Exam 2 pharmacology review

Which of the following medications would the nurse expect the healthcare provider to prescribe for migraine headaches?

A. Allopurinol
B. Sumatriptan
C. Naloxone
D. Filgrastim

B. Sumatriptan

When an ergot preparation is prescribed for the prevention of migraine headaches, it is important for the

nurse to assess if the patient is currently taking what?

A. Acetaminophen
B. Beta-adrenergic blocker
C. Gabapentin
D. Amoxicillin

B. Beta adrenergic blockers

The ergot derivatives help to relieve migraine headaches by which mechanism?

A. Dilating cranial blood vessels
B. Vasoconstriction on cranial blood vessels
C. Blocking opioid receptors
D. Decreasing uric-acid production

Vasoconstriction on cranial blood vessels

A patient is taking acetaminophen with codeine to con-

trol the pain from a fractured arm. Five days later the

patient states, "I'm having problems having a bowel

movement since I started this drug." The most appropriate response is:

A) "This is an expected adverse effect to the use of

codeine. Increase your fluid intake and take a bulk

laxative such as Metamucil."

B) "This is an additive effect of codeine. Stop taking the

medication."

C) "This is an expected adverse effect to the use of

codeine. Double the dose, and it will clear out your

bowel."

D) "You are probably allergic to the codeine. Stop tak-

ing the medication."

A) "This is an expected adverse effect to the use of codeine. Increase your fluid intake and take a bulk laxative such as Metamucil."

Opioid adverse effects are all of the following except:

A) Normotensive BP

B) Respiratory Depression

C) Constipation

D) Sedation

A) Normotensive BP

The nurse is caring for a patient receiving opioid analgesic. What would be priority?

A) Pain intensity, and glucose level

B) Respiratory rate and LOC

C) Respiratory rate and electrolytes

D) Urine output and pain intensity

B) Respiratory rate and

LOC

A young woman attends a "Botox Party" and is injected

with botulinum toxin type A to decrease "frown lines"

between her eyebrows. Later that evening the patient

is admitted to the emergency department and is hysterical, because she cannot move her eyebrows. The

nurse explains that that toxin causes what?

A) "The toxin causes muscle death, which smoothes

wrinkles in the area."

B) "The toxin causes muscle paralysis, preventing

movement and relieving wrinkles."

C) "The drug is a toxin to nerves in the area."

D) "The drug is a permanent muscle relaxant and the

muscles will never move again."

B) "The toxin causes muscle paralysis, preventing movement and relieving wrinkles."

A patient with history migraines is being treated with

ergotamine. The nurse expects an adverse reaction to

the medication if the client complains of

A. Numbness, tingling, and muscle pain
B. Increased appetite and weight gain
C. Frequent urination and thirst
D. Constipation and dry mouth

A. Numbness tingling, & muscle pain

Patient has a severe, unilateral headache with nausea,

vomiting, and light sensitivity. Which drug would you

expect the doctor to order for this patient?

A. Sumatriptan
B. Allopurinol
C. Naloxone
D. Filgrastim

A. Sumatriptan

A patient is taking acetaminophen with codeine to con-

trol the pain from a fractured arm. Five days later the

patient states, "I'm having problems having a bowel

movement since I started this drug." The most appropriate response is:

A) "This is an expected adverse effect to the use of

codeine. Increase your fluid intake and take a bulk

laxative such as Metamucil."

B) "This is an additive effect of codeine. Stop taking the

medication."

C) "This is an expected adverse effect to the use of

codeine. Double the dose, and it will clear out your

bowel."

D) "You are probably allergic to the codeine. Stop taking the medication."

A) "This is an expected adverse effect to the use of codeine. Increase your fluid intake and take a bulk laxative such as Metamucil."

A patient has Demerol 75mg every 3-4 hours prn for

postoperative pain, before administering narcotics

A) Position in Semi-fowlers position

B) Assess the type, location, and intensity of discomfort

C) Evaluate if pain is real

D) Try other measures

B) Assess the type, location, and intensity of discomfort

A geriatric patient has received a narcotic as a postoperative analgesic the nursing care plan should include?

