Silvestri Saunders Comprehensive Review for the NCLEX-RN®

Silvestri Saunders Comprehensive Review for the NCLEX-RN®1. The nurse is caring for a client in labor. The nurse reviews the physician’s prescriptions and notes that the client has a prescription for butorphanol tartrate (Stadol). The nurse understands that this medication is prescribed for: 1. Pain relief 2. Increasing uterine contractions 3. Decreasing uterine contractions 4. Promoting fetal lung maturity 2. The postpartum nurse is caring for a client with an epidural catheter in place for opioid analgesic administration following cesarean birth. If the client develops respiratory depression and requires naloxone (Narcan) as an antidote, the client may complain of which of the following? 1. Increase in her pain level 2. Decrease in her pain level 3. Increase in the amount of itching from the opioid used in the epidural 4. Decrease in the amount of itching from the opioid used in the epidural 3. A client experiencing preterm labor at the twenty-ninth week of gestation has been admitted to the hospital. The client has a prescription to receive betamethasone (Celestone). The nurse understands that the medication will do which of the following? 1. Prevent spontaneous delivery. 2. Stop the uterine contractions. 3. Promote maturation of the fetal lungs. 4. Accelerate the growth rate of the fetus. 4. A client with preeclampsia is receiving magnesium sulfate. The nurse assesses the client closely for which sign of magnesium toxicity? 1. Proteinuria 2. Hyperactive deep tendon reflexes 3. Respiratory rate of 10 breaths/min 4. Serum magnesium level of 5 mEq/L 5. A pregnant client who has human immunodeficiency virus (HIV) infection is being seen in the antenatal clinic. The nurse recalls that zidovudine (AZT) therapy will be initiated when the fetus has reached how many weeks of gestation? 1. 4 2. 14 3. 24 4. 34 6. The nurse has a routine prescription to instill erythromycin ointment (Ilotycin) into the eyes of a newborn. The nurse plans to explain to the parents that the purpose of the medication is to: 1. Help the newborn to see more clearly. 2. Guard against infection acquired during intrauterine life. 3. Ensure the sterility of the conjunctiva in the newborn. 4. Protect the newborn from contracting an eye infection during birth. 7. The nurse has a routine prescription to administer an injection of phytonadione (vitamin K) to the newborn. Before giving the medication, the nurse explains to the client that this medication will: 1. Prevent clotting abnormalities in the newborn. 2. Stimulate the liver to produce vitamin K. 3. Prevent vitamin deficiency of fat-soluble vitamins. 4. Supplement the infant, because breast milk and formula are low in vitamin K. 8. The client who has developed atrial fibrillation is not responding to medication therapy and has been placed on warfarin (Coumadin). The nurse is doing discharge dietary teaching with the client. The nurse would tell the client to avoid which of the following foods while taking this medication? 1. Cherries 2. Potatoes 3. Broccoli 4. Spaghetti 9. A client in preterm labor is being started on intravenous magnesium sulfate to stop the contractions. The nurse checks the medication to ensure that which medication is available as an antidote if needed? 1. Magnesium oxide 2. Vitamin K 3. Aluminum hydroxide 4. Calcium gluconate 10. The nurse had just given an intramuscular dose of methylergonovine (Methergine) to a client following delivery of an infant. The nurse determines that this medication had the intended effect after evaluating for which of the following findings? 1. Decreased pulse rate 2. Increased urine output 3. Improved uterine tone 4. Increased blood pressure 11. The nurse is told that the result of a serum carbamazepine (Tegretol) level for a child who is receiving the medication for the control of seizures is 10 mcg/mL. Based on this laboratory result, the nurse anticipates that the physician will prescribe: 1. Discontinuation of the medication 2. A decrease of the dosage of the medication 3. An increase of the dosage of the medication 4. Continuation of the presently prescribed dosage 12. The nurse is providing instructions to a mother of a child with atopic dermatitis (eczema) regarding the application of topical cortisone cream to the affected skin sites. Which of the following statements, if made by the mother, indicates an understanding of the use of this medication? 1. “I shouldn’t rub the medication into the skin.” 2. “The medication is applied everywhere except the face.” 3. “I need to wash the sites gently before I apply the medication.” 4. “I need to apply the medication generously and allow it to absorb.” 13. The nurse working in the ambulatory care center is providing medication instructions about methylphenidate (Ritalin) to the mother of a child with attention-deficit/hyperactivity disorder (ADHD). The nurse recommends that the mother give the medication to the child: 1. At bedtime 2. With the evening meal 3. Just before the noontime meal 4. In the morning, 2 hours before breakfast 14. A child has been prescribed to take tetracycline hydrochloride. The nurse providing medication information to the mother would plan to emphasize which of the following most important instructions about giving this medication to the child? 1. Give the medication with milk. 2. Give the medication with ice cream. 3. Mix the medication in a Styrofoam cup. 4. Use a straw when giving the medication. 15. The nurse is providing instructions to the parent of a child with iron deficiency anemia about the administration of a liquid oral iron supplement. Which of the following statements, if made by the parent, indicates an understanding of the administration of this medication? 1. “I should give the iron with food.” 2. “I can mix the iron with cereal to give it.” 3. “I should add the iron to the formula in the baby’s bottle.” 4. “I should use a medicine dropper and place the iron near the back of the throat.” 16. The client with psoriasis is being treated with calcipotriene (Dovonex) cream. Administration of high doses of this medication can cause which side effect? 1. Alopecia 2. Hyperkalemia 3. Hypercalcemia 4. Thinning of the skin 17. Collagenase (Santyl) is prescribed for a client with a severe burn to the hand. The nurse is providing instructions to the client and spouse regarding wound treatment. Which of the following should the nurse include in the instructions? 1. Apply twice a day, and leave it open to the air. 2. Apply once a day, and leave it open to the air. 3. Apply twice a day, and cover it with a sterile dressing. 4. Apply once a day, and cover it with a sterile dressing. 18. A nurse is caring for a female client at home with a diagnosis of actinic keratosis. The client tells the nurse that her skin is very dry and irritated. The treatment includes diclofenac sodium (Solaraze). The nurse teaches the client that this medication is from which class of medications? 1. Anti-infectives 2. Vitamin A lotions 3. Coal tar preparations 4. Nonsteroidal anti-inflammatory drugs (NSAIDs) 19. The client with muscle aches and a diagnosis of rheumatism has been given a prescription for capsaicin topical cream. The nurse evaluates that the client understands the use of the medication if the client states that: 1. The medication will act as a local analgesic. 2. The medication acts by decreasing muscle spasms. 3. The medication will cause redness, flaking, and the skin to peel. 4. A heating pad should be put on the area after applying the medication. 20. The client with a burn injury is applying mafenide (Sulfamylon) to the wound. The client calls the physician’s office and tells the nurse that the medication is uncomfortable and is causing a burning sensation. The nurse instructs the client to: 1. Discontinue the medication. 2. Apply a thinner film than prescribed to the burn site. 3. Continue with the treatment, as this is expected. 4. Come to the office to see the physician immediately. 