RN Medical Surgical Drugs EAQ 2022

A client will be taking nitrofurantoin 50 mg orally every evening at home to manage recurrent urinary tract infections. What instructions should the nurse give to the client? Increase the intake of fluids. Strain the urine for crystals and stones. Stop the drug if urinary output increases. Maintain the exact time schedule for taking the drug. A client who had a myocardial infarction receives a prescription for a nitroglycerin patch. What does the nurse identify as the purpose of the nitroglycerin patch? Decreased heart rate lowers cardiac output. Increased cardiac output increases oxygen demand. Decreased cardiac preload reduces cardiac workload. Peripheral venous and arterial constriction increases peripheral resistance. A healthcare provider prescribes enalapril for a client. Which is the most important nursing action? Assess the client for hypokalemia. Ensure that the medication is ingested with food. Monitor the client's blood pressure during therapy. Teach that a missed dose can be doubled at the next scheduled time. An older adult client who has type 1 diabetes and chronic bronchitis is prescribed atenolol for the management of angina pectoris. Which clinical manifestation should alert the nurse to the fact that the client may be developing a life-threatening response to the drug? Difficulty breathing Increased pulse rate Orthostatic hypotension Increased blood glucose A nurse administers two units of packed red blood cells ([RBCs] 250 mL each), followed by 500 mL of 0.9% sodium chloride. How much total solution (blood and sodium chloride) has infused? Record your answer as a whole number. 1000mL A nurse identifies signs of electrolyte depletion in a client with heart failure who is receiving bumetanide and digoxin. What does the nurse determine is the cause of the depletion? Diuretic therapy Sodium restriction Continuous dyspnea Inadequate oral intake A healthcare provider orders heparin 6000 units subcutaneously daily. The pharmacy dispenses a vial containing 10,000 units per milliliter. How many milliliters of heparin should the nurse administer? Include a leading zero if applicable. Record your answer using one decimal place. 0.6mL A client diagnosed with gastroesophageal reflux disease (GERD) is being treated with antacid therapy. When teaching the client about the therapy, what does the nurse reinforce? Antacids should be taken 1 hour before meals. These should be scheduled at 4-hour intervals. Antacid tablets are just as fast and effective as the liquid form. Antacids commonly interfere with the absorption of other drugs. A client asks a nurse why captopril was prescribed. What specific drug classification should the nurse include in the explanation to the client? Diuretic Sedative Hypnotic Antihypertensive During the administration of total parenteral nutrition (TPN), an assessment of the client reveals a bounding pulse, distended jugular veins, dyspnea, and cough. What is the priority nursing intervention? Restart the client's infusion at another site. Slow the rate of the client's infusion of the TPN. Interrupt the client's infusion and notify the healthcare provider. Obtain the vital signs and continue monitoring the client's status. The healthcare provider’s prescription for intravenous fluid states that the client is to receive 1 L of fluid every 8 hours. If the equipment delivers 15 drops/mL, at what rate should the nurse regulate the flow? Record your answer using a whole number. 31 drops/minute A client is admitted to the hospital with a diagnosis of acute pancreatitis. The health care provider's prescriptions include nothing by mouth and total parenteral nutrition (TPN). The nurse explains that the TPN therapy provides what benefit? Is the easiest method for administering needed nutrition Is the safest method for meeting the client's nutritional requirements Will satisfy the client's hunger without the discomfort associated with eating Will meet the client's nutritional needs without causing the discomfort precipitated by eating A client with midsternal pain presents to the emergency department. Vital signs are stable. Which form of nitroglycerin does the nurse anticipate giving initially? Oral Spray Intravenous Transdermal Which information should be included in the teaching plan for the elderly client with peptic ulcer disease who is taking an antacid and sucralfate? Antacids should be taken 30 minutes before a meal. Sucralfate should be taken on an empty stomach one hour before meals. Sucralfate is prescribed for the long-term maintenance of peptic ulcer disease. Sodium bicarbonate is an inexpensive over-the-counter antacid with few adverse effects. A client with irritable bowel syndrome has instructions to take psyllium 2 rounded teaspoons full twice a day for constipation. What is most important for the nurse to include in the teaching plan? Urine may be discolored. Stop taking the laxative once a bowel movement occurs. Each dose should be taken with a full glass of water or juice. Daily use may inhibit