A. Encourage the client to ambulate independently
B. side rails up
C. Restrict fluids to prevent urinary retention
D. Place all four side rails up continuously

B. side rails up

The nurse is providing care for a patient receiving morphine sulfate. An early indication of acute intoxication

with morphine sulfate is

A) Pupil dilation and decreases respiratory rate

B) Pupil constriction and decreased respiratory rate

C) Nausea, vomiting, drowsiness

D) Pruritis and respiratory depression

B) Pupil constriction and decreased respiratory rate

Gastrointestinal (GI) function is best maintained by

A. Restricting fluids and physical activity
B. Maintaining a proper diet, adequate fluid intake, and regular exercise
C. Taking a laxative every day
D. Following a low-fiber diet

B. Maintaining a proper diet, adequate fluid intake, and regular exercise

Several days postoperative bowel surgery, the patient

is eating soft food, ambulating regularly, and using

hydrocodone (Vicodin) for pain. What should the nursing care plan include?

A) Monitoring vital signs for

respiratory depression

B) Inserting a urinary catheter for urinary retention

C) Weaning pain medication to prevent addiction

D) Increasing dietary fiber and fluids and administering a stool softener if needed

D) Increasing dietary fiber and fluids and administering a stool softener if needed

Which of the following would be a desirable and measurable outcome for a patient experiencing severe

pain taking an opioid?

A) A shorter period of time between requests for med-

ication

B) Increased moaning during movement

C) Restlessness during night hours

D) Increased ability to be involved in AM care activities

D) Increased ability to be involved in AM care activities

After the administration of Morphine 10mg, the

client's respiration changed from 20 breaths per

minute to 6 breaths per minute. What medication

would the nurse anticipate being used to reverse the

situation?

A. Acetylcysteine
B. Naloxone
C. Flumazenil
D. Leucovorin

B. Naloxone (Narcan)

A client on a morphine pump is observed to have a

respiratory rate of 8 breaths/min and pinpoint pupils.

What action will the nurse implement at this time?

A. Prepare to administer naloxone and possibly ventilatory support.
B. Encourage the client to take deep breaths and reassess in 1 hour
C. Administer another dose of morphine for breakthrough pain
D. Place the client flat and restrict oxygen

A.Prepare to administer naloxone and possibly ventilatory support.

The nurse would expect to administer morphine as the analgesic of choice for a patient

A. A client experiencing severe acute postoperative pain
B. A client experiencing mild seasonal-allergy symptoms
C. A client experiencing opioid-induced respiratory depression
D. A client experiencing constipation

A. A client experiencing severe acute postoperative pain

A nurse caring for a patient who has complained of

chronic headaches. He reports that he takes Tylenol at

least four times a day. Which of the following will the

nurse evaluate?

A. Deep-tendon reflexes
B. Thyroid function
C. Hepatic function
D. Visual acuity

C. Hepatic function

A 45-year-old patient has breast cancer that has

spread to the liver and spine. The patient has been

taking oxycodone (OxyContin) and amitriptyline (Elavil)

for pain control at home but now has constant severe

pain and is hospitalized for pain control and development of a pain-management program. When doing

the initial assessment, which question will be most

appropriate to ask first?

A) How would you describe your pain?

B) How much medication do you take for the pain?

C) How long have you had this pain?

D) How many times a day do you medicate for pain?

A) How would you describe your pain?

A patient arrives at the emergency department with

a head injury.... She also appears to have a fractured

arm and is in severe pain. She is not being given any

narcotic pain medication at the time because:

A. Opioids increase bone swelling at the fracture site.
B. Opioids prevent diagnostic imaging from detecting fractures.
C. Opioids cause severe hypertension in clients with head injuries.
D. Opioid-induced sedation and respiratory depression can mask neurological deterioration and increase intracranial pressure.

D. Opioid-induced sedation and respiratory depression can mask neurological deterioration and increase intracranial pressure.

