Rn ati pharmacology 2016 Form C proctor
Pharmacology and Pain Management (Howard Community College)
1. A nurse is caring for a client who is taking phenytoin. For which of the following adverse effects should the nurse
monitor and report to the provider?
a. Cognitive impairment
i.
Phenytoin: Anticonvulsant, Antiarrhythmic. Adverse effects: suicidal thoughts, ataxia, agitation,
confusion, dizziness, drowsiness, dysarthria. (davis drug guide).
b. Tachycardia
c.
Elevated Blood Pressure
d. Tinnitus
2. A nurse is teaching a client who has a history of acute myocardial infarction about taking metoprolol to treat
angina. Which of the following instructions should the nurse include?
a. “Stop taking the medication if you become dizzy.”
i.
Advise pt. To sit or lie down if experiencing dizziness or faintness
b. “Check your pulse rate daily.”
i.
Adverse effects is bradycardia. Monitor patient’s pulse. If below 60/min, hold medication and
notify provider. Pg.263 ati 6.0
c.
“Expect to see an increase in your urinary output.”
d. “Call your provider if you lose more than 1 lb per week.”
3. A nurse is caring for a client who develops an anaphylactic reaction to IV antibiotic administration. After
assessing the client’s respiratory status and stopping the medication infusion, which of the following actions
should the nurse take next?
a. Elevate the client’s legs and feet
b. Administer epinephrine IM
i.
Anaphylactic reaction: Treat with epinephrine, bronchodilators, and antihistamines. Provide
respiratory support, and inform the provider. Pg.36 (ati 7.0)
c.
Replace the infusion with 0.9% sodium chloride
d. Give diphenhydramine IM
4. A nurse is assessing a client who is receiving oxytocin via continuous IV infusion for labor augmentation. The
nurse notes six contractions in a 10-min period with a nonreassuring FHR. Which of the following actions should
the nurse take first?
a. Administer terbutaline 0.25mg subq
b. Discontinue the oxytocin IV infusion
c. Turn the client to her left side
d. Apply O2 at 10L/min via face mask
5.
A nurse is preparing to administer lactated ringer’s solution at 100ml/hr. The drop factor of the manual IV tubing
is 15gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the
nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
a.
(100 mL/hr)(15 gtt/mL) = 1500 gtt/hr /60min= 25 gtt/min
6. A client who has active tuberculosis and is taking rifampin reports that his urine and sweat have developed a
red-orange tinge. Which of the following actions should the nurse take?
a. Prepare the client for dialysis
b. Instruct the client to increase his fluid intake
c.
Check the client’s liver function test results
i.
For hepatotoxicity (jaundice, anorexia, and fatigue), monitor liver function. Pg. 376 (ati 7.0).
d. Document this as an expected finding
i.
Discoloration of body fluids: inform patients of expected orange color of urine, saliva, sweat, and
tears. Pg.376 (ati 7.0)
7.
A nurse is teaching a client about self-administration of enoxaparin (Lovenox).
Which of the following
instructions should the nurse include? SATA
a. “Grasp the skin between the thumb and forefinger while injecting the medication.”
i.
Pinch up an area of skin, inject at a 90 degree angle. Pg. 193 (ati 7.0)
ii.
Medications Affecting Coagulation: Self-Administration of Enoxaparin (Active Learning Template Medication, RM Pharm RN 7.0 Chp 25)
b. “Alternate injection sites between the sides of the abdomen.”
i.
Rotate sites b/w right and left anterolateral and posterolateral abdominal walls at least 2 inches
from umbilicus. Pg. 193
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c.
“Expel the air bubble from the prefilled syringe.”
i.
DO NOT expel the air bubble in the syringe unless adjustments must be made to the dose. Pg.
193
d. “Massage the insertion site after injecting the medication.”
i.
DO NOT rub the site 1 to 2 min after injection. Pg. 193 (ati 7.0)
e. “Insert the entire length of the needle into the skin during injection.”
i.
