NURSING 112023 : Silvestri: Saunders Comprehensive Review for the NCLEX-RN® Examination, 5th Edition Pharmacology; Test Bank A+ Guide.

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Silvestri: Saunders Comprehensive Review for the NCLEX-RN® Examination, 5th Edition Pharmacology Test Bank MULTIPLE CHOICE 1. The nurse is caring for a client in labor. The nurse reviews... the physician’s prescriptions and notes that the client has a prescription for butorphanol tartrate (Stadol). The nurse understands that this medication is prescribed for: 1. Pain relief 2. Increasing uterine contractions 3. Decreasing uterine contractions 4. Promoting fetal lung maturity 2. The postpartum nurse is caring for a client with an epidural catheter in place for opioid analgesic administration following cesarean birth. If the client develops respiratory depression and requires naloxone (Narcan) as an antidote, the client may complain of which of the following? 1. Increase in her pain level 2. Decrease in her pain level 3. Increase in the amount of itching from the opioid used in the epidural 4. Decrease in the amount of itching from the opioid used in the epidural 3. A client experiencing preterm labor at the twenty-ninth week of gestation has been admitted to the hospital. The client has a prescription to receive betamethasone (Celestone). The nurse understands that the medication will do which of the following? 1. Prevent spontaneous delivery. 2. Stop the uterine contractions. 3. Promote maturation of the fetal lungs. 4. Accelerate the growth rate of the fetus. 4. A client with preeclampsia is receiving magnesium sulfate. The nurse assesses the client closely for which sign of magnesium toxicity? 1. Proteinuria 2. Hyperactive deep tendon reflexes 3. Respiratory rate of 10 breaths/min 4. Serum magnesium level of 5 mEq/L 5. A pregnant client who has human immunodeficiency virus (HIV) infection is being seen in the antenatal clinic. The nurse recalls that zidovudine (AZT) therapy will be initiated when the fetus has reached how many weeks of gestation? 1. 4 2. 14 3. 24 4. 34 6. The nurse has a routine prescription to instill erythromycin ointment (Ilotycin) into the eyes of a newborn. The nurse plans to explain to the parents that the purpose of the medication is to: 1. Help the newborn to see more clearly. 2. Guard against infection acquired during intrauterine life. 3. Ensure the sterility of the conjunctiva in the newborn. 4. Protect the newborn from contracting an eye infection during birth. 7. The nurse has a routine prescription to administer an injection of phytonadione (vitamin K) to the newborn. Before giving the medication, the nurse explains to the client that this medication will: 1. Prevent clotting abnormalities in the newborn. 2. Stimulate the liver to produce vitamin K. 3. Prevent vitamin deficiency of fat-soluble vitamins. 4. Supplement the infant, because breast milk and formula are low in vitamin K. 8. The client who has developed atrial fibrillation is not responding to medication therapy and has been placed on warfarin (Coumadin). The nurse is doing discharge dietary teaching with the client. The nurse would tell the client to avoid which of the following foods while taking this medication? 1. Cherries 2. Potatoes 3. Broccoli 4. Spaghetti 9. A client in preterm labor is being started on intravenous magnesium sulfate to stop the contractions. The nurse checks the medication to ensure that which medication is available as an antidote if needed? 1. Magnesium oxide 2. Vitamin K 3. Aluminum hydroxide 4. Calcium gluconate 10. The nurse had just given an intramuscular dose of methylergonovine (Methergine) to a client following delivery of an infant. The nurse determines that this medication had the intended effect after evaluating for which of the following findings? 1. Decreased pulse rate 2. Increased urine output 3. Improved uterine tone 4. Increased blood pressure 11. The nurse is told that the result of a serum carbamazepine (Tegretol) level for a child who is receiving the medication for the control of seizures is 10 mcg/mL. Based on this laboratory result, the nurse anticipates that the physician will prescribe: 1. Discontinuation of the medication 2. A decrease of the dosage of the medication 3. An increase of the dosage of the medication 4. Continuation of the presently prescribed dosage 12. The nurse is providing instructions to a mother of a child with atopic dermatitis (eczema) regarding the application of topical cortisone cream to the affected skin sites. Which of the following statements, if made by the mother, indicates an understanding of the use of this medication? 1. “I shouldn’t rub the medication into the skin.” 2. “The medication is applied everywhere except the face.” 3. “I need to wash the sites gently before I apply the medication.” 4. “I need to apply the medication generously and allow it to absorb.” 13. The nurse working in the ambulatory care center is providing medication instructions about methylphenidate (Ritalin) to the mother of a child with attention-deficit/hyperactivity disorder (ADHD). The nurse recommends that the mother give the medication to the child: 1. At bedtime 2. With the evening meal 3. Just before the noontime meal 4. In the morning, 2 hours before breakfast 14. A child has been prescribed to take tetracycline hydrochloride. The nurse providing medication information to the mother would plan to emphasize which of the following most important instructions about giving this medication to the child? 1. Give the medication with milk. 2. Give the medication with ice cream. 3. Mix the medication in a Styrofoam cup. 4. Use a straw when giving the medication. 15. The nurse is providing instructions to the parent of a child with iron deficiency anemia about the administration of a liquid oral iron supplement. Which of the following statements, if made by the parent, indicates an understanding of the administration of this medication? 1. “I should give the iron with food.” 2. “I can mix the iron with cereal to give it.” 3. “I should add the iron to the formula in the baby’s bottle.” 4. “I should use a medicine dropper and place the iron near the back of the throat.” 16. The client with psoriasis is being treated with calcipotriene (Dovonex) cream. Administration of high doses of this medication can cause which side effect? 1. Alopecia 2. Hyperkalemia 3. Hypercalcemia 4. Thinning of the skin 17. Collagenase (Santyl) is prescribed for a client with a severe burn to the hand. The nurse is providing instructions to the client and spouse regarding wound treatment. Which of the following should the nurse include in the instructions? 1. Apply twice a day, and leave it open to the air. 2. Apply once a day, and leave it open to the air. 3. Apply twice a day, and cover it with a sterile dressing. 4. Apply once a day, and cover it with a sterile dressing. 18. A nurse is caring for a female client at home with a diagnosis of actinic keratosis. The client tells the nurse that her skin is very dry and irritated. The treatment includes diclofenac sodium (Solaraze). The nurse teaches the client that this medication is from which class of medications? 1. Anti-infectives 2. Vitamin A lotions 3. Coal tar preparations 4. Nonsteroidal anti-inflammatory drugs (NSAIDs) 19. The client with muscle aches and a diagnosis of rheumatism has been given a prescription for capsaicin topical cream. The nurse evaluates that the client understands the use of the medication if the client states that: 1. The medication will act as a local analgesic. 2. The medication acts by decreasing muscle spasms. 3. The medication will cause redness, flaking, and the skin to peel. 4. A heating pad should be put on the area after applying the medication. 20. The client with a burn injury is applying mafenide (Sulfamylon) to the wound. The client calls the physician’s office and tells the nurse that the medication is uncomfortable and is causing a burning sensation. The nurse instructs the client to: 1. Discontinue the medication. 2. Apply a thinner film than prescribed to the burn site. 3. Continue with the treatment, as this is expected. 4. Come to the office to see the physician immediately. 21. The client with an infected leg wound that is draining purulent material has a prescription for sodium hypochlorite (Dakin solution) to be used in the care of the wound. The nurse would do which of the following while using this solution? 1. Rinse off immediately following irrigation. 2. Pour onto sterile sponges, and pack in wound. 3. Let the solution run freely over normal skin tissue. 4. Use each bottle of solution for 2 weeks before replacing. 22. An adolescent client with severe cystic acne has been prescribed isotretinoin (Accutane). Which statement by the client would suggest the need for further teaching? 1. “I will return to the clinic for blood tests.” 2. “If my lips begin to burn, it is probably because of the medication.” 3. “My eyes may become dry and burn as a result of the medication.” 4. “I need to take my vitamin A supplement so that the treatment will work.” 23. An ambulatory care client with allergic dermatitis has been given a prescription for a tube of diphenhydramine (Benadryl) 1% to use as a topical agent. The nurse determines that the medication was effective if which of the following was assessed? 1. Nighttime sedation 2. Decrease in urticaria 3. Absence of ecchymoses 4. Healing of burned tissue 24. The client with cancer has received a course of chemotherapy and received fluorouracil (Adrucil). The nurse should plan to tell the client to report which of the following immediately? 1. Alopecia 2. Headache 3. Stomatitis and diarrhea 4. Changes in color vision 25. The nurse reviewing a medical record notes that high concentrations of methotrexate followed by leucovorin (citrovorum factor, folic acid) are being given to the client with cancer. The nurse correctly interprets that the reason for therapy with leucovorin is to: 1. Preserve normal cells. 2. Promote protein synthesis. 3. Promote medication excretion. 4. Hasten the effect of the methotrexate. 26. The nurse understands that an indication for the use of asparaginase (Elspar) is: 1. Lung cancer 2. Breast cancer 3. Metastatic prostate cancer 4. Acute lymphocytic leukemia 27. The nurse is caring for a client on the oncology unit who has developed stomatitis during chemotherapy. The nurse would plan which of the following measures to treat this complication? 1. Rinse the mouth with diluted baking soda or saline. 2. Use lemon and glycerin swabs liberally on painful oral lesions. 3. Place the client on NPO status for 12 hours, then resume liquids. 4. Brush the teeth and use nonwaxed dental floss at least twice a day. 28. The client who has been diagnosed with cancer is to receive chemotherapy with both cisplatin (Platinol-AQ) and vincristine (Oncovin). The client asks the nurse why both medications must be given together. The nurse's response is based on the understanding that the purpose of using both medications is to: 1. Prevent the destruction of normal cells. 2. Increase the destruction of tumor cells. 3. Decrease the risk of the alopecia and stomatitis. 4. Increase the likelihood of erythrocyte and leukocyte recovery. 29. The nurse tells the client with leukemia who is receiving chemotherapy that allopurinol (Zyloprim) has been added to the medication list. When the client asks the purpose of the new medication, the nurse responds that the allopurinol is intended to prevent: 1. Nausea 2. Diarrhea 3. Muscle spasms 4. Hyperuricemia 30. The client with breast cancer has been given a prescription for cyclophosphamide (Cytoxan). The nurse determines that the client understands the proper use of the medication if the client states that he or she will: 1. Increase dietary intake of potassium. 2. Take the medication with large meals. 3. Decrease dietary intake of magnesium. 4. Increase fluid intake to 2 to 3 L/day. 31. The nurse should be prepared to institute bleeding precautions in the client receiving antineoplastic medication if which of the following results were reported from the lab? 1. Clotting time, 12 seconds 2. Ammonia level, 28 mcg/dL 3. Platelet count, 50,000 cells/mm3 4. White blood cell count (WBC), 4500/mm3 32. The client with cancer is about to be started on mitomycin (Mutamycin). The nurse should suggest contacting the physician after noting that the client is also taking which of the following medications? 1. Furosemide (Lasix) 2. Ondansetron (Zofran) 3. Warfarin (Coumadin) 4. Allopurinol (Zyloprim) 33. A client with diabetes mellitus taking daily NPH insulin has been started on therapy with dexamethasone (Decadron). The nurse anticipates that which of the following adjustments in medication dosage will be made? 1. Decreased NPH insulin 2. Increased NPH insulin 3. Lower dose of dexamethasone (Decadron) than usual 4. Higher dose of dexamethasone (Decadron) than usual 34. The nurse monitors the blood glucose level of the client who received NPH insulin at 7 AM with an understanding that the client may experience a hypoglycemic reaction between: 1. 9 to 11 AM 2. 1 to 7 PM 3. 7 to 11 PM 4. Midnight to 6 AM 35. The nurse evaluates that the family of a client newly diagnosed with diabetes mellitus correctly understands the reason for having glucagon on hand for emergency home use if the family indicates that the purpose of the medication is to treat: 1. Diabetic ketoacidosis 2. Hypoglycemia from insulin overdose 3. Hyperglycemia from insufficient insulin 4. Hyperglycemia occurring on “sick days” 36. The nurse is teaching a client with hyperthyroidism regarding the prescribed medication propylthiouracil (PTU). The nurse determines that teaching has been successful if the client states that he will report which of the following symptoms to the physician? 1. Fever 2. Nervousness 3. Tiredness 4. Fatigue 37. The nurse teaches the client with hypocalcemia to take calcium carbonate (Os-Cal) at which time? 1. With breakfast 2. At lunch time 3. Just before a meal 4. One hour after a meal 38. The nurse teaches the client being discharged to home with a prescription for a daily dose of prednisone to take the medication: 1. In the early morning 2. In the middle of the day 3. An hour before bedtime 4. Anytime of the day 39. The nurse monitors the client taking octreotide acetate (Sandostatin) for acromegaly for which most frequent side effect of this medication? 1. Diarrhea 2. Dyspnea 3. Constipation 4. Bradycardia 40. A client with a history of coronary artery disease has developed diabetes insipidus as a result of cranial surgery. The client's medication therapy will include vasopressin (Pitressin). The nurse monitors this client most carefully for which of the following sign/ symptom that indicates an adverse effect of this medication? 1. Depression 2. Chest pain 3. Nagging cough 4. Joint stiffness 41. The client has a prescription for sucralfate (Carafate) four times daily. The nurse writes in the medication record to administer the medication at which of the following times? 1. With meals and at bedtime 2. Every 6 hours around the clock 3. One hour after meals and at bedtime 4. One hour before meals and at bedtime 42. The client who chronically uses nonsteroidal anti-inflammatory drugs (NSAIDs) has begun taking misoprostol (Cytotec). Evaluation of the effectiveness of the misoprostol in preventing a side effect of chronic NSAID use is determined by the nurse if the client reports which of the following? 1. “I have fewer muscle aches.” 2. “My joint mobility has improved.” 3. “I no longer have pain above my stomach.” 4. “I am no longer experiencing constipation.” 43. The client in the preoperative holding area has been given a dose of scopolamine. The nurse assesses the client for which of the following side effects of the medication? 1. Dry mouth 2. Diaphoresis 3. Excessive urination 4. Pupillary constriction 44. The client with gastroesophageal reflux disease (GERD) has a new prescription for pantoprazole (Protonix). Which of the following instructions should the nurse plan to provide to the client? 1. Chew the pill thoroughly. 2. Swallow the tablet whole. 3. Crush the pill if it is difficult to swallow. 4. Headache is expected to occur. 45. The client is experiencing diarrhea. The nurse reviews the client’s PRN medication prescription sheet and plans to administer which of the following medications for this problem? 1. Sennosides (Senokot) 2. Bisacodyl (Dulcolax Bowel Prep Kit) 3. Psyllium (Metamucil) 4. Loperamide (Imodium) 46. The client with recurrent constipation has been prescribed psyllium (Metamucil). Teaching provided by the nurse should include which of the following instructions? 1. Mix the psyllium powder with any cold beverage. 2. Mix the psyllium powder with 4 oz of a hot beverage. 3. Mix the psyllium powder with gelatin, applesauce, or pudding. 4. Mix the psyllium powder with 8 oz of water or juice followed by drinking an additional 8 oz of liquid. 47. The nurse is reading the medication list for a postoperative client and notes that a PRN prescription for ondansetron (Zofran) was administered. Evaluation of the effectiveness of the medication is determined by the nurse if the client makes which of the following statements? 1. “My headache is gone.” 2. “The dizziness has stopped.” 3. “I no longer feel nauseous.” 4. “The pain at my incision has decreased.” 48. An older client has been receiving cimetidine (Tagamet). The nurse should report to the physician that the client is experiencing a side effect of the medication if which of the following is noted during the assessment? 1. Tremors 2. Stiff joints 3. Confusion 4. Constipation 49. The nurse monitors the client receiving the first dose of albuterol (Proventil HFA) for which of the following side effects of this medication? 1. Drowsiness 2. Tachycardia 3. Hyperglycemia 4. Hyperkalemia 50. The client has a prescription to receive pirbuterol (Maxair) two puffs and beclomethasone two puffs by metered-dose inhaler. The nurse plans to give these medications most effectively by: 1. Administering the beclomethasone before the pirbuterol 2. Administering the pirbuterol before the beclomethasone 3. Alternating a single puff of each hourly, beginning with the beclomethasone 4. Alternating a single puff of each hourly, beginning with the pirbuterol 51. The client with chronic obstructive pulmonary disease (COPD) is being changed from an oral glucocorticoid to triamcinolone (Azmacort) by inhalation. The nurse plans to monitor the client for which of the following signs and symptoms during the change? 1. Chills, fever, generalized rash 2. Vomiting and diarrhea, increased thirst 3. Blurred vision, headache, and insomnia 4. Anorexia, nausea, weakness, and fatigue 52. The client taking theophylline has a serum theophylline level of 15 mcg/mL. The nurse interprets that this result is _____ the therapeutic range. 1. Below 2. Near the top of 3. In excess of 4. In the middle of 53. The client is taking cetirizine (Zyrtec). The nurse teaches the client to expect which of the following side effects of this medication? 1. Diarrhea 2. Excitability 3. Drowsiness 4. Excess salivation 54. The client is scheduled to receive acetylcysteine (Mucomyst) 20% solution diluted in 0.9% normal saline by nebulizer. Which of the following outcomes would the nurse expect to see as a result of the administration of this medication? 1. Bronchodilation 2. Decreased coughing 3. Absence of wheezing 4. Thinning of respiratory secretions 55. The physician prescribes cromolyn (Intal) for the client with asthma. The nurse identifies that the client correctly understands the purpose of this medication when the client states that the medication will: 1. Suppress an allergic response. 2. Promote bronchodilation. 3. Decrease the risk of infection. 4. Eliminate the need for a rescue inhaler. 56. The nurse teaching the client about the effects of diphenhydramine (Benadryl), an ingredient in the cough suppressant prescribed for the client, should plan to tell the client to do which of the following while taking this medication? 1. Take it on an empty stomach. 2. Avoid activities requiring mental alertness. 3. Use alcohol for additional effect in reducing cough. 4. Avoid chewing sugarless gum or using oral rinses mouth. 57. The physician has prescribed codeine sulfate for a client with a nonproductive cough to suppress the cough reflex. The nurse teaches the client to monitor for: 1. Constipation 2. Painful coughing 3. Difficulty swallowing 4. Increased urination 58. A client with heart disease is taking digoxin (Lanoxin) and complains of having no appetite, diarrhea, and blurry vision. The nurse notes that the client’s serum potassium (K) level is 3.0 ng/mL. Based on analysis of the data, what might the nurse anticipate assessing when reviewing the digoxin level results? 1. Digoxin level lower than 0.5 ng/mL 2. Digoxin level higher than 2 ng/mL 3. Digoxin level of 1.8 ng/mL 4. Digoxin level of 0 ng/mL because of diarrhea 59. The nurse is providing medication information to a client who is beginning medication therapy with enalapril (Vasotec). The nurse reminds the client that which of the following is an anticipated, although unpleasant, side effect of this medication? 1. Rapid pulse 2. Persistent dry cough 3. Increased blood pressure 4. Metallic taste in the mouth 60. A client has recently begun medication therapy with propranolol (Inderal). The long-term care nurse should plan to notify the physician if which of the following assessment findings is noted? 1. Complaints of insomnia 2. Audible expiratory wheezes 3. Decrease in heart rate from 86 to 78 beats/min 4. Decrease in blood pressure from 162/90 to 136/84 mm Hg 61. A client having a myocardial infarction is receiving alteplase (Activase) therapy. Which of the following actions should be carried out by the nurse to monitor for the most frequent adverse effect? 1. Monitor for bleeding. 2. Assess for allergic reaction. 3. Evaluate the client for muscle weakness. 4. Monitor for signs and symptoms of infection. 62. A client is receiving scheduled doses of lovastatin (Mevacor). The nurse evaluates that the medication is having the intended effect if the nurse notes which of the following client data? 1. Weight loss 2. Increased pulse rate 3. Lowered blood pressure 4. Decreased cholesterol level 63. A client taking verapamil (Calan) has been given information about side effects of this medication. The nurse determines that the client understands the information shared if the client states that he or she will watch for which of the following most common side effects of this medication? 1. Weight loss 2. Constipation 3. Nasal stuffiness 4. Abdominal cramping 64. The nurse has a prescription to give a first dose of hydrochlorothiazide (HydroDIURIL) to an assigned client. The nurse would question the prescription if the client has a history of allergy to which of the following? 1. Iodine 2. Shellfish 3. Penicillin 4. Sulfa drugs 65. The nurse has a prescription to give a client a scheduled dose of digoxin (Lanoxin). Prior to administering the medication, the nurse assesses for which of the following manifestations that could indicate digoxin toxicity? 1. Dyspnea, edema, and palpitations 2. Chest pain, hypotension, and paresthesias 3. Constipation, dry mouth, and sleep disorder 4. Double vision, loss of appetite, and nausea 66. A client with a history of angina pectoris complains of substernal chest pain. The nurse checks the client’s blood pressure and administers nitroglycerin, gr 1/4 sublingually. Five minutes later, the client is still experiencing chest pain. If the blood pressure is still stable, the nurse should take which of the following actions next? 1. Administer another nitroglycerin tablet. 2. Administer 10 L of oxygen via nasal cannula. 3. Call for a 12-lead electrocardiogram (ECG) to be performed. 4. Wait an additional 5 minutes, then give a second nitroglycerin tablet. 67. The long-term care client with a history of heart failure has developed paroxysmal nocturnal dyspnea (PND). The nurse reviews the client’s medication record and determines that which of the following medications has been prescribed to treat the PND? 1. Bumetanide (Bumex) 2. Propranolol (Inderal) 3. Warfarin (Coumadin) 4. Acetylsalicylic acid (aspirin) 68. The nurse is working with a client receiving an intravenous heparin sodium drip. The nurse should review which of the following laboratory studies to determine the therapeutic effect of heparin for the client? 1. Bleeding time 2. Thrombin time 3. Prothrombin time (PT) 4. Partial thromboplastin time (PTT) 69. The ambulatory care nurse is providing instructions to a client with a urinary tract infection (UTI) being started on medication therapy with nitrofurantoin (Macrodantin), a urinary antiseptic agent. The nurse tells the client that: 1. It can cause urinary retention. 2. It will cause the urine to become clear. 3. If taken with meals, it will help decrease the risk for gastrointestinal (GI) upset. 4. The sun should be avoided because it is a sulfa-based medication. 70. A client is beginning to take trimethoprim-sulfamethoxazole (Bactrim) for a recurrent urinary tract infection (UTI). The nurse would give the client which of the following instructions regarding this medication? 1. Discontinue medication when symptoms subside. 2. Expect rashes or skin changes as a result of therapy. 3. Take most doses early in the day when fluid intake is greatest. 4. Take each dose with 8 oz of water, and drink extra water each day. 71. A client with a urinary tract infection (UTI) has been prescribed to take ciprofloxacin (Cipro). The nurse notes that the client also has a prescription for theophylline written by a pulmonologist. The nurse should do which of the following? 1. Clarify the medication prescriptions. 2. Encourage intake of antacids. 3. Schedule the doses to be given together. 4. Schedule the doses to be given at the same time. 72. The client with a urinary tract infection (UTI) has dysuria and is given a prescription for phenazopyridine (Pyridium) for symptom relief. The nurse provides medication teaching with this client and tells the client to: 1. Take the medication at bedtime. 2. Take the medication before meals. 3. Notify the physician if headache occurs. 4. Expect the urine to become reddish-orange. 73. The nurse is preparing a subcutaneous dose of bethanechol (Urecholine) prescribed for a client with urinary retention. Before giving the dose, the nurse checks to see that which of the following medications is available on the emergency cart for use if needed? 1. Vitamin K 2. Mucomyst 3. Atropine sulfate 4. Protamine sulfate 74. A client who has undergone renal transplant is receiving ongoing therapy with cyclosporine (Sandimmune). The nurse would be sure to immediately report the results of periodic laboratory results that indicate which of the following? 1. Decreased creatinine level 2. Decreased hemoglobin level 3. Elevated blood urea nitrogen (BUN) level 4. Decreased white blood cell (WBC) count 75. A client is receiving tacrolimus (Prograf) to prevent organ rejection. Which of the following is a nursing considerations associated with this medication? 1. Give with cyclosporine (Sandimmune). 2. Assess for hypoglycemia. 3. Give with grapefruit juice. 4. Assess platelet count for thrombocytopenia. 76. A client must begin medication therapy with mycophenolate mofetil (CellCept) to prevent organ rejection following renal transplantation. The nurse plans to provide which of the following teaching points to the client? 1. Take the dose following meals. 2. Notify the physician if a fever develops. 3. Open the capsule and mix with food before use. 4. Take the medication with an aluminum-based antacid. 77. The client in renal failure is receiving epoetin alfa (Epogen). The nurse would monitor this client for which adverse effect of this medication? 