A nurse is caring for a 10-year-old boy who complains

of chronic headaches. His mother reports that she

gives him Tylenol at least three times a day. Which of

the following will the nurse work with the physician to

evaluate?

A. Renal function
B. Thyroid function
C. Respiratory function
D. Hepatic function

D. Hepatic function

A patient is brought into the emergency room for

swallowing ½ a bottle of acetaminophen. The original

bottle had 100 tablets in it. The nurse should anticipate

the nurse to order what?

A) Administer epinephrine

B) Mucomyst

C) Draw labs for platelet count

D) Send pt for abdominal CT

B) Mucomyst

Before beginning a pump infusion of an opioid. The

nurse should minimally do which of the following?

A) Note last void

B) Have the pt describe the pain more specifically

C) Obtain baseline BP, RR and rhythm, and depth

D) Complete full physical assessment

C) Obtain baseline BP, RR and rhythm, and depth

Which of the following statements by the patient indicates to the nurse that the patient has a good understanding of the use of nonsteroidal anti-inflammatory drug therapy?

A. “I will take aspirin with my NSAID for additional pain relief.”
B. “I should report black, tarry stools or unusual bleeding.”
C. “I should take the medication on an empty stomach.”
D. “Kidney function does not need to be monitored.”

B. “I should report black, tarry stools or unusual bleeding.”

The home health nurse instructs the client to avoid taking the NSAID, ibuprofen. The rationale for the nurses action is that the patient has demonstrated a decrease in

A. Serum sodium
B. White blood cell count
C. Platelet count
D. Blood glucose

C. Platelet count

A nurse is administering anti-inflammatory to a patient who has severe rheumatoid arthritis. Which of the following would the nurse question if ordered by the physician?

A) Oral antibiotic agent

B) Oral anticoagulant

C) Antihypertensive agent

D) Antibiotic

B) Oral anticoagulant

A patient presents at the emergency department complaining of dizziness, mental confusion, and difficulty

hearing. What should the nurse suspect is wrong with the patient?

A) Anakinra toxicity

B) Ibuprofen toxicity

C) Salicylism

D) Acetaminophen toxicity

C) Salicylism

1) What drug treats long term arthritis?

A. Naloxone
B. Celecoxib
C. Sumatriptan
D. Filgrastim

B. Celecoxib

The nursing instructor is talking about anemia. The instructor explains that when a person has chronic

renal failure, it leads to a decrease in the production of red blood cells, and the person becomes anemic. This

anemia is usually caused by a loss of:

A. Filgrastim
B. Thrombopoietin
C. Erythropoietin
D. Fibrinogen

C. Erythropoietin

client reports fever, chills, and flank pain. Which condition should the nurse suspect?

A. Cystitis
B. Pyelonephritis
C. Urethritis
D. Renal calculi

B. Pyelonephritis

Pt has UTI what will the nurse assess?

A) Flank pain, dysuria, burning sensation during urination

B) Fever, chills, flank pain (pyelonephritis)

C) Dysuria, frequency, urgency

A) Flank pain, dysuria, burning sensation during urination

A client is admitted after overdose with acetaminophen. What medication would the nurse expect

to be administered?

A) Oxymetazoline hydrochloride

B) Acetylcysteine

C) Darbepoetin alfa

D) Daptomycin

B) Acetylcysteine

A client prescribed codeine for a persistent, debilitating cough tells the nurse, "I was sure that codeine was a narcotic that people take for pain." The nurse should cite what mechanism of action when describing this

use of codeine?

A) Stimulation of the reticular activating system (RAS)

B) Vasodilation of the alveolar capillaries

C) Depression of the cough center in the medulla oblongata

D) Desensitization of the cough receptors in the sinuses and trachea

C) Depression of the cough center in the medulla oblongata

A 79-year-old woman has recently moved to a

long-term care facility, and the nurse at the facility

is conducting a medication reconciliation. The nurse

notes that the woman has recently been taking tamoxifen. The nurse is justified in concluding that the woman has a history of what malignancy?

