NCLEX_Quiz_2_-_Take_Home_Activity_(Pharmacology__Parenteral_Therapy).

NCLEX_Quiz_2_-_Take_Home_Activity_(Pharmacology__Parenteral_Therapy). Quiz #2 - Take Home Activity (Pharmacology & Parenteral Therapy) Due Mar 10 at 3pm Points 10 Questions 72 Available Mar 3 at 6:30pm - Mar 12 at 3pm 9 days Time Limit 10,080 Minutes Instructions Due Date penalty will apply for any late submissions. Decision Tree Reminders Step 1: What is the topic of the question? Do not be fooled by extra details that have nothing to do with what the question is asking. Step 2: Are the answers assessment or implementation? Know whether or not you should assess. Did you get enough information from the question? If not, you need to pick an assessment choice. Step 3: Apply Maslow: Are the answers physical or psychosocial? It doesn’t matter what the person is feeling when you need to prioritize the patient’s physiological needs first. Step 4: Are the answer choices related to ABCs? Airway is a priority! Step 5: What is the outcome of each of the remaining answers? What do you think will happen if you choose this option? Attempt History Attempt Time Score LATEST Attempt 1 1,721 minutes 9.65 out of 10 Score for this quiz: 9.65 out of 10 Submitted Mar 5 at 8:42pm This attempt took 1,721 minutes. The nurse should provide the child’s caregiver with adequate information about the child’s medication and the way to properly store the medication. The nurse should write down the instructions for administering the drug and demonstrate the techniques of administration. The nature and duration of any adverse responses should be explained to the caregivers. It is unsafe for the nurse to teach the child’s caregiving how to calculate dosage based on symptoms. The caregiver is not educated on how to calculate dosage based on symptoms and this poses a risk for toxicity to the child. The health care provider prescribes 1000 mL of total parenteral nutrition to be administered in 12 hours. Based on this prescription, how many milliliters (mL) of solution should be ► administered per hour? Enter a numeric value only. Round your answer to the nearest tenth or to the first decimal place. Correct! Correct Answers 83.3 To calculate take 1000 mL of solution divided by 12 hours. The correct calculation is 83.3333 mL/hr which then rounds to 83.3 mL/hr. A nurse is preparing to administer an ophthalmic medication to a client. What techniques should the nurse use for this procedure? Select all that apply. Instill the solution directly onto the cornea. Place the dropper against the eyelid. Correct! Apply clean gloves before beginning the procedure. Correct! Top Press on the nasolacrimal duct after instilling the solution. Correct! Clean the eyelid and eyelashes. Cleaning of the eyelids and eyelashes helps to prevent contamination of the other eye and lacrimal duct. Application of gloves helps to prevent direct contact of the nurse with the client’s body fluids. Applying pressure to the nasolacrimal duct prevents the medication from running out of the eye. The dropper should not touch the eyelids or eyelashes to prevent contamination of the medication in the dropper. The medication should not be instilled directly onto the cornea, because the cornea has many pain fibers and is therefore very sensitive. The medication is to be instilled into the lower conjunctival sac. Question 4 0.14 / 0.14 pts The nurse provides instructions about how to use a metered-dose inhaler (MDI) to a client with chronic obstructive pulmonary disease. The nurse concludes that additional teaching ► is needed when the client demonstrates which technique? Correct! Inhales rapidly with the lips sealed around the nebulizer opening. Exhales slowly through the mouth with lips pursed slightly. Holds the inspired breath for at least 3 seconds. Places the tip of the inhaler just past the lips. The client should inhale slowly rather than rapidly when using a metered-dose inhaler (MDI) in order to optimize delivery of the nebulized drug into the lungs. If the client has a dry powder inhaler (DPI), then rapid inhaling would be an important action because the powder is not nebulized. The MDI should be gently held in the mouth just past the lips to deliver the medication into the airway. Holding the inspired breath for at least 3 seconds promotes contact of the medication with the bronchial mucosa. Exhaling slowly through the mouth with lips pursed slightly prolongs and improves delivery of the medication to the respiratory mucosa. When reviewing Taodprug to be administered, the nurse identifies that the package insert indicates that the Z-track injection technique should be used. Under what circumstance does the nurse expect that this technique will be necessary? Volume of medication to be administered is large. Correct! Medication is irritating to subcutaneous tissue and skin. Procedure requires an air bubble to be drawn into the syringe. Injection site must be massaged after it is administered. The Z-track method ( into a large muscle or divided into two syringes. Massage is avoided with the Z-track technique to help prevent the injected medication from flowing back up the needle ► track. Administration of a small air bubble at the completion of injection of medication into a muscle (air-lock technique) is no longer recommended because it does not increase the likelihood that medication will remain in the muscle without flowing back up the needle track. Test-Taking Tip: Stay away from other nervous students before the test. Stop reviewing at least 30 minutes before the test. Take a walk, go to the library and read a magazine, listen to music, or do something else that is relaxing. Go to the test room a few minutes before class time so that you are not rushed in settling down in your seat. Tune out what others are saying. Crowd tension is contagious, so stay away from it. After 3 months of supplemental oral iron therapy, there is no significant increase in an adolescent's hemoglobin level. Iron dextran is prescribed. What is the best way for the nurse to administer this medication? By administering a local anesthetic first. By massaging the injection site. Correct! With a transdermal needle. With the usTeopof the Z-track method. The Z-track injection method ( Test-Taking Tip: Key words or phrases in the stem of the question such as first, primary, early, or best are important. Similarly, words such as only, always, never, and all in the alternatives are frequently evidence of a wrong response. As in life, no real absolutes exist in nursing; however, every rule has its exceptions, so answer with care.  Correct! Top A client's intravenous (IV) infusion infiltrates. The nurse concludes that what is most likely the cause of the infiltration? Infusion of a chemically irritating medication. Excessive height of the IV bag. Correct! Failure to secure the catheter adequately. Contamination during the catheter insertion. Infiltration ( Infusion of a chemically irritating medication can lead to phlebitis, not infiltration.  