21. The client with an infected leg wound that is draining purulent material has a prescription for sodium hypochlorite (Dakin solution) to be used in the care of the wound. The nurse would do which of the following while using this solution? 1. Rinse off immediately following irrigation. 2. Pour onto sterile sponges, and pack in wound. 3. Let the solution run freely over normal skin tissue. 4. Use each bottle of solution for 2 weeks before replacing. 22. An adolescent client with severe cystic acne has been prescribed isotretinoin (Accutane). Which statement by the client would suggest the need for further teaching? 1. “I will return to the clinic for blood tests.” 2. “If my lips begin to burn, it is probably because of the medication.” 3. “My eyes may become dry and burn as a result of the medication.” 4. “I need to take my vitamin A supplement so that the treatment will work.” 23. An ambulatory care client with allergic dermatitis has been given a prescription for a tube of diphenhydramine (Benadryl) 1% to use as a topical agent. The nurse determines that the medication was effective if which of the following was assessed? 1. Nighttime sedation 2. Decrease in urticaria 3. Absence of ecchymoses 4. Healing of burned tissue 24. The client with cancer has received a course of chemotherapy and received fluorouracil (Adrucil). The nurse should plan to tell the client to report which of the following immediately? 1. Alopecia 2. Headache 3. Stomatitis and diarrhea 4. Changes in color vision 25. The nurse reviewing a medical record notes that high concentrations of methotrexate followed by leucovorin (citrovorum factor, folic acid) are being given to the client with cancer. The nurse correctly interprets that the reason for therapy with leucovorin is to: 1. Preserve normal cells. 2. Promote protein synthesis. 3. Promote medication excretion. 4. Hasten the effect of the methotrexate. 26. The nurse understands that an indication for the use of asparaginase (Elspar) is: 1. Lung cancer 2. Breast cancer 3. Metastatic prostate cancer 4. Acute lymphocytic leukemia 27. The nurse is caring for a client on the oncology unit who has developed stomatitis during chemotherapy. The nurse would plan which of the following measures to treat this complication? 1. Rinse the mouth with diluted baking soda or saline. 2. Use lemon and glycerin swabs liberally on painful oral lesions. 3. Place the client on NPO status for 12 hours, then resume liquids. 4. Brush the teeth and use nonwaxed dental floss at least twice a day. 28. The client who has been diagnosed with cancer is to receive chemotherapy with both cisplatin (Platinol-AQ) and vincristine (Oncovin). The client asks the nurse why both medications must be given together. The nurse's response is based on the understanding that the purpose of using both medications is to: 1. Prevent the destruction of normal cells. 2. Increase the destruction of tumor cells. 3. Decrease the risk of the alopecia and stomatitis. 4. Increase the likelihood of erythrocyte and leukocyte recovery. 29. The nurse tells the client with leukemia who is receiving chemotherapy that allopurinol (Zyloprim) has been added to the medication list. When the client asks the purpose of the new medication, the nurse responds that the allopurinol is intended to prevent: 1. Nausea 2. Diarrhea 3. Muscle spasms 4. Hyperuricemia 30. The client with breast cancer has been given a prescription for cyclophosphamide (Cytoxan). The nurse determines that the client understands the proper use of the medication if the client states that he or she will: 1. Increase dietary intake of potassium. 2. Take the medication with large meals. 3. Decrease dietary intake of magnesium. 4. Increase fluid intake to 2 to 3 L/day. 31. The nurse should be prepared to institute bleeding precautions in the client receiving antineoplastic medication if which of the following results were reported from the lab? 1. Clotting time, 12 seconds 2. Ammonia level, 28 mcg/dL 3. Platelet count, 50,000 cells/mm3 4. White blood cell count (WBC), 4500/mm3 32. The client with cancer is about to be started on mitomycin (Mutamycin). The nurse should suggest contacting the physician after noting that the client is also taking which of the following medications? 1. Furosemide (Lasix) 2. Ondansetron (Zofran) 3. Warfarin (Coumadin) 4. Allopurinol (Zyloprim) 33. A client with diabetes mellitus taking daily NPH insulin has been started on therapy with dexamethasone (Decadron). The nurse anticipates that which of the following adjustments in medication dosage will be made? 1. Decreased NPH insulin 2. Increased NPH insulin 3. Lower dose of dexamethasone (Decadron) than usual 4. Higher dose of dexamethasone (Decadron) than usual 34. The nurse monitors the blood glucose level of the client who received NPH insulin at 7 AM with an understanding that the client may experience a hypoglycemic reaction between: 1. 9 to 11 AM 2. 1 to 7 PM 3. 7 to 11 PM 4. Midnight to 6 AM 35. The nurse evaluates that the family of a client newly diagnosed with diabetes mellitus correctly understands the reason for having glucagon on hand for emergency home use if the family indicates that the purpose of the medication is to treat: 1. Diabetic ketoacidosis 2. Hypoglycemia from insulin overdose 3. Hyperglycemia from insufficient insulin 4. Hyperglycemia occurring on “sick days” 36. The nurse is teaching a client with hyperthyroidism regarding the prescribed medication propylthiouracil (PTU). The nurse determines that teaching has been successful if the client states that he will report which of the following symptoms to the physician? 1. Fever 2. Nervousness 3. Tiredness 4. Fatigue 37. The nurse teaches the client with hypocalcemia to take calcium carbonate (Os-Cal) at which time? 1. With breakfast 2. At lunch time 3. Just before a meal 4. One hour after a meal 38. The nurse teaches the client being discharged to home with a prescription for a daily dose of prednisone to take the medication: 1. In the early morning 2. In the middle of the day 3. An hour before bedtime 4. Anytime of the day 39. The nurse monitors the client taking octreotide acetate (Sandostatin) for acromegaly for which most frequent side effect of this medication? 1. Diarrhea 2. Dyspnea 3. Constipation 4. Bradycardia 40. A client with a history of coronary artery disease has developed diabetes insipidus as a result of cranial surgery. The client's medication therapy will include vasopressin (Pitressin). The nurse monitors this client most carefully for which of the following sign/ symptom that indicates an adverse effect of this medication? 1. Depression 2. Chest pain 3. Nagging cough 4. Joint stiffness 41. The client has a prescription for sucralfate (Carafate) four times daily. The nurse writes in the medication record to administer the medication at which of the following times? 1. With meals and at bedtime 2. Every 6 hours around the clock 3. One hour after meals and at bedtime 4. One hour before meals and at bedtime 42. The client who chronically uses nonsteroidal anti-inflammatory drugs (NSAIDs) has begun taking misoprostol (Cytotec). Evaluation of the effectiveness of the misoprostol in preventing a side effect of chronic NSAID use is determined by the nurse if the client reports which of the following? 1. “I have fewer muscle aches.” 2. “My joint mobility has improved.” 3. “I no longer have pain above my stomach.” 4. “I am no longer experiencing constipation.” 43. The client in the preoperative holding area has been given a dose of scopolamine. The nurse assesses the client for which of the following side effects of the medication? 1. Dry mouth 2. Diaphoresis 3. Excessive urination 4. Pupillary constriction 44. The client with gastroesophageal reflux disease (GERD) has a new prescription for pantoprazole (Protonix). Which of the following instructions should the nurse plan to provide to the client? 1. Chew the pill thoroughly. 2. Swallow the tablet whole. 3. Crush the pill if it is difficult to swallow. 4. Headache is expected to occur. 