1. Depression 2. Bradycardia 3. Fever 4. Hypertension 78. The preoperative medication sheet identifies that cyclopentolate (Cyclogyl) is prescribed for a client prior to cataract surgery. The nurse understands that the action of the medication is to: 1. Lubricate the affected eye. 2. Dilate the pupil of the affected eye. 3. Promote miosis of the affected eye. 4. Constrict the pupil of the affected eye. 79. The client being discharged to home with a prescription for eye drops to be given in the left eye has received instructions regarding self-administration of the drops. The nurse determines that the client needs further instruction if, on return demonstration, the client: 1. Lies supine, pulls up on the upper lid, and puts the drop in the upper lid 2. Lies supine, pulls down on the lower lid, and puts the drop in the lower lid 3. Tilts the head back, pulls down on the lower lid, and puts the drop in the lower lid 4. Lies with head to the right, puts the drop in the inner canthus, and slowly turns to the left while blinking 80. The nurse teaching a mother how to administer ear drops to an infant tells the mother to pull the child’s ear: 1. Up and back and direct the solution onto the eardrum 2. Down and back and direct the solution onto the eardrum 3. Up and back and direct the solution toward the wall of the canal 4. Down and back and direct the solution toward the wall of the canal SC: Integrated Process: Teaching and Learning 81. The nurse is describing medication side effects to a client who is taking a benzodiazepine. The nurse tells the client to take the medication only as prescribed because of the most serious risk of: 1. Headache 2. Skin rashes 3. Dependence 4. Gastrointestinal side effects 82. The nurse would question the physician if which of the following medications was prescribed for a client with glaucoma? 1. Pilocarpine HCl (Pilocar) 2. Pilocarpine nitrate 3. Atropine sulfate (Isopto Atropine) 4. Carteolol hydrochloride (Ocupress) 83. When teaching the client about the effects of a miotic medication, the nurse plans to tell the client that the medication will: 1. Reshape the lens to eliminate blurred vision. 2. Interrupt the drainage of aqueous humor from the eye. 3. Dilate the pupil to reduce intraocular pressure. 4. Lower intraocular pressure and improve blood flow to the retina. 84. Betaxolol (Betoptic) eye drops have been prescribed for the client with glaucoma. The nurse monitoring this client for side effects of the medication would place highest priority on which of the following? 1. Pulse rate 2. Blood glucose 3. Respiratory rate 4. Oxygen saturation 85. The client who has sustained an eye injury has been prescribed prednisolone (Inflamase). The nurse would most carefully monitor for side effects of this medication if the client has which of the following health problems listed on the medical record? 1. Cirrhosis 2. Hypertension 3. Diabetes mellitus 4. Chronic constipation 86. The client with chronic glaucoma is being started on medication therapy with acetazolamide (Diamox). The nurse teaches the client that which of the following symptoms can occur early in the use of this medication? 1. Diuresis 2. Fatigue 3. Headache 4. Loss of libido 87. The nurse is assisting in the care of a client who is being seen in the clinic with a suspected acetaminophen (Tylenol) overdose. Which of the following medications should the nurse plan to have readily available if the suspected diagnosis is confirmed? 1. Auranofin (Ridaura) 2. Pentostatin (Nipent) 3. Fludarabine (Fludara) 4. Acetylcysteine (Mucomyst) 88. The client reports frequent use of acetaminophen (Tylenol) for relief of frequent headaches and other discomforts. The nurse should evaluate which of the diagnostic data to determine if the client is at risk for toxicity? 1. The chest x-ray 2. The upper gastrointestinal x-ray results 3. The electrocardiogram 4. The liver function studies 89. The client with a history of spinal cord injury is beginning medication therapy with baclofen (Lioresal). The nurse determines that the client understands the side effects of the medication if the client states which of the following? 1. “The medication may make me drowsy.” 2. “The medication can cause high blood pressure.” 3. “The medication may increase my sensitivity to bright light.” 4. “The medication may cause me to have some muscle pain.” 90. The nurse is assisting in the care of a client who is being evaluated for possible myasthenia gravis. The health care provider gives a test dose of edrophonium (Tensilon). Evaluation of the results indicates that the test is positive. Which of the following would be the expected response noted by the nurse? 1. Joint pain for the next 15 minutes 2. A decrease in muscle strength within 1 to 3 minutes 3. An increase in muscle strength within 1 to 3 minutes 4. Feelings of faintness or dizziness for 5 to 10 minutes 91. The nurse is assisting in the care of a client with myasthenia gravis who is receiving pyridostigmine (Mestinon). Which of the following medications should the nurse plan to have readily available should the client develop cholinergic crisis because of excessive medication dosage? 1. Vitamin K 2. Atropine sulfate 3. Protamine sulfate 4. Acetylcysteine (Mucomyst) 92. The client with myasthenia gravis becomes increasingly weaker. The physician injects a dose of edrophonium (Tensilon) to determine whether the client is experiencing a myasthenic crisis or a cholinergic crisis. The nurse expects that the client will have which of the following reactions if the client is in cholinergic crisis? 1. No change in the condition 2. Complaints of muscle spasms 3. An improvement of the weakness 4. A temporary worsening of the condition 93. The nurse is providing instructions to a client beginning medication therapy with divalproex sodium (Depakote) for treatment of absence seizures. The nurse instructs the client that which of the following represents the most frequent side effect of this medication? 1. Tinnitus 2. Irritability 3. Blue vision 4. Nausea and vomiting 94. The nurse is speaking with a female client taking phenytoin (Dilantin) for seizure control. The client states that she has started using birth control pills to prevent pregnancy. Which of the following would be an important point for the nurse to stress to the client? 1. Oral contraceptives decrease the effectiveness of phenytoin. 2. Severe gastrointestinal side effects can occur when phenytoin and oral contraceptives are taken together. 3. There is an increased risk of thrombophlebitis when phenytoin and oral contraceptives are taken at the same time. 4. Phenytoin may decrease effectiveness of birth control pills, and additional measures should be taken to avoid pregnancy. 95. The nurse is reading the laboratory results for a client being treated with carbamazepine (Tegretol) for prophylaxis of complex partial seizures. When evaluating the client’s laboratory data, the nurse determines that which of the following values is consistent with an adverse effect of this medication? 1. Blood urea nitrogen (BUN), 19 mg/dL 2. Sodium level, 136 mEq/L 3. Platelet count, 350,000/mm3 4. White blood cell count, 3200/mm3 96. The nurse is caring for a client receiving codeine sulfate for pain. The nurse determines that the client is experiencing a side effect of the medication based on which of the following findings? 1. Distended jugular veins 2. Bounding peripheral pulses 3. No bowel movement in 3 days 4. Change in blood pressure from 120/60 to 140/80 mm Hg 97. The nurse is administering a prescribed dose of dexamethasone (Decadron) to a client following cranial surgery. Which of the following interventions would the nurse perform to assess for a common side effect of this medication? 1. Monitor for hair loss. 2. Monitor laboratory test results for hyperkalemia. 3. Assess for decreased skin turgor. 4. Obtain a prescription for blood glucose monitoring. 98. The client with a new medication prescription for allopurinol (Zyloprim) asks the nurse, “I know this is for gout, but how does it work?” In formulating a response, the nurse understands that allopurinol: 1. Decreases uric acid production 2. Reduces the production of fibrinogen 3. Lowers the risk of sulfa crystal formation in the urine 4. Prevents influx of calcium ions during cell depolarization 99. The client newly diagnosed with gout has been prescribed allopurinol (Zyloprim). The nurse would be concerned if the client was also currently taking: 1. Digoxin (Lanoxin) 2. Adenosine (Adenocard) 3. Warfarin (Coumadin) 4. Ergonovine maleate (Ergotrate) 100. The client tentatively diagnosed with gout has received a prescription for colchicine. The nurse understands that colchicine is a(n): 1. Anti-inflammatory agent specific for gout 2. Nonsteroidal anti-inflammatory drug (NSAID) 3. Analgesic that relieves pain 4. Osmotic diuretic that facilitates the removal of uric acid 101. The client with osteoarthritis is receiving diclofenac sodium (Voltaren). The nurse would be concerned about the administration of this medication if the client’s history and physical included a diagnosis of: 1. Graves’ disease 2. Peptic ulcer disease 3. Coronary artery disease 4. Benign prostatic hypertrophy 102. Baclofen (Lioresal) is prescribed for the client with multiple sclerosis. The nurse determines that the medication is having the intended effect if which of the following is noted in the client? 1. Increased muscle tone 2. Increased range of motion 3. Decreased muscle spasms 4. Decreased local pain and tenderness 103. Dantrolene sodium (Dantrium) is prescribed for the client experiencing flexor spasms. The client asks the nurse how the medication is going to help. The nurse replies that this medication acts: 1. To depress the spinal reflexes causing the spasms 2. On the central nervous system (CNS) to suppress spasms 3. Directly on the skeletal muscle to relieve the spasms 4. Within the spinal cord to suppress excess reflex activity 104. The nurse is reviewing laboratory results for a client taking dantrolene sodium (Dantrium). The nurse should notify the physician if which of the following is noted on the laboratory report sheet? 1. Creatinine level, 0.6 mg/dL 2. Platelet count, 290,000/mm3 3. Blood urea nitrogen (BUN) level, 9 mg/dL 4. Lactic dehydrogenase (LDH) level, 600 units/L 105. The nurse is reviewing the medical record of a newly assigned client and notes that the client is receiving cyclobenzaprine hydrochloride (Flexeril) for the treatment of muscle spasms. The nurse questions the prescription if which of the following disorders is noted in the admission history? 1. Hypothyroidism 2. Chronic bronchitis 3. Recurrent pneumonia 4. Angle-closure glaucoma 106. The nurse is assigned to care for a client with multiple sclerosis who is receiving an intravenous (IV) dose of methocarbamol (Robaxin). The nurse monitors the client knowing that which of the following is an expected side effect? 1. Dark green colored urine 2. Excitability 3. Insomnia 4. Hypertension 107. The nurse is collecting data from a client with a history of renal transplantation. The nurse understands that the medication of choice for preventing organ rejection is: 1. Probenecid 2. Indomethacin (Indocin) 3. Prednisone 4. Cyclosporine (Sandimmune) 108. Cyclosporine (Sandimmune) is prescribed for the client following allogenic kidney transplantation. The nurse provides instructions to the client regarding the medication and tells the client that: 1. There are no known adverse effects of the medication. 2. The medication will need to be taken for a period of 6 months. 3. Blood levels of the medication will need to be measured periodically. 4. The medication is administered by the intravenous (IV) route on a monthly basis. 109. Blood work has been drawn on a client who has been taking cyclosporine (Sandimmune) following allogenic liver transplantation. The nurse checks the results of which of the following tests to determine the presence of an adverse effect related to this medication? 1. Hematocrit level 2. Hemoglobin level 3. Cholesterol level 4. Blood urea nitrogen (BUN) level 110. Dapsone (DDS) is prescribed for a client with acquired immunodeficiency syndrome (AIDS) for the treatment of toxoplasmosis. The nurse provides medication instructions and determines that the client understands the instructions if the client states that he or she will: 1. Report a sore throat to the physician. 2. Discontinue the medication if nausea develops. 3. Plan to take the medication every 4 hours around the clock. 4. Expect that abdominal pain and jaundice will occur as normal side effects. 111. The client who is seropositive for human immunodeficiency virus (HIV) has been taking ritonavir (Norvir). The nurse tells the client that which follow-up laboratory study will be necessary while taking this medication? 1. Platelet count 2. Triglyceride level 3. Prothrombin time (PT) 4. International normalized ratio (INR) 112. The client who is seropositive for human immunodeficiency virus (HIV) has been taking stavudine (d4T, Zerit XR). The nurse assesses which of the following most closely while the client is taking this medication? 1. Appetite 2. Gastrointestinal function 3. Presence of paresthesia 4. Level of consciousness (LOC) 113. The nurse is assigned to care for a client with cytomegalovirus retinitis and acquired immunodeficiency syndrome (AIDS) who is receiving foscarnet (Foscavir). The nurse reviews the physician’s prescriptions, expecting to note a prescription for which of the following laboratory tests while this client is taking the medication? 1. CD4+ cell count 2. Serum albumin level 3. Serum creatinine level 4. Lymphocyte count 114. The client with acquired immunodeficiency syndrome (AIDS) and Pneumocystis jiroveci infection has been receiving pentamidine (Pentam 300). The nurse caring for the client monitors the client most closely for signs of: 1. Nausea 2. Fatigue 3. Infection 4. CD4+ cell count 115. The client with human immunodeficiency virus (HIV) infection has been started on therapy with zidovudine (AZT, Retrovir). The nurse reviews the physician’s prescriptions, expecting to note that which of the following laboratory tests have been prescribed? 1. Blood culture 2. Blood glucose level 3. Blood urea nitrogen level (BUN) 4. Complete blood cell count (CBC) 116. The nurse is preparing to administer pentamidine isethionate (Pentam 300) to an assigned client by the intravenous route. The nurse plans to monitor which of the following most closely after administering this medication? 1. Capillary refill 2. Peripheral pulses 3. Blood pressure (BP) 4. Level of consciousness 117. Ketoconazole (Nizoral) is prescribed for an assigned client. The nurse prepares to administer the medication: 1. With food 2. With an antacid 3. With 8 oz of water 4. On an empty stomach 118. A client receiving long-term therapy with lithium carbonate (Lithobid) exhibits muscle tremors, confusion, vomiting, and diarrhea. The nurse anticipates that the results of the latest test of the serum lithium level will be between: 1. 0 and 0.5 mEq/L 2. 0.6 and 1.0 mEq/L 3. 1.0 and 1.3 mEq/L 4. 1.5 and 2.0 mEq/L 119. The nurse is administering thioridazine hydrochloride (Mellaril). The nurse will monitor the client carefully for which of the following? 1. Weight gain 2. Photosensitivity 3. Cardiac dysrhythmias 4. Extrapyramidal movements 120. A client has been started on therapy with lithium carbonate (Lithobid). The nurse instructs the client to do which of the following? 1. Limit salt intake. 2. Limit food intake. 3. Maintain a fluid intake of 2 to 3 L/day. 4. Stop the medication if gastrointestinal (GI) disturbances occur. 121. The nurse is discussing the past week’s activities with a client receiving amitriptyline hydrochloride. The nurse determines that the medication is most effective for this client if the client reports which of the following? 1. A decrease in appetite 2. Sleeping 14 to 16 hours each day 3. Ability to get to work on time each day 4. Having difficulty concentrating on an activity 122. The client taking buspirone hydrochloride (BuSpar) for 1 month is scheduled for a follow-up appointment. The nurse gathers data from the client and interprets that the medication is effective if the client reports an absence of: 1. Delusions 2. Paranoid thoughts 3. Palpitations and anxiety 4. Alcohol withdrawal symptoms 123. The nurse employed in the mental health clinic is interviewing a female client who has had clomipramine hydrochloride (Anafranil) prescribed. The nurse interprets that the client is noncompliant with taking the medication as prescribed if the client exhibits which of the following behaviors? 1. Tired, fatigued appearance 2. Complaints of hunger and fatigue 3. Slight dizziness when standing up quickly 4. Frequently checking her purse for her keys 124. The client has been started on medication therapy with alprazolam (Xanax). When the nurse teaches the client that the medication should not be discontinued abruptly, the client asks why. The nurse should incorporate which of the following when formulating a reply? 1. The client is likely to suffer irreversible kidney damage. 2. The client is likely to become resistant to medication effects. 3. It will make the medication much less effective if it must be restarted. 4. Rebound central nervous system (CNS) excitation could occur, including seizure activity. 125. The client with schizophrenia has been started on medication therapy with clozapine (Clozaril). The nurse reviews the results of laboratory studies for this client to detect which of the following adverse effects of this medication? 1. Platelet count 2. Blood glucose level 3. Liver function 4. White blood cell (WBC) count COMPLETION 1. The nurse is preparing to administer a 50-mcg dose of medication to a client. The medication is available in 100 mcg/5 mL. How many mL should the nurse administer? Answer: __________ mL 2. A client is prescribed to receive metoclopramide (Reglan) 5 mg IV. How many milliliters should the nurse administer if the available concentration is 10 mg/2 mL? Answer: __________ mL MULTIPLE RESPONSE 1. The nurse is assigned to care for a client with metastatic breast cancer who is taking tamoxifen citrate (Soltamox). The nurse plans to monitor for which of the following changes in laboratory values for this client? Select all that apply. 1. Increased lipase level 2. Increased serum potassium level 3. Increasing blood glucose level 4. Increase in serum calcium level 5. Decreased low-density lipoprotein levels 2. When teaching the client with adrenal insufficiency about cortisone (Cortone), the nurse should include which of the following? Select all that apply. 1. Increase intake of sodium. 2. Take the medication with food. 3. Increase intake of potassium-rich foods. 4. Stay away from people with active infections. 5. Discontinue the medication when symptoms subside. 6. Notify the physician if illness occurs or surgery is anticipated. 3. The client has begun therapy with oxtriphylline. The nurse determines that the client understands dietary alterations if the client states to limit which of the following while taking this medication? Select all that apply. 1. Milk 2. Coffee 3. Oysters 4. Oranges 5. Pineapple 6. Chocolate 4. The nurse has provided discharge instructions to a client being placed on long-term anticoagulant therapy with warfarin (Coumadin). Adequate learning would be evident if the client makes which of the following statements? Select all that apply. 1. “I will inform my dentist that I am taking Coumadin.” 2. “I may take over-the-counter medications as needed.” 3. “I should alternate the timing of my daily dose of Coumadin.” 4. “I will have my blood levels checked as prescribed by my physician.” 5. “I will report any signs of blood in my urine or stool to my physician.” 6. “I should use a firm-bristled toothbrush to prevent the side effects of Coumadin.” . 5. The nurse is assisting in the care of a client being discharged on phenytoin (Dilantin), 100 mg 3 times daily, for seizure control. When providing client teaching about this medication, the nurse should be sure to include which of the following points? Select all that apply. 1. Break the capsules so they are easier to swallow. 2. Use a soft toothbrush while taking this medication. 3. If a dose is missed, just wait until the next one is due. 4. Alcohol should be avoided while taking this medication. 5. The medication may turn the client’s urine pink, red, or brown. 6. Sore throat is a common side effect of the medication and is nothing to worry about. 6. The client with schizophrenia has been started on medication therapy with clozapine (Clozaril). Which of the following are side effects of this medication? Select all that apply. 1. Diarrhea 2. Sedation 3. Dry mouth 4. Weight loss 5. Orthostatic hypotension 6. Presence of a fixed stare 7. The client has begun taking phenelzine (Nardil). At the initiation of therapy, which of the following items does the nurse teach the client to allow in the diet? Select all that apply. 1. Avocados 2. Figs and raisins 3. Bologna or salami 4. Carrots or radishes 5. Sweet potatoes and squash 6. Red wine, such as Chianti or sherry 8. The nurse has a prescription to administer a dose of iron by a parenteral route to an assigned client. Which of the following would the nurse implement to administer this medication correctly via the intramuscular route? Select all that apply. 1. Use a Z-track method. 2. Administer the medication only in the deltoid. 3. Aspirate for blood after the needle is inserted. 4. Use an air lock when drawing up the medication. 5. Change the needle after drawing up the dose and before injection. 6. Massage the injection site well after injection to hasten absorption. Carbidopa-levodopa (Sinemet) adverse effect? Impaired voluntary movements The home health nurse visits a client who is taking phenytoin (Dilantin) for control of seizures. During the assessment, the nurse notes that the client is taking birth control pills. Which information should the nurse include in the teaching plan? Meperidine hydrochloride (Demerol) has been prescribed for a client to treat pain. Which are side/adverse effects of this medication? Select all that apply. 1. Diarrhea 2. Tremors 3. Drowsiness 4. Hypotension 5. Urinary frequency 6. Increased respiratory rate ◦2. Tremors ◦3. Drowsiness ◦4. Hypotension ? 3. Slurred speech c/o of back spams, Since aspirin intoxication is suspected, the nurse should assess the client for which manifestation? 1. Tinnitus 7. A client with trigeminal neuralgia is being treated with carbamazepine (Tegretol), 400 The nurse in a long-term care facility is reviewing the health care provider's (HCP) prescriptions on an assigned client. The nurse notes that the HCP prescribed ropinirole hydrochloride (Requip). The nurse determines that this medication has been prescribed to treat which condition in the client? 4. Parkinsonian syndrome A client is receiving phenobarbital sodium (Luminal) for the treatment of a seizure disorder. Which finding on the nursing assessment would indicate that the client is experiencing a common side effect of this medication? 1. Drowsiness A client with suspected opioid overdose has received a dose of naloxone hydrochloride (Narcan). The client subsequently becomes restless, starts to vomit, and complains of 50 mg/min A client is scheduled to begin medication therapy with valproic acid (Depakene). The nurse looks for the results of which laboratory test(s) before administering the first dose? Liver function tests A client is scheduled to begin therapy with carbamazepine (Tegretol). The nurse should assess the results of which test(s) before administering the first dose of this medication to the client? Complete blood cell count Dantrolene sodium (Dantrium) has been administered to a client with a spinal cord injury. The nurse determines that the client is experiencing an adverse effect of the medication if which is noted? Abdominal pain The nurse notes that a client taking ergotamine tartrate (Cafergot) is having the intended effects of therapy if the client states relief from which symptom? Headaches A client who has been taking phenytoin (Dilantin) for seizure control has a serum phenytoin drug level of 8 mcg/mL. The nurse should make which interpretation about this value? An inadequate drug level A client has a medication prescription for phenytoin (Dilantin) to be administered by the intravenous route. After drawing up the medication, the nurse notes the presence of precipitate in the syringe. Which action should the nurse take Discard the syringe and begin again. A client with a diagnosis of Parkinson's disease began taking amantadine (Symmetrel) approximately 2 weeks ago. The client reports to the clinic for a follow-up evaluation. The nurse determines that the client is experiencing an adverse effect related to the use of this medication if which is noted? Client complaints of urinary retention A client with insomnia has been started on zolpidem (Ambien). After instructing the client in how to obtain the maximal effect of zolpidem, the nurse determines that the client demonstrates understanding of correct administration of the medication by which The nurse has the following prescription for a postcraniotomy client, "dexamethasone (Decadron) 4 mg by the intravenous (IV) route now." How does the nurse administer the medication? IV push over 1 minute A client is experiencing impotence after taking guanfacine (Tenex). The client states, "I would sooner have a stroke than keep living with the effects of this medication." What is the most appropriate response by the nurse? You are concerned about the effects of your medication." A client with Parkinson's disease has been prescribed benztropine (Cogentin). The nurse should assess for which gastrointestinal (GI) problems as a side effect of this medication? Dry mouth A client has been prescribed cyclobenzaprine (Flexeril) for the treatment of painful muscle spasms accompanying a herniated intervertebral disk. The nurse should withhold the medication and question the prescription if the client has a concurrent prescription for which medication? Tranylcypromine (Parnate) to perform which action? Institute seizure precautions. The nurse has a prescription to administer phenytoin (Dilantin) 100 mg by the intravenous (IV) route to a client. The nurse administers the medication after preparing it in which solution? 0.9% normal saline with an in-line filter The nurse in the health care provider's office is reviewing the results of a client's phenytoin (Dilantin) level determination performed that morning. The nurse identifies that a therapeutic drug level has been achieved if which result is noted? 