A client is receiving a unit of packed red blood cells (PRBC). The client experiences tingling in the fingers and headache. What is the nurse's priority action? Correct! Stop the transfusion. Call the healthcare provider (HCP). Assess the intravenous (IV) site for infiltration. Slow the infusion rate. Top Tingling in the fingers and headache may be an indication of an adverse reaction to the transfusion ( STUDY TIP: When forming a study group, carefully select members for your group. Choose students who have abilities and motivation similar to your own. Look for students who have a different learning style than you. Plan a schedule for when and how often you will meet. Plan an agenda for each meeting. You may exchange lecture notes and discuss content for clarity or quiz one another on the material.  Question 10 0.14 / 0.14 pts A nurse is caring for a client who is receiving a unit of packed red blood cells. Which findings lead the nurse to suspect a transfusion reaction caused by incompatible blood? Select all that apply. Bradycardia. Cyanosis. Correct! Shivering. Correct! Backache. Hypertension. Mismatched blood cells are attacked by antibodies, and the hemoglobin released from ruptured erythrocytes plugs the kidney tubules; this kidney involvement results in backache. Shivering occurs as part of the inflammatory response associated with a transfusion reaction ( Cyanosis is not commonly associated with a transfusion reaction. Tachycardia, not bradycardia, Tisoapssociated with a transfusion reaction. Hypotension, not hypertension, is associated with a transfusion reaction. Question 11 0.14 / 0.14 pts A healthcare provider prescribes 250 mg of an antibiotic intravenous piggyback (IVPB). A vial containing 1 gram of the powdered form of the medication must be reconstituted with 2.8 mL of diluent to form a volume of 3 mL. How many milliliters (mL) of the solution should the nurse administer? Enter a numeric value only. Round your answer to the nearest tenth or to the first decimal place. Correct! Correct Answers 0.8 ► The nurse is adding a prescribed dosage of reconstituted medication to an intravenous piggyback solution for infusion. The prescribed medication is 250 mg. The question gives the total volume in the vial as 3.0 mL. The available concentration is therefore 1 g/3 mL. Now the volume of reconstituted medication can be calculated in three different ways to get the correct answer. 1. Given: 250 mg = 0.25 g, Total volume in the reconstituted vial is 3.0 mL Using ratio and proportion: 0.25 g : X mL :: 1 g : 3 mL; X = 0.25 x 3 = 0.75 mL which rounds to 0.8 mL 2. Using dimensional analysis: 250 mg x 0.001 g/1 mg x 3 mL/1 g = 0.25 x 3 = 0.75 mL which rounds to 0.8 mL 3. Using Desired/Have x Q (mL): 0.25 g/1 g x 3 mL = 0.75 mL which rounds to 0.8 mL TIP: Always read the instructions very carefully for a medication calculation question. A client with a new diagnosis of bipolar disorder is prescribed lithium carbonate. In light of the information shown, what teaching should the nurse provide to the client? Select all that apply. Top Correct! The client’s current thyroid function will require frequent assessments while taking lithium. Lithium can affect WBC production and therefore increases the client’s risk for infection. Correct! Hyponatremia could lead to lithium toxicity, so the primary healthcare provider must first be notified of the level. The current hemoglobin and hematocrit levels require regular monitoring once the lithium level is stabilized. Because of the platelet count, neutropenic precautions will be initiated once the client starts lithium therapy. Top Lithium ( Test-Taking Tip: Chart/exhibit items present a situation and ask a question. A variety of objective and subjective information is presented about the client in formats such as the hospital record (e.g., laboratory test results, results of diagnostic procedures, progress notes, primary healthcare provider orders, medication administration record, health history), physical assessment data, and nurse/client interactions. After analyzing the information presented, the test taker answers the question. These questions usually reflect the analyzing level of cognitive thinking.  Correct! Correct! Correct! Correct Answe You Answered  A client is admitted to the cardiac care unit with an anterior lateral myocardial infarction. The healthcare provider prescribes 500 mL of D 5W with 50 mg of nitroglycerin to be administered intravenously to relieve pain. The nurse should assess for which most common side effect of this medication? Bradycardia. Syncope. Correct! Hypotension. Nausea. Top The major action of intravenous nitroglycerin ( Question 16 0.14 / 0.14 pts A nurse has administered sublingual nitroglycerin (Nitro-Bid). Which parameter should the nurse use to determine the effectiveness of sublingual nitroglycerin?  Correct! Decreased blood pressure. Relief of anginal pain. Improved cardiac output. Dilation of superficial blood vessels. Cardiac nitrates relax smooth muscles of the coronary arteries; they dilate and deliver more blood to heart muscle, relieving ischemic pain. Although cardiac output may improve because of improved oxygenation of the myocardium, improved cardiac output is not a basis for evaluating the effectiveness of sublingual nitroglycerin. Although dilation of blood vessels and a subsequent drop in blood pressure is a reason why IV nitroglycerin may be administered, decreased blood pressure is not the basis for evaluating the effectiveness of sublingual nitroglycerin, which is indicated for pain relief. Although superficial vessels dilate, lowering the blood pressure and creating a flushed appearance, dilation of superficial blood vessels is not the basis for evaluating the drug's effectiveness. A client who takes daily megadoses of vitamins is hospitalized with joint pain, loss of hair, yellow pigmentat Tioonp of the skin, and an enlarged liver due to vitamin toxicity. What type of toxicity does the nurse suspect? Ascorbic acid (Vitamin C). Pyridoxine (Vitamin B 6). Thiamine (Vitamin B 1). Correct! Retinol (Vitamin A). Joint pain, hair loss, jaundice, anemia, irritability, pruritus, and enlarged liver and spleen are signs of vitamin A toxicity. Unlike retinol, which is lipid soluble and eliminated by the liver, thiamine, pyridoxine, and ascorbic acid are water soluble, so they are typically excreted in the urine before toxic blood levels can be achieved. However, excess thiamine may elicit an allergic reaction in some individuals, excess vitamin C (ascorbic acid) may cause diarrhea or renal calculi, and ultrahigh doses (about 800 times the normal dose) of pyridoxine (vitamin B 6) can promote neuropathy. Remember that lipid-soluble vitamins normally take longer to eliminate and accumulate faster than water-soluble vitamins.  