ATI Pharmacology 2019 B

ATI Pharmacology 2019 B 1) A nurse is caring for a pt who is receiving Haloperidol. The nurse should identify which of the following findings as an adverse effect of the med? -Akathisia = CORRECT ANSWER An adverse effect associated with haloperidol is the development of extrapyramidal manifestations such as dystonia, pseudoparkinsonism, and akathisia. -Paresthesia Haloperidol, an antipsychotic neuroleptic medication, can cause CNS adverse effects such as seizures, confusion, and neuroleptic syndrome. However, paresthesia is not an adverse effect of haloperidol. -Excess tear production Haloperidol has anticholinergic properties that can cause sensory adverse effects such as increased intraocular pressure, blurred vision, and dry eyes. -Anxiety Haloperidol can be prescribed to treat severe agitation as well as psychotic manifestations. 2) A nurse is providing teaching to a pt who is to start taking Sumatriptan. Which of the following adverse effects should the nurse instruct the pt to monitor for and report to the provider? -Chest pressure= CORRECT ANSWER Sumatriptan is an antimigraine agent which can cause coronary vasospasms, resulting in angina. The client should report chest pressure or heavy arms to the provider. -White patches on the tongue White patches on the tongue can indicate a fungal infection, which is not an adverse effect of sumatriptan. -Bruising Ecchymosis can indicate thrombocytopenia, which is not an adverse effect of sumatriptan. -Insomnia Sumatriptan can cause drowsiness and sedation as an adverse effect of the medication. 3) A nurse is teaching a pt who is starting to take Amitriptyline. Which of the following findings should the nurse include in the teaching as an adverse effect of the med? -Diarrhea Constipation is an adverse effect of amitriptyline. -Cough Developing a cough is not an adverse effect of amitriptyline. -Urinary retention = CORRECT ANSWER The nurse should instruct the client that amitriptyline causes the anticholinergic effect of urinary retention. -Increased libido A decrease in libido is an adverse effect of amitriptyline. 4) A nurse is assessing a pt who is taking Tamoxifen to treat breast cancer. Which of the following findings is the priority for the nurse to report to the provider? -Hot flashes The client is at risk for hot flashes as an adverse effect of tamoxifen; however, another finding is the priority to report to the provider. The nurse should encourage the client to avoid caffeine and spicy foods to prevent hot flashes. -Gastrointestinal irritation The client is at risk for gastrointestinal irritation (GI) as an adverse effect of tamoxifen; however, another finding is the priority to report to the provider. The nurse should administer the medication with food or fluids to reduce GI irritation. -Vaginal dryness The client is at risk for vaginal dryness as an adverse effect of tamoxifen; however, another finding is the priority to report to the provider. The nurse should encourage the client to use vaginal moisturizers if dryness occurs. -Leg tenderness = CORRECT ANSWER The greatest risk to this client is the development of a thromboembolism, which is an adverse effect of tamoxifen. The nurse should also monitor the client for other manifestations of a thromboembolism, including leg tenderness, redness, swelling, and shortness of breath. 5) A nurse is teaching a pt who is taking Allopurinol for the treatment of gout. Which of the following info should the nurse include in the teaching? -Plan to increase the dosage each week by 200 mg increments. The nurse should instruct the client to increase the dosage each week by 50 to 100 mg until they experience relief or reach a maximum of 800 mg daily. -Prolonged use of the medication can cause glaucoma. The nurse should instruct the client that the prolonged use of allopurinol can cause cataracts; therefore, the client should have periodic ophthalmic checkups. -Drink 2 L of water daily. = CORRECT ANSWER The nurse should instruct the client to drink at least 2 L of water each day to prevent renal stone formation and kidney injury, because allopurinol is eliminated through the kidneys. -A fine red rash is transient and can be treated with antihistamines. The nurse should instruct the client to report a rash to the provider immediately as this can be an indication of hypersensitivity syndrome, a life-threatening toxicity. Treatment for allopurinol toxicity can require hemodialysis or the administration of glucocorticoid medications 6) A nurse is caring for a pt who has diabetes mellitus