VATI RN PHARMACOLOGY EXAM 2022 QUESTIONS AND ANSWERS COMPLETE SOLUTION

VATI RN PHARMACOLOGY EXAM 2022 QUESTIONS AND ANSWERS COMPLETE SOLUTION A nurse is preparing to administer diclofenac to a client who has chronic bursitis. Which of the following actions should the nurse take? a. administer the medication at bedtime b. avoid administering the medication with antacids c. administer the medication with food d. crush the medication prior to administration - Answer - Administer the medication with food Diclofenac is an NSAID and can cause gastric irritation. Clients should take NSAIDs with food or milk to minimize gastric nurse should not administer the medication at bedtime because the client should remain upright for 15 to 30 min after administration to prevent esophageal irritation. Diclofenac is available as an entericcoated tablet for delayed release. Clients should not crush or chew sustained-release medications because doing so will increase gastrointestinal adverse effects and decrease the effectiveness of the medication. A nurse is planning care for a client who has asthma and a prescription for methylprednisolone. Which of the following laboratory values should the nurse monitor while the client is receiving this medication? a. Aspartate aminotransferase (AST) b. Fibrin split products c. BUN d. Glucose - Answer - Glucose Methylprednisolone therapy increases the synthesis of glucose and decreases the uptake of glucose by the muscles and adipose tissues, resulting in increased circulating glucose. Therefore, it is important for the nurse to monitor blood glucose levels regularly while clients are receiving corticosteroid therapy. Aspartate aminotransferase is an enzyme that is present in the heart, liver, skeletal muscles, and other highly metabolic tissues. AST levels are increased in conditions that cause cellular injury, such as liver disease; however, methylprednisolone therapy does not affect AST levels. Fibrin split products are present in the serum when thromboses are present. Increased levels of fibrin split products can increase disseminated intravascular coagulation (DIC); however, methylprednisolone therapy does not affect blood clotting. BUN levels reflect kidney function and glomerular filtration. Hydration status and nephrotoxic medications can alter BUN levels; however, methylprednisolone therapy does not affect renal function. A nurse is caring for a client who is postmenopausal and has a prescription for raloxifene. The nurse should instruct the client that raloxifene is prescribed for which of the following reasons? a. To treat irritable bowel syndrome b. To reduce the risk for breast cancer c. To reduce the occurrence of hot flashes d. To lower the risk of pulmonary embolism - Answer - To reduce the risk for breast cancer Raloxifene can lower the risk for breast cancer in postmenopausal clients who have a high risk for developing estrogen-receptive types of breast cancer. The medication also reduces the risk for and can treat postmenopausal osteoporosis.Raloxifene is a selective estrogen receptor modulator. In clients who are postmenopausal, it can reduce the risk for and treat osteoporosis and protect against breast cancer. Hot flashes are an adverse effect of raloxifene. Raloxifene reduces the occurrence of fractures related to osteoporosis and reduces the cholesterol level in clients who are postmenopausal.Raloxifene can cause several significant cardiovascular and respiratory adverse effects, such as thromboembolism, stroke, peripheral edema, pneumonia, and the development of pulmonary emboli. Clients should not take this medication prior to periods of prolonged immobilization, such as surgery. A history of thromboembolic events is a contraindication for taking this medication. A nurse is caring for a client who is receiving heparin by continuous IV infusion for treatment of venous thrombosis. Which of the following laboratory values should the nurse monitor for in order to titrate the heparin dose? a. platelet function assay b. aPTT c. INR d. Amylase - Answer - aPTT The nurse should monitor the aPTT of a client who is receiving heparin by continuous IV infusion. When beginning heparin therapy, the nurse should monitor the aPTT every 4 to 6 hr. Once the client has achieved the desired range, the nurse should monitor the aPTT daily. The nurse should monitor the platelet function assay of a client who has a bleeding disorder. This test evaluates platelet function and ability to cause hemostasis; however, heparin does not affect it.The nurse should monitor a client's INR to evaluate the effects of warfarin therapy. The nurse should ensure the collection of the client's blood specimen prior to administering the daily warfarin dose.The nurse should review the amylase levels of a client who has pancreatitis. Amylase is a pancreatic enzyme that increases in clients who have acute or chronic pancreatitis; however, heparin does not affect this enzyme. A nurse is assessing a client who has a positive Trousseau's sign. Wich of the following medications should the nurse plan to administer? a. sodium bicarbonate b. manesium sulfate c. calcium gluconate d. potassium chloride - Answer - Calcium gluconate The nurse should identify that a positive Trousseau's sign is a manifestation of hypocalcemia. Therefore, the nurse should plan to administer calcium gluconate to treat hypocalcemia. Sodium bicarbonate is administered to treat metabolic acidosis. The nurse should recognize that sodium bicarbonate is not used to treat a positive Trousseau's sign.Magnesium sulfate is administered to treat hypomagnesemia. The nurse should recognize that magnesium sulfate is not used to treat a positive Trousseau's sign. Potassium chloride is administered to treat hypokalemia. The nurse should recognize that potassium chloride is not used to treat a positive Trousseau's sign. A nurse is preparing to administer morphine 0.3 mg/kg PO to a school-aged child who weighs 88 lb. Available is morphine oral solution 2mg/ml. How many mL should the nurse administer? - Answer - 6 mL A nurse is administering haloperidol to a client who has schizophrenia. For which of the following adverse effects should the nurse monitor? a. gingival hyperplasia b. muscle rigidity c. polyuria d. bruising - Answer - Muscle rigidity A client who is taking haloperidol, a first-generation antipsychotic agent, can develop extrapyramidal effects, such as parkinsonism, which manifests as tremors, bradykinesia, loss of balance, mask-like facial expression, shuffling gait, and muscle rigidity. Haloperidol is an antipsychotic agent that can cause akathisia (motor restlessness) within hours of receiving the first dose; however, gingival hyperplasia is not an adverse effect of haloperidol. Phenytoin is an example of a medication that causes gingival hyperplasia.Haloperidol has several genitourinary adverse effects, including urinary retention and impotence; however, urinary output does not typically increase.Haloperidol has significant cardiovascular effects, including dysrhythmias, myocardial infarction, severe heart failure, and hypotension; however, it does not affect blood coagulation. A nurse receives a verbal prescription from the provider for hydrochlorothiazide 25 mg by mouth daily for a client who has hypertension. Which of the following indicates how the nurse should transcribe the prescription in the client's medical record? a. Hydrochlorothiazide 25.0 mg orally q.d. b. Hydrochlorothiazide 25 mg PO daily c. HCTZ 25.0 mg by mouth daily d. HCTZ 25 mg PO OD - Answer - Hydrochlorothiazide 25 mg PO daily The nurse should transcribe the provider's prescription by spelling out the name of the medication, recording the dosage as a whole number, and spelling out the word