Insert needle completely pg. 193 (ati 7.0)
8. A nurse is caring for a client who is receiving warfarin to treat atrial fibrillation. Which of the following laboratory
values should the nurse identify as outside the expected reference range for this client?
a. aPTT 36 seconds
b. Hgb 15.2 g/dL
i.
c.
Normal: 12-18
Hct 43%
i.
36-54%
d. INR 4.5
i.
INR of 2-3 for treatment of acute myocardial infarction, atrial fibrillation, pulmonary embolism,
venous thrombosis, or tissue heart valves. Pg. 194 (ati 7.0)
9. A nurse is caring for a client who is receiving ondansetron IV. Which of the following findings is an indication that
the ondansetron is effective?
a. Increased urinary output
b. Decreased nausea
i.
Ondansetron is an antiemetic. Administer antiemetic such as ondansetron for GI discomfort
(nausea and vomiting). Pg. 334 (ati 7.0).
ii.
c.
Serotonin antagonist: prevents emesis pg. 221 (ati 7.0)
Absence of peripheral neuropathy
d. Reduced dizziness
i.
Complication dizziness, diarrhea, headache. Pg. 222 (ati 7.0)
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10. A nurse is caring for a client who has major depression and a new prescription for citalopram. Which of the
following adverse effects is priority of the nurse to report to the provider?
a. Confusion
b. Insomnia
c.
Bruxism
i.
Grinding of the teeth, usually during sleep. (pg.50 ati 7.0)e
d. Weight loss
i.
Weight gain not loss (pg.50 ati 7.0)
11. A nurse is planning care for a client who is experiencing acute cocaine toxicity. The nurse should plan to
provide which of the following treatments?
a. Gastric lavage
i.
Gastric irrigation, cleaning out stomach contents (pg 117)
b. Saline cathartic
c.
i.
Used to speed up defecation.
ii.
Often used after gastric lavage.
Naloxone
i.
Used to reverse the effects of opioids
d. Diazepam
i.
Muscle relaxant. CNS depressant. (pg 117)
ii.
Cocaine is a CNS stimulant.
12. A nurse is providing teaching to a client who has diabetes insipidus and is receiving desmopressin. Which of the
following statements should the nurse include in the teaching?
a. “Your urine might have a reddish tint while taking this medication.”
b. “You will need to check your blood glucose every morning while taking this medication.”
c. “You can expect to have less urine output when you are taking this medication.”
i.
Desmopressin is an antidiuretic, an agent of choice for DI (pg 319)
d. “You will need weekly laboratory work to determine your blood clotting time.”
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13. A nurse is teaching a client who has pernicious anemia to self-administer nasal cyanocobalamin. Which of the
following information should the nurse include in the teaching?
a. “Plan to self-administer this medication for the next 6 months.”
i.
Treatment can take months (pg. 233)
b. “Administer the medication into the nostril once per week.”
c.
“Use a nasal decongestant 15 minutes before the mediation if you have a stuffy nose.”
d. “Lie down for 1 hour after administering the medication.”
i.
Complication is hypokalemia. Muscle weakness, fatigue, etc. Maybe the reason why to rest after
medication?
14. A nurse is planning to teach a client who has a gout allopurinol. Which of the following instructions should the
nurse include in the teaching?
a. Take after meals
i.
Advise clients to take oral gout medication with food or after meals to minimize GI distress. (pg.
266)
b. Take an iron supplement
c.
Limit daily fluid intake to 1 liter
d. Increase calcium intake
15. A nurse is assessing a client who has a heart failure and is taking digoxin. Which of the following findings should
the nurse identify as an early indication of medication toxicity?
a. Visual disturbances
i.
Indications of digoxin toxicity (fatigue, weakness, vision changes, GI effects) (pg. 164)
b. Insomnia
c.