and is taking Glyburide. The pt reports feeling confused and anxious. Which of the following actions should the nurse take first? -Perform a capillary blood glucose test. = CORRECT ANSWER The greatest risk to this client is injury from hypoglycemia. Therefore, the nurse should perform a capillary blood glucose test to determine the client's blood glucose status. Manifestations of hypoglycemia include weakness, anxiety, confusion, sweating, and seizures. -Provide the client with a protein-rich snack. The nurse should provide the client with a protein-rich snack after determining the client's blood glucose value and providing a carbohydrate first. However, there is another action that the nurse should take first. -Give the client 120 mL (4 oz) of orange juice. The nurse should give the client 10 to 15 g of carbohydrates, such as 4 oz of orange juice, to treat hypoglycemia. However, there is another action that the nurse should take first. -Schedule an early meal tray. The nurse should schedule an early meal tray to maintain the client's blood glucose level following the initial interventions for hypoglycemia. However, there is another action the nurse should take first. 7) A nurse is administering Cefotetan via intermittent IV bolus to a pt who suddenly develops dyspnea and widespread hives. Which of the following actions should the nurse take first? -Administer epinephrine 0.5 mL via IV bolus. The nurse should administer epinephrine, which is a beta-adrenergic agonist that can stimulate the heart, cause vasoconstriction of blood vessels in the skin and mucous membranes, and cause bronchodilation in the lungs. However, there is another action the nurse should take first. -Discontinue the medication IV infusion. = CORRECT ANSWER The greatest risk to the client is respiratory arrest from anaphylaxis. Therefore, the first action the nurse should take is to discontinue the medication IV infusion to prevent the client from receiving more medication. However, the nurse should not remove the IV catheter. Instead, the nurse should change the tubing and administer 0.9% sodium chloride by continuous IV infusion. -Elevate the client's legs above the level of the heart. The nurse should elevate the client's legs and feet to a level above the client's heart to facilitate blood flow to the vital organs. However, there is another action the nurse should take first. -Collect a blood specimen for ABGs. The nurse should collect a blood specimen for ABGs levels to evaluate the client's respiratory status. However, there is another action the nurse should take first. 8) A nurse is preparing to administer 0.9% Sodium Chloride 1000mL IV over 8hr to a pt. The drop factor of the manual IV tubing is 15gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (round to nearest whole #, do not use trailing zero) The nurse should set the manual IV infusion to deliver 0.9% sodium chloride IV at 31 gtt/min. = CORRECT ANSWER 9) A nurse is teaching about a new prescription for Ciprofloxan to a pt who has a UTI. The nurse should identify which of the following statements as an indication that the pt understands the teaching? -"I will take this medication with an antacid to prevent gastrointestinal upset." The client should avoid taking ciprofloxacin with an antacid containing aluminum, magnesium, or calcium because this can decrease the effectiveness of the medication. The nurse should instruct the client to take antacids 2 hr before or 6 hr after the ciprofloxacin. -"I will stop taking this medication when I no longer have pain upon urination." The client should take the full course of ciprofloxacin to prevent reoccurring colonization of bacteria. -"I will report any signs of tendon pain or swelling." = CORRECT ANSWER Ciprofloxacin, a fluoroquinolone, is associated with a risk of tendon rupture. This risk is increased in older adult clients, so the client should notify the provider at the onset of tendon pain or swelling. -"I will take this medication with milk." The client should take ciprofloxacin with water and increase fluids to 2 to 3 L daily to avoid the development of crystals in the kidneys. Milk products will decrease the absorption of the medication. 