NURS MISC Ati Pharmacology Pre-Assessment & Assessment Quiz 1 with Answers

NURS MISC Ati Pharmacology Pre-Assessment Quiz 1 with Answers A client has been prescribed metoclopramide. Which of the following should the nurse include in client education regarding this medication? Select one: a. Notify your provider if you experience restlessness or spasms of the face or neck. An adverse effect of Reglan is extrapyramidal symptoms. The client should stop the medication and notify the provider if these occur. b. This medication can cause urinary frequency. c. Decrease your fluid intake while taking this medication. d. This medication can cause insomnia. A 52-year-old client with a history of angina has been prescribed transdermal nitroglycerin. Which of the following adverse effects is not seen with this therapy? Select one: a. Headache b. Orthostatic hypotension c. Tolerance d. Productive cough Correct – Nitroglycerin therapy does not directly have an effect lung function. Physiologically, vasodilation should effect capillary perfusion and decrease lung secretions. A nurse is caring for a client prescribed montelukast. Which of the following should the nurse include in teaching related to this medication? Select one: a. Advise client to take the medication once daily at bedtime. Clients should take montelukast once daily at bedtime. b. If the client forgets to take the medication for a few days he can double up on doses to catch up. c. Avoid dairy products while taking this medication. d. This medication is for acute management of asthma A nurse is caring for a client prescribed ferrous sulfate for the treatment of anemia. Which of the following instructions should be included in client teaching about this medication? Select one: a. Take the medication on an empty stomach to maximize absorption. The nurse should instruct the clients to take iron on an empty stomach, such as 1 hr before meals to maximize absorption. Stomach acid increases absorption. If GI adverse effects occur, the client can take with food to increase adherence to therapy even though absorption is also decreased. b. Take prescribed antacids at the same time as this medication. c. Decrease dietary fiber intake while taking this medication. d. Notify your provider if your stool becomes dark green. A nurse is caring for a client who has diabetes and a new prescription for 14 units of regular insulin and 28 units of NPH insulin subcutaneously at breakfast daily. What is the total number of units of insulin that the nurse should prepare in the insulin syringe? 42 Units Each order of for units of insulin is combined in the same syringe. The nurse should withdraw the regular insulin into the syringe first. A nurse is caring for a client receiving patient-controlled analgesia (PCA). Which of the following interventions should the nurse take while caring for this client? Select one: a. Increase client's 4-hr limit as needed. b. Encourage the client to use the PCA before dressing changes. The nurse should encourage the client to use the PCA prophylactically prior to activities that are likely to augment pain levels. c. Advise the client to use the pump sparingly to prevent addiction. d. Encourage the client's family to administer PCA while client is sleeping. A nurse is reviewing the medication class, benzodiazepines. The nurse would use caution when administering benzodiazepines to which of the below clients? Select one: a. A client with insomnia. b. A client with renal failure. c. A client with hypertension. d. A client with glaucoma. Correct – benzodiazepines can increase intraocular pressure due to the pupil-dilating effects of the Medication. A client has been prescribed lisinopril. Which of the following medication interactions should the nurse instruct this client about? Select one: a. Escitalopram b. Potassium supplements Correct. Potassium supplements and potassium-sparing diuretics increase the risk of hyperkalemia in clients taking ACE inhibitors such as lisinopril. Clients should only take potassium supplements if prescribed by the provider. Clients should also avoid salt substitutes that contain potassium. c. Magnesium supplements d. Ciprofloxacin A client has been prescribed vasopressin for the treatment of diabetes insipidus. What is the expected pharmacological action of this medication? a. To stimulate the pancreas to secrete insulin. b. To increase blood pressure. c. To slow the absorption of glucose in the intestine. d. To increase reabsorption of water in the renal tubules. The expected pharmacological action is to promote reabsorption of water within the kidney A nurse is caring for a client receiving a dopamine infusion via a peripheral IV. Which of the following actions should the nurse take if the IV site appears infiltrated? Select one: a. Apply a warm compress to the site. b. Apply a cold compress to the site. c. Slow the infusion and continue to monitor the site. d. Stop the infusion. Correct. If infiltration is suspected, the infusion should be stopped. Necrosis can occur from extravasation of high doses of dopamine. Extravasation can be treated with local injection of an alpha- adrenergic blocking agent, such as Phentolamine. A nurse is caring for a client newly prescribed doxazosin mesylate. Which of the following instructions should the nurse include in client education regarding taking the first dose of this medication? Select one: a. There is no need to avoid normal activities. b. Change positions slowly and lie down if dizziness occurs. First-dose orthostatic hypotension can occur with Cardura. The nurse should instruct clients to change positions slowly and to lie down if feeling dizzy, lightheaded or faint. c. Do not eat green leafy vegetables. d. Avoid dairy products while taking this medication A nurse have provided education to a client regarding prescribed levothyroxene sodium. What of the following client statements demonstrates understanding of medication administration? Select one: a. "I should take my medication as needed to alleviate symptoms." b. "I should take the medication on a full stomach." c. "I should take the medication in the morning to prevent insomnia." Synthroid should be taken once in the morning to preventinsomnia. d. "I should take the medication in divided doses to ensure therapeutic drug levels." A 55-year-old client has levothyroxine ordered. Which of the below past medical history concerns may contraindicate with her medication management of hypothyroidism? Select one: a. Peripheral