SAUNDERS ATI PHARMACOLOGY STUDY GUIDE COMPLETE SOLUTION WITH RATIONALS: GRADED A | 100% CORRECT

SAUNDERS ATI PHARMACOLOGY STUDY GUIDE COMPLETE SOLUTION WITH RATIONALSSAUNDERS ATI PHARMACOLOGY STUDY GUIDE COMPLETE SOLUTION WITH RATIONALS: GRADED A | 100% CORRECT1. The nurse is monitoring a client who is receiving oxytocin (Pitocin) to induce labor. Which assessment finding would cause the nurse to immediately discontinue the oxytocin infusion? 2. A pregnant client is receiving magnesium sulfate for the management of preeclampsia. The nurse determines that the client is experiencing toxicity from the medication if which finding is noted on assessment? 3. The nurse is monitoring a client in preterm labor who is receiving intravenous magnesium sulfate. The nurse should monitor for which adverse effects of this medication? Select all that apply. 4. The nurse instructor asks a nursing student to describe the procedure for administering erythromycin ointment to the eyes of a newborn. Which student statement indicates that further teaching is needed? 5. A client in preterm labor (31 weeks) who is dilated to 4 cm has been started on magnesium sulfate and contractions have stopped. If the client’s labor can be inhibited for the next 48 hours, the nurse anticipates a prescription for which medication? 6. Methylergonovine (Methergine) is prescribed for a woman to treat postpartum hemorrhage. Before administration of methylergonovine, what is the priority nursing assessment? 7. The nurse is preparing to administer beractant (Survanta) to a premature infant who has respiratory distress syndrome. The nurse plans to administer the medication by which route? 8. An opioid analgesic is administered to a client in labor. The nurse assigned to care for the client ensures that which medication is readily available if respiratory depression occurs? 9. Rho(D) immune globulin (RhoGAM) is prescribed for a client after delivery and the nurse provides information to the client about the purpose of the medication. The nurse determines that the woman understands the purpose if the woman states that it will protect her next baby from which condition? 10. Methylergonovine (Methergine) is prescribed for a client with postpartum hemorrhage. Before administering the medication, the nurse contacts the health care provider who prescribed the medication if which condition is documented in the client’s medical history? 1. The nurse is providing medication instructions to a parent. Which statement by the parent indicates a need for further instruction? 2. A health care provider’s prescription reads “ampicillin sodium 125 mg IV every 6 hours.” The medication label reads “1 g and reconstitute with 7.4 mL of bacteriostatic water.” The nurse prepares to draw up how many mL to administer one dose? 3 A pediatric client with ventricular septal defect repair is placed on a maintenance dosage of digoxin (Lanoxin). The dosage is 0.07 mg/ kg/ day, and the client’s weight is 7.2 kg. The health care provider (HCP) prescribes the digoxin to be given twice daily. The nurse prepares how much digoxin to administer to the client at each dose? 4. Sulfisoxazole (Gantrisin), 1 g orally four times daily, is prescribed for an adolescent with a urinary tract infection. The medication label reads “500-mg tablets.” The nurse has determined that the dosage prescribed is safe. The nurse administers how many tablets per dose to the adolescent? 5. Penicillin G procaine (Wycillin), 1,000,000 units IM (intramuscularly), is prescribed for a child with an infection. The medication label reads “1,200,000 units per 2 mL.” The nurse has determined that the dose prescribed is safe. The nurse administers how many milliliters per dose to the child? 6. The nurse prepares to administer an intramuscular injection to a 4-month-old infant. The nurse selects which best site to administer the injection? 7. Atropine sulfate, 0.6 mg intramuscularly, is prescribed for a child preoperatively. The nurse has determined that the dose prescribed is safe and prepares to administer how many milliliters to the child? Fill in the blank (refer to figure). 1. Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which finding indicates the presence of systemic toxicity from this medication? 2. The health education nurse provides instructions to a group of clients regarding measures that will assist in preventing skin cancer. Which instructions should the nurse provide?” 3. Mafenide acetate (Sulfamylon) is prescribed for a client with a burn injury. When applying the medication, the client complains of local discomfort and burning. The nurse should take which most appropriate action? 4. A burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site of injury. The nurse monitors the client, knowing that which finding indicates that a systemic effect has occurred?” 5. Isotretinoin (Amnesteem or Claravis) is pre“scribed for a client with severe acne. Before the administration of this medication, the nurse anticipates that which laboratory test will be prescribed? 