RN Pharmacology Online Practice 2023 B

A nurse is preparing to administer a new prescription of amoxicillin/clavulanic to a client. The client tells the nurse that they are allergic to penicillin. Which of the following actions should the nurse take first?

Update the client's medical record.

Notify the provider.

Withhold the medication.

Inform the pharmacist of the client's allergy to penicillin.

Withhold the medication.

The nurse is planning teaching about the client's new medication. Which of the following information should the nurse include? Select all that apply.

(Sumatriptan 50mg PO PRN migraine (not exceed 200mg in 24hr)

This medication may cause you to feel tired.

This medication will decrease your blood pressure.

This medication can cause a feeling of pressure in your chest.

This medication can also be taken daily to prevent migraine headaches.

You can take a second dose of this medication at least two hours after the initial dose if the headache persists.

This medication will start to alleviate the headache within one hour after taking a dose.

This medication may cause you to feel tired.

This medication can cause a feeling of pressure in your chest.

You can take a second dose of this medication at least two hours after the initial dose if the headache persists.

This medication will start to alleviate the headache within one hour after taking a dose.

A nurse at a clinic is providing follow-up care to a client who is taking fluoxetine for depression. Which of the following findings should the nurse identify as an adverse effect of the medication?

a. Tingling toes

b. Sexual dysfunction

c. Absence of dreams

d. Pica

b. Sexual dysfunction

Click to highlight the findings from the client's medical record that indicates a potential adverse reaction to their prescribed medication and requires the nurse to report to provider. To deselect a finding, click on the finding again.

(Enoxaparin 40 mg Subcutaneous daily)

Body System

Findings

NEURO

Client is alert to person, place, time, and situation.

Client reports headache and occasional anxiety.

GI/GU

Client reports nausea.

Abdomen soft and rounded, non-distended.

Bowel sounds are normoactive in all 4 quadrants.

Bladder non-distended; continent.

Urine output of 25 mL/hr.

VITAL SIGNS

Temperature 38.4° C (101.2° F)

Heart rate 106/min

Respiratory rate 20/min

Blood pressure 140/64 mm Hg

Oxygen Saturation 97% on room air

INTEGUMENTARY

Skin cool, dry and intact.

Small pinpoint petechiae is present on bilateral extremities.

NEURO

Headache

GI/GU

Nausea

Integumentary

Small pinpoint petechiae is present on bilateral extremities.

For each body system below, click to specify the adverse effect that the nurse should include when providing client education about the newly prescribed medication. Choose the most likely option for the dropdowns in the table below by choosing from the lists of options.

Bupropion XR 150 mg daily once daily in AM for three days then increase to 150 mg twice daily.

Genitourinary- libido

Gastrointestinal- constipation

Metabolic- weight loss

A nurse is planning to administer IV midazolam for a client who is receiving moderate sedation. Which of the following actions should the nurse plan to take?

A. Ensure that naloxone is available in the event of toxicity.

B. administer the midazolam over one minute.

c. Expect the client's respiratory rate to increase.

d. Expect the client to respond to simple commands.

d. Expect the client to respond to simple commands.

A nurse is preparing to administer 0.9% sodium chloride 1,000 mL IV over 8 hr to a client. The drop factor of the manual IV tubing is 15 gtt/mL. How many gtt/min should the nurse set the manual IV infusion to deliver? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

31

For each body system below, click to specify the client's assessment findings that indicate an adverse effect of the client's prescribed medication. Choose the most likely option for the dropdowns in the table below by choosing from the lists of options.

Atorvastatin 40 mg once daily by mouth

Gastrointestinal/Genitourinary - urine characteristics

Musculoskeletal/Integumentary- Muscle weakness

Neurological- dizziness

A nurse is caring for a client who has developed hypomagnesemia due to long-term therapy with lansoprazole. The nurse should monitor the client for which of the following manifestations?

A Bradycardia

b. Hypotension

c. Muscle weakness

d. Disorientation

d. Disorientation

Which client statements indicate an understanding of the teaching? Click to specify if the client statement indicates an understanding or need for further education.