15 mcg/mL A client with a history of simple partial seizures is taking clorazepate (Tranxene). The client asks the nurse if there is a risk of addiction with this medication. The nurse's long 30 minutes A client with narcolepsy has been prescribed dextroamphetamine (DextroStat). The client complains to the nurse that he cannot sleep well at night and does not want to take the medication any longer. Before making any specific comment, the nurse plans medication at what time? 30 minutes before meals A client with myasthenia gravis who is taking neostigmine (Prostigmin) is experiencing frequent exacerbations of myasthenic crisis and cholinergic crisis. The nurse teaches the client that it is most important that this medication be taken in which manner? On time A client began taking amantadine (Symmetrel) approximately 2 weeks ago. The nurse determines that the medication is having a therapeutic effect if the client exhibits which finding? Decreased rigidity and akinesia A client has been prescribed a cough formula containing codeine sulfate. The nurse has given the client instructions for its use. The nurse concludes that the client understands the instructions if the client verbalizes to self-assess for which side effect? Constipation Propofol (Diprivan) is prescribed to induce sedation in a client who is intubated and is Complete blood cell (CBC) count A nurse is transcribing a prescription for antibiotic therapy for a client with bacterial meningitis. The nurse understands that the medication that will be prescribed for the client will have which characteristic? Crosses the blood-brain barrier The health care provider is preparing to administer edrophonium (Enlon) to the client with myasthenia gravis. In planning care, the nurse understands which about the administration of edrophonium? Select all that apply. ◦2. Atropine is used to reverse the effects of edrophonium. ◦3. If symptoms worsen following administration of edrophonium, the crisis is cholinergic. ◦4. Edrophonium is used to distinguish between a myasthenic crisis and a cholinergic Normal saline solution A client is suspected of having myasthenia gravis. Edrophonium (Enlon) is administered intravenously to determine the diagnosis. Which indicates that the client may have myasthenia gravis? An increase in muscle strength within 30 to 60 seconds following administration of the medication Meperidine hydrochloride (Demerol) is prescribed for a client with pain. What should the nurse monitor for as a side/adverse effect of this medication? Urinary retention The nurse is caring for a client receiving morphine sulfate for pain. Because this medication has been prescribed for this client, which nursing action should be included in the plan of care? Encourage the client to cough and deep breathe. A nurse is caring for a client who has been taking hydrocodone for the last 3 months. Which side/adverse effects of this medication should the nurse assess the client for Psychological and physical dependence A nurse is reviewing the results of a test on a sample drawn from a child who is receiving carbamazepine (Tegretol) for the control of seizures. The results indicate a serum carbamazepine level of 10 mcg/mL. The nurse analyzes the results and anticipates that the health care provider (HCP) will note which prescription? Continuation of the presently prescribed dosage The nurse is caring for a client who underwent an open reduction internal fixation to the right hip. When administering opioid analgesics for pain, the nurse should instruct the client that The nurse is assisting in the care of a client with myasthenia gravis who is receiving pyridostigmine (Mestinon). Which medication should the nurse plan to have readily available should the client develop cholinergic crisis because of excessive medication dosage? Atropine sulfate A client with myasthenia gravis becomes increasingly weaker. The health care provider (HCP) injects a dose of edrophonium (Enlon) to determine whether the client is experiencing a myasthenic crisis or a cholinergic crisis. The nurse expects that the client will have which reaction if in cholinergic crisis? A temporary worsening of the condition A nurse is providing instructions to a client beginning medication therapy with divalproex sodium (Depakote) for treatment of absence seizures. The nurse instructs the client that which represents the most frequent side effect of this medication? Nausea and vomiting A nurse is speaking with a client taking phenytoin (Dilantin) for seizure control. The client states that she has started using birth control pills to prevent pregnancy. Which would be an important point for the nurse to emphasize to the client? Phenytoin may decrease effectiveness of birth control pills, and additional measures should be taken to avoid pregnancy. A nurse is reading the laboratory results for a client being treated with carbamazepine (Tegretol) for prophylaxis of complex partial seizures. When evaluating the client's laboratory test will be prescribed? triglyceride test A client with squamous cell carcinoma of the larynx is receiving bleomycin intravenously. The nurse caring for the client anticipates that which diagnostic study will be prescribed? pulmonary function studies Bleomycin is an antineoplastic medication that can cause interstitial pneumonitis, which can progress to pulmonary fibrosis. Pulmonary function studies along with hematological, hepatic, and renal function tests need to be monitored. The nurse needs to monitor lung sounds for dyspnea and crackles, which indicate pulmonary toxicity. The medication needs to be discontinued immediately if pulmonary toxicity occurs. he nurse is monitoring a client who is taking digoxin (Lanoxin) for adverse effects. Which findings are characteristic of digoxin toxicity? Select all that apply. Nausea and vomiting Diarrhea Blurred vision Nausea and vomiting Prior to administering a client's daily dose of digoxin, the nurse reviews the client's laboratory data and notes the following results: serum calcium, 9.8 mg/dL; serum magnesium, 1.2 mg/dL; serum potassium, 4.1 mEq/L; serum creatinine, 0.9 mg/dL. Which result should alert the nurse that the client is at risk for digoxin toxicity? should check which measurement before administering the medication? Weight Apical pulse Blood pressure Potassium level Blood pressure Ramipril (Altace) is an angiotensin-converting enzyme (ACE) inhibitor, and a serious side effect of this drug is profound hypotension. The client's blood pressure should be checked before administration of this medication. The medication does not cause weight gain or loss, bradycardia, or depletion of potassium. Study Mode Question 22 of 111 ▲▼ A client with hypertension has a new prescription for a medication called moexipril (Univasc). The nurse plans to provide written directions that tell the client to take the contact the HCP if which assessment finding is documented in the client's medical record? Muscle weakness History of asthma Presence of infection Complete atrioventricular (AV) block Complete atrioventricular (AV) block Quinidine gluconate is an antidysrhythmic medication used to maintain normal sinus rhythm after conversion of atrial fibrillation or atrial flutter. It is contraindicated in complete AV block Study Mode Question 43 of 111 ▲▼ Reduce pain. Reduce inflammation. Inhibit platelet aggregation. Maintain a normal body temperature. Inhibit platelet aggregation. Atenolol (Tenormin) has been prescribed for a client, and the client asks the nurse about the action of the medication. How should the nurse respond regarding the action of this medication? Slows the heart rate Allergy to eggs Nephrotic syndrome Allergy to sulfonamides Allergy to sulfonamides The nurse is performing an assessment on a client with a diagnosis of chronic angina pectoris. The client is receiving sotalol (Betapace) orally daily. Which assessment finding indicates to the nurse that the client is experiencing a side/adverse effect related to the medication? Dry mouth Diaphoresis Palpitations Difficulty swallowing Palpitations Daily administration of dipyridamole (Persantine) been prescribed for the client, and the nurse teaches the client about the medication. Which client statement indicates an understanding of the instructions? "This medication will prevent a stroke." "This medication will prevent a heart attack." " this client relative to the medication therapy? Auscultate bowel sounds. Study Mode Question 91 of 111 ▲▼ A nurse is caring for a client with hyperlipidemia who is taking cholestyramine (Questran). Which nursing assessment is most significant for this client relative to the medication therapy? Test-Taking Strategy: Note the strategic word most and focus on the subject, assessment of the client receiving cholestyramine (Questran). Knowledge of the medication is needed to answer this question. Remember that the medication's site of action is the bowel and can result in constipation. This will direct you to option 2. The other options do not relate to this medication A nurse should educate the client receiving pravastatin (Pravachol) to immediately report which finding? atigue Diarrhea Sore throat Muscle pain Muscle pain Pravastatin is used to treat hyperlipidemia. Muscle pain could indicate rhabdomyolysis, a serious complication of this medication. A health care provider writes a prescription for digoxin (Lanoxin), 0.25 mg daily. The nurse teaches the client about the medication and tells the client that it is most important to be sure to implement which measure? if the pulse is slower than 60 bpm Study Mode Question 107 of 111 ▲▼ The nurse has a prescription to give a client a scheduled dose of digoxin (Lanoxin). Prior to administering the medication, the nurse should assess for which manifestations that could indicate digoxin toxicity? Dyspnea, edema, and palpitations Chest pain, hypotension, and paresthesias Constipation, dry mouth, and sleep disorder Double vision, loss of appetite, and nausea "The medication causes the pupil to constrict and will lower the pressure in the eye." In preparation for cataract surgery, the nurse is to administer cyclopentolate (Cyclogyl) eyedrops. The nurse understands that which characterizes the medication action? Produces miosis of the operative eye Dilates the pupil of the operative eye Constricts the pupil of the operative eye Provides lubrication to the operative eye Dilates the pupil of the operative eye The nurse is performing an admission assessment on a client who has a history of glaucoma and uses latanoprost (Xalatan) eye drops. Which assessment finding would indicate a side effect of these eye drops? Irregular pulse Periorbital edema Elevated blood pressure Brown pigmentation of the iris Brown pigmentation of the iris Study Mode Question 15 of 31 ▲▼ The nursing student is assigned to care for a client with glaucoma for whom pilocarpine hydrochloride (Isopto Carpine) eye drops have been prescribed. The nursing instructor asks the student to describe the action of the eye medication. Which statement by the student indicates an understanding of the purpose of this medication? "The medication prevents blurred vision by relaxing the muscles of the eyes." "The medication dilates the eye to prevent increased pressure from occurring." "The medication increases the blood flow to the retina and also will lower the pressure in the eye." " Monitoring body weight This medication is an antiglaucoma medication and a β-adrenergic blocker. The nurse assesses for evidence of heart failure manifested by dizziness, night cough, peripheral edema, and distended neck veins The nurse working in a long-term care facility notes that several clients are taking pilocarpine hydrochloride (Isopto Carpine) eye drops. The nurse ensures that which medication is available on the nursing unit for use if a client should develop systemic toxicity from pilocarpine hydrochloride? Atropine sulfate Disulfiram (Antabuse) Naloxone hydrochloride Cyclopentolate (Cyclogyl) Atropine sulfate Pilocarpine hydrochloride is a cholinergic agent. Atropine sulfate must be available in the event of systemic toxicity from pilocarpine hydrochloride. The preoperative medication sheet identifies that cyclopentolate (Cyclogyl) is prescribed for a client before cataract surgery. Which is the action of the medication? It lubricates the eye. Constriction of the pupil occurs. Paralysis of the ciliary muscle occurs. This medication will promote miosis. Paralysis of the ciliary muscle occurs. client with chronic glaucoma is being started on medication therapy with acetazolamide (Diamox). The nurse teaches the client that which can occur early with the use of this medication? Fatigue Diuresis Headache Loss of libido Diuresis Diuresis is an early side effect of acetazolamide that usually subsides with continued treatment. This is because the medication is also a weak diuretic, although it is no longer prescribed for that purpose. Fatigue, headache, and loss of libido are common Vomiting following cancer chemotherapy A client with gastrointestinal hypermotility has a prescription to receive atropine sulfate. The nurse should withhold the medication and question the prescription if the client has a history of which disease process? Biliary colic Sinus bradycardia Peptic ulcer disease Narrow-angle glaucoma Narrow-angle glaucoma Atropine sulfate can cause a blockade of muscarinic receptors on the iris sphincter, producing mydriasis (dilation of the pupils). It also produces cycloplegia (relaxation of the ciliary muscles). It is contraindicated in clients with narrow-angle glaucoma. The other options are therapeutic reasons for using the medication. atropine sulfate is an anticholinergic medication. Next, think about the effects of an anticholinergic and about the therapeutic reasons for using atropine sulfate to direct you to the correct option. A client has received a dose of dimenhydrinate (Dramamine). The nurse should observe relief of what symptom to evaluate that the medication has been effective? Chills Headache Nausea and vomiting Side effects of scopolamine, an anticholinergic medication, are dry mouth, urinary retention, decreased sweating, and dilation of the pupils. Each of the incorrect options states the opposite of a side effect of this medication. A client in the postanesthesia care unit (PACU) has a prescription for droperidol (Inapsine). The nurse determines that this medication has been prescribed to treat which condition? Pain Nausea Headache Confusion Nausea After it is chilled in the refrigerator Study Mode Question 40 of 75 ▲▼ The nurse has administered prochlorperazine to a client for relief of nausea and vomiting. The nurse should then assess the client for which frequent side effect of this medication? Diarrhea Drooling Blurred vision Excessive tearing Blurred vision A client rings the call bell and asks for medication to relieve postoperative gas pains. The nurse selects which medication to be given as prescribed on the medication sheet? Droperidol Simethicone (Mylicon) Acetaminophen (Tylenol) Magnesium hydroxide (MOM) Simethicone (Mylicon) Mineral oil has been prescribed for a child with constipation, and the nurse teaches the ▲▼ Which finding suggests to the nurse that a client with bleeding esophageal varices is experiencing an adverse effect of vasopressin therapy? Complaints of chest pain Vasopressin therapy causes vasoconstriction, and adverse effects include myocardial ischemia, which may be evident by the client's complaints of chest pain Study Mode Question 73 of 75 ▲▼ A client with recurrent constipation has been prescribed psyllium (Metamucil). Teaching provided by the nurse should include which instruction? Metamucil is a bulk-forming laxative. It should be mixed with 8 oz of water or juice, followed by drinking another 8 oz of liquid. This will help prevent impaction of the medication in the stomach or small intestine. The other options are incorrect methods of administration. A client with acquired immunodeficiency syndrome experiences nausea, vomiting, and abdominal pain radiating to the back after taking didanosine (Videx). The ambulatory care nurse should provide which response as telephone advice to this client? Pancreatitis, which can be fatal, is the major dose-limiting toxicity associated with the administration of didanosine. Clients should be monitored for indications of developing pancreatitis, which include increased serum amylase in association with increased serum triglycerides; decreased serum calcium; and nausea, vomiting, or abdominal pain radiating to the back. If evolving pancreatitis is diagnosed, the medication should be discontinued. The client should be seen by the HCP. A client with acquired immunodeficiency syndrome is taking zalcitabine. The nurse interprets that the client is experiencing an adverse effect of this medication if which is reported by the client? Numbness or burning sensations in the arms or legs Numbness or burning sensations in the arms or legs A client with human immunodeficiency virus infection is taking indinavir (Crixivan). The nurse plans to provide the client with which direction when providing instructions about the use of this medication? Options 2 and 3 can be eliminated first because they are comparable or alike. Regarding the remaining choices, recall that medication absorption is maximized if the medication is taken on an empty stomach. Study Mode Question 26 of 112 ▲▼ A client is receiving acyclovir (Zovirax) by the intravenous (IV) route for treatment of cytomegalovirus infection. After reconstituting the powder dispensed by the pharmacy, the nurse should administer this medication via which method? Slow IV infusion over 1 hour A client has been diagnosed with chlamydial infection, and azithromycin (Zithromax) has been prescribed. The nurse should instruct the client to take the medication in which way? Eliminate options 1, 3, and 4 because they are comparable or alike in that they all indicate administration of the medication with another substance. Study Mode Question 34 of 112 ▲▼ The nurse is developing a plan of care for a client who is receiving amphotericin B intravenously to treat a severe fungal infection. A main component of the plan of care is monitoring for adverse effects related to the administration of this medication. Which should the nurse include in a list of manifestations to watch for? Amphotericin B is an antifungal. Vision and hearing alterations, seizures, hepatic failure, paresthesias (tingling, numbness, or pain in the hands and feet), and coagulation defects also occur. Other adverse reactions include nephrotoxicity, which occurs commonly and is evidenced by decreased urine output. Cardiovascular toxicity (as evidenced by hypotension and ventricular fibrillation) and anaphylactic reaction occur rarely. Tobramycin sulfate is prescribed for a client with a diagnosis of cellulitis. The nurse is administering the medication by intermittent intravenous infusion every 8 hours. The nurse monitors the client for signs of an adverse effect related to this medication and determines that which, if noted on assessment, would indicate the presence of an adverse effect? A client has been receiving foscarnet sodium as part of therapy for the treatment of cytomegalovirus retinitis and acquired immunodeficiency syndrome (AIDS). The home care nurse should periodically review results of which laboratory blood test to assess for adverse effects to this medication? A client is scheduled to receive a first dose of pentamidine (Pentam 300) intravenously. What should the nurse plan to carefully monitor as the priority during administration of pentamidine can cause severe and sudden hypotension Pyrimethamine (Daraprim) has been added to the medication regimen for a client with acquired immunodeficiency syndrome. On review of the client's record, the nurse notes this new prescription and plans care knowing that it has been prescribed to treat which condition? Cyclosporine (Sandimmune) is prescribed for a client who received a kidney transplant. The nurse would be most concerned if a review of the medical record revealed that the client currently is taking which prescribed medications? Question 54 of 112 ▲▼ The nurse is preparing to administer a prescribed dose of cyclosporine (Sandimmune) by intravenous (IV) administration. Which priority item would the nurse have available during administration of this medication? Abacavir succinate (Ziagen) has been prescribed for a client, and the client asks the nurse about the action of the medication. How should the nurse respond? Inhibits activity of HIV-1 reverse transcriptase Inhibits activity of HIV-1 reverse transcriptase Abacavir (Ziagen) has been prescribed for a client. The nurse tells the client that which blood test will be done periodically while the client is taking this medication? Liver function tests Abacavir (Ziagen) has been prescribed for a client, who asks the nurse about the side effect of the medication. What should the nurse tell the client is a frequent side effect of this medication? A client admitted to the hospital is taking abacavir (Ziagen). The nurse should monitor the client for which adverse effect of the medication? A client admitted to the hospital is taking zidovudine (Retrovir). The nurse monitors the client for which adverse effect of the medication? Neurotoxicity A 2-year-old with Pneumocystis jiroveci pneumonia is to begin treatment with highly active antiretroviral therapy (HAART). The nurse anticipates that the health care One nucleoside reverse transcriptase inhibitor and one non-nucleoside reverse transcriptase inhibitor Two nucleoside analogues and one protease inhibitor Recall that antiviral therapy includes both reverse transcriptase inhibitors and protease inhibitors A nurse is monitoring a client receiving cyclosporine (Sandimmune). Which sign or symptom should indicate to the nurse that the client is experiencing an adverse effect from this medication? Tremors A nurse is preparing to administer ticarcillin. An abnormal elevation in which laboratory value should prompt the nurse to withhold the medication and notify the health care provider before administering the medication? nurse reviews the medication history of a client and notes that the client is taking leflunomide (Arava). During assessment of the client, the nurse should ask which question to determine the effectiveness of this medication? Leflunomide is an immunomodulatory agent and has an anti-inflammatory action. The medication provides symptomatic relief of rheumatoid arthritis The nurse notes that a client is receiving lamivudine (Epivir). The nurse determines that this medication has been prescribed to treat which condition? Human immunodeficiency virus (HIV) Human immunodeficiency virus (HIV) A pregnant client who has human immunodeficiency virus (HIV) infection is being seen in the antenatal clinic. The nurse recalls that zidovudine (AZT) therapy will be initiated when the fetus has reached how many weeks of gestation? A client is receiving tacrolimus (Prograf) to prevent organ rejection. Which is a nursing consideration associated with this medication? A nurse is collecting data from a client with a history of renal transplantation. The nurse understands that which medication is the medication of choice for preventing organ rejection? The client who is seropositive for human immunodeficiency virus (HIV) has been taking ritonavir (Norvir). The nurse tells the client that which follow-up laboratory study will be necessary while taking this medication? Eliminate options 1, 3, and 4 because they are comparable or alike in that they relate to bleeding and clotting factors. A client who is seropositive for human immunodeficiency virus (HIV) has been taking stavudine (d4T, Zerit XR). The nurse assesses which most closely while the client is taking this medication? The medication can cause peripheral neuropathy The nurse is preparing to administer pentamidine (Pentam 300) to an assigned client by the intravenous route. The nurse plans to monitor which item most closely after administering this medication? Blood pressure (BP) Ketoconazole is prescribed for an assigned client. The nurse prepares to administer the medication by which method? With food Allopurinol (Zyloprim) is prescribed for a client and the nurse provides medication instructions to the client. Which instruction should the nurse provide? - since allopurinol treats gout/kidney stones it is important to drink enough fluid to further decrease risk of kidney stone formation Colchicine (Colcrys) is prescribed for a client with a diagnosis of gout. The nurse reviews the client's record, knowing that this medication would be used with caution in which disorder? Diabetes mellitus Kidney disease The nurse is analyzing the laboratory studies on a client receiving dantrolene sodium (Dantrium). Which laboratory test would identify an adverse effect associated with the administration of this medication? Liver function tests Cyclobenzaprine hydrochloride (Flexeril) is prescribed for a client for muscle spasms and the nurse is reviewing the client's record. Which disorder, if noted in the record, would indicate a need to contact the health care provider about the administration of this medication? cyclobenzaprine hydrochloride has anticholinergic effects, can increase eye pressure The nurse is administering an intravenous dose of methocarbamol (Robaxin) to a client with multiple sclerosis. For which side/adverse effect should the nurse monitor? - methocarbamol (Robaxin) is a muscle relaxant via lowering action potential through agonism of Gaba a receptor Oral dantrolene sodium (Dantrium) has been prescribed to a client for the treatment of spasticity. The nurse understands that the usual maintenance adult dosage of this medication is which dosage? Auranofin (Ridaura) has been prescribed for a client with rheumatoid arthritis. The nurse provides instructions to the client about the medication and tells the client to notify the health care provider (HCP) if which occurs? Auranofin is a gold preparation that is given orally rather than by injection. Early signs and symptoms of toxic reactions A client with multiple sclerosis is receiving baclofen (Lioresal). The nurse assessing the client monitors for which finding as an indication of a primary therapeutic response to the medication? Increased range of motion of all extremities Decreased muscle spasms A client with muscle spasms in the lumbar area of the spine has been started on cyclobenzaprine (Flexeril). The nurse should monitor for which most frequent side effect of the medication? Question 22 of 61 ▲▼ Etanercept (Enbrel) is prescribed for a client with rheumatoid arthritis. The nurse should monitor the client for which adverse effect of the medication following administration? Note the subject, adverse effects. Use the ABCs-airway, breathing, and circulation- The nurse notes that a client has been taking colchicine. The nurse assesses the client for which finding that is an indication for the use of this medication? Dantrolene (Dantrium) is prescribed for a client with spinal cord injury for discomfort caused by spasticity. Which laboratory measure should the nurse monitor while the client is taking this medication? A client with a diagnosis of rheumatoid arthritis is taking sulindac (Clinoril). The health care provider prescribes misoprostol (Cytotec) for the client. The nurse explains that this medication has been prescribed for which purpose? A nurse is collecting data from a client and notes that the client is taking acetylsalicylic acid (ASA), or aspirin, 5 g daily in divided doses. The nurse determines that this medication has been prescribed to treat which condition? Acetylsalicylic acid (ASA), or aspirin, has been prescribed for a client with rheumatoid arthritis. The nurse tells the client that a blood test to assess the serum aspirin level will be done periodically. Which is the therapeutic serum level for an antiarthritic effect? Acetylsalicylic acid (ASA), or aspirin, has been prescribed for a client, and the client asks the nurse about the side effects of the medication. The nurse responds that which is an occasional side effect of ASA? What should the nurse anticipate when evaluating for the effects of raloxifene (Evista) in an older client? Raloxifene is an estrogen receptor modulator. It was developed to limit the side effects of estrogen while producing beneficial effects Dantrolene sodium (Dantrium) is prescribed for the client experiencing flexor spasms. The nurse monitors the client, knowing that which is the therapeutic action of this medication? Acts directly on the skeletal muscle to relieve spasticity The health care provider is planning to administer a skeletal muscle relaxant to a client with a spinal cord injury. The medication will be administered intrathecally (within the spinal column). Which medication should the nurse expect to be prescribed and administered by this route? Baclofen (Lioresal) A client with muscle spasms is taking an oral maintenance dose of baclofen (Lioresal). Which represents a safe maintenance dose for this medication? Calcium carbonate (Os-Cal) is prescribed for a client with hypocalcemia. How should the nurse instruct the client to take the medication? The nurse asks a nursing student about the uses of the medication dantrolene (Dantrium). The nursing student correctly states that dantrolene is used to manage hypermetabolism of skeletal muscle that occurs in which condition? A client tentatively diagnosed with gout has received a prescription for colchicine. The nurse understands that colchicine is which type of medication? A client with osteoarthritis is receiving diclofenac sodium (Voltaren). The nurse would be concerned about the administration of this medication if the client's history and physical included a diagnosis of which condition? Diclofenac sodium (Voltaren) is a nonsteroidal anti-inflammatory drug (NSAID). It is a prostaglandin inhibitor and decreases mucous production in the stomach. Use of NSAIDs in the client with ulcer disease could place the client at risk for perforation and hemorrhage A nurse is reviewing laboratory results for a client taking dantrolene sodium (Dantrium). The nurse should notify the health care provider (HCP) if which finding is noted on the laboratory report sheet? Creatinine level 0.6 mg/dL treatment and throughout the treatment interval. It is administered in the lowest effective dosage for the shortest time necessary. The LDH level reported in option 4 is high. (The normal level is 140 to 280 units/L A nurse is assigned to care for a client with multiple sclerosis who is receiving an intravenous (IV) dose of methocarbamol (Robaxin). The nurse monitors the client knowing that which is an expected side effect? 1. Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which finding indicates the presence of systemic toxicity from this medication? 1. Tinnitus 2. Diarrhea 3. Constipation 4. Decreased respirations 2. Mafenide acetate (Sulfamylon) is prescribed for a client with a burn injury. When applying the medication, the client complains of local discomfort and burning. The nurse should take which most appropriate action? 1. Discontinue the medication. 2. Notify the health care provider. 3. Inform the client that this is expected 4. Apply a thinner film than prescribed to the burn site. 3. A burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site of injury. The nurse monitors the client, knowing that which finding indicates that a systemic effect has occurred? 1. Hyperventilation 2. Local rash at the burn site 3. Elevated blood pressure 4. Isotretinoin (Amnesteem or Claravis) is prescribed for a client with severe acne. Before the administration of this medication, the nurse anticipates that which laboratory test will be prescribed? 1. Platelet count 2. Triglyceride level 3. Complete blood count 4. White blood cell count 5. A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes isotretinoin (Amnesteem or Claravis). The nurse reviews the client's medication record and would contact the HCP if the client is taking which medication? 1. Vitamin A 2. Digoxin (Lanoxin) 3. Furosemide (Lasix) 4. Phenytoin (Dilantin) 6. The nurse is applying a topical corticosteroid to a client with eczema. The nurse should monitor for the potential for increased systemic absorption of the medication if the medication were being applied to which body area? 1. Back 2. Axilla 3. Soles of the feet 4. Palms of the hands 7. The clinic nurse is performing an admission assessment on a client and notes that the client is taking azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect that the client is being treated for which condition? 1. Acne 2. Eczema 3. Hair loss 4. Herpes simplex 8. Silver sulfadiazine (Silvadene, Thermazene, SSD cream) is prescribed for a client with a partial-thickness burn and the nurse provides teaching about the medication. Which statement made by the client indicates a need for further teaching about the treatments? 1. "The medication is an antibacterial." 2. "The medication will help heal the burn." 3. "The medication will permanently stain my skin." 4. "The medication should be applied directly to the wound." 9. The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse reminds the children that chemical sunscreens are most effective when applied at which times? 1. Immediately before swimming 2. 5 minutes before exposure to the sun 3. Immediately before exposure to the sun 4. At least 30 minutes before exposure to the sun 10. A hospitalized client is diagnosed with scabies. The health care provider (HCP) recommended that the client and the client's roommate be treated with lindane. Which finding if noted on this client's chart would alert the nurse to notify the HCP before the treatment with lindane? 1. Client history of diabetes 2. Client history of hypertension 3. Client history of seizure disorders 4. Client history of coronary artery disease 11. Isotretinoin (Clavaris) has been prescribed for an adolescent with a diagnosis of severe cystic acne. The nurse provides instructions to the adolescent regarding the use of the medication. Which statement, if made by the adolescent, indicates a need for further instruction? 1. "I will return to the clinic for blood tests." 2. "If my lips begin to burn, this is probably because of the medication." 3. "My eyes may become dry and burn as a result of the medication." 4. "I need to be sure to take my vitamin A supplement so that the treatment will work." 12. The clinic nurse is caring for a client with a diagnosis of scabies who has just been prescribed crotamiton (Eurax). The nurse instructs the client to perform which action when applying this medication? 1. Apply the medication to the entire body, washing it off after 2 hours. 2. Apply the application to the entire body, leave it on for 24 hours, and then take a cleansing bath. 3. Apply the medication to the entire body, avoiding the skin folds and creases, and wash it off in 12 hours. 4. Massage the medication into the skin from the chin downward. Apply a second application in 24 hours, followed by a cleansing bath 48 hours after the second application. 13. A client has been given diphenhydramine (Benadryl) as a topical agent for allergic dermatitis. The nurse should instruct the client to observe for which intended medication effect? 1. Nighttime sedation 2. A decrease in urticaria 3. Healing of burned tissue 4. Resolution of ecchymoses 14. A home health nurse is visiting a client who has been started on therapy with clotrimazole (Lotrimin). The nurse determineseffectiveness of the medication by noting a decrease in which problem? 1. Pain 2. Rash 3. Fever 4. Sneezing 15. An outbreak of head lice infestation has occurred at a local school. The school nurse is providing instructions to the mothers of the children attending the school regarding the application of malathion (Ovide). The nurse should tell the mothers to take which action? 1. Apply the lotion immediately after washing the hair. 2. Pour the lotion onto the hair and then rinse immediately. 3. Allow the lotion to remain on the hair for 10 minutes and then rinse with water. 4. Leave the lotion on for 8 to 12 hours, and then wash the hair with nonmedicated shampoo. 16. A client is seen in the clinic for a complaint of scalp itching that has been persistent over the past several weeks. After an assessment, it is determined that the client has head lice. Lindane shampoo is prescribed, and the nurse provides instructions to the client regarding the use of the medication. The nurse should tell the client to take which measure? 1. Apply the shampoo as prescribed for 10 days in a row. 2. Apply the shampoo to the entire head, neck, and chest area. 3. Work the shampoo into dry hair, and leave it in place for 4 minutes. 4. Leave the shampoo on for 8 to 12 hours and then remove by washing. 17. Lindane is prescribed for the treatment of scabies. The nurse reviews the client's record, knowing that this medication therapy would be contraindicated in which situation? 1. A 17-year-old with seizure disorders 2. An older client with diabetes mellitus 3. A 52-year-old man with hypertension 4. A 42-year-old woman with coronary artery disease 18. The nurse is applying a topical glucocorticoid as prescribed for a client with psoriasis. The nurse would be least concerned about the potential for systemic absorption of the medication if it were being applied to which body area? 1. Back 2. Neck 3. Scalp 4. Axilla 19. A topical glucocorticoid is prescribed for an infant with dermatitis in the gluteal area. The nurse provides instructions to the mother regarding the use of the medication. Which statement by the mother indicates an understanding of the use of the medication? 1. "I should not rub the medication into the skin." 2. "The medication will help relieve the inflammation." 3. "I need to apply the medication in a thick layer to protect the skin." 4. "I should protect the area by covering with a diaper and plastic pants." 20. A child with severe seborrheic dermatitis is receiving treatments of topical glucocorticoid applied over an extensive area of the body, followed by the application of an occlusive dressing. The nurse should monitor the child closely, knowing that which systemic effect can occur as a result of this treatment? 1. Local infection 2. Growth retardation 3. Thinning of the skin 4. Adrenal hyperactivity 21. A client with acute seborrheic dermatitis of the back, chest, and legs is receiving treatments with salicylic acid. The nurse should monitor the client for which symptom that indicates the presence of systemic toxicity from this medication? 1. Diarrhea 2. Constipation 3. Lower leg pain 4. Increased respirations 22. Topical azelaic acid (Azelex) is prescribed for a client, and the clinic nurse provides instructions regarding the use of this medication. Which statement by the client indicates a need for further instruction? 1. "I need to apply the medication twice daily." 2. "I The medication is used to treat my eczema." 3. "I need to massage a thin film gently into the affected area." 4. "I need to wash and dry my skin before I apply the medication." 23. Minoxidil (Rogaine) is prescribed for a client to treat hair loss. The nurse provides instructions to the client regarding the application of the medication. Which statement by the client indicates that teaching is effective? 1. "I will apply the prescribed amount of solution at bedtime." 2. "I will apply the prescribed amount of solution twice a day." 3. "I will apply the prescribed amount of solution four times a day." 4. "I will apply the prescribed amount of solution three times a day." 24. Minoxidil (Rogaine) is prescribed for a client to treat hair loss. The client asks the nurse if the hair will continue to grow when the medication is stopped. What is the appropriate nursing response? 1. "The hair will continue to grow." 2. "Newly gained hair is lost in 3 to 4 months." 3. "I'm not sure—you need to ask your health care provider." 4. "It depends on how long you have been taking the medication." 25. The school nurse has provided instructions regarding the use of permethrin rinse (Nix) to the parents of children diagnosed with pediculosis capitis (head lice). Which statement by one of the parents indicates a need for further instruction? 1. "The hair should not be shampooed for 24 hours after treatment." 2. "It is applied to the hair after shampooing and left on for 24 hours." 3. "The permethrin rinse can be obtained over the counter in a local pharmacy." 4. "It is applied to the hair after shampooing, left on for 10 minutes, and then rinsed out." 26. A child is diagnosed with impetigo. The health care provider prescribes a topical medication for treatment. The nurse anticipates that which medication will be prescribed? 1. Cortisone 2. Benzoyl peroxide 3. Acyclovir (Zovirax) 4. Mupirocin (Bactroban) 27. Coal tar has been prescribed for the client with psoriasis, and the nurse provides instructions to the client regarding this treatment. Which statement by the client indicates a need for further instruction? 1. "The medication can cause diarrhea." 2. "The medication can cause phototoxicity." 3. "The medication has an unpleasant odor." 4. "The medication can stain the skin and hair." 28. Mafenide acetate (Sulfamylon) is prescribed for a client with a burn injury to the hand. Which should the nurse include in the instructions to the client regarding the use of this medication? 1. If stinging occurs, discontinue the medication. 2. Apply a thinner film than prescribed to the burn site if the medication stings. 3. It is normal to experience local discomfort and stinging and burning after the medication is applied. 4. If local stinging and burning occur after the medication is applied, notify the health care provider. 29. A burn-injured client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site of injury. The nurse should monitor the client for which systemic effect that can occur from the use of this medication? 1. Acidosis 2. Alkalosis 3. Hypotension 4. Hypertension 30. A Vigilon nonocclusive burn dressing is prescribed for a client with a partial-thickness burn to the hand. The nurse includes which intervention in the plan of care regarding this treatment? 1. Change the Vigilon dressing weekly. 2. Change the Vigilon dressing every 3 days. 3. Apply the Vigilon dressing over a sterile dry dressing. 4. Secure the Vigilon dressing over the wound with tape. 31. Sodium hypochlorite (Dakin's) solution is prescribed for a client with a wound on the left foot that is draining purulent material. Which action should the nurse plan to take? 1. Irrigate the wound with the solution. 2. Soak the foot in the solution for 20 minutes daily. 3. Place the solution in the wound and cover with an occlusive dressing. 4. Soak a sterile dressing with the solution and pack the dressing into the wound. 32. Tretinoin (Retin-A) is prescribed for a client with acne, and the nurse provides instructions to the client regarding the medication. Which statement by the client indicates a need for further instruction? 1. "I need to avoid exposure to the sun." 2. "I should start to see results in 2 to 3 weeks." 3. "I will cleanse the skin thoroughly before applying the medication." 4. "If my skin begins to peel, I will notify the health care provider (HCP)." 33. The nurse provides instructions to a client regarding the use of tretinoin (Retin-A). Which statement by the client indicates a need for further instruction? 1. "I should begin to see results in about 3 weeks." 2. "I will apply the medication liberally to the skin." 3. "I will wash my hands thoroughly after applying this medication." 4. "I cannot use any cosmetics while I am using this medication." 34. Isotretinoin (Claravis) is prescribed for a client to treat severe cystic acne, and the nurse provides instructions to the client regarding the medication. Which statement by the client indicates a need for further instruction? 1. "I need to take the medication with food." 2. "I will be taking the medication twice a day." 3. "I will need to take the medication for 15 to 20 weeks." 4. "I can crush the tablets if I have difficulty swallowing them." 35. Isotretinoin (Claravis) is prescribed for a client with severe acne. The nurse instructs the client regarding the importance of follow-up assessments to evaluate which laboratory value? 1. Cholesterol level 2. Triglyceride level 3. Sedimentation rate 4. Complete blood cell count 36. A health care provider (HCP) prescribes isotretinoin (Claravis) for a client with severe acne. The nurse reviews the client's record and notifies the HCP if which prescribed medication is noted on the medication record? 1. Digoxin (Lanoxin) 2. Furosemide (Lasix) 3. Phenytoin (Dilantin) 4. Doxycycline (Vibramycin) 37. The health care provider has prescribed a topical anti-inflammatory cream for a client with a muscular sprain. The nurse provides instructions to the client regarding the medication. Which statement by the client indicates an understanding of this prescribed treatment? 1. "The medication is addicting." 2. "The medication will act as a local anesthetic." 3. "I will apply a heating pad to the area after applying the medication." 4. "The medication may make me sleepy but will stop the muscle spasms." 38. Collagenase (Santyl) is prescribed for a client with a severe burn to the hand. The home care nurse provides instructions to the client regarding the use of the medication. Which client statement indicates an accurate understanding of the use of this medication? 1. "I will apply the ointment at bedtime and in the morning." 2. "I will apply the ointment once a day and leave it open to the air." 3. "I will apply the ointment twice a day and leave it open to the air." 4. "I will apply the ointment once a day and cover it with a sterile dressing." 39. Lindane is prescribed to a client for the treatment of scabies. The nurse reviews the client's record knowing that this medication is contraindicated in which client? 1. An older client 2. A 6-year-old child 3. A 42-year-old woman 4. A 52-year-old man with hypertension 40. Hydrocolloid gel (DuoDERM) is prescribed for a client with a leg ulcer. The home health nurse is preparing a plan of care for the client and should appropriately document which intervention? 1. Changing the DuoDERM daily 2. Changing the DuoDERM every 3 to 5 days 3. Applying the DuoDERM over a dry, sterile dressing 4. Applying the DuoDERM over a normal saline-soaked dressing 41. A nurse is caring for a client with a burn injury to the lower legs. Nitrofurazone is prescribed to be applied to the sites of injury. Which action should the nurse document in the plan of care as the appropriate method for applying this medication? 1. Apply a thick layer directly to the burn sites. 2. Apply a 1/16-inch film directly to the burn sites. 3. Apply saline-soaked dressings over the medication. 4. Apply a ½-inch film around the burn sites after cleansing the wounds. 42. The health care provider has prescribed coal tar treatments for a client with psoriasis, and the nurse provides information to the client about the treatments. Which statement, if made by the client, indicates a need for further education about the treatments? 1. "The medication has an unpleasant odor." 2. "The medication can cause phototoxicity." 3. "The medication can stain the skin and hair." 4. "The medication always causes systemic toxicity." 43. Sodium hypochlorite (Dakin's solution) is prescribed for a client with a leg wound that is draining purulent material. The home health nurse teaches a family member how to perform wound treatments. Which statement, if made by the family member, indicates a need for further teaching? 1. "A fresh solution needs to be prepared frequently." 2. "I should rinse the solution off immediately after the irrigation." 3. "The solution should not come in contact with normal skin tissue." 4. "I will soak a sterile dressing with solution and pack it into the wound." 44. The nurse has provided instructions to a client regarding the use of tretinoin (Retin-A). Which statement, if made by the client, indicates the need for further instructions? 1. "I must apply it to wet to damp skin." 2. "Optimal results will be seen after 6 weeks." 3. "I will wash my hands thoroughly after applying the medication." 4. "I will cleanse the skin thoroughly before applying the medication." 45. A client is seen in the clinic for complaints of skin itchiness that has persisted for several weeks. After an assessment, the client is determined to have scabies. Lindane is prescribed, and the nurse provides instructions to the client regarding the use of the medication. Which action should the nurse tell the client to take? 1. Apply the cream for 2 days in a row. 2. Apply a thick layer of cream to the entire body. 3. Apply the cream to the entire body and scalp, excluding the face. 4. Leave the cream on for 8 to 12 hours, and then remove it by washing. 46. A topical corticosteroid is prescribed for a client with dermatitis. The nurse provides instructions to the client regarding the use of the medication. Which statement by the client would indicate a need for further instruction? 1. "I need to apply the medication in a thin film." 2. "I should gently rub the medication into the skin." 3. "The medication will help relieve the inflammation and itching." 4. "I should place a bandage over the site after applying the medication." 47. Dextranomer is prescribed for a client with a pressure ulcer. The nursing instructor asks a nursing student, who is preparing to perform the treatment, about the medication and the procedure. Which statement, if made by the student, indicates a need for further research? 1. "It is effective in wet wounds." 2. "It should be packed lightly into the wound." 3. "The wound bed must be dried thoroughly before the medication is applied." 4. "Maceration of tissue surrounding the wound can occur from the medication." 48. The home health care nurse makes a home visit to a client who has an ulcer on the medial aspect of the left ankle. The wound is being treated with DuoDERM (a hydrocolloid). The nurse removes the DuoDERM, cleanses the wound as prescribed, and reapplies the DuoDERM. The nurse schedules the next visit for wound care and changing the DuoDERM in how many days, which is the maximum number of days? 49. Isotretinoin (Claravis) is prescribed for a client with severe cystic acne. The nurse provides instructions to the client regarding administration of the medication. Which phrase, if stated by the client, would indicate a need for further teaching regarding this medication? 1. "I need to continue to take my vitamin A supplements." 2. "The medication may cause dryness and burning in my eyes." 3. "I need to use emollients and lip balms for my dry skin and lips." 4. "I will need to return for a blood test to check my triglyceride level." 50. A burn client has been having 1% silver sulfadiazine applied to burns twice a day for the last 3 days. Which laboratory abnormality indicates that the client is experiencing an adverse effect of this medication? 1. Serum sodium of 120 mEq/L 2. Serum potassium of 3.0 mEq/L 3. White blood cells of 3000 cells/mm3 4. pH 7.30, Pco2 of 35 mm Hg, HCO3– of 19 mEq/L 51. A nurse is providing instructions to a mother of a child with atopic dermatitis (eczema) regarding the application of topical cortisone cream to the affected skin sites. Which statement, if made by the mother, indicates an understanding of the use of this medication? 1. "I shouldn't rub the medication into the skin." 2. "The medication is applied everywhere except the face." 3. "I need to wash the sites gently before I apply the medication." 4. "I need to apply the medication generously and allow it to absorb." 52. A client with psoriasis is being treated with calcipotriene (Dovonex) cream. Administration of high doses of this medication can cause which adverse effect? 1. Alopecia 2. Hyperkalemia 3. Hypercalcemia 4. Thinning of the skin 53. Collagenase (Santyl) is prescribed for a client with a severe burn to the hand. The nurse is providing instructions to the client and spouse regarding wound treatment. Which should the nurse include in the instructions? 1. Apply once a day and leave it open to the air. 2. Apply twice a day and leave it open to the air. 3. Apply twice a day and cover it with a sterile dressing. 4. Apply once a day and cover it with a sterile dressing. 54. The nurse is caring for a client at home with a diagnosis of actinic keratosis. The client tells the nurse that her skin is very dry and irritated. The treatment includes diclofenac sodium (Solaraze). The nurse teaches the client that this medication is from which class of medications? 1. Anti-infectives 2. Vitamin A lotions 3. Coal tar preparations 4. Nonsteroidal anti-inflammatory drugs (NSAIDs) 55. A client with muscle aches and a diagnosis of rheumatism has been given a prescription for capsaicin topical cream. The nurse determines that the client understands the use of the medication if the client makes which statement? 1. The medication will act as a local analgesic. 2. The medication acts by decreasing muscle spasms. 3. The medication will cause redness, flaking, and the skin to peel. 4. A heating pad should be put on the area after applying the medication. 56. A client with a burn injury is applying mafenide (Sulfamylon) to the wound. The client calls the health care provider's office and tells the nurse that the medication is uncomfortable and is causing a burning sensation. The nurse should instruct the client to take which action? 1. Discontinue the medication. 2. Continue with the treatment, as this is expected. 3. Apply a thinner film than prescribed to the burn site. 4. Come to the office to see the health care provider (HCP) immediately. 57. A client with an infected leg wound that is draining purulent material has a prescription for sodium hypochlorite (Dakin solution) to be used in the care of the wound. The nurse should implement which action while using this solution? 1. Rinse off immediately following irrigation. 2. Pour onto sterile sponges, and pack in wound. 3. Let the solution run freely over normal skin tissue. 4. Use each bottle of solution for 2 weeks before replacing. 58. An adolescent with severe cystic acne has been prescribed isotretinoin (Claravis). Which statement by the client would suggest the need for further teaching? 1. "I will return to the clinic for blood tests." 2. "If my lips begin to burn, it is probably because of the medication." 3. "My eyes may become dry and burn as a result of the medication." 4. "I need to take my vitamin A supplement so that the treatment will work." 59. An ambulatory care client with allergic dermatitis has been given a prescription for a tube of diphenhydramine (Benadryl) 1% to use as a topical agent. The nurse determines that the medication was effective if which finding was noted? 1. Nighttime sedation 2. Decrease in urticaria 3. Absence of ecchymoses 4. Healing of burned tissue 1. Chemotherapy dosage is frequently based on total body surface area (BSA), so it is important for the nurse to perform which assessment before administering chemotherapy? 1. Measure the client's abdominal girth. 2. Calculate the client's body mass index. 3. Ask the client about his or her weight and height. 4. Measure the client's current weight and height. 2. A client with squamous cell carcinoma of the larynx is receiving bleomycin intravenously. The nurse caring for the client anticipates that which diagnostic study will be prescribed? 1. Echocardiography 2. Electrocardiography 3. Cervical radiography 4. Pulmonary function studies A client with acute myelocytic leukemia is being treated with busulfan (Myleran, Busulfex). Which laboratory value would the nurse specifically monitor during treatment with this medication? 1. Clotting time 2. Uric acid level 3. Potassium level 4. Blood glucose level 3. A client with small cell lung cancer is being treated with etoposide (Toposar). The nurse monitors the client during administration, knowing that which adverse effect is specifically associated with this medication? 1. Alopecia 2. Chest pain 3. Pulmonary fibrosis 4. Orthostatic hypotension 4. A clinic nurse prepares a teaching plan for a client receiving an antineoplastic medication. When implementing the plan, the nurse should make which statement to the client? 1. "You can take aspirin (acetylsalicylic acid) as needed for headache." 2. "You can drink beverages containing alcohol in moderate amounts each evening." 3. "You need to consult with the health care provider (HCP) before receiving immunizations." 4. "It is fine to receive a flu vaccine at the local health fair without HCP approval because the flu is so contagious." 5. A client with ovarian cancer is being treated with vincristine (Vincasar). The nurse monitors the client, knowing that which manifestation indicates an adverse effect specific to this medication? 1. Diarrhea 2. Hair loss 3. Chest pain 4.Peripheral neuropathy 6. The nurse is reviewing the history and physical examination of a client who will be receiving asparaginase (Elspar), an antineoplastic agent. The nurse contacts the health care provider before administering the medication if which disorder is documented in the client's history? 1. Pancreatitis 2. Diabetes mellitus 3. Myocardial infarction 4. Chronic obstructive pulmonary disease 7. Tamoxifen citrate is prescribed for a client with metastatic breast carcinoma. The nurse administering the medication understands that which is the primary action of this medication? 1. It increases DNA and RNA synthesis. 2. It promotes the biosynthesis of nucleic acids. 3. It increases estrogen concentration and estrogen response. 4. It competitively binds to estrogen receptors on tumors and other tissue targets. 8. A client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which laboratory value while the client is taking this medication? 1. Glucose level 2. Calcium level 3. Potassium level 4. Prothrombin time 9. Megestrol acetate (Megace), an antineoplastic medication, is prescribed for a client with metastatic endometrial carcinoma. The nurse reviews the client's history and should contact the health care provider if which diagnosis is documented in the client's history? 1. Gout 2. Asthma 3. Thrombophlebitis 4. Myocardial infarction 10. The nurse is monitoring the intravenous (IV) infusion of an antineoplastic medication. During the infusion, the client complains of pain at the insertion site. On inspection of the site, the nurse notes redness and swelling and that the infusion of the medication has slowed in rate. The nurse suspects extravasation and should take which actions? Select all that apply. 1. Stop the infusion. 2. Notify the health care provider (HCP). 