ATI NR293 Pharmacology Midterm Questions And Answers./Top Score

1 Pharmacology Midterm 1. A nurse is caring for a 4-year-old child who is resistant to taking medication. Which of the following strategies should the nurse use to elicit the child’s cooperation? a. Offer the child a cho ...

1 Pharmacology Midterm 1. A nurse is caring for a 4-year-old child who is resistant to taking medication. Which of the following strategies should the nurse use to elicit the child’s cooperation? a. Offer the child a choice of taking the medication with juice or water b. Tell the child it is candy c. Hide the medications in a large dish of ice cream d. Tell the child he will have a shot instead 2. A nurse is caring for a client who has difficulty swallowing medications and is prescribed enteric-coated aspirin PO once daily. The client asks if the medication can be crushed to make it easier to swallow. Which of the following responses should the nurse provide? a. "Crushing the medication might cause you to have a stomachache or indigestion. i. Rationale: The pill is enteric-coated to prevent breakdown in the stomach and decrease the possibility of GI distress. Crushing destroys protection. b. "Crushing the medication is a good idea, and I can mix it in some ice cream for you.” c. "Crushing the medication would release all the medication at once, rather than over time." d. "Crushing is unsafe, as it destroys the ingredients in the medication." 3. A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first? a. A. Check the client's vital signs. i. Rationale: It is possible that the client's nausea is secondary to digoxin toxicity. Assess for bradycardia, a symptom of digoxin toxicity. The nurse should withhold the medication and call the provider if the client's heart rate is less than 60 bpm. b. Request a dietitian consult. c. Suggest that the client rests before eating the meal. d. Request an order for an antiemetic. 4. A nurse is caring for a client who has thrombophlebitis and is receiving heparin by continuous IV infusion. The client asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give? a. "It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level." b. "A pharmacist is the person to answer that question." c. "Heparin does not dissolve clots. It stops new clots from forming." i. Rationale: This statement accurately answers the client's question. d. "The oral medication you will take after this IV will dissolve the clot. 5. A nurse is caring for a client who has bipolar disorder and has been taking lithium for 1 year. Before administering the medication, the nurse should check to see that which of the following tests have been completed? a. Thyroid hormone assay i. Rationale: Thyroid testing is important because long-term use of lithium may lead to thyroid dysfunction. b. Liver function tests: i. Rationale: LFTs must be monitored before and during valproic acid therapy c. Erythrocyte sedimentation rate 2 Pharmacology Midterm i. Rationale: This is not a necessary test related to lithium therapy. d. Brain natriuretic peptide 6. A nurse is providing discharge teaching to a client who has asthma and new prescriptions for cromolyn and albuterol, both by nebulizer. Which of the following statements by the client indicates an understanding of the teaching? a. “If my breathing begins to feel tight, I will use the cromolyn immediately.” b. “I will be sure to take the albuterol before taking the cromolyn.” i. Rationale: The client should always use the bronchodilator (albuterol) prior to using the leukotriene modifier (cromolyn). Using the bronchodilator first allows the airways to be opened, ensuring that the maximum dose of medication will get to the client's lungs. c. “I will use both medications immediately after exercising.” d. “I will administer the medications 10 minutes apart.” 7. A nurse is completing a medication history for a client who reports using over-thecounter calcium carbonate antacid. Which of the following recommendations should the nurse make about taking this medication? a. Decrease bulk in the diet to counteract the adverse effect of diarrhea. b. Take the medication with dairy products to increase absorption. c. Reduce sodium intake. d. Drink a glass of water after taking the medication. i. Calcium carbonate is a dietary supplement used when the amount of calcium taken in the diet is not enough. Calcium carbonate may also be used as an antacid to relieve heartburn, acid indigestion, and stomach upset. The client should drink a full glass of water after taking an antacid to enhance its effectiveness. 