Vascular Disease b. Osteoporosis Correct: There is an increased risk for fractures, especially in older adults. c. Asthma d. Scleroderma A nurse is preparing to administer an intramuscular injection to an adult client. At what angle should the nurse administer the medication using the ventrogluteal site? Select one: a. a 45 degree angle b. A 90 degree angle IM injections should be administered at a 90 degree angle. c. a 75 degree angle d. a 60 degree angle A nurse has just administered a wrong medication to a client. Which of the following actions should the nurse take next? Select one: a. Report error to the provider. Correct. The nurse should acknowledge the error and report it to the provider for further orders. The nurse should also monitor the client for adverse effects. b. No action is needed. c. Complete an institutional incident report. d. Inform the client that the wrong medication was given. A 45-year-old client is taking methylprednisolone. What pharmacological action should the nurse expect with this therapy? Select one: a. Suppression of airway mucus production. Correct – Corticosteroids, such as methylprednisolone (Solu-Medrol) will suppress airway mucus production. b. Suppression of candidiasis. c. Fortification of bones. d. Suppression of beta receptors. Before administering blood products, which action should be taken? Select one: a. Prime IV tubing with 0.45% sodium chloride. b. Administer epinephrine. c. Document client response. d. Assess the client’s temperature. Correct: Assess the client’s vital signs, obtain consent for the procedure and ensure compatibility. Prime the IV tubing with 0.9% sodium chloride. The nurse would not document client response or administer epinephrine prior to starting the transfusion. A client has been prescribed isosorbide mononitrate. Which of the following should the nurse include in this client's education related to this medication? Select one: a. You can crush this medication if needed. b. Take an additional tablet if you experience chest pain. c. This medication is prescribed for long-term prophylaxis against anginal attacks. Isosorbide mononitrate (Imdur) is used forlong-term prophylaxis against anginal attacks. d. Take the medication in the evening after dinner. A nurse is caring for a client prescribed the HMG CoA reductase inhibitor, atorvastatin. Which of the following should be monitored while this medication is prescribed? Select one: a. Hearing screenings b. Visual acuity screenings c. Renal function tests d. Liver function tests Correct. Statins (HMG CoA reductase inhibitors) like atorvastatin (Lipitor) can cause hepatotoxicity. Prior to initiating therapy the client's baseline liver function should be determined then liver function tests should be checked after 12 weeks of therapy and then every 6 months. The nurse should advise the client to observe for symptoms of liver dysfunction (anorexia, vomiting, nausea, jaundice) and to notify the provider if these occur. A nurse is caring for a client prescribed hydromorphone for severe pain. The client's respiratory rate has decreased from 16 breaths per minute to 6. Which if the following medications should the nurse prepare to administer? Select one: a. Naloxone Correct. This client is experiencing respiratory depression likely related to over administration of hydromorphone (Dilaudid). Naloxone (Narcan) and nalmefene (Revex) are opioid antagonists used to reverse an overdose of opioids. b. Flumazenil c. Aluminum hydroxide d. Activated charcoal A nurse is caring for a client prescribed digoxin. Which the following should alert the nurse to possible digitalis toxicity? Select one: a. anorexia and weakness Correct. Anorexia, fatigue and weakness are signs of potential digitalis toxicity. GI effects of digitalis toxicity include anorexia, nausea, vomiting and abdominal pain. CNS effects include fatigue, weakness, vision changes (diplopia, blurred vision, yellow-green or white halos around objects). Bradycardia is also commonly noted in digitalis toxicity. b. tachycardia and increased urination c. hyperactivity and hunger d. polyphagia and polydipsia A nurse is caring for a client who is prescribed warfarin therapy for an artificial heart valve. Which of the following laboratory values should the nurse monitor for a therapeutic effect of warfarin? PT (Prothrombin time) This test is used to monitor warfarin therapy. For a client receiving full anticoagulant therapy, the PT should typically be approximately two to three times the normal value, depending on the indication for therapeutic anticoagulation. A nurse is preparing to administer 10 units of regular insulin and 20 units of NPH insulin to a client. What is the sequence of events the nurse should follow? • Inspect vials for contaminants: With the exception of NPH insulin, all insulin available today is supplied as a clear, colorless solution. Do not use insulin that is colored, cloudy, or has formed a precipitate. The first step is to observe the characteristics of the regular and NPH insulin to determine whether they are safe to use. • Roll NPH vial between palms of hands: Because NPH insulin is a suspension, the particles must be evenly dispersed by rolling the vial gently between the palms of the hands. This should be done gently because vigorous mixing may cause the solution to become frothy and cause inaccurate dosing. If granules or clumps are present after mixing, discard the solution. This should be done prior to withdrawing the solution into the syringe. • Inject air into NPH insulin vial: This creates a pressure in the vial for accuracy in measuring the amount prescribed. • Inject air into regular insulin vial: The amount of air injected into the vial of short-acting insulin is equal to the amount to be administered. • Withdraw short-acting insulin into syringe: When the prescription requires the administration of two types of insulin, it is preferable to mix the solutions into one syringe if they are compatible to prevent the client from receiving two injections. Of the longer-acting insulin available, only NPH insulin is mixed with short-acting insulin. When two insulins are to be mixed, withdraw the short-acting insulin first to avoid contaminating the stock vial with NPH insulin. • Add intermediate insulin to syringe: The mixture is stable for 28 days. A client is prescribed propranolol. Which of the following client history findings would require the nurse to clarify this medication prescription? Select one: a. Tachydysrhythmias