizure. Which of the following should the nurse identify as an adverse effect of this medication? a) Hypoglycemia b) Bradycardia c) Red man syndrome d) Hypotension A nurse is consulting a formulary about a client’s new prescription for raloxifene. The nurse should identify that this medication is used to treat which of the following conditions? a) Osteoporosis b) Hypothyroidism c) Urinary tract infection d) Deep vein thrombosis A nurse is providing discharge dietary teaching to a client who has a something and is taking medication theophylline and to provide general instructions the nurse should include? a) Avoid caffeinated beverages b) Take the medication with meals c) Restrict milk products d) Limit sodium intake
The nurse is mixing regular insulin and NPH into a syringe for a client who has diabetes mellitus. Which of the following actions should the nurse take first? a) Withdrawal NPH from the vial b) Inject air into the NPH vial c) Inject air into the regular vial d) Withdrawal regular insulin from the vial A nurse is teaching a client who has a new prescription of Alendronate for osteoporosis. What instructions should the nurse include? a) Take the medication immediately after breakfast b) Take the medication with an antacid c) Sit upright for at least 30 mins after taking the medication d) Drink orange juice with the medication A nurse is caring for a client who is postoperative following a thyroidectomy and is receiving morphine for pain. Which of the following findings should the nurse recognize as an adverse effect of morphine? a) Bladder distention b) Productive cough c) Gastrointestinal bleeding d) Decrease deep tending reflexes A nurse is teaching a client who has pernicious anemia to self-administer cyanocobalamin. Which of the following information should the nurse include in the teaching? a) Use nasal decongestion 15 mins before the medication if you have a stuffy nose b) Lie down for 1 hour after administering the medication c) Administer the medication into one nostril once per week d) Plan to self-administer this medication for the next 6 months
A nurse is teaching a newly license nurse about medication reconciliation. The nurse should instruct the newly license nurse for medication reconciliation for which of the following clients? a) Client who is transported to radiology b) A client who has a consultation for c) A client who has a referral for social services d) A client who has been transferred to a step-down unit A nurse is assessing a client how received a dinoprostone gel to stimulate the cervical ripening. Which of the following is the nurse’s priority? a) Back pain b) Flushing c) Nausea d) Uterine tachysystole A nurse is performing a return demonstration of an enoxaparin administration. Which of the following client actions indicates an understanding of the teaching? a) Messages the site to enhance absorption b) Injections the medication into a muscle c) Administers the medication into the abdomen d) Aspirates the medication after injection A nurse is assessing a client how has been taking digoxin and …….. which of the following findings to the nurse indicates this client has developed digoxin toxicity? a) Ringing in the ears b) Hyperkalemia c) Blurred vision d) Hypertension
A nurse is caring for a client who received neostigmine 1 hour ago and is experiencing muscarinic response. Which if the following manifestations should the nurse expect? a) Headache b) Excessive salivation c) Fever d) Myoclonic seizure A nurse in the emergency department is reviewing a medication record for client who reports vomiting blood. The nurse should anticipate the provider will discontinue which of the following medications? a) NPH insulin b) Clopidogrel c) Furosemide d) Pantoprazole A nurse is assessing a who is receiving clindamycin. Which of the following findings should the nurse identify as an adverse effect of this medication? a) Agitation b) Report of blurred vision c) Hypertension d) Watery diarrhea A nurse is teaching a client who is to start taking Cromolyn. Which of the following information should the nurse include in the teaching? a) Cromolyn should take effect within 5 mins b) Cromolyn should dilate the bronchioles c) Cromolyn can be used after exercise d) Cromolyn is a long-term management medication