6. A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes isotretinoin (Amnesteem or Claravis). The nurse reviews the client’s medication record and would contact the HCP if the client is taking which medication?” 7. The nurse is applying a topical corticosteroid to a client with eczema. The nurse should monitor for the potential for increased systemic absorption of the medication if the medication were being applied to which body area?” 8. The clinic nurse is performing an admission assessment on a client and notes that the client is taking azelaic acid (Azelex). Because of the medication Rx, the nurse would suspect that the client is being treated for which condition? 9. Silver sulfadiazine (Silvadene, Thermazene, SSD cream) is prescribed for a client with a partial-thickness burn and the nurse provides teaching about the medication. Which statement made by the client indicates a need for further teaching about the treatments? 10. The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse reminds the children that chemical sunscreens are most effective when applied at which times? 1. Chemotherapy dosage is frequently based on total body surface area (BSA), so it is important for the nurse to perform which assessment before administering chemotherapy? 2. A client with squamous cell carcinoma of the larynx is receiving bleomycin intravenously. The nurse caring for the client anticipates that which diagnostic study will be prescribed? 3. A client with acute myelocytic leukemia is being treated with busulfan (Myleran, Busulfex). Which laboratory value would the nurse specifically monitor during treatment with this medication? 4. A client with small cell lung cancer is being treated with etoposide (Toposar). The nurse monitors the client during administration, knowing that which adverse effect is specifically associated with this medication? 5. A clinic nurse prepares a teaching plan for a client receiving an antineoplastic medication. When implementing the plan, the nurse should make which statement to the client? 6. “A client with ovarian cancer is being treated with vincristine (Vincasar). The nurse monitors the client, knowing that which manifestation indicates an AE specific to this medication? 7. The nurse is reviewing the history and physical examination of a client who will be receiving asparaginase (Elspar), an antineoplastic agent. The nurse contacts the health care provider before administering the medication if which disorder is documented in the client’s history? 8. Tamoxifen citrate is prescribed for a client with metastatic breast carcinoma. The nurse administering the medication understands that which is the primary action of this medication? 9. A client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which laboratory value while the client is taking this medication? 10. Megestrol acetate (Megace), an antineoplastic medication, is prescribed for a client with metastatic endometrial carcinoma. The nurse reviews the client’s history and should contact the health care provider if which diagnosis is documented in the client’s history? 11. The nurse is monitoring the intravenous (IV) infusion of an antineoplastic medication. During the infusion, the client complais of pain at the insertion site. On inspection of the site, the nurse notes redness and swelling and that the infusion of the medication has slowed in rate. The nurse suspects extravasation and should take which actions? 12. The nurse is analyzing the laboratory results of a client with leukemia who has received a regimen of chemotherapy. Which laboratory value would the nurse specifically note as a result of the massive cell destruction that occurred from the chemotherapy? 13. The nurse is providing medication instructions to a client with breast cancer who is receiving cyclophosphamide. The nurse should tell the client to take which action? 14. A client with non–Hodgkin’s lymphoma is receiving daunorubicin (DaunoXome). Which finding would indicate to the nurse that the client is experiencing an AE r/t the medication? 15. The nurse is monitoring the laboratory results of a client receiving an antineoplastic medication by the intravenous route. The nurse plans to initiate bleeding precautions if which laboratory result is noted? Chapter 55 Endocrine Medications 600. The nurse is teaching a client how to mix regular insulin and NPH insulin in the same syringe. Which action, if performed by the client, indicates the need for further teaching? a. withdraws the NPH insulin first b. withdraws the regular insulin first c. injects air into NPH insulin vial first d. injects an amount of air equal to the desired dose of insulin into each vial 601. The home care nurse visits a client recently diagnosed with diabetes mellitus who is taking Humulin NPH insulin daily. The client asks the nurse how to store the unopened vials of insulin. The nurse should tell the client to take which action? a. freeze the insulin b. refrigerate the insulin c. store the insulin in a dark, dry place. d. keep the insulin at room temperature 602. Glimepiride (Amaryl) is prescribed for a client with diabetes mellitus. The nurse instructs the client to avoid consuming which food while taking this medication? a. alcohol b. organ meats