the absorption of some fat-soluble vitamins. A nurse is preparing a client for discharge from the emergency department. Which client statement provides evidence that the client understands the instructions for the prescribed highdose ampicillin? "I should take this medication with meals." "I can stop taking this medication when I feel better." "I will miss eating my yogurt while taking this medication." "I must increase my intake of fluids while taking this medication." A healthcare provider prescribes famotidine 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? Only at bedtime, when famotidine is not taken Only if famotidine is ineffective At the same time as famotidine, with a full glass of water One hour before or 2 hours after famotidine A client with cirrhosis of the liver and ascites has been taking chlorothiazide, a thiazide diuretic. Why did the provider add spironolactone to the client’s medication regimen? To stimulate sodium excretion To help prevent potassium loss To increase urine specific gravity To reduce arterial blood pressure A client will be discharged with a peripherally inserted central venous catheter (PICC) for administration of peripheral parenteral nutrition (PPN). What would be appropriate for the nurse to include in the client's discharge teaching? Learning how to change the percutaneous catheter Determining which days to self-administer the PPN solution Arranging for professional help to monitor the alternative nutrition Scheduling administration of the PPN solution around mealtimes The healthcare provider prescribes 7500 units erythropoietin to be administered subcutaneously weekly. The vial reads 10,000 units per milliliter. How much erythropoietin will the nurse give for each weekly dose? Include a leading zero if applicable. Record your answer using two decimal places. 0.75mL The nurse is preparing to discharge a client who presented to the emergency room for an acute asthma attack. The nurse notes that upon discharge the healthcare provider has prescribed theophylline 300 mg orally to be taken daily at 9:00 AM. The nurse will teach the client to take the medication on which schedule? With a meal Only at bedtime At a specific time prescribed Until symptoms are gone A client is scheduled to receive intravenous (IV) fluids to be delivered at 80 mL/hr. To adjust the drip rate when administering the IV via gravity, what must the nurse determine? Total volume of fluid in the IV bag Size of the needle or catheter in the vein Drops per milliliter delivered by the infusion set Diameter of the tubing being used to instill the fluid 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? Bile salts Folic acid Vitamin A Vitamin K A client who has a gastric ulcer asks what to do if epigastric pain occurs. The nurse evaluates that teaching is effective when the client makes which statement? "Eliminating fluids with meals will prevent pain." "I will increase my food intake to avoid an empty stomach." "Taking an aspirin with milk will relieve my pain and coat my ulcer." "Taking an antacid preparation will decrease pain due to gastric acid." A client with hepatitis B asks the nurse, "Are there any medications to help me get rid of this problem?" Which is the best response by the nurse? "Sedatives can be given to help you relax." "We can give you immune serum globulin." "Vitamin supplements are frequently helpful and hasten recovery." "There are medications to help reduce viral load and liver inflammation." A client admitted for uncontrolled hypertension and chest pain was prescribed a low-sodium diet and started on furosemide. The nurse should instruct the client to include which foods in the diet? Liver Apples Cabbage Bananas A nurse teaches a client who is scheduled for a kidney transplant about the need for immunosuppressive medications. The nurse determines that the client understands the teaching when the client states that medications must be taken for what period of time? "For the rest of my life." "Until the surgery is over." "Until the surgery heals." "During the intraoperative period." After surgery, a client received a prescription for 8 mg of morphine sulfate to be given by injection. The vial on hand is labeled 1 mL = 10 mg. How much solution should the nurse administer? Record your answer using one decimal place and include a leading zero if applicable. 