A nurse is reviewing the medications of a client is experiencing orthostatic hypotension. The nurse should identify this finding as an adverse effect of which of the following medications? a) Imipramine b) Levothyroxine c) Montelukast d) Omeprazole A nurse is caring for a client who has hyponatremia and is receiving an infusion of a prescribed hypertonic solution. Which of the following findings should indicate to the nurse that the treatment is effective? a) Absent Chvostek’s sign b) Improved cognition c) Decreased vomiting d) Cardiac arrhythmias absent A nurse is teaching a client who has a new prescription for a nitroglycerin transdermal patch. Which of the following instructions should the nurse include? a) “Discontinue the patch if you experience a headache.” b) “Apply a new patch if you have chest pain.” c) “Cover the patch with dry gauze when taking a shower.” d) “Remove the patch prior to going to bed.” A nurse is reviewing the laboratory results of a client who has a prescription for sodium polystyrene sulfonate (Kayexalate) every 6 hr. which of the following should the nurse report to the provider? a) Creatinine 0.72 mg/dL b) Sodium 138 mEq/L c) Magnesium 2 mEq/L d) Potassium 5.2 mEq/L
A nurse is caring for a client who has tuberculosis and is taking isoniazid and rifampin. Which of the following outcomes indicates that the client is adhering to the medication regimen? a) The client has a negative sputum culture b) The client tests negative for HIV c) The client has a positive purified protein derivative test d) The client’s liver function test results are within the expected reference range A client is caring for a client who develops an anaphylactic reaction to IV administration. After assessing the client’s respiratory status and stopping the medication infusion. Which of the following actions should the nurse take next? a) Replace the infusion with 0.9% sodium chloride b) Give diphenhydramine IM c) Elevate the client’s legs and feet d) Administer epinephrine IM A nurse is caring for a client who is taking sertraline and reports a desire to begin taking supplements. Which of the following supplements should the nurse advise the client to avoid? a) St. John’s Wort b) Ginger root c) Black cohosh d) Coenzyme Q10 A nurse is caring for a client who has heart failure and a new prescription for lisinopril. For which of the following adverse effects should the nurse monitor when administering lisinopril? a) Bradycardia b) Hypokalemia c) Tinnitus d) Hypotension
A nurse is assessing a client who is receiving heparin IV continuous IV. The client has an PPT of 90 seconds. They should monitor the client for which of the following changes in their vital signs? a) Decreased temperature b) Increased pulse rate c) Decreased respiratory rate d) Increased blood pressure A nurse is preparing to administer medication to a client and discovers a medication error. The nurse should recognize that which of the following staff members is responsible for completing an incident report? a) The quality improvement committee b) The nurse who identifies the error c) The nurse who caused the error d) The charge nurse A nurse is planning care for a client who is receiving morphine via continuous epidural infusion. The nurse should monitor the client for which of the following? a) Pruritus – Sign of allergic reaction to morphine b) Cough c) Tachypnea d) Gastric bleeding A nurse is preparing to administer digoxin orally to a client. Identify the sequence of steps the nurse should take. (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.) a) Obtain the client’s apical heart rate b) Open the medication package c) Document administration of the medication d) Remove the medication from the dispensing system e) Compare the client’s wristband to the medication administration record ✓ a, b, c, d, e (in that order)
A nurse is reviewing the medical record of an adult client who has a fever and a prescription for acetaminophen. Which of the following findings should the nurse identify as a contraindication for receiving this medication? a) Alcohol use disorder b) Chronic kidney disease c) Hepatitis B vaccine within the last week d) Diabetes mellitus A home health nurse is visiting a client who has heart failure and a prescription for furosemide. The nurse identifies that the client has gained 2.5 kg (5 lb.) since the last visit 2 days ago. Which of the following actions should the nurse take first? a) Encourage the client to dangle the legs while sitting in a chair b) Teach the client about foods low in sodium c) Determine medication adherence by the client d) Notify the provider of the client’s weight gain A nurse is preparing to administer the initial dose of penicillin G IM to a client. The nurse should monitor for which of the following as an indication of an allergic reaction following the injection? a) Urticaria b) Bradycardia c) Pallor d) Dyspepsia A nurse is teaching a client who has angina a new prescription for sublingual nitroglycerin tablets. Which of the following instructions should the nurse include in the teaching? a) “Discard any tablets you do not use every 6 months.” b) “Take one tablet each morning 30 minutes prior to eating.” c) “Keep the tablets at room temperature in their original glass bottle.” d) “Place the tablet between your cheek and gum to dissolve.”
