PHARM 2 FINAL
1.) A nurse is caring for a client admitted with chest pain. The client's initial troponin one level is within normal limits, but six hours later, it shows significant elevation. How would the nurse interpret the change in the troponin level 1?
-The elevation indicates myocardial injury is likely to occur between the initial and subsequent tests, suggesting an evolving myocardial infarction.
2.) A nurse is reviewing an ECG rhythm strip of a patient taking atenolol who reports dizziness and fatigue. The ECG shows a heart rate of 52bpm, a regular rhythm, a P wave before each two QRS complex, a PR interval of zero point one eight seconds, and a QRS duration of zero point one zero seconds. Which nursing action is a priority based on this ECG interpretation?
-Withhold the atenolol dose and notify the provider about the bradycardia and the symptoms
3.) A nurse is reviewing an EKG of a patient whose heart rate is 45bpm and is complaining of dizziness and fatigue. Which action should the nurse take first?
· Administer atropine as prescribed to increase your heart rate
4.) A nurse is reviewing a client's medical record who has anemia. Which of the following findings in the client's past medical history should the nurse anticipate?
· Renal dysfunction
5.) A nurse is reinforcing the potential adverse effects of statin therapy with the client who has recently started taking this medication. Which of the following symptoms should the nurse reinforce as important to report?
-Muscle pain
6.) A nurse is collecting data from a client who has been diagnosed with severe dyslipidemia. Which of the following manifestations should the nurse recognize as directly associated with this condition?
-Xanthomas around the eyes
7.) A nurse is caring for a client who had been administered alteplase following an acute MI. Which of the following manifestations should the nurse prioritize for immediate intervention?
-Sudden and severe headache
8.) A nurse is reinforcing teaching to a client about the risk factors of MI. Which of the following should the nurse include as a common cause of MI?
· Atherosclerosis
9.) A nurse is reinforcing teaching with a client who has been prescribed enoxaparin for DVT. Which of the following instructions should the nurse include regarding the administration of the medication?
-Inject the medication 2 inches away from the umbilicus
10.) A nurse is collecting data from a client’s who has been prescribed anticoagulant therapy. Which of the following clients should the nurse identify as having a contraindication to the prescribed medication?
-A client who has peptic ulcer disease and hx of GI bleed
11.) A nurse is reviewing a medical record of a client prescribed eplerenone. Which of the findings is a priority for the nurse to check prior to administering this medication?
-Lab for creatine clearance
12.) A nurse is assisting in the care of a client who was newly diagnosed with hypertension. Which of the following medications should the nurse expect to be prescribed to the client?
-Hydrochlorothiazide /HTCZ
13.) A nurse is caring for a client who is being managed for hypertension and stable angina. Which of the following medications should the nurse to expect will be prescribed for this client?
-Nifedipine/ pericardium
14.) A nurse is caring for a client who has a prescription for hydralazine for hypertension. Which of the following classes of medication should the nurse identify hydralazine belongs to?
-vasodilator
15.) A nurse is assisting in the care of a client who has a new prescription for metoprolol. Which of the following classes of medications should the nurse identify metoprolol belongs to?
-beta-blocker
16.) A nurse is evaluating a client presenting with reports of a regular heartbeat and chest pain. The client's ECG indicates an irregular rhythm with a heart rate of 130 and no discernible P wave. Considering the client's clinical presentation and the ECG findings, which of the following Arrhythmias should the nurse identify?
-AFIB
17.) A nurse is caring for a client who has heart failure and is prescribed nitroglycerin. Which of the following describes the effect the medication has on the body?
-improves the blood flow to the heart
18.) A nurse is reviewing a medication list of a client who has heart failure. Which medication is classified as a potassium-sparing diuretic that helps prevent fluid overload?
-spironolactone
19.) A nurse is reinforcing education with a client who has heart failure on the importance of managing hypertension. Which medication is an angiotensin-converting enzyme (ACE) inhibitor that prevents vasoconstriction?
-lisinopril
20.) A nurse is caring for a client who has heart failure and is prescribed a beta blocker. Which medication belongs to the beta-blocker classification?
-carvedilol
21.) The nurse is reviewing the effects of heart failure on the body. Which of the effects should the nurse identify as a result of the heart's reduced ability to pump blood effectively in heart failure?