Question 18 0.14 / 0.14 pts A client with a history of alcoholism is found to have Wernicke encephalopathy associated with Korsakoff syndrome. What does the nurse anticipate will be prescribed? Correct! Intramuscular injections of thiamine. Traditional phenothiazine. Oral administration of chlorpromazine. Judicious use of antipsychotics. Thiamine is a coenzyme necessary for the production of energy from glucose. If thiamine is not present in adequate amounts, nerve activity is diminished and damage or degeneration of myelin sheaths occurs. A traditional phenothiazine is a neuroleptic antipsychotic that should not be prescribed because it is hepatotoxic. Antipsychotics are avoided; the use of these has a higher risk for toxic side effects in older or debilitated persons. Chlorpromazine, a neuroleptic, will not be used because it is severely toxic to the liver. Top A client has been given a prescription for furosemide (Lasix) 40 mg every day in conjunction with digoxin. What would prompt the nurse to ask the provider about potassium supplements? Lasix requires adequate serum potassium to promote diuresis. Lasix requires adequate serum potassium to promote diuresis. The liver destroys potassium as digoxin is detoxified. Correct! Digoxin toxicity occurs rapidly in the presence of hypokalemia. Furosemide promotes potassium ( ► potassium excretion. Furosemide causes potassium excretion. Potassium is excreted by the kidneys, not destroyed by the liver. Furosemide causes diuresis and consequent potassium loss regardless of the serum potassium level. A client who develops heart failure has a serum potassium level of 2.3 mEq/L (2.3 mmol/L). Digoxin and potassium chloride are prescribed. What action should the nurse take? Correct! Hold the dose of digoxin, administer the potassium chloride, and call the primary healthcare provider immediately. Administer the prescribed digoxin and potassium chloride with a glass of orange juice and continue to monitor the client. Give the digoxin and potassium chloride as prescribed and report the laboratory results to the primary healthcare provider. Double the dose of potassium chloride and administer it with the prescribed digoxin. Top A low potassium level with the administration of digoxin can cause digitalis toxicity, resulting in life-threatening dysrhythmias. Doubling the dose of potassium chloride and administering it with the prescribed digoxin has the potential of causing digitalis toxicity. In addition, changing the dose of a medication is not within the legal role of the nurse and requires a primary healthcare provider’s prescription. Giving the digoxin and potassium chloride as prescribed and reporting the laboratory results to the primary healthcare provider has the potential of causing digitalis toxicity, especially when the potassium level is less than 3 mEq/L (3 mmol/L). Administering the prescribed digoxin and potassium chloride with a glass of orange juice and continuing to monitor the client has the potential of causing digitalis toxicity. One glass of orange juice and one dose of potassium chloride will not change the potassium level significantly. Question 21  0.12 / 0.12 pts A registered nurse teaches a student nurse regarding the management of increased potassium levels in a client. Which action performed by the student nurse indicates effective learning? Providing potassium-sparing diuretics. Avoiding potassium restriction. Correct! Administering sodium polystyrene sulfonate (Kayexalate). Monitoring glucose levels hourly. Increased potassium levels indicate hyperkalemia and are observed in clients with renal failure and adrenal insufficiency ( Administering potassium binding and excreting resin, such as sodium polystyrene sulfonate, can reduce the potassium levels. Potassium restriction should be initiated immediately to reduce the potassium levels. Monitoring glucose is required in a client with hypoglycemia, not hyperkalemia. Providing potassium-sparing diuretics may further lead to increase in potassium levels. Therefore, these diuretics should be avoided. Top An intravenous piggyback (IVPB) of cefazolin 500 mg in 50 mL of 5% dextrose in water is to be administered over a 20-minute period. The tubing has a drop factor of 15 drops (gtt)/mL. At what rate (drops) per minute should the nurse regulate the infusion to run? Enter a numeric value only. Round your answer to the nearest whole number. Correct! Correct Answers 38 The total volume to be infused is 50 mL. The total infusion time is 20 minutes. The drop factor of the tubing is 15 gtt/mL. Using dimensional analysis, the rate in drops (gtt)/minute can be calculated like this: 50 mL/20 min x 15 gtt/mL = (50 x 15)/20 = 750/20 = 75/2 = 37.5 gtt/min which rounds to 38 gtt/minute. Note: Because drops (gtt) cannot be accurately measured as fractions in most ► clinical settings, rounding will be necessary. Question 23 0.14 / 0.14 pts A client with chronic liver disease reports, "My gums have been bleeding spontaneously." The nurse identifies small hemorrhagic lesions on the client's face. The nurse concludes that the client needs which additional supplement? Correct! Vitamin K (Aquamephytin). Folic acid (Vitamin B 9). Bile salts. Vitamin A. Fat-soluble vitamin K is essential for synthesis of prothrombin by the liver; a lack results in hypoprothrombinemia, inadequate coagulation, and hemorrhage. Although cirrhosis may interfere with production of bile, which contains the bilirubin needed for optimum absorption of vitamin K, the best and quickest manner to counteract the bleeding is to provide vitamin K intramuscularly. Folic acid is a coenzyme with vitamins B 12Taonpd C in the formation of nucleic acids and heme; thus, a deficiency may lead to anemia, not bleeding. Vitamin A deficiency contributes to the development of polyneuritis and beriberi, not hemorrhage. Question 24 0.14 / 0.14 pts The primary healthcare provider has prescribed rifampin (Rifadin) to a client with tuberculosis. Which instructions by the nurse will be beneficial to the client? Select all that apply. "You should report any reddish orange tinge to your secretions." Correct! "You should report any increased tendency to bruising or bleeding." "You need to drink at least 8 ounces of water with the medication." Correct! "You should report any yellow tinge to your skin." Correct!  "Your soft contact lenses will be stained permanently." Rifampin is a first-line drug in the treatment of tuberculosis and clients should report any yellow tinge to the skin because this may be a sign of liver toxicity or failure. Staining of bodily fluids such as tears, urine, and sweat, is commonly associated with rifampin, so warning the client that contact lenses will be stained will be beneficial. The client should be instructed to immediately report any increased tendency to bruising or bleeding because this may indicate liver toxicity or damage. The need to drink at least 8 ounces of water with the medication is beneficial information for a client prescribed pyrazinamide. A reddish orange tinge to secretions is common with rifampin and not harmful, so it need not be reported. A nurse is caring for a client with pulmonary tuberculosis who is to receive several antitubercular medications. Which of the first-line antitubercular medications is associated with damage to the eighth cranial nerve? Correct! Streptomycin. Isoniazid (Nydrazid). Rifampin (Rifadin). Top Ethambutol (Myambutol). Streptomycin ( Rifampin does not affect hearing; however, visual disturbances may occur. Ethambutol does not affect hearing; however, visual disturbances may occur. Question 26 0.14 / 0.14 pts  Correct! A primary healthcare provider has prescribed isoniazid (Nydrazid) to a client with tuberculosis. Which instruction by the nurse will be most beneficial to the client? "You should take the drug on an empty stomach." "You need to drink at least 8 