HESI Pharmacology Nightingale College Fall 2023

HESI Pharmacology Nightingale College Fall 2023 A client is scheduled for a spiral computed tomography (CT) scan with contrast to evaluate for PE. Which information in the client's history requires follow up by the nurse? Takes metformin hydrochloride for type 2 DM. A client diagnosed with MS who self-administers beta 1 a interferon, reports feeling increasingly depressed. Which action should the nurse implement? Notify the healthcare provider of the findings immediately. 00:0401:32 Before administering the initial dose of sumatriptan succinate to a client with a migraine headache. It is most important to determine if the client's history includes which problem? CAD A client receives a prescription for ciprofloxacin 400 mg intravenously (IV) every 12 hours which is to be infused over an hour. The IV bag contains ciprofloxacin 400 mg in dextrose 5%in water (D5W) 200mL. How many mL/hr should the nurse program the infusion pump to deliver? 200 Before administering a laxative to a bedfast client it is most important for the nurse to perform which assessment? Determine the frequency and consistency of bowel movements. Hormone replacement therapy with levothyroxine sodium is prescribed for a client with hypothyroidism. The nurse should instruct the client to report which symptom because it indicates that the client is taking too much of the hormonal agent levothyroxine sodium? Restlessness A male client reports to the nurse that he is experiencing gastrointestinal distress from a high dose of a corticosteroid and is planning to stop taking the medication. In response to the client's statement which nursing action is most important for the nurse to implement? Advise the client that medication should be gradually stopped rather than abruptly. A client is receiving pilocarpine hydrochloride ophthalmic drops for glaucoma. The client calls the clinic nurse and reports difficulty seeing at night. Which explanation should the nurse provide? The eye drops slow pupil response to accommodate for darkness A client is receiving rifampin an antitubercular medication. Which statement by this client should prompt the nurse to notify the healthcare provider of a potential problem? Reports that the sclera are yellow. Which action should the nurse implement to assess the effectiveness of the Calcium channel blocker amlodipine? Measure the client's BP. A male client has been receiving the antibiotic gentamicin sulfate IV piggyback every 12 hours for several days. Which observation by the nurse indicates that the client may be experiencing an adverse effect of gentamicin? Hearing has decreased. An older adult client with restless legs syndrome begins taking melatonin at bedtime. When evaluating the effectiveness of the herb which assessment should the nurse complete? Determine sleep patterns. 00:0301:32 The nurse prepares to administer a scheduled dose of labetalol by mouth to a client with HTN. The client's V/Signs are temp 99% (37.2*C) heart rate 48 beats/ minute RR 16 breaths/min and BP 150/90 mm/Hg. Which action should the nurse take? Withhold the scheduled dose and notify the healthcare provider. The nurse is planning discharge teaching for a client with DM who has a new prescription for insulin glargine. Which action should the nurse plan to include in the discharge teaching? Teach the client self-injection skills for daily subcutaneous administration. The nurse is caring for a client who takes methotrexate for rheumatoid arthritis and is now prescribed adalimumab. Which instructions should the nurse provide the client? Have a chest x ray prior to your first dose. The nurse provide discharge instructions to a client who has been prescribed gabapentin 300 mg by mouth three times a day for post herpetic neuralgia. Which symptoms should the nurse tell the client to report to the healthcare provider? Gastric irritation To evaluate the effectiveness of a client's prescription for rosuvastatin which action should the nurse implement? Obtain the client's HR, and BP. A client receives a prescription for itraconazole. Which information provided by the client requires additional instruction by the nurse? Take the medication with antacids. The nurse is preparing a client with COPD and chronic productive cough for discharged home. Which prescribed medication should the nurse review with the client to manage this symptom? Guaifenesin When caring for a client with diabetes insipidus who is receiving an antidiuretic hormone intranasally which serum lab test is most important for the nurse to monitor? Osmolality A client is receiving tamsulosin an alpha adrenergic - blocking agent for the management of urinary retention due to benign prostatic hyperplasia (BPH). Which instruction is most important for the nurse to provide? Stand and sit up slowly. A client with chemotherapy induced nausea receives a prescription for metoclopramide. Which adverse effect is most important for the nurse to report? Involuntary movements A client is receiving orlistat as part of a weight management program. Which ongoing assessment should be included in the plan of care to determine the effectiveness of the medication? Body mass index A client who received a renal transplant three months ago is readmitted to the acute care unit with signs of graft rejection. While taking the client's history the nurse determines that the client has been selfadministering St. John's wort an herbal preparation on the advice of a friend. Which information is most significant about this finding? St John's Wort can decrease plasma concentrations of cyclosporine When preparing