-increased peripheral edema
22.) A nurse is collecting data on a client who has right-sided heart failure. Which of the following findings should the nurse expect?
-JVD
23.) A client with heart failure is taking digoxin and has recently been prescribed amiodarone. The nurse notes the client's potassium level is 3.3, and the digoxin level is 2. What clinical manifestations should the nurse prioritize for early recognition of digoxin toxicity?
-Nausea, blurred vision with green and yellow halo
24.) A 68yr old patient with AFIB is prescribed digoxin. A nurse notes the patient's potassium level is 3.2. What is the priority nursing action?
· Hold the digoxin
25.) A nurse is reinforcing teaching with a client who has cerebral edema and a prescription for mannitol. Which of the following statements should the nurse include?
· expect an increase in urine output
26.) A nurse is reviewing a laboratory result of a client who is taking hydrochlorothiazide. Which of the following laboratory findings should the nurse recognize as a contraindication for continuing this medication?
· Potassium
27.) A nurse is preparing to administer Lasix to a client who has heart failure, for which of the following conditions should the nurse withhold the medication and notify the charge nurse?
· Hypokalemia
28.) A nurse is caring for a client who is prescribed a diuretic medication, spironolactone. Which of the following classes of diuretics should the nurse educate the client on?
· Potassium sparing
29.) A nurse is caring for a client who has heart failure and is prescribed a diuretic medication. Which of the following classes of diuretic medications should the nurse recognize as the most commonly prescribed for a client who has heart failure?
· Loop
30.) A nurse is reviewing a schedule of immunizations and notes that certain vaccines require a series of doses for full efficiency. Which of the following vaccines should the nurse identify typically requires a three-dose series to complete the initial immunization process?
· Hepatitis B Vaccine
31.) A nurse is reinforcing teaching with a client who has been prescribed oral alkylating agents as part of their cancer treatment. Which of the following pieces of information should the nurse include?
· You should wear gloves
32.) A nurse is reinforcing the characteristics of different types of cancer with a group of newly licensed nurses. Which of the following statements should the nurse make?
· A sarcoma affects bones and soft tissue, including fats and muscles
33.) A nurse is reinforcing teaching for a client who has been prescribed nirmatrelvir/ ritonavir to treat COVID-19 manifestations. Which of the following statements by the client shows effective teaching?
· This medication has a lot of drug interactions
34.) A nurse is collecting data from a client with respiratory distress, fever, and influenza exposure in the past 36 hours. Which of the following should the nurse anticipate?
· The client will start antivirals immediately regardless of test results
35.) A nurse is collecting data from a client who has been diagnosed with a reinfection of hepatitis C. The client states, “Why did my health care provider order a test to know what subtype of hepatitis C I have”?
· You must know what subtype of hepatitis C is present in your body to help the provider prescribe the most effective medication.
36.) A nurse is collecting data from a client diagnosed with HIV who has not taken antiviral therapy. Which manifestation could indicate the client's HIV has progressed to the AIDS phase?
· Lymph node swelling and poorly healing sores in the mouth
37.) A nurse is preparing to administer a mixture of 10 units of NPH insulin and 5 units of regular insulin to a client. Which action demonstrates the safest technique for mixing these insulin for maintaining their effectiveness?
· You must inject air first
38.) A nurse is collecting data on a client who has been taking methimazole for treatment for hyperthyroidism. Which of the following findings should the nurse identify as a potential serious hematological adverse effect?
· Thrombocytopenia
39.) A nurse is reinforcing teaching to a client who has hypothyroidism about medication administration of levothyroxine. Which of the following statements by the nurse should be included in this teaching?
· Take with a full glass of water 30 – 60 minutes before breakfast
40.) A nurse is reinforcing teaching to a client who is scheduled to receive radioactive iodine therapy about dietary considerations. Which of the following client statements indicates an understanding of the dietary restrictions?
· I should avoid foods high in iodine
41.) A nurse is reviewing the medication profile of a client who has type 2 diabetes mellitus and is considering the initiation of sulfonylureas. Which of the following client conditions would be a contraindication for the sulfonylurea?