Captopril 12.5 mg twice a day by mouth

Understanding: "I will notify my provider if I feel sick" and "I should take acetaminophen instead of ibuprofen for a headache"

need for further education: "I will eat foods high in potassium," "Coughing is expected while taking this medication," and "I should take this medication with meals"

A nurse is providing teaching to a client who has multiple sclerosis and a new prescription for methylprednisolone. Which of the following instructions should the nurse include? (Select all that apply.)

Blood glucose levels will be monitored during therapy

Avoid contact with people who have known infections

Take the medication 1 hr before breakfast.

Decrease dietary intake of foods containing potassium.

Grapefruit juice can increase the effects of the medication.

Blood glucose levels will be monitored during therapy

Avoid contact with people who have known infections

Grapefruit juice can increase the effects of the medication.

A nurse is caring for a client who reports lethargy and myalgia after taking clozapine for 6 months. Which of the following actions should the nurse plan to take?

AInfuse 0.9% sodium chloride 1,000 mL IV fluid bolus.

Schedule the client for an electroencephalogram.

Obtain WBC with absolute neutrophil count.

Place the client on a tyramine-free diet.

Obtain WBC with absolute neutrophil count.

A nurse is assessing a client who is postoperative following an outpatient endoscopy procedure using midazolam. The nurse should monitor for which of the following findings as an indication that the client is ready for discharge

The client's capnography has returned to baseline.

The client can respond to their name when called.

The client is passing flatus.

The client is requesting oral intake.

The client's capnography has returned to baseline.

A nurse is reviewing the assessment findings of a client who is taking carbamazepine for a seizure disorder. Which of the following findings should the nurse report to the provider as an adverse effect of carbamazepine?

Hypersalivation

Dysuria

An increased uric acid level

A decreased WBC count

A decreased WBC count

A nurse is developing a teaching plan for a client who has a new prescription for simvastatin. Which of the following instructions should the nurse include in the teaching plan? (Select all that apply.)

Report muscle pain to the provider

Avoid taking the medication with grapefruit juice.

Take the medication in the early morning

Expect a flushing of the skin as a reaction to the medication

Expect therapy with this medication to be lifelong.

Report muscle pain to the provider

Avoid taking the medication with grapefruit juice.

Expect therapy with this medication to be lifelong.

A nurse is teaching a client who is to start taking famotidine for peptic ulcer disease. Which of the following client statements should the nurse identify as understanding of the teaching?

"I will stop taking famotidine when my stomach pain is gone.

"I will take famotidine anytime my stomach hurts.

"I know smoking makes famotidine less effective

"I know that famotidine will turn my stools black."

"I know smoking makes famotidine less effective

A nurse is assessing a client who is taking propylthiouracil for the treatment of Graves' disease. Which of the following findings should the nurse identify as an indication that the medication has been effective?

Decrease in WBC count

Decrease in amount of time sleeping

Increase in appetite

Increase in ability to focus

Increase in ability to focus

A nurse is collecting a medication history from a client who has a new prescription for lithium. Which of the following over-the-counter medications should the nurse identify as needing to be discontinued by the client?

Aspirin

Ibuprofen

Famotidine

Bisacodyl

Ibuprofen

A nurse is teaching a client who is scheduled for a colonoscopy and has a prescription for polyethylene glycol-electrolyte solution and bisacodyl. Which of the following statements should the nurse make?

"Expect a bowel movement 2 hr following the first dose of the bowel cleanser.

"Plan to drink 2 liters of the bowel cleanser solution.

"Plan to drink 1 large glass of red cranberry juice the day before the procedure.

"Expect to drink the bowel cleanser solution over an 8 hr period."

"Plan to drink 2 liters of the bowel cleanser solution.

A nurse is planning discharge teaching for a client who has a prescription for furosemide. Which of the following statements should the nurse plan to include in the teaching?

"This medication increases your risk for hypertension.

"Avoid potassium-rich foods in your diet.