c. whole-grain cereals d. carbonated beverages 603. Sildenafil (Viagra) is prescribed to treat a client with erectile dysfunction. The nurse reviews the client’s medical record and should question the prescription if which data is noted in the client’s history? a. insomnia b. neuralgia c. use of nitroglycerin d. use of multivitamins 604. The health care provider (HCP) prescribes exenatide (Byetta) for a client with type 1 diabetes mellitus who takes insulin. The nurse should plan to take which most appropriate intervention? a. withhold the medication and call the HCP, questioning the prescription for the client. b. administer the medication within 60 minutes before the morning and evening meal. c. monitor the client for gastrointestinal side effects after administering the medication. d. withdraw the insulin from the prefilled pen into an insulin syringe to prepare for administration. 605. A client is taking Humulin NPH insulin and regular insulin every morning. The nurse should provide which instructions to the client? Select all that apply a. hypoglycemia may be experiences before dinnertime. b. the insulin dose should be decreased if illness occurs. c. the insulin should be administered at room temperature. d. the insulin vial needs to be shaken vigorously to break up the precipitates. c. the NPH insulin should be drawn into the syringe first, then the regular insulin. 606. The home health care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client is prescribed repaglinide (Prandin) and metformin (Glucophage) and asks the nurse to explain these medications. The nurse should provide which instructions to the client? Select all that apply. a. diarrhea may occur secondary to the metformin. b. the repalginide is not taken if a meal is skipped. c. the repaglinide is taken 30 minutes before eating. d. a simple sugar food item is carried and used to treat mild hypoglycemia associated with repaglinide. e. muscle pain is an expected effect of metformin and may be treated with acetaminophen (Tylenol). 607. The community health nurse visits a client at home. Prednisone, 10mg orally daily, has been prescribed for the client and the nurse teaches the client about the medication. Which statement, if made by the client, indicates that further teaching is necessary? a. “I can take aspirin or my antihistamine if I need it.” b. “I need to take the medication every day at the same time.” c. “I need to avoid coffee, tea, cola, and chocolate in my diet.” d. “If I gain more than 5 pounds a week, I will call my health care provider (HCP). 608. A client with hyperthyroidism has been given methimazole (Tapazole). Which nursing considerations are associated with this medication? Select all that apply. a. administer methimazole with food. b. place the client on a low-calorie, low-protein diet. c. assess the client for unexplained bruising or bleeding. d. instruct the client to report side/adverse effects such as sore throat, fever, or headaches e. use special radioactive precautions when handling the clients urine for the first 24 hours following initial administration. 609. The nurse is monitoring a client receiving levothyroxine sodium (Synthroid) for hypothyroidism. Which findings indicate the presence of a side effect associated with this medication? Select all that apply. a. insomnia b. weight loss c. bradycardia d. constipation e. mild heat intolerance 610. The nurse provides instructions to a client who is taking levothyroxine (Synthroid). The nurse should tell the client to take the medication at which time? a. with food b. at lunchtime c. on an empty stomach d. at bedtime with a snack 611. The nurse provides medication instructions to a client who is taking levothyroxine (Synthroid) and should tell the client to notify the health care provider (HCP) if which problem occurs? a. fatigue b. tremors c. cold intolerance d. excessively dry skin 612. The nurse performs an admission assessment on a client who visits a health care clinic for the first time. The client tells the nurse that propylthiouracil (PTU) is taken daily. The nurse continues to collect data from the client, suspecting that the client has a history of which condition? a. myxedema b. graves’ disease c. addison’s disease d. cushing’s syndrome 613. The nurse is instructing a client regarding intranasal desmopressin (DDAVP). The nurse should tell the client that which occurrence is a side effect of the medication? a. headache b. vulval pain c. runny nose d. flushed skin 614. A daily dose of prednisone is prescribed for a client. The nurse provides instructions to the client regarding administration of the medication and should instruct the client that which time is best to take this medication? a. at noon b. at bedtime c. early morning d. any time, at the same time, each day 615. Prednisone is prescribed for a client with diabetes mellitus who is taking Humulin NPH insulin daily. Which prescription change does the nurse anticipate during therapy with the prednisone? a. an additional dose of prednisone daily b. a decreased amount of daily Humulin NPH insulin c. an increased amount of daily Humulin NPH insulin d. the