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Terms in this set (67)A client receives a prescription for esomeprazole (Nexium) for heartburn. Which finding in the client's history should the nurse report to the healthcare provider before administering the prescription? Eats spicy food three times a week. History of deep vein thrombosis. A male client who is in the terminal stage of cancer is cared for at home by his family and receives a prescription for morphine at a rate to control intractable pain. When the hospice nurse visits, the client awakens, moans in severe pain, and asks for an increase in the morphine dosage. After determining the client's respirations are 10 per minute, what is the best action for the nurse to implement? Titrate the morphine dose upward until the client has adequate pain relief. Titrate the morphine dose upward until the client has adequate pain relief. A client with Paget's disease is started on calcitonin (Calcimar) 500 mcg subcutaneously daily. During the initial treatment, what is the priority nursing action? Assess the injection site for inflammation. Observe the client for signs of hypersensitivity. A client is taking cyclosporine for renal allograft rejection prevention. After 9 months of drug therapy, the nurse reviews laboratory data and notes that the blood urea nitrogen level is 36 mg/dl. What additional finding should the nurse identify? Hypotension. Creatinine 28 mg/dl. The nurse receives a unit of blood from the blood bank for a postoperative client who is currently in the X-ray department. What action should the nurse implement? Return the blood to the blood bank for refrigeration within 30 minutes. Return the blood to the blood bank for refrigeration within 30 minutes. Which side effects should the nurse monitor for a client who is receiving dexamethasone (Decadron) following neurosurgery? (Select all that apply.) Select all that apply Mood swings. A client is taking danazol (Danocrine) for endometriosis and calls the clinic nurse to complain of a dark, swollen, and painful leg. What instructions should the nurse provide the client? Wear support stockings. Proceed to the closest emergency room. A client asks the nurse to explain the meaning of a narrow therapeutic index of a medication. What information should the nurse use to answer the question? The onset of action for the medication occurs very quickly. A small margin exists between safe and toxic plasma levels. A c lient is receiving fentanyl via an epidural infusion. Which side effect should the nurse anticipate in the first 24 hours of epidural analgesia ? Headache. Urinary retention. The healthcare provider prescribes a medication for an older adult client who is complaining of insomnia, and instructs the client to return in two weeks. The nurse should question which prescription? Zolpidem (Ambien) 10 milligrams orally at bedtime. Eszopiclone (Lunesta) 10 milligrams orally at bedtime. Which route should the nurse clarify with the healthcare provider prior to administering a drug with a high first-pass effect? Oral. Oral. The therapeutic effect of insulin in treating Type 1 diabetes mellitus is based on which physiologic action? Facilitates transport of glucose into the cells. Facilitates transport of glucose into the cells. The healthcare provider discontinues prednisone, a glucocorticoid, for a client with chronic obstructive pulmonary disease. What instructions should the nurse give the client about the regimen to follow? Life-long treatment is common for chronic disease. The dose must be tapered over the course of 7 to 10 days. What pathophysiological action supports the expected outcome for a client with chronic cancer pain who is treated with imipramine (Tofranil), a tricyclic antidepressant? Increases pain threshold by stimulating opiate receptors in the CNS to release of endogenous enkephalins. Decreases transmission of pain impulses by altering serotonin and norepinephrine activity at nerve synapses. A client receives a new prescription for ciprofloxacin (Cipro), a synthetic quinolone. When teaching about this drug, which information in the client's history requires special emphasis by the nurse? Snacks on dairy products such as yogurt or ice cream. Works twenty hours a week as a lifeguard at the local pool. A client who is receiving chemotherapy is prescribed ondansetron (Zofran). What side effect should the nurse include in the teaching plan? Headache. Headache. Which heparin concentration should the nurse use to convert an intravenous site to a heparin lock? 10 units/ml. 100 units/ml. Which findings should the nurse identify in an adult client with possible chronic salicylate intoxication? Tinnitus and hearing loss. Tinnitus and hearing loss. A client is admitted for atrial fibrillation, and the healthcare provider prescribes disopyramide (Norpace). After explaining the action of this antidysrhythmic agent, which complaint should the nurse instruct the client to report? Joint pain. Daily weight gain of 2 pounds. An emergency department triage nurse is interviewing a female client who has a history of epilepsy with tonic-clonic seizures controlled by phenytoin (Dilantin). Which information is most significant in planning this client's care? She has missed 2 menstrual periods. She ran out of her medication 4 days ago. The healthcare provider prescribes pyridostigmine bromide (Mestinon) tablets for a client with myasthenia gravis (MG). What instruction should the nurse provide this client? Increase activity in the afternoon when the medication is most effective. Take the medication 30 to 45 minutes before eating. What action should the nurse implement to provide analgesic titration for a client in pain ? Teach the client to increase the time range between doses of pain medication. Determine the optimal analgesic dosage required that causes the least side effects. Which common side effect should the nurse alert a female client about when medroxyprogesterone (Depo-Provera) is prescribed? Leg or calf pain. Vaginal bleeding after discontinuing the medication. Miotic drug therapy for the treatment of glaucoma is based chiefly upon which physiologic action? Enhancing aqueous humor outflow. Enhancing aqueous humor outflow. A client receives a new prescription for nitroglycerin (Nitrostat) tablets. Which instruction should the nurse include in this client's teaching? Take the medication at least an hour before every meal. Place under the tongue as needed every 5 minutes up to 3 times.