45. The client is experiencing diarrhea. The nurse reviews the client’s PRN medication prescription sheet and plans to administer which of the following medications for this problem? 1. Sennosides (Senokot) 2. Bisacodyl (Dulcolax Bowel Prep Kit) 3. Psyllium (Metamucil) 4. Loperamide (Imodium) 46. The client with recurrent constipation has been prescribed psyllium (Metamucil). Teaching provided by the nurse should include which of the following instructions? 1. Mix the psyllium powder with any cold beverage. 2. Mix the psyllium powder with 4 oz of a hot beverage. 3. Mix the psyllium powder with gelatin, applesauce, or pudding. 4. Mix the psyllium powder with 8 oz of water or juice followed by drinking an additional 8 oz of liquid. 47. The nurse is reading the medication list for a postoperative client and notes that a PRN prescription for ondansetron (Zofran) was administered. Evaluation of the effectiveness of the medication is determined by the nurse if the client makes which of the following statements? 1. “My headache is gone.” 2. “The dizziness has stopped.” 3. “I no longer feel nauseous.” 4. “The pain at my incision has decreased.” 48. An older client has been receiving cimetidine (Tagamet). The nurse should report to the physician that the client is experiencing a side effect of the medication if which of the following is noted during the assessment? 1. Tremors 2. Stiff joints 3. Confusion 4. Constipation 49. The nurse monitors the client receiving the first dose of albuterol (Proventil HFA) for which of the following side effects of this medication? 1. Drowsiness 2. Tachycardia 3. Hyperglycemia 4. Hyperkalemia 50. The client has a prescription to receive pirbuterol (Maxair) two puffs and beclomethasone two puffs by metered-dose inhaler. The nurse plans to give these medications most effectively by: 1. Administering the beclomethasone before the pirbuterol 2. Administering the pirbuterol before the beclomethasone 3. Alternating a single puff of each hourly, beginning with the beclomethasone 4. Alternating a single puff of each hourly, beginning with the pirbuterol 51. The client with chronic obstructive pulmonary disease (COPD) is being changed from an oral glucocorticoid to triamcinolone (Azmacort) by inhalation. The nurse plans to monitor the client for which of the following signs and symptoms during the change? 1. Chills, fever, generalized rash 2. Vomiting and diarrhea, increased thirst 3. Blurred vision, headache, and insomnia 4. Anorexia, nausea, weakness, and fatigue 52. The client taking theophylline has a serum theophylline level of 15 mcg/mL. The nurse interprets that this result is _____ the therapeutic range. 1. Below 2. Near the top of 3. In excess of 4. In the middle of 53. The client is taking cetirizine (Zyrtec). The nurse teaches the client to expect which of the following side effects of this medication? 1. Diarrhea 2. Excitability 3. Drowsiness 4. Excess salivation 54. The client is scheduled to receive acetylcysteine (Mucomyst) 20% solution diluted in 0.9% normal saline by nebulizer. Which of the following outcomes would the nurse expect to see as a result of the administration of this medication? 1. Bronchodilation 2. Decreased coughing 3. Absence of wheezing 4. Thinning of respiratory secretions 55. The physician prescribes cromolyn (Intal) for the client with asthma. The nurse identifies that the client correctly understands the purpose of this medication when the client states that the medication will: 1. Suppress an allergic response. 2. Promote bronchodilation. 3. Decrease the risk of infection. 4. Eliminate the need for a rescue inhaler. 56. The nurse teaching the client about the effects of diphenhydramine (Benadryl), an ingredient in the cough suppressant prescribed for the client, should plan to tell the client to do which of the following while taking this medication? 1. Take it on an empty stomach. 2. Avoid activities requiring mental alertness. 3. Use alcohol for additional effect in reducing cough. 4. Avoid chewing sugarless gum or using oral rinses mouth. 57. The physician has prescribed codeine sulfate for a client with a nonproductive cough to suppress the cough reflex. The nurse teaches the client to monitor for: 1. Constipation 2. Painful coughing 3. Difficulty swallowing 4. Increased urination 58. A client with heart disease is taking digoxin (Lanoxin) and complains of having no appetite, diarrhea, and blurry vision. The nurse notes that the client’s serum potassium (K) level is 3.0 ng/mL. Based on analysis of the data, what might the nurse anticipate assessing when reviewing the digoxin level results? 1. Digoxin level lower than 0.5 ng/mL 2. Digoxin level higher than 2 ng/mL 3. Digoxin level of 1.8 ng/mL 4. Digoxin level of 0 ng/mL because of diarrhea 59. The nurse is providing medication information to a client who is beginning medication therapy with enalapril (Vasotec). The nurse reminds the client that which of the following is an anticipated, although unpleasant, side effect of this medication? 1. Rapid pulse 2. Persistent dry cough 3. Increased blood pressure 4. Metallic taste in the mouth 60. A client has recently begun medication therapy with propranolol (Inderal). The long-term care nurse should plan to notify the physician if which of the following assessment findings is noted? 1. Complaints of insomnia 2. Audible expiratory wheezes 3. Decrease in heart rate from 86 to 78 beats/min 4. Decrease in blood pressure from 162/90 to 136/84 mm Hg 61. A client having a myocardial infarction is receiving alteplase (Activase) therapy. Which of the following actions should be carried out by the nurse to monitor for the most frequent adverse effect? 1. Monitor for bleeding. 2. Assess for allergic reaction. 3. Evaluate the client for muscle weakness. 4. Monitor for signs and symptoms of infection. 62. A client is receiving scheduled doses of lovastatin (Mevacor). The nurse evaluates that the medication is having the intended effect if the nurse notes which of the following client data? 1. Weight loss 2. Increased pulse rate 3. Lowered blood pressure 4. Decreased cholesterol level 63. A client taking verapamil (Calan) has been given information about side effects of this medication. The nurse determines that the client understands the information shared if the client states that he or she will watch for which of the following most common side effects of this medication? 1. Weight loss 2. Constipation 3. Nasal stuffiness 4. Abdominal cramping 64. The nurse has a prescription to give a first dose of hydrochlorothiazide (HydroDIURIL) to an assigned client. The nurse would question the prescription if the client has a history of allergy to which of the following? 1. Iodine 2. Shellfish 3. Penicillin 4. Sulfa drugs 65. The nurse has a prescription to give a client a scheduled dose of digoxin (Lanoxin). Prior to administering the medication, the nurse assesses for which of the following manifestations that could indicate digoxin toxicity? 1. Dyspnea, edema, and palpitations 2. Chest pain, hypotension, and paresthesias 3. Constipation, dry mouth, and sleep disorder 4. Double vision, loss of appetite, and nausea 66. A client with a history of angina pectoris complains of substernal chest pain. The nurse checks the client’s blood pressure and administers nitroglycerin, gr 1/4 sublingually. Five minutes later, the client is still experiencing chest pain. If the blood pressure is still stable, the nurse should take which of the following actions next? 1. Administer another nitroglycerin tablet. 2. Administer 10 L of oxygen via nasal cannula. 3. Call for a 12-lead electrocardiogram (ECG) to be performed. 4. Wait an additional 5 minutes, then give a second nitroglycerin tablet. 67. The long-term care client with a history of heart failure has developed paroxysmal nocturnal dyspnea (PND). The nurse reviews the client’s medication record and determines that which of the following medications has been prescribed to treat the PND? 1. Bumetanide (Bumex) 2. Propranolol (Inderal) 3. Warfarin (Coumadin) 4. Acetylsalicylic acid (aspirin) 68. The nurse is working with a client receiving an intravenous heparin sodium drip. The nurse should review which of the following laboratory studies to determine the therapeutic effect of heparin for the client? 