PHAR 225 Pharmacology 245 Questions and Answers Latest updated 2021/2022,100% CORRECT

PHAR 225 Pharmacology 245 Questions and Answers Latest updated 2021/2022 1. A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half- life of 4 days. How many times per day should the nurse expect to administer this medication? A. One B. Two C. Three D. Four 2. A nurse educator is reviewing medication metabolism at an in-service presentation. Which of the following factors should the educator include as a reason to administer lower medication dosages? (Select all that apply.) A. Increased renal excretion B. Increased medication-metabolizing enzymes C. Liver failure D. Peripheral vascular disease E. Concurrent use of medication the same pathway metabolizes 3. A nurse is preparing to administer eye drops to a client. Which of the following actions should the nurse take? (Select all that apply.) A. Have the client lie on one side. B. Ask the client to look up at the ceiling. C. Tell the client to blink when the drops enter the eye. 4. A nurse is teaching a client about transdermal patches. Which of the following statements should the nurse identify as an indication that the client understands? A. "I will clean the site with an alcohol swab before I apply the patch." B. "I will rotate the application sites weekly." C. "I will apply the patch to an area of skin with no hair." D. "I will place the new patch on the site of the old patch." 5. A nurse reviewing a client's medical record notes a new prescription for verifying the trough level of the client's medication. Which of the following actions should the nurse take? A. Obtain a blood specimen immediately prior to administering the next dose of medication. B. Verify that the client has been taking the medication for 24hr before obtaining a blood specimen. C. Ask the client to provide a urine specimen after the next dose of medication. D. Administer the medication, and obtain a blood specimen 30 min later. 6. A nurse is preparing a client's medications. Which the of following actions should the nurse take in following legal practice guidelines? (Select all that apply.) A. Teach the client about the medication. B. Determine the dosage. C. Monitor for adverse effects. D. Lock compartments for controlled substances. E. Determine the client's insurance status. 7. A nurse is preparing to administer digoxin to a client who states, "I don't want to take that medication. I do not want one more pill." Which of the following responses should the nurse make? A. "Your physician prescribed it for so you really should take it." B. "Well, let's just get it over quickly then." you, C. "Okay, I'll just give you your other medications." D. "Tell me your concerns about taking this medication." 8. A nurse is reviewing a client's prescribed medications. Which of the following situations represents a contraindication to medication administration? A. The client drank grapefruit juice, which could reduce a medication's effectiveness. B. The medication has orthostatic hypotension as an adverse effect. C. A medication is approved for ages 12 and older, and the client is 8 years old. D. An antianxiety medication that has an adverse effect of drowsiness is prescribed as a preoperative sedative. 9. A nurse is assessing a client before administering medications. Which of the following data should the nurse obtain? (Select all that apply.) A. Use of herbal products B. Daily fluid intake C. Ability to swallow D. Previous surgical history E. Allergies 10. A nurse is working with a newly licensed nurse who is administering medications to clients. Which of the following actions should the nurse identify as an indication that the newly hired nurse understands medication error prevention? A. Taking all medications out of the unit-dose wrappers before entering the client's room B. Checking the prescription when a single dose requires administration of multiple tablets C. Administering a medication, then looking up the usual dosage range D. Relying on another nurse to clarify a medication prescription 11. A nurse in a clinic is caring for a group of clients. The nurse should contact the provider about a potential contraindication to a medication for which of the following clients? (Select all that apply.) A. A client at 8 weeks of gestation who asks for an influenza immunization B. A client who takes prednisone and has a possible fungal infection C. A client who has chronic liver disease and is taking hydrocodone / acetaminophen D. A client who has peptic ulcer disease, takes sucralfate, and has started taking OTC aluminum hydroxide E. A client who has a prosthetic heart valve, takes warfarin, and reports a suspected pregnancy 12. A nurse is preparing to administer an IM dose of penicillin to a client who has a new prescription. The client states when they took penicillin 3 years ago, they developed a rash. Which of the following actions should the nurse take? A. Administer the prescribed dose. B. Withhold the medication. C. Ask the provider to change the prescription to an oral form. D. Administer an oral antihistamine the same time. 13. A nurse is providing discharge instructions for a client who has a new prescription for an antihypertensive medication. Which of the following statements should the nurse give? A. "Be sure to limit your potassium intake while taking the medication." B. "You should check your blood pressure every 8 hours while taking this medication." C. "Your medication dosage will be increased if you develop tachycardia." D. "Change positions slowly when you move from sitting to standing." 14. A nurse is reviewing a client's health record and notes that the client experienced permanent extrapyramidal effects caused by a previous medication. The nurse should recognize that the medication affected which of the following systems in the client? A. Cardiovascular B. Immune C. Central nervous D. Gastrointestinal 15. A nurse is caring for a client who is taking oral oxycodone. The client is also taking ibuprofen in three recommended doses daily. The nurse should identify that an interaction between these two medications will cause which of the following findings? A. A decrease in blood levels of ibuprofen, possibly leading to a need for increased doses of this medication B. A decrease in blood levels of oxycodone, possibly leading to a need for increased doses of this medication. C. An increase in the expected therapeutic effect of both medications D. An increase in expected adverse effects for both medications 16. A nurse is preparing to administer medications to a 4-month-old infant. Which of the following pharmacokinetic principles should the nurse consider when administering medications to this client? (Select all that apply.) A. Infants have a more rapid gastric emptying time. B. Infants have immature liver function. C. Infants' blood-brain barrier is poorly developed. D. Infants have an increased ability to absorb topical medications. E. Infants have an increased number of protein-binding sites. 17. A nurse in a provider's office is reviewing the medical record of a client who is pregnant and at the first prenatal visit. Which of the following immunizations can the nurse administer safely to this client? A. Varicella vaccine B. Rubella vaccine C. Inactivated influenza vaccine D. Measles vaccine 18. A nurse on a medical-surgical unit administers a hypnotic medication to an older adult client at 2100. The next morning, the client is drowsy and wants to sleep instead of eating breakfast. Which of the following factors should the nurse identify as a possible reason for the client's drowsiness? A. Reduced cardiac function B. First-pass effect C. Reduced hepatic function D. Increased gastric motility 19. A nurse is caring for a client who has increased liver enzymes and is taking herbal supplements. Which of the following herbal supplements should the nurse report to the provider as the potential cause? A. Glucosamine B. Saw palmetto C. Kava D. St. John's Wort 2. A nurse is caring for a client who requests information on the use of feverfew. Which of the tallowing responses should the nurse make? A. "It is used to treat skin infections." B. "It can decrease the frequency of migraine headaches." C. "It can lessen the nasal congestion in the common cold." D. "It can relieve nausea of morning sickness during pregnancy." 