The nurse administers the initial dose of a fentanyl (Duragesic) transdermal patch to a client with chronic pain. When monitoring the client an hour later, which assessment is most important for the nurse to obtain? Level of consciousness. Numeric pain scale. A client is beginning therapy with montelukast (Singulair) PO 10 mg once a day in the evening. The client asks the nurse, "When should I begin to feel better?" How should the nurse respond? Immediately. Within 24 hours. What is the expected outcome of esomeprazole (Nexium) when prescribed for a client with gastroesophageal reflux disease (GERD)? Promotion of rapid tissue healing. Promotion of rapid tissue healing. A client at 30-weeks gestation is in preterm labor. The healthcare provider prescribes two 12-mg doses of betamethasone (Celestone) intramuscularly every 12 hours. The client asks the nurse why she is receiving the Celestone. What information should the nurse use to explain the action of the medication? Suppresses uterine contractions. Stimulates fetal surfactant production. Which drug of choice is indicated for acute ventricular dysrhythmias associated with myocardial infarction? Diltiazem.VT dys Amiodarone. A school-aged child is taking methylphenidate hydrochloride (Ritalin, Biphentin) for the treatment of attention-deficit hyperactivity disorder (ADHD). The mother tells the nurse that she gives the medication at bedtime so it is "working" during school the next morning. What modification to the administration plan should the nurse recommend to this mother? Continue administering the medication dose at bedtime. Administer at least six hours before bedtime. A client is taking sulfisoxazole (Gantrisin) for a urinary tract infection (UTI) and complains of nausea and gastric upset since starting the medication. Which additional adverse reaction should the nurse instruct the client to report? Rash. Rash. What is the effect of beta-blocking agents when used for treatment of glaucoma? Inhibiting aqueous humor production. Inhibiting aqueous humor production. A client with depression receives a prescription for amitriptyline (Elavil). Which instruction should the nurse include in the client's teaching? Do not ingest foods with tyramine. Avoid the consumption of alcohol. A resident of a long-term care facility is taking lithium carbonate (Eskalith) to treat bipolar disorder. Which instruction should the nurse provide to this client's caregivers? Offer the morning dose of the medicine before breakfast. Report symptoms of hypothyroidism such as fatigue and constipation. A pediatric client who has been diagnosed with partial seizures receives a prescription for topiramate (Topamax). What information should the nurse provide to the child's parents? Do not crush the tablet prior to administration. Do not crush the tablet prior to administration. A 48-year-old client is experiencing a severe anaphylactic reaction to an injection of contrast media. What pharmacologic agent is of greatest use in this situation? Dopamine (Intropin). Epinephrine (Adrenalin). A client with chronic gouty arthritis takes allopurinol (Zyloprim) and experiences an acute attack of gouty arthritis. The healthcare provider prescribes concurrent low-dose colchicine. What information should the nurse provide the client that best explains the action of the colchicine? Acts like aspirin to relieve pain. Reduces inflammation at the affected site. The nurse should expect the healthcare provider to prescribed what treatment regimen for a client with peptic ulcer caused by Helicobacter pylori ? (Select all that apply.) Select all that apply Clarithromycin (Biaxin). The nurse is providing medication teaching for a client who has recently received a prescription for clozapine (Clozaril). Which instruction should be included in this client's teaching plan? Avoid prolonged sun exposure. Rise slowly from a lying position. A client with pneumonia receives a prescription for tetracycline (Sumycin). What precaution should the nurse include in this client's teaching? Take the medication with a glass of orange juice. Avoid diary products for 2 hours after taking the medication. A client is diagnosed with peptic ulcer disease and receives a prescription for esomeprazole (Nexium) 20 mg capsule daily. When providing this client with discharge teaching, the nurse should include which instruction? Drink fluids between meals to relieve gastric distress. Take at same time each day one hour before eating a meal. A client with chronic schizophrenia illness is admitted after taking risperidone (Risperdal) 10 mg/day for