"Take each dose of medication in the evening before bed

"Drink a glass of milk with each dose of medication."

"Drink a glass of milk with each dose of medication."

A nurse is caring for a client who is taking atorvastatin for hyperlipidemia. Which of the following client laboratory values should the nurse monitor

Creatinine kinase

Erythrocyte sedimentation rate

International normalized ratio

Potassium

Creatinine kinase

A nurse is caring for a client who received 0.9% sodium chloride 1 L over 4 hr instead of over 8 hr as prescribed. Which of the following information should the nurse enter as a complete documentation of the incident?

IV fluid infused over 4 hr instead of the prescribed 8 hr. Client tolerated fluids well, provider notified.

1 L of 0.9% sodium chloride completed at 0900. Client denies shortness of breath.

0.9% sodium chloride 1 L IV infused over 4 hr. Vital signs stable, provider notified.

IV fluid initiated at 0500. Lungs clear to auscultation.

0.9% sodium chloride 1 L IV infused over 4 hr. Vital signs stable, provider notified.

A nurse is reviewing the medical record of a client who has hypertension. The nurse should identify which of the following findings as a contraindication for receiving propranolol?Cholelithiasis

Asthma

Angina pectoris

Tachycardia

Asthma

A nurse is administering digoxin immune Fab to a client following a medication error. Which of the following findings should the nurse identify as an indication that the medication was effective?

Sinus rhythm

A decrease in the platelet count

An increase in the alanine transaminase (ALT) level

Deep tendon reflexes 2+

Sinus rhythm

A nurse is caring for a client who is taking acetazolamide for chronic open-angle glaucoma. Which of the following adverse effects should the nurse instruct the client to monitor for and report to the primary care provider?

Tingling of fingers

Constipation

Weight gain

Oliguria

Tingling of fingers

A nurse is providing teaching to a client who has a prescription for trimethoprim/sulfamethoxazole. Which of the following instructions should the nurse include in the teaching?

Take the medication with food.

Expect a fine, red rash as a transient effect.

Drink 8 to 10 glasses of water daily.

Store the medication in the refrigerator.

Drink 8 to 10 glasses of water daily.

A nurse is teaching a client who is starting to take amitriptyline. Which of the following findings should the nurse include in the teaching as an adverse effect of the medication?

Muscle twitching

Cough

Urinary retention

Increased libido

Urinary retention

A nurse is caring for a client who has diabetes mellitus and is taking glyburide. The client reports feeling confused and anxious. Which of the following actions should the nurse take first?

Perform a capillary blood glucose test.

Provide the client with a protein-rich snack.

Give the client 120 mL (4 oz) of orange juice.

Schedule an early meal tray.

Perform a capillary blood glucose test.

A nurse is preparing to administer 0.9% sodium chloride 1,500 mL to infuse over 8 hr to a client who is postoperative. How many mL/hr should the nurse set the IV pump to deliver? (Round to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

187.5 mL/hr

A nurse is administering cefotetan via intermittent IV bolus to a client who suddenly develops dyspnea and widespread hives. Which of the following actions should the nurse take first?

Administer epinephrine 0.5 mL via IV bolus.

Discontinue the medication IV infusion.

Elevate the client's legs above the level of the heart.

Collect a blood specimen for ABGs.

Discontinue the medication IV infusion.

A nurse administers ceftazidime to a client who has a severe penicillin allergy. The nurse should identify which of the following client findings as an indication that they should complete an incident report?

The client reports shortness of breath.

The client is also taking lisinopril.

The client's pulse rate is 60/min.

The client's WBC count is 14,000/mm3 (5,000 to 10,000/mm3).

The client reports shortness of breath.

A nurse is assessing a client who is taking tamoxifen to treat breast cancer. Which of the following findings is the priority for the nurse to report to the provider?

Hot flashes

Gastrointestinal irritation

Vaginal dryness

Leg tenderness

Leg tenderness

A nurse is assessing a client who has myasthenia gravis and is taking neostigmine. Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect?