A) Breast cancer

B) Cervical cancer

C) Ovarian cancer

D) Malignant melanoma

A) Breast cancer

A nurse educator is discussing the role of protooncogenes in the pathophysiology of cancer. What typically triggers protooncogenes to differentiate into oncogenes?

A) exposure to a low-pH environment

B) exposure to chemotherapeutic agents

C) ischemia

D) exposure to carcinogens

D) exposure to carcinogens

What is the first action by the oncology nurse when

observing extravasation with the client receiving vincristine?

A) Obtain a photograph of the site.

B) Stop the infusion.

C) Apply warm compresses.

D) Consult the health care provider.

B) Stop the infusion.

An adult client who has been diagnosed with a rectal

tumor is scheduled to begin treatment with cisplatin.

The nurse has conducted client teaching about the

possibility of nausea and vomiting. In order to reduce

the client's risk of severe nausea, the nurse should:

A) administer a combination of antiemetics prior to the

administration of the drug.

B) place the client on a low-residue diet.

C) ensure that the client is NPO from midnight prior to

receiving the drug.

D) encourage the client to request antiemetics if the

nausea becomes unbearable.

A) administer a combination of antiemetics prior to the

administration of the drug.

A nurse administers ondansetron to a client receiving

chemotherapy for which reason?

A) Relieve inflammation

B) Decrease secretions

C) Prevent hypersensitivity

D) Reduce vomiting

D) Reduce vomiting

A client with a diagnosis of bladder cancer is started

on a chemotherapeutic regimen that includes three

agents. What is the rationale for using multiple antineoplastic agents?

A) The use of three agents increases the length of

treatment.

B) The use of three agents decreases the development

of cell resistance.

C) The use of three agents increases the quantity of

one of the agents.

D) The use of three agents decreases the adverse effects.

B) The use of three agents

decreases the development of cell resistance.

What potential benefit is unique to biologic agent therapies?

A) They may be administered long term without the

need for regular blood work.

B) They may affect cancer cells while leaving normal

body cells unaffected.

C) Administered does not require a certified

chemotherapeutic nurse.

D) Cytotoxic adverse effects are rarely experienced.

B) They may affect cancer cells while leaving normal

body cells unaffected.

When describing the process of cancer cell growth

to a client, the nurse addresses angiogenesis. Which

description would the nurse include?

A) A process in which the cells lose their ability to differentiate and organize

B) The process of creating new blood vessels to supply

oxygen and nutrients to the cells

C) The process of growing without the usual homeostatic restrictions that regulate cells

D) A process that involves the cells traveling to other

areas of the body to develop new tumors

B) The process of creating new blood vessels to supply

oxygen and nutrients to the cells

A client's chemotherapeutic regimen includes procarbazine. What is the client's most likely diagnosis?

A) Hodgkin lymphoma

B) Pancreatic cancer

C) Astrocytoma

D) Neuroblastoma

A) Hodgkin lymphoma

A client is being treated on the oncology unit and has

developed worsening adverse effects over the past

several days of chemotherapy. Administration of filgrastim may aid in achieving what desired outcome?

A) Increased platelet levels

B) Resolution of mucositis

C) Prevention of hemorrhagic cystitis

D) Increased leukocytes

D) Increased leukocytes

The nurse is preparing to administer cisplatin to a client. The nurse anticipates the client will also be prescribed which drug to counteract some adverse reactions?

A) Amifostine

B) Dexrazoxane

C) Mesna

D) Leucovorin

A) Amifostine

A 25-year-old female client is prescribed methotrexate

to treat rheumatoid arthritis (RA). The nurse should

teach the client to:

A) drink milk with the medication.

B) use an effective contraceptive.

C) expect a mild rash and itching.

D) take a pain reliever for sore throat.

B) use an effective contraceptive.

The nurse is describing the necessity of recovery periods between treatment cycles to a client receiving chemotherapy. How should the nurse best explain the need?

