NURSING 239 Pharm Hesi Prep assignment with answers

NURSING 239 Pharm quiz assignment answers 1.ID: Which route should the nurse clarify with the healthcare provider prior to administering a drug with a high first-pass effect? A. Intravenous. B. Buccal. C. Sublingual. D. Oral. Correct Awarded 5.0 points out of 5.0 possible points. 2.ID: A client calls the clinic and states that she forgot to take her oral contraceptives for the past two days. Which instruction is best for the nurse to provide to this client? A. Quit the pills for this cycle, use an alternate method of contraception, and resume pills on the fifth day of menstruation. B. Take 4 pills now and use an alternate method of contraception for the rest of this cycle. C. Take 2 pills a day for 2 days and use an alternate method of contraception for 7 days. Correct D. Take one extra pill per day for the rest of this cycle, then resume taking pills as usual next cycle. 3.ID: The healthcare provider prescribes a medication for an older adult client who is complaining of insomnia, and instructs the client to return in two weeks. The nurse should question which prescription? A. Temazepam (Restoril) 7.5 milligrams orally at bedtime. B. Eszopiclone (Lunesta) 10 milligrams orally at bedtime. Correct C. Ramelteon (Rozerem) 8 milligrams orally at bedtime. D. Zolpidem (Ambien) 10 milligrams orally at bedtime. 4.ID: A client with chronic kidney disease (CKD) and severe anemia refuses blood transfusions. The healthcare provider prescribes epoetin alfa. Which action should the nurse explain to the client about the medication's therapeutic response? A. Stimulates erythropoiesis in the bone marrow to increase circulating erythrocytes. Correct B. Accelerates neutrophil production, maturation, and activation. C. Increases production and maturation of granulocytes and macrophages. D. Activates the immune system with development of T and B cells and natural killer cells. 5.ID: Which statement by a client warrants further instruction by the nurse about the changing insulin needs of a diabetic client during pregnancy? A. I will increase my insulin dosage by 5 units each month during the first trimester.Correct B. Breastfeeding will decrease my insulin needs to lower than my prepregnancy levels. C. Insulin dosage will likely need to be increased during the second and third trimesters. Incorrect D. Episodes of hypoglycemia are more likely to occur during the first 3 months. 6.ID: A client receives a new prescription for ciprofloxacin (Cipro), a synthetic quinolone. When teaching about this drug, which information in the client's history requires special emphasis by the nurse? A. Snacks on dairy products such as yogurt or ice cream. B. Works twenty hours a week as a lifeguard at the local pool. Correct C. Previously had a mild allergic reaction to a cephalosporin. D. Consumes alcoholic drinks occasionally on the weekends. 7.ID: Which common side effect should the nurse alert a female client about when medroxyprogesterone (Depo-Provera) is prescribed? A. Leg or calf pain. Incorrect B. Jaundice during the first 3 weeks of administration. C. Headaches or visual changes. D. Vaginal bleeding after discontinuing the medication. Correct 8.ID: When assessing a client prior to the administration of digoxin (Lanoxin), which data is most important for the nurse to consider? A. Bilateral lower extremity dependent rubor. B. Presence of a grade 2 murmur. C. Nailbed capillary refill of 5 seconds. D. Irregular apical pulse with a rate of 87. Correct 9.ID: A client is receiving fentanyl via an epidural infusion. Which side effect should the nurse anticipate in the first 24 hours of epidural analgesia? A. Urinary retention. Correct B. Headache. C. Abdominal cramping and diarrhea. D. Agitation. 10.ID: A resident of a long­term care facility is taking lithium carbonate (Eskalith) to treat bipolar disorder. Which instruction should the nurse provide to this client's caregivers? A. Report symptoms of hypothyroidism such as fatigue and constipation. Correct B. Encourage high energy fluid intake by providing sports drinks or sodas. C. Have the client chew the pill if it is difficult to swallow. D. Offer the morning dose of the medicine before breakfast. 11.ID: An emergency department triage nurse is interviewing a female client who has a history of epilepsy with tonic-clonic seizures controlled by phenytoin (Dilantin). Which information is most significant in planning this client's care? A. She has had no dental care for several years. B. She has smoked 3 packs of cigarettes a day for 10 years. C. She has missed 2 menstrual periods. D. She ran out of her medication 4 days ago. Correct 12.ID: An elderly client is admitted with suspected bacterial pneumonia and lethargy. Ten minutes after the nurse initiates low­flow oxygen per nasal cannula and a peripheral IV with a secondary infusion of ticarcillin (Ticar), the client becomes disoriented, restless, and tachypneic. Which nursing action has the highest priority? A. Observe the client's trunk and back for any hives and ask about the onset of urticaria. B. Call for the emergency resuscitation team and retrieve the unit's crash cart. C. Notify the healthcare provider and prepare to administer IV diphenhydramine (Benadryl). D. Stop the IV piggyback infusion and increase the oxygen flow to 3 L/minute.Correct 13.ID: The healthcare provider prescribes pyridostigmine bromide (Mestinon) tablets for a client with myasthenia gravis (MG). What instruction should the nurse provide this client? A. Take the medication 30 to 45 minutes before eating. Correct B. Give the client a dietary guide that describes low-protein foods. C. Increase activity in the afternoon when the medication is most effective. D. Use a PRN dose for increasing muscular weakness or fasciculations. 14.ID: A female client receives a prescription for cefadroxil (Duricef) for a urinary tract infection. The client informs the nurse that she is currently taking oral contraceptives (OCP). What information is important for the nurse to share with the client? A. Avoid prolonged sun exposure while taking the antibiotic. B. Use an additional form of contraception until your menstrual cycle. Correct C. The antibiotic may be less effective while taking OCP. D. The medication combination potentiates the risk of adverse reactions. 15.ID: Miotic drug therapy for the treatment of glaucoma is based chiefly upon which physiologic action? A. Inhibiting aqueous humor production. B. Enhancing aqueous humor outflow. Correct C. Preventing extraocular infection. D. Maintaining intraocular pressure. 16.ID: The mother of a newborn asks the nurse why her infant needs the vitamin K (AquaMEPHYTON) injection. What information should the nurse provide? A. The synthesis of vitamin K is inadequate for 3 to 4 months in the newborn. B. Oral vitamin K impedes the synthesis of clotting factors in the liver. C. Bacteria that synthesize vitamin K are not present in the newborn's intestinal tract. Correct D. The maternal diet is often deficient in vitamin K, so the infant is deficient in the vitamin. Awarded 17.ID: A client receives a new prescription for nitroglycerin (Nitrostat) tablets. Which instruction should the nurse include in this client's teaching? A. Resume normal activities after chest pain relief is obtained. B. Take the medication at least an hour before every meal. C. Monitor your pulse for 60 seconds before administration. D. Place under the tongue as needed every 5 minutes up to 3 times. Correct 18.ID: Which client requires the most immediate intervention by the nurse? A. A client with low back pain who is experiencing tolerance to the effects of an analgesic. B. An adolescent with a history of drug addiction who is requesting a sedative. C. A client with a chronic renal disease who is demonstrating a therapeutic response to a diuretic. D. A young adult who is reporting an anaphylactic response to an antibiotic.Correct