10) A nurse is preparing to teach a pt who is to start a new prescription for extended release Verapamil. Which of the following instructions should the nurse plan to include? -Take the medication on an empty stomach. The nurse should instruct the client to take extended release verapamil with food to minimize gastric distress. -Avoid crowds. Avoiding crowds is not necessary for the client who is taking verapamil because it does not cause an immunosuppression disorder. -Discontinue the medication if palpitations occur. The nurse should instruct the client that verapamil can cause palpitations, which should be reported to the provider. The client should never discontinue the medication abruptly because the client might experience chest pain. -Change positions slowly. = CORRECT ANSWER The nurse should instruct the client to change positions gradually to prevent orthostatic hypotension and syncope. -A nurse is caring for a pt who is refusing to take their scheduled morning Furosemide. Which of the following statements should the nurse make? -"By not taking your furosemide, you might retain fluid and develop swelling." = CORRECT ANSWER The nurse should respect the client's right to refuse the medication and inform the client of the risks of not taking the medication, notify the provider, and document the refusal. Furosemide is a loop diuretic given to reduce edema. -"You can double your dose of furosemide this evening if that would be better for you." The nurse should respect the client's right to refuse the medication and identify that the client should not double the medication dose if missed. -"If you do not take your furosemide, we might get in trouble." The nurse should respect the client's right to refuse the medication and inform the client of the risks of not taking the medication, notify the provider, and document the refusal. This response uses nontherapeutic communication because the nurse is threatening the client. -"I'll go ahead and mix the furosemide into your breakfast cereal." The nurse should respect the client's right to refuse the medication and inform the client of the risks of not taking the medication, notify the provider, and document the refusal. This response is dismissing the client's right to refuse a medication. -A nurse is providing teaching to a pt who has a prescription for Trimethoprim/Sulfamethoxazole. Which of the following instructions should the nurse include in the teaching? -Take the medication with food. The nurse should instruct the client to take the medication on an empty stomach either 1 hr before or 2 hr after meals. -Expect a fine, red rash as a transient effect. The nurse should instruct the client to notify the provider if a rash develops, because this can be an indication of Stevens-Johnson syndrome. However, the client should not expect to have a fine, red rash as a transient effect. -Drink 8 to 10 glasses of water daily. = CORRECT ANSWER The nurse should instruct the client to increase water intake to 1,920 to 2,400 mL (65 to 81 oz) a day to decrease the chance of kidney damage from crystallization. -Store the medication in the refrigerator. The nurse should inform the client to store trimethoprim/sulfamethoxazole in a light-resistant container at room temperature. 13) A nurse in a clinic is caring for a pt who is taking Aspirin for treatment of arthritis. The nurse should identify which of the following findings as an indication that the pt is beginning to exhibit salicylism? -Gastric distress Gastric distress is a possible adverse effect of aspirin therapy, but it is not an indication of salicylism. Gastric distress can be minimized by taking aspirin with food or an enteric form of the medication. -Oliguria Kidney impairment is an adverse effect associated with aspirin use. Manifestations include reduced urinary output, weight gain, and elevated BUN and creatinine levels. However, oliguria is not an indication of salicylism. -Excessive bruising Excessive bruising is a possible adverse effect of aspirin therapy, caused by the antiplatelet effects of the medication. However, excessive bruising is not an indication of salicylism. -Tinnitus = CORRECT ANSWER Tinnitus is a manifestation of aspirin toxicity, also called salicylism. Other manifestations include sweating, headache, and dizziness. 14) A nurse is caring for a pt who has heart failure and a prescription for Enalapril. The nurse should monitor the pt for which of the following findings as an adverse effect of the med? -Bradycardia Enalapril is an ACE inhibitor that has several cardiovascular adverse effects including hypotension, tachycardia, and dysrhythmias. -Hyperkalemia = CORRECT ANSWER Enalapril improves cardiac functioning in clients who have heart failure and can cause hyperkalemia due to potassium retention by the kidneys. -Loss of smell Enalapril can cause several sensory adverse effects such as a loss of taste. However, it does not cause a loss of smell.