PHARM 503 ATI A
1. A nurse is caring for a client who has acute angle closure glaucoma and has been receiving a
continuous IV infusion of mannitol 25% for one hour which of the following adverse affects should the
nur
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PHARM 503 ATI A
1. A nurse is caring for a client who has acute angle closure glaucoma and has been receiving a
continuous IV infusion of mannitol 25% for one hour which of the following adverse affects should the
nurse report to the provider immediately
a. Peripheral edema
i. The greatest risk to the client receiving mannitol IV is development of heart failure therefore
the nurse should report peripheral edema to the provider immediately
2. A nurse is providing teaching to a client with peptic ulcer disease and is to start a new prescription for
sucralfate. The nurse explain to the client with medication
a. Forms a protective barrier over ulcers
i. Sucralfate a mucosal protectant forms a gel like substance coating the ulcer creating a barrier to
hydrochloric acid
3. Nurse is caring for a client who is 24 hour post operative following abdominal surgery and has been
taking morphine sulfate PRN for incisional pain the nurse should assess the client for which of the
following adverse affects
a. Urinary retention
i. morphine increases bladder sphincter and detrussor muscle tone as well as dulling the clients
ability to perceive bladder fullness resulting in urinary retention
4. A nurse is providing teaching about insulin glargine to a client who has type I diabetes mellitus. Which
of the following should the nurse include in the instructions
a. Do not mix this medication in a syringe with other insulins
i. insulin glargine does not cause peaks instead it maintains a study blood level over a 24 hour
period which reduces the risk of hypoglycemia
5. A nurse is caring for a client who is taking acetazolamide for chronic open angle glaucoma for which of
the following adverse affects should the nurse instruct the client to monitor and report
a. Tingling of fingers
i. Hyperglycemia rather than hypoglycemia is an adverse effect of Acetazolaminde
6. A client is just diagnosed with tuberculosis and is prescribed a for medication regimen of isoniazid ,
pyrainamide, rifampin, and ethambutol. The client asks why he has to take so many pills. Which of the
following is an appropriate response by the nurse
a. This regimen will eliminate various combinations of resistant strains of TB
i. The risk of undesired effects increases with multi medication therapy
7. The nurse is caring for a client who is receiving long term treatment for systemic lupus erythematosus
with prednisone the nurse should inform the client to expect to undergo which of the following
diagnostic test to monitor for long-term complications
a. Bone density scans
i. Adverse effects of glucocorticoids include osteoporosis which is monitored with regular
schedule bone density scans
8. At 0900 a nurse is preparing the clients medications based on the chart findings which of the following
medications should the nurse administer first
a. Sodium polystyrene sulfate
i. You do not need to give pain medication first if the patient's pain is only moderate
9. A nurse is caring for a client who has pneumonia the client tells nurse she is pregnant but has not told
her provider which of the following medication orders should the nurse question
a. Doxycycline
i. pregnancy is a contraindication for doxycycline, a tetracycline antibiotic, due to the
medications adverse affects on developing bones and teeth
10. A nurse is caring for a client to his heart failure and is prescribe enalapril the nurse should monitor the
client for which of the following
a. Hyperkalemia
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i. a client taking enalapril can develop hyperkalemia due to potassium retention by the kidneys
11. A nurses in a providers office is assessing a client who has been taking aspirin daily. For the past year
which of the following findings should the nurse notify the provider immediately
a. Hyperventilation
i. aspirin may cause gastrointestinal distress including heartburn but that is not the most urgent
finding
12. A nurse is caring for an older adult client. The client received 0.9% sodium chloride 1L over 4 hr
instead of over 8hr as prescribed which of the following entries is appropriate documentation of this
occurrence in the clients medical record.