addition of an oral hypoglycemic medication daily 616. A client with diabetes mellitus visits a health care clinic. The clients diabetes mellitus previously had been well controlled with glyburide (DiaBeta) daily, but recently the fasting blood glucose level has been 180 to 200 mg/dL. Which medication, if added to the clients regimen, may have contributed to the hyperglycemia? a. Prednisone b. Phenelzine (Nardil) c. Atenolol (Tenormin) d. Allopurinol (Zyloprim) Chapter 57: GI Medications 643. A client with Crohn’s disease is scheduled to receive an infusion of infliximab (Remicade). What intervention by the nurse will determine the effectiveness of treatment? a. monitoring the leukocyte count for 2 days after the infusion. b. checking the frequency and consistency of bowel movements. c. checking serum liver enzyme levels before and after the infusion d. carrying out a Hematest on gastric fluids after the infusion is completed. 644. A client has a PRN prescription for loperamide hydrochloride (Imodium). For which condition should the nurse administer this medication? a. constipation b. abdominal pain c. an episode of diarrhea d. hematest-positive nasogastric tube drainage 645. A client has a PRN prescription for ondansetron (Zofran). For which condition should the nurse administer this medication to the postoperative client? a. paralytic ileus b. incisional pain c. urinary retention d. nausea and vomiting 646. A client has begun medication therapy with pancrelipase (Pancrease MT,). The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed? a. weight loss b. relief of heartburn c. reduction of steatorrhea d. absence of abdominal pain 647. An older client recently has been taking cimetidine (Tagamet). The nurse monitors the client for which most frequent central nervous system side effect of this medication? a. tremors b. dizziness c. confusion d. hallucination 648. A client with a gastric ulcer has a prescription for sucralfate (Carfate), 1g by mouth four times daily. The nurse should schedule the medication for which times? a. with meals and at bedtime b. every 6 hours around the clock c. one hour after meals and at bedtime d. one hour before meals and at bedtime 649. A client who chronically uses nonsteroidal anti-inflammatory drugs (NSAIDS) had been taking misoprostol (Cytotec). The nurse determines that the medication is having the intended therapeutic effect if which finding is noted? a. resolved diarrhea b. relief of epigastric pain c. decreased platelet count d. decreased white blood cell count 650. A client has been taking omeprazole (Prilosec) for 4 weeks. The ambulatory care nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptom? a. diarrhea b. heartburn c. flatulence d. constipation 651. A client with a peptic ulcer is diagnosed with a Helicobactor pylori infection. The nurse is teaching the client about the medicaitons prescribed, including clarithromycin (Biaxin), esomeprazole (Nexium), and amoxicillin (Amoxil). Which statement by the client indicates the best understanding of the medication regimen? a. “My ulcer will heal because these medications will kill the bacteria.” b. “These medicaitons are only taken when I have pain from my ulcer.” c. “The medicaitons will kill the bacteria and stop the acid production.” d. “These medications will coat the ulcer and decrease the acid production in my stomach.” 652. A client has a new prescription for metoclopramide (Reglan). On review of the chart, the nurse identifies that this medication can be safely administered with which condition? a. intestinal obstruction b. peptic ulcer with melena c. diverticulitis with perforation d. vomiting following cancer chemotherapy 653. A histamine (H2)receptor antagonist will be prescribed for a client. The nurse understands that which medications are H2 –receptor antagonist? Select all that apply. a. Nizatidine (Axid) b. Ranitidine (Zantac) c. Famotidine (Pepcid) d. Cimetidine (Tagamet) e. Esomeprazole (Nexium) f. Lansoprazole (Prevacid) 654. The nurse has given instructions to a client who has just been prescribed cholestyramine (Questran). Which statement by the client indicates a need for further instructions? a. “I will continue taking vitamin supplements.” b. “This medication will help lower my cholesterol.” c. “This medication should only be taken with water.” d. “A high-fiber diet is important while taking this medication.” Chapter 59 679. A client has a prescription to take guaifenesin (Mucinex). The nurse determines that the client understands the proper administration of this medication if the client states that he or she will perform which action? 1. Take an extra dose if fever develops 2. Take the medication with meals only 3. Take the tablet with a full glass of water 4. Decrease the amount of daily fluid intake 680. The nurse is preparing to administer a dose of naloxone hydrochloride intravenously to a client with an intravenous opioid overdose. Which supportive medical equipment should the nurse plan to have at the client’s bedside if needed? 