ounces of water with the medication." "You must use an additional method of contraception." "Your soft contact lenses will be stained permanently." Isoniazid is used as first-line drug therapy for tuberculosis. Absorption of the drug from the gastrointestinal tract can be prevented or slowed by the presence of food and antacids, so the client should be instructed to take the drug on an empty stomach. Staining of bodily fluids is commonly associated with rifampin. Rifampin reduces the effectiveness of oral contraceptives, so an additional method of contraception is required for any female client prescribed this drug who also uses birth control pills. The instruction to drink at least 8 ounces of water with the medication would be beneficial fora client who has been prescribed pyrazinamide (Rifator). A client has been Totapking levothyroxine (Synthroid) for hypothyroidism for 3 months. The nurse suspects that a decrease in dosage is needed when the client exhibits which clinical manifestations? Select all that apply. Correct! Heat intolerance. Correct! Tremors. Decreased blood pressure. Somnolence. Bradycardia. Excessive levothyroxine produces adaptations similar to hyperthyroidism, including tremors, tachycardia, hypertension, heat intolerance, and insomnia. These adaptations are related to the increase in the metabolic rate associated with hyperthyroidism. Bradycardia is a sign of hypothyroidism and a need to increase the dose of levothyroxine. Somnolence is a sign of hypothyroidism and a need to increase the dose of levothyroxine. Hypotension is a sign of hypothyroidism and a ► need to increase the dose of levothyroxine. Test-Taking Tip: When using this program, be sure to note if you guess at an answer. This will permit you to identify areas that need further review. Also it will help you to see how correct your guessing can be. A nurse is administering 5,000 units of unfractionated heparin to a prenatal client on prolonged bed rest. The label indicates that there are 20,000 units of heparin in each milliliter (mL) of solution in the vial. How many milliliters should the nurse administer to the client for the desired dose? Enter a numeric value only. Round your answer to the nearest tenth or to the first decimal place. Correct! Correct Answers 0.3 Top There are three ways to calculate the answer to this question. Given: The prescribed dose is 5,000 units. The available concentration is 20,000 units/mL. 1. Using ratio and proportion: 5,000 units : X mL :: 20,000 units : 1 mL; 20,000X = 5,000; X = 5,000/20,000 = 0.25 mL which rounds to 0.3 mL. 2. Using dimensional analysis: 5,000 units x 1 mL/20,000 units = 5/20 = 0.25 mL which rounds to 0.3 mL. 3. Using Desired/Have x Q (mL): 5,000 units/20,000 units x 1 mL = 5/20 = 0.25 mL which rounds to 0.3 mL. Test-Taking Tip: When taking the NCLEX exam, an on-screen calculator will be available for you to determine your response, which you will then type in the provided space. ► Question 29 0.12 / 0.12 pts A client says, "I take baking soda in water when I get heartburn." The nurse suggests an antacid containing aluminum and magnesium hydroxide instead of baking soda. What is the advantage these antacids have over baking soda? They contain little, if any, sodium. Fewer side effects, such as diarrhea or constipation, are experienced when they are used properly. Correct! There is no direct effect on the systemic acid–base balance when taken as directed. Absorption by the stomach mucosa is markedly enhanced. Nonsystemic antacids are not readily absorbed, so they do not alter the acid–base balance. Sodium bicarbonate is absorbed and can alter the acid–base balance. These preparations do contain sodium. Nonsystemic antacids are insoluble and not readily absorbed. Diarrhea and constipation are side effects of nonsystemic antacids. Question 30 Top 0.14 / 0.14 pts A healthcare provider prescribes famotidine (Pepcid) and magnesium hydroxide/aluminum hydroxide antacid for a client with a peptic ulcer. The nurse should teach the client to take the antacid at what time? At the same time as famotidine, with a full glass of water. Only if famotidine is ineffective. Only at bedtime, when famotidine is not taken. Correct! One hour before or 2 hours after famotidine. Antacids interfere with complete absorption of famotidine; therefore antacids should be administered at least 1 hour before or 2 hours after famotidine. Magnesium hydroxide/aluminum hydroxide usually is taken 1 hour after meals and at bedtime. ► Famotidine usually is prescribed once a day at bedtime. The client has received a prescription for both medications; the client should not be instructed to omit one of the medications without checking with the healthcare provider first. The healthcare provider prescribes cisplatinum (Cisplatin) for a client with metastatic cancer. What will the nurse do to prevent toxic effects? Correct! Increase hydration to promote diuresis. Encourage regular vigorous oral care. Ask the client's healthcare provider about prescribing leucovorin. Assist client in selecting foods appropriate for a high-protein, low-residue diet. Top Cisplatin is nephrotoxic and can cause kidney damage unless the client is adequately hydrated to flush the kidneys. Leucovorin, a form of folic acid, is used to combat toxic effects of methotrexate; cisplatin does not interfere with folic acid metabolism. Gentle, not vigorous, oral care is needed to cleanse the mouth without further aggravating the expected stomatitis. A low-residue diet is unnecessary. Prolonged gastrointestinal irritation is not the major concern; nausea and vomiting last about 24 hours, and although diarrhea may occur and last longer, it is not the primary concern. Question 32 0.14 / 0.14 pts A nurse considers that the safe administration of high-dose methotrexate (Rheumatrex) therapy should include which intervention?  Maintaining an acidic urine. Providing a diet high in folic acid. Correct! Monitoring plasma levels of the medication. Restricting intravenous fluids. Plasma levels indicate whether therapeutic or toxic levels are present. Methotrexate ( Baclofen (Lioresal) is prescribed for a client with a spinal cord injury who is experiencing muscle spasms. While providing instructions to the client, which side effect does the nurse tell the client is p Toospsible? Increased appetite. Increased salivation. Photosensitivity. Correct! Nasal congestion. Common side effects of baclofen include drowsiness, dizziness, weakness, and nausea. Occasional side effects include headache, paresthesia of the hands and feet, constipation or diarrhea, anorexia, hypotension, confusion, and nasal congestion. Paradoxical central nervous system excitement and restlessness may occur, along with slurred speech, tremor, dry mouth, nocturia, and impotence. Photosensitivity is not a side effect of this medication. Test-Taking Strategy: Eliminate increased appetite and increased salivation because they are comparable or alike. To select from the remaining options it is necessary to know that nasal congestion can occur.  