Potassium 4.4 mEq/L
i.
Normal range. Hypokalemia presents digoxin toxicity.
d. Sudden weight gain
16. A nurse is reviewing the medical record of a client who is taking clozapine. Which of the following findings should
the nurse report to the provider immediately?
a. LDL 220 mg/dL
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b. WBC 2,500/mm3
i.
Agranulocytosis can occur. Obtain baseline WBC and monitor weekly, bi‑weekly, to monthly (pg.
72)
ii.
Normal 4,500 to 11,000
iii.
ATI Practice: The client who takes clozapine can develop lethargy and myalgia caused by the
adverse effect of agranulocytopenia. Therefore, monitoring the WBC with absolute neutrophil
count weekly for the first 6 months of treatment is recommended. After 6 months, monitoring can
be changed to occur every 2 weeks up to 1 year.
c.
Fasting blood glucose 180 mg/dL
d. BMI of 28
17. A nurse is reviewing the medications of a client.
The nurse should recognize that which of the following
medications increases the client’s risk for constipation?
a. Hydrocodone
i.
Antitussive: Opioid
ii.
Adverse effects includes: CNS depression, constipation, nausea, vomiting. (pg. 133)
b. Neomycin sulfate
c.
i.
Aminoglycoside: treats aerobic gram (-) bacilli
ii.
Complications: ototoxicity, nephrotoxicity, intense neuromuscular blockade (pg. 365)
Prednisone
i.
Glucocorticoid
ii.
If used 10 days or more can cause: bone loss, hyperglycemia and glycosuria, myopathy, peptic
ulcer, etc. (see pg. 128).
d. Lactulose
i.
Laxative
ii.
Complications: GI irritation, rectal burning sensation etc. (see pg. 224)
18. A nurse is caring for a client who is receiving IV amphotericin B. which of the following findings should the nurse
identify as an acute infusion reaction?
a. Dry cough
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b. Fever
i.
c.
Infusion reactions: Fever, chills, rigors, and headache 1 to 3 hr after initiation. (pg.378)
Pedal edema
d. Hyperglycemia
19. A nurse is providing teaching to a client who has a new prescription for bumetanide for heart failure. Which of
the following instructions should the nurse include in the teaching?
a. “You should monitor for hearing difficulties.”
i.
One of the adverse effects: OTOTOXICITY - advise the clients to notify the provider of tinnitus,
which may indicate ototoxicity. (pg.237 ati 6.0)
b. “You should take this medication on an empty stomach.”
c.
“You should take the medication at bedtime.”
i.
No no. = nocturia = falls = bad (pg.238 ati 6.0)
ii.
Usual dosing time 0800 and 1400. (pg.238)
d. “You should decrease your intake of foods high in potassium.”
i.
Bumetanide increases risk for hypokalemia: teach patient to eat foods high in potassium
20. A nurse is evaluating a client’s response to a new prescription for phenazopyridine. Which of the following
outcomes of the medication should the nurse expect?
a. Decreased manifestations of GERD
b. Improved movements of joints
c.
Increased ability to cough up secretions
d. Relieved burning upon urination
i.
Phenazopyridine: Urinary tract analgesic (Pg 372)
ii.
Therapeutic uses: relieves manifestations of burning with urination, pain, frequency, and urgency.
21. A nurse is caring for a client who has diabetes mellitus and is taking pioglitazone. The nurse should plan to
monitor the client for which of the following adverse effects?
a. Insomnia
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b. Tinnitus
c.
Orthostatic hypotension
d. Fluid retention
i.
Pioglitazone is a Thiazolidinediones (glitazones); Oral antidiabetic (pg. 512 ati 6.0)
ii.
Complications include: fluid retention, elevations in LDL, Hepatotoxicity. (pg. 513 ati 6.0).
22. A nurse is caring for a client who has a new prescription for tetracycline. Which of the following statements by
the client indicates an understanding of the teaching?
a. “I will avoid drinking milk when i take this medication.”
i.