3. Prepare to apply ice or heat to the site. 4. Restart the IV at a distal part of the same vein. 5. Prepare to administer a prescribed antidote into the site. 6. Increase the flow rate of the solution to flush the skin and subcutaneous tissue. 11. The nurse is analyzing the laboratory results of a client with leukemia who has received a regimen of chemotherapy. Which laboratory value would the nurse specifically note as a result of the massive cell destruction that occurred from the chemotherapy? 1. Anemia 2. Decreased platelets 3. Increased uric acid level 4. Decreased leukocyte count 12. The nurse is providing medication instructions to a client with breast cancer who is receiving cyclophosphamide. The nurse should tell the client to take which action? 1. Take the medication with food. 2. Increase fluid intake to 2000 to 3000 mL daily. 3. Decrease sodium intake while taking the medication. 4. Increase potassium intake while taking the medication. 13. A client with non–Hodgkin's lymphoma is receiving daunorubicin (DaunoXome). Which finding would indicate to the nurse that the client is experiencing an adverse effect related to the medication? 1. Fever 2. Sores in the mouth and throat 3. Complaints of nausea and vomiting 4. Crackles on auscultation of the lungs 14. The nurse is reviewing the record of a client who arrives at the health care clinic. The nurse notes that the client is taking letrozole (Femara). The nurse should suspect that the client has which disorder? 1. Hypothyroidism 2. Diabetes mellitus 3. Chronic kidney disease 4. Advanced breast cancer 15. A nurse is monitoring a client with acute lymphocytic leukemia for toxic effects of asparaginase (Elspar). The nurse should notify the health care provider if monitoring reveals which finding? 1. Alopecia 2. Oral ulcerations 3. Prolonged blood clotting times 4. Decreased white blood cell count 16. A client with testicular cancer is receiving cisplatin. The nurse assesses for which finding as a toxic effect of this medication? 1. Tinnitus 2. Diarrhea 3. Nausea and vomiting 4. Elevated white blood cell (WBC) count 17. The nurse transcribes a medication prescription for ifosfamide (Ifex) for a client with a diagnosis of germ cell cancer of the testes. The nurse reviews the client's history and looks for another prescription for which medication, which usually is administered with the antineoplastic medication? 1. Prednisone 2. Mesna (Mesnex) 3. Bleomycin sulfate 4. Melphalan (Alkeran) 18. A client with squamous cell carcinoma is receiving bleomycin. To determine whether adverse effects of this medication are occurring, the nurse should carefully assess which item? 1. Lung sounds 2. Platelet count 3. Blood pressure 4. White blood cell count 19. The nurse caring for a client receiving vincristine (Oncovin) is monitoring the client for toxicity. The nurse interprets that the client is experiencing a toxic effect of this medication on the basis of which assessment finding? 1. Nausea and vomiting 2. Decreased platelet count 3. Decreased white blood cell count 4. Weakness and sensory loss in the legs 20. A client with cancer is receiving a continuous intravenous infusion of morphine sulfate. The nurse monitoring the client for adverse effects would become most concerned about which vital sign? 1. Temperature of 99.1° F 2. Apical heart rate of 90 beats/min 3. Blood pressure of 110/70 mm Hg 4. Respirations of 10 breaths per minute 21. A client is receiving intravesical chemotherapy for cancer of the bladder. The nurse should plan to take which action after the completion of each treatment? 1. Encourage increased intake of oral fluids. 2. Provide increased doses of opioid analgesics. 3. Place the client on strict contact isolation for 24 hours. 4. Keep the client on nothing by mouth (nil per os [NPO]) status for 6 hours. 22. A female client with a diagnosis of breast cancer is taking cyclophosphamide. The client calls the health care clinic and tells the nurse that the medication is upsetting her stomach. Which instruction should the nurse provide to the client? 1. Take the medication with food. 2. Avoid drinking fluids while taking the medication. 3. Try to take the medication with a small amount of orange juice. 4. Continue to take the medication on an empty stomach, and lie down after taking the medication. 23. The nurse is preparing a plan of care for a client who will be receiving intravenous bleomycin sulfate for the treatment of cancer. In developing the plan of care, the nurse includes monitoring of which option as the priority? 1. Heart rate 2. Lung sounds 3. Bowel sounds 4. Level of consciousness 24. The nurse is monitoring a client with leukemia who is receiving doxorubicin (Adriamycin PFS) by intravenous infusion. The nurse should monitor for which assessment finding that would indicate toxicity to the medication? 1. Elevated creatinine 2. Red coloration in the urine 3. Elevated blood urea nitrogen 4. Electrocardiogram (ECG) changes 25. The nurse is collecting subjective and objective data from a client and notes that the client is taking capecitabine (Xeloda). The nurse determines that this medication has been prescribed to treat which condition? 1. Hypothyroidism 2. Kidney dysfunction 3. Cushing's syndrome 4. Metastatic breast cancer 26. Capecitabine (Xeloda) has been prescribed for a client, and the client asks the nurse about the action of the medication. The nurse responds that this medication has which mechanism of action? 1. Promotes DNA synthesis 2. Interferes with protein synthesis 3. Assists with the processing of RNA 4. Processes enzymes needed for cellular growth 27. The health care provider (HCP) writes a prescription for capecitabine (Xeloda) for a client who was admitted to the hospital. The nurse should contact the HCP to verify the prescription if which condition is noted in the assessment data? 1. Myalgia 2. Psoriasis 3. Rheumatoid arthritis 4. Chronic kidney disease 28. Capecitabine (Xeloda) has been prescribed for a client. The nurse should tell the client that which blood test will be done periodically while the client is taking this medication? 1. Liver function tests 2. Bilirubin level assay 3. Triglyceride level determination 4. Complete blood cell count (CBC) 29. Capecitabine (Xeloda) has been prescribed for a client, and the client asks the nurse about the side effects of the medication. The nurse responds that a frequent side effect of this medication is which finding? 1. Diarrhea 2. Weakness 3. Irritability 4. Increased appetite 30. A client admitted to the hospital is taking capecitabine (Xeloda). The nurse should monitor the client for which symptom that is an adverse effect of the medication? 1. Dyspnea 2. Dizziness 3. Headache 4. Constipation 31. Capecitabine (Xeloda) has been prescribed, and the nurse provides instructions to the client about the medication. Which statement by the client indicates the need for further instruction? 1. "I need to monitor my temperature." 2. "I need to be sure to go to the clinic to receive my yearly flu vaccine." 3. "I may have some diarrhea, but if it becomes severe, I will call my health care provider." 4. "It's important for me to contact my health care provider if I have any fever or other signs of infection." 32. A female client with carcinoma of the breast is admitted to the hospital for treatment with intravenously administered doxorubicin (Adriamycin). The client tells the nurse she has been told by her friends that she is going to lose all her hair. What is the appropriate nursing response? 1. "Your friends are correct." 2. "You will not lose your hair." 3. "Hair loss may occur, but it will grow back just as it is now." 4. "Hair loss may occur, and it will grow back, but it may have a different color or texture." 33. The clinic nurse prepares instructions for a client who developed stomatitis after the administration of a course of antineoplastic medications. The nurse should provide the client with which instruction? 1. Avoid foods and fluids for the next 24 hours. 2. Swab the mouth daily with lemon and glycerin pads. 3. Brush the teeth and use waxed dental floss three times a day. 4. Rinse the mouth with a diluted solution of baking soda or saline. 34. The client with bladder cancer is receiving cisplatin and vincristine (Vincasar PFS). The nurse preparing to give the medication understands that which is the purpose of administering both of these medications? 1. To prevent alopecia 2. To decrease the destruction of cells 3. To increase the therapeutic response 4. To prevent gastrointestinal side effects 35. A client with lung cancer is receiving a high dose of methotrexate (Trexall). Leucovorin (citrovorum factor, folic acid) is also prescribed. The nurse planning care for the client should understand that the purpose of administering the leucovorin is to promote which action? 1. Preserve normal cells. 2. Promote DNA synthesis. 3. Enable medication excretion. 4. Facilitate the synthesis of nucleic acids. 36. The nurse administering a combination chemotherapy regimen understands that it is important to implement which action? 1. Give two agents from the same medication class. 2. Give two agents with like nadirs at the same time. 3. Test the client's knowledge about each agent's nadir. 4. Avoid giving agents with the same nadirs and toxicities at the same time. 37. A client with cancer has received a course of chemotherapy and received fluorouracil (Adrucil). The nurse should tell the client to report which finding immediately? 1. Alopecia 2. Headache 3. Stomatitis and diarrhea 4. Changes in color vision 38. The nurse reviewing a medical record notes that high concentrations of methotrexate followed by leucovorin (citrovorum factor, folic acid) are being given to the client with cancer. The nurse correctly interprets that which is the reason for therapy with leucovorin? 1. Preserve normal cells. 2. Promote protein synthesis. 3. Promote medication excretion. 4. Hasten the effect of the methotrexate. 39. The nurse understands that which condition is an indication for the use of asparaginase (Elspar)? 1. Lung cancer 2. Breast cancer 3. Metastatic prostate cancer 4. Acute lymphocytic leukemia 40. The nurse is caring for a client on the oncology unit who has developed stomatitis during chemotherapy. The nurse should plan which measure to treat this complication? 1. Rinse the mouth with diluted baking soda or saline. 2. Use lemon and glycerin swabs liberally on painful oral lesions. 3. Place the client on NPO status for 12 hours, and then resume liquids. 4. Brush the teeth and use non-waxed dental floss at least twice a day. 41. A client who has been diagnosed with cancer is to receive chemotherapy with both cisplatin (Platinol-AQ) and vincristine (Oncovin). The client asks the nurse why both medications must be given together. The nurse's response is based on the understanding that the purpose of using both medications is to promote which action? 1. Increase the destruction of tumor cells. 2. Prevent the destruction of normal cells. 3. Decrease the risk of the alopecia and stomatitis. 4. Increase the likelihood of erythrocyte and leukocyte recovery. 42. The nurse tells a client with leukemia who is receiving chemotherapy that allopurinol (Zyloprim) has been added to the medication list. When the client asks the purpose of the new medication, the nurse responds that the allopurinol is intended to prevent which problem? 1. Nausea 2. Diarrhea 3. Muscle spasms 4. Hyperuricemia 43. The client with breast cancer has been given a prescription for cyclophosphamide. The nurse determines that the client understands the proper use of the medication if the client states that he or she will take which measure? 1. Increase dietary intake of potassium. 2. Increase fluid intake to 2 to 3 L/day. 3. Take the medication with large meals. 4. Decrease dietary intake of magnesium. 44. The nurse should be prepared to institute bleeding precautions in the client receiving antineoplastic medication if which result was reported from the laboratory? 1. Clotting time 12 seconds 2. Ammonia level 28 mcg/dL 3. Platelet count 50,000 cells/mm3 4. White blood cell count (WBC) 4500 cells/mm3 45. A client with cancer is about to be started on mitomycin (Mutamycin). The nurse should contact the health care provider after noting that the client is also taking which medication? 1. Furosemide (Lasix) 2. Ondansetron (Zofran) 3. Warfarin (Coumadin) 4. Allopurinol (Zyloprim) 46. A nurse is assigned to care for a client with metastatic breast cancer who is taking tamoxifen citrate. The nurse plans to monitor for which changes in laboratory values for this client? Select all that apply. 1. Increase in lipase level 2. Increase in blood glucose level 3. Increase in serum calcium level 4. Increase in serum potassium level 5. Decrease in low-density lipoprotein levels 47. A client has been on treatment for rheumatoid arthritis for 3 weeks. During the administration of etanercept, which is most important for the nurse to assess? 1. The injection site for itching and edema 2. The white blood cell counts and platelet counts 3. Whether the client is experiencing fatigue and joint pain 4. Whether the client is experiencing a metallic taste in the mouth, and a loss of appetite 48. Allopurinol (Zyloprim) is prescribed for a client and the nurse provides medication instructions to the client. Which instruction should the nurse provide? 1. Drink 3000 mL of fluid a day. 2. Take the medication on an empty stomach. 3. The effect of the medication will occur immediately. 4. Any swelling of the lips is a normal expected response. 49. Colchicine (Colcrys) is prescribed for a client with a diagnosis of gout. The nurse reviews the client's record, knowing that this medication would be used with caution in which disorder? 1. Myxedema 2. Kidney disease 3. Hypothyroidism 4. Diabetes mellitus 50. Alendronate (Fosamax) is prescribed for a client with osteoporosis and the nurse is providing instructions on administration of the medication. Which instruction should the nurse provide? 1. Take the medication at bedtime. 2. Take the medication in the morning with breakfast. 3. Lie down for 30 minutes after taking the medication. 4. Take the medication with a full glass of water after rising in the morning. 51. The nurse is preparing discharge instructions for a client receiving baclofen. Which instruction should be included in the teaching plan? 1. Restrict fluid intake. 2. Avoid the use of alcohol. 3. Stop the medication if diarrhea occurs. 4. Notify the health care provider (HCP) if fatigue occurs. 52. The nurse is analyzing the laboratory studies on a client receiving dantrolene sodium (Dantrium). Which laboratory test would identify an adverse effect associated with the administration of this medication? 1. Platelet count 2. Creatinine level 3. Liver function tests 4. Blood urea nitrogen level 53. Cyclobenzaprine hydrochloride (Flexeril) is prescribed for a client for muscle spasms and the nurse is reviewing the client's record. Which disorder, if noted in the record, would indicate a need to contact the health care provider about the administration of this medication? 1. Glaucoma 2. Emphysema 3. Hypothyroidism 4. Diabetes mellitus 54. In monitoring a client's response to disease-modifying antirheumatic drugs (DMARDs), which assessment findings would the nurse consider acceptable responses? Select all that apply. 1. Symptom control during periods of emotional stress 2. Normal white blood cell, platelet, and neutrophil counts 3. Radiological findings that show no progression of joint degeneration 4. An increased range of motion in the affected joints 3 months into therapy 5. Inflammation and irritation at the injection site 3 days after the injection is given 6. A low-grade temperature on rising in the morning that remains throughout the day 55. The nurse is administering an intravenous dose of methocarbamol (Robaxin) to a client with multiple sclerosis. For which side/adverse effect should the nurse monitor? 1. Tachycardia 2. Rapid pulse 3. Bradycardia 4. Hypertension 56. A client is taking large doses of acetylsalicylic acid (aspirin) for rheumatoid arthritis. Which assessment finding indicates that the client is experiencing ototoxicity as a result of the medication? 1. Dizziness, sore throat, and purpura 2. GI bleeding, ecchymosis, and dizziness 3. Gastrointestinal (GI) upset and dizziness 4. Tinnitus, hearing loss, dizziness, and ataxia 57. A client is seen in the hospital emergency department after injury to his right ankle. The client tells the nurse that he twisted his ankle while playing volleyball. The health care provider (HCP) has prescribed a topical analgesic cream for the injury. The nurse providing instruction about the medication should provide the client with which information? 1. To avoid hazardous activities while using the cream because it causes drowsiness 2. To apply the medication three times a day and place a heating pad on top of the area 3. That the medication contains a combination of medications, one of which is an analgesic 4. That the onset of headache indicates a systemic reaction and the HCP must be notified 58. Oral dantrolene sodium (Dantrium) has been prescribed to a client for the treatment of spasticity. The nurse understands that the usual maintenance adult dosage of this medication is which dosage? 1. 50 mg daily 2. 100 mg daily 3. 100 mg twice daily 4. 200 mg four times daily 59. A client with gout has begun to take allopurinol (Zyloprim). The home health nurse provides which instruction to the client when using the medication? 1. Drink at least 8 glasses of fluid every day. 2. Take the medication one hour before eating. 3. Put ice on the upper and lower lips if they swell. 4. Use an antihistamine lotion if an itchy rash develops. 60. The home health nurse is providing dietary instructions to a client who is taking probenecid (Benemid) for the treatment of gout. Which food should the nurse instruct the client to continue to eat? 1. Liver 2. Shrimp 3. Scallops 4. Spinach 61. Auranofin (Ridaura) has been prescribed for a client with rheumatoid arthritis. The nurse provides instructions to the client about the medication and tells the client to notify the health care provider (HCP) if which occurs? 1. Nausea 2. Diarrhea 3. Loss of appetite 4. Metallic taste in the mouth 62. An older client with rheumatoid arthritis has been instructed by the health care provider to take ibuprofen (Motrin IB) 300 mg orally (PO) four times daily. The home care nurse reading the medication prescription knows that the instruction has been effective when the client states the instructed dose is which? 1. The normal adult dose 2. Higher than the normal adult dose 3. An unusual dosage for this diagnosis 4. Two times higher than the normal adult dose 63. A client with multiple sclerosis is receiving baclofen (Lioresal). The nurse assessing the client monitors for which finding as an indication of a primary therapeutic response to the medication? 1. Decreased nausea 2. Decreased muscle spasms 3. Increased muscle tone and strength 4. Increased range of motion of all extremities 64. The nurse is providing medication instructions to a client with multiple sclerosis receiving baclofen (Lioresal). Which information should the nurse include in the instructions? 1. Watch for urinary retention as a side effect. 2. Stop taking the medication if diarrhea occurs. 3. Restrict fluid intake while taking this medication. 4. Notify the health care provider (HCP) if fatigue occurs. 65. The nurse overhears the health care provider (HCP) tell a client with rheumatoid arthritis that the condition needs to be treated with gold therapy. The nurse interprets that the HCP is referring to which medication? 1. Prednisone 2. Pentostatin (Nipent) 3. Auranofin (Ridaura) 4. Fludarabine (Fludara) 66. The home care nurse is visiting a client who sustained a severe muscle sprain to the back. Carisoprodol (Soma) is prescribed for the client. The nurse provides instructions to the client regarding the medication and should teach the client to take which measure? 1. To avoid driving until the reaction to the medication is known 2. To understand that muscle spasms will be reduced but the pain may increase 3. To limit alcohol consumption to two drinks daily while taking the medication 4. To try to avoid missing doses, but if a dose is missed to take it as soon as it is remembered 67. A client with muscle spasms in the lumbar area of the spine has been started on cyclobenzaprine (Flexeril). The nurse should monitor for which most frequent side effect of the medication? 1. Weakness 2. Confusion 3. Excitability 4. Drowsiness 68. Etanercept (Enbrel) is prescribed for a client with rheumatoid arthritis. The nurse should monitor the client for which adverse effect of the medication following administration? 1. Dyspnea 2. Headache 3. Dizziness 4. Abdominal discomfort 69. The nurse gives a dose of diazepam (Valium) to an assigned client. What is the most important action to be taken by the nurse before leaving the room? 1. Instituting safety measures 2. Closing the curtains in the room 3. Lowering the volume on the television set 4. Giving the client the remote control for the television set 70. The nurse notes that a client has been taking colchicine. The nurse assesses the client for which finding that is an indication for the use of this medication? 1. Double vision 2. Difficulty urinating 3. Migraine headaches 4. Joint inflammation and pain 71. A clinic nurse is performing an assessment on a client with rheumatoid arthritis who has been taking acetylsalicylic acid (aspirin) for the disorder. The nurse assesses the client for signs of aspirin toxicity. Which finding should alert the nurse to the possibility of toxicity? 1. Fever and signs of hyperventilation 2. Constipation and abdominal bloating 3. Client complaint of visual disturbances 4. A decreased respiratory rate and client complaint of diarrhea 72. Dantrolene (Dantrium) is prescribed for a client experiencing discomfort caused by spasticity. In providing instructions to the client regarding the medication, what should the nurse emphasize? 1. Return to the clinic in 1 month for an eye examination. 2. Expect that periodic liver function studies will be required. 3. Return to the clinic weekly for blood pressure measurements. 4. Expect that the medication may take 8 weeks to begin to have an effect. 73. A client has been administered cyclobenzaprine (Flexeril) for the management of muscle spasms in the cervical spine. The client is experiencing drowsiness, dizziness, and dry mouth. How should the nurse interpret these findings? 1. Represent an allergic reaction to the medication 2. Are related to the problem with the cervical spine 3. Are the most common side effects of this medication 4. Are dose related, so the client should cut the medication dose in half 74. The health care provider (HCP) has prescribed trolamine salicylate (Myoflex) topical cream for a client with a diagnosis of rheumatism who is complaining of muscular aches. Which should the nurse tell the client regarding this medication? 1. The medication will act as a local anesthetic. 2. The medication acts by decreasing muscle spasms. 3. The medication is prescribed to cause the skin to peel. 4. Apply a heating pad to the area after applying the medication. 75. Dantrolene (Dantrium) is prescribed for a client with spinal cord injury for discomfort caused by spasticity. Which laboratory measure should the nurse monitor while the client is taking this medication? 1. Creatinine 2. Sedimentation rate 3. Liver function studies 4. White blood cell count 76. A client with multiple sclerosis is receiving diazepam (Valium), a centrally acting skeletal muscle relaxant. Which finding, if noted during the nursing assessment, would indicate that the client is experiencing a side effect of this medication? 1. Headache 2. Drowsiness 3. Urinary retention 4. Increased salivation 77. A client with a diagnosis of rheumatoid arthritis is taking sulindac (Clinoril). The health care provider prescribes misoprostol (Cytotec) for the client. The nurse explains that this medication has been prescribed for which purpose? 1. To enhance the effects of the sulindac 2. To prepare the client for weaning off the sulindac 3. To prevent further development of arthritic nodules 4. To prevent gastric complications such as ulcer disease 78. Diclofenac (Voltaren) is prescribed for a client with osteoarthritis. Which medication, if noted on the client's record, would alert the nurse to consult with the health care provider? 1. Phenytoin (Dilantin) 2. Primidone (Mysoline) 3. Acetaminophen (Tylenol) 4. Warfarin sodium (Coumadin) 79. The home health nurse is reviewing medications with a client receiving colchicine for the treatment of gout. The nurse evaluates that the medication is effective if the client reports a decrease in which measure? 1. Headaches 2. Blood glucose 3. Blood pressure 4. Joint inflammation 80. A nurse is collecting data from a client and notes that the client is taking acetylsalicylic acid (ASA), or aspirin, 5 g daily in divided doses. The nurse determines that this medication has been prescribed to treat which condition? 1. Backache 2. Muscle aches 3. Frequent headaches 4. Rheumatoid arthritis 81. Acetylsalicylic acid (ASA), or aspirin, has been prescribed for a client with rheumatoid arthritis. The nurse tells the client that a blood test to assess the serum aspirin level will be done periodically. Which is the therapeutic serum level for an antiarthritic effect? 1. 5 to 10 mg/dL 2. 10 to 20 mg/dL 3. 20 to 30 mg/dL 4. 30 to 40 mg/dL 82. Acetylsalicylic acid (ASA), or aspirin, has been prescribed for a client, and the client asks the nurse about the side effects of the medication. The nurse responds that which is an occasional side effect of ASA? 1. Heartburn 2. Muscle aches 3. Constipation 4. Burning on urination 83. A client is admitted to the hospital, and the nurse notes that the client is taking acetylsalicylic acid (ASA), or aspirin, to treat a chronic rheumatoid disorder. The nurse should monitor the client for which sign or symptom that indicates a toxic effect of the medication? 1. Jaundice 2. Peripheral edema 3. Ringing in the ears 4. Bilateral lung crackles 84. Acetylsalicylic acid (ASA), or aspirin, has been prescribed for a client with rheumatoid arthritis, and the nurse provides instructions to the client about the medication. Which statement by the client indicates the need for further teaching? 1. "I should not crush or break the enteric-coated form of aspirin." 2. "I need to take this medication on an empty stomach for it to work." 3. "It may take 1 to 3 weeks for a therapeutic anti-inflammatory effect to occur." 4. "I should call my health care provider (HCP) if I experience stomach pain that will not go away." 85. What should the nurse anticipate when evaluating for the effects of raloxifene (Evista) in an older client? 1. Increased bone density 2. Relief of leg cramps and tenderness 3. A decrease in severity of hot flashes 4. A resumption of the menstrual cycle 86. Dantrolene sodium (Dantrium) is prescribed for the client experiencing flexor spasms. The nurse monitors the client, knowing that which is the therapeutic action of this medication? 1. Depresses spinal reflexes 2. Acts on the central nervous system to suppress spasms 3. Acts directly on the skeletal muscle to relieve spasticity 4. Acts within the spinal cord to suppress hyperactive reflexes 87. The health care provider is planning to administer a skeletal muscle relaxant to a client with a spinal cord injury. The medication will be administered intrathecally (within the spinal column). Which medication should the nurse expect to be prescribed and administered by this route? 1. Baclofen (Lioresal) 2. Chlorzoxazone (Parafon Forte) 3. Dantrolene sodium (Dantrium) 4. Cyclobenzaprine hydrochloride (Amrix) 88. The nurse is reviewing the health care provider's (HCP) prescriptions for an adult client who has been admitted to the hospital after a back injury. Carisoprodol (Soma) is prescribed for the client to relieve the muscle spasms. The HCP has prescribed 350 mg to be administered four times a day. Which should the nurse conclude? 1. The prescription is the normal adult dosage. 2. The prescription is lower than normal dosage. 3. The prescription is higher than normal dosage. 