1. Bleeding time 2. Thrombin time 3. Prothrombin time (PT) 4. Partial thromboplastin time (PTT) 69. The ambulatory care nurse is providing instructions to a client with a urinary tract infection (UTI) being started on medication therapy with nitrofurantoin (Macrodantin), a urinary antiseptic agent. The nurse tells the client that: 1. It can cause urinary retention. 2. It will cause the urine to become clear. 3. If taken with meals, it will help decrease the risk for gastrointestinal (GI) upset. 4. The sun should be avoided because it is a sulfa-based medication. 70. A client is beginning to take trimethoprim-sulfamethoxazole (Bactrim) for a recurrent urinary tract infection (UTI). The nurse would give the client which of the following instructions regarding this medication? 1. Discontinue medication when symptoms subside. 2. Expect rashes or skin changes as a result of therapy. 3. Take most doses early in the day when fluid intake is greatest. 4. Take each dose with 8 oz of water, and drink extra water each day. 71. A client with a urinary tract infection (UTI) has been prescribed to take ciprofloxacin (Cipro). The nurse notes that the client also has a prescription for theophylline written by a pulmonologist. The nurse should do which of the following? 1. Clarify the medication prescriptions. 2. Encourage intake of antacids. 3. Schedule the doses to be given together. 4. Schedule the doses to be given at the same time. 72. The client with a urinary tract infection (UTI) has dysuria and is given a prescription for phenazopyridine (Pyridium) for symptom relief. The nurse provides medication teaching with this client and tells the client to: 1. Take the medication at bedtime. 2. Take the medication before meals. 3. Notify the physician if headache occurs. 4. Expect the urine to become reddish-orange. 73. The nurse is preparing a subcutaneous dose of bethanechol (Urecholine) prescribed for a client with urinary retention. Before giving the dose, the nurse checks to see that which of the following medications is available on the emergency cart for use if needed? 1. Vitamin K 2. Mucomyst 3. Atropine sulfate 4. Protamine sulfate 74. A client who has undergone renal transplant is receiving ongoing therapy with cyclosporine (Sandimmune). The nurse would be sure to immediately report the results of periodic laboratory results that indicate which of the following? 1. Decreased creatinine level 2. Decreased hemoglobin level 3. Elevated blood urea nitrogen (BUN) level 4. Decreased white blood cell (WBC) count 75. A client is receiving tacrolimus (Prograf) to prevent organ rejection. Which of the following is a nursing considerations associated with this medication? 1. Give with cyclosporine (Sandimmune). 2. Assess for hypoglycemia. 3. Give with grapefruit juice. 4. Assess platelet count for thrombocytopenia. 76. A client must begin medication therapy with mycophenolate mofetil (CellCept) to prevent organ rejection following renal transplantation. The nurse plans to provide which of the following teaching points to the client? 1. Take the dose following meals. 2. Notify the physician if a fever develops. 3. Open the capsule and mix with food before use. 4. Take the medication with an aluminum-based antacid. 77. The client in renal failure is receiving epoetin alfa (Epogen). The nurse would monitor this client for which adverse effect of this medication? 1. Depression 2. Bradycardia 3. Fever 4. Hypertension 78. The preoperative medication sheet identifies that cyclopentolate (Cyclogyl) is prescribed for a client prior to cataract surgery. The nurse understands that the action of the medication is to: 1. Lubricate the affected eye. 2. Dilate the pupil of the affected eye. 3. Promote miosis of the affected eye. 4. Constrict the pupil of the affected eye. 79. The client being discharged to home with a prescription for eye drops to be given in the left eye has received instructions regarding self-administration of the drops. The nurse determines that the client needs further instruction if, on return demonstration, the client: 1. Lies supine, pulls up on the upper lid, and puts the drop in the upper lid 2. Lies supine, pulls down on the lower lid, and puts the drop in the lower lid 3. Tilts the head back, pulls down on the lower lid, and puts the drop in the lower lid 4. Lies with head to the right, puts the drop in the inner canthus, and slowly turns to the left while blinking 80. The nurse teaching a mother how to administer ear drops to an infant tells the mother to pull the child’s ear: 1. Up and back and direct the solution onto the eardrum 2. Down and back and direct the solution onto the eardrum 3. Up and back and direct the solution toward the wall of the canal 4. Down and back and direct the solution toward the wall of the canal SC: Integrated Process: Teaching and Learning 81. The nurse is describing medication side effects to a client who is taking a benzodiazepine. The nurse tells the client to take the medication only as prescribed because of the most serious risk of: 1. Headache 2. Skin rashes 3. Dependence 4. Gastrointestinal side effects 82. The nurse would question the physician if which of the following medications was prescribed for a client with glaucoma? 1. Pilocarpine HCl (Pilocar) 2. Pilocarpine nitrate 3. Atropine sulfate (Isopto Atropine) 4. Carteolol hydrochloride (Ocupress) 83. When teaching the client about the effects of a miotic medication, the nurse plans to tell the client that the medication will: 1. Reshape the lens to eliminate blurred vision. 2. Interrupt the drainage of aqueous humor from the eye. 3. Dilate the pupil to reduce intraocular pressure. 4. Lower intraocular pressure and improve blood flow to the retina. 84. Betaxolol (Betoptic) eye drops have been prescribed for the client with glaucoma. The nurse monitoring this client for side effects of the medication would place highest priority on which of the following? 1. Pulse rate 2. Blood glucose 3. Respiratory rate 4. Oxygen saturation 85. The client who has sustained an eye injury has been prescribed prednisolone (Inflamase). The nurse would most carefully monitor for side effects of this medication if the client has which of the following health problems listed on the medical record? 1. Cirrhosis 2. Hypertension 3. Diabetes mellitus 4. Chronic constipation 86. The client with chronic glaucoma is being started on medication therapy with acetazolamide (Diamox). The nurse teaches the client that which of the following symptoms can occur early in the use of this medication? 1. Diuresis 2. Fatigue 3. Headache 4. Loss of libido 87. The nurse is assisting in the care of a client who is being seen in the clinic with a suspected acetaminophen (Tylenol) overdose. Which of the following medications should the nurse plan to have readily available if the suspected diagnosis is confirmed? 1. Auranofin (Ridaura) 2. Pentostatin (Nipent) 3. Fludarabine (Fludara) 4. Acetylcysteine (Mucomyst) 88. The client reports frequent use of acetaminophen (Tylenol) for relief of frequent headaches and other discomforts. The nurse should evaluate which of the diagnostic data to determine if the client is at risk for toxicity? 1. The chest x-ray 2. The upper gastrointestinal x-ray results 3. The electrocardiogram 4. The liver function studies 89. The client with a history of spinal cord injury is beginning medication therapy with baclofen (Lioresal). The nurse determines that the client understands the side effects of the medication if the client states which of the following? 1. “The medication may make me drowsy.” 2. “The medication can cause high blood pressure.” 3. “The medication may increase my sensitivity to bright light.” 4. “The medication may cause me to have some muscle pain.” 90. The nurse is assisting in the care of a client who is being evaluated for possible myasthenia gravis. The health care provider gives a test dose of edrophonium (Tensilon). Evaluation of the results indicates that the test is positive. Which of the following would be the expected response noted by the nurse? 