20. A nurse is reviewing a client's current medications. The client states, "I also take ginkgo biloba." Which of the following medications has the potential to interact with ginkgo biloba? A. Acetaminophen B. Warfarin C. Digoxin D. Lisinopril 21. A nurse is caring for a client who asks about the potential adverse effects of smoking cannabis. Which of the following manifestations should the nurse include in the response? (Select all that apply.) A. Decreased heart rate B. Dry mouth C. Hallucinations D. Hypertension E. Increased urination 22. A nurse is teaching about the use of medical marijuana with a group of newly licensed nurses. Which of the following statements indicates an understanding of the teaching? A. A health care provider must write a prescription for medical marijuana. B. Medical marijuana is a Schedule V controlled substance in the United States. C. Pharmacies must obtain certification prior to dispensing medical marijuana. D. The FDA does not recognize the marijuana plant as a form of medicine. 23. A nurse working in an emergency department is caring for a client who has benzodiazepine toxicity. Which of the following actions is the nurse's priority? A. Administer flumazenil. B. Identify the client's level of orientation. C. Infuse IV fluids. D. Prepare the client for gastric lavage. 24. A nurse is teaching a client who has a new prescription for escitalopram for treatment of generalized anxiety disorder. Which of the following statements by the client indicates understanding of the teaching? A. "I should take the medication on an empty stomach." B. "I will follow a low-sodium diet while taking this medication." C. "I need to discontinue this medication slowly." D. "I should not crush this medication before swallowing." 25. A nurse is providing teaching to a client who has a new prescription for buspirone to treat anxiety. Which of the following information should the nurse include? A. "Take this medication on an empty stomach." B. "Expect optimal therapeutic effects within 24 hr." C. "Take this medication when needed for anxiety." D. "This medication has a low risk for dependency." 26. A nurse is teaching a client who has obsessive-compulsive disorder and has a new prescription for paroxetine. Which of the following instructions should the nurse include? A. "It can take several weeks before you feel like the medication is helping." B. "Take the medication just before bedtime to promote sleep." C. "You should take the medication when needed for obsessive urges." D. "Monitor for weight gain while taking this medication." 27. A nurse is caring for a client who takes paroxetine to treat posttraumatic stress disorder and reports that they grind their teeth during the night. The nurse should identify which of the following interventions to manage bruxism? (Select all that apply.) A. Concurrent administration of buspirone B. Administration of a different SSRI C. Use of a mouth guard D. Changing to a different class of antidepressant medication E. Increasing the dose of paroxetine 28. A nurse is teaching the guardians of a child who has a new prescription for desipramine. The nurse should include that which of the following adverse effects is the priority to report to the provider? A. Constipation B. Suicidal thoughts C. Photophobia D. Dry mouth 2. A nurse is teaching an adolescent client who has a new prescription for clomipramine for OCD. Which of the following instructions should the nurse include to minimize an adverse effect of his medication? A. Wear sunglasses when outdoors. B. Check your temperature daily. C. Take this medication in the morning. D. Add extra calories to your diet. 29. A nurse is caring for a school-age child who has a new prescription for atomoxetine. The nurse should monitor the client for which of the following manifestations as an adverse effect of this medication? A. Kidney toxicity B. Liver damage C. Seizure activity D. Adrenal insufficiency 30. A nurse is teaching the caregiver of a school-age child about transdermal methylphenidate. Which of the following instructions should the nurse include? A. Apply one patch twice per day. B. Leave the patch on for 9 hr. C. Apply the patch to the child's waist. D. Use opened tray within 6 months. 31. A nurse is teaching the guardians and their school-age child about a new prescription for lisdexamfetamine. Which of the following information should the include in the teaching? (Select all that apply.) A. An adverse effect of this medication is CNS stimulation. B. Administer the medication before bedtime. C. Monitor blood pressure while taking this medication. D. Therapeutic effects of this medication will take 1 to 3 weeks to fully develop. E. This medication raises the levels of dopamine in the brain. 32. A nurse is providing teaching to a group of new parents about medications. The nurse should include that aspirin is contraindicated for children who have a viral infection due to the risk of developing which of the following adverse effects? Reye's syndrome Visual disturbances Diabetes mellitus Wilms' tumor 33. A nurse is providing teaching to a client who has chronic kidney failure with an AV fistula for hemodialysis and a new prescription for epoetin alfa. Which of the following therapeutic effects of epoetin alfa should the nurse include in the teaching? Reduces blood pressure Inhibits clotting of fistula Promotes RBC production Stimulates growth of neutrophils 34. A nurse is caring for a client who has peptic ulcer disease and reports a headache. Which of the following medications should the nurse plan to administer? Ibuprofen Naproxen Aspirin Acetaminophen 35. A nurse is preparing to administer heparin 8,000 units subcutaneously every 8hr. Available is heparin 10,000 units/1mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.) 0.8 mL 36. A nurse is preparing to administer an enteral tube feeding through an NG tube at 250 mL over 4 hr. The nurse should set the pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) 250/4 = 62.5} 63 mL/hr 37. A nurse is preparing to administer amoxicillin 250 mg liquid supspension PO every 8 hr to an older adult client. The amount available is amoxicillin 50 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) 5 mL 38. A nurse is caring for a client who has a prescription for clopidogrel. The nurse should monitor the client for which of the following adverse effects? Insomnia Hypotension Bleeding Constipation 39. A nurse is teaching a newly licensed nurse about contraindications to ceftriaxone. The nurse should include a severe allergy to which of the following medications as a contraindication to ceftriaxone? Gentamicin Clindamycin Piperacillin Sulfamethoxazole-trimethoprim 40. A nurse is providing teaching to a newly licensed nurse about metoclopramide. The nurse should include in the teaching that which of the following conditions is a contraindication to this medication? Hyperthyroidism Intestinal obstruction Glaucoma Low blood pressure 41. A nurse is assessing a client who has a new prescription for chlorpromazine to treat schizophrenia. The client has a mask-like facial expression and is experiencing involuntary movements and tremors. Which of the following medications should the nurse anticipate administering? Amantadine Bupropion Phenelzine Hydroxyzine 42. A nurse is administering subcutaneous epinephrine for a client who is experiencing anaphylaxis. The nurse should monitor the client for which of the following adverse effects? Hypotension Hyperthermia Hypoglycemia Tachycardia 43. A nurse is providing teaching to a client who has a urinary tract infection and new prescriptions for phenazopyridine and ciprofloxacin. Which of the following statements by the client indicates the need for further teaching? "If the phenazopyridine upsets my stomach, I can take it with meals." "The phenazopyridine will relieve my discomfort, but the ciprofloxacin will get rid of the infection." "I need to drink 2 liters of fluid per day while I am taking the ciprofloxacin." "I should notify my provider immediately if my urine turns an orange color." 