A) Time is needed to replace many of the healthy body

cells killed by chemotherapy.

B) The restoration of fluid balance and nutrition is

needed before continuing with chemotherapy.

C) Time is required for the successful application of

radiotherapy between cycles of chemotherapy.

D) There is a need to restore a physiologic reserve of

energy before further chemotherapy.

A) Time is needed to

replace many of the

healthy body cells killed by

chemotherapy.

The nurse would contact the health care provider before administering an adrenergic drug to a client who

is also taking which drug?

A) Analgesic

B) Antibiotic

C) MAO inhibitor

D) Diuretic

C) MAO inhibitor

A nurse is implementing a plan of care for a client who has a wound infection. Which of the following actions

is the nurse's priority?

a. Monitor the client for superinfection.

b. Teach the client about wound care.

c. Obtain a wound specimen for culture.

d. Administer antibiotic therapy

c. Obtain a wound specimen for culture.

When asked about drug allergies, a patient says, "I can't take sulfa drugs because I'm allergic to them."

Which question should the nurse ask next?

a. Who prescribed that medication for you?

b. What happened when you took the sulfa drug?

c. Do you have any other drug allergies?

d. How long ago did this happen?

b. What happened when you took the sulfa drug?

What interventions should the nurse implement in a 50-year-old patient with bronchitis who is receiving TMP-SMZ and Lisinopril (Zestril)? (Select all that apply.)

a. Encourage fluids

b. Administer laxatives

c. Observer for undesired side effects

d. Monitor urinary output

e. Assess lung sounds

a. Encourage fluids

c. Observer for undesired side effects

d. Monitor urinary output

e. Assess lung sounds

The nurse knows the use of tetracyclines is limited in children because of which adverse effect?

a. Discoloration of teeth

b. Threat of sunburn

c. Stunting of the growth plate

d. Pseudomembranous colitis

a. Discoloration of teeth

Which drug(s), if prescribed for a patient taking docycycline (Vibramycin), will the nurse question? (Select all

that apply.)

a. Antacids

b. Prenatal vitamins

c. Warfarin

d. Morphine

a. Antacids

b. Prenatal vitamins

c. Warfarin

The patient tells the nurse that she has developed vaginal discharge since she began taking minocycline

(Minocin) for acne. What does the nurse suspect may

be occurring?

a. The patient has been exposed to other infectious

agents.

b. The patient is experiencing an allergic reaction.

c. A drug-drug interaction is taking place.

d. A superinfection has developed.

d. A superinfection has developed.

A patient has a new prescription for erythromycin.

The nurse should include which information in patient

teaching? (Select all that apply.)

a. If GI irritation occurs, the patient can take the drug

with a small snack.

b. If GI upset occurs the drug will have to be discontinued.

c. Each dose should be taken with a sip of water.

d. Use another form of birth control if the patient is

taking oral contraceptives.

e. The drug may be taken with an antacid to avoid GI

problems.

a. If GI irritation occurs, the patient can take the drug

with a small snack. d. Use another form of birth control if the patient is

taking oral contraceptives.

What nursing assessments would be important to perform prior to the initiation of a macrolide antibiotic?

(Select all that apply.)

a. Urinalysis

b. Current medication list for potential drug interac-

tions

c. Baseline hearing function

d. Baseline liver function

e. Baseline cardiac function

b. Current medication list for potential drug interactions

c. Baseline hearing function

d. Baseline liver function

e. Baseline cardiac function

macrolide antibiotic commonly known to cause the

greatest amount of GI distress:

erythromycin

azithromycin

clarithromycin

erythromycin

During intravenous quinolone therapy in an

88-year-old patient, which potential problem is of most

concern when assessing for adverse effects?

a. Tendon rupture

b. Nephrotoxicity

c. Rhabdomyolysis

d. Hepatotoxicity

a. Tendon rupture

A patient prescribed nitrofurantoin (Macrodantin) for

a UTI should be advised by the nurse to contact the

health care prescriber immediately if which condition develops?

a. Frequency in urination

b. Brown urine

c. Diarrhea

d. Swelling around the eyes and lips

d. Swelling around the eyes and lips

The nurse is doing a morning assessment on a

65-year-old patient who is receiving vancomycin. The

patient states that her ears have been ringing all night.