1. Joint pain for the next 15 minutes 2. A decrease in muscle strength within 1 to 3 minutes 3. An increase in muscle strength within 1 to 3 minutes 4. Feelings of faintness or dizziness for 5 to 10 minutes 91. The nurse is assisting in the care of a client with myasthenia gravis who is receiving pyridostigmine (Mestinon). Which of the following medications should the nurse plan to have readily available should the client develop cholinergic crisis because of excessive medication dosage? 1. Vitamin K 2. Atropine sulfate 3. Protamine sulfate 4. Acetylcysteine (Mucomyst) 92. The client with myasthenia gravis becomes increasingly weaker. The physician injects a dose of edrophonium (Tensilon) to determine whether the client is experiencing a myasthenic crisis or a cholinergic crisis. The nurse expects that the client will have which of the following reactions if the client is in cholinergic crisis? 1. No change in the condition 2. Complaints of muscle spasms 3. An improvement of the weakness 4. A temporary worsening of the condition 93. The nurse is providing instructions to a client beginning medication therapy with divalproex sodium (Depakote) for treatment of absence seizures. The nurse instructs the client that which of the following represents the most frequent side effect of this medication? 1. Tinnitus 2. Irritability 3. Blue vision 4. Nausea and vomiting 94. The nurse is speaking with a female client taking phenytoin (Dilantin) for seizure control. The client states that she has started using birth control pills to prevent pregnancy. Which of the following would be an important point for the nurse to stress to the client? 1. Oral contraceptives decrease the effectiveness of phenytoin. 2. Severe gastrointestinal side effects can occur when phenytoin and oral contraceptives are taken together. 3. There is an increased risk of thrombophlebitis when phenytoin and oral contraceptives are taken at the same time. 4. Phenytoin may decrease effectiveness of birth control pills, and additional measures should be taken to avoid pregnancy. 95. The nurse is reading the laboratory results for a client being treated with carbamazepine (Tegretol) for prophylaxis of complex partial seizures. When evaluating the client’s laboratory data, the nurse determines that which of the following values is consistent with an adverse effect of this medication? 1. Blood urea nitrogen (BUN), 19 mg/dL 2. Sodium level, 136 mEq/L 3. Platelet count, 350,000/mm3 4. White blood cell count, 3200/mm3 96. The nurse is caring for a client receiving codeine sulfate for pain. The nurse determines that the client is experiencing a side effect of the medication based on which of the following findings? 1. Distended jugular veins 2. Bounding peripheral pulses 3. No bowel movement in 3 days 4. Change in blood pressure from 120/60 to 140/80 mm Hg 97. The nurse is administering a prescribed dose of dexamethasone (Decadron) to a client following cranial surgery. Which of the following interventions would the nurse perform to assess for a common side effect of this medication? 1. Monitor for hair loss. 2. Monitor laboratory test results for hyperkalemia. 3. Assess for decreased skin turgor. 4. Obtain a prescription for blood glucose monitoring. 98. The client with a new medication prescription for allopurinol (Zyloprim) asks the nurse, “I know this is for gout, but how does it work?” In formulating a response, the nurse understands that allopurinol: 1. Decreases uric acid production 2. Reduces the production of fibrinogen 3. Lowers the risk of sulfa crystal formation in the urine 4. Prevents influx of calcium ions during cell depolarization 99. The client newly diagnosed with gout has been prescribed allopurinol (Zyloprim). The nurse would be concerned if the client was also currently taking: 1. Digoxin (Lanoxin) 2. Adenosine (Adenocard) 3. Warfarin (Coumadin) 4. Ergonovine maleate (Ergotrate) 100. The client tentatively diagnosed with gout has received a prescription for colchicine. The nurse understands that colchicine is a(n): 1. Anti-inflammatory agent specific for gout 2. Nonsteroidal anti-inflammatory drug (NSAID) 3. Analgesic that relieves pain 4. Osmotic diuretic that facilitates the removal of uric acid 101. The client with osteoarthritis is receiving diclofenac sodium (Voltaren). The nurse would be concerned about the administration of this medication if the client’s history and physical included a diagnosis of: 1. Graves’ disease 2. Peptic ulcer disease 3. Coronary artery disease 4. Benign prostatic hypertrophy 102. Baclofen (Lioresal) is prescribed for the client with multiple sclerosis. The nurse determines that the medication is having the intended effect if which of the following is noted in the client? 1. Increased muscle tone 2. Increased range of motion 3. Decreased muscle spasms 4. Decreased local pain and tenderness 103. Dantrolene sodium (Dantrium) is prescribed for the client experiencing flexor spasms. The client asks the nurse how the medication is going to help. The nurse replies that this medication acts: 1. To depress the spinal reflexes causing the spasms 2. On the central nervous system (CNS) to suppress spasms 3. Directly on the skeletal muscle to relieve the spasms 4. Within the spinal cord to suppress excess reflex activity 104. The nurse is reviewing laboratory results for a client taking dantrolene sodium (Dantrium). The nurse should notify the physician if which of the following is noted on the laboratory report sheet? 1. Creatinine level, 0.6 mg/dL 2. Platelet count, 290,000/mm3 3. Blood urea nitrogen (BUN) level, 9 mg/dL 4. Lactic dehydrogenase (LDH) level, 600 units/L 105. The nurse is reviewing the medical record of a newly assigned client and notes that the client is receiving cyclobenzaprine hydrochloride (Flexeril) for the treatment of muscle spasms. The nurse questions the prescription if which of the following disorders is noted in the admission history? 1. Hypothyroidism 2. Chronic bronchitis 3. Recurrent pneumonia 4. Angle-closure glaucoma 106. The nurse is assigned to care for a client with multiple sclerosis who is receiving an intravenous (IV) dose of methocarbamol (Robaxin). The nurse monitors the client knowing that which of the following is an expected side effect? 1. Dark green colored urine 2. Excitability 3. Insomnia 4. Hypertension 107. The nurse is collecting data from a client with a history of renal transplantation. The nurse understands that the medication of choice for preventing organ rejection is: 1. Probenecid 2. Indomethacin (Indocin) 3. Prednisone 4. Cyclosporine (Sandimmune) 108. Cyclosporine (Sandimmune) is prescribed for the client following allogenic kidney transplantation. The nurse provides instructions to the client regarding the medication and tells the client that: 1. There are no known adverse effects of the medication. 2. The medication will need to be taken for a period of 6 months. 3. Blood levels of the medication will need to be measured periodically. 4. The medication is administered by the intravenous (IV) route on a monthly basis. 109. Blood work has been drawn on a client who has been taking cyclosporine (Sandimmune) following allogenic liver transplantation. The nurse checks the results of which of the following tests to determine the presence of an adverse effect related to this medication? 1. Hematocrit level 2. Hemoglobin level 3. Cholesterol level 4. Blood urea nitrogen (BUN) level 110. Dapsone (DDS) is prescribed for a client with acquired immunodeficiency syndrome (AIDS) for the treatment of toxoplasmosis. The nurse provides medication instructions and determines that the client understands the instructions if the client states that he or she will: 1. Report a sore throat to the physician. 2. Discontinue the medication if nausea develops. 3. Plan to take the medication every 4 hours around the clock. 