0.8mL A client is admitted to the emergency department with burns to the anterior trunk, entire right arm, and anterior right leg. The practitioner prescribes morphine sulfate for pain. What route of administration should the nurse expect to administer this medication? Orally Intravenously Subcutaneously Intramuscularly The nurse is caring for a client with diabetes mellitus who is scheduled to receive an intravenous (IV) administration of 25 units of insulin in 250 mL normal saline. What does the nurse recognize as the only type of insulin that is compatible with intravenous solutions? NPH insulin Insulin lispro Regular insulin Insulin glargine Which assessment should the nurse obtain before administering digoxin to a client? Apical heart rate Radial pulse on the left side Radial pulse in both right and left arms Difference between apical and radial pulses A nurse is caring for a client who is receiving total parenteral nutrition (TPN) after extensive colon surgery. The nurse concludes that the client understands teaching about the purpose of TPN when the client makes which statement? "TPN provides supplemental nutrition." "TPN provides short-term nutrition after surgery." "TPN provides total nutrition when gastrointestinal function is questionable." "TPN assists people who are unable to eat but have active gastrointestinal function." A client with a head injury has been receiving dexamethasone. The health care provider plans to reduce the dosage gradually and to continue a lower maintenance dosage. Which effect associated with the gradual dosage reduction of the drug should the nurse explain to the client? Builds glycogen stores in the muscles Produces antibodies by the immune system Allows the increased intracranial pressure to return to normal Promotes return of cortisone production by the adrenal glands When taking the blood pressure of a client who had a thyroidectomy, the nurse identifies that the client is pale and has spasms of the hand. The nurse notifies the health care provider. Which should the nurse expect the health care provider to prescribe? Calcium Magnesium Bicarbonate Potassium chloride What is the maximum length of time a nurse should allow an intravenous bag of solution to infuse? 6 hours 12 hours 18 hours 24 hours A nurse gave a client the prescribed sodium polystyrene sulfonate. What assessment finding indicates that the drug has been effective? The presence of diarrhea A narrowing of the QRS complex An increase in serum calcium level A decrease in serum potassium level A client receiving intravenous vancomycin reports ringing in both ears. Which initial action should the nurse take? Notify the primary healthcare provider. Consult an audiologist. Stop the infusion. Document the finding and continue to monitor the client. A client with burns develops a wound infection. The nurse plans to teach the client that local wound infections primarily are treated with what type of antibiotics? Oral Topical Intravenous Intramuscular A nurse is caring for a client who is receiving serum albumin. What indicates that the albumin is effective? Improved clotting of blood Formation of red blood cells Activation of white blood cells (WBCs) Effective cardiac output A healthcare provider prescribes 20 mEq potassium chloride to be given to a client over an 8-hour period by IV drip in 1000 mL of D5W. The IV equipment is calibrated at 10 drops per milliliter. At how many drops per minute should the nurse regulate the IV? Record your answer using a whole number. 21 drops/min Which nursing interventions are important when caring for clients receiving IV digoxin? Select all that apply. Monitor the heart rate closely Check the blood levels of digoxin Administer the dose over 1 minute Monitor the serum potassium level Give the drug with other infusing medications A client is receiving an antihypertensive drug intravenously for control of severe hypertension. The client's blood pressure is 160/94 mm Hg before the infusion. Fifteen minutes after the infusion is started, the blood pressure increases to 180/100 mm Hg. Which type of response is the client demonstrating? Allergic Synergistic Paradoxical Hypersusceptibility A client has been given a prescription for furosemide 40 mg every day in conjunction with digoxin. What would prompt the nurse to ask the provider about potassium supplements? Digoxin causes significant potassium depletion. The liver destroys potassium as digoxin is detoxified. Lasix requires adequate serum potassium to promote diuresis. Digoxin toxicity occurs rapidly in the presence of hypokalemia. A client is to receive 2000 mL of intravenous (IV) fluid in 12 hours. At what rate should the nurse set the electronic infusion control device? Record your answer using a whole number. 167 mL/hr A client with type 1 diabetes comes to the clinic because of concerns regarding erratic control of blood glucose with the prescribed insulin therapy. The client has been experiencing a sudden fall in the blood glucose level, followed by a sudden episode of hyperglycemia. Which complication of insulin therapy should the nurse conclude that the client is experiencing? Somogyi effect Dawn phenomenon Diabetic ketoacidosis Hyperosmolar nonketotic syndrome A client is experiencing both tingling of the extremities and tetany. What should the nurse anticipate will be prescribed by the healthcare provider? Dialysis Calcium supplements Mechanical ventilation Intravenous fluids with potassium A child is to receive 60 mg of phenytoin. The medication is available as an oral suspension that contains 125 mg/5 mL. How many milliliters should the nurse administer? Record your answer using one decimal place. 