4. The dosage prescribed requires further clarification with the HCP. 89. A client who has rheumatoid arthritis has begun treatment with anakinra (Kineret) and has received the first injection. What finding would indicate that the health care provider (HCP) should be notified and that the medication should be discontinued? 1. Irritation and erythema at the injection site 2. Concurrent therapy with a tumor necrosis factor inhibitor 3. No relief of arthritic symptoms during the first week of treatment 4. White blood cell count of 12,000 cells/mm3 and a temperature of 99.9° F 90. A film-coated form of diflunisal, a nonsteroidal anti-inflammatory medication, has been prescribed for a client to treat chronic rheumatoid arthritis. The client calls the clinic nurse because of difficulty swallowing the tablets. Which instruction should the nurse provide to the client? 1. Crush the tablets and mix with food. 2. Open the tablet and mix the contents with food. 3. Swallow the tablets with large amounts of water or milk. 4. Notify the health care provider (HCP) for a medication change. 91. A client with muscle spasms is taking an oral maintenance dose of baclofen (Lioresal). Which represents a safe maintenance dose for this medication? 1. 15 mg four times daily 2. 25 mg four times daily 3. 30 mg four times daily 4. 40 mg four times daily 92. A client is to receive a prescription for methocarbamol (Robaxin). The nurse provides instructions to the client about the medication. Which client statement would indicate a need for further education? 1. "My urine may turn brown or green." 2. "I might get some nasal congestion from this medication." 3. "This medication is prescribed to help relieve my muscle spasms." 4. "If my vision becomes blurred, I don't need to be concerned about it." 93. A client is receiving baclofen (Lioresal) for muscle spasms because of a spinal cord injury. Which side/adverse effect related to this medication should the nurse monitor the client for? 1. Muscle pain 2. Hypertension 3. Slurred speech 4. Photosensitivity 94. Calcium carbonate (Os-Cal) is prescribed for a client with hypocalcemia. How should the nurse instruct the client to take the medication? 1. With meals 2. Every 4 hours 3. Just before meals 4. 1 hour after meals 95. A nurse is teaching a client who will be discharged on alendronate (Fosamax) about the medication. Which should be included in the teaching plan? Select all that apply. 1. Take the medication at the same time. 2. Report musculoskeletal pain immediately. 3. Take the medication on an empty stomach. 4. Consume coffee when taking the medication. 5. Remain upright for 30 minutes following ingestion. 96. The nurse asks a nursing student about the uses of the medication dantrolene (Dantrium). The nursing student correctly states that dantrolene is used to manage hypermetabolism of skeletal muscle that occurs in which condition? 1. Low back pain 2. General anesthesia 3. Malignant hyperthermia 4. Hyperplasia of the prostate 97. The nurse teaches the client with hypocalcemia to take calcium carbonate (Os-Cal) at which time? 1. With breakfast 2. At lunch time 3. Just before a meal 4. One hour after a meal 98. A client with a history of spinal cord injury is beginning medication therapy with baclofen (Lioresal). The nurse determines that the client understands the side effects of the medication if the client makes which statement? 1. "The medication may make me drowsy." 2. "The medication can cause high blood pressure." 3. "The medication may cause me to have some muscle pain." 4. "The medication may increase my sensitivity to bright light." 99. A client with a new medication prescription for allopurinol (Zyloprim) asks the nurse, "I know this is for gout, but how does it work?" In formulating a response, the nurse understands that which is the action of allopurinol? 1. Decreases uric acid production 2. Reduces the production of fibrinogen 3. Lowers the risk of sulfa crystal formation in the urine 4. Prevents influx of calcium ions during cell depolarization 100. A client newly diagnosed with gout has been prescribed allopurinol (Zyloprim). The nurse would be concerned if the client was also currently taking which medication? 1. Digoxin (Lanoxin) 2. Warfarin (Coumadin) 3. Adenosine (Adenocard) 4. Ergonovine maleate (Ergotrate) 2 101. A client tentatively diagnosed with gout has received a prescription for colchicine. The nurse understands that colchicine is which type of medication? 1. Analgesic that relieves pain 2. Anti-inflammatory agent specific for gout 3. Nonsteroidal anti-inflammatory drug (NSAID) 4. Osmotic diuretic that facilitates the removal of uric acid 102. A client with osteoarthritis is receiving diclofenac sodium (Voltaren). The nurse would be concerned about the administration of this medication if the client's history and physical included a diagnosis of which condition? 1. Graves' disease 2. Peptic ulcer disease 3. Coronary artery disease 4. Benign prostatic hypertrophy 103. Baclofen (Lioresal) is prescribed for the client with multiple sclerosis. The nurse determines that the medication is having the intended effect if which finding is noted in the client? 1. Increased muscle tone 2. Increased range of motion 3. Decreased muscle spasms 4. Decreased local pain and tenderness 104. Dantrolene sodium (Dantrium) is prescribed for the client experiencing flexor spasms. The client asks the nurse how the medication is going to help. The nurse replies that this medication acts in which way? 1. To depress the spinal reflexes causing the spasms 2. Directly on the skeletal muscle to relieve the spasms 3. Within the spinal cord to suppress excess reflex activity 4. On the central nervous system (CNS) to suppress spasms 2 105. A nurse is reviewing laboratory results for a client taking dantrolene sodium (Dantrium). The nurse should notify the health care provider (HCP) if which finding is noted on the laboratory report sheet? 1. Creatinine level 0.6 mg/dL 2. Platelet count 290,000 cells/mm3 3. Blood urea nitrogen (BUN) level 9 mg/dL 4. Lactic dehydrogenase (LDH) level 600 units/L 106. A nurse is reviewing the medical record of a newly assigned client and notes that the client is receiving cyclobenzaprine hydrochloride (Flexeril) for the treatment of muscle spasms. The nurse questions the prescription if which disorder is noted in the admission history? 1. Hypothyroidism 2. Chronic bronchitis 3. Recurrent pneumonia 4. Angle-closure glaucoma 107. A nurse is assigned to care for a client with multiple sclerosis who is receiving an intravenous (IV) dose of methocarbamol (Robaxin). The nurse monitors the client knowing that which is an expected side effect? 1. Insomnia 2. Excitability 3. Hypertension 4. Dark green–colored urine 1. A client's medication sheet contains a prescription for sertraline (Zoloft). To ensure safe administration of the medication, how should the nurse administer the dose? 1. On an empty stomach 2. At the same time each evening 3. Evenly spaced around the clock 4. As needed when the client complains of depression 2. A client with schizophrenia has been started on medication therapy with clozapine (Clozaril). The nurse should assess the results of which laboratory study to monitor for adverse effects from this medication? 1. Platelet count 2. Blood glucose level 3. Liver function studies 4. White blood cell count 3. A client is scheduled for discharge and will be taking phenobarbital sodium (Luminal) for an extended period. The nurse would place highest priority on teaching the client which point that directly relates to client safety? 1. Take the medication only with meals. 2. Take the medication at the same time each day. 3. Use a dose container to help prevent missed doses. 4. Avoid drinking alcohol while taking this medication. 4. The nurse is describing the medication side and adverse effects to a client who is taking oxazepam (Serax). What information should the nurse incorporate in the discussion? 1. Consume a low-fiber diet. 2. Increase fluids and bulk in the diet. 3. Rest if the heart begins to beat rapidly. 4. Take antidiarrheal agents if diarrhea occurs. 5. The nurse is administering risperidone (Risperdal) to a client who is scheduled to be discharged. Before discharge, which instruction should the nurse provide to the client? 1. Get adequate sunlight. 2. Continue driving as usual. 3. Avoid foods rich in potassium. 4. Get up slowly when changing positions. 6. The nurse is teaching a client who is being started on imipramine (Tofranil) about the medication. The nurse should inform the client to expect maximum desired effects at what time period following initiation of the medication? 1. In 2 months 2. In 2 to 3 weeks 3. During the first week 4. During the sixth week of administration 7. A hospitalized client is started on phenelzine (Nardil) for the treatment of depression. The nurse should instruct the client that which foods are acceptable to consume while taking this medication? Select all that apply. 1. Figs 2. Yogurt 3. Crackers 4. Aged cheese 5. Tossed salad 6. Oatmeal raisin cookies 8. The nurse notes that a client with schizophrenia and receiving an antipsychotic medication is moving her mouth, protruding her tongue, and grimacing as she watches television. The nurse determines that the client is experiencing which medication complication? 1. Parkinsonism 2. Tardive dyskinesia 3. Hypertensive crisis 4. Neuroleptic malignant syndrome 9. The nurse is performing a follow-up teaching session with a client discharged 1 month ago. The client is taking fluoxetine (Prozac). What information would be important for the nurse to obtain during this client visit regarding the side/adverse effects of the medication? 1. Cardiovascular symptoms 2. Gastrointestinal dysfunctions 3. Problems with mouth dryness 4. Problems with excessive sweating 10. A client who has been taking buspirone (Buspar) for 1 month returns to the clinic for a follow-up assessment. The nurse determines that the medication is effective if the absence of which manifestation has occurred? 1. Paranoid thought process 2. Rapid heartbeat or anxiety 3. Alcohol withdrawal symptoms 4. Thought broadcasting or delusions 11. A client taking lithium carbonate reports vomiting, abdominal pain, diarrhea, blurred vision, tinnitus, and tremors. The lithium level is 2.5 mEq/L. This level is indicative of which finding? 1. Toxic 2. Normal 3. Slightly above normal 4. Excessively below normal 12. A client gives the home health nurse a bottle of clomipramine (Anafranil). The nurse notes that the medication has not been taken by the client in 2 months. Which behavior observed in the client would validate noncompliance with this medication? 1. Complaints of insomnia 2. Complaints of hunger and fatigue 3. A pulse rate less than 60 beats/minute 4. Frequent hand-washing with hot soapy water A hospitalized client has begun taking bupropion (Wellbutrin) as an antidepressant agent. The nurse understands that which is an adverse effect, indicating that the client is taking an excessive amount of medication? 1. Constipation 2. Seizure activity 3. Increased weight 4. Dizziness when getting upright 13. A client receiving tricyclic antidepressants arrives at the mental health clinic. Which observation would indicate that the client is following the medication plan correctly? 1. Client reports not going to work for this past week. 2. Client complains of not being able to "do anything" anymore. 3. Client arrives at the clinic neat and appropriate in appearance. 4. Client reports sleeping 12 hours per night and 3 to 4 hours during the day. 14. The health care provider is planning to prescribe a medication for a client with major depression. Which medication should the nurse expect to be prescribed? 1. Clozapine (Clozaril) 2. Amitriptyline (Elavil) 3. Paroxetine hydrochloride (Paxil) 4. Tranylcypromine sulfate (Parnate) 15. The nurse is providing instructions to a client regarding the side effects of chlorpromazine (Thorazine). The nurse instructs the client that which may occur with the use of this medication? 1. Dry mouth 2. Hand tremors 3. Lip smacking 4. Increased urinary output 16. A monoamine oxidase inhibitor (MAOI) is prescribed for a client. Which sign or symptom is indicative of toxicity? 1. Lethargy 2. Restlessness 3. Lack of energy 4. Feelings of fatigue 17. The nurse is caring for a client receiving haloperidol (Haldol). To determine whether the client is experiencing akathisia as an adverse effect of the medication, what should the nurse observe the client for? 1. Lip smacking 2. Puffing of the cheeks 3. Rapid tongue movements 4. Restlessness or constant generalized movement 18. A client is starting to take imipramine (Tofranil) once each day. The nurse determines that additional client teaching is needed on the basis of which statement by the client? 1. "I need to avoid alcohol while taking this medication." 2. "I'll take the medication in the morning before breakfast." 3. "I won't notice any medication effects for at least 2 weeks." 4. "I'll be sure to take a missed medication dose as soon as possible unless it is almost time for the next dose." 19. A client has a lithium level of 2.4 mEq/L. The nurse should immediately assess the client for which sign or symptom? 1. Diarrhea 2. Weakness 3. Blurred vision 4. No assessment is needed because this is a therapeutic value. 20. A client with anxiety is starting therapy with lorazepam (Ativan). The nurse who is preparing to administer the first dose reviews the client's medical record. Which factor in the client's history should prompt the nurse to consult with the health care provider before administering the medication? 1. Hypothyroidism 2. Diabetes mellitus 3. Narrow angle glaucoma 4. Coronary artery disease 21. The mother of a child with attention deficit hyperactivity disorder (ADHD) has been given instructions about how to administer methylphenidate (Ritalin) to the child. Which response by the mother shows she understands the information about the best way to administer the medication? 1. At bedtime 2. After breakfast 3. At the evening meal 4. With a bedtime snack 22. The nurse taking a medication history for a client who has been admitted to the nursing unit notes that the client is receiving olanzapine (Zyprexa). The nurse interprets that this client most likely has a history of which disorder? 1. Hypertension 2. Schizophrenia 3. Diabetes mellitus 4. Diabetes insipidus 23. A client diagnosed with schizophrenia has a new prescription for risperidone (Risperdal). The nurse should assess baseline laboratory results for which study before administering the first dose of this medication? 1. Platelet count 2. Blood clotting tests 3. Liver function studies 4. Complete blood count 24. A client with depression has a prescription for sertraline (Zoloft). The nurse should withhold the medication and question the prescription if which is documented in the client's record? 1. History of diabetes mellitus 2. History of myocardial infarction 3. Use of phenelzine sulfate (Nardil) 4. History of irritable bowel syndrome 25. A client has been given a prescription for tacrine (Cognex) to control moderate dementia of the Alzheimer's type, and the nurse provides instructions to the client and the spouse. What statement by the spouse should the nurse use to determine that they understand information about the medication? 1. "I should not administer food with the medication." 2. "If a dose is missed, I should double the next dose." 3. "If jaundice develops, I need to notify the health care provider (HCP)." 4. "If flulike symptoms such as muscle aches occur, I should call the health care provider immediately." 26. The nurse has given instructions to a client taking lithium carbonate (Lithobid). What statement by the client indicates that the client needs further information? 1. "I will take the lithium with meals." 2. "I will decrease fluid intake while taking the lithium." 3. "Lithium blood levels must be monitored very closely." 4. "I will call my health care provider (HCP) if excessive diarrhea, vomiting, or sweating occurs." 27. A client with a psychotic disorder is receiving haloperidol (Haldol). The nurse should assess for which toxic effect of this medication? 1. Nausea 2. Hypotension 3. Blurred vision 4. Excessive salivation 28. Buspirone hydrochloride (BuSpar) is prescribed for a client with an anxiety disorder. The nurse plans to include which teaching point when reviewing this medication with the client? 1. The medication is addicting. 2. Dizziness and nervousness may occur. 3. Tolerance can develop with this medication. 4. The medication can produce a sedating effect. 29. A client with bipolar mood disorder has been given a prescription for carbamazepine (Tegretol). The nurse teaching the client about medication side effects and adverse effects instructs the client to notify the health care provider (HCP) if which symptom develops? 1. Nausea 2. Dizziness 3. Sore throat 4. Drowsiness 30. Neuroleptic malignant syndrome develops in a client taking chlorpromazine. The nurse checks the nursing unit medication cart to see if which medication is available to treat this adverse reaction? 1. Protamine sulfate 2. Bromocriptine (Parlodel) 3. Phytonadione (vitamin K) 4. Enalapril maleate (Vasotec) 31. Fluoxetine hydrochloride (Prozac) is prescribed for a client. The nurse should teach the client to take the medication by which method? 1. Just before bedtime 2. With the evening meal 3. At noon with an antacid 4. In the morning on first arising 32. A client with a diagnosis of schizophrenia is taking haloperidol (Haldol). The nurse understands that this medication will exert its therapeutic effect through which mechanism? 1. Blocking serotonin reuptake 2. Inhibiting the breakdown of released acetylcholine 3. Blocking the uptake of norepinephrine and serotonin 4. Blocking dopamine from binding to postsynaptic receptors in the brain 33. A client who has been taking ziprasidone (Geodon) reports to the health care clinic for a follow-up visit. The nurse assesses for a therapeutic effect of the medication by asking the client which question? 1. "Have you had more restful sleep during daytime naps?" 2. "Have you experienced relief of heartburn and indigestion with meals?" 3. "Have you experienced an increase in concentration during daily activities?" 4. "Have you had a decrease in heart palpitations with outside physical activities?" 34. A client with bipolar disorder is receiving lithium carbonate (Lithobid). The nurse who administers the medication knows that lithium is used primarily to treat which condition? 1. Hypertensive emergencies 2. The manic phase of bipolar disease 3. Both depressive and manic episodes 4. The depressive phase of bipolar disease 35. A client receiving thioridazine hydrochloride complains of feeling faint when trying to get out of bed in the morning. The nurse recognizes this complaint as a symptom of which disorder? 1. Cardiac dysrhythmias 2. Postural hypotension 3. Psychosomatic disorder 4. Respiratory insufficiency 36. A client with depression who is taking tranylcypromine sulfate (Parnate) has been instructed on the appropriate diet. The nurse determines that the client understands the diet if which foods are selected from the dietary menu? 1. Pickled herring, French fries, and milk 2. Pepperoni pizza, salad, and a cola drink 3. Roasted chicken, roasted potatoes, and beer 4. Fried haddock, baked potato, and a cola drink 37. A client is being treated for depression with amitriptyline hydrochloride. During the initial phases of treatment, the most important nursing intervention is which action? 1. Obtain frequent drug blood levels. 2. Provide the client a tyramine-free diet. 3. Assess the client for anticholinergic effects. 4. Obtain postural blood pressures before the administration of each dose. 38. A client who is on lithium carbonate complains of nausea. Later that day the client complains of drowsiness, muscle weakness, and lack of coordination. It is time for the client's 4:00 pm dose of lithium. What is the best nursing action? 1. Give the 4:00 pm dose and document the client's complaints. 2. Give the 4:00 pm dose, and notify the health care provider of the client's complaints. 3. Withhold the 4:00 pm dose, and notify the health care provider of the client's complaints. 4. Withhold the 4:00 pm dose for 30 minutes before administering, and reeducate the client that these are normal side effects of the medication. 39. The nurse is caring for a client who has been treated with long-term antipsychotic medication. During the assessment, the nurse checks the client for tardive dyskinesia. If tardive dyskinesia is present, what would the most likely assessment findings be? 1. Severe headache, flushing, tremors, and ataxia 2. Abnormal breathing through the nostrils, accompanied by a thrill 3. Severe hypertension, migraine headache, and "marbles in the mouth" syndrome 4. Abnormal movements and involuntary movements of the mouth, tongue, and face 40. A nurse is providing dietary instructions to a client who is taking tranylcypromine sulfate (Parnate). The nurse emphasizes that which needs to be avoided while the client is taking this medication? 1. Salami 2. Scallops 3. Pineapple 4. Mashed potatoes 41. The nurse is caring for a client who has been prescribed disulfiram (Antabuse). Which statement by the client indicates to the nurse the need for further teaching about this medication? 1. "I'll have to check my aftershave lotion." 2. "I must be careful taking cold medicines." 3. "As long as I don't drink alcohol, I'll be fine." 4. "I'll have to be more careful with the ingredients I use for cooking." 42. A client is taking a monoamine oxidase inhibitor (MAOI). What is the primary reason the nurse needs to assess this client closely? 1. Hypotension may indicate toxicity. 2. These medications increase the amount of MAO in the liver. 3. Headache, hypertension, and nausea and vomiting may indicate toxicity. 4. Hypotensive crisis may be precipitated by foods rich in tyramine and tryptophan. 43. The nurse is caring for a client who is taking a maintenance dosage of lithium carbonate (Lithobid). What is the most important nursing action in the client's plan of care? 1. Monitor intake and output. 2. Monitor daily serum lithium levels. 3. Observe for remission of a depressive state. 4. Perform a weekly electrocardiogram (ECG). . 44. The nurse is caring for a client with neuroleptic malignant syndrome (NMS) that resulted from the use of antipsychotic medications. Which assessment finding would the nurse anticipate to note resulting from this syndrome? 1. Dysphagia 2. Bradycardia 3. Hypotension 4. Hyperpyrexia 45. The nurse is developing a teaching plan for a client who will be receiving phenelzine sulfate (Nardil). The nurse should instruct the client to avoid which item? 1. Vasodilators 2. Aged cheeses 3. Digitalis preparations 4. Cherries and blueberries 46. A client with an anxiety disorder is taking buspirone (BuSpar) orally. The client tells the nurse that it is difficult to swallow the tablets. Which is the best instruction to provide to the client? 1. Crush the tablets before taking them. 2. Mix the tablet uncrushed in apple sauce. 3. Purchase the liquid preparation with the next refill. 4. Call the health care provider (HCP) for a change in medication. 47. A client is receiving fluphenazine (Prolixin) daily. The nurse should teach the client to take which measure to minimize common side effects of this medication? 1. Monitor the temperature daily. 2. Use hard sour candy or sugarless gum. 3. Eat snacks at midmorning and at bedtime. 4. Have the blood pressure checked once a week. 48. The 26-year-old female client with schizophrenia has been prescribed chlorpromazine hydrochloride (Thorazine). The client calls the mental health clinic and tells the nurse that her urine has become dark. The client has no other urinary symptoms. The nurse should provide which information to the client? 1. To seek treatment for a urinary tract infection 2. That this symptom indicates medication toxicity 3. To increase her intake of acid-ash foods and liquids 4. That this is an expected side effect of the medication 49. A client who is receiving lithium carbonate (Lithobid) complains of loose, watery stools and difficulty walking. The nurse would expect the client's serum lithium level to be at which value? 1. 0.7 mEq/L 2. 1.0 mEq/L 3. 1.3 mEq/L 4. 1.8 mEq/L 50. A client begins to experience extrapyramidal side effects from an antipsychotic medication. The nurse anticipates that the health care provider will prescribe which medication to treat this condition? 1. Haloperidol 2. Benztropine 3. Chlorpromazine 4. Prochlorperazine 51. A client is prescribed tranylcypromine (Marplan). The nurse should instruct the client to avoid which item? 1. All dairy products 2. Exposure to sunlight 3. Green leafy vegetables 4. A glass of wine with dinner 52. A nurse working in the ambulatory care center is providing medication instructions about methylphenidate (Ritalin) to the mother of a child with attention-deficit/hyperactivity disorder (ADHD). At which time does the nurse recommend that the mother give the medication to the child? 1. At bedtime 2. With the evening meal 3. Just before the noontime meal 4. In the morning, 2 hours before breakfast 53. The nurse is describing medication side effects to a client who is taking a benzodiazepine. The nurse should tell the client to take the medication only as prescribed because of which most serious risk? 1. Headache 2. Skin rashes 3. Dependence 4. Gastrointestinal side effects 54. A client receiving long-term therapy with lithium carbonate (Lithobid) exhibits muscle tremors, confusion, vomiting, and diarrhea. The nurse anticipates that the results of the latest test of the serum lithium level will be between which laboratory value range? 1. 0 and 0.5 mEq/L 2. 0.6 and 1.0 mEq/L 3. 1.0 and 1.3 mEq/L 4. 1.5 and 2.0 mEq/L 55. A nurse is administering thioridazine hydrochloride. The nurse should monitor the client carefully for which adverse effect? 1. Weight gain 2. Photosensitivity 3. Cardiac dysrhythmias 4. Extrapyramidal movements 56. A client has been started on therapy with lithium carbonate (Lithobid). The nurse instructs the client to be sure to take which action while taking the medication? 1. Limit salt intake. 2. Limit food intake. 3. Maintain a fluid intake of 2 to 3 L/day. 4. Stop the medication if gastrointestinal (GI) disturbances occur. 57. A nurse is discussing the past week's activities with a client receiving amitriptyline hydrochloride. The nurse determines that the medication is most effective for this client if the client reports which? 1. A decrease in appetite 2. Sleeping 14 to 16 hours each day 3. Ability to get to work on time each day 4. Having difficulty concentrating on an activity 58. A client taking buspirone hydrochloride for 1 month is scheduled for a follow-up appointment. The nurse gathers data from the client and interprets that the medication is effective if the client reports an absence of which? 1. Delusions 2. Paranoid thoughts 3. Palpitations and anxiety 4. Alcohol withdrawal symptoms 59. A nurse employed in the mental health clinic is interviewing a client who has had clomipramine hydrochloride (Anafranil) prescribed. The nurse interprets that the client is noncompliant with taking the medication as prescribed if the client exhibits which behavior? 1. Tired, fatigued appearance 2. Complaints of hunger and fatigue 3. Slight dizziness when standing up quickly 4. Frequently checking her purse for her keys 60. A client has been started on medication therapy with alprazolam (Xanax). When the nurse teaches the client that the medication should not be discontinued abruptly, the client asks why. The nurse should incorporate which when formulating a reply? 1. The client is likely to suffer irreversible kidney damage. 2. The client is likely to become resistant to medication effects. 3. It will make the medication much less effective if it must be restarted. 4. Rebound central nervous system (CNS) excitation could occur, including seizure activity. 61. A client with schizophrenia has been started on medication therapy with clozapine (Clozaril). The nurse reviews the result of which laboratory study to detect which adverse effect of this medication? 1. Platelet count 2. Liver function 3. Blood glucose level 4. White blood cell (WBC) count 62. A client with schizophrenia has been started on medication therapy with clozapine (Clozaril). The nurse should teach the client about which side/adverse effects of this medication? Select all that apply. 