What does the nurse know about vancomycin and

ringing in the ears?

a. Only low-pitched sounds are affected by van-

comycin.

b. Tinnitus is a sign of vancomycin allergy.

c. Ototoxicity is caused by damage to cranial nerve

VIII.

d. Only female patients have ringing in their ears.

c. Ototoxicity is caused by damage to cranial nerve

VIII.

A nurse is teaching a client who has a severe UTI

about ciprofloxacin. Which of the following information about adverse reactions should the nurse include?

(Select all that apply.)

a. Expect excessive night time perspiration.

b. Take the medication with milk.

c. Inspect the mouth for cottage cheese-like lesions.

d. Observe for pain and swelling of the Achilles ten-

don.

e. Watch for vaginal yeast infection.

c. Inspect the mouth for cottage cheese-like lesions.

d. Observe for pain and swelling of the Achilles ten-

don.

e. Watch for vaginal yeast infection.

A 58-year-old man is receiving vancomycin as part of

the treatment for a severe bone infection. After the

infusion, he begins to experience some itching and flushing of the neck, face, and upper body. He reports

no chills or difficulty breathing. What does the nurse

suspect is happening?

a. An allergic reaction has occurred.

b. An anaphylactic reaction is about to occur.

c. The IV dose may have infused too quickly.

d. The medication will not be effective for the bone

infection.

c. The IV dose may have infused too quickly.

The trough level that the nurse drew for a patient

taking gentamicin (Garamycin) is 3.5 mcg/ml. What is

the best action by the nurse?

a. Repeat the trough level after the next dose of medication.

b. Give the patient Benadryl to decrease the risk of a

reaction.

c. Hold the mediation and contact the health care

provider.

d. Administer the medication at the correct time.

c. Hold the mediation and contact the health care

provider.

Metronidazole is primarily used for treatment of disorders caused by organisms in which area of the body?

a. Respiratory tract

b. Urinary tract

c. Gastrointestinal tract

d. Peripheral nervous system

c. Gastrointestinal tract

What symptom(s) will the nurse advise the patient

taking metronidazole to report to the health care

provider? (Select all that apply.)

a. Diarrhea

b. Photophobia

c. Numbness and tingling of the

hands

d. Headache

e. New, unusual bruising or bleeding

f. Urinary urgency

a. Diarrhea

c. Numbness and tingling of the

hands

d. Headache

e. New, unusual bruising or bleeding

A nurse is providing education to a client who has a

new prescription for oral linezolid (Zyvox) to treat a skin

infection. The nurse should instruct the client to avoid

which foods? (Select all that apply.)

a. Aged cheeses

b. Pickled herring

c. Red wine

d. Juices

e. Wheat bread

f. Salami

a. Aged cheeses

b. Pickled herring

c. Red wine

f. Salami

A patient has a new order for clindamycin (Cleocin) for treatment of chronic osteomyelitis. The nurse know

that which co-existing condition(s) would pose a contraindication to the use of this drug? (Select all that

apply.)

a. QT prolongation

b. Renal insufficiency

c. Allergy

d. Ulcerative coliti/ c. dificcle

c. Allergy

d. Ulcerative coliti/c. dificcle

The nurse is reviewing the therapeutic effects of NSAIDs. Which effect should the nurse include?

A. Antimicrobial
B. Antipyretic
C. Sedative
D. Anxiolytic

B. Antipyretic

Which client should the nurse question an ibuprofen prescription for?

A. A client with seasonal allergies
B. A client with chronic kidney disease
C. A client with hypothyroidism
D. A client with migraine headaches

B. A client with chronic kidney disease

Which statement by a client taking ibuprofen indicates understanding?