8. A nurse is caring for a client who has deep vein thrombosis and has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make? a. "Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level." i. Rationale: However, these medications work in different ways to achieve therapeutic coagulation and must be given together until therapeutic levels of anticoagulation can be achieved by warfarin alone, which is usually within 1 to 5 days. When the client's PT and INR are within therapeutic range, the heparin can be discontinued. b. "I will call the provider to get a prescription for discontinuing the IV heparin today.” c. "Both heparin and warfarin work together to dissolve the clots." d. "The IV heparin increases the effects of the warfarin and decreases the length of your hospital stay." 9. A nurse is providing teaching to a client who has asthma and a new prescription for inhaled beclomethasone. Which of the following instructions should the nurse provide? a. Check the pulse after medication administration. b. Take the medication with meals. c. C. Rinse the mouth after administration. 3 Pharmacology Midterm i. Rationale: Use of glucocorticoids by metered dose inhaler can allow a fungal overgrowth in the mouth. Rinsing the mouth after administration can lessen the likelihood of this complication. d. Limit caffeine intake. 10. A nurse is teaching a client who has a new prescription for colchicine to treat gout. Which of the following instructions should the nurse include? a. "Take this medication with food if nausea develops." b. B. "Monitor for muscle pain." i. Rationale: This medication can cause rhabdomyolysis. The client should monitor and report muscle pain. c. "Expect to have increased bruising." d. "Increase your intake of grapefruit juice” 11. A nurse is caring for a client who has active pulmonary tuberculosis (TB) and is to be started on intravenous rifampin therapy. The nurse should instruct the client that this medication can cause which of the following adverse effects? a. Constipation b. Black colored stools c. Staining of teeth d. Body secretions turning a red-orange color i. Rationale: Rifampin is used in combination with other medicines to treat TB. Rifampin will cause the urine, stool, saliva, sputum, sweat, and tears to turn reddish-orange to reddish-brown. 12. A nurse caring for a client who has hypertension and asks the nurse about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients who have a history of which of the following conditions? a) Asthma 1. Rationale: Propranolol, a beta-blocker, is contraindicated in clients who have asthma because it can cause bronchospasms. Propranolol blocks the sympathetic stimulation, which prevents smooth muscle relaxation. b) Glaucoma c) Depression d) Migraines 4 Pharmacology Midterm 13. A nurse is teaching a client who has chronic kidney disease and a new prescription for epoetin alfa. The nurse should instruct the client to increase dietary intake of which of the following substances? a. Iron i. Rationale: Epoetin alfa is a synthetic form of erythropoietin, a substance produced by the kidneys that stimulates the bone marrow to produce red blood cells. b. Protein c. Potassium d. Sodium 14. A nurse is assessing a client who is receiving IV vancomycin. The nurse notes a flushing of the neck and tachycardia. Which of the following actions should the nurse take? a. A. Document that the client experienced an anaphylactic reaction to the medication. b. Change the IV infusion site. c. Decrease the infusion rate on the IV. i. Rationale: This client is experiencing Red man syndrome, which includes a flushing of the neck, face, upper body, arms and back along with tachycardia, hypotension and urticaria. This can lead to an anaphylactic reaction if the IV infusion rate is not slowed down to run greater than 1 hour. d. Apply cold compresses to the neck area. 15. A nurse is teaching a client who has a urinary tract infection (UTI) and is taking ciprofloxacin. Which of the following instructions should the nurse give to the client? a. "If the medicine causes an upset stomach, take an antacid at the same time." b. "Limit your daily fluid intake while taking this medication." c. "This medication can cause photophobia, so be sure to wear sunglasses outdoors." d. "You should report any tendon discomfort you experience while taking this medication." 5 Pharmacology Midterm i. Rationale: The nurse should instruct the client to report any tendon discomfort as well as swelling or inflammation of the tendons due to the risk of tendon rupture. 