to apply a scheduled fentanyl transdermal patch the nurse notes that the previously applied patch is intact on the client's upper back and the client denies pain. Apply the new patch in a different location after removing the original patch. During a home visit the nurse assesses a client with Alzheimer's disease who recently started a new prescription for rivastigmine. The caregiver reports that the client seems to be thinking more clearly but is not sleeping well at night. Which action should the nurse take? Explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started. Based on a client's serum digoxin level the client is diagnosed with digoxin toxicity. Which action should the nurse expect to implement? Begin cardioversion to stabilize heart rhythm. The nurse administering IV fluconazole to client who has systemic candidiasis. After reviewing the client's diagnostic studies the nurse identifies a rising trend in the liver enzyme levels for aspartate aminotransferase (AST also called SGOT). Which action should the nurse implement? Hold the dose and notify the HCP of the changes in the laboratory studies. A client with muscle spasticity receives a prescription for baclofen. Which information provided by the client requires additional instruction by the nurse? Discontinue when spasms cease. A postoperative client has a prescription for ketorolac 30 mg IV every 6 hours. Which intervention should the nurse implement to determine if the expected outcome of the medication has been achieved? Perform a pain assessment using a numeric scale. A client uses transdermal contraceptive calls to the clinic because she forgot to apply a new patch three days ago. Which instruction should the nurse provide to the client? Apply the new patch today and use a backup method for 7 days. A female client with a history of PUD receives a prescription for misoprostol. Which information provided by the client indicates to the nurse a need for further teaching? Ensure a negative pregnancy test results 2 weeks before therapy. The nurse is caring for an older client with multiple comorbidities. Which medication should the nurse recognize as increasing the client's risk for fractures? Lansoprazole During a home visit the nurse assesses a client with Alzheimer's disease who recently started a new prescription for rivastigmine. The caregiver reports that the client seems to be thinking more clearly but is not sleeping well at night. Which action should the nurse take? Explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started The nurse is preparing a discharge teaching plan for a client who is taking ciprofloxacin hydrochloride tablets which were prescribed because of a suspected anthrax exposure. Which instructions should be included in the teaching plan? Increase fluid intake while taking the medication Limit exposure to sunlight and avoid tanning beds. Report any tendon pain or swelling to the HCP immediately. A client with emphysema is complaining of difficulty breathing and is exhibiting audible wheezing. The nurse administers albuterol as prescribed for the third time within last 12 hours. Which assessment finding warrants immediate intervention by the nurse? Irregular rapid heartbeat The healthcare provider prescribes ceftazidime 1500 mg intravenously (IV) every 12 hours. The available vial is labeled "ceftazidime 1 gram." And the instructions for reconstitution state for IV use add 10 ml sterile water for injection. Concentration after reconstitution 100 mg/ml. How many ml should the nurse administer? 15 The nurse observes that a client has become lethargic 30 minutes after receiving an opioid injection for pain. Which V/S should the nurse obtain first? RR The home health nurse observes a client self - administering an epinephrine injection using an autoinjector pen. Which client requires intervention by the nurse? Cleanses the injection pen for re-use. A client has a prescription for clopidogrel bisulfate 75mg by mouth daily at 0900. In which situation should the nurse hold this medication? Elective surgery is scheduled in two hours An adolescent with MDD has been taking duloxetine for the past 12 days. Which assessment finding requires immediate follow up? Describes life as without purpose A male client with a newly diagnosed seizure disorder starts a prescription for clonazepam. One week later the nurse observes that his speech is slurred and he has an ataxic gait. Which action should the nurse implement? Explain the need to refrain from alcohol use while taking the drug. Which assessment data indicates to the nurse that a client is having an anaphylactic reaction to a medication? Wheezing and dyspnea A client with schizophrenia receives a prescription for fluphenazine. Which instruction is most important for the nurse to include when teaching the client about this drug? Notify your HCP immediately if involuntary movements develop Two months after taking nitrofurantoin for a bacterial infection a client reports the onset of severe watery diarrhea to the home health nurse. How should the nurse respond? Determine if the full course of the initial prescription of medication was taken The nurse assesses a client with intermittent claudication who is receiving pentoxifylline. Monitor numeric pain scale A client is taking clonazepam benztropine haloperidol and divalproex. The nurse suspects that the client is experiencing akathisia because the client is rocking back and forth in the chair and having difficulty still. Which medication is most likely to the cause of this condition? HALOperidol The adult client recently has been diagnosed with asthma. Which medicati