NURS 406 Assessment 1 & 2 Pharmacology Capstone Exams

Assessment 1 1. The first action the nurse should take is to assess the client for injury due to medication error. Assess the client 2. A nurse is reviewing the medical record of a client who received medications 1 hr ago and reports having chest pain. The nurse should recognize that chest pain can be an adverse effect of which of the following medication? Albuterol Furosemide Digoxin Atenolol 3. A nurse is providing teaching to a client who has a new prescription for ranitidine for the treatment of Zollinger-Ellison syndrome. The nurse should explain to the client that ranitidine treats ulcers through which of the following actions? It decreases stomach motility It reduces gastric acid production It forms a protective barrier in the stomach lining. It neutralizes gastric acid. 4. A nurse is caring for a client who has open-angle glaucoma and a new prescription for acetazolamide. Prior to administering the first dose, the nurse should ask the client if they have allergy to which of the following medication classifications? Nitrates Sulfa-based medications Antilipemic agents Proton pump inhibitors 5. A nurse is caring for a client who has HIV and is starting therapy with ritonavir and zidovudine. The client asks why they must take both medications. Which of the following response should the nurse make? If you take the two medications together, it will shorten the duration of you…. Taking the two medications together keeps you from becoming resistant to either of them. Taking the two medication together keeps you from developing toxicity from either of them Zidovudine will help protect you from the possible adverse effects of ritonavir 6. A nurse is providing teaching to a client who has type 2 diabetes mellitus and is starting to take immediate release exenatide. Which of the following client statements indicates an understanding of the teaching? I will discard the open injector pen after two months I will inject the medication into the muscle of my thigh I will store open injector pens at room temperature I will take this medication one hour before morning and evening meals. 7. A nurse is providing teaching to a client who has a new prescription for folic acid. The client states I thought that was only given during pregnancy. Which of the following statements should the nurse make? Folic acid is important for stimulating the immune system Folic acid is given to increase the absorption of the medication Folic acid is administered to minimize the manifestations of benign prostatic hyperplasia Folic acid important for the building of blood cells. 8. A nurse in the PACU is caring for a client who has received general anesthesia and has manifestation of malignant hyperthermia. Which of the following medications should the nurse expect to administer? Diazepam Dantrolene Cyclobenzaprine Metaxalone 9. A nurse is caring for a client who refuses a prescribed influenza immunization. Which of the following actions should the nurse take first? Contact the provider who prescribed the immunization Ask the client to describe their concerns Provide the client with education about the immunization Document the client refusal of the immunization 10. A nurse is caring for a client who has a prescription for a hypotonic Iv fluid. Which of the following solution the nurse expects to administer? 0.45% sodium chloride 0.9% sodium chloride 3% sodium chloride Lactated ringers 11. A nurse in an emergency department is caring for a client who has a new prescription for acetylcysteine. For which of the following condition should the nurse expect to administer this medication? Gastrointestinal bleed Acute bronchospasm Morphine toxicity Acetaminophen toxicity 12. A nurse is obtaining vital signs for a client who has been taking propranolol. Which of the following finding should the nurse identify as an adverse effect of the medication? Respiratory rate 20/min Oral temperature 37.8 Blood pressure 118/78 mm Apical pulse 50 /min 13. A nurse is providing teaching to a client who has neuropathic pain and a new prescription for amitriptyline once per day. Which of the following information should the nurse include in the teaching? Increase fluids while taking the medication Expect an elevation in blood pressure with initial doses of the medication Stop the medication immediately if urine becomes orange in color Take the medication in the morning 14. A nurse is providing teaching to a client who has a new prescription for oral extended-release potassium chloride tablets. Which of the following instructions should the nurse include in the teaching? Do not crush this medication Dissolve the tablet in your mouth Take this medication on an empty stomach Take this medication every other day 15. A nurse is providing teaching to a client who has a new prescription for levothyroxine. Which of the following statements by the client indications an understanding of the teaching? I should take this medication with food I will take three doses each day I might not realize the full effect of the medication for several weeks I might gain weight while taking this medication if I do not exercise 16. While assessing a client at the beginning of the shift a nurse notes that the client received a medication in error from the nurse on the previous shift. At which of the following times should the nurse plan to complete an incident report about the error? After the end of the current shift After contacting risk management As soon as the assessment is complete As soon as the nurse from the previous shift has been informed 17. A nurse is preparing to administer a second unit of packed RBCs to a client who is experiencing hemorrhagic shock. The nurse should monitor the client for which of the following manifestation as an indication of circulatory