16. A nurse is preparing to administer verapamil by IV bolus to a client who is having cardiac dysrhythmias. For which of the following adverse effects should the nurse monitor when giving this medication? a. Hyperthermia b. Hypotension i. Rationale: Verapamil, a calcium channel blocker, can be used to control supraventricular tachyarrhythmias. It also decreases blood pressure and acts as a coronary vasodilator and antianginal agent. A major adverse effect of verapamil is hypotension; therefore, blood pressure and pulse must be monitored before and during parenteral administration. c. Ototoxicity d. Muscle pain 17. A nurse is caring for a client who has a fungal infection and has a new prescription for amphotericin B. Which of the following laboratory values should the nurse report to the provider before initiating the medication? a. Sodium 140 mEq/L b. Potassium 4.5 mEq/L c. BUN 55 mg/dL i. Rationale: This BUN level is above the expected reference range (10-20 mg/dL). Amphotericin B is nephrotoxic and is contraindicated if BUN is > 40mg/dL. d. D. Glucose 120 mg/dL e. Glucose 120 mg/dL 18. A nurse is providing teaching to a client who has renal failure and an elevated phosphorous level. The provider instructed the client to take aluminum hydroxide 300 mg PO three times daily. For which of the following adverse effects should the nurse inform the client? a. Constipation i. Rationale: Constipation is a common side effect of aluminum-based antacids. The nurse should instruct the client to increase fiber intake and that stool softeners or laxatives may be needed b. B. Metallic taste c. Headache d. Muscle spasms 19. A nurse is teaching a client who has been taking prednisone to treat asthma and has a new prescription to discontinue the medication. The nurse should explain to the client to reduce the dose gradually to prevent which of the following adverse effects? 6 Pharmacology Midterm a. Hyperglycemia b. Adrenocortical insufficiency Rationale: Prednisone, a corticosteroid, is similar to cortisol, the glucocorticoid hormone produced by the adrenal glands. It relieves inflammation and is used to treat certain forms of arthritis, severe allergies, autoimmune disorders, and asthma. Administration of glucocorticoids can suppress production of glucocorticoids, and an abrupt withdrawal of the drug can lead to a syndrome of adrenal insufficiency. c. Severe dehydration d. Rebound pulmonary congestion 20. A nurse is preparing a client for surgery. Prior to administering the prescribed hydroxyzine, the nurse should explain to the client that the medication is for which of the following indications? (Select all that apply.) a. Controlling emesis b. Diminishing anxiety c. Reducing the amount of narcotics needed for pain relief d. Preventing thrombus formation e. Drying secretions 21. A nurse is caring for a client who has streptococcal pneumonia and a prescription for penicillin G by intermittent IV bolus. 10 minutes into the infusion of the third dose, the client reports that the IV site itches and that he feels dizzy and short of breath. Which of the following actions should the nurse take first? a. Stop the infusion. i. Rationale: When using the airway, breathing, circulation approach to client care, the nurse should place the priority on stopping the infusion. The client is exhibiting signs of penicillin anaphylaxis and the first action that should be taken is to withdraw the medication. b. Call the client's provider. c. Elevate the head of the bed. d. Auscultate the client's breath sounds. 22. A nurse is caring for a client who is taking lisinopril. Which of the following outcomes indicates a therapeutic effect of the medication? a. Decreased blood pressure i. Rationale: Lisinopril, an ACE inhibitor, may be used alone or in combination with other antihypertensives in the management of hypertension and congestive heart failure. A therapeutic effect of the medication is a decrease in blood pressure. b. Increase of HDL cholesterol c. Prevention of bipolar manic episodes d. Improved sexual function 23. A nurse is caring for a client who has poison ivy and is prescribed diphenhydramine. Which of the following instructions should the nurse give regarding the adverse effect of dry mouth associated with diphenhydramine? a. "Administer the medication with food." b. "Chew on sugarless gum or suck on hard, sour candies." 7 Pharmacology Midterm i. Rationale: Clients who report dry mouth can get the most effective relief by sucking on hard candies (especially the sour varieties that stimulate salivation), chewing gum, or rinsing the mouth frequently. It is the local effect of these actions that provides comfort to the client. c. "Place a humidifier at your bedside every evening." d. “discontinue the medication and notify your provider” 24. A nurse is caring for a client who has an infection and a prescription for gentamicin intermittent IV bolus every 8 hr. A peak and trough is required with the next dose. Which of the following actions should the nurse take to obtain an accurate gentamicin serum level? a. Draw a trough level at 0900 and a peak level at 2100. b. Draw a peak level 90 min prior to administering the medication and a trough level 90 min after the dose. c. Draw a trough level immediately prior to administering the medication and a peak level 30 min after the dose. i. Rationale: Timing of the peak and trough is based on the pharmacokinetics of absorption and the half-life of the medication. The trough level is the lowest serum level after pharmacokinetic effects have taken place. For divided doses, correct timing for the trough is just before administering the next dose. The peak is the highest serum level of the medication; if this level is too low, then the medication will not be effective. Correct timing for the peak is between 30 and 60 min after the dose has finished infusing. d. Draw a peak level at 0900 and a trough level at 2100. 