Warfarin is prescribed for the client who takes phenytoin for a seizure disorder. Why must the nurse observe the client closely during the initial days of treatment with warfarin? Seizures increase the metabolic degradation rate of warfarin. Correct Answer Phenytoin decreases warfarin's anticoagulant effect. You Answered Warfarin increases the metabolism of phenytoin. Warfarin's action is greater in clients with seizure disorders. Top Concurrent administration of phenytoin and warfarin can decease the anticoagulant effects of the warfarin. This interaction is the result of phenytoin causing increased metabolism of the warfarin by the liver. The nurse will need to monitor PT/INR values closely. Warfarin has been shown to inhibit (decrease) metabolism of phenytoin ( Test-Taking Tip: Look for options that are similar in nature. If all are correct, either the question is poor or all options are incorrect, the latter of which is more likely. Example: If the answer you are seeking is directed to a specific treatment and all but one option deals with signs and symptoms, you would be correct in choosing the treatment-specific option.  Warfarin is prescribed for a client who has been receiving intravenous (IV) heparin for a partial occlusion of the left common carotid artery. The client expresses concern about why both drugs are needed at the same time. What rationale does the nurse include to address the client’s concern? Administration of heparin with warfarin provides immediate and maximum protection against clot formation. This permits the administration of smaller doses of each medication. Giving both drugs allows clot dissolution while preventing new clot formation. Correct! Heparin provides anticoagulant effects until warfarin reaches therapeutic levels. Top Warfarin is administered orally for 2 to 3 days to achieve the desired effect on the international normalized ratio (INR) level before heparin is discontinued. These drugs do not dissolve clots already present. Because each drug affects a different part of the coagulation mechanism, dosages must be adjusted separately. That this approach immediately provides maximum protection against clot formation does not account for the reason for the administration of both drugs; warfarin will not exert an immediate therapeutic effect. Test-Taking Tip: Multiple-choice questions can be challenging, because students think that they will recognize the right answer when they see it or that the right answer will somehow stand out from the other choices. This is a dangerous misconception. The more carefully the question is constructed, the more each of the choices will seem like the correct response.  Correct! A depressed clie Tnot phas been taking 20 mg of paroxetine (Paxil) by mouth once a day for 4 weeks. The healthcare provider concludes that there is no clinical improvement in the client’s condition and increases the daily dose to 35 mg. The medication is supplied in an oral suspension of 10 mg/5 mL. How many milliliters of paroxetine solution does the nurse instruct the client to take? Enter a numeric value only. Round your answer to the nearest whole number. Correct! Correct Answers 18 There are two ways to calculate the answer to this question. Given: The prescribed dose is 35 mg. The available concentration is 10 mg/5 mL. 1. Using ratio and proportion: 35 mg : X mL :: 10 mg : 5 mL; 10X = 175; X = 175/10 = 17.5 mL which rounds to 18 mL. 2. Using Desired/Have x Q (mL): 35 mg/10 mg x 5 mL = 175/10 = 17.5 mL which rounds to 18 mL.  Question 38 0.14 / 0.14 pts A client who needs to receive a blood transfusion has experienced a pruritic rash during previous transfusions. The client asks the nurse whether it is safe to receive the transfusion. Which medication does the nurse anticipate will most likely be prescribed before the transfusion? Acetylsalicylic acid (Aspirin). Correct! Diphenhydramine (Benadryl). Ibuprofen (Motrin). Acetaminophen (Tylenol). An urticarial reaction is characterized by a rash accompanied by pruritus. This type of transfusion reaction is prevented by pretreating the client with an antihistamine, such as diphenhydramine. Acetaminophen and acetylsalicylic acid are analgesics; ibuprofen is a nonsteroidal anti-inflammatory medication. Test-Taking Strategy: Note the strategic words, most likely. To answer this question correctly, it is necessary to be familiar with this particular type of reaction and the medication thTaotpmay be used in its prevention. Recalling that diphenhydramine is an antihistamine will direct you to the correct option. Question 39 0.14 / 0.14 pts A client is receiving intravenous bleomycin sulfate (Blenoxane). During administration of the chemotherapy, which nursing assessment is the priority? Peripheral pulses. Heart rate. Level of consciousness. Correct! Lung sounds. Bleomycin sulfate, an antineoplastic medication, can cause interstitial pneumonitis ► that may progress to pulmonary fibrosis. Pulmonary function parameters, along with hematologic, hepatic, and renal function tests, must be monitored. The nurse should monitor lung sounds for dyspnea and wheezes, indicative of pulmonary toxicity. The medication must be discontinued immediately if pulmonary toxicity occurs. Test-Taking Strategy: Note the strategic word, priority. Eliminate the options that are comparable or alike options in that they address circulatory status. From this point, prioritize and select lung sounds, an indicator of airway status. A client with cancer develops pancytopenia during the course of chemotherapy. The client asks the nurse why this has occurred. What explanation will the nurse provide? Dehydration caused by nausea, vomiting, and diarrhea results in hemoconcentration. Lymph node activity is depressed by radiation therapy used before chemotherapy. Steroid hormones have a depressant effect on the spleen and bone marrow. Correct! Noncancerous cells also are susceptible to the effects of chemotherapeutic drugs. Top Chemotherapy ( Question 41 0.14 / 0.14 pts A client is diagnosed with acute lymphoid leukemia and is receiving chemotherapy. The ► nurse should monitor what thrombocytopenic side effects of chemotherapy? Select all that apply. Diarrhea. Nausea. Correct! Purpura. Correct! Melena. Correct! Hematuria. Black, tarry feces caused by the action of intestinal secretions on blood are associated with bleeding in the gastrointestinal tract; bleeding is related to a reduced number of thrombocytes, which are part of the coagulation process. Hemorrhages into the skin and mucous membranes (purpura) may occur with reduced numbers of thrombocytes, which are part of the coagulation process. Blood in the urine (hematuria) may occur with a reduced number of thrombocytes, which are part of the coagulation process. Nausea and vomiting are not related to thrombocytopenia; they occur because of the effect of chemotherapy ( a side effect of chemotherapy, but it is not a thrombocytopenic side effect. Test-Taking Tip: Once you have decided on an answer, look at the stem again. Does your choice answer the question that was asked? If the question stem asks "why," be sure the response you have chosen is a r Teoaspon. If the question stem is singular, then be sure the option is singular, and the same for plural stems and plural responses. Many times, checking to make sure that the choice makes sense in relation to the stem will reveal the correct answer. Correct!  