A. “I will take aspirin with this medication for additional pain relief.”
B. “I will report black, tarry stools.”
C. “I should take this medication on an empty stomach.”
D. “Garlic supplements will protect my stomach.”

B. “I will report black, tarry stools.”

A client with coronary artery disease asks why aspirin 81 mg is prescribed daily. Which response is correct?

A. “It decreases anxiety.”
B. “It prevents platelet aggregation and clot formation.”
C. “It lowers your cholesterol.”
D. “It increases your cardiac output.”

B. “It prevents platelet aggregation and clot formation.”

A child has chickenpox and a temperature of 102.9°F. Which instruction should the nurse provide?

A. Administer aspirin every 4 hours.
B. Alternate aspirin and ibuprofen.
C. Use acetaminophen instead of aspirin.
D. Avoid all antipyretic medications.

C. Use acetaminophen instead of aspirin.

Which finding is most consistent with salicylate toxicity?

A. Constipation and bradycardia
B. Tinnitus, confusion, and hyperventilation
C. Urinary retention and pinpoint pupils
D. Jaundice and clay-colored stool

B. Tinnitus, confusion, and hyperventilation

Which statement best describes celecoxib?

A. It selectively inhibits COX-2 to reduce pain and inflammation.
B. It activates COX-1 to protect the stomach.
C. It directly blocks opioid receptors.
D. It increases prostaglandin production.

A. It selectively inhibits COX-2 to reduce pain and inflammation.

Which history is most concerning before administering celecoxib?

A. Seasonal allergies
B. Recent coronary artery bypass graft surgery
C. Motion sickness
D. Iron-deficiency anemia

B. Recent coronary artery bypass graft surgery

Which statement by a client taking prednisone indicates a need for further teaching?

A. “I will take the medication with food.”
B. “I will report fever or signs of infection.”
C. “I can stop taking it as soon as I feel better.”
D. “The medication can increase my blood glucose.”

C. “I can stop taking it as soon as I feel better.”

Which adverse effects should the nurse monitor in a client receiving long-term prednisone? Select all that apply.

A. Hyperglycemia
B. Increased infection risk
C. Osteoporosis
D. Adrenal suppression
E. Hypotension from the first dose
F. Delayed wound healing

A. Hyperglycemia
B. Increased infection risk
C. Osteoporosis
D. Adrenal suppression
F. Delayed wound healing

Which statement about allopurinol is correct?

A. It immediately relieves pain during an acute gout attack.
B. It decreases uric-acid production to prevent future attacks.
C. It increases leukocyte migration into the joint.
D. It increases renal reabsorption of uric acid.

B. It decreases uric-acid production to prevent future attacks.

Which finding requires immediate action in a client taking allopurinol?

A. Mild nausea after the dose
B. Increased urinary output
C. A new widespread rash
D. Decreased joint discomfort

C. A new widespread rash

Which laboratory result demonstrates that allopurinol is effective?

A. Decreased serum uric acid
B. Increased platelet count
C. Increased hemoglobin
D. Decreased INR

A. Decreased serum uric acid

A postoperative client is groggy and requests morphine for severe pain. Which finding is most important before administration?

A. Bowel sounds
B. Respiratory rate and level of consciousness
C. Time of the last bowel movement
D. Incision length

B. Respiratory rate and level of consciousness

A client receiving morphine has respirations of 7/min, pinpoint pupils, and cannot remain awake. Which action is the priority?

A. Place the client flat and reassess in 30 minutes.
B. Support ventilation and administer naloxone.
C. Administer another dose for breakthrough pain.
D. Encourage oral fluids.

B. Support ventilation and administer naloxone.

A client improves after receiving naloxone for an opioid overdose. Which action remains essential?

A. Discharge the client immediately.
B. Monitor for recurrent respiratory depression.
C. Withhold oxygen to evaluate respiratory function.
D. Administer a benzodiazepine.

B. Monitor for recurrent respiratory depression.

Which teaching should the nurse include for a client discharged with an opioid?