three months. The nurse implements a daily assessment using the Abnormal Involuntary Movement Scale (AIMS). What findings should the nurse report to the healthcare provider? Cogwheel rigidity. Tremors and muscle twitching. The healthcare provider has prescribed digoxin for a client who has been taking furosemide (Lasix) for six months. What laboratory serum levels should the nurse review before administering the digoxin? Calcium. Potassium. When assessing a client prior to the administration of digoxin (Lanoxin, APO-Digoxin), which data is most important for the nurse to consider? Presence of a grade 2 murmur. Irregular apical pulse with a rate of 87. A male client with meningitis is prescribed cefotaxime (Claforan) IV and asks the nurse why he cannot receive an oral drug, such as cefaclor (Ceclor) or cefadroxil (Duricef),that he has taken before for infections. How should the nurse respond when considering the actions of cephalosporins? Cefazolin (Ancef) is another IV antibiotic that can be prescribed. Cefotaxime (Claforan) provides therapeutic CNS concentrations. The nurse should instruct a client to avoid which product while taking carisoprodol (Soma) for muscle spasms? Aspirin products. Alcoholic beverages. When prescribed for a client with hepatic encephalopathy, what is the therapeutic action of lactulose (Portalac)? Lowers the pH of the colon. Lowers the pH of the colon. What teaching should the nurse provide a client who has received a new prescription for sildenafil (Viagra)? (Select all that apply.) Select all that apply Take within 30 to 60 minutes of sexual stimulation. A client who takes a statin and gemfibrozil (Lopid) for hyperlipidemia reports onset of muscle pain and weakness. What additional assessment is most important for the nurse to obtain? Serum liver enzymes. Serum liver enzymes. A client who has Trichomonas vaginalis receives a prescription for metronidazole (Flagyl). Which instruction should the nurse provide during client education? Do not ingest with diary products. Avoid over-the-counter antitussives. A client with rheumatoid arthritis is receiving a prescription for minocycline (Minocin). Which side effect is most important for the nurse to instruct the client to report? Loss of balance and dizziness. Loss of balance and dizziness. A client receives a prescription for sulfamethoxazole-trimethoprim (Septra) for a urinary tract infection (UTI). What instruction should the nurse provide the client? Ingest food prior to taking the antibiotic. Drink at least 8 glasses of water a day. The nurse should withhold which medication if a client reports nausea, vomiting, and diarrhea? Colchicine (Colchicine). A client who is diagnosed with methillicin-resistant Staphylococcus aureus receives a prescription for vancomycin (Vancocin). Which assessment should the nurse perform to identify a potential adverse effect? Whisper test. Whisper test. Based on the blood culture and sensitivity results, the healthcare provider prescribes an IV aminoglycoside antibiotic and discontinues the current prescription for another broad spectrum antibiotic. The medication administration record indicates that the client received the broad spectrum antibiotic two hours ago. Which action should the nurse implement? Obtain peak and trough serum levels so the
aminoglycoside antibiotic can be initiated. Administer the initial dose of the aminoglycoside antibiotic as soon as possible. A client calls the clinic and states that she forgot to take her oral contraceptives for the past two days. Which instruction is best for the nurse to provide to this client? Take 2 pills a day for 2 days and use an alternate method of contraception for 7 days. Take 2 pills a day for 2 days and use an alternate method of contraception for 7 days. A client with chronic pancreatitis receives a new prescription for pancrelipase (Pancrease). Which instruction is most important for the nurse to include in this client's teaching? Avoid prolonged exposure to direct sunlight. Take the medication when consuming food. A client who is recently diagnosised with myasthenia gravis receives a prescription for pyridostigmine (Mestinon), a cholinergic agent. Which information should the nurse instruct the client to implement when taking this medication? Always take