· The client is currently experiencing DKA
42.) A nurse is reinforcing teaching with a client who has diabetes about managing hypoglycemia. Which of the following actions should the nurse instruct the client to take immediately upon experiencing the manifestations of hypoglycemia?
· Consume 15- 20 grams of simple carbohydrates
43.) A nurse is teaching a client about the significant adverse effects of oral hypoglycemic medication. Which of the following adverse effects should the nurse instruct the client to seek medical attention immediately due to its life-threatening potential?
· Lactic acidosis related to metformin use
44.) A nurse is reviewing the potential side effects of antihistamines with a client who has Meniere’s disease. Which of the following side effects should the nurse include as a result of the medication's anticholinergic effect?
- Dry eyes, with blurred vision
45.) A nurse is reviewing the medical history of a client scheduled to receive an anti-VEGF intravitreal injection for the treatment of wet age-related macular degeneration. Which of the following findings in the client's HX should the nurse recognize as a contraindication for this procedure?
- The client has a history of a heart attack 2 yrs ago
46.) A nurse is assisting with counseling clients at a community health fair about the safe use of OTC medication. Which of the following clients should the nurse reinforce teaching to before seeking a consult with a health care provider before taking antihistamines?
- A 58-year-old patient who has BPH
47.) A nurse is preparing to administer meclizine to a client who has vertigo. Which action of meclizine should the nurse include for the client as part of the education reinforcement?
- Meclizine blocks histamine H1 receptors that have an anticholinergic effect, which controls vertigo
48.) A nurse is providing care to a client experiencing severe allergic manifestations. Which of the following medications should the nurse recognize as a first-generation antihistamine that may also provide relief for vertigo and motion sickness?
- Meclizine
49.) A nurse is reinforcing education to a client who has a new diagnosis of dry age-related macular degeneration. Which of the following supplements should the nurse reinforce that the client takes daily to slow the progression of vision loss?
- Vitamin C
50.) A nurse is reviewing a treatment plan for a client who has a diagnosis of wet age-related macular degeneration. Which of the following medications should the nurse anticipate will be prescribed to slow the progression of the disease?
- VEGF injection/
51.) A nurse is preparing to administer methohexital for a client undergoing a short surgical procedure. Which of the following actions is most important for the nurse to take prior to administration?
- Ensure you have resuscitation equipment
52.) A nurse is reinforcing education with a client about the impact of hormonal imbalance on health. Which of the following conditions is directly associated with polycystic ovarian syndrome PCOS and clients assigned female at birth?
- Elevated blood glucose
53.) A nurse is assisting in the care of a client who is experiencing menopause. For which of the following effects of low estrogen levels should the nurse monitor the client?
- Pain during sexual intercourse
54.) A nurse is reinforcing education with a client who is experiencing infertility. Which of the following clients’ statements indicates an understanding of the education?
- A break in your hormone cycle can prevent my ovaries from producing or releasing a mature ovum
55.) A nurse is caring for a client who has been diagnosed with H. Pylori. Which of the following medications should the nurse expect the provider to prescribe?
- Amoxicillin antibiotic
56.) A nurse is reinforcing teaching to a client about the mechanism of action of a medication prescribed for irritable bowel syndrome with constipation. Which of the following pharmacological actions should the nurse describe as being a characteristic of medications used to treat IBS?
- Increasing fluid secretions in the intestines to soften the stool and promote bowel movement
57.) A nurse is reviewing the medical history of a client who has been prescribed diazepam, a benzodiazepine medication. Which of the following client conditions alerts the nurse that benzodiazepines are contraindicated?
- Angle glaucoma closure
58.) A nurse is preparing to administer medication to a client experiencing severe anxiety and muscle spasms. Which of the following medication classifications can treat both conditions?
- Benzodiazepine
59.) A nurse is reinforcing teaching with a client on the use of onabotulinum toxin (Botox) for managing spasticity. Which of the following classifications of Botox belongs to?
- Neuromuscular blocking agent
60.) A nurse is reviewing a client's chart who is prescribed a muscle relaxant. Which of the following is classified as a peripheral-acting muscle relaxant?
- Dantrolene
61.) A nurse in a provider's office is reviewing several electronic medical records of a client to prepare for their visit. Which of the following clients should the nurse anticipate and observe for spasticity?
- A client who had a stroke a month ago