Interaction with milk products, calcium or iron supplements, laxatives containing magnesium and
antacids causes formation of nonabsorbable chelates, thus reducing the absorption of
tetracycline. (pg.364)
b. “I should take an iron supplement with this medication.”
c.
“I won’t worry if i experience diarrhea while taking this medications.”
i.
Instruct clients to notify provider if diarrhea occurs - Suprainfection of the bowel - antibiotic
associated pseudomembranous colitis. (pg. 604 ati 6.0)
d. “I will discontinue this medication when my symptoms go away.”
23. A nurse is preparing to administer phenytoin suspension 2.5 mg/kg PO twice a day to a toddler. The toddler
weighs 22 lb. how many mg should the nurse administer per dose? (Round the answer to the nearest whole
number. Use a leading zero if it applies. Do not use a trailing zero.)
a.
Answer 25mg/dose
i.
22 lb= 10kg
ii.
10 kg x 2.5mg= 25
24. A nurse is reviewing the medication administration record of a client who received propranolol from a nurse on
the previous shift.
The nurse notes the client had an apical heart rate of 50/min prior to administer of the
medication. Which of the following actions should the nurse take?
a. Notify the ethics committee
b. Notify the pharmacy
c. Call the nurse to return to the facility
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i.
Evidence Based Porn ( GODDAMIT PLD)
d. File an incident report
25. A nurse is caring for a client who has acute heart failure and is receiving furosemide via IV bolus. The nurse
should identify that which of the following findings indicates a desired therapeutic effects?
a. Decreased weight
i.
Weight loss Pg 143
b. Decreased blood glucose level
i.
c.
Hyperglycemia is a common adverse effect
Increased blood pressure
i.
Should decrease BP Pg 143
d. Increased sputum production
26. A charge nurse is supervising nursing care for four clients. The nurse should recognize that which of the following
situations requires an incident report?
a. A client receives an acetaminophen suppository in place of an oral prescription
i.
Fails the 6 rights; Right route?
b. A nurse administers an antibiotic to a client 30 min after it is due
i.
c.
30 mins b4 or after is ok for antibiotics per, Med Porn
A nurse administers albuterol to a client who has a heart rate of 55/min
i.
Complication is Tachycardia so it’s ok.
d. A client vomits after receiving an oral medication
i.
No need for such drastic things (soo0o dramatic)
27. A nurse is caring for a client who has peptic ulcer disease and is to start antacid therapy. Which of the following
information should the nurse give the client?
a. Take antacids to help inactivate Helicobacter pylori
i.
Inactivate pepsin
b. Take chewable tablets rather than suspensions
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c.
Take antacids within 30 min of other medications
i.
Take all medications at least 1 hr before or after taking an antacid (pg.218)
d. Take antacids 1hr after meals, 3hr after meals, and at bedtime
i.
Medication can be administered seven times a day: 1 hr and 3 hr after meals, and again at
bedtime. (Pg 218)
28. A nurse is teaching a client who has a prescription for ferrous gluconate. Which of the following statements by
the client indicates an understanding of the teaching?
a. “I should stay upright for at least 15 minutes after taking this medication.”
b. “I should notify my provider if my stools turn black.”
i.
c.
It is normal for stool to turn Black or dark Green
“I should take this medication with 8 ounces of milk.”
i.
Milk inhibits absorptions and could lead to toxicity
d. “I should take an antacid with this medication to prevent stomach upset.”
i.
Same as milk homies!
29. A nurse is providing teaching to a client who is to receive a series of allergy tests. The nurse should instruct the
client to avoid which of the following medications for up to 4 weeks before the procedure?
a. Diphenhydramine
i.
Allergic reactions range from minor to serious. Mild rashes and hives can be treated with
diphenhydramine.
b. Albuterol
c.