44. A nurse is caring for an older adult client who has a prescription for zolpidem at bedtime to promote sleep. The nurse should plan to monitor the client for which of the following adverse effects? Ecchymosis Decreased urine output Increased blood pressure Dizziness 45. A nurse is reviewing laboratory values for a client who reports fatigue and cold intolerance. The client has an increased thyroid stimulating hormone (TSH) level and a decreased total T3 and T4 level. The nurse should anticipate a prescription for which of the following medications? Methimazole Somatropin Levothyroxine Propylthiouracil 46. A nurse is providing teaching to a client who has a new prescription for hydrochlorothiazide 50 mg PO daily to treat hypertension. Which of the following instructions should the nurse include in the teaching? "Take hydrochlorothiazide as needed for edema." "Check your weight once each week." "Take the hydrochlorothiazide on an empty stomach." "Take the hydrochlorothiazide in the morning." 47. A nurse is caring for a client who is at 28 weeks of gestation and is experiencing preterm labor. Which of the following medications should the nurse plan to administer? Oxytocin Nifedipine Dinoprostone Misoprostol 48. A nurse is providing teaching to a client who has cirrhosis and a new prescription for lactulose. The nurse should instruct the client that lactulose has which of the following therapeutic effects? Increases blood pressure Prevents esophageal bleeding Decreases heart rate Reduces ammonia levels 49. A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression. Which of the following diagnostic tests should the nurse plan to perform prior to starting the client on this medication? Hearing examination Glucose tolerance test Electrocardiogram Pulmonary function tests 50. A nurse is providing teaching to a client who has gout and a new prescription for allopurinol. The nurse should instruct the client to discontinue taking the medication for which of the following adverse effects? Nausea Metallic taste Fever Drowsiness 51. A nurse is assessing a client who is receiving IV gentamicin three times daily. Which of the following findings indicates that the client is experiencing an adverse effect of this medication? Hypoglycemia Proteinuria Nasal congestion Visual disturbances 52. A nurse is providing teaching for a client who is withdrawing from alcohol and has a new prescription for propranolol. Which of the following information should the nurse include in the teaching? A. Increases the risk for seizure activity B. Provides a form of aversion therapy C. Decreases cravings D. Can increase blood pressure 53. A charge nurse is planning a staff education session to discuss medications used during the care of a client experiencing alcohol withdrawal . Which of the following medications should the charge nurse include the discus (Select all that apply.) A. Lorazepam B. Diazepam C. Disulfiram D. Naltrexone E. Acamprosate 54. A nurse is teaching a client who has a new prescription for clonidine to assist with maintenance of abstinence from opioids. The nurse should instruct the client to monitor for which of the following adverse effects? A. Diarrhea B. Dry mouth C. Insomnia D. Hypertension 55. A nurse is teaching a client who has tobacco use disorder about nicotine replacement therapy. Which of the following statements by the client indicates understanding of the teaching? A. "I should avoid eating right before I chew a piece of nicotine gum." B. "I will need to stop using the nicotine gum after 1 year." C. "I know that nicotine gum is a safe alternative to smoking if I become pregnant." D. "I must chew the nicotine gum quickly for about 15 minutes." 56. A nurse in an acute mental health facility is caring for a client who is experiencing withdrawal from opioid use and has a new prescription for clonidine. Which of the following actions should the nurse identify as the priority? A. Administer the clonidine on the prescribed schedule. B. Provide ice chips at the client's bedside. C. Educate the client on the effects of clonidine. D. Obtain baseline vital signs. 57. A nurse in the post-anesthesia recovery unit is caring for a client who received a nondepolarizing neuromuscular blocking agent and has muscle weakness. The nurse should expect a prescription for which of the following medications? A. Neostigmine B. Naloxone C. Dantrolene D. Vecuronium 58. A nurse is providing information to a client who has early Parkinson's disease and a new prescription for pramipexole. The nurse should instruct the client to monitor for which of the following adverse effects of this medication? A. Hallucinations B. Increased salivation C. Diarrhea D. Discoloration of urine 59. A nurse is teaching a client who has a new prescription for levodopa / carbidopa for Parkinson's disease. Which of the following instructions should the nurse include? A. Increase intake of protein-rich foods. B. Expect muscle twitching to occur. C. Take this medication with food. D. Anticipate relief of manifestations in 24 hr. 60. A nurse is preparing to administer a medication to a client who has absence seizures. The nurse should expect to administer which of the following medications to the client? (Select all that apply.) A. Phenytoin B. Ethosuximide C. Gabapentin D. Carbamazepine 61. A nurse is reviewing a new prescription for oxcarbazepine with a client who has partial seizures. Which of the following instructions should the nurse include? (Select all that apply.) A. "Use caution if given a prescription for a diuretic medication." B. "Consider using an alternate form of contraception if you are using oral contraceptives." C. "Chew gum to increase saliva production." D. "Avoid driving until you see how the medication affects you." E. "Notify your provider if you develop a skin rash." 62. A nurse in the operating room is caring for a client who received a dose of succinylcholine. During the operation, the client suddenly develops rigidity and a rise in body temperature. The nurse should expect a prescription for which of the following medications? A. Neostigmine B. Naloxone C. Dantrolene D. Vecuronium 63. A nurse in the post-anesthesia care unit is caring for a client who is experiencing malignant hyperthermia. Which of the following actions should the nurse take? (Select all that apply.) A. Place a cooling blanket on the client. B. Administer oxygen at 100%. C. Administer iced 0.9% sodium chloride. D. Administer potassium chloride IV. E. Monitor core body temperature. 