25. A nurse in a substance abuse clinic is assessing a client who recently started taking disulfiram. The client reports having discontinued the medication after experiencing severe nausea and vomiting. Which of the following reasons should the nurse suspect to be a likely cause of the client's distress? a. The client demonstrated an allergic response to the medication. b. The client experienced a common side effect to the medication. c. The client consumed alcohol while taking the medication. i. Rationale: Disulfiram is given to clients who have a history of alcohol abuse. It produces a sensitivity to alcohol that results in a highly unpleasant reaction when the client ingests even small amounts of alcohol. When combined with alcohol, disulfiram produces nausea and vomiting. d. The client took an overdose of the medication. 26. A nurse is reviewing the medical record of a client who has been on levothyroxine for several months. Which of the following findings indicates a therapeutic response to the medication? 8 Pharmacology Midterm a. Decrease in level of thyroxine (T4) b. Increase in weight c. Increase in hour of sleep per night d. Decrease in level of thyroid stimulating hormone (TSH). 27. A nurse on an oncology unit is preparing to administer doxorubicin to a client who has breast cancer. Prior to beginning the infusion, the nurse verifies the client's current cumulative lifetime dose of the medication. For which of the following reasons is this verification necessary? a. An excess amount of doxorubicin can lead to myelosuppression. b. Exceeding the lifetime cumulative dose limit of doxorubicin might cause extravasation. c. An excess amount of doxorubicin can lead to cardiomyopathy. i. Rationale: Doxorubicin is an antineoplastic antibiotic used in the treatment of various cancers. Irreversible cardiomyopathy with congestive heart failure can result from repeated doses of doxorubicin, and prolonged use can also cause severe heart damage, even years after the client has stopped taking it. The maximum cumulative dose a client should receive is 550 mg/m or 450 mg/m with a history of radiation to the mediastinum. d. Exceeding the lifetime cumulative dose limit of doxorubicin might produce red tinged urine and sweat. 28. A nurse is caring for a client who is taking naproxen following an exacerbation of rheumatoid arthritis. Which of the following statements by the client requires further discussion by the nurse? a. "I signed up for a swimming class." b. "I've been taking an antacid to help with indigestion." i. NSAIDs, like naproxen, can cause serious adverse gastrointestinal reactions such as ulceration, bleeding, and perforation. Warning manifestations such as nausea or vomiting, gastrointestinal burning, and blood in the stool reported by the client require further investigation by the nurse. The client might be taking an antacid because he is experiencing one or more of these manifestations. 9 Pharmacology Midterm c. "I've lost 2 pounds since my appointment 2 weeks ago." d. "The naproxen is easier to take when I crush it and put it in applesauce." 29. A nurse is caring for a client who has heart failure and a prescription for digoxin. Which of the following statements by the client indicates an adverse effect of the medication? a. "I can walk a mile a day." b. "I've had a backache for several days." c. "I am urinating more frequently." d. "I feel nauseated and have no appetite." Rationale: Anorexia, nausea, vomiting, and abdominal discomfort are early signs of digoxin toxicity. 