1. Diarrhea 2. Sedation 3. Dry mouth 4. Weight loss 5. Orthostatic hypotension 6. Presence of a fixed stare 63. A client has begun taking phenelzine (Nardil). At the initiation of therapy, which items does the nurse teach the client are acceptable to consume? Select all that apply. 1. Avocados 2. Figs and raisins 3. Bologna or salami 4. Carrots or radishes 5. Sweet potatoes and squash 6. Red wine, such as Chianti or sherry 64. The nursing student needs to administer potassium chloride intravenously as prescribed to a client with hypokalemia. The nursing instructor determines that the student is unprepared for this procedure if the student states that which action is part of the plan for preparation and administration of the potassium? 1. Obtaining an intravenous (IV) infusion pump 2. Monitoring urine output during administration 3. Preparing the medication for bolus administration 4. Ensuring that the medication is diluted in the appropriate amount of normal saline 65. A client with atrial fibrillation is receiving a continuous heparin infusion at 1000 units/hour. The nurse determines that the client is receiving the therapeutic effect based on which results? 1. Prothrombin time of 12.5 seconds 2. Activated partial thromboplastin time of 60 seconds 3. Activated partial thromboplastin time of 28 seconds 4. Activated partial thromboplastin time longer than 120 seconds 66. The nurse provides discharge instructions to a client who is taking warfarin sodium (Coumadin). Which statement, by the client, reflects the need for further teaching? 1. "I will avoid alcohol consumption." 2. "I will take my pills every day at the same time." 3. "I have already called my family to pick up a Medic-Alert bracelet." 4. "I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated." 67. A client who is receiving digoxin (Lanoxin) daily has a serum potassium level of 3 mEq/L and is complaining of anorexia. The health care provider prescribes determination of the serum digoxin level to rule out digoxin toxicity. The nurse checks the results, knowing that which value is the therapeutic serum level (range) for digoxin? 1. 0.5 to 2 ng/mL 2. 1.2 to 2.8 ng/mL 3. 3.0 to 5.0 ng/mL 4. 3.5 to 5.5 ng/mL 68. A client is being treated with procainamide for a cardiac dysrhythmia. Following intravenous administration of the medication, the client complains of dizziness. What intervention should the nurse take first? 1. Measure the heart rate on the rhythm strip. 2. Administer prescribed nitroglycerin tablets. 3. Obtain a 12-lead electrocardiogram immediately. 4. Auscultate the client's apical pulse and obtain a blood pressure. 69. The nurse is monitoring a client who is taking propranolol (Inderal LA). Which assessment data indicates a potential serious complication associated with this medication? 1. The development of complaints of insomnia 2. The development of audible expiratory wheezes 3. A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of 138/72 mm Hg after two doses of the medication 4. A baseline resting heart rate of 88 beats/minute followed by a resting heart rate of 72 beats/minute after two doses of the medication 70. A client with atrial fibrillation secondary to mitral stenosis is receiving a heparin sodium infusion at 1000 units/hour and warfarin sodium (Coumadin) 7.5 mg at 5:00 pm daily. The morning laboratory results are as follows: activated partial thromboplastin time (aPTT) = 32 seconds; internationalized normalized ratio (INR) = 1.3. The nurse should plan to take which action based on the client's laboratory results? 1. Collaborate with the health care provider (HCP) to discontinue the heparin infusion and administer the warfarin sodium as prescribed. 2. Collaborate with the HCP to obtain a prescription to increase the heparin infusion and administer the warfarin sodium as prescribed. 3. Collaborate with the HCP to withhold the warfarin sodium since the client is receiving a heparin infusion and the aPTT is within the therapeutic range. 4. Collaborate with the HCP to continue the heparin infusion at the same rate and to discuss use of dabigatran etexilate (Pradaxa) in place of warfarin sodium. 71. A client is diagnosed with an ST-segment elevation myocardial infarction (STEMI) and is receiving tissue plasminogen activator, alteplase (Activase, tPA). Which action is a priority nursing intervention? 1. Monitor for kidney failure. 2. Monitor psychosocial status. 3. Monitor for signs of bleeding. 4. Have heparin sodium available. 72. The nurse is planning to administer hydrochlorothiazide to a client. The nurse understands that which is a concern related to the administration of this medication? 1. Hypouricemia, hyperkalemia 2. Increased risk of osteoporosis 3. Hypokalemia, hyperglycemia, sulfa allergy 4. Hyperkalemia, hypoglycemia, penicillin allergy 73. The home health care nurse is visiting a client with elevated triglyceride levels and a serum cholesterol level of 398 mg/dL. The client is taking cholestyramine (Questran). Which statement, by the client, indicates the need for further education? 1. "Constipation and bloating might be a problem." 2. "I'll continue to watch my diet and reduce my fats." 3. "Walking a mile each day will help the whole process." 4. "I'll continue my nicotinic acid from the health food store." 74. The nurse is monitoring a client who is taking digoxin (Lanoxin) for adverse effects. Which findings are characteristic of digoxin toxicity? Select all that apply. 1. Tremors 2. Diarrhea 3. Irritability 4. Blurred vision 5. Nausea and vomiting 75. Prior to administering a client's daily dose of digoxin, the nurse reviews the client's laboratory data and notes the following results: serum calcium, 9.8 mg/dL; serum magnesium, 1.2 mg/dL; serum potassium, 4.1 mEq/L; serum creatinine, 0.9 mg/dL. Which result should alert the nurse that the client is at risk for digoxin toxicity? 1. Serum calcium level 2. Serum potassium level 3. Serum creatinine level 4. Serum magnesium level 76. A client being treated for heart failure is administered intravenous bumetanide. Which outcome indicates the medication has achieved the expected effect? 1. Cough becomes productive of frothy pink sputum 2. The serum potassium level changes from 3. 8 to 3.1 mEq/L 3.B-natriuretic peptide (BNP) factor increases from 200 to 262 pg/mL 4. Urine output increases from 10 mL/hour to greater than 50 mL hourly 77. Intravenous heparin therapy is prescribed for a client. While implementing this prescription, the nurse ensures that which medication is available on the nursing unit? 1. Vitamin K 2. Protamine sulfate 3. Potassium chloride 4. Aminocaproic acid (Amicar) 78. A client is prescribed nicotinic acid (niacin) for hyperlipidemia and the nurse provides instructions to the client about the medication. Which statement by the client indicates an understanding of the instructions? 1. "It is not necessary to avoid the use of alcohol." 2. "The medication should be taken with meals to decrease flushing." 3. "Clay-colored stools are a common side effect and should not be of concern." 4. "Ibuprofen (Motrin) taken 30 minutes before the nicotinic acid should decrease the flushing." 79. The nurse is reviewing the record of a client who arrives at the health care clinic. The nurse notes that irbesartan (Avapro) has been prescribed for the client. The nurse should suspect that the client has which condition? 1. Hypertension 2. Hypothyroidism 3. Diabetes mellitus 4. Renal transplant rejection 80. The home care nurse instructs a client on how to administer enoxaparin (Lovenox) subcutaneously. Which statement, if made by the client, indicates an understanding of how to administer this medication? 1. "I need to hold my skin flat before I put the needle into my skin." 2. "I need to massage the skin with the alcohol wipe after I give the injection." 3. "A syringe that has a small ⅝-inch needle is used to administer the injection." 4. "I need to pull back on the syringe and aspirate before pushing the medication into my skin." 81. A client is scheduled for a dose of ramipril (Altace). The nurse should check which measurement before administering the medication? 1. Weight 2. Apical pulse 3. Blood pressure 4. Potassium level 82. The clinic nurse is providing instructions to a client with hypertension who will be taking captopril (Capoten). Which statement by the client indicates a need for further instruction? 1. "I need to change positions slowly." 2. "I need to avoid taking hot baths or showers." 3. "I need to drink at least 4 quarts of water daily." 4. "I need to sit down and rest if dizziness or lightheadedness occurs." 83. A thrombolytic is administered in the hospital emergency department to a client who has had a myocardial infarction. The client's spouse asks the nurse about the purpose of the medication. The nurse bases the response on which fact regarding this medication? 1. Thrombolytics suppress the production of fibrin. 2. Thrombolytics act to prevent thrombus formation. 3. Thrombolytics act to dissolve thrombi that have already formed. 4. Thrombolytics have been proved to reverse all detrimental effects of heart attacks. 84. A client who had surgery 3 days earlier is receiving heparin sulfate by subcutaneous injection every 12 hours. In planning for the client's morning care, the priority nursing intervention is which action? 1. Allow the client to sit only at the bedside. 2. Assist the client to shave using an electric razor. 3. Monitor the prothrombin time (PT) every 4 hours. 4. Tell the client that brushing the teeth is not allowed. 85. A client scheduled to take a subcutaneous anticoagulant at home says to the nurse, "I'm not sure I will be able to take this medication at home." Which statement by the nurse is most appropriate? 1. "Maybe your spouse can give you your shots." 2. "You'll be fine once you get used to giving your own shots." 3. "What are your concerns about taking this medication at home?" 4. "Don't worry. Your health care provider knows what's best for you." 86. A client is being discharged on warfarin sodium (Coumadin), and the nurse provides instructions to the client regarding the medication. Which statement, if made by the client, indicates to the nurse that the client understands the teaching provided? 1. "I'll stop my medication if I see bruising." 2. "Stiff joints are common while taking warfarin." 3. "This medication will prevent me from having a stroke." 4. "If I notice blood-tinged urine, I will call the health care provider." 87. A client receives education regarding self-administration of enoxaparin (Lovenox) on discharge to home. The client complains, "I feel as if the health care provider is discharging me too soon if I still have to take injections at home." What is the best nursing response? 1. "Are you not happy about going home?" 2. "Do you want to stay in the hospital forever?" 3. "You'll have to take that up with the health care provider." 4. "Research shows that it is best for clients to administer this medication at home rather than stay in the hospital." 88. The nurse is caring for a client who is taking warfarin (Coumadin), an oral anticoagulant. The nurse notes the presence of gross hematuria and large areas of bruising on the client's body. The nurse notifies the health care provider and ensures that which prescribed medication is available? 1. Heparin sulfate 2. Protamine sulfate 3. Phytonadione (vitamin K) 4. Oral potassium supplements 89. The home care nurse has given instructions to a client who is beginning therapy with digoxin (Lanoxin). The nurse determines a need for further teaching of the instructions if the client makes which statement? 1. "If I miss a dose, I should just take two the next day." 2. "I shouldn't change brands without asking the health care provider first." 3. "I should call the health care provider if my daily pulse rate is under 60 or over 100." 4. "The pills should be kept in their original container so they don't get mixed up with my other medicines." 90. A client who began medication therapy with prazosin hydrochloride (Minipress) 1 week earlier arrives at the health care clinic for follow-up evaluation and care. The nurse interprets that the client is experiencing the expected benefit of therapy if which is noted? 1. Increased pulse 2. Increased platelet count 3. Decreased blood pressure 4. Decreased blood glucose level 91. A hypertensive client has been prescribed clonidine hydrochloride (Catapres-TTS), a transdermal patch. The nurse provides written instructions to the client on the use of the patch. Which statement by the client indicates the need for further instruction? 1. "I need to change the patch every 24 hours." 2. "I need to apply the patch to a hairless body site." 3. "I need to apply the patch to skin areas that are not broken." 4. "I need to apply the patch to the skin on the upper arm or body." 92. A client with hypertension has begun taking spironolactone (Aldactone). The nurse teaches the client to limit intake of which food? 1. Rice 2. Salad 3. Oatmeal 4. Citrus fruits 93. A client with hypertension has a new prescription for a medication called moexipril (Univasc). The nurse plans to provide written directions that tell the client to take the medication at which time? 1. At bedtime 2. With meals 3. 1 hour before meals 4. With a snack in late afternoon 94. A health care provider (HCP) prescribes warfarin sodium (Coumadin) for a client. The home care nurse visits the client at home and teaches the client about the medication and its administration. Which statement by the client indicates a need for further teaching? 1. "The urine normally changes to orange." 2. "This medicine will still be working 4 to 5 days after it is discontinued." 3. "This medication will require frequent blood work to monitor its effects." 4. "I cannot take aspirin or any aspirin-containing medications while I'm on this medication." 95. The nurse has been given a medication prescription to administer intravenous (IV) hydralazine (Apresoline). The nurse obtains which priority piece of equipment needed for use during administration of this medication? 1. Pulse oximetry 2. Cardiac monitor 3. Noninvasive blood pressure cuff 4. Nonrebreather oxygen face mask 96. The nurse is reviewing the assessment findings for a client who has been taking spironolactone (Aldactone) for treatment of hypertension. Which, if noted in the client's record, would indicate that the client is experiencing an adverse effect related to the medication? 1. Client complaint of dry skin 2. A potassium level of 3.5 mEq/L 3. A potassium level of 5.8 mEq/L 4. Client complaint of constipation 97. The nurse is providing instructions to a client with chronic atrial fibrillation who is being started on quinidine sulfate. The nurse should plan to provide which instruction to the client? 1. Wear a Medic-Alert bracelet. 2. Take the medication only on an empty stomach. 3. Stop taking the prescribed digoxin (Lanoxin) when this medication is started. 4. Open the sustained-release capsules and mix with applesauce if the medication is difficult to swallow. 98. The nurse notes a persistent, dry cough in an adult client being seen in the ambulatory clinic. When questioned, the client states that the cough began approximately 2 months ago. On further assessment, the nurse learns that the client began taking quinapril (Accupril) shortly before the time that the cough began. How should the nurse interpret the development of the cough? 1. An early indication of heart failure 2. Caused by neutropenia as a result of therapy 3. Caused by a concurrent upper respiratory infection 4. An expected although bothersome side effect of therapy 99. A client with angina pectoris has been given a new prescription for nitroglycerin transdermal patches. The client indicates an understanding of how to use this medication administration system by making which statement? 1. "I need to wait until the next day to apply a new patch if it falls off." 2. "I need to alternate daily dosage times to prevent tolerance to the medication." 3. "I need to place the patch in the area of a skin fold to promote better adherence." 4. "I need to apply the patch in the morning and leave it in place for 12 to 14 hours as directed." 100. A client in the hospital emergency department who received nitroglycerin for chest pain has obtained relief but now complains of a headache. The nurse should interpret that this client is most likely experiencing which condition? 1. An expected medication side effect 2. An allergic reaction to nitroglycerin 3. An early sign of tolerance to the medication 4. A warning that the medication should not be used again 101. A client who has begun taking betaxolol (Kerlone) demonstrates an effective response to the medication as indicated by which nursing assessment finding? 1. Increase in edema to 3+ 2. Weight gain of 5 pounds 3. Decrease in pulse rate from 74 beats/min to 58 beats/min 4. Decrease in blood pressure from 142/94 mm Hg to 128/82 mm Hg 102. A client who is taking chlorothiazide (HydroDIURIL) comes to the clinic for periodic evaluation. In monitoring the client's laboratory test results for medication side effects, what is the clinic nurse most likely to note if a side effect is present? 1. Hypokalemia 2. Hypocalcemia 3. Hypernatremia 4. Hyperphosphatemia 103. A client is taking amiloride (Midamor) 10 mg orally daily. What medication instruction should the nurse provide to the client? 1. Take the dose without food. 2. Eat foods with extra sodium. 3. Take the dose in the morning. 4. Withhold the dose if the blood pressure is high. 104. Lisinopril (Prinivil) has been prescribed for a client. What should the nurse instruct the client to do? 1. Take the medication with food only. 2. Discontinue the medication if nausea occurs. 3. Rise slowly from a reclining to a sitting position. 4. Expect to note a full therapeutic effect immediately. 105. A health care provider (HCP) prescribes quinidine gluconate for a client. The nurse decides to withhold the medication and contact the HCP if which assessment finding is documented in the client's medical record? 1. Muscle weakness 2. History of asthma 3. Presence of infection 4. Complete atrioventricular (AV) block 106. A client is to be discharged from the hospital on quinidine gluconate to control ventricular ectopy. The nurse provides instructions to the client about the medication. Which statement by the client indicates a need for further instruction? 1. "The best time to schedule this medication is with meals." 2. "I need to avoid alcohol, caffeine, and cigarettes while I am on this medication." 3. "I need to stop the medication immediately if diarrhea, nausea, or vomiting occurs." 4. "I need to take this medication regularly, even if the heartbeat feels strong and regular." 107. A client has been prescribed pindolol (Visken) for hypertension. The nurse provides anticipatory guidance, knowing that which common side effect of this medication may decrease client compliance? 1. Impotence 2. Mood swings 3. Increased appetite 4. Difficulty swallowing 108. A client receiving total parenteral nutrition (TPN) has a history of heart failure. The health care provider has prescribed furosemide (Lasix) 40 mg by mouth daily to prevent fluid overload. Which laboratory value should the nurse monitor to identify the presence of an adverse effect from this medication? 1. Sodium 2. Glucose 3. Potassium 4. Magnesium 109. A client with heart failure is scheduled to be discharged to home with digoxin (Lanoxin) and furosemide (Lasix) as daily prescribed medications. The nurse tells the client to report which finding as an indication that the medications are not having the intended effect? 1. Sudden increase in appetite 2. Weight gain of 2 to 3 lb in a few days 3. Increased urine output during the day 4. Cough accompanied by other signs of respiratory infection 110. A client with pulmonary edema has a prescription to receive morphine sulfate intravenously. The nurse should determine that the client is experiencing an intended effect of the medication as indicated by which assessment finding? 1. Increased pulse rate 2. Relief of apprehension 3. Decreased urine output 4. Increased blood pressure 111. The nurse has provided instructions to a client receiving enalapril maleate (Vasotec). Which statement by the client indicates a need for further instruction? 1. "I need to rise slowly from a lying to sitting position." 2. "I need to notify the health care provider if fatigue occurs." 3. "I need to notify the health care provider (HCP) if a sore throat occurs." 4. "I know that several weeks of therapy may be required for the full therapeutic effect." 112. A health care provider writes a prescription for lisinopril (Zestril) for a hospitalized client. The nurse caring for the client determines that the medication has been prescribed to treat which disorder? 1. Hypertension 2. Immune disorder 3. Venous insufficiency 4. Gastroesophageal reflux disorder 113. A client taking an angiotensin-converting enzyme (ACE) inhibitor to treat hypertension calls the clinic nurse and reports that he has a dry, nonproductive cough that is very bothersome. The nurse should respond by making which statement? 1. The medication may need to be changed. 2. The cough must be the start of a respiratory infection. 3. The medication needs to be taken with large amounts of water to prevent the cough. 4. This sometimes happens, and the client will need to take a cough medication with each dose of medication. 114. The home care nurse visits a client with a diagnosis of unstable angina. The client is taking acetylsalicylic acid (aspirin) on a daily basis to reduce the risk of myocardial infarction (MI). Which medication dose would the nurse expect the client to be taking? 1. 300 to 325 mg daily 2. 650 to 700 mg daily 3. 1.3 g daily 4. 3 g daily 115. The nurse prepares to teach a client with subarachnoid hemorrhage about the effects of nimodipine. The nurse plans to explain which information about the purpose of this medication? 1. β-Adrenergic blocker that will decrease blood pressure 2. Vasodilator that has an affinity for cerebral blood vessels 3. Diuretic that will decrease blood pressure by decreasing fluid volume 4. Calcium channel blocker that will decrease spasm in cerebral blood vessels 116. A client is being treated for moderate hypertension and has been taking diltiazem (Cardizem) for several months. The client schedules an appointment with the health care provider because of episodes of chest pain, and Prinzmetal's angina is diagnosed. The nurse understands that this medication will provide which therapeutic effect for this new diagnosis? 1. Increases oxygen demands within the myocardium 2. Increases the force of contraction of ventricular tissues 3. Prevents influx of calcium ions in vascular smooth muscle 4. Leads to an increase in calcium absorption in the vascular smooth muscle 3 117. A client with chronic atrial fibrillation is being started on quinidine sulfate (Quinidine) as maintenance therapy for dysrhythmia suppression, and the nurse provides instructions to the client about the medication. Which statement by the client indicates a need for further instruction? 1. "I will avoid chewing the tablets." 2. "I will take the dose at the same time each day." 3. "I will take the medication with food if my stomach becomes upset." 4. "I will stop taking the prescribed anticoagulant after starting this new medication." 118. Fenofibrate (Tricor) is prescribed for a client with hyperlipidemia. The nurse reviews the client's medical history for the presence of what condition that contraindicates the use of this medication? 1. Angina 2. Mitral valve stenosis 3. Cirrhosis of the liver 4. Coronary artery disease 119. Acetylsalicylic acid (ASA), or aspirin, has been prescribed for a client with angina, and the client asks the nurse how the medication will help. The nurse responds that this medication has been prescribed for which purpose? 1. Reduce pain. 2. Reduce inflammation. 3. Inhibit platelet aggregation. 4. Maintain a normal body temperature. 120. A nurse is collecting data from a client and notes that the client is taking atenolol (Tenormin). What has this medication been prescribed to treat? 1. Hypertension 2. Ulcerative colitis 3. Rheumatoid arthritis 4. Second-degree heart block 1. Hypertension 121. Atenolol (Tenormin) has been prescribed for a client, and the client asks the nurse about the action of the medication. How should the nurse respond regarding the action of this medication? 1. Slows the heart rate 2. Increases cardiac output 3. Increases myocardial oxygen demand 4. Maintains the blood pressure at a level within the 140/90 mm Hg range 122. The health care provider (HCP) writes a prescription for atenolol (Tenormin) for a client who was admitted to the hospital. The nurse contacts the HCP to verify the prescription if which finding is noted in the assessment data? 1. Temperature is 100.1° F. 2. Apical heart rate is 48 beats/min. 3. Blood pressure is 138/82 mm Hg. 4. Pedal pulses are bounding and strong. 123. Atenolol (Tenormin) has been prescribed for a hospitalized client. The nurse should check which item before administering this medication? 1. Pedal pulses 2. Apical heart rate 3. Most recent potassium level 4. Most recent electrolyte levels 124. Atenolol (Tenormin) has been prescribed for a client, and the client asks the nurse about the side effects of the medication. What should the nurse tell the client is an occasional side effect of this medication? 1. Dry skin 2. Flushing 3. Decreased libido 4. Increased blood pressure 125. A client admitted to the hospital is taking atenolol (Tenormin). The nurse monitors the client for which sign or symptom of an adverse effect of the medication? 1. Nausea 2. Diaphoresis 3. Hypotension 4. Tachycardia 126. Atenolol (Tenormin) has been prescribed for a client, and the nurse provides instructions to the client about the medication. Which statement by the client indicates the need for further teaching? 1. "I need to rise slowly from a lying to a sitting position." 2. "If I feel that my heart rate is too low, I should stop the medication." 3. "It will take 1 to 2 weeks before my blood pressure becomes controlled." 4. "I should avoid tasks that require alertness until I know how the medication will affect my body." 127. A nurse is collecting subjective and objective data from a client and notes that the client is taking atorvastatin (Lipitor). What should the nurse determine that this medication has been prescribed to specifically treat? 1. Heart failure 2. Hypertension 3. Angina pectoris 4. Hypercholesterolemia 128. Atorvastatin (Lipitor) has been prescribed for a client, and the client asks the nurse about the action of the medication. How should nurse respond about the action of this medication? 1. Increases plasma cholesterol 2. Increases plasma triglycerides 3. Decreases low-density lipoproteins (LDLs) 4. Decreases high-density lipoproteins (HDLs) 129. The health care provider (HCP) writes a prescription for atorvastatin (Lipitor) for a client who was admitted to the hospital. The nurse contacts the HCP to verify the prescription if which finding is noted in the assessment data? 1. Renal calculi 2. Chronic heart failure 3. Cirrhosis of the liver 4. Coronary artery disease 130. Atorvastatin (Lipitor) has been prescribed for a client. The nurse tells the client that which blood test will be done periodically while the client is taking this medication? 1. Neutrophil count 2. Liver function studies 3. White blood cell count 4. Complete blood cell (CBC) count 131. Atorvastatin (Lipitor) has been prescribed for a client, and the client asks the nurse about the side effects of the medication. What should the nurse tell the client is a frequent side effect of this medication? 1. Tremors 2. Lethargy 3. Headache 4. Tiredness 132. A client seen in the health care clinic for follow-up care is taking atorvastatin (Lipitor). The nurse should assess the client for which adverse effect of the medication? 1. Earache 2. Hearing loss 3. Photosensitivity 4. Lung congestion 133. Atorvastatin (Lipitor) has been prescribed for a client, and the nurse provides instructions to the client about the medication. Which statement by the client indicates the need for further teaching? 