overload? Chills Wheezing Dyspnea Flushing 18. A nurse is planning care for a client who has neutropenia. Which of the following medication should the nurse expect to administer? Epoetin Filgastrim Enoxaparin Oprelvekin 19. A nurse is teaching a client who has a new prescription for brimonidine to treat open-angle glaucoma. Which of the following client statement indicate an understanding of the teaching? It’s ok to put the drops in my eyes while I’m wearing my contacts I can expect to feel some irritation when I put these drops in my eyes I should expect to stop taking the medication after 3 weeks At least these drops will help clear up the redness I get in my eyes sometimes 20. A nurse is caring for a client who has varicella- zoster virus. Which of the following medications should the nurse expect to administer? Acyclovir Vancomycin Gentamicin Quinine 21. A nurse is caring for a client who is receiving a continuous intravenous infusion of heparin. The nurse should expect to administer which of the following medications if the client experiences acute heparin toxicity. Vitamin K Physostigmine Protamine Calcium gluconate 22. A nurse is providing teaching to a client who has Parkinson's disease and has a new prescription for carbidopa/levodopa. Which of the following instructions should the nurse include in the teaching? "Stop taking the medication if your urine becomes dark." "Take this medication at the first sign of tremors." "Increase your intake of foods high in protein." "Move slowly when you stand up." 23. A nurse is teaching a client who is starting subcutaneous leuprolide for the treatment of prostate cancer. Which of the following information should the nurse include in the teaching? Increase calcium intake. Keep the solution cold for administration. Monitor for low blood glucose levels. This medication can cause constipation. 24. A nurse is reviewing the laboratory findings for a client who is taking zidovudine to treat HIV. Which of the following findings should the nurse report to the provider? Platelets 165,000/mm3 Neutrophil count 650/mm3 Hgb 15 g/dL Albumin 4 g/dL 25. A nurse is teaching a group of newly licensed nurses about the prevention of medication errors. Which of the following factors should the nurse identify as the most frequent cause of fatal medication errors? Incorrect packaging, such as a topical medication packaged as an oral medication Delivery device problems, such as an infusion pump malfunction Name confusion between two medications with similar sounding names Incorrect labeling of a medication dispensed by the pharmacy 26. A nurse in an intensive care unit is caring for a client who has a sudden onset of sustained supraventricular tachycardia (SVT). Which of the following medications should the nurse plan to administer? Atropine Enalapril Lidocaine Adenosine 27. A nurse is caring for a client who has osteoporosis and a new prescription for raloxifene. Which of the following should the nurse assess prior to initiating therapy? CBC results Family history of colon cancer Thyroid function Pregnancy status 28. A nurse is providing teaching to a client who has a new prescription for oxybutynin. Which of the following client statements indicate an understanding of the teaching? "I will limit my fluid intake." "I may continue to take my antihistamines." "I should eat less berry." "I need to avoid jogging on warm days." 29. A nurse is monitoring a client who received an excessive dose of morphine. Which of the following adverse effects should the nurse identify as the priority? Nausea and vomiting Urinary retention Decreased respirations Increased drowsiness 30. A nurse is providing teaching to a client who has a new prescription for allopurinol to treat gout. Which of the following instructions should the nurse include in the teaching? "Expect to experience a harmless rash while taking this medication." "Increase your fluid intake." "Increase your dietary beer intake to prevent constipation." "Take one dose every hour until the pain subsides." 31. A nurse is teaching a client who has asthma about using a beclomethasone inhaler along with an albuterol inhaler. Which of the following instructions should the nurse include about the beclomethasone inhaler? "You should gargle with water after each use of this inhaler." "There is no need to use a spacer for this inhaler.” “You should use this inhaler for any acute incidents of shortness of breath.” “Use the beclomethasone inhaler before using your albuterol inhaler to increase absorption.” 32. A nurse is reviewing laboratory results prior to administering ketorolac to a client. Which of the following findings should the nurse report to the provider prior to administration? Sodium 140 mEq/L Creatinine 1.6 mg/dL Aspartate aminotransferase (AST) 33 units/L Lactic acid 6 mg/dL 33. A nurse is providing teaching to a client who has a new prescription for transdermal nitroglycerin patches to treat angina pectoris. Which of the following instructions should the nurse include in the teaching? "Remove the patch for two to four hours daily." "Cover the patch with plastic wrap." "Apply a new patch each day after waking up." "Replace the existing patch with a new patch as soon as anginal pain begins." 