2.4mL A client is to receive 125 mL of intravenous (IV) fluid every hour. The drop factor of the IV tubing is 10 gtt/mL. How many drops per minute should the nurse administer? Record your answer using a whole number. 21gtts/min A client with type 1 diabetes consistently has high glucose levels on awakening in the morning. What should the nurse instruct the client to do to differentiate between the Somogyi effect and the dawn phenomenon? Eat a snack before going to bed. Measure the blood glucose level between 2 AM and 4 AM. Identify whether morning symptoms are typical for hyperglycemia. Administer the prescribed bedtime insulin immediately before going to bed. The healthcare provider prescribes enoxaparin to be administered subcutaneously daily to a client who had a total knee replacement. To ensure client safety, which measure would the nurse take when administering this medication? Remove air pocket from prepackaged syringe before administration. Rub the injection site after administration for 30 seconds. Administer medication over 2 minutes. Administer in the abdomen area only. A client with myasthenia gravis, who is living in a nursing home, experiences inadequate symptomatic control with pyridostigmine bromide, and long-term steroid therapy has been initiated. What is especially important for the nurse to ensure? The client increases sodium intake. Protective isolation is established. Total daily fluid intake is decreased. The client is monitored for an exacerbation of symptoms. A nurse is caring for an older adult who is taking acetaminophen for the relief of chronic pain. Which substance is most important for the nurse to determine if the client is taking because it intensifies the most serious adverse effect of acetaminophen? Alcohol Caffeine Saw palmetto St. John's wort A client is admitted to the hospital with pancytopenia as a result of chemotherapy. What should the nurse plan to teach this client in an effort to minimize the risk of complications as a result of pancytopenia? Avoid traumatic injuries and exposure to infection. Perform frequent mouth care with a firm toothbrush. Increase oral fluid intake to a minimum of 3 L daily. Report any unusual muscle cramps or tingling sensations in the extremities. A client who weighs 176 pounds (80 kg) is being immunosuppressed by daily maintenance doses of cyclosporine to prevent organ transplant rejection. The dose prescribed is 8 mg/kg each day. How many milligrams should the nurse plan to administer each day? Record your answer using a whole number. 640mg A client has had a recent brain attack (cerebrovascular accident/stroke). What does the nurse anticipate will be prescribed daily to prevent straining due to constipation? Stimulant laxatives such as bisacodyl Tap water enemas Stool softener Saline laxatives such as magnesium citrate A client with rheumatoid arthritis takes aspirin routinely to reduce pain. The client asks whether it is the arthritis, the aspirin, or some other ear problem that causes the bilateral ear buzzing the client is now experiencing. What is an appropriate nursing response? "The ringing in your ears is a sign of an ear infection." "Aspirin may have caused some nerve damage in your ear." "Accumulation of ear wax causes ringing in the ears." "Your symptoms are an expected response to the aging process." A client is diagnosed with type 2 diabetes, and the health care provider prescribes an oral hypoglycemic. For what side effect should the nurse teach this client to monitor? Ketonuria Weight loss Ketoacidosis Low blood sugar A client with a history of coronary artery disease is admitted with pneumonia. The healthcare provider prescribes atenolol. What should the nurse monitor to determine the therapeutic effect of atenolol? Heart rate Respirations Temperature Pulse oximetry Which medication should the nurse anticipate the healthcare provider will prescribe to relieve the pain experienced by a client with rheumatoid arthritis? Aspirin Hydromorphone Meperidine Alprazolam A nurse is caring for a client who is a victim of trauma and is to receive a blood transfusion. How should the nurse respond when the client expresses fear that acquired immunodeficiency syndrome (AIDS) may be acquired as a result of the blood transfusion? "The blood is treated with radiation to kill the virus." "The ability to directly identify HIV has eliminated this concern." "Consideration should be given to donating your own blood for transfusion." "Screening for the human immunodeficiency virus (HIV) antibodies has minimized this risk." A client using fentanyl transdermal patches for pain management in late-stage cancer dies. What should the hospice nurse who is caring for this client do about the patch? Tell the family to remove and dispose of the patch. Leave the patch in place for the mortician to remove. Have the family return the patch to the pharmacy for disposal. Remove and dispose of the patch in an appropriate receptacle. A client receiving chemotherapy asks the nurse why an antibiotic was prescribed. Which tissue affected by chemotherapy should the nurse consider