A nurse is providing teaching to a client who has a new prescription for theophylline, a sustained-released capsule. Which of the following statements by the client indicates an understanding of the teaching? a) “I can take my medication in the morning with my coffee.” b) “I may sprinkle the medication in applesauce.” c) “I should limit my fluid intake while on this medication.” d) “I will need to have blood levels drawn.” A nurse is mixing regular insulin and NPH insulin in the same syringe prior to administering it to client who has diabetes mellitus following actions should the nurse take first? a) Withdraw the regular insulin from the viral b) Withdraw the NPH insulin form the vial c) Inject air into the NPH vial d) Inject air into the regular insulin vial A nurse is preparing to administer subcutaneous heparin to a client. Which of the following should the nurse take? a) Massage the site after administering the medication b) Use a 21-gauge needle for the injection c) Aspirate before injecting the medication d) Insert the needle at least 5 cm (2 in) from the umbilicus A nurse is caring for a client who has a prescription for amoxicillin. Which of the following findings indicates the client is experiencing an allergic reaction? a) Nausea b) Cardiac dysrhythmia c) Laryngeal edema d) Insomnia
A nurse is teaching a newly licensed nurse about medication reconciliation. The nurse should instruct the newly licensed nurse to perform medication reconciliation for which of the following? a) A client who has a referral for social services b) A client who is transdermal to radiology c) A client who is transferal to a step-down unit d) A client who has a consultation for physical therapy A nurse is reviewing the laboratory values of a client who is taking atorvastatin. Which of the following laboratory values indicates the treatment has been effective? a) BUN 15 mg/Dl b) Blood glucose 90 mg/dL c) Urine specific gravity 1.020 d) LDL 120 mg/dL A nurse is receiving a medication prescription by telephone from a provider. The provider states, “Administer 6 milligrams of morphine IV push every 3 hours as needed for acute pain.” How should the nurse transcribe the prescription in the client’s medical record? a) Morphine 6 mg IV push every 3 hrs. PRN acute pain b) MSO 6 mg IV push every 3 hrs. PRN acute pain c) MS 6 mg IV push every 3 hrs. PRN acute pain d) Morphine 6.0 mg IV push every 3 hrs. PRN acute pain A nurse is assessing a client’s IV infusion site and notes that the site is cool and edematous. Which of the following actions should the nurse take? a) Show the IV solution rate b) Initiate a new IV distal to the initial site c) Maintain the extremity below the level of the heart d) Apply a warm, moist compress
A nurse is providing teaching to a client who has a new prescription for clozapine. Which of the following statements should the nurse include in the teaching? a) “Diarrhea is a common adverse effect of this medication. b) “Ringing in the ears is an expected adverse effect of this medication. c) “Notify your provider if you develop a fever while taking this medication.” d) “You might experience weight loss while taking this medication.” A nurse is teaching a client about oral contraceptive. Which of the following information should the nurse include in the teaching? a) Abdominal pain is an expected adverse effect of oral contraceptives b) It can take up to 1 year to become pregnant after stopping an oral contraceptive c) Some herbal supplements can decrease the effectiveness of an oral contraceptive d) A pelvic examination is needed prior to starting an oral contraceptive A nurse is planning to administer medication to an older adult client who has dysphagia. Which of the following actions should the nurse plan to take? a) Tilt the client’s head back when administering the medications b) Mix the medications with a semisolid food for the client c) Administer more than one pill to the client at a time d) Place the medications on the back of the client’s tongue A nurse is providing teaching to a client about the administration of omeprazole. Which of the following should the nurse include? a) “You cannot take this medication with an antacid.” b) “You should reduce your intake of calcium while taking this medication.” c) “You should take this medication before meals.” d) “You can take a second dose if symptoms persist up to 2 hours after the first dose.”