a. 0.9% sodium chloride 1L IV infused over 4 hr. Vital signs stable
i. The nurse should only chart factual information without using judgmental language in the
medical record
13. Nurse is caring for a client who is starting a new prescription for warfarin which of the following
medication should the nurse plan to administer if the clients experiences bleeding
a. Vitamin K
i. Vitamin K as an antodone acetylcysteine is the antidote for warfarin toxicity
14. A nurse is monitoring clients receiving an IV infusion of magnesium sulfate for preterm labor which of
the following findings indicate to the nurse that the client is experiencing magnesium toxicity
a. Decreased level of consciousness
i. magnesium toxicity results in central nervous system depression
15. A nurse is caring for a client who is taking tamoxifen for the treatment of breast cancer the nurse
informed the client that which of the following side effects can develop select all that apply
a. Menstrual irregularities
b. hot flashes
c. bruising
i. Tamoxifen is an anti-estrogen medication
16. A nurse is caring for a client to the emergency department following a diazepam overdose the nurse
should administer which of the following medications
a. Flumazenil
i. Is the reversal agent for benzodiazepine toxicity
17. A nurse is assessing a client who is taking propylthiouracil for treatment of. Graves' disease which of
the following findings indicate the fact of this of this medication
a. Increase in ability to focus
i. a client who has Graves' disease has difficulty focusing and increased ability to focus indicates
effectiveness of the medication
18. A nurses providing teaching to a client who has depression and is prescribed fluoxetine which of the
following statements indicates to the nurse and the client understands the teaching
a. I should take acetaminophen instead of ibuprofen for my headaches while taking this medication
i. You do not need a tyramine restriction for this kind of medication
19. A nurse is caring for a client who is to start therapy with benztropine for which of the following
findings should the nurse monitor
a. Tachycardia
i. benztropine is an anti-cholinergic agent
20. A nurse is providing teaching for a client who is to begin pharmacological therapy for a new diagnosis
of asthma which of the following medications should the nurse instruct the client to use during an acute
asthma attack
a. Albuterol
i. albuterol is a short acting beta 2 adrenergic agonist which causes bronchodilation relieves
bronchospasm during acute asthma attacks the nurse should instruct the client to keep
medication nearby for emergency use
21. A nurse is playing to provide medication education for client to begin a course of therapy with
metronidazole which of the following should the nurse instruct the client to avoid during the course of
therapy
a. Beer
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i. the combination of metronidazole and alcohol can cause a disulfiram like reaction that can
include severe vomiting hypotension and weakness
22. A client is receiving a second dose of IV cefazolin
postoperatively. The nurse notes uriticaria, dysrhythmia anxiety and
hypotension. Which of the following should the nurse anticipate
administering?
a. Parenteral epinephrine
i. The client findings indicate an allergic reaction to cefazolin therefore
the nurse should anticipate administering parenteral epinephrine to
induce vasoconstriction and bronchodilation
23. A nurses providing teaching to a client regarding the administration of Ferrous sulfate which of the
following instruction should the nurse include in the teaching
a. Take the tablet on an empty stomach
i. black stools are a common and harmless side effect of oral iron administration
24. And nurses providing teaching to a client who is taking tetracycline PO and reports gastrointestinal
distress which of the following should the nurse include in the teaching
a. Take the medication with applesauce
i. to reduce gastrointestinal distress the client should take the medication with food such as
applesauce
25. A client newly diagnosed with hypothyroidism is prescribed levothyroxine 0.25 mg PO daily after six
weeks of treatment the nurse determines that the medication was effective if the
a. Thyroid stimulating hormone level is 2 microunits/milliliter
i. Measuring TSH is the most sensitive method for determining thyroid activity a TSH level 2
micro units per milliliter indicates appropriate thyroid activity
26. A nurse Is providing teaching to a client who is diagnosed with migraine headaches the client is