when formulating a response? Liver Blood Bone marrow Lymph nodes A nurse is caring for a client who is receiving aspirin therapy. Which clinical indicator would be related to this therapy? Urinary calculi Atrophy of the liver Prolonged bleeding time Premature erythrocyte destruction A client who has a long leg cast for a fractured bone is to be discharged from the emergency department. When discussing pain management, when does the nurse advise the client to take the prescribed as-needed oxycodone? Just as a last resort Before going to sleep As the pain becomes intense When the discomfort begins A nurse is reviewing the history and physicals of several clients from the clinic who are taking rifampin for the treatment of tuberculosis. Which client presents a specific concern for the nurse? 45-year-old taking a loop diuretic 26-year-old taking oral contraceptives 32-year-old taking a proton pump inhibitor 72-year-old taking intermediate-acting insulin The healthcare provider has prescribed enoxaparin 1 mg/kg for a client who had a total knee replacement. The client weighs 187 pounds (85 kg). This medication is available in a concentration of 30 mg/0.3 mL. What dose will the nurse administer in milliliters? 0.8 mL 0.85 mL 0.9 mL 0.95 mL A client with diabetic ketoacidosis who is receiving intravenous fluids and insulin complains of tingling and numbness of the fingers and toes and shortness of breath. The cardiac monitor shows the appearance of a U wave. What complication does the nurse suspect? Hypokalemia Hypoglycemia Hypernatremia Hypercalcemia A client is diagnosed with myasthenia gravis, and the anticholinesterase medication pyridostigmine is prescribed. When teaching the client about this medication, the nurse explains to expect an increase in what function? Intestinal peristalsis Salivary and gastric secretions Contraction of skeletal muscles Secretion and discharge of tears A nurse is caring for a client who is scheduled for a bilateral adrenalectomy. Which medication should the nurse expect to be prescribed for this client on the day of surgery and in the immediate postoperative period? Methimazole Regular insulin Pituitary extract Hydrocortisone succinate A blood donor whose blood type is O negative is known as a "universal donor." What does the nurse consider about O negative blood that accounts for this classification? It does not have any of the antigens that can cause a reaction. The donor can donate blood more frequently than other people. More people have this blood type, so it is more universally available. It is more frequently administered when compared with other blood types. A client is admitted and diagnosed with myasthenia gravis. Pyridostigmine bromide therapy via tablets has been prescribed. The nurse anticipates that the dosage will be changed frequently during the first week of therapy. While the dosage is being adjusted, what action does the nurse perform? Administer the medication after meals. Administer the medication on an empty stomach. Evaluate the client's psychological responses between medication doses. Evaluate the client's muscle strength every hour after the medication is given. A client newly diagnosed with diabetes arrives at the emergency department complaining of dizziness and weakness. The client's spouse reports that the client has been confused since this morning. The spouse reports that the client administered the morning dose of 10 units of regular insulin and 25 units of NPH insulin with difficulty and did not eat much breakfast. What does the nurse identify as the most likely cause of the client's signs and symptoms? Hyperglycemia Hyperlipidemia Hypoglycemia Hypocalcemia Which information does the nurse include in the teaching plan for the client who is prescribed sumatriptan for migraine headache? Should be administered when headache is at its peak Should be administered by deep intramuscular injection Is contraindicated in people with coronary artery disease Injectable sumatriptan may be administered every 6 hours as needed A client with a seizure disorder is receiving phenytoin and phenobarbital. What client statement indicates that the instructions regarding the medications are understood? "I will not have any seizures with these medications." "These medicines must be continued to prevent falls and injury." "Stopping the drugs can cause continuous seizures and I may die." "By my staying on the medicines I will prevent post-seizure confusion." A client presents with a severe stiff neck, shuffling gate, and other extrapyramidal symptoms. Benztropine 2.5 mg by mouth is prescribed. The medication is available in 1- mg scored tablets. How many tablets should the nurse administer? Record your answer using one decimal place. 2.5 tabs Metoprolol is prescribed for a client with hypertension. For which side effect should the nurse monitor the client? Hirsutism Bradycardia Restlessness Hypertension A healthcare provider orders guaifenesin 300 mg four times a day. The dosage strength is 200 milligrams/5 milliliters. How many milliliters should the nurse administer for each dose? Record your answer using one decimal place. 