64. A nurse is teaching a client who has a new prescription for baclofen to treat muscle spasms. Which of the following statements by the client indicates an understanding of the teaching? (Select all that apply.) A. "I will stop taking this medication right away if I develop dizziness." B. "I know the doctor will gradually increase my dose of this medication for a while." C. "I should increase fiber to prevent constipation from this medication." D. "I won't be able to drink alcohol while I'm taking this medication." E. "I should take this medication on an empty stomach each morning." 65. A nurse is reviewing the medical record of a client who reports urinary incontinence and asks about a prescription for oxybutynin. The nurse should recognize that oxybutynin is contraindicated in the presence of which of the following conditions? A. Bursitis B. Sinusitis C. Depression D. Glaucoma 66. A nurse is assessing a client who has a prescription for bethanechol to treat urinary retention. The nurse should identify that which of the following findings is a manifestation of muscarinic stimulation? A. Dry mouth B. Hypertension C. Excessive perspiration D Fecal impaction 67. A nurse is providing instructions to a client who has been experiencing insomnia and has a new prescription for temazepam. The nurse should inform the client that which of the following manifestations are adverse effects of temazepam? (Select all that apply.) A. Incoordination B. Hypertension C. Pruritus D. Sleep driving E. Amnesia 68. A nurse is caring for a client who is receiving moderate sedation with diazepam IV. The client is oversedated. Which of the following medications should the nurse expect to administer to this client? A. Ketamine B. Naltrexone C. Flumazenil D. Fluvoxamine 69. A nurse is teaching a client who has a new prescription for ramelteon. The nurse should instruct the client to avoid which of the following foods at the time of medication administration? A. Baked potato B. Fried chicken C. Whole-grain bread D. Citrus fruits 70. A nurse is caring for a client who is to undergo a surgical procedure. Which of the following preexisting conditions can be a contraindication for the use of ketamine as an intravenous anesthetic? A. Peptic ulcer disease B. Breast cancer C. Diabetes mellitus D. Schizophrenia 71. A nurse is providing instructions to a client who has a new prescription for zolpidem. Which of the following instructions should the nurse include? A. "Notify the provider if you plan to become pregnant." B. "Take the medication 1hr before you plan to go to sleep." C. "Allow at least 6hr for sleep when taking zolpidem." D. "To increase the effectiveness of zolpidem, take it with a bedtime snack." 72. A nurse is reviewing the health record of a client who asks about using propranolol to treat hypertension. The nurse should recognize which of the following conditions is a contraindication for taking propranolol? A. Asthma B. Glaucoma C. Hypertension D. Tachycardia 73. A nurse is teaching a client who has a new prescription for verapamil to control hypertension. Which of the following instructions should the nurse include? A. Increase the amount of fiber in the diet. B. Drink grapefruit juice daily to increase vitamin C intake. C. Decrease the amount of calcium in the diet. D. Withhold food for 1hr after the medication is taken. 74. A nurse is caring for a client who has a new prescription for captopril for hypertension. The nurse should monitor the client for which of the following as an adverse effect of this medication? A. Hypokalemia B. Hypernatremia C. Neutropenia D. Bradycardia 75. A nurse in an acute care facility is caring for a client who is receiving IV nitroprusside for hypertensive crisis. Which of the following conditions should the nurse monitor the client for as an adverse effect of this medication? A. Intestinal ileus B. Neutropenia C. Delirium D. Hyperthermia 76. A nurse is planning to administer a first dose of captopril to a client who has hypertension. Which of the following medications can intensify first dose hypotension? (Select all that apply.) A. Simvastatin B. Hydrochlorothiazide C. Phenytoin D. Clonidine E. Aliskiren 77. A nurse is assessing a client who is taking amiodarone to treat atrial fibrillation. Which of the following findings is a manifestation of amiodarone toxicity? A. Light yellow urine B. Report of tinnitus C. Productive cough D. Blue-gray skin discoloration. 78. A nurse is caring for a client who received IV verapamil to treat supraventricular tachycardia (SVT). The client's pulse rate is now 98 / min and the blood pressure is 74/44 mg Hg. The nurse should expect a prescription for which of the following IV medications? A. Calcium gluconate B. Sodium bicarbonate C. Potassium chloride D. Magnesium sulfate 79. A nurse is assessing a client who is taking digoxin to treat heart failure. Which of the following findings is a manifestation of digoxin toxicity? A. Bruising B. Report of metallic taste C. Muscle pain D. Report of anorexia 90. A nurse is assessing a client who has taken procainamide to treat dysrhythmias for the last 12 months. The nurse should assess the client for which of the following manifestations as an adverse effect of this medication? (Select all that apply.) A. Hypertension B. Widened QRS complex C. Narrowed QT interval 91 A nurse is preparing to administer propranolol to a client who has a dysrhythmia. Which of the following actions should the nurse plan to take? A. Hold propranolol for an apical pulse greater than 100 / min. B. Administer propranolol to increase the client's blood pressure. C. Assist the client when sitting up or standing after taking this medication. D. Check for hypokalemia frequently due to the risk for propranolol toxicity. 92. A nurse is providing teaching to a client who is starting simvastatin. Which of the following information should the nurse include in the teaching? A. Take this medication in the evening. B. Change position slowly when rising from a chair. C. Maintain a steady intake of green leafy vegetables. D. Consume no more than 1 L/day of fluid. 93. A nurse is collecting data from a client who is taking gemfibrozil. Which of the following assessment findings should the nurse identify as an adverse effect of this medication? A. Mental status changes B. Tremor C. Jaundice D. Pneumonia 94. A nurse is teaching a client who is taking digoxin and has a new prescription for colesevelam. Which of the following instructions should the nurse include in the teaching? A. "Take digoxin with your morning dose of colesevelam." B. "Your sodium and potassium levels will be monitored periodically while taking colesevelam." C. "Watch for bleeding or bruising while taking colesevelam." D. "Take colesevelam with food and at least one glass of water." 95. A nurse is completing a nursing history for a client who takes simvastatin. The nurse should identify which of the following disorders as a contraindication to adding ezetimibe to the client's medications? A. History of severe constipation B. History of hypertension C. Active hepatitis C D. Type 2 diabetes mellitus 96. A nurse is caring for a client who has a new prescription for alirocumab to reduce cholesterol. The nurse should monitor for which of the following findings as an adverse effect of alirocumab? (Select all that apply.) A. Muscle aches B. Vasculitis C. Hearing loss 97. A nurse is planning to administer subcutaneous al enoxaparin 40 mg using a prefilled syringe of enoxaparin 40 mg / 0.4 mL to an adult client following hip arthroplasty. Which of the following actions should the nurse plan to take? A. Expel the air bubble from the prefilled syringe before injecting. B. Insert the needle completely into the client's tissue. C. Administer the injection in the client's thigh. D. Aspirate carefully after inserting the needle into the client's skin. 98. A nurse is caring for a client who is receiving heparin by continuous IV infusion. The client begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse prepare to administer? A. Vitamin K B. Atropine C. Protamine D. Calcium gluconate 99. A nurse is planning to administer IV alteplase to a client. Which of the following interventions should the nurse plan to take? A. Administer IM enoxaparin along with the alteplase dose. B. Obtain the client's weight. C. Administer aminocaproic acid IV prior to alteplase infusion. D. Prepare to administer alteplase within 8hr of manifestation onset. 