A. Restrict fluids to prevent urinary retention.
B. Use measures to prevent constipation.
C. Take the medication only on an empty stomach.
D. Increase the dose when tolerance develops.

B. Use measures to prevent constipation.

A client requires progressively larger opioid doses to obtain the same pain relief. How should the nurse interpret this finding?

A. Addiction
B. Tolerance
C. Withdrawal
D. Allergy

B. Tolerance

The nurse should question butorphanol for which client?

A. A client who is physically dependent on a full opioid agonist
B. A client with mild postoperative pain
C. A client with acetaminophen allergy
D. A client with chronic constipation

A. A client who is physically dependent on a full opioid agonist

Which client should not receive acetaminophen without further evaluation?

A. A client with a mild headache
B. A client with liver disease
C. A client with peptic ulcer disease
D. A client with seasonal allergies

B. A client with liver disease

What is the most serious effect of an acute acetaminophen overdose?

A. Respiratory depression
B. Hepatic necrosis
C. Tendon rupture
D. Gastrointestinal hemorrhage

B. Hepatic necrosis

Which medication should the nurse anticipate for acetaminophen overdose?

A. Naloxone
B. Acetylcysteine
C. Leucovorin
D. Flumazenil

B. Acetylcysteine

A client has received ketorolac for five days and continues to report pain. Which action should the nurse take?

A. Request continuation for another five days.
B. Hold the medication and contact the provider.
C. Administer it with ibuprofen.
D. Double the ketorolac dose.

B. Hold the medication and contact the provider.

Which client should not receive ketorolac?

A. A client with active gastrointestinal bleeding
B. A client with neuropathic pain
C. A client with allergic rhinitis
D. A client with a tension headache

A. A client with active gastrointestinal bleeding

Which finding is an early manifestation of systemic lidocaine toxicity?

A. Circumoral numbness, metallic taste, and tinnitus
B. Diarrhea and abdominal cramping
C. Polyuria and excessive thirst
D. Jaundice and clay-colored stool

A. Circumoral numbness, metallic taste, and tinnitus

A client develops seizures and dysrhythmias after receiving lidocaine. Which treatment should the nurse anticipate?

A. Acetylcysteine
B. Intravenous lipid emulsion
C. Naloxone
D. Protamine sulfate

B. Intravenous lipid emulsion

A client receives gabapentin despite having no seizure disorder. Which indication is most likely?

A. Acute inflammatory pain
B. Neuropathic pain
C. Migraine vasoconstriction
D. Opioid overdose

B. Neuropathic pain

Which instruction should the nurse provide to a client taking gabapentin?

A. Stop the medication immediately when pain improves.
B. Avoid driving until the medication’s effects are known.
C. Take magnesium antacids with each dose.
D. Expect increased alertness.

B. Avoid driving until the medication’s effects are known.

How does sumatriptan relieve an acute migraine?

A. It blocks acetylcholine at skeletal muscles.
B. It activates serotonin receptors and constricts cranial vessels.
C. It increases CGRP activity.
D. It inhibits uric-acid production.

B. It activates serotonin receptors and constricts cranial vessels.

Which client should not receive sumatriptan?

A. A client with coronary artery disease
B. A client with seasonal allergies
C. A client with gout
D. A client with iron-deficiency anemia

A. A client with coronary artery disease

A client taking an SSRI receives sumatriptan. Which findings suggest serotonin syndrome?

A. Bradycardia, constipation, and hypothermia
B. Agitation, diaphoresis, hyperreflexia, and fever
C. Tinnitus, hyperventilation, and confusion
D. Pinpoint pupils and respiratory depression

B. Agitation, diaphoresis, hyperreflexia, and fever

Why might ubrogepant be selected instead of sumatriptan for a client with cardiovascular disease?

A. Ubrogepant does not produce therapeutic vasoconstriction.
B. Ubrogepant permanently prevents migraines.
C. Ubrogepant is an opioid antagonist.
D. Ubrogepant increases platelet aggregation

A. Ubrogepant does not produce therapeutic vasoconstriction.