7.5 mL Levothyroxine 12.5 mcg orally each day is prescribed for a client with hypothyroidism. The pharmacy dispensed 90 tablets with each tablet containing 12.5 mcg. Six weeks later, the healthcare provider increases the client's dose to 25 mcg daily and gives the client a prescription to be filled at the pharmacy. The client asks the nurse whether the tablets in the original prescription can be used before filling the new prescription. How many of the original tablets should the nurse instruct the client to take daily? Record your answer using a whole number. 2 tab The nurse is caring for a client admitted for a severe kidney infection and hyponatremia. The healthcare provider prescribes ceftriaxone 1 gram to be administered intravenously over 30 minutes. The intravenous (IV) piggyback contains 50 mL. The IV tubing drop factor is 15 drops/mL. At what rate will the nurse infuse the medication? 15 drops/min 20 drops/min 25 drops/min 30 drops/min After cataract surgery the nurse teaches a client how to self-administer eyedrops. The nurse reinforces the use of what technique? Placing the drops on the cornea of the eye Raising the upper eyelid with gentle traction Holding the dropper tip above the conjunctival sac Squeezing the eye shut after instilling the medication While the nurse is at the bedside of a client in acute renal failure, the client states, "My healthcare provider said that I will be getting some insulin. Do I also have diabetes?" What is the best nursing response? "No, the insulin will help your body handle the increased potassium level." "I suggest that you ask your healthcare provider that question." "You probably had an elevated blood glucose level, so your healthcare provider is being cautious." "No, but insulin will reduce the toxins in your blood by lowering your metabolic rate." A nurse concludes that clients who receive intravenous (IV) fluids rather than total parenteral nutrition for gastrointestinal problems lose weight for what reason? Lack of bulk in the diet Deficient carbohydrate intake Insufficient intake of water-soluble vitamins Increasing concentrations of electrolytes in the cells A primary health care provider prescribes 1000 mL total parenteral nutrition (TPN) to be infused over 12 hours via a central venous access device. What is most important for the nurse to obtain when preparing the equipment? An infusion pump A steady intravenous (IV) pole An infusion set delivering 60 gtts/mL A set of hemostats to be taped at the bedside A client with a recent history of sinusitis develops meningitis and demonstrates a positive Brudzinski sign. What is the priority nursing care? Monitoring intracranial pressure Adding pads to the side of the bed Administering prescribed antibiotics Hydrating the client with hypotonic saline A client is admitted to the hospital with a diagnosis of an exacerbation of asthma. What should the nurse plan to do to best help this client? Determine the client's emotional state. Give prescribed drugs to promote bronchiolar dilation. Provide education about the impact of a family history. Encourage the client to use an incentive spirometer routinely. The healthcare provider prescribes isosorbide dinitrate 10 mg for a client with chronic angina pectoris. The client asks the nurse why the isosorbide dinitrate is prescribed. How will the nurse respond? "It prevents excessive blood clotting." "It suppresses irritability in the ventricles." "It improves oxygen supply to heart tissue." "The inotropic action increases the force of contraction of the heart." A client who has been diagnosed with acute lymphocytic leukemia will be receiving doxorubicin infusions as part of a chemotherapy regimen. The nurse monitors the client for signs and symptoms of doxorubicin toxicity. What clinical finding indicates that toxicity has occurred? Alopecia Dyspnea Metallic taste to food Cardiac rhythm abnormallities A nurse is planning to administer a prescribed intravenous solution that contains potassium chloride. What assessment should be brought to the healthcare provider's attention before administration of the intravenous line? Uncharacteristic irritability Poor tissue turgor with tenting Urinary output of 200 mL during the previous 8 hours Oral fluid intake of 300 mL during the previous 12 hours A client with type 1 diabetes is placed on an insulin pump. What is the priority short-term goal when teaching this client to control the diabetes? "The client will adhere to the medical regimen." "The client will remain normoglycemic for 3 weeks." "The client will demonstrate correct use of the insulin pump." "The client will list three self-care activities that are necessary to control the diabetes." A client with a history of malabsorption syndrome is admitted to the hospital for medical management. Total parenteral nutrition (TPN) has been prescribed. What action will the nurse take to prevent a major reaction to the TPN infusion? Record the