A nurse is assessing for allergies with a client who is scheduled to receive the influenza vaccine. Which of the following allergies should the nurse report to the provider as a possible contraindication to receiving the vaccine? a) Eggs b) Shellfish c) Peanuts d) Milk A nurse is caring for a client who has a new diagnosis of benign prostate hypertrophy and a prescription for doxazosin. The client tells the nurse. “I do not take this medication. I would prefer a natural therapy.” Which of the following supplements should the nurse suggest the client discuss with the provider? a) Black cohosh b) Garlic c) Feverfew d) Saw palmetto A nurse is caring for a client who is taking digoxin to treat heart failure. Which of the following predisposes this client to developing digoxin toxicity? a) Taking a high ceiling diuretic b) Having a 10-year history of COPD c) Having a prolapsed mitral valve d) Taking an HMG CoA reductase inhibitor A nurse is administering naloxone to a client who has developed an adverse reaction to morphine. The nurse should identify which of the following findings as a therapeutic effect of naloxone? a) Decreased nausea b) Increased pain relief c) Decreased blood pressure d) Increased respiratory rate
A nurse is reviewing the medical record of a client who has sinusitis and a new prescription for cefuroxime. Which of the following client information is the priority for the nurse to report to the provider? a) The client has a BUN of 18 mg/Dl b) The client takes an aspirin daily c) The client has a history of a severe penicillin allergy d) The client reports a history of nausea with cefuroxime A nurse is assessing a client who has hypermagnesemia. Which of the following medications should the nurse prepare to administer? a) Protamine sulfate b) Acetylcysteine c) Calcium gluconate d) Flumazenil A nurse is assessing a client following the administration of ondansetron (Zofran). Which of the following findings should indicate to the nurse that the ondansetron has been effective? a) Client reports a decrease in pain b) Client reports a decrease in nausea c) Client reports a decrease in coughing d) Client reports a decrease in diarrhea A nurse manager is planning an in-service about pain management with opioids for client who has cancer. Which of the following information should the nurse manager include? a) IM administration is recommended if PO opioids are ineffective b) Respiratory depression decreases as opioid tolerance develops c) Meperidine is the opioid of choice for treating chronic pain d) Withhold PRN pain medication for the client who is receiving opioids every 6 hrs.
A nurse is reviewing the list of current medication for a client who is to start prescription for carbamazepine. The nurse should identify that which of the following medications interacts with carbamazepine? a) Nicotine transdermal system b) Diphenhydramine c) Estrogen-progestin combination (non-hormonal forms of contraception) d) Beclomethasone A nurse is caring for a client who has a respiratory infection and is receiving an antibiotic. Which of the following medications puts the client at risk for developing hearing loss? a) Rifampin b) Ciprofloxacin c) Penicillin G d) Gentamicin A nurse is reviewing a client’s medical history before administering a new prescription of atropine. Which of the following client conditions is contraindicated? ✓ Glaucoma A nurse is providing teaching to a client who has a new prescription for carbamazepine for the treatment of seizures. The nurse should instruct the client to monitor for which of the following adverse effects? a) Insomnia b) Blurred vision c) Tachypnea d) Metallic taste A nurse is preparing to administer 4000 units of heparin available is 10,000 units = ??? ✓ 0.4
A nursing is caring for a client who reports that his current pain medication is no longer relieving her pain. Which of the following medications requires the nurse to obtain a written rather than a verbal prescription from the provider? ✓ Fentanyl A charge nurse is observing a newly licensed nurse provide care to a group of clients. Which of the following action by the newly licensed nurse requires the charge nurse to complete an incident report? ✓ A client who has a lithium level of 1.8 receives her morning dose A nurse is caring for a client who has a alcohol use disorder and is experiencing withdrawals. Which of the following interventions is a priority at this time? a) Encourage participation in a 12-step program b) Implement seizure precautions A nurse is planning care for a group of clients. which of the following client’s medications should be monitored by the nurse for hearing loss related to a medication interaction? ✓ Furosemide and amikacin A nurse is caring for a client who has major depression and a new prescription for citalopram. which of the following adverse effects is the priority for the nurse to report to the provider? a) Insomnia b) Bruxism c) Confusion d) Weight loss