100. A nurse is monitoring a client who takes aspirin daily. The nurse should identify which of the following manifestations as adverse effects of aspirin? (Select all that apply.) A. Hypertension B. Coffee-ground emesis C. Tinnitus D. Paresthesias of the extremities E. Nausea 101. A nurse is caring for a client who has atrial fibrillation and a new prescription for dabigatran. Which of the following medications is prescribed concurrently to treat an adverse effect of dabigatran? A. Vitamin K B. Protamine C. Omeprazole D. Probenecid 102. A nurse is teaching a client who has angina pectoris and is learning how to treat acute anginal attacks. The clients asks, "What is my next step if I take one tablet, wait 5 minutes, but still have anginal pain?" Which of the following responses should the nurse make? A. "Take two more sublingual tablets at the same time." % 3D B. "Call the emergency response team." C. "Take a sustained-release nitroglycerin capsule." D. "Wait another 5 minutes then take a second sublingual tablet." 103. A nurse is teaching a client who has a new prescription for nitroglycerin transdermal patch for angina pectoris. Which of the following instructions should the nurse include? A. Remove the patch each evening. B. Cut each patch in half if angina attacks are under control. C. Take off the nitroglycerin patch for 30 min if a headache occurs. D. Apply a new patch every 48 hr. 104. A nurse is taking a medication history from a client who has angina and is to begin taking ranolazine. The nurse should report which of the following medications in the client's history that can interact with ranolazine? (Select all that apply.) A. Digoxin B. Simvastatin od C. Verapamil D. Amlodipine E. Nitroglycerin transdermal patch 105. A nurse is caring for a client who is prescribed isosorbide mononitrate for chronic stable angina and develops reflex tachycardia. Which of the following medications should the nurse expect to administer? A. Furosemide B. Captopril C. Ranolazine D. Metoprolol 106. A nurse is teaching a client who has angina how to use nitroglycerin transdermal ointment. The nurse should include which of the following instructions? A. "Remove the prior dose before applying a new dose." B. "Rub the ointment directly into your skin until it is no longer visible." C. "Cover the applied ointment with a clean gauze pad." D. "Apply the ointment to the same skin area each time." 107. A nurse in a provider's office is monitoring blood electrolytes for four clients who take digoxin. Which of the following electrolyte values increases a client's risk for digoxin toxicity? A. Calcium 9.2 mg/dL B. Calcium 10.3 mg/dL C. Potassium 3.4 mEq/L D. Potassium 4.8 mEq?L 108. A nurse is caring for a client who has a new prescription for digoxin and takes multiple other medications. The nurse should recognize that concurrent use of which of the following medications places the client at risk for digoxin toxicity? A. Phenytoin B. Verapamil C. Warfarin D. Aluminum hydroxide 109. A nurse is administering a dopamine infusion at a low dose to a client who has severe heart failure. Which of the following findings is an expected effect of this medication? A. Lowered heart rate B. Increased urine output C. Decreased conduction through the AV node D. Vasoconstriction of renal blood vessels 110. A nurse is providing teaching to a client who has a new prescription for digoxin. The nurse should instruct the client to monitor and report which of the following adverse effects that is a manifestation of digoxin toxicity? (Select all that apply.) A. Fatigue B. Constipation C. Anorexia D. Rash E. Blurred vision 111. A nurse is teaching a client who has a new prescription for digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching? A. Contact provider if heart rate is less than 60 / min. B. Check pulse rate for 30 seconds and multiply result by 2. C. Increase intake of sodium. D. Take with food if nausea occurs. 112. A nurse is caring for a client who has a new prescription for phenelzine for the treatment of depression. Which of the following indicates that the client has developed an adverse effect of this medication? A. Orthostatic hypotension B. Hearing loss C. Gastrointestinal bleeding D. Weight loss 113. A nurse is providing teaching to a client who has a new prescription for amitriptyline for treatment of depression. Which of the following should the nurse include in the teaching? (Select all that apply.) A. Expect therapeutic effects in 24 to 48 hr. B. Discontinue the medication after a week of improved mood. C. Change positions slowly to minimize dizziness. D. Decrease dietary fiber intake to control diarrhea. E. Chew sugarless gum to prevent dry mouth. 114. A nurse is providing discharge teaching to a client who has a new prescription for fluoxetine for posttraumatic stress disorder. Which of the following statements should the nurse include in the teaching? A. "You can have a decreased desire for intimacy while taking this medication." B. "You should take this medication at bedtime to help promote sleep." C. "You will have fewer urinary adverse effects if you urinate just before taking this medication." D. "You'll need to wear sunglasses when outdoors due to the light sensitivity caused by this medication." 115. A nurse is caring for a client who has depression and a new prescription for venlafaxine. The nurse should monitor the client for which of the following manifestations as an adverse effect of this medication? (Select all that apply.) A. Mydriasis B. Dizziness C. Decreased libido D. Alopecia E. Hypotension 116. A nurse is caring for a client who has been taking sertraline for the past 2 days. Which of the following assessment findings should alert the nurse to the possibility that the client is developing serotonin syndrome? A. Bruising B. Fever C. Tinnitus D. Rash 117. A nurse is reviewing laboratory findings and notes that a client's lithium level is 2.1 mEg/L. Which of the following is an appropriate action by the nurse? A. Perform immediate gastric lavage. B. Prepare the client for hemodialysis. C. Administer an additional oral dose of lithium. D. Request a stat repeat of the laboratory test. 118. A nurse is caring for a client who has a new prescription for lithium carbonate. When teaching the client about ways to prevent lithium toxicity, the nurse should advise the client to do which of the following? A. Avoid the use of acetaminophen for headaches. B. Restrict intake of foods rich in sodium. C. Decrease fluid intake to less than 1,500 mL daily. D. Limit aerobic activity in hot weather. 119. A nurse is assessing a client who takes lithium carbonate for the treatment of bipolar disorder. The nurse should identify which of the following findings is a possible indication of toxicity to this medication? A. Severe hypertension B. Coarse tremors C. Constipation D. Muscle spasms 120. A nurse is caring for a client who has a new prescription for valproic acid. The nurse should instruct the client to have which of the following blood laboratory tests completed periodically? (Select all that apply.) A. Thrombocyte count B. Glucose C. Amylase D. Liver function tests E. Potassium 121. A nurse is preparing a teaching plan for a client who has bipolar disorder and a new prescription for carbamazepine. Which of the following instructions should the nurse include in the teaching? A. "This medication can safely be taken during pregnancy." B. "Eliminate grapefruit juice from your diet." C. "You will need to have a complete blood count and carbamazepine levels drawn periodically." D. "Notify your provider if you develop a rash." E. "Avoid driving for the first few days after starting this medication." 