30. A nurse is providing teaching for a client who has anemia and a new prescription for ferrous sulfate liquid. Which of the following instructions should the nurse provide? a. Take the medication on an empty stomach to decrease gastrointestinal irritation. b. Take the medication with orange juice to enhance absorption. i. Take between meals for optimal absorption ii. Rationale: Ascorbic acid (vitamin C), which is found in orange juice, will enhance the absorption of iron and increase its bioavailability. This will also help to decrease the gastrointestinal side effects of iron. c. Take the medication with milk. d. Rinse the mouth before taking the iron. 31. A nurse is preparing to administer a dose of lactulose to a client who has cirrhosis. The client states, "I don't need this medication. I am not constipated." The nurse should explain that in clients who have cirrhosis, lactulose is used to decrease levels of which of the following components in the bloodstream? a. Glucose b. Ammonia i. Rationale: Lactulose, a disaccharide, is a sugar that works as an osmotic diuretic. It prevents absorption of ammonia in the colon. Accumulation of ammonia in the bloodstream, which occurs in pathologic conditions of the 10 Pharmacology Midterm liver, such as cirrhosis, may affect the central nervous system, causing hepatic encephalopathy or coma. c. Potassium d. Bicarbonate 32. A nurse is caring for a client who has HIV-1 infection and is prescribed zidovudine as part of antiretroviral therapy. The nurse should monitor the client for which of the following adverse effects of this medication? a. Cardiac dysrhythmia b. Metabolic alkalosis c. Renal failure d. Aplastic anemia 33. A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication? a. The leukocyte count b. The platelet count c. The hematocrit (Hct) i. Rationale: Epoetin alfa is an antianemic medication that is indicated in the treatment of clients who have anemia due to reduced production of endogenous erythropoietin, which may occur in clients who have endstage renal disease or myelosuppression from chemotherapy. The therapeutic effect of epoetin alfa is enhanced red blood cell production, which is reflected in an increased RBC, Hgb, and Hct. d. The erythrocyte sedimentation rate (ESR) 34. A nurse is caring for a client who is prescribed warfarin therapy for an artificial heart valve. Which of the following laboratory values should the nurse monitor for a therapeutic effect of warfarin? a. Hemoglobin b. Prothrombin time (PT) 11 Pharmacology Midterm i. Rationale: This test is used to monitor warfarin therapy. For a client receiving full anticoagulant therapy,should typically be approximately two to three times the normal value, depending on the indication for therapeutic anticoagulation. c. Bleeding time d. Activated partial thromboplastin time (aPTT) 35. A nurse in a critical care unit is caring for a client who is postoperative following a right pneumonectomy. After extubation from the ventilator, in which of the following positions should the client be placed? a. Prone b. On the nonoperative side c. Sims' d. Semi-Fowler's i. Rationale: Pneumonectomy is the surgical removal of the lung, which is most commonly performed to remove a tumor in a client who has lung cancer. Following extubation from the ventilator, the client should be placed in semi-Fowler's position to help to ensure adequate ventilation and decrease the risk of complications. This position also offers the client the most comfort. 36. A nurse in a coronary care unit is admitting a client who has had CPR following a cardiac arrest. The client is receiving lidocaine IV at 2 mg/min. When the client asks the nurse why he is receiving that medication, the nurse should explain that it has which of the following actions? a. Prevents dysrhythmias i. Rationale: Lidocaine is an antidysrhythmic medication that delays the conduction in the heart and reduces the automaticity of heart tissue. b. Slows intestinal motility c. Dissolves blood clots d. Relieves pain 12 Pharmacology Midterm 37. A nurse in a provider's clinic is assessing a client who has cancer and a prescription for methotrexate PO. Which of the following actions should the nurse take when the client reports bleeding gums? a. Explain to the client that this is an expected adverse effect. b. Check the value of the client's current platelet count. i. Rationale: The nurse should recognize that the bleeding is likely due to the adverse effect of the chemotherapy and needs to be evaluated further. Bleeding gums is a sign of thrombocytopenia (decreased platelet count) secondary to bone marrow suppression, which can be life-threatening in a client who is receiving chemotherapy. c. Instruct the client to use an electric toothbrush. d. Have the client make an appointment to see the dentist. 