NCLEX PHARM PRACTICE pn Latest Graded A+

A nurse is monitoring a client who has just returned to the unit following surgery. The client received an initial dose of morphine 5 mg IV bolus for pain relief. Which of the following adverse effects should the nurse r ...

A nurse is monitoring a client who has just returned to the unit following surgery. The client received an initial dose of morphine 5 mg IV bolus for pain relief. Which of the following adverse effects should the nurse report immediately to the provider? Emesis Sedation Respiratory rate 11/min Blood pressure 100/74 mm Hg - ANSWER Respiratory rate 11/min When using the airway, breathing, circulation approach to client care, the priority finding is a respiratory rate of 11/min indicating respiratory depression. A nurse is reinforcing teaching with a client who is prescribed captopril for hypertension. Which of the following side effects should the nurse instruct the client to report to the provider immediately? Photosensitivity Weight loss Sore throat Altered taste sensation - ANSWER Sore throat The greatest risk to the client is infection related to neutropenia. Unexplained fever, sore throat, and fatigue can indicate an infection and should be immediately reported to the provider. A nurse is reinforcing teaching with a client who has a new prescription for spironolactone for hypertension. Which of the following instructions should the nurse include in the teaching? Increase foods high in zinc. Restrict foods high in potassium. Restrict foods high in vitamin K. Increase foods high in magnesium. - ANSWER Restrict foods high in potassium. Spironolactone is a potassium-sparing diuretic, which can cause hyperkalemia. Therefore, the client should restrict foods that are high in potassium. A nurse is reinforcing teaching with a client about the adverse effects of simvastatin. For which of the following adverse effects should the nurse instruct the client to monitor? Muscle pain Fine hand tremors Urinary retention Double vision - ANSWER Muscle pain The nurse should instruct the client to notify the provider if muscle pain or tenderness develops, because this could indicate rhabdomyolysis. A nurse is performing the third check before administering hydromorphone to a client. After opening the unit-dose packet, the client tells the nurse he does not want to take the medication now. Which of the following actions should the nurse take? Complete an unusual occurrence report of the incident. Encourage the client to take the medication. Leave the medication at the client's bedside in case he changes his mind. Dispose of the medication with a second nurse as a witness. - ANSWER Dispose of the medication with a second nurse as a witness. The nurse must have a witness when disposing of a controlled substance. A nurse is caring for a client who is prescribed an IM injection of penicillin G benzathine. The client asks why the injection must be given IM instead of through his IV line. Which of the following is the correct response by the nurse? "The medication is more rapidly absorbed when given IM." "Your medication can't be given IV because it is not water-soluble." "You will experience less discomfort with an IM injection." "An IM injection allows more precise control of the medication level in your blood." - ANSWER "Your medication can't be given IV because it is not water-soluble." Medications cannot be administered IV if they are not water-soluble. A nurse is assisting with the care of a client who is in preterm labor and is receiving magnesium sulfate by continuous IV infusion. Which of the following findings indicats magnesium toxicity? Urinary output 60 mL/hr Hyporeflexia Respirations 14/min Tachycardia - ANSWER Hyporeflexia Magnesium sulfate depresses neuromuscular activity, leading to muscle weakness and paralysis. Therefore, hyporeflexia can indicate magnesium toxicity. A nurse is reinforcing teaching with a client who is prescribed a scopolamine patch for motion sickness. Which of the following client statements indicates an understanding of the teaching? "I may have a runny nose during therapy." "I should replace the patch every day." "I may experience diarrhea as a potential side effect." "I should place the patch behind my ear." - ANSWER "I should place the patch behind my ear." The client should place the scopolamine patch behind the ear. A nurse is monitoring a client who is receiving IV amphotericin B. Which of the following findings indicates an adverse reaction to this medication? Serum potassium level 5.6 mEq/dL Hematocrit 55% Polyuria Vertigo - ANSWER Vertigo Ototoxicity is an adverse effect of amphotericin B. Manifestations of ototoxicity include vertigo, tinnitus, and hearing loss. A nurse is reinforcing teaching with a client who is using phenylephrine nasal spray three times daily and reports rebound congestion. Which of the following instructions should the nurse include to reduce the effects of rebound congestion? "Decrease the frequency to twice daily." "Continue use for one more week." "Discontinue use in the left nostril, then in the right nostril." "Add oxymetazoline nasal spray to relieve symptoms." - ANSWER "Discontinue use in the left nostril, then in the right nostril." Discontinuing the drug one nostril at a time can overcome rebound congestion. A nurse is caring for a client who has just received a prescription for tolbutamide to treat diabetes mellitus. The nurse should question the prescription if the client reports which of the following medication allergies? Amoxicillin-clavulanate Trimethoprim/sulfamethoxazole Azithromycin Cephalexin - ANSWER Trimethoprim/sulfamethoxazole Clients who have a hypersensitivity to sulfonamide antibiotics might also be allergic to sulfonylureas such as tolbutamide. Therefore, the nurse should question the client's prescription for tolbutamide. A nurse is caring for a client who has a new prescription for eplerenone to treat hypertension. For which of the following adverse effects should the nurse monitor? Hematuria Hypernatremia Hyperkalemia Constipation - ANSWER Hyperkalemia