122. A nurse is teaching a client, who has schizophrenia, strategies to cope with anticholinergic effects of fluphenazine. Which of the following should the nurse suggest to the client to minimize anticholinergic effects? A. Take the medication in the morning to prevent insomnia. B. Chew sugarless gum to moisten the mouth C. Use cooling measures to decrease fever D. Take an antacid to relieve nausea 123. A nurse is assessing a client who recently began taking haloperidol. Which of the following findings is the priority to report to the provider? A. Shuffling gait B. Neck spasms C. Drowsiness D. Sexual dysfunction 124. A nurse is providing discharge teaching to a client who has a new prescription for clozapine. Which of the following statements should the nurse include in the teaching? A. "You should have a high-carbohydrate snack between meals and at bedtime." B. "You are likely to develop hand tremors if you take this medication for a long period of time." C. "You may experience temporary numbness of your mouth after each dose." D. "You should have your white blood cell count monitored every week." 125. A nurse is providing teaching for a client who Is to begin taking risperidone. Which of the following instructions should the nurse include? A. "Add extra snacks to your diet to prevent weight loss." B. "Notify the provider if you have trouble sleeping." C. "You may begin to have mild seizures while taking this medication." D. "This medication is likely to increase your libido." 126. A nurse is following up with a client who takes chlorpromazine for the treatment of schizophrenia. The nurse should expect to find the greatest improvement in which of the following manifestations? (Select all that apply.) A. Disorganized speech B. Bizarre behavior C. Impaired social interactions D. Hallucinations E. Decreased motivation 127. A nursing is planning care for a client who is receiving furosemide IV for peripheral edema. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.) A. Assess for tinnitus. B. Report urine output 50 mL/hr. C. Monitor blood potassium levels. D. Elevate the head of bed slowly before ambulation E. Recommend eating a banana daily. 128. A nurse is providing information to a client who has a new prescription for hydrochlorothiazide. Which of the following information should the nurse include? A. Take the medication with food. B. Plan to take the medication at bedtime. C. Expect increased swelling of the ankles. D. Fluid intake should be limited in the morning. 129. A nurse is monitoring a client who is receiving spironolactone. Which of the following findings should the nurse report to the provider? A. Blood sodium 144 mEq /L B. Urine output 120 mL in 4hr C. Blood potassium 5.2 mEq /L D. Blood pressure 140/90 mm Hg 130. A nurse is caring for a client who has increased intracranial pressure and is receiving mannitol. Which of the following findings should the nurse report to the provider? A. Blood glucose 150 mg/dL B. Urine output 40 mL/hr C. Dyspnea D. Bilateral equal pupil size 131. A nurse is planning care for a client who is has a new prescription for torsemide. The nurse should plan to monitor for which of the following conditions as potential adverse reactions of this medication? (Select all that apply.) A. Respiratory acidosis B. Hypokalemia C. Hypotension D. Ototoxicity E. Ventricular dysrhythmias 132. A nurse is teaching clients about the use of insulin to treat type 1 diabetes mellitus. For which of the following types of insulin should the nurse tell the clients to expect a peak effect 1 to 5hr after administration? A. Insulin glargine B. NPH insulin C. Regular insulin D. Insulin lispro 133. A nurse is caring for a client who has been taking acarbose for type 2 diabetes mellitus. Which of the following laboratory tests should the nurse plan to monitor? A. WBC B. Amylase C. Platelet count D. Liver function tests ed son 134. A nurse is providing teaching to a client who has type 2 diabetes mellitus and is starting repaglinide. Which of the following statements by the client indicates understanding of the administration of this medication? A. "I'll take this medication after I eat." B. "I'll take this medicine 30 minutes before I eat." C. "I'll take this medicine just before I go to bed." D. "I'll take this medication at least 1 hour before I eat." 135. A nurse is providing teaching for a client who has a new prescription for metformin. Which of the following findings should the nurse instruct the client to report as an adverse effect of metformin? A. Somnolence B. Constipation C. Fluid retention D. Weight gain 136. A nurse is providing teaching to a client who has a prescription for pramlintide for type 1 diabetes mellitus. Which of the following should the nurse include in the teaching? (Select all that apply.) A. "Take oral medications 30 min before injection." B. "Use upper arms as preferred injection sites." C. "Mix pramlintide with the breakfast dose of insulin." D. "Inject pramlintide just before a meal." E. "Discard open vials after 28 days." 137. A nurse is caring for a client who is taking propylthiouracil. Which of the following findings should the nurse monitor for as an adverse effect of this medication? A. Bradycardia B. Insomnia C. Heat intolerance D. Weight loss 138. A nurse is teaching a client who has Grave's disease and a new prescription for propranolol. Which of the following client statements indicates effective teaching? A. "Propranolol helps increase blood flow to my thyroid gland." B. "Propranolol is used to prevent excess glucose in my blood." C. "Propranolol will decrease my tremors and fast heart beat." D. "Propranolol promotes a decrease of thyroid hormone in my body." 139. A nurse is caring for an older adult client who has hypothyroidism and a new prescription for levothyroxine. Which of the following dosage schedules should the nurse expect for this client? A. The client will start at a high dosage, and the amount will be tapered as needed. B. The client will remain on the initial dosage during the course of treatment. C. The client's dosage will be adjusted daily based on blood levels. D. The client will start on a low dosage, which can be gradually increased. 140. A nurse is caring for a client who is taking for somatropin to stimulate growth. The nurse should plan to monitor the client's urine for which of the following? A. Bilirubin B. Protein C. Potassium D. Calcium 141. A nurse is reviewing the medical record of a client who takes desmopressin for diabetes insipidus. Which of the following findings is an adverse effect of desmopressin? A. Hypovolemia B. Hypercalcemia C. Agitation D. Headache 142. A nurse is admitting a client for a total hip arthroplasty. The client takes hydrocortisone for Addison's disease. Which of the following actions the nurse's priority? A. Administering a supplemental dose of hydrocortisone B. Instructing the client about coughing and deep breathing C. Collecting additional information about the client's history of Addison's disease D. Inserting an indwelling urinary catheter 143. A nurse is teaching a client about terbutaline. Which of the following statements by the client indicates understanding of the teaching? A. "This medication will stop my contractions." B. "This medication will prevent vaginal bleeding." C. "This medication will promote blood flow to my baby." D. "This medication will increase my prostaglandin production." 