Tachycardia

Oliguria

Xerostomia

Miosis

Miosis

A nurse is administering donepezil to a client who has Alzheimer's disease. Which of the following findings should the nurse report to the provider immediately?

Dyspepsia

Diarrhea

Dizziness

Dyspnea

Dyspnea

A nurse is caring for a client who is refusing to take their scheduled morning furosemide. Which of the following statements should the nurse make?

"If you do not take your furosemide, we might get in trouble.

"You can double your dose of furosemide this evening if that would be better for you."

"By not taking your furosemide, you might retain fluid and develop swelling.

" I'll go ahead and mix the furosemide into your breakfast cereal."

"By not taking your furosemide, you might retain fluid and develop swelling.

A nurse is preparing to administer ciprofloxacin 15 mg/kg PO every 12 hr to a child who weighs 20 kg. 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.)

300mg

A nurse in an emergency department is caring for a client whose family reports the client has taken large amounts of diazepam. Which of the following medications should the nurse anticipate administering?

Ondansetron

Magnesium sulfate

Flumazenil

Protamine sulfate

Flumazenil

A nurse is providing teaching to a client who has a prescription for ergotamine sublingual to treat migraine headaches. Which of the following information should the nurse include in the instructions?

"Take one tablet three times a day before meals."

Take one tablet every 15 minutes until migraine subsides."

"Take up to eight tablets as needed within a 24-hour period."

"Take one tablet at onset of migraine."

"Take one tablet at onset of migraine."

A nurse in the emergency department is caring for a client who has heroin toxicity. The client is unresponsive with pinpoint pupils and a respiratory rate of 6/min. Which of the following medications should the nurse plan to administer?

Methadone

Bupropion

Diazepam

Naloxone

Naloxone

A nurse is caring for a client who has acute acetaminophen toxicity. Which of the following medications should the nurse anticipate administering?

Vitamin K

Physostigmine

Benztropine

Acetylcysteine

Acetylcysteine

A nurse is reviewing the electronic medical record for a client who is receiving heparin via continuous IV infusion for deep vein thrombosis. Which of the following findings should the nurse identify as an adverse effect of heparin that requires notification of the provider?

Urinary frequency

Xerostomia

Diplopia

Generalized petechiae

Generalized petechiae

A nurse is caring for the parent of a newborn. The parent asks the nurse when their newborn should receive the first diphtheria, tetanus, and pertussis vaccine (DTaP). Which of the following ages should the nurse advise the parent to immunize their newborn?

At birth

6 months

2 months

15 months

2 months

A nurse is preparing to administer PO sodium polystyrene sulfonate to a client who has hyperkalemia. Which of the following actions should the nurse plan to take?

Hold the client's other oral medications for 8 hr post administration.

Inform the client that this medication can turn stool a light tan color.

Keep the client's solution in the refrigerator for up to 72 hr.

Monitor the client for constipation.

Monitor the client for constipation.

A nurse is providing teaching to a client about the use of ethinyl estradiol/norelgestromin. Which of the following statements by the client indicates an understanding of the teaching?

"I will apply the patch once a week for 2 weeks.

"I will leave the existing patch on for 4 hours after applying the new patch.

"I will fold the sticky sides of the old patch together before disposing it."

"I will apply the patch within 14 days of menses."

"I will fold the sticky sides of the old patch together before disposing it."

A nurse is providing teaching to a client who has a new prescription for ferrous sulfate. The nurse should instruct the client to take the medication with which of the following to promote absorption?Vitamin E

Orange juice

Milk

Antacids

Orange juice

A nurse on the acute care unit is caring for a client who is receiving gentamicin IV. Which of the following findings should the nurse report to the provider as an adverse effect of the medication?Constipation

Hypoglycemia

Tinnitus

Joint pain

Tinnitus

A nurse is teaching a client about warfarin. The client asks if they can take aspirin while taking the warfarin. Which of the following responses should the nurse make?

"It is safe to take an enteric-coated aspirin.

"The INR lab work must be monitored more frequently if aspirin is taken

"Acetaminophen may be substituted for aspirin.