Acetaminophen
d. Pseudoephedrine hydrochloride
30. A nurse is caring for a client who has cancer and is undergoing chemotherapy. The client is receiving filgrastim
before each chemotherapy dose. The nurse should monitor for an increase in which of the following types of cells
to determine the effectiveness of the medication?
a. Thrombocytes
i.
Platelet
b. Erythrocytes
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i.
c.
RBCs
Reticulocytes
i.
Baby RBCs
d. Granulocytes
i.
WBC, the drug is leukopoietic (Definition)
31. A nurse is assessing a client who takes levothyroxine for hypothyroidism. The nurse should identify that which of
the following findings indicates the need for an increase in dosage? (SATA)
a. Impaired short-term memory
i.
Slow thought process and speech are expected findings for hypothyroidism
b. BP 178/30 mmHg
i.
Hypotension
c. Cold intolerance
i.
Intolerance to cold (pg 513 MedSurg)
d. Heart rate 46/min
i.
Bradycardia (Pg 513 MedSurg)
e. Diaphoresis
i.
Dry Flakey Skin
32. A nurse recently administered filgrastim intravenously to a client who has a cancer and is receiving cytotoxic
chemotherapy. For which of the following data. Discovered after the medication was administered, should the
nurse file an incident report?
a. The client’s absolute neutrophil count was 2,500/mm3 before the medication was administered.
i.
Decrease or interrupt treatment if Neutrophil count exceeds 10k
b. The client had chemotherapy 12hr before the medication was administered
i.
c.
Admin by subQ 24hrs after each round of chemo (Pg 203)
The nurse flushed the client’s IV line with dextrose 5% in water before and after the medication was
administered.
d. The medication vial sat at room temperature for 2hr before it was administered.
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33. A nurse is caring for a client who has heart failure and is taking digoxin and hydrochlorothiazide. The nurse
should monitor of the following adverse effects of hydrochlorothiazide?
a. Hypernatremia
i.
hyponatremia
b. Hypophosphatemia
c.
Hypermagnesemia
i.
Hypomagnesemia
d. Hypokalemia
i.
Pg 144
34. A nurse is assessing a client who is receiving morphine for pain control. Which of the following findings should
the nurse report to the provider?
a. Drowsiness
b. Bladder distention
i.
c.
Pg 285
BP 100/76 mmHg
d. Pupillary constriction
35. A nurse is teaching a client who has angina about a new prescription for sublingual nitroglycerin tablets. Which
of the following instructions should the nurse include in the teaching?
a. “Take one tablet each morning 30 minutes prior to eating.”
i.
Should be used for angina pectoris, Use is for rapid onset, short duration.
b. “Keep the tablets at room temperature in their original glass bottle.”
i.
Angina: Client Teaching for a New Prescription of Sublingual Nitroglycerin (RN QSEN - Safety ,
Active Learning Template - Medication, RM Pharm RN 7.0 Chp 22)
c.
“Place the tablet between your cheek and gum to dissolve.”
i.
That would be buccal
d. “Discard any tablets you do not use every 6 months.”
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36. A nurse is caring for a client who is taking triamterene. For which of the following laboratory values should the
nurse withhold the medication?
a. Sodium 142 mEq/L
i.
WNL 135-145
b. BUN 16 mg/dL
i.
WNL 12-20
c. Potassium 5.3 mEq/L
i.
Treat hyperkalemia by D/Cing medication (pg 146)
ii.
Triamterene is a potassium sparing diuretic
d. Albumin 4 g/dL
i.
WNL 3.5-5
37. A nurse is caring for a client who is taking broad spectrum antibiotics for pneumonia. The nurse should identify
that the client is at risk for developing which of the following types of infection?
a. Nosocomial infection
i.
Hospital acquired infection
b. Systemic infection
i.
An infection of the entire body
c. Superinfection
i.
Pg 323 med surg (antibiotics)
ii.