4. Expect that abdominal pain and jaundice will occur as normal side effects. 111. The client who is seropositive for human immunodeficiency virus (HIV) has been taking ritonavir (Norvir). The nurse tells the client that which follow-up laboratory study will be necessary while taking this medication? 1. Platelet count 2. Triglyceride level 3. Prothrombin time (PT) 4. International normalized ratio (INR) 112. The client who is seropositive for human immunodeficiency virus (HIV) has been taking stavudine (d4T, Zerit XR). The nurse assesses which of the following most closely while the client is taking this medication? 1. Appetite 2. Gastrointestinal function 3. Presence of paresthesia 4. Level of consciousness (LOC) 113. The nurse is assigned to care for a client with cytomegalovirus retinitis and acquired immunodeficiency syndrome (AIDS) who is receiving foscarnet (Foscavir). The nurse reviews the physician’s prescriptions, expecting to note a prescription for which of the following laboratory tests while this client is taking the medication? 1. CD4 cell count 2. Serum albumin level 3. Serum creatinine level 4. Lymphocyte count 114. The client with acquired immunodeficiency syndrome (AIDS) and Pneumocystis jiroveci infection has been receiving pentamidine (Pentam 300). The nurse caring for the client monitors the client most closely for signs of: 1. Nausea 2. Fatigue 3. Infection 4. CD4 cell count 115. The client with human immunodeficiency virus (HIV) infection has been started on therapy with zidovudine (AZT, Retrovir). The nurse reviews the physician’s prescriptions, expecting to note that which of the following laboratory tests have been prescribed? 1. Blood culture 2. Blood glucose level 3. Blood urea nitrogen level (BUN) 4. Complete blood cell count (CBC) 116. The nurse is preparing to administer pentamidine isethionate (Pentam 300) to an assigned client by the intravenous route. The nurse plans to monitor which of the following most closely after administering this medication? 1. Capillary refill 2. Peripheral pulses 3. Blood pressure (BP) 4. Level of consciousness 117. Ketoconazole (Nizoral) is prescribed for an assigned client. The nurse prepares to administer the medication: 1. With food 2. With an antacid 3. With 8 oz of water 4. On an empty stomach 118. A client receiving long-term therapy with lithium carbonate (Lithobid) exhibits muscle tremors, confusion, vomiting, and diarrhea. The nurse anticipates that the results of the latest test of the serum lithium level will be between: 1. 0 and 0.5 mEq/L 2. 0.6 and 1.0 mEq/L 3. 1.0 and 1.3 mEq/L 4. 1.5 and 2.0 mEq/L 119. The nurse is administering thioridazine hydrochloride (Mellaril). The nurse will monitor the client carefully for which of the following? 1. Weight gain 2. Photosensitivity 3. Cardiac dysrhythmias 4. Extrapyramidal movements 120. A client has been started on therapy with lithium carbonate (Lithobid). The nurse instructs the client to do which of the following? 1. Limit salt intake. 2. Limit food intake. 3. Maintain a fluid intake of 2 to 3 L/day. 4. Stop the medication if gastrointestinal (GI) disturbances occur. 121. The nurse is discussing the past week’s activities with a client receiving amitriptyline hydrochloride. The nurse determines that the medication is most effective for this client if the client reports which of the following? 1. A decrease in appetite 2. Sleeping 14 to 16 hours each day 3. Ability to get to work on time each day 4. Having difficulty concentrating on an activity 122. The client taking buspirone hydrochloride (BuSpar) for 1 month is scheduled for a follow-up appointment. The nurse gathers data from the client and interprets that the medication is effective if the client reports an absence of: 1. Delusions 2. Paranoid thoughts 3. Palpitations and anxiety 4. Alcohol withdrawal symptoms 123. The nurse employed in the mental health clinic is interviewing a female client who has had clomipramine hydrochloride (Anafranil) prescribed. The nurse interprets that the client is noncompliant with taking the medication as prescribed if the client exhibits which of the following behaviors? 1. Tired, fatigued appearance 2. Complaints of hunger and fatigue 3. Slight dizziness when standing up quickly 4. Frequently checking her purse for her keys 124. The client has been started on medication therapy with alprazolam (Xanax). When the nurse teaches the client that the medication should not be discontinued abruptly, the client asks why. The nurse should incorporate which of the following when formulating a reply? 1. The client is likely to suffer irreversible kidney damage. 2. The client is likely to become resistant to medication effects. 3. It will make the medication much less effective if it must be restarted. 4. Rebound central nervous system (CNS) excitation could occur, including seizure activity. 125. The client with schizophrenia has been started on medication therapy with clozapine (Clozaril). The nurse reviews the results of laboratory studies for this client to detect which of the following adverse effects of this medication? 1. Platelet count 2. Blood glucose level 3. Liver function 4. White blood cell (WBC) count COMPLETION 1. The nurse is preparing to administer a 50-mcg dose of medication to a client. The medication is available in 100 mcg/5 mL. How many mL should the nurse administer? Answer: __________ mL 2. A client is prescribed to receive metoclopramide (Reglan) 5 mg IV. How many milliliters should the nurse administer if the available concentration is 10 mg/2 mL? Answer: __________ mL MULTIPLE RESPONSE 1. The nurse is assigned to care for a client with metastatic breast cancer who is taking tamoxifen citrate (Soltamox). The nurse plans to monitor for which of the following changes in laboratory values for this client? Select all that apply. 1. Increased lipase level 2. Increased serum potassium level 3. Increasing blood glucose level 4. Increase in serum calcium level 5. Decreased low-density lipoprotein levels 2. When teaching the client with adrenal insufficiency about cortisone (Cortone), the nurse should include which of the following? Select all that apply. 1. Increase intake of sodium. 2. Take the medication with food. 3. Increase intake of potassium-rich foods. 4. Stay away from people with active infections. 5. Discontinue the medication when symptoms subside. 6. Notify the physician if illness occurs or surgery is anticipated. 3. The client has begun therapy with oxtriphylline. The nurse determines that the client understands dietary alterations if the client states to limit which of the following while taking this medication? Select all that apply. 1. Milk 2. Coffee 3. Oysters 4. Oranges 5. Pineapple 6. Chocolate 4. The nurse has provided discharge instructions to a client being placed on long-term anticoagulant therapy with warfarin (Coumadin). Adequate learning would be evident if the client makes which of the following statements? Select all that apply. 1. “I will inform my dentist that I am taking Coumadin.” 2. “I may take over-the-counter medications as needed.” 3. “I should alternate the timing of my daily dose of Coumadin.” 4. “I will have my blood levels checked as prescribed by my physician.” 5. “I will report any signs of blood in my urine or stool to my physician.” 6. “I should use a firm-bristled toothbrush to prevent the side effects of Coumadin.” . 5. The nurse is assisting in the care of a client being discharged on phenytoin (Dilantin), 100 mg 3 times daily, for seizure control. When providing client teaching about this medication, the nurse should be sure to include which of the following points? Select all that apply. 1. Break the capsules so they are easier to swallow. 2. Use a soft toothbrush while taking this medication. 3. If a dose is missed, just wait until the next one is due. 4. Alcohol should be avoided while taking this medication. 5. The medication may turn the client’s urine pink, red, or brown. 6. Sore throat is a common side effect of the medication and is nothing to worry about. 