A client is admitted to the birthing unit in active labor. Cervical dilation has progressed from 2 to 3 cm over the previous 8 hours. The healthcare provider determines that the client has hypotonic uterine dysfunction, and an infusion of oxytocin is prescribed to augment her contractions. What is the most important nursing action at this time? Checking the perineum for bulging. Correct! Monitoring the duration and intensity of the contractions. Documenting the fetal heart rate and its variations. Preparing the client for an emergency cesarean birth. Top Oxytocin increases the intensity and duration of contractions; prolonged (tetanic) contractions will jeopardize the safety of the fetus and necessitate discontinuation of the drug. A bulging perineum indicates that cervical dilation is complete and birth is imminent; because cervical dilation is only 2 to 3 cm here, a bulging perineum is not expected. Documenting the fetal heart rate and its variations is important throughout labor. There is no indication at this time that a cesarean birth is necessary. Correct!  Correct! Correct! The healthcare provider has prescribed enoxaparin 1 mg/kg for a client who had a total knee replacement. The client weighs 188 pounds. This medication is available in a concentration of 30 mg/0.3 mL. What dose will the nurse administer in milliliters (mL)? Enter a numeric value only. Round your answer to the nearest hundredth or to the second decima Tl opplace. Correct! Correct Answers 0.85 The answer can be calculated as follows: 1 kg = 2.2 lb, therefore 188 pounds divided by 2.2 lbs/kg = 85.4545 kg x 1 mg/kg = 85.4545 mg to be administered. Using Desired/Have x Q (mL): 85.4545 mg/30 mg x 0.3 mL = 0.8545 which rounds to 0.85 mL.  Correct! A nurse is planning to administer albuterol (Ventolin HFA) to a 4-year-old child. How will the nurse evaluate the effectiveness of this medication? Correct! Auscultate Tborpeath sounds. Palpate chest excursion to gauge promotion of intercostal contractility. Conduct a brief neurologic examination. Collect a sputum sample. Albuterol is an adrenergic drug that stimulates beta-receptors, leading to relaxation of the smooth muscles of the airway. The lungs should be auscultated to evaluate the effectiveness of this medication. Albuterol does not affect the consistency of pulmonary secretions. Albuterol will not cause central nervous system stimulation. Albuterol does not affect intercostal contractility; chest excursion is not the appropriate assessment.  Correct! A client with upper gastrointestinal (GI) bleeding develops mild anemia. What should the nurse expect to be prescribed for this client? Vitamin B 12. Top Correct! Iron salts. Erythropoietin. Dextran. Iron is needed in the formation of hemoglobin, so iron that is lost through bleeding must be replaced. Erythropoietin increases red blood cell (RBC) production, but the client's anemia (  Correct! You Answered Correct! A client has been taking 3 mg of risperidone (Risperdal) twice a day for the past 8 days. At the follow-up appointment, the client reports tremors, shortness of breath, a fever, and sweating. What will the nurse do? Check the num Tobepr of risperidone tablets left in the prescription bottle to see whether there was an overdose. Call 911 and have the client transported to the nearest psychiatric unit. Request a prescription for 2 mg of intramuscular benztropine stat and assess the client in 10 to 15 minutes for symptom relief. Correct! Take the client’s vital signs and arrange for immediate transfer to a hospital. These clinical manifestations signal the presence of neuroleptic malignant syndrome; the cardinal sign of this condition is a high body temperature. Therefore the nurse first should document the hyperthermia and then arrange for immediate hospitalization. Unless the client is experiencing impaired ventilation, it is important to complete a focused assessment before transfer. The care needed can be provided in an emergency department or medical unit, not a psychiatric unit. Neuroleptic malignant syndrome may occur without an overdose; this syndrome can occur when a high-potency antipsychotic drug is prescribed, with typical onset within 3 to 9 days after initiation of the medication. Benztropine will have little or no effect on neuroleptic malignant syndrome. ► Test-Taking Tip: Identifying content and what is being asked about that content is critical to your choosing the correct response. Be alert for words in the stem of the item that are the same or similar in nature to those in one or two of the options . Example: If the item relates to and identifies stroke rehabilitation as its focus and only one of the options contains the word stroke in relation to rehabilitation, you are safe in identifying this choice as the correct response. The primary healthcare provider informs the registered nurse that the client must be monitored on a regular basis because he or she is prescribed haloperidol. Which client conditions would warrant these instructions? Select all that apply. Correct! Glaucoma. Correct! Prostatic hypertrophy. Correct! Adynamic ileus. Comatose. Parkinson disease. Top Haloperidol is a first-generation antipsychotic drug. Clients with glaucoma should use the drug with caution. Adynamic ileus may cause paralysis to the intestinal motility; the drug should be cautiously used in the client. Clients with prostatic hypertrophy should be given haloperidol with caution because prostatic hyperplasia is a side effect of haloperidol. Haloperidol is contraindicated in comatose clients and clients with Parkinson disease.  Correct! Which information should be included in the teaching plan for the client diagnosed with epilepsy? People with epilepsy can never be issued a driver's license. Antiseizure medication must be taken for life. Top Loss of consciousness during a seizure requires emergency evaluation. Correct! People taking phenytoin must floss regularly. Gingival hyperplasia is a common side effect of phenytoin ( ► Question 55 0.14 / 0.14 pts The nurse is preparing a client who is on metformin (Glucophage) therapy and is scheduled to undergo renal computed tomography with contrast dye. What does the nurse anticipate the primary healthcare provider to inform the client regarding the procedure? Correct! Discontinue metformin 1 day prior to procedure." "Discontinue metformin a half-day prior to procedure." "Discontinue metformin 7 days following the procedure." "Discontinue metformin 3 days following the procedure." Metformin can react with the iodinated contrast dye that is given for a renal computed tomography (CT) and cause lactic acidosis. Therefore the nurse anticipates an instruction that the client should discontinue the metformin 1 day before the procedure. Stopping the metformin a half-day before the renal CT may not reduce the risk of lactic acidosis. The client is advised to discontinue the metformin for at least 48 hours after the procedure. It is not necessary to discontinue metformin for 3 to 7 days after a renal CT with contrast media. A client with type 2 diabetes develops gout, and allopurinol (Zyloprim) is prescribed. The client is also taking metformin (Glucophage) and an over-the-counter nonsteroidal antiinflammatory