A nurse is caring for a client who requires a re-insertion of a short peripheral venous catheter. in which of the following locations should the nurse place the catheter? ✓ A vein on the client’s wrist A nurse is assessing a client who is in labor and is receiving epidural anesthesia. which of the following findings should the nurse identify as the priority? ✓ Hypotension A nursing is providing teaching to a client who has a prescription for omeprazole. which of the following instructions should the nurse include in the teaching? ✓ Long term use increase risk of fractures A nurse is reviewing a client’s laboratory results before administering furosemide 40 mg IV bolus. For which of the following values should the nurse withhold the medication and contact the provider? ✓ Potassium 2.5 mEq/L The nurse is assessing a client who takes glipizide for the treatment of type 2 diabetes mellitus. Which of the following findings indicates effectiveness of the medication? ✓ Hgba1c 6.5% A nurse in the emergency department is caring for a client who reports a severe headache. the client’s blood pressure is 280/160 mm hg. the nurse should plan to administer which of the following medications? ✓ Nitroprusside
A nurse is teaching the parent of a toddler who is to begin taking ferrous fumarate. which of the following statements by the parent indicates an understanding of the teaching? ✓ I will rinse my child’s mouth with water after she takes the medicine A nurse is caring for a client who is to start therapy with lovastatin. the nurse should prepare the client for which of the following diagnostic assessments? ✓ Liver function test A nurse is developing a teaching plan for an older adult client who has a new prescription for insulin glargine. which of the following expected outcomes should the nurse include in the plan? ✓ The client will wear his reading glasses when drawing insulin glargine A nurse is caring for a client who is receiving a continuous IV infusion of magnesium sulfate for preterm labor. the nurse should discontinue the infusion and prepare to administer claim gluconate if the client demonstrates which of the following findings? (Select all that apply) ✓ Absence of deep-tendon reflexes ✓ Urine output 80 mL/hr. ✓ Decreased LOC A nurse is teaching a client who has a new prescription for nitroglycerin patches. the nurse should identify which of the following statements as an indication that the client understands the teaching? ✓ I will rotate application sites to avoid skin irritation
Nurse in a provider’s office is preparing to teach a middle adult client who has a new diagnosis of metabolic syndrome and an HbA1c of 6.5%. Which of the following medications should the nurse plan to teach the client about first? ✓ Metformin A nurse is teaching a client who has active pulmonary tuberculosis about management of medication for the disease. which of the following statements is appropriate for the nurse to make? ✓ You will need to take two or more medication to treat your disease A nurse is planning care for a client who has a prescription for erythromycin lactobionate IV bolus. which of the following actions should the nurse include in the plan of care? ✓ Monitor for hearing loss A nurse is obtaining a medication history from a client who has gout and is prescribed probenecid. the nurse should notify the provider that the client is taking which of the following over-the counter medications? ✓ Salicylic acid A nurse is teaching a client who has HIV and a new prescription for efavirenz. Which of the following instructions should the nurse include in the teaching? ✓ Notify provider for the appearance of a skin rash A nurse is evaluating a client who has tuberculosis and has been taking rifampin for 1 month. which of the following laboratory tests should the nurse review to evaluate for an adverse effect of this medication? ✓ ALT
A nurse is teaching a client who has multiple allergies about using an epinephrine auto- injector. Which of the following instructions should the nurse include? ✓ Administer the medication thorough clothing if necessary For ferrous gluconate. Which of the following statements by the client indicates an understanding of the teaching? ✓ I should stay upright for 15 minutes after taking this medication A nurse is preparing to administer methylprednisolone sodium succinate 80 mg IV bolus. the nurse reconstitutes the 125 mg in the vial in powder form to 2 mL. How many mL should the nurse administer? DOSAGE CALCULATION ✓ 1.3 A nurse is caring for a client who has heart failure. the nurse administered furosemide 60 mg IV bolus 30 min earlier. for which of the following findings should the nurse notify the provider? ✓ Client reports difficulty hearing A nurse is caring for a client who has diabetes mellitus and is taking pioglitazone. The nurse should plan to monitor the client for which of the following adverse effects? ✓ Orthostatic hypotension A nurse is wanting to report a n infusion reaction for a client who is receiving a dose via IV of amphotericin B. which is the following findings that indicate to the nurse that the patient is experiencing an acute infusion reaction? ✓ Fever