FR Principles of Antimicrobial Therapy: Identifying Types of Infections (Active Learning Template
- System Disorder, RM Pharm RN 7.0 Chp 43)
d. Resistant infection
38. A nurse is reviewing the laboratory values of a client who is taking atorvastatin. Which of the following laboratory
values indicates that the treatment has been e
ffective?
a. BUN 15 mg/dL
b. Blood glucose 90 mg/dL
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c. LDL 120 mg/dL
i.
<130
d. Urine specific gravity 1.020
39. A nurse is preparing to titrate a continuous nitroprusside infusion for a client. The nurse should plan to titrate the
infusion according to which of the following assessments?
a. Stroke volume
b. Blood pressure
i.
c.
Pg 160
Cardiac output
d. Urine output
40. A nurse is assessing a client’s IV infusion site that notes that the site is cool and edematous. Which of the
following actions should the nurse take?
a. Slow the IV solution rate
i.
D/C IV from that site
b. Maintain the extremity below the level of the heart
i.
Promote drainage by holding up high
c. Apply warm, moist compress
i.
Intravenous Therapy: Nursing Actions for IV Infiltration (RN QSEN - Safety , Active Learning
Template - Nursing Skill, RM Pharm RN 7.0 Chp 4)
d. Initiate a new IV distal to the initial site
41. A nurse is providing teaching to a client who has a new prescription for tetracycline. The nurse should instruct
the client to take which of the following dietary supplements at a different time t han the tetracycline?
a. Vitamin C
b. Folic acid
c. Calcium carbonate
i.
Pg 364. Avoid milk products and antacids, or separate by 2 hrs
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d. Fish oil
42. A nurse is caring for a client who has a life-threatening ventricular dysrhythmia.
Which of the following
medications should the nurse anticipate administering? Pg 175 (Class IB)
a. Dopamine
i.
Pg 165
b. Digoxin
c.
Verapamil
d. Amiodarone
43. A nurse is teaching a client who has HIV and a new prescription for efavirenz. Which of the following instructions
should the nurse include in the teaching?
a. Take a double dose of this medication if a dose is missed
i.
Take as prescribed do not skip dose to minimize development of resistance
b. Expect severe nausea and vomiting for the first week of therapy
c. Notify the provider for the appearance of a skin rash
d. Swallow the medication with milk upon awakening in the morning
i.
Take at night on an empty stomach
44. A nurse is a reviewing the laboratory results of a client who has diabetes mellitus and is taking glipizide. Which of
the following values indicates that the client is adhering to the treatment plan?
a. Creatinine 1.0 mg/dL
i.
Doesn’t affect the kidneys so i don’t think so… lol
b. HbA1c 6.8%
c.
Total cholesterol 225 mg/dL
i.
Total should be <200
d. Positive urinary ketones
i.
Means poorly controlled diabetes
45. A nurse is reviewing medication prescriptions for a client.
administration record should the nurse request clarification?
Which of the entries on the client’s medication
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a. Morphine 4mg IV every 4 hr PRN for pain
b. Simvastatin 40mg PO at bedtime
c.
Levothyroxine 100mcg PO every morning
d. Acetaminophen 500 mg every 4hr PRN for fever
46. A nurse is providing teaching to a client who has a new prescription for paroxetine. The nurse should instruct the
client monitor for which the following adverse effects?
a. Tinnitus
b. Peripheral edema
c. Drowsiness
i.
Pg 50
d. Alopecia (sudden hair loss)
47. A nurse is providing teaching about the adverse effects of ergotamine to a client who has migraine headaches.
Which of the following adverse effects should the nurse include in the teaching?
a. Blurred vision
b. Tinnitus
c.
Hematuria
d. Parethesias
i.
Acute or chronic overdose (ergotism)
ii.