6. The client with schizophrenia has been started on medication therapy with clozapine (Clozaril). Which of the following are side effects of this medication? Select all that apply. 1. Diarrhea 2. Sedation 3. Dry mouth 4. Weight loss 5. Orthostatic hypotension 6. Presence of a fixed stare 7. The client has begun taking phenelzine (Nardil). At the initiation of therapy, which of the following items does the nurse teach the client to allow in the diet? Select all that apply. 1. Avocados 2. Figs and raisins 3. Bologna or salami 4. Carrots or radishes 5. Sweet potatoes and squash 6. Red wine, such as Chianti or sherry 8. The nurse has a prescription to administer a dose of iron by a parenteral route to an assigned client. Which of the following would the nurse implement to administer this medication correctly via the intramuscular route? Select all that apply. 1. Use a Z-track method. 2. Administer the medication only in the deltoid. 3. Aspirate for blood after the needle is inserted. 4. Use an air lock when drawing up the medication. 5. Change the needle after drawing up the dose and before injection. 6. Massage the injection site well after injection to hasten absorption. Carbidopa-levodopa (Sinemet) adverse effect? Impaired voluntary movements The home health nurse visits a client who is taking phenytoin (Dilantin) for control of seizures. During the assessment, the nurse notes that the client is taking birth control pills. Which information should the nurse include in the teaching plan? Meperidine hydrochloride (Demerol) has been prescribed for a client to treat pain. Which are side/adverse effects of this medication? Select all that apply. 1. Diarrhea 2. Tremors 3. Drowsiness 4. Hypotension 5. Urinary frequency 6. Increased respiratory rate ?2. Tremors ?3. Drowsiness ?4. Hypotension ? 3. Slurred speech c/o of back spams, Since aspirin intoxication is suspected, the nurse should assess the client for which manifestation? 1. Tinnitus 7. A client with trigeminal neuralgia is being treated with carbamazepine (Tegretol), 400 The nurse in a long-term care facility is reviewing the health care provider's (HCP) prescriptions on an assigned client. The nurse notes that the HCP prescribed ropinirole hydrochloride (Requip). The nurse determines that this medication has been prescribed to treat which condition in the client? 4. Parkinsonian syndrome A client is receiving phenobarbital sodium (Luminal) for the treatment of a seizure disorder. Which finding on the nursing assessment would indicate that the client is experiencing a common side effect of this medication? 1. Drowsiness A client with suspected opioid overdose has received a dose of naloxone hydrochloride (Narcan). The client subsequently becomes restless, starts to vomit, and complains of 50 mg/min A client is scheduled to begin medication therapy with valproic acid (Depakene). The nurse looks for the results of which laboratory test(s) before administering the first dose? Liver function tests A client is scheduled to begin therapy with carbamazepine (Tegretol). The nurse should assess the results of which test(s) before administering the first dose of this medication to the client? Complete blood cell count Dantrolene sodium (Dantrium) has been administered to a client with a spinal cord injury. The nurse determines that the client is experiencing an adverse effect of the medication if which is noted? Abdominal pain The nurse notes that a client taking ergotamine tartrate (Cafergot) is having the intended effects of therapy if the client states relief from which symptom? Headaches A client who has been taking phenytoin (Dilantin) for seizure control has a serum phenytoin drug level of 8 mcg/mL. The nurse should make which interpretation about this value? An inadequate drug level A client has a medication prescription for phenytoin (Dilantin) to be administered by the intravenous route. After drawing up the medication, the nurse notes the presence of precipitate in the syringe. Which action should the nurse take Discard the syringe and begin again. A client with a diagnosis of Parkinson's disease began taking amantadine (Symmetrel) approximately 2 weeks ago. The client reports to the clinic for a follow-up evaluation. The nurse determines that the client is experiencing an adverse effect related to the use of this medication if which is noted? Client complaints of urinary retention A client with insomnia has been started on zolpidem (Ambien). After instructing the client in how to obtain the maximal effect of zolpidem, the nurse determines that the client demonstrates understanding of correct administration of the medication by which The nurse has the following prescription for a postcraniotomy client, "dexamethasone (Decadron) 4 mg by the intravenous (IV) route now." How does the nurse administer the medication? IV push over 1 minute A client is experiencing impotence after taking guanfacine (Tenex). The client states, "I would sooner have a stroke than keep living with the effects of this medication." What is the most appropriate response by the nurse? You are concerned about the effects of your medication." A client with Parkinson's disease has been prescribed benztropine (Cogentin). The nurse should assess for which gastrointestinal (GI) problems as a side effect of this medication? Dry mouth A client has been prescribed cyclobenzaprine (Flexeril) for the treatment of painful muscle spasms accompanying a herniated intervertebral disk. The nurse should withhold the medication and question the prescription if the client has a concurrent prescription for which medication? Tranylcypromine (Parnate) to perform which action? Institute seizure precautions. The nurse has a prescription to administer phenytoin (Dilantin) 100 mg by the intravenous (IV) route to a client. The nurse administers the medication after preparing it in which solution? 0.9% normal saline with an in-line filter The nurse in the health care provider's office is reviewing the results of a client's phenytoin (Dilantin) level determination performed that morning. The nurse identifies that a therapeutic drug level has been achieved if which result is noted? 15 mcg/mL A client with a history of simple partial seizures is taking clorazepate (Tranxene). The client asks the nurse if there is a risk of addiction with this medication. The nurse's long 30 minutes A client with narcolepsy has been prescribed dextroamphetamine (DextroStat). The client complains to the nurse that he cannot sleep well at night and does not want to take the medication any longer. Before making any specific comment, the nurse plans medication at what time? 30 minutes before meals A client with myasthenia gravis who is taking neostigmine (Prostigmin) is experiencing frequent exacerbations of myasthenic crisis and cholinergic crisis. The nurse teaches the client that it is most important that this medication be taken in which manner? On time A client began taking amantadine (Symmetrel) approximately 2 weeks ago. The nurse determines that the medication is having a therapeutic effect if the client exhibits which finding? Decreased rigidity and akinesia A client has been prescribed a cough formula containing codeine sulfate. The nurse has given the client instructions for its use. The nurse concludes that the client understands the instructions if the client verbalizes to self-assess for which side effect? Constipation Propofol (Diprivan) is prescribed to induce sedation in a client who is intubated and is Complete blood cell (CBC) count A nurse is transcribing a prescription for antibiotic therapy for a client with bacterial meningitis. The nurse understands that the medication that will be prescribed for the client will have which characteristic? Crosses the blood-brain barrier The health care provider is preparing to administer edrophonium (Enlon) to the client with myasthenia gravis. In planning care, the nurse understands which about the administration of edrophonium? Select all that apply. ?2. Atropine is used to reverse the effects of edrophonium. ?3. If symptoms worsen