A nurse is providing teaching to a client who has a new prescription for paroxetine. the nurse should instruct the client to monitor for which of the following adverse effects? ✓ Drowsiness A client who has Graves’ disease is prescribed methimazole. Which of the following effects should the nurse expect to see after the client has taken, he medication for 2 months? ✓ Increased sleeping A nurse is teaching a client who has a new prescription for ergotamine to treat vascular headaches. The nurse should inform the client that which of the following is a potential adverse effect of this medication? ✓ Muscle pain A nurse is reviewing a client’s 0800 laboratory values at 1100. the nurse notes that the client received heparin at 1000. which of the following laboratory values warrants an incident report? ✓ aPTT 90 A nurse is administering medications to a client. which of the following medications should the nurse plan to administer by a parental route? ✓ Fondaparinux A nurse is providing teaching to a client who has a new prescription for warfarin about potential interactions with over-the-counter products. which of the following products should the nurse instruct the client to avoid? ✓ Naproxen
A nurse is assessing a client who takes levothyroxine for hypothyroidism. the nurse should identify that which of the following findings indicates the need for an increase in dosage? Select all that apply ✓ Heart rate 46 ✓ Cold intolerance ✓ Impaired short-term memory A nurse is teaching a client who is to begin cyclophosphamide therapy to treat cancer. Which of the following adverse effects of this medication should the nurse include in the teaching? ✓ Leukopenia A nurse is reviewing the medical record of a client who is receiving vancomycin daily. the nurse should review which of the following laboratory results prior to administering the next dose? ✓ Creatinine level A nurse is providing teaching to a client who has a new prescription for phenelzine. which of the following foods should the nurse instruct the client to avoid? ✓ Cheddar cheese A nurse is preparing to administer nitroglycerin topical ointment to a client. which of the following actions should the nurse plan to take? ✓ Measure dosage on medication applicator paper A nurse is caring for a client who is taking azathioprine to treat rheumatoid arthritis. which of the following laboratory values indicates an adverse effect of this medication? ✓ WBC 3,000
A nurse is providing teaching to a client who has a new prescription for phenelzine. the nurse instruct the client to avoid which of the following foods? ✓ Smoked salmon A nurse is reviewing the laboratory data of a client who is receiving filgrastim. which of the following laboratory values should the nurse monitor to evaluate the effectiveness of the treatment? ✓ WBC count A nurse is planning to administer medications to a client who weighs 198 lb. the prescription reads, “filgrastim 5mcg/kg, subcutaneous, daily”. available is filgrastim 300 mcg/mL. how many ml should the nurse plan to give with each dose? DOSAGE CALCULATION ✓ 1.5 A nurse is providing teaching to a client who has a new prescription for nitroglycerin. which of the following client statements indicates an understanding of the teaching? ✓ I will call 911 if plain is not relieved after taking the medication A nurse is providing discharge teaching to a client who is receiving warfarin. Which of the following statements is appropriate to make? ✓ Avoid eating large amounts of cabbage and broccoli A nurse is reviewing the medical record of a client who has sinusitis and a new prescription for cefuroxime. which of the following client information is the priority for the nurse to report to the provider? ✓ Client with a history of severe Penicillin allergy
A nurse recently administered filgrastim intravenously to a client who has cancer and is receiving cytotoxic chemotherapy. for which of the following data, discovered after the medication was administered, should the nurse file an incident report.? ✓ Vile sat out for 2 hours at room temperature before administration A nurse is assessing a client who is receiving heparin therapy for deep-vein thrombosis. Which of the following findings should indicate to the nurse that the therapy is effective? ✓ Platelets within the expected range A nurse receives a prescription to give tobramycin to a client daily. Which of the following laboratory values should the nurse report to the provider? ✓ Serum creatinine 2.5 A nurse is providing teaching to a client who has a new prescription for nitroglycerin sublingual. which of the following client responses indicates an understanding of the teaching? ✓ Keep tablets in dark container at room temperature A nurse is reviewing a client’s medical record before administering acetaminophen 650 mg PO every 6 hr. Which of the following findings indicates a need for the nurse to notify the provider? ✓ History of alcohol use disorder A nurse is preparing to administer the initial dose of penicillin G IM to a client. The nurse should monitor for which of the following as an indication of an allergic reaction following the injection? ✓ Urticaria
A nurse is assessing a client who has been taking lithium for one year. Which of the following client reports is the nurse’s priority? ✓ Mild thirst