Muscle pain, paresthesias in fingers and toes; peripheral ischemia (298)
48. A nurse is assessing a client who has a prescription for cefaclor. Which of the following findings should the nurse
recognize as an indication of an allergic reaction?
a. Hematuria
b. Slurred speech
c. Pruritus
i.
d. Tremor
Pg 358
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49. A nurse is providing teaching to a client who has a new prescription for theophylline, a sustained-release
capsule. Which of the following statements by the client indicates an understanding of the teaching?
a. “I may sprinkle the medication in applesauce.”
i.
Do not crush or chew sustained-release
b. “I should limit my fluid intake while on this medication.’
c. “I will need to have blood levels drawn.”
i.
Monitor blood level
d. “I can take my medication in the morning with my coffee.”
i.
Caffeine can increase theophylline levels, avoid consuming with caffeine
ii.
Pg 127
50. A nurse is teaching client who has active pulmonary tuberculosis about management of medication for the
disease. Which of the following statements is appropriate for the nurse to make?
a. “You will need to undergo tuberculin skin tests every 6 months while taking medication for your disease.”
b. “You will need to take two or more medications to treat your disease.”
i.
c.
Pg 375
“You should anticipate taking medication to treat your disease for at least the next 3 years.”
i.
24 months (pg.375)
d. “You should report monthly to have your blood drawn to monitor kidney function while taking medication.”
i.
Liver function tests not kidney (pg 376)
51. A nurse is reviewing the medication administration record of a client who is to receive phenytoin 300 mg PO daily.
The medication sent by the pharmacy is a vial of phenytoin 50 mg/mL for injection. Which of the following actions
should the nurse take?
a. Check medication calculations with the second nurse.
b. Refer to the original medication order.
c.
Administer 6mL of the medication intravenously
d. Ask the client what route he usually takes the medication
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52. A nurse is teaching a client who has stable angina and a new prescription for nitroglycerin transdermal patches
0.8 mg/hr daily. Which of the following statements by the client indicates an understanding of the teaching? (pg
170)
a. “I will apply a new patch to the same site whenever i replace it.”
i.
Rotate sites with every application
b. “I can put a second patch on if I have chest pain.”
i.
c.
Do not apply more patches than prescribed
“I can cut the patches in half to save money.”
i.
Always apply whole patch to get the prescribed dosage
d. “I will take the patch off after dinner every night.”
i.
In order to prevent tolerance to nitroglycerin, the client should remove the patch for 10-12 hr
during the 24 hr period
53. A nurse is preparing to administer enoxaparin 1mg/kg subq every 12hr. The client’s weight is 121lb. Available is
enoxaparin 60mg/0.6mL. How many mL should the nurse administer per dose? (Round the answer to the nearest
tenth. Use leading zero if it applies. Do not use the trailing zero.)
a. 0.6
54. A nurse is assessing a client who has muscarinic agonist poisoning. Following administration of atropine, which
of the following findings should indicate to the nurse that the treatment has been effective?
a. BP 90/50 mmHg
i.
Bradycardia, hypotension are complications of extreme muscarinic agonists stimulation (pg 114)
b. Hyperactive bowel sounds
c. Heart rate 90/min
d. Increased salivation
i.
Low doses of Atropine decreases salivation
55. A nurse is preparing to administer subcutaneous heparin to a client. Which of the following actions should the
nurse take?
a. Insert the needle at least 5cm (2in) from the umbilicus
i.
Insert need at 2 inches from the umbilicus
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ii.
Pg 192
b. Massage the site after administering the medication
c.
i.
Apply gentle pressure for 1-2 min after the injection
ii.
Pg 192
Use a 21-gauge needle for the injection
i.
20-22 gauge to withdraw med from the vial
ii.
25-26 gauge to administer
iii.
Pg 192
d. Aspirate before injecting the medication.
i.
Do not aspirate
ii.
Pg 192
56. A nurse is caring for a client who received digoxin 0.25mg instead of 0.125mg, as the provider prescribed. The
nurse administered the medication 4hr ago. Which of the following actions should the nurse take first?
a. Notify the provider who prescribed the medication
b. Check the client’s apical heart rate
c.