prescribed something ergotamine sublingual which of the following should the nurse include in her
instructions
a. Take one tablet at onset of migraine
i. one tablet should be taken immediately after the unsent of aura or headache
27. A nurse is providing teaching to a client who has a new prescription for phenytoin. Which of the
following statements by the client indicates an understanding of the teaching
a. I should let my dentist know I'm taking this medication
i. The client should NOT take phenytoin with milk or other calcium-containing foods because
phenytoin can decrease the absorption of calcium and vitamin D
28. A nurses providing teaching to a client who is to start therapy with digoxin which of the following
should the nurse instruct the client to monitor and report
a. Yellow tinged vision
i. The nurse should instruct the client to monitor for and report yellow tinged vision which is a
sign of digoxin toxicity and should be reported to the provider
29. A nurse administers ceftazidime to a client who has a sever penicillin allergy. Which of the following
requires and incident report
a. The client reports shortness of breath
i. Severe penicillin allergy is a contraindication for ceftazidime, a cephalosporin antibiotic, due to
the potential for cross sensitivity. Shortness of breath can indicate anaphylaxis
30. A nurse is assessing a client whose taking Indomethacin which of the following should the nurse
monitor to evaluate the medications effectiveness
a. Reduced pain
i. indomethacin is a nonsteroidal anti-inflammatory medication which reduces pain and
inflammation
31. A nurse is caring for a client who has just been transferred from the PACU to the medical-surgical unit
following colon resection the client reports pain of an eight on a scale from 0 to 10 and has a
prescription for morphine sulfate 4 mg IV bolus PRN pain every two hours which of the following
actions should the nurse take first
a. Check the clients PAC you medication record first
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i. administering morphine sulfate is an appropriate action but is not the first action the nurse
should take you need to know your client
32. A nurse is preparing to administer hydromorphone for a postoperative client which of the following
indicates that the nurse should withhold the next dose of the medication
a. A clients respiratory rate is eight per minute
i. The clients respiratory rate is below expected reference range there for the nurse should
withhold medication
33. A nurse is planning teaching for a child who has been prescribed fluticasone propionate for chronic
asthma the nurse plans to teach the child to use a spacer to minimize the risk for which of the following
a. Candidiasis of the mouth
i. Side effects of inhaled corticosteroids include dysphonia and oral candidiasis using a spacer
and rinsing the mouth after inhalation will minimize the amount of medication remaining in the
oropharynx preventing the development of the side effects
34. A client who has a history of hypertension tells the nurse that he uses over-the-counter oral
decongestants for nasal congestion the nurse should advise the client that decongestants
a. Constrict blood vessels
i. sympathomimetics work by constricting blood vessels which relieves congestion however this
vasoconstrictive effects can also increase blood pressure
35. A nurse is providing teaching to a client who is to begin taking oxybutynin for urinary incontinence
which of the following symptoms should the nurse tell the client to expect. ( all that apply)
a. Dry mouth
b. blurred vision
c. photophobia
i. Oxybutynin is an anti-cholinergic agents that can cause dry mouth
ii. Oxybutynin is an anticholinergic agents that can cause blurred vision
iii. Oxybutynin is an anti-cholinergic agent that can cause photophobia
36. A nurse is planning to teach a client about taking methotrexate for which of the following should the
nurse instruct the client to monitor and report to the provider
a. Fever
i. methotrexate an immunosuppressant can cause bone marrow suppression the nurse should
advise the client to muncher any poor indications of infection such as fever or sore throat
37. A nurse is administering donepezil to a client who has Alzheimer's disease. Which of the following
documented findings should the nurse report to the provider immediately
a. Dyspnea
i. Using ABC priority setting framework, the greatest risk to the client is dyspnea as a result of
bronchoconstriction caused by elevated acetylcholine levels in the lungs.