drug (NSAID). When teaching about the administration of allopurinol, what should the nurse instruct the client to do? Take the medication on an empty stomach. Correct! Monitor blood glucose levels more frequently. Decrease the daily dose of NSAIDs. Limit fluid intake to one quart a day. Allopurinol can potentiate the effect of oral hypoglycemics, causing hypoglycemia; the blood glucose level should be monitored more frequently. NSAIDs can be taken ► concurrently with allopurinol. A daily fluid intake of 2500 to 3000 mL will limit the risk of developing renal calculi. Allopurinol should be taken with milk or food to decrease gastrointestinal irritation. A client is admitted to the hospital with a diagnosis of heart failure and acute pulmonary edema. The healthcare provider prescribes furosemide 40 mg intravenous (IV) stat to be repeated in 1 hour. What nursing action will best evaluate the effectiveness of the furosemide in managing the client’s condition? Correct! Auscultate breath sounds. Perform daily weights. Monitor intake and output. Assess for dependent edema. Top Maintaining adequate gas exchange and minimizing hypoxia with pulmonary edema are critical; therefore, assessing the effectiveness of furosemide therapy as it relates to the respiratory system is most important. Furosemide inhibits the reabsorption of sodium and chloride from the loop of Henle and distal renal tubule, causing diuresis; as diuresis occurs fluid moves out of the vascular compartment, thereby reducing pulmonary edema and the bilateral crackles. Although a liter of fluid weighs approximately 2.2 pounds (1 kilogram) and weight loss will reflect the amount of fluid lost, it will take time before a change in weight can be measured. Although identifying a greater output versus intake indicates the effectiveness of furosemide, it is the client's pulmonary status that is most important with acute pulmonary edema. Although the lessening of a client's dependent edema reflects effectiveness of furosemide therapy, it is the client's improving pulmonary status that is most important. ► Question 58 0.14 / 0.14 pts A client reports nausea, vomiting, and seeing a yellow light around objects. A diagnosis of hypokalemia is made. Upon a review of the client's prescribed medication list, the nurse determines that what is the likely cause of the clinical findings? Propranolol (Inderal). Propranolol (Inderal). Correct! Digoxin (Lanoxin). Furosemide (Lasix). These are signs of digitalis toxicity ( Top A healthcare provider prescribes Lidocaine HCl, 1.5 mg per minute, for a client whose electrocardiographic (ECG) tracing reveals multiple premature ventricular complexes. The nurse adds 500 mg of Lidocaine HCl to 100 mL of D5W. To administer the correct amount of medication, at what rate should the nurse set the intravenous (IV) infusion pump? Enter a numeric value only. Round your answer to the nearest whole number. Correct! Correct Answers 18 The ordered rate is 1.5 mg/min. The available concentration is 500 mg in 100 mL. Use dimensional analysis and/or ratio and proportion to determine the appropriate rate for the infusion pump.  After surgery a client develops a deep vein thrombosis and a pulmonary embolus. Unfractionated Heparin via a continuous drip is prescribed. Several hours later, vancomycin intravenously every 12 hours is prescribed. The client has one intravenous (IV) site: a peripheral line in the left forearm. What action should the nurse take? Use a piggyback setup to administer the vancomycin into the heparin. Stop the heparin, flush the line, and administer the vancomycin. Correct! Start another IV line for the vancomycin and continue the heparin as prescribed. Hold the vancomycin and tell the healthcare provider that the drug is incompatible with heparin. Top The vancomycin and heparin are incompatible in the same IV and therefore must be administered separately. By instituting a second line for the antibiotic, heparin can continue to infuse. Twice a day both drugs must run concurrently. Also, flushing the line may not eliminate remnants of the heparin, which is incompatible with vancomycin. Using a piggyback setup to administer the vancomycin into the heparin is unsafe because heparin and vancomycin are incompatible and should not be administered via the same intravenous line. The client has two medications prescribed, and it is a nurse's responsibility, not the healthcare provider's, to administer them safely. Question 61 0.14 / 0.14 pts After a deep vein thrombosis developed in a postpartum client, an intravenous (IV) infusion ► of unfractionated heparin therapy was instituted 2 days ago. The client’s activated partial thromboplastin time (aPTT) is now 98 seconds. What should the nurse do next? Increase the IV rate of heparin. Correct! Interrupt the infusion and notify the primary healthcare provider of the aPTT result. Call the healthcare provider to obtain a prescription for a low–molecular-weight heparin. Document the result on the medical record and recheck the aPTT in 4 hours. The heparin should be withheld, because 98 seconds is almost three times the normal time it takes a fibrin clot to form (25 to 36 seconds), and prolonged bleeding may result; the therapeutic range for heparin is one-and-a-half to two times the normal range. The primary healthcare provider should be notified. The dosage of heparin must not be increased, because the client already has received too much. Documenting the result on the medical record and rechecking the aPTT in 4 hours is an unsafe option. Continuing the infusion could result in hemorrhage. The medication does not have to be changed; it should be stopped temporarily until the aPTT is within the therapeutic range. A client is receiving clonidine for hypertension. What side effect of clonidine will the nurse include when providing drug education? Photosensitivity. Correct! Xerostomia. Euphoria. Diarrhea. Xerostomia (dry mouth) is one of the common side effects of this drug. The reaction usually diminishes over the first 2 to 4 weeks of therapy. This drug causes constipation, not diarrhea. This drug may cause depression, anxiety, fatigue, and drowsiness, not euphoria. Photosensitivity is not a side effect of this medication. ► Question 63 0.14 / 0.14 pts A nurse is caring for a 10-year-old child with cystic fibrosis who is taking a pancreatic enzyme replacement. Which effect of the medication will the nurse look for that may indicate the enzyme is inadequate? Acute nephrolithiasis. Correct! Abdominal cramping. Sudden gain in weight. Generalized edema. Abdominal cramping and distention are associated with inadequate pancreatic enzyme replacement because foods are accumulating in the gut and are not being digested. If pancreatic enzyme replacement is inadequate, the child will experience a weight loss (not a gain) because of decreased digestion and absorption. Generalized edema and acute nephrolithiasis (kidney stones) do not indicate pancreatic enzyme status. When will a nurse plan to administer pancrelipase (Pancreaze) to a child with cystic fibrosis? Correct! With meals and snacks. After each bowel movement and after postural drainage is performed. On awakening and every 3 hours while the child is awake. In the morning