with meals to avoid gastrointestinal distress. Take the medication at least 30 minutes before eating meals. An older client is taking warfarin sodium (Coumadin) PO 2.5 mg twice a day. Which laboratory value should the nurse identify as a therapeutic response of the medication? INR of 2 to 3. INR of 2 to 3. The mother of a newborn asks the nurse why her infant needs the vitamin K (AquaMEPHYTON) injection. What information should the nurse provide? Bacteria that synthesize vitamin K are not present in the newborn's intestinal tract. Bacteria that synthesize vitamin K are not present in the newborn's intestinal tract. A 38-year-old gravida 2 para 2 is diagnosed with bacterial vaginosis 9-months postpartum. A prescription is written for metronidazole (Flagyl). Which information is most important for the nurse to obtain from the client before initiating treatment? Sexual history. Method of infant feeding. A client receives a new prescription for pentazocine (Talwin), a mixed opioid agonist-antagonist, after an opioid agonist is discontinued. What is the advantage for the client when the new prescription is implemented? Tolerance does not occur. Respiratory depression is less. A female client receives a prescription for cefadroxil (Duricef) for a urinary tract infection. The client informs the nurse that she is currently taking oral contraceptives (OCP). What information is important for the nurse to share with the client? The antibiotic may be less effective while taking OCP. Use an additional form of contraception until your menstrual cycle. Which statement by a client warrants further instruction by the nurse about the changing insulin needs of a diabetic client during pregnancy? "Episodes of hypoglycemia are more likely to occur during the first 3 months." "I will increase my insulin dosage by 5 units each month during the first trimester." The healthcare provider prescribes oral antifungal therapy for a client with onychomycosis. What information should the nurse tell the client? A single dose of the oral antifungal agent is usually sufficient to treat the infection. The infection is difficult to eradicate and requires prolonged therapy for 3 to 6 months. A client receives a new prescription for an angiotensin-converting enzyme (ACE) inhibitor. What client history contraindicates its use? Asthma. Renal artery stenosis. Sets found in the same folderPharm Evolve Practice68 terms xofrostyox HESI pharm practice test 125 terms sbryant5 HESI Pharmacology Exam Practice245 terms snegash22 NSG-322 PRACTICE HESI61 terms Karrah_Smith Other sets by this creatorCrit Care test 375 terms lbpeters14 Crit Care test 359 terms lbpeters14 Crit Care test 339 terms lbpeters14 Crit Care test 333 terms lbpeters14 Other Quizlet setsDevelopmental Psychology Test 150 terms Morgan_McNabb ULTIMATE STUDY GUIDE FOR BIOLOGY109 terms egrashopper S2 Bio Exam - Pham96 terms Isaac_Basi Ch. 1-4 Test 173 terms epete25 Related questionsQUESTION what are the uses of atropine sulfate? 11 answers QUESTION What is the dosing for ranolazin 15 answers QUESTION When would you hold a calcium channel blocker? 15 answers QUESTION The nurse is caring for a client with osteoporosis who has been prescribed zoledronic acid. What should the nurse teach the client about the administration of this medication? 3 answers What should the nurse assess prior to administering digoxin?A nurse should assess the apical pulse for a full minute before administering digoxin due to its positive inotropic action (it increases contractility, stroke volume, and, thus, cardiac output), negative chronotropic action (it decreases heart rate), and negative dromotropic action (it decreases electrical conduction ...
What should you do before administering digoxin?Monitor apical pulse for 1 full min before administering. Withhold dose and notify health care professional if pulse rate is <60 bpm in an adult, <70 bpm in a child, or <90 bpm in an infant. Notify health care professional promptly of any significant changes in rate, rhythm, or quality of pulse.
What should a nurse know about digoxin?Serum digoxin levels should be monitored, with a normal therapeutic range from 0.8 to 2 ng/mL. Serum potassium levels should also be closely monitored for patients on digoxin because hypokalemia increases the effect of digoxin and can result in digoxin toxicity.
How do nurses assess for digoxin toxicity?An additional nursing intervention to guard against digoxin toxicity is to assess the apical pulse for one full minute before administering digoxin. Hold the next dose and contact the physician if the apical pulse is less than 60 or more than 120 beats per minute.
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When assessing a client prior to the administration of digoxin Lanoxin APO digoxin which data is most important for the nurse to consider?
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