38. A nurse is caring for a client who has bipolar disorder and has been taking lithium for 1 year. Before administering the medication, the nurse should check to see that which of the following tests have been completed? a. Thyroid hormone assay i. Rationale: Thyroid testing is important because long-term use of lithium may lead to thyroid dysfunction. b. Liver function test c. Erythrocyte sedimentation rate d. Brain natriuretic peptide 39. A nurse in a mental health clinic is caring for a client who has bipolar disorder and a prescription for an antipsychotic medication. The provider and nursing staff suspect the client is not adhering to his medication therapy. Which of the following interventions should the staff use to encourage the client's adherence? (Select all that apply.) a. Perform mouth checks following the administration of the medication. b. Provide for once-daily dosing. c. Use sustained-release forms. d. Engage the client in conversation following medication administration. 13 Pharmacology Midterm e. Rotate staff that administer the medications. Rationale: Perform mouth checks following the administration of medication is incorrect. Mouth checks may not find pills that the client has hidden in his mouth.Provide for once-daily dosing is correct. Once-daily dosing of medications simplifies the therapy, making it easier for the client to comply.Use sustained-release forms is correct. Sustained-release forms remain in the client's system longer, requiring less frequent dosing.Engage the client in conversation following medication administration is correct. If the client is speaking, he will be less likely able to hide the medication in his mouth.Rotate staff that administers the medications is incorrect. Rotating treatment providers is an obstacle that increases the risk of a client's nonadherence to therapy. 40. A nurse in a provider's clinic is caring for a client who reports erectile dysfunction and requests a prescription for sildenafil. Which of the following medications currently prescribed for the client is a contraindication to taking sildenafil? a. Isosorbide i. Rationale: Clients who are on nitrates including isosorbide and nitroglycerin preparations cannot take sildenafil, because of the serious medication interaction. There is the possibility of sudden death due to hypotension. b. Phenytoin c. Metronidazole d. Prednisone 41. A nurse is caring for a client who has developed gout. Which of the following medications should the nurse prepare to administer? a. Zolpidem b. Alprazolam c. Spironolactone d. Allopurinol i. Rationale: Allopurinol is a xanthene oxidase inhibitor that reduces uric acid synthesis. The medication is prescribed to treat gout. 42. A nurse is caring for a client who has diabetes insipidus and is receiving vasopressin. The nurse should identify which of the following findings as an indication that the medication is effective? 14 Pharmacology Midterm a. A decrease in blood sugar b. A decrease in blood pressure. c. A decrease in urine output i. Rationale: The major manifestations of diabetes insipidus are excessive urination and extreme thirst. Vasopressin is used to control frequent urination, increased thirst, and loss of water associated with diabetes insipidus. A decreased urine output is the desired response. d. A decrease in specific gravity 43. A nurse on a medical unit is planning care for an older adult client who takes several medications. Which of the following prescribed medications places the client at risk for orthostatic hypotension? (Select all that apply.) a. Furosemide b. Telmisartan c. Duloxetine d. Clopidogrel e. Atorvastatin Rationale: Furosemide is correct. This medication is used to reduce edema and hypertension, and an adverse effect is orthostatic hypotension. Telmisartan is correct. This medication is used to control hypertension, and an adverse effect is orthostatic hypotension. Duloxetine is correct. This medication is used to treat depression and anxiety disorder, and an adverse effect is orthostatic hypotension. Clopidogrel is incorrect. This medication is used to reduce the risk of MI and stroke and does not cause orthostatic hypotension. Atorvastatin is incorrect. 44. A home health nurse is assessing an older adult client who reports falling a couple of times over the past week. Which of the following findings should the nurse suspect is contributing to the client's falls? a. The client takes alprazolam. i. Rationale: Alprazolam is a CNS depressant that can cause dizziness and orthostatic hypotension, which can cause the client to lose his balance and fall. b. The client has a nonslip bath mat in his shower. 15 Pharmacology Midterm c. The client uses a raised toilet seat. d. The client wears fitted slippers. 