144. A nurse is caring for a client who has preeclampsia and is receiving magnesium sulfate IV continuous infusion. Which of the following findings 2 should the nurse report to the provider? A. 2+ deep tendon reflexes B. 2+ pedal edema C. 24 mL/hr urinary output D. Respirations 12/min 145. A nurse is caring for a client who has a new prescription for oxytocin to stimulate uterine contractions. Which of the following actions should the nurse take? (Select all that apply.) C. Stop infusion if uterine contractions occur every 4 min and last 45 seconds. D. Increase medication infusion rate rapidly. E. Fetal heart rate continuously monitor. 146. A nurse is caring for a client who and is receiving oxytocin. The nurse should monitor the client for which of the following as complications of oxytocin? (Select all that apply.) A. Uterine rupture B. Uterine tachysystole C. Placental abruption D. Hyponatremia E. Placenta previa 147. A nurse is reviewing a new prescription for terbutaline with a client who has a history of preterm labor. Which of the following client statements indicates understanding of the teaching? A. "I can increase my activity now that I've started on this medication." B. "I will increase my daily fluid intake to 3 quarts." C. "I will report increasing intensity of contractions to my doctor." D. "I am glad this will prevent preterm labor." 148. A nurse is reviewing the health care record of a client who is asking about conjugated equine estrogens. The nurse should inform the client this medication is contraindicated in which of the following conditions? A. Atrophic vaginitis B. Dysfunctional uterine bleeding C. Osteoporosis D. Thrombophlebitis 149. A nurse is providing teaching to a female client who is taking testosterone to treat advanced breast cancer. The nurse should tell the client that which of the following are adverse effects of this medication? (Select all that apply.) A. Deepening voice B. Weight gain C. Low blood pressure D. Dry mouth E. Facial hair 150. A nurse is explaining the mechanism of action of combination oral contraceptives to a group of clients. The nurse should tell the clients that which of the following actions occur with the use of combination oral contraceptives? (Select all that apply.) A. Thickening the cervical mucus B. Inducing maturation of ovarian follicle C. Increasing development of the D. Altering the endometrial lining E. Inhibiting ovulation 151. A nurse is providing teaching to a client who will start alfuzosin for treatment of benign prostatic hyperplasia. The nurse should instruct the client that which of the following is an adverse effect of this medication? A. Bradycardia B. Edema C. Hypotension D. Tremor 152. A nurse is caring for a client who has angina and asks about obtaining a prescription for sildenafil to treat erectile dysfunction. Which of the following medications is contraindicated with sildenafil? A. Aspirin B. Isosorbide C. Clopidogrel D. Atorvastatin 153. A nurse is providing teaching to a newly licensed nurse about caring for a client who has a prescription for gemfibrozil. The nurse should instruct the newly licensed nurse to monitor which of the following laboratory tests? Platelet count Electrolyte levels Thyroid function Liver function 154. A nurse is caring for a client who has a new prescription for ergotamine. The nurse should recognize that ergotamine is administered to treat which of the following conditions? Raynaud's phenomenon Migraine headaches Ulcerative colitis Anemia 155. A nurse is reviewing the laboratory values for a client who is receiving a continuous IV heparin infusion and has an aPTT of 90 seconds. Which of the following actions should the nurse prepare to take? Administer vitamin K Reduce the infusion rate Give the client a low-dose aspirin Request an INR 156. A nurse is providing teaching to a client who has rhematoid arthritis and a prescription for long-term prednisone therapy. The nurse should instruct the client to monitor for which of the following adverse effects? Stress fractures Orthostatic hypotension Gingival ulcerations Weight loss 157. A nurse is caring for a client who has a new prescription for tamoxifen. The nurse should recognize that tamoxifen has which of the following therapeutic effects? Antiestrogenic Antimicrobial Androgenic Anti-inflammatory 158. A nurse is caring for a client who has a new prescription for amphotericin B. The nurse should plan to monitor the client for which of the following adverse effects? Hyperkalemia Hypertension Constipation Nephrotoxicity 159. A nurse is administering subcutaneous heparin to a client who is at risk for deep vein thrombosis. Which of the following actions should the nurse take? Administer the medication into the client's abdomen. Inject the medication into a muscle. Massage the site after administering the medication. Use a 22-gauge needle to administer the medication. 160. A nurse is reviewing the laboratory results for a client who has a prescription for filgrastim. The nurse should recognize that an increase in which of the following values indicates a therapeutic effect of this medication? Erythrocyte count Neutrophil count Lymphocyte count Thrombocyte count 161. A nurse is providing teaching to a client who has ulcerative colitis and a new prescription for sulfasalazine. The nurse should instruct the client to monitor for which of the following adverse effects of this medication? Jaundice Constipation Oral candidiasis Sedation 162. A nurse is planning care for a client who has a seizure disorder and a new prescription for valproic acid. Which of the following laboratory values should the nurse plan to monitor? (Select all that apply.) BUN PTT Aspartate aminotransferase (AST) Urinalysis Alanine aminotransferase (ALT) 163. A nurse is caring for a client who has a new diagnosis of oral candidiasis after taking tetracycline for 7 days. The nurse should recognize that candidiasis is a manifestation of which of the following adverse effects? Allergic response Superinfection Renal toxicity Hepatotoxicity 164. A nurse is preparing to administer furosemide 4 mg/kg/day PO divided into 2 equal doses daily to a toddler who weighs 22 lb. How many mg should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) 40mg STEP 1: What is the unit of measurement the nurse should calculate? kg STEP 2: Set up an equation and solve for X. 2.2 lb/1 kg = client's weight in lb/X kg 2.2 lb/1 kg = 22 lb/X kg X = 10 kg STEP 3: Round if necessary. STEP 4: Reassess to determine whether the conversion to kg makes sense. If 1 kg = 2.2 lb, it makes sense that 22 lb = 10 kg. STEP 5: What is the unit of measurement the nurse should calculate? mg STEP 6: Set up an equation and solve for X. mg x kg / day = X 4 mg x 10 kg = 40 mg/day STEP 7: Round if necessary. 165. A nurse is caring for a client who has a prescription for chlorothiazide to treat hypertension. The nurse should plan to monitor the client for which of the following adverse effects? Thrombophlebitis Hyperactive reflexes Muscle weakness Hypoglycemia 166. A nurse on a medical unit is preparing to administer alendronate 40 mg PO for an older adult client who has Paget's disease of the bone. Which of the following actions should be the nurse's priority? Administer the medication to the client before breakfast in the morning. Ambulate the client to a chair prior to administering the medication. Give the medication to the client with water rather than milk. Teach the client how to take the medication at home. 167. A nurse is caring for a client who has been taking isoniazid and rifampin for 3 weeks for the treatment of active pulmonary tuberculosis (TB). The client reports his urine is an orange color. Which of the following statements should the nurse make? "Stop taking the isoniazid for 3 days and the discoloration should go away." "Rifampin can turn body fluids orange." "I'll make an appointment for you to see the provider this afternoon." "Isoniazid can cause bladder irritation." 