Illinois NUR 339 – nurse is caring for a client who
Subject: Biology / General Biology
Question
nurse is caring for a client who is receiving penicillin by intermittent IV bolus. The client develops wheezing, dyspnea, cyanosis, and tachycardia. The nurse should administer which of the following medications first?
Hydrocortisone sodium succinate (Solu-Cortef)
Prednisone (Deltasone)
Epinephrine (Adrenalin)
Isoproterenol (Isuprel)
A nurse is caring for an older adult client who is receiving gentamicin (Garamycin) following abdominal surgery. Which of the following physiological changes is most important for the nurse to consider when administering this medication?
Increased gastric pH
Decreased renal blood flow
Decreased serum albumin
Increased body fat
A nurse is caring for a client who has acute angina and has a prescription for nitroglycerin. Which of the following is an appropriate intervention for this nurse to take when administering this medication?
Replace the nitroglycerin transdermal patch every 4 hr
Administer a sustained-release nitroglycerin tablet orally
Massage the nitroglycerin ointment completely into the skin
Administer a nitroglycerin tablet sublingual every 5 min
A nurse in the emergency department is admitting a client who is diaphoretic, vomiting, and reports severe abdominal pain. His roommate states that the client swallowed ?a whole bottle? of acetaminophen (Tylenol). Which of the following medications should the nurse prepare to administer?
Acetylcysteine (Mucomyst)
Deferoxamine (Desferal)
Naloxone (Narcan)
Flumazenil (Romazicon)
A nurse is caring for a postoperative client who is receiving patient controlled analgesia with IV morphine. The nurse should recognize that which of the following is the priority assessment?
Urticaria
Hypotension
Bradypnea
Drowsiness
A nurse is preparing to administer infliximab (Remicade) to a client who has rheumatoid arthritis. The nurse should monitor the client for which of the following adverse effects? (Select all that apply)
Bradycardia
Jaundice
Neutropenia
Fever
Polyuria
A nurse has just administered meperidine (Demerol) intramuscularly to a client who has an ankle fracture. Which of the following actions should the nurse take next?
Assess the client?s respiratory status
Reassess the client?s pain level
Document the client?s medication record
Check the client?s blood pressure
A nurse is caring for a client who is experiencing an anaphylactic reaction. Which of the following medications should the nurse administer?
Isoproterenol (Isuprel)
Lidocaine (Xylocaine)
Atropine sulfate
Calcium chloride
A nurse is assessing a client who has been taking anti-tuberculosis medications for the past 3 months. The nurse should instruct the client to notify the provider if which of the following occurs?
Alopecia
Jaundice
Weight gain
Polyuria
A nurse is caring for a client who has been taking ferrous sulfate (Feosol) over a 2 month period. Which of the following findings is an expected response?
Decreased inflammation
Reduced frequency of coughing
Increased energy
Improved vision
A nurse is caring for a client who has a new prescription for estrogen-progestin combination (Ortho-Novum). Which of the following medications may interact with this medication and require the use of additional non-hormonal birth control?
Amlodipine (Norvasc)
Phenytoin (Dilantin)
Docusate sodium (Colace)
Thiamine (Vitamin b1)
A child with cerebral palsy is prescribed baclofen (Lioresal). Which of the following therapeutic effects should the nurse monitor?
Increase in urine output
Decrease in anxiety
Increase in energy
Decrease in spasticity
A nurse is assessing a client who is taking naproxen (Naprosyn). Which of the following is an expected report from the client?
Reduced bleeding
Reduced pain
Increased appetite
Improved breathing
A nurse is teaching a client who is preoperative how to use patient-controlled analgesia with morphine sulfate. Which of the following statements by the client requires additional teaching?
?I will be asked to describe and rate my pain occasionally?
?I don?t have to worry about getting an overdose of the medication?
?I will not receive any pain medication during the lockout period?
?I should push the pain button when the pain becomes severe?
A nurse is caring for a client who is receiving haloperidol (Haldol). The nurse should document which of the following findings as dystonia?
Pacing
Lip smacking
Tremors
Neck spasms
A nurse is assessing a client who takes diphenoxylate with atropine (Lomotil) for inflammatory bowel disease. For which of the following should the nurse monitor?