intake and output. Administer the infusion slowly. Change the site every 24 hours. Check the vital signs every 4 hours. A client has a tonic-clonic seizure caused by an overdose of aspirin. What is an appropriate nursing action? Check reflexes every 2 hours. Prepare a setup for a central venous pressure (CVP) line. Insert a urinary retention catheter. Monitor vital signs every 15 minutes. A client who had a tonic-clonic seizure of unknown etiology is to begin taking phenytoin. What instructions will the nurse give to the client? Take the medication on an empty stomach. Brush the teeth and gums three times daily. Stop taking the drug if abdominal pain occurs. Note any change in pulse and respiratory rates. A health care provider prescribes psyllium 3.5 g twice a day for constipation. What is most important for the nurse to teach this client? Urine may be discolored. Each dose should be taken with a full glass of water. Use only when necessary because it can cause dependence. Daily use may inhibit the absorption of some fat-soluble vitamins. A client is admitted for dehydration and an intravenous (IV) infusion of normal saline at 125 mL/hr has been started. One hour after the IV initiation the client begins screaming, "I can't breathe!" What is the nurse’s priority action? Elevate the head of the bed and obtain vital signs. Discontinue the IV site and contact the primary healthcare provider. Change the IV to an intermittent infusion device. Contact the primary healthcare provider to obtain a prescription for a sedative. For a client with difficulty swallowing, the nurse should crush which medication? Metoprolol extended release Felodipine sustained release Acetaminophen extra strength Potassium chloride extended release A client has a tonic-clonic seizure that involves all extremities. The nurse anticipates that the healthcare provider will prescribe the intravenous administration of which drug? Naloxone Diazepam Epinephrine Atropine A client is to receive conscious sedation during a cardiac catheterization. Which route of administration should the nurse explain will be used to deliver the conscious sedation? Via a face mask Into the epidural space Through an intravenous catheter Around the nerves innervating the chest wall What should the nurse include when teaching a client with severe Parkinson disease about carbidopa-levodopa? Multivitamins should be taken daily. Alcohol consumption should be in moderation. The medication should be taken with meals. A high-protein diet should be followed. An intravenous (IV) solution of 1000 mL 5% dextrose in water is to be infused at 125 mL/hr to correct a client's fluid imbalance. The infusion set delivers 15 drops/mL. To ensure that the solution will infuse over an 8-hour period, at how many drops per minute should the nurse set the rate of flow? Record your answer using a whole number. 31gtts/min Prednisone, an adrenal steroid, is prescribed for a client with an exacerbation of colitis. When administering the first dose of the medication, what information does the nurse provide to the client? Prednisone protects the client from getting an infection. The medication may cause weight loss by decreasing appetite. Prednisone is not curative, but does cause a suppression of the inflammatory process. The medication is relatively slow in precipitating a response, but is effective in reducing symptoms. A client with a parotid tumor that involves the lymph glands in the neck is prescribed vincristine, cyclophosphamide, and prednisone. The nurse should monitor the client for what adverse effect? Peripheral paresthesia Anginal-type chest pain Ophthalmic papilledema Bilateral crackles in the lung A client is admitted with head trauma after a fall. The client is being prepared for a supratentorial craniotomy with burr holes, and an intravenous infusion of mannitol is instituted. The nurse concludes that this medication primarily is given to do what? Lower blood pressure Prevent hypoglycemia Increase cardiac output Decrease fluid in the brain Which medication should the nurse question when it is prescribed for a client with acute pancreatitis? Ranitidine Cimetidine Meperidine Promethazine A healthcare provider prescribes mannitol for a client with a head injury. The nurse concludes that the purpose of the medication is to relieve cerebral edema by which mechanism? Decreasing the production of cerebrospinal fluid Limiting the metabolic requirements of the brain Drawing fluid from brain cells into the bloodstream Preventing uncontrolled electrical discharges in the brain A nurse is caring for a client who is scheduled to have an abdominal perineal resection for colorectal cancer. The client has type B negative blood. If a blood infusion is needed, which type is preferred for administration? A positive B negative O negative AB positive A client with tuberculosis is to begin combination therapy with isoniazid, rifampin, pyrazinamide, and streptomycin. The client says, "I've never had to take so much medication for an infection before." How will