45. A nurse is teaching a client who takes warfarin daily. Which of the following statements by the client indicates a need for further teaching? a. "I have started taking ginger root to treat my joint stiffness." i. Rationale: Ginger root can interfere with the blood clotting effect of warfarin and place the client at risk for bleeding. This statement indicates the client needs further teaching. b. "I take this medication at the same time each day.” c. "I eat a green salad every night with dinner." d. "I had my INR checked three weeks ago." 46. A nurse is teaching a client about the adverse effects of cisplatin. Which of the following adverse effects should the nurse include in the teaching? a. Tinnitus i. Rationale: tinnitus and hearing loss are adverse effects b. Constipation c. Hyperkalemia d. Weight gain 47. A nurse is completing a medical interview with a client who has elevated cholesterol levels and takes warfarin. The nurse should recognize that which of the following actions by the client can potentiate the effects of warfarin? a. The client follows a low-fat diet to reduce cholesterol b. The client drinks a glass of grapefruit juice every day. c. The client sprinkles flax seeds on food 1 hr before taking the anticoagulant. d. The client uses garlic to lower cholesterol levels. Rationale: The nurse should recognize that garlic can potentiate the action of the warfarin. 16 Pharmacology Midterm 48. A nurse is caring for a client who has a new prescription for ferrous sulfate tablets twice daily for iron-deficiency anemia. The client asks the nurse why the provider instructed that she take the ferrous sulfate between meals. Which of the following responses should the nurse make? a. "Taking the medication between meals will help you avoid becoming constipated." b. "Taking the medication with food increases the risk of esophagitis." c. "Taking the medication between meals will help you absorb the medication more efficiently." i. Rationale: Ferrous sulfate provides the iron needed by the body to produce red blood cells. Taking iron supplements between meals helps to increase the bioavailability of the iron. d. "The medication can cause nausea if taken with food." 49. A nurse is caring for a female client who has rheumatoid arthritis and asks the nurse if it is safe for her to take aspirin. The nurse should recognize which of the following findings in the client's history is a contraindication to this medication? a. Report of recent migraine headaches b. History of gastric ulcers i. Rationale: Aspirin is contraindicated for clients who have a history of gastrointestinal bleeding and peptic ulcer disease because it impedes platelet aggregation. An adverse effect of aspirin is gastric bleeding. c. Current diagnosis of glaucoma d. Prior reports of amenorrhea 50. A nurse is providing discharge teaching for a client who has a new prescription for warfarin. Which of the following instructions should the nurse include in the teaching? a. Mild nosebleeds are common during initial treatment. b. Use an electric razor while on this medication. i. Rationale: Warfarin, an anticoagulant, increases the client’s risk for bleeding. The nurse should teach the client safety measures, such as using an electric razor, to decrease the risk for injury and bleeding. 17 Pharmacology Midterm c. If a dose of the medication is missed, double the dose at the next scheduled time. d. Increase fiber intake to reduce the adverse effect of constipation. 51. A nurse is providing teaching to a client who has emphysema and a new prescription for theophylline. Which of the following instructions should the nurse provide? a. Consume a high-protein diet. b. Administer the medication with food. c. Avoid caffeine while taking this medication. i. Rationale: The nurse should instruct the client that caffeine should be avoided while taking theophylline, as it can increase central nervous system stimulation. d. Increase fluids to 1L/per day. 52. Nurse is teaching about furosemide, the nurse should recommend what foods about best source of potassium a. Bananas 53. Status asthmatics a. acute severe asthma or a severe asthma exacerbation. It refers to an asthma attack that doesn't improve with traditional treatments, such as inhaled bronchodilators 54. Morphine or any kind of drug like this watch a. Respiratory rate 55. Giving ophthalmic ointment for Conjunctivitis, what instructions do you have a. Put ointment in the eye (pull lower eyelid down) 56. Bacterial junctivitis a. Increased tears, wake up and ‘stuck’ shut, inflammation of whites of eyes 57. Jenomycin, what would we do to reduce adverse effects? 18 Pharmacology Midterm a. Erythromycin enteric-coated base b. Take with food and water and on regular schedule 58. Methrotrodonizol (flagyl): which of the following sense is an adverse effect? a. Metallic taste 59. 4 clients and you gave all medications, but procardia/nitrate was given to wrong person what do you do first? a. Check vitals 60. What should be consideration when determining schedule of giving scheduled medications 61. fiafilin --what instructions would nurse give a. Don’t take with caffeine 62. Public school: what foods to avoid when taking rx a. Grapefruit 63. What nursing considerations before giving Dilantin suspension a. Shake vigorously for 5 minutes