Increased oral secretions
Urinary retention
Bradycardia
Hearing loss
A nurse is providing care to a client who has heart failure. While verifying the orders with the medication administration record, the nurse notes that the prescription for digoxin (Lanoxin) was transcribed incorrectly. As a result, the client received an extra dose of the medication yesterday. Which of the following actions should the nurse take first?
Complete an incident report
Withhold the next dose
Notify the charge nurse
Obtain a set of vital signs
A nurse is admitting a client to a long-term care facility. While reconciling the medications the client takes at home with those prescribed in the facility, the nurse discovers a discrepancy in the dosages. Which of the following actions should the nurse take?
Clarify the medication dosages with the provider
Ask a family member to verify the medication dosages
Contact the pharmacist regarding the dosage discrepancies
Change the prescribed medication dosages to reconcile the discrepancy
A nurse is caring for a client who is receiving therapy with the clonidine (Catapres) transdermal patch. The client reports lightheadedness and drowsiness. Which of the following actions should the nurse take?
Remove the patch
Administer a prescribed antiemetic
Measure blood pressure
Elevate the head of the bed
A nurse is admitting a client who has chest pain to the emergency department. Which of the following medications should the nurse anticipate administering to reduce cardiac demand?
Heparin
Pentazocine (Talwin)
Morphine
Butorphanol (Stadol)
A nurse in the emergency department is admitting a client who reports nausea and insomnia. He is diaphoretic, tachycardic and has severe tremors. He states that he ?quit drinking? alcohol the previous evening. Which of the following medications should the nurse prepare to administer to manage the client?s withdrawal from alcohol?
Disulfram (Antabuse)
Chlordiazepoxide (Librium)
Naltrexone (Vivitrol)
Acamprosate (Campral)
A client has an IV infusion of nitroprusside (Nitropress) at 2 mcg/kg/min. The order reads to titrate the nitroprusside by 0.5 mcg/kg/min to maintain a mean arterial pressure (MAP) of 70 to 110 mm Hg The client has a MAP of 120 mm Hg. The nurse should next titrate the nitroprusside to which of the following dosages? (Round your answer to the nearest tenth)
—?????????????
A nurse is providing teaching to a client who was recently diagnosed as HIV positive. The client is beginning antiretroviral therapy with zidovudine (Retrovir). Which of the following statements should the nurse include in the teaching? (Select all that apply)
?This medication increases CD4 T-cell count?
?This medication must be taken with other antiretroviral medicines?
?This medication prevents you from transmitting the HIV infection?
?This medication cures an HIV infection?
?This medication has few adverse effects?
A client is diagnosed with a urinary tract infection. Her past history reveals an allergy to a thiazide diuretic. Which of the following medications is contraindicated?
Trimethoprim/Sulfamethoxazole (Bactrim)
Ciprofloxacin (Cipro)
Amoxicillin/clavulanate (Augmentin)
Nitrofurantoin (Macrodantin)
A nurse is providing teaching to a client who has just started taking lithium. Which of the following statements indicates the client understands the teaching?
?I should call my doctor if I develop hand tremors?
?I should inject the medication subcutaneously?
?I should take this medication on an empty stomach?
?I should expect to feel better in just a few days?
A nurse is caring for a 4 year old client, who is taking amoxicillin (Amoxil) 50 mg/kg/day PO in three divided doses. Which of the following resources should the nurse consult to verify that the dose is safe for the client?
The client?s BMI record
Medication administration record
Physician?s Desk Reference
The client?s health history
A nurse is caring for a client who is receiving a fentanyl transdermal system (Duragesic). Which of the following is most important to document in the client?s record?
Skin integrity
Fluid intake
Respiratory rate
Pulse rate
A nurse is talking with a client who is undergoing methadone (Dolophine) substitution to treat an opiod addiction. What information should the nurse give the client about this treatment?
Subcutaneous injections are the preferred route of administration
Avoid foods containing tyramine during treatment
Adverse effects will last a couple of days
Withdrawal symptoms are likely to mimic those of influenza
A nurse is caring for a client who has rheumatoid arthritis. The client is prescribed methotrexate (Rheumatrex). For which of the following should the nurse instruct the client to monitor and report to the provider?