1. Nasogastric tube 2. Paracentesis tray 3. Resuscitation equipment 4. Central line insertion tray 681. The nurse teaches a client about the effects of diphenhydramine (Benadryl), which has been prescribed as a cough suppressant. The nurse determines that the client needs further instruction if the client makes which statement? 1. “I will take the medication on an empty stomach.” 2. “I won’t drink alcohol while taking this medication.” 3. “I will use sugarless gum, candy, or oral rinses to decrease dryness in my mouth.” 4. “I won’t do activities that require mental alertness while taking this medication.” 682. A cromolyn sodium inhaler is prescribed for a client with allergic asthma. The nurse provides instructions regarding the side and adverse effects of this medication and should tell the client that which undesirable effect is associated with this medication? 1. Insomnia 2. Constipation 3. Hypotension 4. Bronchospasm 683. Terbutaline is prescribed for a client with bronchitis. The nurse understands that this medication should be used with caution if which medical condition is present in the client? 1. Osteoarthritis 2. Hypothyroidism 3. Diabetes mellitus 4. Polycystic disease 684. Zafirlukast (Accolate) is prescribed for a client with bronchial asthma. Which laboratory test does the nurse expect to be prescribed before the administration of this medication? 1. Platelet count 2. Neutrophil count 3. Liver function tests 4. Complete blood count 685. A client has been taking isoniazid for 11/2 months. The client complains to the nurse about numbness, paresthesias, and tingling in the extremities. The nurse interprets that the client is experiencing which problem? 1. Hypercalcemia 2. Peripheral neuritis 3. Small blood vessel spasm 4. Impaired peripheral circulation 686. A client is to begin a 6-month course of therapy with isoniazid. The nurse should plan to teach the client to take which action? 1. Use alcohol in small amounts only. 2. Report yellow eyes or skin immediately. 3. Increase intake of Swiss or aged cheeses. 4. Avoid vitamin supplements during therapy. 687. A client has been started on long-term therapy with rifampin (Rifadin). The nurse should provide which information to the client about the medication? 1. Should always be taken with food or antacids 2. Should be double-dosed if one dose is forgotten 3. Causes orange discoloration of sweat, tears, urine, and feces 4. May be discontinued independently if symptoms are gone in 3 months 688. The nurse has given a client taking ethambutol (Myambutol) information about the medication. The nurse determines that the client understands the instructions if the client states he or she will immediately report which finding? 1. Impaired sense of hearing 2. Gastrointestinal side effects 3. Orange-red discoloration of body secretions 4. Difficulty in discriminating the color red from green 689. A client with tuberculosis is being started on antituberculosis therapy with isoniazid. Before giving the client the first dose, the nurse should ensure that which baseline study has been completed? 1. Electrolyte levels 2. Coagulation times 3. Liver enzyme levels 4. Serum creatinine level 690. The nurse has a prescription to give a client salmeterol (Serevent Diskus), two puffs, and beclomethasone dipropionate (Qvar), two puffs, by metered-dose inhaler. The nurse should administer the medication using which procedure? 1. Beclomethasone first and then the salmeterol 2. Salmeterol first and then the beclomethasone 3. Alternating a single puff of each, beginning with the salmeterol 4. Alternating a single puff of each, beginning with the beclomethasone 691. Rifabutin (Mycobutin) is prescribed for a client with active Mycobacterium avium complex (MAC) disease and tuberculosis. For which side/ adverse effects of the medication should the nurse monitor? Select all that apply. 1. Signs of hepatitis 2. Flulike syndrome 3. Low neutrophil count 4. Vitamin B6 deficiency 5. Ocular pain or blurred vision 6. Tingling and numbness of the fingers 692. A client has begun therapy with theophylline (Theo-24). The nurse should plan to teach the client to limit the intake of which items while taking this medication? 1. Coffee, cola, and chocolate 2. Oysters, lobster, and shrimp 3. Melons, oranges, and pineapple 4. Cottage cheese, cream cheese, and dairy creamers 693. The nurse has just administered the first dose of omalizumab (Xolair) to a client. Which statement by the client would alert the nurse that the client may be experiencing a life-threatening effect? 1. “I have a severe headache.” 2. “My feet are quite swollen.” 3. “I am nauseated and may vomit.” 4. “My lips and tongue are swollen.” 694. The nurse is caring for a client with a diagnosis of influenza who first began to experience symptoms yesterday. Antiviral therapy is prescribed and the nurse provides instructions to the client about the therapy. Which statement by the client indicates an understanding of the instructions? 1. “I must take the medication exactly as prescribed.” 2. “Once I start the medication, I will no longer be contagious.” 3. “I will not get any colds or infections while taking this medication.” 4. “This medication has minimal side effects and I can return to normal activities.”