34. A nurse is assessing a client who reports taking spironolactone 50 mg PO twice daily for several months. For which of the following manifestations should the nurse withhold the prescribed dose of spironolactone and notify the provider? Muscle weakness BUN 15 mg/dL Gynecomastia BP 118/78 35. A nurse is caring for four clients who have peptic ulcer disease. The nurse should recognize that misoprostol is contraindicated for which of the following clients? A client who might be pregnant A client who is experiencing diarrhea A client who is receiving long-term NSAID therapy A client who has a gastrointestinal bleed 36. A nurse is caring for a client who refuses a prescribed dose of valproic acid 250 mg PO. The client states, "I don't want to take that pill because it makes me feel nauseated." Which of the following actions should the nurse take? (Select all that apply.) Educate the client about the possible consequences of not taking the medication. Suggest the client take food with the medication to minimize GI effects. Document the client's refusal in the medication administration record. Offer to administer the medication IM. Recommend the client ask the provider to prescribe an enteric-coated medication. 37. A nurse is providing teaching to a client who has a new prescription for Montelukast. Which of the following statements by the client indicates an understanding of the teaching? I will take an extra dose of this medication. If I have an acute asthma attack I can take up to four tables per day to help control my asthma symptoms I will take this medication every day to control my exercise induced asthma I should always keep this medication with me in case I have an acute asthma attack 38. A nurse is caring for a client who is experiencing respiratory depression after taking an excessive dose of oxycodone. Which of the following medication should the nurse expect administer? Bisacodyl Naloxone Flumazenil Pentazocine 39. A nurse is teaching the partner of a client who has diabetes mellitus how to manager episodes of severe hypoglycemia when the clients is unresponsive, which of the following actions should the nurse instruct the partner to take first? Administer glucagon IM to the client Call emergency medical services Check the clients blood glucose level Transport the client to the emergency department 40. A nurse is planning a staff education session about adverse effects of medications. Which of the following information should the nurse include when discussing the adverse effects of anticholinergic medications? (Select all that apply.) Blurred vision Polyuria Productive cough Tachycardia Constipation 41. A nurse is reviewing medical records for a group of clients. Which of the following findings should the nurse report to the provider? A client who is taking citalopram and has a prolonged Q-T interval A client who is taking duloxetine and has alanine transaminase (ALT) of 32 units A client who is taking fluoxetine and has gained 1kg (2.2 lb.) over 12 weeks A client who is taking carbamazepine and has a platelet count of 320,000 mm 42. A nurse is preparing to administer verapamil to a client who is 2 days post myocardial infarction. The nurse should monitor the client for which of the following outcomes as a therapeutic response to the medication? Increased heart rate Increase blood pressure Decreased pulmonary congestion Decreased anginal pain 43. A nurse is discussing adverse effects with a client who has non-Hodgkin’s lymphoma and is starting to take methotrexate. Which of the following information should the nurse provide? Methotrexate can increase the risk for bleeding Methotrexate can cause bradycardia Methotrexate can cause arthritic pain Methotrexate can cause insomnia. 44. A nurse is caring who has a prescription for terazosin. The nurse should identify that this medication is indicated for which of the following disorders. (Selected all that apply) Hypertension Heart failure Male pattern baldness Benign prostatic hypertrophy Erectile dysfunction 45. A nurse for a client who has a prescription for vancomycin 1 g Iv intermittent infusion over 30 min every 12 hr. Which of the following actions should the nurse take? Request a serum through level blood draw for 60 min after completion of infusion Change the infusion site after each dose administration Contact the provider for prescription clarification Request a serum peak level to be draw 30 min prior infusion. 46. A nurse is preparing to administer mannitol IV to a client. The nurse should monitor the client for which of the following manifestations as an expected outcome of this medication? Decreased tyramine levels Correction of arterial Reduced intracranial pressure Increased hemoglobin levels 47. A nurse is providing teaching to a client who has a new prescription for ciprofloxacin. Which of the following client statements indicate an understanding of the teaching? “I will stop taking this medication when I feel better.” “I should wear protective clothing when I go outdoors.” “I should take my medication daily in the morning with milk.” “I should stop taking my birth control pills while I’m taking this medication.” 48. A nurse is providing teaching for a client who has a new prescription for oral metronidazole. Which of the following teaching points is the priority for the nurse to include? “You should report a rash to your provider? “You should take the medication with food or milk, if you experience gastrointestinal upset” “You might have a metallic taste in your mouth while taking this medication.” “You urine might become brownish color white taking this medication.” 49. A nurse is assessing a client who has heart failure and is taking digoxin. Which of the following manifestations should the nurse report to the provider as an indication of digoxin toxicity? Vomiting Dilated pupils Bruising Peripheral edema 50. A nurse is caring for a client who has recurrent lower urinary tract infections (UTIs). Which of following medications should the nurse expect to administer? Ganciclovir Amphotericin B Azithromycin Nitrofurantoin A nurse is caring for a client who has a new prescription for alosetron. Which of the following therapeutic eects should the nurse expect the client to experience? A decrease in the amount of gastric acid production A decrease in the frequency of defecation An increase in gastric motility An increase in the absorption of water into the intestine