Insomnia
Urinary retention
Constipation
Sore throat
A nurse is caring for a client who has received acetaminophen (Tylenol) 650 mg and hydrocodone (Vicodin) 5 mg every 4 hr for the past 24 hr. Which of the following is an appropriate action for the nurse to take?
Complete an incident report
Decrease acetaminophen to 325 mg every 4 hr
Stagger the medications every 2 hr
Suggest a time change with the pharmacy
A nurse is preparing to administer ibandronic acid (Boniva) IV to a client who has osteoporosis. Which of the following laboratory values should the nurse review prior to administration?
Serum creatinine level
Blood glucose level
Vitamin D level
Erythrocyte sedimentation rate
A nurse is planning teaching for a client who has leukemia and is receiving chemotherapy. The client is to start taking allopurinol (Zyloprim). The nurse should instruct the client that this medication will:
Prevent cardiac toxicity
Decrease blood glucose levels
Decrease uric acid levels
Prevent urinary tract infections
A nurse is caring for four older adult client who are taking digoxin (Lanoxin). Which of the following clients is at greatest risk for developing digoxin toxicity?
A client taking pramipexole (Mirapex) for Parkinson?s disease
A client taking allopurinol (Zyloprim) for gout
A client taking fluoxetine (Prozac) for depression
A client taking furosemide (Lasix) for edema
A nurse is assessing a client who is taking enalapril (Vasotec). Which of the following findings indicates an expected response?
Relaxed muscles
Prolonged P wave
Oliguria
Increased exercise tolerance
A nurse is caring for a client who has an order for clozapine (Clozaril) 350 mg PO daily. The nurse recognizes that which of the following findings is a side effect of this medication?
Fasting blood glucose of 220 mg/dL
Serum sodium 136 mg/dL
WBC 8, 000 mm3
Weight loss of 3.36 kg (5 lb) in 2 weeks
A nurse is planning discharge teaching for a client who is to start therapy with repaglinide (Prandin).? Which of the following should the nurse include in the teaching?
?Hold the medication if your blood glucose is less than 120 mg/dL?
?Monitor for irritability and diaphoresis?
?Take the medication 1 hr before mealtime?
?Increase your protein intake?
A client with diabetes mellitus is admitted to the medical unit. The client has a routine before breakfast prescription for 8 units of Regular insulin and 18 units of NPH. The primary care provider adds an additional dose of Regular insulin based on the following:
Blood glucose Regular Insulin Dose
121 to 150 ????????? 2 units
151 to 180?????????? 4 units
181 to 200 ????????? 6 units
201 to 250 ????????? 8 units??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
250??????????????????????????????????? call provider
The clients prebreakfast blood glucose is 192 mg/dL. Which dosage of insulin should the nurse administer?
8 units of Regular, 24 units of NPH
8 units of Regular, 18 units of NPH
14 units of Regular, 18 units of NPH
14 units of Regular, 24 units of NPH
A nurse is providing teaching to a client who had a total gastrectomy. The client has a new prescription for cyanocobalamin (vitamin b12). Which of the following client statements indicates an understanding of the teaching?
?After I receive injections for a week, I will be able to switch to a pill?
?Increasing my intake of green, leafy vegetables will increase my vitamin b12 levels?
?I will have to take this medication for the rest of my life?
?I need to have my vitamin b12 levels measured once a month?
A nurse is caring for a client who has a prescription for Metformin (Glucophage) twice daily. Which of the following is an expected outcome?
Bedtime blood glucose 150 mg/dL
Hemoglobin A1C 6.4%
Systolic blood pressure 146 mm Hg
Premeal plasma glucose 135 mg/dL
A nurse is caring for a client who has a systemic infection. During the infusion of vancomycin (Vancocin), the client develops a rash and becomes flushed. Which of the following is an appropriate action for the nurse to take?
Document a penicillin allergy in the client?s chart
Administer naloxone (Narcan) 1 mg IV
Obtain a prescription for oral vancomycin
Decrease the rate of administration
A client who has cancer is receiving extended-release morphine sulfate (Avinza) 30 mg PO every 12 hr. three hr after the last dose, the client requests pain medication. Which of the following assessment findings is the best indication of the client?s need for more pain medication?