following administration of edrophonium, the crisis is cholinergic. ?4. Edrophonium is used to distinguish between a myasthenic crisis and a cholinergic Normal saline solution A client is suspected of having myasthenia gravis. Edrophonium (Enlon) is administered intravenously to determine the diagnosis. Which indicates that the client may have myasthenia gravis? An increase in muscle strength within 30 to 60 seconds following administration of the medication Meperidine hydrochloride (Demerol) is prescribed for a client with pain. What should the nurse monitor for as a side/adverse effect of this medication? Urinary retention The nurse is caring for a client receiving morphine sulfate for pain. Because this medication has been prescribed for this client, which nursing action should be included in the plan of care? Encourage the client to cough and deep breathe. A nurse is caring for a client who has been taking hydrocodone for the last 3 months. Which side/adverse effects of this medication should the nurse assess the client for Psychological and physical dependence A nurse is reviewing the results of a test on a sample drawn from a child who is receiving carbamazepine (Tegretol) for the control of seizures. The results indicate a serum carbamazepine level of 10 mcg/mL. The nurse analyzes the results and anticipates that the health care provider (HCP) will note which prescription? Continuation of the presently prescribed dosage The nurse is caring for a client who underwent an open reduction internal fixation to the right hip. When administering opioid analgesics for pain, the nurse should instruct the client that The nurse is assisting in the care of a client with myasthenia gravis who is receiving pyridostigmine (Mestinon). Which medication should the nurse plan to have readily available should the client develop cholinergic crisis because of excessive medication dosage? Atropine sulfate A client with myasthenia gravis becomes increasingly weaker. The health care provider (HCP) injects a dose of edrophonium (Enlon) to determine whether the client is experiencing a myasthenic crisis or a cholinergic crisis. The nurse expects that the client will have which reaction if in cholinergic crisis? A temporary worsening of the condition A nurse is providing instructions to a client beginning medication therapy with divalproex sodium (Depakote) for treatment of absence seizures. The nurse instructs the client that which represents the most frequent side effect of this medication? Nausea and vomiting A nurse is speaking with a client taking phenytoin (Dilantin) for seizure control. The client states that she has started using birth control pills to prevent pregnancy. Which would be an important point for the nurse to emphasize to the client? Phenytoin may decrease effectiveness of birth control pills, and additional measures should be taken to avoid pregnancy. A nurse is reading the laboratory results for a client being treated with carbamazepine (Tegretol) for prophylaxis of complex partial seizures. When evaluating the client's laboratory test will be prescribed? triglyceride test 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? pulmonary function studies Bleomycin is an antineoplastic medication that can cause interstitial pneumonitis, which can progress to pulmonary fibrosis. Pulmonary function studies along with hematological, hepatic, and renal function tests need to be monitored. The nurse needs to monitor lung sounds for dyspnea and crackles, which indicate pulmonary toxicity. The medication needs to be discontinued immediately if pulmonary toxicity occurs. he nurse is monitoring a client who is taking digoxin (Lanoxin) for adverse effects. Which findings are characteristic of digoxin toxicity? Select all that apply. Nausea and vomiting Diarrhea Blurred vision Nausea and vomiting Prior to administering a client's daily dose of digoxin, the nurse reviews the client's laboratory data and notes the following results: serum calcium, 9.8 mg/dL; serum magnesium, 1.2 mg/dL; serum potassium, 4.1 mEq/L; serum creatinine, 0.9 mg/dL. Which result should alert the nurse that the client is at risk for digoxin toxicity? should check which measurement before administering the medication? Weight Apical pulse Blood pressure Potassium level Blood pressure Ramipril (Altace) is an angiotensin-converting enzyme (ACE) inhibitor, and a serious side effect of this drug is profound hypotension. The client's blood pressure should be checked before administration of this medication. The medication does not cause weight gain or loss, bradycardia, or depletion of potassium. Study Mode Question 22 of 111 ?? A client with hypertension has a new prescription for a medication called moexipril (Univasc). The nurse plans to provide written directions that tell the client to take the contact the HCP if which assessment finding is documented in the client's medical record? Muscle weakness History of asthma Presence of infection Complete atrioventricular (AV) block Complete atrioventricular (AV) block Quinidine gluconate is an antidysrhythmic medication used to maintain normal sinus rhythm after conversion of atrial fibrillation or atrial flutter. It is contraindicated in complete AV block Study Mode Question 43 of 111 ?? Reduce pain. Reduce inflammation. Inhibit platelet aggregation. Maintain a normal body temperature. Inhibit platelet aggregation. Atenolol (Tenormin) has been prescribed for a client, and the client asks the nurse about the action of the medication. How should the nurse respond regarding the action of this medication? Slows the heart rate Allergy to eggs Nephrotic syndrome Allergy to sulfonamides Allergy to sulfonamides The nurse is performing an assessment on a client with a diagnosis of chronic angina pectoris. The client is receiving sotalol (Betapace) orally daily. Which assessment finding indicates to the nurse that the client is experiencing a side/adverse effect related to the medication? Dry mouth Diaphoresis Palpitations Difficulty swallowing Palpitations Daily administration of dipyridamole (Persantine) been prescribed for the client, and the nurse teaches the client about the medication. Which client statement indicates an understanding of the instructions? "This medication will prevent a stroke." "This medication will prevent a heart attack." " this client relative to the medication therapy? Auscultate bowel sounds. Study Mode Question 91 of 111 ?? A nurse is caring for a client with hyperlipidemia who is taking cholestyramine (Questran). Which nursing assessment is most significant for this client relative to the medication therapy? Test-Taking Strategy: Note the strategic word most and focus on the subject, assessment of the client receiving cholestyramine (Questran). Knowledge of the medication is needed to answer this question. Remember that the medication's site of action is the bowel and can result in constipation. This will direct you to option 2. The other options do not relate to this medication A nurse should educate the client receiving pravastatin (Pravachol) to immediately report which finding? atigue Diarrhea Sore throat Muscle pain Muscle pain Pravastatin is used to treat hyperlipidemia. Muscle pain could indicate rhabdomyolysis, a serious complication of this medication. A health care provider writes a prescription for digoxin (Lanoxin), 0.25 mg daily. The nurse teaches the client about the medication and tells the client that it is most important to be sure to implement which measure? if the pulse is slower than 60 bpm Study Mode Question 107 of 111 ?? The nurse has a prescription to give a client a scheduled dose of digoxin (Lanoxin). Prior to administering the medication, the nurse should assess for which manifestations that could indicate digoxin toxicity? Dyspnea, edema, and palpitations Chest pain, hypotension, and paresthesias Constipation, dry mouth, and sleep disorder Double vision, loss of appetite, and nausea "The medication causes the pupil to constrict and will lower the pressure in the eye." In preparatio