"Aspirin will increase the risk of bleeding."

"Aspirin will increase the risk of bleeding."

A nurse is assessing a client's vital signs prior to the administration of PO digoxin. The client's BP is 144/86 mm Hg, heart rate is 55/min, and respiratory rate is 20/min. The nurse should withhold the medication and contact the provider for which of the following findings?

Diastolic BP

Systolic BP

Heart rate

Respiratory rate

Heart rate

A nurse is providing discharge instructions to a client who has heart failure and a new prescription for captopril. Which of the following client statements indicates an understanding of the teaching?

"I should take the medication with food."

"I should take naproxen if I develop joint pain."

"I should tell my provider if I develop a sore throat."

"I should expect the medication to cause my urine to look orange."

"I should tell my provider if I develop a sore throat."

A nurse is providing teaching to a client who is taking bupropion for smoking cessation. Which of the following findings should the nurse identify as an adverse effect of the medication?

Cough

Joint pain

Alopecia

Insomnia

Insomnia

A nurse is planning care for a client who has hypertension and is to start taking metoprolol. Which of the following interventions should the nurse include in the plan of care?%

Weigh the client weekly.

Determine apical pulse prior to administering.

Administer the medication 30 min prior to breakfast.

Monitor the client for jaundice.

Determine apical pulse prior to administering.

A nurse is caring for a client who is receiving heparin therapy via continuous IV infusion to treat a pulmonary embolism. Which of the following findings should the nurse identify as an adverse effect of the medication and report to the provider?

Vomiting

Blood in the urine

Positive Chvostek's sign

Ringing in the ears

Blood in the urine

A nurse is caring for a client who has hypocalcemia and is receiving calcium citrate. The nurse should identify that which of the following findings indicates a therapeutic response to the medication?

Positive Chvostek's sign

Client report of decreased paresthesia

Client report of increased thirst

Increase in urinary output

Client report of decreased paresthesia

A nurse is administering baclofen to a client who has a spinal cord injury. Which of the following findings should the nurse document as a therapeutic outcome?

Increase in seizure threshold

Decrease in flexor and extensor spasticity

Increase in cognitive function

Decrease in paralysis of the extremities

Decrease in flexor and extensor spasticity

A nurse is providing teaching to a client who is to start taking sumatriptan. Which of the following adverse effects should the nurse instruct the client to monitor for and report to the provider?

Chest pressure

White patches on the tongue

Bruising

Insomnia

Chest pressure

A nurse is caring for a client who has heart failure and a prescription for enalapril. Which of the following findings as an adverse effect of the medication should the nurse monitor the client for?

Bradycardia

Hyperkalemia

Loss of smell

Hypoglycemia

Hyperkalemia

A nurse is reviewing assessment findings for a client who has a new prescription for ceftazidime via intermittent IV bolus. Which of the following findings should the nurse identify as a contraindication to this medication?

Increased WBC count

Allergy to lamotrigine

Increased LDL level

Allergy to cephalosporins

Allergy to cephalosporins

A nurse receives a verbal order from the provider to administer morphine five milligrams every 4 hours subcutaneously for severe pain as needed. The nurse should identify which of the following entries as the correct format for the medication administration record (MAR)

MSO4 5 mg subcut every 4 hr PRN severe pain

Morphine 5 mg subcut every 4 hr PRN severe pain

MSO4 5 mg SQ every 4 hr PRN severe pain

Morphine 5.0 mg subcutaneously every 4 hr PRN severe pain

Morphine 5 mg subcut every 4 hr PRN severe pain

A nurse is caring for a client who has cancer and is prescribed oral morphine and docusate sodium. Which of the following adverse effects of morphine should the nurse instruct the client can be minimized by taking daily docusate sodium?

Constipation

Drowsiness

Facial flushing

Itching

Constipation

Drag 1 condition and 1 client finding to fill in each blank in the following sentence.

The nurse is reviewing the client's medical record, which of the following is the client at risk for............. developing due to ............

client is at risk for developing hypomagnesemia due to long-term use of omeprazole