Self-report
Elevated blood pressure
Facial grimacing
Flushed skin
A nurse is providing teaching to a school-age child and his parents. The child has a new prescription for methylphenidate (Concerta). For which of the following adverse effects should the nurse instruct the parents to monitor (Select all that apply)
Insomnia
Oliguria
Palpitations
Weight loss
Nose bleed
A nurse is caring for a client who is receiving anticoagulant therapy with warfarin (Coumadin). The client is prescribed cefotetan (cefotan) by intermittent IV bolus for pneumonia. The nurse should monitor the client for which of the following?
Hypoglycemia
Paresthesias
Hyperkalemia
Hemorrhage
A client who has been taking atenolol (Tenormin) receives a new prescription for nifedipine (Procardia). For which of the following interactions should the nurse monitor?
Hypotension
Tachycardia
Bleeding
Angina
A nurse is caring for a client who has open angle glaucoma and was prescribed pilocarpine (Piloccar) 1 gtt of 3% solution. The nurse should recognize that which of the following findings indicates the client is developing systemic cholinergic toxicity?
Tachycardia
Hypertension
Stinging and burning sensation in her eye
Salivation and sweating
A nurse is reviewing laboratory findings of a client who has a prescription for lithium carbonate. For which of the following findings should the nurse withhold the medication and notify the provider?
Hemoglobin 15 g/dL
Potassium 3.7 mEq/L
Lithium level 1.0 mEq/L
Sodium 125 mEq/L
A client is questioning the nurse about why she is receiving frequent doses of IV antibiotics. Which of the following responses by the nurse is appropriate?
?It decreases the risk of an allergic reaction?
?It helps to prevent the emergence of drug-resistant bacteria?
?It helps to maintain a steady drug level?
?It decreases the length of necessary treatment?
A nurse is caring for a client who has tuberculosis and is being treated with a combination medication therapy. To evaluate the effectiveness of the treatment, the nurse should periodically monitor which of the following laboratory results?
Serum creatinine level
Septum culture
Hct and Hgb level
Tuberculin skin test
A nurse is reviewing the medication administration record for a client who has metastatic cancer and a fentanyl (Duragesic) transdermal patch for pain. The client reports a pain level of 10 on a scale of 0 to 10. Which of the following medications should the nurse anticipate administering?
Alprazolam (Xanax)
Butorphanol (Stadol)
Carbamazepine (Tegretol)
Hydromorphone (Dilaudid)
A nurse is caring for a client who has been taking furosemide (Lasix) for 3 days to treat heart failure. Which of the following findings indicates ta the medication is effective?
Reduced levels of HDL
Increased LOC
Clear lung sounds
Potassium within the expected reference range
A nurse is caring for a CHF client who is receiving 0.9% sodium chloride IV at 80 mL/hr. The nurse assesses bibasilar rales. Which of the following prescriptions should the nurse question?
Digoxin (Lanoxin) 0.125 mg PO
Hetastarch (Hespan) 50 mL/hr IV
Furosemide (Lasix) 20 mg IV push
Sodium nitroprusside (Nitropress) 3 mcg/kg/min IV
A nurse is caring for a client who is taking amoxicillin (Amoxil) and is experiencing adverse effects. Which of the following instructions should the nurse give to the client?
?Take this medication with a snack?
?Administer the medication at bedtime?
?Monitor for increased urine output?
?Stand up slowly after taking this medication?
A nurse is preparing to administer insulin to a client who has diabetes mellitus. The client is to receive insulin aspart (Novolog) 5 units and NPH insulin (Humulin N) 15 units subcutaneously in the morning. Which of the following actions should the nurse take first?
Draw up 5 units of insulin aspart from the vial
Draw up 15 units of NPH insulin from the vial
Inject 5 units of air into the insulin aspart vial
Inject 15 units of air into the NPH insulin vial
?A nurse is caring for a school-age child who has been prescribed diphenhydramine (Benadryl). Which of the following adverse effects is the highest priority?
Dry mucous membranes
Diarrhea
Sedation
Ataxia
A nurse is administering ondansetron (Zofran) to a client prior to chemotherapy. For which of the following outcomes should the nurse monitor?