168. A nurse is preparing to administer lactated Ringer's (LR) 1,000 mL IV to infuse over 8 hr. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) 21 gtt/min Ratio and Proportion and Desired Over Have STEP 1: What is the unit of measurement the nurse should calculate? gtt/min STEP 2: What is the volume the nurse should infuse? 1,000 mL STEP 3: What is the total infusion time? 8 hr STEP 4: Should the nurse convert the units of measurement? Yes (hr does not equal min) 1 hr/60 min = 8 hr/X min X = 480 min STEP 5: Set up an equation and solve for X. Volume (mL)/Time(min) X Drop Factor (gtt/mL) = X 1,000 mL/480 min x 10 gtt/mL = X gtt/min X = 20.833 STEP 6: Round if necessary. 20.833 = 21 169. A nurse is caring for a client who has a new prescription for enalapril. The nurse should monitor the client for which of the following adverse effects of this medication? Ecchymosis Jaundice Hypotension Hypokalemia 170. A nurse is preparing to administer prochlorperazine 2.5 mg IV. Available is prochlorperazine injection 5 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.) 0.5 mL Ratio and Proportion STEP 1: What is the unit of measurement the nurse should calculate? mL STEP 2: What is the dose the nurse should administer? Dose to administer= Desired 2.5 mg STEP 3: What is the dose available? Dose available = Have 5 mg STEP 4: Should the nurse convert the units of measurement? No STEP 5: What is the quantity of the dose available? 1 mL STEP 6: Set up an equation and solve for X. Have/Quantity = Desired/X 5 mg/1 mL = 2.5 mg/X mL X = 0.5 171. A nurse is providing teaching to a newly licensed nurse about administering morphine via IV bolus to a client. Which of the following information should the nurse include in the teaching? Respiratory depression can occur 7 min after the morphine is administered. The morphine will peak in 10 min. Withhold the morphine if the client has a respiratory rate less than 16/min. Administer the morphine over 2 min. 172. A nurse is providing teaching to a parent of a child who has asthma and a new prescription for a cromolyn sodium metered dose inhaler. Which of the following statements by the parent indicates the need for further teaching? "I will give my child a dose as soon as wheezing starts." "My child should rinse out his mouth after using the inhaler." "My child should exhale completely before placing the inhaler in his mouth." "If my child has difficulty breathing in the dose, a spacer can be used." 173. A nurse is preparing a discharge teaching plan for a 6-year-old client who has asthma and several prescription medications using metered dose inhalers (MDIs). Which of the following interventions should the nurse include in the plan? Add a spacer to each MDI. Instruct the child to inhale more rapidly than usual when using an MDI. Request that the provider change the child's medications from inhaled to oral formulations. Administer oxygen by facemask along with the MDI. 174. A nurse is administering oral hydroxyzine to a client. Which of the following adverse effects should the nurse instruct the client to expect? Diarrhea Anxiety Nausea and vomiting Dry mouth 175. A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40 mg daily, but the client reports that she has been taking extra doses to promote weight loss. Which of the following findings should indicate to the nurse that the client is dehydrated? Urine specific gravity 1.035 Distended neck veins BUN 18 mg/dL Bounding radial pulses 176. A nurse is preparing a discharge teaching plan for a client who is to begin long-term oral prednisone for asthma. Which of the following instructions should the nurse include in the plan? Stop taking the medication if a rash occurs. Take the medication on an empty stomach to enhance absorption. Schedule the medication on alternate days to decrease adverse effects. Treat shortness of breath with an extra dose of the medication. 177. A nurse is providing teaching to a client who has hypertension and type 1 diabetes mellitus and a new prescription for metoprolol. Which of the following statements by the client indicates an understanding of the teaching? "I might have difficulty recognizing when my blood sugar is low." "I will have less risk for developing an infection while I take this medication." "I should be concerned about losing excess weight while I take this medication." "I could have more problems with high blood sugars while taking this medication." 178. A nurse is preparing to administer ampicillin 500 mg in 50 mL of dextrose 5% in water (D5W) to infuse over 15 min. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) 33 gtt/min STEP 1: What is the unit of measurement the nurse should calculate? gtt/min STEP 2: What is the quantity of the drop factor that is available? 10 gtt/min STEP 3: What is the total infusion time? 15 min STEP 4: What is the volume the nurse should infuse? 50 mL STEP 5: Should the nurse convert the units of measurement? No STEP 6: Set up an equation and solve for X. Quantity/1 mL x Conversion (hr)/ Conversion(min) x Volume (mL)/Time (min) = X gtt/min 10 gtt/1 mL x 50 mL/15 min = X gtt/min X = 33.3333 STEP 7: Round if necessary. 33.3333 = 33 gtt/min 179. A nurse is planning to administer epoetin alfa to a client who has chronic kidney failure. Which of the following data should the nurse plan to review prior to administration of this medication? Blood pressure Temperature Blood glucose levels Total protein level 180. A nurse is planning care for a female client who has severe irritable bowel syndrome with diarrhea (IBS-D) and a new prescription for alosetron. Which of the following interventions should the nurse include in the plan of care? The client must sign an agreement with the provider before beginning alosetron. The client must stop taking alosetron if diarrhea continues 1 week after beginning the medication. The client should expect to have a slower heart rate while taking alosetron. The client should use a barrier birth control method because alosetron interacts with oral contraceptives. 181. A nurse is caring for a client and realizes after administering the 0900 medications that she administered digoxin 0.25 mg PO to the client instead of the prescribed digoxin 0.125 mg PO. Which of the following actions should the nurse take first? Notify the provider. Contact the nursing supervisor. Assess the client's apical pulse. Complete an incident report. 182. A nurse is providing discharge teaching to a client who has angina pectoris and a new prescription for verapamil. The client tells the nurse, "My brother takes verapamil for high blood pressure. Do you think the provider made a mistake?" Which of the following responses should the nurse make? "Verapamil is used to treat both high blood pressure and angina." "You should talk to your provider to make sure the prescription is correct for you." "Are you concerned that you might have high blood pressure?" "Your provider has prescribed verapamil so that you will not develop high blood pressure." 183. A nurse is providing discharge teaching to a client who had a kidney transplant and has a prescription for oral cyclosporine. Which of the following statements by the client indicates an understanding of the teaching? "I will be able to stop taking this medication 6 months after my su