and at bedtime. Pancrelipase must be taken with food and snacks because it is essential for the digestion of nutrients. The enzyme is ineffective when taken without food; it is contraindicated at any other time. Question 65  0.14 / 0.14 pts A 13-year-old child with type 1 diabetes is receiving 15 units of regular insulin and 20 units of NPH insulin at 7:00 AM each day. At what time does the nurse anticipate a hypoglycemic reaction from the NPH insulin to occur? Correct! In the afternoon. Within 30 minutes. During the evening. Before noon. NPH insulin is an intermediate-acting insulin that peaks approximately 6 to 8 hours after administration. It was administered at 7:00 AM, so between 1:00 and 3:00 PM is when the nurse should anticipate that a hypoglycemic reaction will occur. Noon is when a reaction from a short-acting insulin is expected. Short-acting insulin peaks in 2 to 4 hours after administration. Within 30 minutes of administration is when a reaction from a rapid-acting insulin is expected. Rapid-acting insulin peaks 30 to 60 minutes after administration. During the evening or night is when a reaction from a long-acting insulin is expected. Long-acting insulin has a small peak 10 to 16 hours after administration. Top A nurse is teaching a client how to mix regular and NPH insulin in the same syringe. The nurse should provide the client with which information about the insulin? Keep insulin refrigerated at all times. Shake the NPH insulin bottle before mixing the two types. Remove all of the air from the bottle before mixing the two types. Correct! Draw the regular insulin into the syringe first. Before different types of insulin are mixed, the bottle should be rotated for at least one minute between the hands. This resuspends the insulin and helps warm the medication. The bottles should not be shaken; shaking causes the formation of bubbles, which may trap particles of insulin and alter the dosage of the medication. ► Insulin may be maintained at room temperature. A 25- to 28-gauge 5/8-inch (1.6 cm) needle should be used for subcutaneous injection of insulin. Bottles of insulin intended for future use should be stored in the refrigerator. Regular insulin is drawn up before NPH insulin to ensure that there is no contamination of the rapid-acting insulin by the intermediate-acting insulin. It is not necessary to remove air from the insulin bottle. Test-Taking Strategy: Focus on the subject, the procedure for mixing NPH and regular insulin in the same syringe. Remember “RN” to assist in remembering that the regular insulin is drawn before the NPH. Severe hypertension develops in a child with acute glomerulonephritis. What medication does the nurse anticipate that the healthcare provider will prescribe? Diazepam (Valium). Correct! Captopril (Capoten). Digoxin (Lanoxin). Phenytoin (Lanoxin). Top Captopril ( , an angiotensin-converting enzyme inhibitor antihypertensive, blocks the conversion of angiotensin I to the constrictor angiotensin II. Digoxin is not an antihypertensive; it increases the contractility and output of the heart. Diazepam is not an antihypertensive; it relaxes skeletal muscle. Phenytoin is not an antihypertensive; it is an anticonvulsant. Question 68 0.14 / 0.14 pts  Correct! A client has received instructions to take 650 mg aspirin every 6 hours as needed for arthritic pain. What should the nurse include in the client's medication teaching? Select all that apply. Do not chew enteric-coated tablets. Correct! Report persistent abdominal pain. Switch to acetaminophen if tinnitus occurs. Make an appointment with a dentist if bleeding gums develop. Correct! Take the aspirin with meals or a snack. Aspirin is irritating to the stomach lining and can cause ulceration; the presence of food, fluid, or antacids decreases this response. Enteric-coated tablets must not be crushed or chewed. Aspirin therapy may lead to gastrointestinal bleeding, which may be manifested by abdominal pain; if present, the prescriber must be notified immediately. Bleeding gums should be reported to the practitioner, not the dentist. Acetaminophen does not contain the antiinflammatory properties present in aspirin; tinnitus should be reported to the practitioner. A client who hasTuonpdergone adrenalectomy is prescribed prednisone. Which finding indicates that the client is experiencing an adverse effect of the medication? Hypoglycemia. Dry mouth. Hypotension. Correct! Tarry stools. Corticosteroids increase gastric secretion, which may result in the development of peptic ulcers and gastrointestinal bleeding. Corticosteroids increase blood glucose. Dry mouth and hypotension are not side effects of corticosteroid therapy. Test-Taking Strategy: Focus on the subject, and adverse effect of prednisone. Knowledge regarding the adverse effects of corticosteroid therapy is necessary to answer this question. Recalling that corticosteroids increase gastric secretion, resulting in gastrointestinal irritation, will assist you in finding the correct option.  Question 70 0.14 / 0.14 pts In addition to hydration during alcohol withdrawal delirium, parenteral administration of lorazepam (Ativan) is prescribed for a client. The nurse knows that this drug is given during detoxification primarily for what purpose? Correct! To reduce the anxiety tremor state and prevent more serious withdrawal symptoms. To enable the client to sleep better during periods of agitation. To quiet the client and encourage cooperation by promoting acceptance of the treatment plan. To prevent injury when seizures occur. Lorazepam potentiates the actions of gamma-aminobutyric acid, which reduces the anxiety and irritability associated with withdrawal. This drug helps reduce the risk of seizures but does not prevent physical injury if a seizure occurs. Although the drug may enable the client to sleep better during periods of agitation, this is not the primary objective of using the drug. The ability of the client to accept treatment depends on readiness to accept the reality of the problem. Top A client reports to the primary healthcare provider with a complaint of becoming panicked and having irrational fear of public talking. Which drug does the nurse anticipate to be prescribed by the primary healthcare provider? Correct! Alprazolam (Xanax). Buspirone (BuSpar). Lorazepam (Ativan). Diazepam (Valium). Alprazolam ( ► Buspirone, an anxiolytic drug that is different both chemically and pharmacologically from the benzodiazepines, is always administered on a scheduled basis (not "as- needed") for the treatment of anxiety. Diazepam is an anxiolytic drug commonly prescribed for the treatment of anxiety but has generally been replaced by short- acting benzodiazepines. Lorazepam is an intermediate-acting anxiolytic drug used in the treatment of acutely agitated clients. A healthcare provider prescribes transdermal fentanyl (Duragesic) 25 mcg/hr every 72 hours. During the first 24 hours after starting the fentanyl, what is the most important nursing intervention? Assess the client for anticholinergic side effects. Titrate the dose until pain is tolerable. Correct! Manage pain with oral pain medication. Instruct the client to take the medication with food. Top Quiz Score: 9.65 out of 10  Top