Decreased pain
Improved mood
Increased energy
Decreased vomiting
A client has a new prescription for oral nitroglycerin sustained release capsules once a day. During the nursing history, the client reveals the usual medications. Which of the medications should the nurse question at this time?
Diazepam (Valium)
Sildenafil (Viagra)
Lansoprazole (Prevacid)
Gemfibrozil (Lopid)
A nurse receives a phone call from a client who has heart failure and reports a dry cough for the last week. After reviewing the client?s medical record, the nurse asks the client to come to the provider?s office. The nurse should then instruct the client to stop taking which of the following daily medications until he sees the provider?
Lisinopril (Zestril)
Hydrochlorothiazide
Isosorbide (Imdur)
Nifedipine (Procardia)
A client is administering verapamil (Calan) to a client via IV bolus. The nurse should monitor for a
Sudden increase in heart rate
Rapid increase of aPTT
Rapid decrease of aPTT
Sudden decrease in heart rate
A client who has supraventricular tachycardia is receiving procainamide. The nurse recognizes the pharmacological action of this medication is to
Increase sinoatrial node conduction
Promote systemic vasoconstriction
Decrease cardiac preload
Control the rate of cardiac contraction
A nurse is providing instruction to four clients regarding medication self-administration. Which of the following actions by a client indicates a need for further teaching?
Client uses cotton swab to apply antibiotic ointment
Client allows 1 min between puffs when he uses a metered dose inhaler
Client rolls insulin suspension between his palms
Client take iron supplements at bedtime
A nurse is caring for a client who is to receive 1500 mL of 0.9% sodium chloride IV over 8 hr. The nurse plans to use IV tubing with a drip factor of 10 gtt/min. How many gtt/min of IV fluid should the client receive? (Round to the nearest whole number)
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A nurse is caring for a client who has a new prescription for bupropion HCl (Wellbutrin). Which of the following should the nurse recognize as a contraindication for the use of this medication?
Bradycardia
Seizure
Xerostomia
GERD
A nurse is preparing to administer cisplatin (Platinol-AQ) to a client with advanced bladder cancer. Which of the following diagnostic tests should the nurse review prior to administering this medications?
Serum thyroxine
CBC
HgB A1C
Serum albumin
A client with cirrhosis has been given spironolactone (Aldactone). Which of the following findings indicates that the medication is having the desired effect?
Urine output 20 mL/hr
Decreasing abdominal girth
Potassium level of 5.2 mEq/L
Absence of fever
A nurse is caring for a client who has a prescription for levodopa carbidopa (Sinemet). Which of the following should the nurse recognize as an adverse effect of the medication?
Dyskinesia
Constipation
Weight gain
Hirsutism
A nurse is reviewing the laboratory tests for a client who has had an acute myocardial infarction. The client is to receive warfarin (Coumadin) 10 mg PO. The nurse notes an INR of 2.6. Which of the following actions should the nurse plan to take?
Decrease the dose by 5 mg
Increase the dose by 2.5 mg
Give the dose as prescribed
Hold the next dose
A nurse is teaching a client who has decided to quit smoking about a nicotine transdermal system (Nicotrol). Which of the following instructions should the nurse include?
Cleanse the skin with alcohol prior to applying the patch
Apply the patch first thing in the morning and remove it at bedtime
Place the patch the same skin area for the furation of the treatment
Moisten the patch and hold it agains the skin until it adheres
During an admission assessment, a client reports taking gingko biloba. Which of the following questions should the nurse ask the client?
?Are you taking an anticoagulant??
?Are you taking an antidiabetic medication?
?Are you taking a muscle relaxant?
?Are you taking hormone replacments??
A nurse is caring for a client who has a new prescription for zolpidem (Ambien) 10 mg by her mouth. Which of the following statements bt the client indicates understanding regarding this medication?
?I will stop taking m medication in a week as I don?t get constipated
?I will take vitamin C to increase the effectivessness of the medication?
?You need to take the medication with food?
?I will take my medication at bedime?
A nurse is monitoring a client who is taking fosinopril (Monopril)> The nurse should understand that the medication has a beneficial effect on which of the following body systems?
Gastrointestinal
Pulmonary
Reproductive
Cardiovascular