38. A nurse is caring for a client who is candidiasis which of the following medications to the nurse expect
to administer
a. Fluconasole
i. Is an antifungal medication effective for treating oral pharyngeal and systemic candidiasis
39. A nurse is administering baclofen for a client who has a spinal cord injury which of the following
should the nurse document as a therapeutic outcome
a. Decrease in flexor and extensor spasticity
i. baclofen decreases the frequency and severity of muscle spasm's allowing for improved muscle
function
40. A nurse is caring for a client is experiencing acute alcohol withdrawal for. Which of the following is a
client prescribed chlordiazepoxide
a. Prevent delirium tremens
i. the client should take chlordiazepoxide to prevent delirium tremens for client experiencing
acute alcohol withdrawal
ii. A treatment of the benzodiazepine group used to treat anxiety and alcohol withdrawal
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41. The nurse is preparing to administer amoxicillin 250 mg PO to a school aged child, available is
amoxicillin oral suspension 200 mg over 5 mL how many milliliters should the nurse administer. round
to the nearest 10th
a. 6.3
i. 250 mg times 5 mL divided by 200 mg
42. A nurses caring for a client who is receiving haloperidol for which of the following adverse affects of
the nurse be observing
a. Akathisia
i. Akathisia is an extra extrapyramidal symptom that can be caused by haloperidol
43. A nurse is planning care for a client who is prescribed metoclopramide following bowel surgery for
which of the following address affection of the nurse monitor
a. Sedation
i. metoclopramide has multiple effects on the central nervous system including sedation fatigue
restlessness headache sleeping is dystonia
44. A nurse is assisting a client who is taking salmenterol. which of the following reports from the client
indicates effectiveness of this medication
a. Improved breathing
i. Improved mood just not indicate effectiveness of salmenterol
45. A nurse is assessing a client who is receiving epoetin alpha to treat anemia for which of the following
findings should the nurse monitor related to this medication
a. Increased blood pressure
46. A nurse is teaching a client who is to start a new prescription for verapamil. Which of the following
instructions should the nurse plan to include
a. Change positions slowly
i. Verapamil is given to treat cardiac dysrhythmias, which may cause palpitations. Discontinuing
the medication abruptly may cause complications. Instead the client should report this finding
to the provider, who may decide to lower or discontinue the medication on a tapered dose
47. A nurses caring for a client taking Atorvastatin which of the following should the nurse monitor for the
client
a. CK
i. Mild injury causing muscle weakness or aches develops in some clients taking statins and this
occasionally progresses to myositis creatinine kinase (CK) levels rise in response to enzyme is
released with muscle injury
48. A nurse is assessing a client who is taking oral contraceptives which of the following medications will
interfere with the effectiveness of oral contraceptives
a. Carbamazepine
i. There are no medication interactions between oral contraceptives and lorazepam
49. A nurse is caring for a client has heart failure and is discharged with a prescription for furosemide.
The nurse should plan to instruct the client that which of the following are potential adverse effects for
this medication select all that apply
a. Dizziness:
i. The diuretic action of furosemide can result in A significant drop in blood pressure causing
lightheadedness and dizziness
b. hypokalemia:
i. diuretic action of furosemide promotes the excretion of potassium increasing the clients risk
for hypokalemia
c. urinary frequency:
i. The diuretic action of furosemide result in urinary frequency
50. A nurse is monitoring a client who is receiving amphotericin B intermittent IV bolus for histoplasmosis
for which of the following adverse affects of the nurse notify the provider
a. Fever
i. fever and chills are signs of an infusion reaction that requires immediate intervention
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51. A Client is taking trimethoprim/ sulfamethoxazole which of the following findings should the nurse
reports the provider
a. Vesicular, crusty rash
i. This is a sign of Steven Johnson syndrome and adverse affect the nurse should report to the
provider
52. Nurse is caring for a client who recently began taking oral amoxicillin and
clavulanate potassium and reports urticaria which of the following
intervention should the nurse take
a. Request a change in the type of antibiotic
53. A nurse is providing teaching about clindamycin to a client which of the
following is an adverse effects of this medication that the nurse should instruct
the client to report to the provider
a. Watery diarrhea
i. An adverse effect of clincamycin because it can cause clostridium
defficile associated diarrhea which manifests as watery diarrhea
without treatment this adverse affects can be fatal
54. The nurses providing teaching to a client who takes Valporic acid for which of the following should the
nurse instruct the client to monitor and report to the provider
a. Jaundice
i. Valporic acid is unlikely to cause blurred vision
55. A nurses caring for a client who has a new diagnosis of type 1 diabetes mellitus. The nurse administers
regular insulin six units subcutaneously at 0700 at 1000 the client reports feeling nauseous and
lightheaded which of the following actions should the nurse take first
a. Check the clients blood glucose level
i. the first action that a nurse should take using the nursing process is to assess the client therefore
the nurse should check the clients blood glucose level
56. A nurse in the clinic is talking to a client on the phone who tells the nurse he has not taken any of his
morning medications and reports tinnitus the nurse instructs the client to come to the clinic and
withhold which of the following medications
a. Aspirin
i. tinnitus is not a side effect of clopidogrel
57. A nurse is assessing a client who has myasthenia gravis and is taking neostigmine which of the
following findings should alert the nurse that the client is experiencing an adverse reaction
a. Nausea
i. Neostigmine is more likely to cause bradycardia than tachycardia
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