the nurse respond? "This type of organism is difficult to destroy." "Streptomycin prevents side effects of the other drugs." "You'll only need to take the medications for a couple of weeks." "Aggressive therapy is needed because the infection is well advanced." A client who is postoperative hip replacement is receiving morphine by patient-controlled analgesia and has a respiratory rate of 6 breaths/min. What intervention should the nurse anticipate? Nasotracheal suction Mechanical ventilation Naloxone administration Cardiopulmonary resuscitation A client is diagnosed with multiple myeloma. What does the nurse expect the plan of care to include? Radiotherapy on an outpatient basis Human leukocyte interferon therapy Surgery to remove the invasive lesions Chemotherapy employing a combination of drugs A client is newly diagnosed with hypertension. The primary healthcare provider prescribes an antihypertensive medication to be taken once in the morning and a 2 gram sodium diet. What is most important for the nurse to teach the client about lowering the blood pressure? "Avoid adding salt to cooked foods." "Use less salt when preparing foods." "Take your medicine exactly as prescribed." "Measure your blood pressure every morning." A client develops a fever after surgery. Ceftriaxone is prescribed. For which potential adverse effect should the nurse monitor the client? Dehydration Heart failure Constipation Allergic response A client who is on long-term corticosteroid therapy following an adrenalectomy is admitted to the surgical intensive care unit after being involved in a motor vehicle crash. What is the nurse’s mostimportant concern related to the client’s history? The dosage of steroids may have to be tapered down slowly. Steroid therapy will need to be increased to avert a life-threatening crisis. Osteoporosis secondary to long-term corticosteroids increases fracture risk. The client will be at greater risk of infection secondary to immunosuppression. A nurse administers the drug desmopressin acetate (DDAVP) to a client with diabetes insipidus. What should the nurse monitor to evaluate the effectiveness of the drug? Arterial blood pH Intake and output Fasting serum glucose Pulse and respiratory rates A client has a prescription for an antibiotic in an intravenous piggyback (IVPB) of 50 mL of D5W to run for 30 minutes. The microdrip tubing has a drop factor of 60 gtt/mL. At what rate should the nurse set the IV infusion? Record your answer using a whole number. 100gtts/min The nurse provides teaching to a client who has received a prescription for oral pancreatic enzymes, pancrelipase. The nurse evaluates that teaching is understood when the client identifies which time for medication scheduling? At bedtime With meals One hour before meals On arising each morning A client is admitted to the hospital with a diagnosis of deep vein thrombosis, and intravenous (IV) heparin sodium is prescribed. If the client experiences excessive bleeding, what should the nurse be prepared to administer? Vitamin K Oprelvekin Warfarin sodium Protamine sulfate Hydrocortisone is prescribed for a client with Addison disease. Before discharge, the nurse teaches the client about this medication. What did the nurse include as a therapeutic effect of the drug? Supports a better response to stress Promotes a decrease in blood pressure Decreases episodes of shortness of breath Controls an excessive loss of potassium from the body A client with postradiation enteritis is to continue receiving total parenteral nutrition (TPN) at home after discharge. What information should the nurse include in the client's teaching plan? Showing how to mix the nutritional solutions Demonstrating how to test capillary glucose levels Identifying the types of infusion pumps that can be used Checking for catheter placement by palpating the insertion site A client who is dehydrated is to receive an intravenous (IV) solution of normal saline to be infused at 175 mL/hr. The drop factor of the IV set is 15 gtts/mL. At what drop rate will the nurse adjust the flow to provide the prescribed solution? Record your answer using a whole number. 44 gtts/min A client who is receiving atenolol for hypertension frequently reports feeling dizzy. What effect of atenolol should the nurse consider may be responsible this response? Depleting acetylcholine Stimulating histamine release Blocking the adrenergic response Decreasing adrenal release of epinephrine A nurse prepares to administer intravenous (IV) albumin to a client with ascites. What effect does the nurse anticipate? Ascites and blood ammonia levels will decrease. Decreased capillary perfusion and blood pressure. Venous stasis and blood urea nitrogen level will increase. As extravascular fluid decreases, the hematocrit will decrease. A client is scheduled to receive conscious sedation during a colonoscopy. The client asks the nurse, "How will they 'knock me out' for this procedure?" Which answer by the nurse correctly describes the route of administration for conscious sedation? "