Initiate a medication error incident report
d. Monitor the client’s potassium level
57. A nurse is preparing to administer the varicella vaccine to a group of clients. The nurse should identify which of
the following clients as having a contraindication for receiving this immunization?
a. An older adult client living in a long-term care facility
b. A young adult who has an allergy to eggs
i.
c.
Influenza vaccine
A child who recently received the human papillomavirus vaccine
d. A client who has AIDS
58. A nurse is caring for a client who has tuberculosis and is taking isoniazid and rifampin. Which of the following
outcomes indicates that the client is adhering to the medication regimen?
a. The client tests negative for HIV
lOMoARcPSD|6879242
b. The client’s liver function test results are within the expected reference ranges
c.
The client has a positive purified protein derivative test
d. The client has a negative sputum culture (p.376)
59. A nurse is planning to teach a client who has asthma about taking montelukast.
Which of the following
information should the nurse include about the purpose of this medication?
a. Controls inflammation in the airways
i.
Leukotriene modifier: Reduces inflammation, bronchoconstriction, airway edema, mucus
production
ii.
Pg 129
b. Relieves acute bronchospasms
c.
Inhibits replications of neutrophils
d. Activates beta2-receptors in smooth muscle1
60. A nurse is caring for a client who received succinylcholine IV bolus during an abdominal surgery. The client
develops malignant hyperthermia. The nurse should administer which of the following medications?
a. Baclofen
b. Acetylcysteine
c. Dantrolene
i.
Administer dantrolene to decrease metabolic activity of skeletal muscle.
d. Naloxone
61. A nurse is assessing a client who has a prescription for levothyroxine. Which of the following findings should the
nurse recognizes as an adverse reaction?
a. Tremor
i.
Pg 324
b. Lethargy
c.
Nasal congestion
d. Bradycardia
i.
Tachycardia
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62. A nurse is caring for a client who reports taking propranolol for several years but has recently stopped for
financial reasons. The nurse should assess the client for which of the following findings?
a. Tachycardia
b. Rhinitis
c.
Bradypnea
d. Hyperkalemia
63. A provider has prescribed procaine penicillin G 600,000 units IM for a client who has a streptococcal throat
infection. Which of the following actions should the nurse take?
a. Use the deltoid site for the injection
b. Inject the medication quickly over 2 to 3 seconds
c. Insert the needle at 90 degree angle
d. Ask the provider to prescribe the medication orally
64. A nurse is teaching a client who has diabetes mellitus and a new prescription for a combination of lispro insulin
and NPH insulin. Which of the following statements by the client indicates an understanding of the teaching?
a. “I will expect the lispro insulin to be cloudy.”
i.
Clear
b. “I should eat within 1hr after my injection.”
c.
“I should draw up the NPH insulin first.”
i.
NRRN
d. “I will mix these medications in one syringe.”
65. A client who has Graves’ disease is prescribed methimazole. Which of the following effects should the nurse
expect to see after the client has taken the medication for 2 months?
a. Increased sleeping
b. Weight loss
c.
Increase in pulse rate
d. Warmer skin
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66. A nurse is teaching a female adult client who has a new prescription for azathioprine to treat active rheumatoid
arthritis. The nurse should inform the client about the need for which of the following diagnostic tests prior to
starting the medication?
a. Pregnancy test
i.
Women who are pregnant, plan to become pregnant, or are breastfeeding should consult provider
about use
ii.
Pregnancy Category D
iii.
Pg 227
b. Electrocardiogram
c.
Bone density scan
d. HbA1c
67. A nurse is assessing a client who has just received an initial dose of penicillin G intramuscularly. Which of the
following findings is the nurse’s priority?
a. Redness at the injection site
b. Lethargy
c.
Nausea
d. Stridor