1. "This medication will lower my cholesterol level." 2. "I will need to have blood tests drawn while I am taking this medication." 3. "I won't need to adhere to a low-fat diet as long as I take this medication faithfully." 4. "I need to talk to the health care provider (HCP) before taking any over-the-counter medications." ." 134. Diltiazem (Cardizem) is prescribed for a client with Prinzmetal's variant angina. The nurse should plan care, knowing that this medication works by which method? 1. Increasing the heart rate 2. Constricting peripheral arteries 3. Increasing sinoatrial (SA) and atrioventricular (AV) conduction 4. Inhibiting calcium movement across cell membranes of cardiac and smooth muscle 135. A client with cardiac disease has begun taking propranolol (Inderal LA), and the nurse provides information to the client about the medication. The nurse should tell the client to contact the health care provider (HCP) if which symptoms develop? 1. Insomnia and headache 2. Nausea and constipation 3. Night cough and dyspnea 4. Drowsiness and nightmares 136. Hydrochlorothiazide (HydroDIURIL) has been prescribed for a client. The nurse contacts the health care provider to verify the prescription if which condition is noted in the assessment data? 1. Hypertension 2. Allergy to eggs 3. Nephrotic syndrome 4. Allergy to sulfonamides 137. A client is seen in the clinic complaining of anorexia and nausea. The health care provider suspects that the client may be experiencing digoxin toxicity. While waiting for test results to become available, the nurse should assess the client for which sign or symptom that would support a diagnosis of digoxin toxicity? 1. Edema 2. Chest pain 3. Constipation 4. Photophobia 138. The nurse is administering a dose of intravenous hydralazine (Apresoline) to a client. The nurse should ensure that which item is in place before injecting the medication? 1. Central line 2. Foley catheter 3. Pulse oximeter 4. Blood pressure cuff 139. The nurse is performing an assessment on a client with a diagnosis of chronic angina pectoris. The client is receiving sotalol (Betapace) orally daily. Which assessment finding indicates to the nurse that the client is experiencing a side/adverse effect related to the medication? 1. Dry mouth 2. Diaphoresis 3. Palpitations 4. Difficulty swallowing 140. The nurse is caring for a client with hypertension receiving torsemide (Demadex) orally daily. Which laboratory test result would indicate to the nurse that the client may be experiencing an adverse effect related to the medication? 1. A chloride level of 98 mEq/L 2. A sodium level of 135 mEq/L 3. A potassium level of 3.1 mEq/L 4. A blood urea nitrogen (BUN) of 15 mg/dL 141. The nurse has given a client information about the use of nitroglycerin sublingual tablets. The client has a prescription for PRN use if chest pain occurs. Which client statement indicates an understanding of this medication? 1. "It's best to keep this medication in a shirt pocket close to the body." 2. "I need to discard unused tablets 6 to 9 months after the bottle is opened." 3. "I will avoid using the medication until the chest pain actually begins and gets worse." 4. "I can take aspirin for any headache that occurs when I first start taking the nitroglycerin." 142. A client is due for a dose of bumetanide. The nurse should temporarily withhold the dose and notify the health care provider (HCP) if which laboratory test result is noted? 1. Sodium 137 mEq/L 2. Chloride 106 mEq/L 3. Potassium 2.9 mEq/L 4. Magnesium 2.6 mg/dL 143. The nurse has given a client the prescribed dose of intravenous hydralazine (Apresoline). The nurse evaluates the effectiveness of the medication by monitoring which client parameter? 1. Pulse rate 2. Urine output 3. Blood pressure 4. Potassium level 144. The nurse has completed giving medication instructions to a client receiving benazepril (Lotensin). Which client statement indicates to the nurse that the client needs further instruction? 1. "I need to change positions slowly." 2. "I will monitor my blood pressure every week." 3. "I will report signs and symptoms of infection immediately." 4. "I can use salt substitutes freely and eat foods high in potassium." 145. The nurse has conducted medication instructions with a client receiving lovastatin (Mevacor). Which periodic blood study will be necessary and included in the client's instructions? 1. Bleeding time 2. Blood glucose levels 3. Liver function studies 4. Complete blood cell count 146. Daily administration of dipyridamole (Persantine) been prescribed for the client, and the nurse teaches the client about the medication. Which client statement indicates an understanding of the instructions? 1. "This medication will prevent a stroke." 2. "This medication will prevent a heart attack." 3. "This medication will help keep my blood pressure down." 4. "If I take this medicine with my Coumadin, it will protect my artificial heart valve." 147. A client in the postpartum care unit who is recovering from disseminated intravascular coagulopathy is to be discharged on low dosages of an anticoagulant medication. In developing home care instructions for this client, the nurse should include which prioritysafety instruction regarding this medication? 1. Avoid brushing the teeth. 2. Avoid taking acetylsalicylic acid (aspirin). 3. Avoid walking long distances and climbing stairs. 4. Avoid all activities because bruising injuries can occur. 148. Levothyroxine (Synthroid) is prescribed for a client diagnosed with hypothyroidism. The nurse reviews the client's record and notes that the client is presently taking warfarin (Coumadin). The nurse contacts the health care provider (HCP), anticipating that the HCP will prescribe which medication? 1. A decreased dosage of warfarin 2. An increased dosage of warfarin 3. A decreased dosage of levothyroxine 4. An increased dosage of levothyroxine 149. A nurse prepares to administer sodium polystyrene sulfonate (Kayexalate) to a client. Before administering the medication, the nurse reviews the action of the medication and understands that which is released by this medication? 1. Bicarbonate in exchange for primarily sodium ions 2. Potassium ions in exchange for primarily sodium ions 3. Sodium ions in exchange for primarily potassium ions 4. Sodium ions in exchange for primarily bicarbonate ions 150. A home health nurse instructs a client about the use of a nitrate patch. The nurse should make which statement to the client to prevent client tolerance to nitrates? 1. "Do not remove the patches." 2. "Have a 12-hour ‘no-nitrate' time." 3. "Ensure a 24-hour ‘no-nitrate' time." 4. "Keep nitrates on 24 hours, then off 24 hours." 151. A client with nausea and bradycardia is admitted to a medical unit. The family hands a nurse a small white envelope labeled "heart pill." The envelope is sent to the pharmacy and it is found to be digoxin (Lanoxin). A family member states, "That health care provider doesn't know how to take care of my family." Which statement would convey a therapeutic response by the nurse? 1. "Don't worry about this. I'll take care of everything." 2. "You are concerned your loved one receives the best care." 3. "You're right! I've never seen them put pills in an envelope." 4. "I think you're wrong. That health care provider (HCP) has been in practice more than 30 years." 152. A male client is on enalapril (Vasotec) for the treatment of hypertension. The nurse teaches the client that he should seek emergent care if he experiences which adverse effect? 1. Nausea 2. Insomnia 3. Dry cough 4. Swelling of the tongue 153. What should the nurse teach a client about an expected outcome of nesiritide (Natrecor) administration? 1. The client will have an increase in urine output. 2. The client will have an absence of dysrhythmias. 3. The client will have an increase in blood pressure. 4. The client will have an increase in pulmonary capillary wedge pressure. 154. A client is admitted to a hospital with acute myocardial infarction and is started on tissue plasminogen activator (tPA, Activase) by infusion. Of the following parameters, which one should a nurse determine requires the least frequent assessment to detect complications of therapy with tPA? 1. Neurological signs 2. Blood pressure and pulse 3. Presence of bowel sounds 4. Complaints of abdominal and back pain 155. A hospitalized client with coronary artery disease complains of substernal chest pain. After assessing the client's heart rate and blood pressure, a nurse administers nitroglycerin, 0.4 mg, sublingually. After 5 minutes the client states, "My chest still hurts." Which actions should the nurse take? Select all that apply. 1. Call a Code Blue. 2. Contact the client's family. 3. Assess the client's pain level. 4. Check the client's blood pressure. 5. Contact the health care provider (HCP). 6. Administer a second nitroglycerin, 0.4 mg, sublingually. 156. A client has developed paroxysmal nocturnal dyspnea. Which medication should the nurse anticipate will be prescribed by the health care provider? 1. Bumetanide 2. Lidocaine (Xylocaine) 3. Propranolol (Inderal LA) 4. Streptokinase (Streptase) 157. A home health care nurse is visiting an older client at home. Furosemide (Lasix) is prescribed for the client and the nurse teaches the client about the medication. Which statement, if made by the client, indicates the need for further teaching? 1. "I will sit up slowly before standing each morning." 2. "I will take my medication every morning with breakfast." 3. "I need to drink lots of coffee and tea to keep myself healthy." 4. "I will call my health care provider (HCP) if my ankles swell or my rings get tight." 158. In reviewing the medication records of the following group of clients, the nurse determines that which client would be at greatest risk for developing hyperkalemia? 1. Client receiving bumetanide 2. Client receiving furosemide (Lasix) 3. Client receiving spironolactone (Aldactone) 4. Client receiving hydrochlorothiazide (HCTZ) 159. The nurse is caring for a client who is receiving dopamine. Which potential problem is a priority concern for this client? 1. Fluid overload 2. Peripheral vasoconstriction 3. Inability to perform self-care 4. Inability to discriminate hot or cold sensations 160. The health care provider has prescribed clonidine (Catapres) for a client with hypertension. The nurse should inform the client that which is a side effect of this medication? 1. Diarrhea 2. Constipation 3. Hypertension 4. Increased salivation 161. Gemfibrozil (Lopid) is prescribed for a client. Which laboratory finding should alert the nurse about the need to withhold the medication and contact the health care provider? 1. Elevated glucose 2. Elevated triglycerides 3. Elevated liver function tests 4. Elevated blood urea nitrogen (BUN) 162. A nurse is caring for a client with hyperlipidemia who is taking cholestyramine (Questran). Which nursing assessment is most significant for this client relative to the medication therapy? 1. Observe for joint pain. 2. Auscultate bowel sounds. 3. Assess deep tendon reflexes. 4. Monitor cardiac rate and rhythm. 163. A nurse should educate the client receiving pravastatin (Pravachol) to immediately report which finding? 1. Fatigue 2. Diarrhea 3. Sore throat 4. Muscle pain 164. The nurse has completed medication administration that included a nitroglycerin. Within minutes, the client is complaining of a headache. Which is the priority nursing action at this time? 1. Evaluate pupil response. 2. Place the client on the left side. 3. Administer the prescribed analgesic. 4. Notify the health care provider (HCP) immediately. 165. A client is admitted to the emergency department with a diagnosis of myocardial infarction (MI). The health care provider (HCP) prescribes the administration of alteplase (Activase). To achieve the best therapeutic outcome, the nurse understands this medication must be administered at which time? 1. Within 4 to 6 hours after onset of chest pain 2. Concurrently with the administration of heparin 3. With the administration solution set protected from light 4. After the results of all laboratory tests have been received 166. The nurse is preparing to administer furosemide (Lasix) to a client with a diagnosis of heart failure. Which is the most important laboratory test result for the nurse to check before administering this medication? 1. Blood urea nitrogen 2. Cholesterol level 3. Potassium level 4. Creatinine level 167. The nurse is preparing to administer furosemide (Lasix) 40 mg by intravenous (IV) injection (IV push) to a client. The nurse should administer the medication over which time period? 1. 10 seconds 2. 30 seconds 3. 1 minute 4. 5 minutes 168. A health care provider writes a prescription for digoxin (Lanoxin), 0.25 mg daily. The nurse teaches the client about the medication and tells the client that it is most important to be sure to implement which measure? 1. Count the radial and carotid pulses every morning. 2. Check the blood pressure every morning and evening. 3. Stop taking the medication if the pulse is faster than 100 beats/min. 4. Withhold the medication, and call the health care provider if the pulse is slower than 60 beats/min. 169. A client with angina pectoris is experiencing chest pain that radiates down the left arm. The nurse administers a sublingual nitroglycerin tablet to the client. The client's pain is unrelieved, and the nurse determines that the client needs another nitroglycerin tablet. Which vital sign is the most important for the nurse to check before administering the medication? 1. Temperature 2. Respirations 3. Blood pressure 4. Radial pulse rate 170. Atenolol hydrochloride (Tenormin) is prescribed for a hospitalized client. The nurse should perform which action as a priority before administering this medication? 1. Listen to the client's lung sounds. 2. Check the client's blood pressure. 3. Assess the client for muscle weakness. 4. Check the client's most recent electrolyte levels. 171. A man who has developed atrial fibrillation and has been placed on warfarin (Coumadin). The nurse is doing discharge dietary teaching with the client and determines that the client needs additional education if he stated he would choose which foods while taking this medication? 1. Cherries 2. Potatoes 3. Broccoli 4. Spaghetti 172. A client with heart disease is taking digoxin (Lanoxin) and complains of having no appetite, and experiencing diarrhea and blurry vision. The nurse notes that the client's serum potassium (K) level is 3.0 mEq/L. Based on analysis of the data, what might the nurse expect to note when reviewing the digoxin level results? 1. Digoxin level of 1.8 ng/mL 2. Digoxin level higher than 2 ng/mL 3. Digoxin level lower than 0.5 ng/mL 4. Digoxin level of 0 ng/mL because of diarrhea 173. The nurse is providing medication information to a client who is beginning medication therapy with enalapril (Vasotec). The nurse should tell the client that which is an anticipated, although unpleasant, side effect of this medication? 1. Rapid pulse 2. Persistent dry cough 3. Increased blood pressure 4. Metallic taste in the mouth 174. A client has recently begun medication therapy with propranolol (Inderal LA). The long-term care nurse should plan to notify the health care provider (HCP) if which assessment finding is noted? 1. Complaints of insomnia 2. Audible expiratory wheezes 3. Decrease in heart rate from 86 to 78 beats/min 4. Decrease in blood pressure from 162/90 to 136/84 mm Hg 175. A client is receiving scheduled doses of lovastatin (Mevacor). The nurse determines that the medication is having the intended effect if which is noted? 1. Weight loss 2. Increased pulse rate 3. Lowered blood pressure 4. Decreased cholesterol level 176. A client taking verapamil (Calan) has been given information about side effects of this medication. The nurse determines that the client understands the information if the client states to watch for which most common side effect of this medication? 1. Weight loss 2. Constipation 3. Nasal stuffiness 4. Abdominal cramping 177. The nurse has a prescription to give a first dose of hydrochlorothiazide (HydroDIURIL) to an assigned client. The nurse would question the prescription if the client has a history of allergy to which item? 1. Iodine 2. Shellfish 3. Penicillin 4. Sulfa drugs 178. The nurse has a prescription to give a client a scheduled dose of digoxin (Lanoxin). Prior to administering the medication, the nurse should assess for which manifestations that could indicate digoxin toxicity? 1. Dyspnea, edema, and palpitations 2. Chest pain, hypotension, and paresthesias 3. Constipation, dry mouth, and sleep disorder 4. Double vision, loss of appetite, and nausea 179. A hospitalized client with a history of angina pectoris complains of substernal chest pain. The nurse checks the client's blood pressure and administers nitroglycerin, gr 1/4 sublingually. Five minutes later, the client is still experiencing chest pain. If the blood pressure remains stable, the nurse should take which action next? 1. Administer another nitroglycerin tablet. 2. Administer 10 L of oxygen via nasal cannula. 3. Call for a 12-lead electrocardiogram (ECG) to be performed. 4. Wait an additional 5 minutes, and then give a second nitroglycerin tablet. 180. The long-term care client with a history of heart failure has developed paroxysmal nocturnal dyspnea (PND). The nurse reviews the client's medication record and determines that which medication has been prescribed to treat the PND? 1. Bumetanide 2. Warfarin (Coumadin) 3. Propranolol (Inderal LA) 4. Acetylsalicylic acid (aspirin) 181. The nurse is working with a client receiving an intravenous heparin sodium drip. The nurse should review which laboratory study to determine the therapeutic effect of heparin for the client? 1. Bleeding time 2. Thrombin time 3. Prothrombin time (PT) 4. Partial thromboplastin time (PTT) 182. The nurse is caring for a child with heart failure (HF). The nurse provides instructions to the mother regarding the procedure for administration of the prescribed digoxin (Lanoxin). Which statement by the mother indicates a need for further teaching? 1. "I will make sure to mix the medication with food." 2. "I need to take the child's pulse before administering the medication." 3. "If more than one dose is missed, I need to call the health care provider." 4. "If the child vomits after being given the medication, I should not repeat the dose." 1. "I will make sure to mix the medication with food." 1.Your client is dx with end stage liver failure and receiving lactulose/granulote. which lab test tells you it is effective? A. serum ammonia 2.Your elderly pt is being administered Lomotil, what kind of drug? 3.A nurse is caring for a client with cirrhosis who has a new prescription for cephulac (Lactulose). Following administration, the nurse will monitor the client for which adverse effect of this medication? 4.the nurse administers antidiarrheal drugs... a. after each loose bowel movement 5.trimethoprim/sulfa (Bactrim)- antibiotic tx of spontaneous bacterial peritonitis if pt is allergic to quinolones, gastroenteritis 6.metronidazole (Flagyl) -less potential for renal toxicity , BUT SHOULD ONLY USE FOR SHORT PERIOD OF TIME, can be useful for fistulas assoc w/ CD 7.diphenoxylate hydrochloride & atropine sulfate (Lomotil) -habit forming, use with caution in gastroenteritis 8.dicyclomine hydrochloride (Bentyl) -anticholenergic, tx of IBS decreased GI motitlity 9.sulfasalazine= 5 ASA-anti inflam 10.mesolamine- 5ASA 11.azathioprine (Imuran) -immunospuressant, do not give with allupurinal, take with food, ly down if nausea, report abd pain, jaundice, vomiting, sore throat infection, dyspnea, dizziness, bleeding/bruising 12.A client has begun medication therapy with pancrelipase (Pancrease). The nurse determines that the medication is having the optimal intended benefit if which effect is observed? A. Weight loss B. Relief of heartburn C. Reduction of steatorrhea D. Absence of abdominal pain C. Reduction of steatorrhea 13. ... 14.inflixicab (Remicade) -used in combo with steroids for the tx of U.C, can be used for Toxic megacolon 15.adalimumab (Humira) -with steroids for U.C, Mostly used for Crohns disease 16.natalizumab (Tysabrri) -can cause progressive multifocal leukoencephalopathy (PML), a deadly infection of the brain must be free of all infections before giving and monitor LOC 17.certizumab pegol (Cimzia) 1282 18.propranolol (Inderal) - prevent bleeding in pt with esophageal varicies 19.terlipressin vasoactve drugs, may cause ischemic complications and dysrhytmias- used for bleeding 20.somatostatin (Ostreotide) same as terlipressin but with more serious side effects 21.lactulose -may eliminate or reduce ammonia levels in the body; used in patients with encephalopathy; used for a laxative effect, drug is vicscous and sticky, given PO or NGT, increases osmotic pressure to draw fluid into the colon and prevents absorption of ammonia in the colon, desired effect is 2-3 soft stools/day with decreased confusion, may report bloating/cramping, do NOT give with NONABSORBIC ANTIBIOTICS (FLAGYL, NEOMYCIN,) FREQUENTLY ASSES FOR LOC, ASTERIXIS & FETOR HEPATICUS A client has a PRN order for loperamide (Imodium). The nurse should plan to administer this medication if the client has: Polyethylene glycol-electrlyte solution (GoLYTELY) is prescribed for the female client scheduled for a colonoscopy. The client begins to experience diarrhea following administration of the solution. What action by the nurse is appropriate? explain that diarrhea is expected 1. A client with Crohn's disease is scheduled to receive an infusion of infliximab (Remicade). What intervention by the nurse will determine the effectiveness of treatment? 1. A client has a PRN prescription for loperamide hydrochloride (Imodium). For which condition should the nurse administer this medication? 1. Constipation 1. A client has a PRN prescription for ondansetron (Zofran). For which condition should the nurse administer this medication to the postoperative client? 1. Paralytic ileus 2. Incisional pain 3. Urinary retention 4. Nausea and vomiting 4 1. A client has begun medication therapy with pancrelipase (Pancrease MT). The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed? 3 A client has been taking omeprazole (Prilosec) for 4 weeks. The ambulatory care nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptom? Dicyclomine hydrochloride (Bentyl) has been prescribed for a client with irritable bowel syndrome, and the nurse provides instructions to the client about how to take this medication. Which statement, if made by the client, best indicates an understanding of how to take this medication? 1. "I should take the pill with food and at meal times." 2. "I should take the pill 30 minutes before each meal." 3. "I should take the pill after I have finished eating my meal." 4. "I should take the pill when I first wake up in the morning and right before I go to bed." The nurse is preparing to administer prescribed medications to a client with hepatic encephalopathy. The nurse anticipates that the health care provider's prescriptions will include which medication? 1. Bisacodyl (Dulcolax) 2. Lactulose (Chronulac) 3. Magnesium hydroxide (Milk of Magnesia) 4. Psyllium hydrophilic mucilloid (Metamucil 1. A client with gastrointestinal hypermotility has a prescription to receive atropine sulfate. The nurse should withhold the medication and question the prescription if the client has a history of which disease process? 1. Biliary colic 2. Sinus bradycardia 3. Peptic ulcer disease 4. Narrow-angle glaucoma A client admitted to the medical nursing unit has a diagnosis of gastroesophageal reflux disease (GERD). Metoclopramide (Reglan) has been prescribed four times a day. The nurse should schedule administration of the medication for which times? 1. Every 8 hours 2. With meals and at bedtime 3. Right after meals and at bedtime 4. 30 minutes before meals and at bedtime 1. Oral neomycin has been prescribed for a client with a diagnosis of portosystemic encephalopathy. The nurse reviews the health care provider's prescription and determines that this medication has been prescribed for which purpose? 1. Prevent infection. 2. Prevent restlessness in the client. 3. Prevent fluid retention and ascites. 4. Destroy normal bacteria found in the bowel. 1. Lactulose (Chronulac) is prescribed for a client with a diagnosis of hepatic encephalopathy. The nurse should determine that this medication has had a therapeutic effect if assessment reveals which finding? 1. Increased protein level 2. Increased red blood cell count 3. Decreased serum ammonia level 4. Decreased white blood cell count A health care provider has written a prescription for ranitidine (Zantac) 300 mg once daily. The client indicates understanding of use of this medication by stating that the prescribed dose is best taken at what time? 1. At bedtime 2. After lunch 3. With supper 4. Before breakfast A preoperative client receives a dose of scopolamine. The nurse determines that which sign or symptom later displayed by the client is a result of medication side effects? 1. Dry mouth 2. Diaphoresis 3. Excessive urination 4. Pupillary constriction A client with peptic ulcer disease who has been given a prescription for propantheline (Pro-Banthine) asks the nurse how to take the medication. The nurse explains that this medication should be taken in which way? 1. With meals 2. With antacids 3. Just after meals 4. 30 minutes before meals The nurse has just given a client a dose of a PRN medication called loperamide (Imodium). The nurse documents in the client's record that the client received this medication for complaints of what symptom? 1. Diarrhea 2. Tarry stools 3. Constipation 4. Abdominal pain A client has just been given a prescription for diphenoxylate with atropine (Lomotil). The nurse determines that the client understands important information about this medication if the client makes what statement? 1. "It's best to take this medication with a laxative." 2. "This medication contains a habit-forming ingredient." 3. "Drooling may occur while I am taking this medication." 4. "Irritability may occur while I am taking this medication." . A client has a prescription for magnesium citrate to prevent constipation after undergoing barium studies of the gastrointestinal tract. How should the nurse administer the magnesium citrate? 1. With fruit juice only 2. At room temperature 3. With a full glass of water 4. After it is chilled in the refrigerator 1. The nurse has administered prochlorperazine to a client for relief of nausea and vomiting. The nurse should then assess the client for which frequent side effect of this medication? 1. Diarrhea 2. Drooling 3. Blurred vision 4. Excessive tearing 1. A client has begun medication therapy with pancrelipase (Pancrease MT). Which finding indicates that the medication is effective? 1. Relief of heartburn 2. Elimination of abdominal pain 3. Stabilization of blood glucose levels 4. A decrease in the amount of fat in the stools 4 1. The nurse is preparing to give a client directions for proper use of aluminum hydroxide tablets. Which instruction by the nurse is appropriate? 1. "Take the tablet at the same time as an antacid." 2. "Swallow the tablet whole with a full glass of water." 3. "Take each dose with a laxative to prevent constipation." 4. "Chew the tablet thoroughly and then drink 8 ounces of water." A client reports frequent use of sodium bicarbonate to relieve heartburn after meals. The nurse should monitor the client for which condition that the client is at risk for with long-term frequent use of this medication? 1. Urinary calculi 2. Chronic bronchitis 3. Metabolic alkalosis 4. Respiratory acidosis 1. Mineral oil has been prescribed for a child with constipation, and the nurse teaches the mother about administration of the mineral oil. Which statement by the mother indicateseffective teaching? 1. "I will administer the mineral oil before each meal." 2. "I will administer the mineral oil followed by a glass of warm water." 3. "I will mix the mineral oil with a chilled drink before administration." 4. "I will mix the mineral oil with 8 ounces of warm juice before administration." 3 1. Which finding suggests to the nurse that a client with bleeding esophageal varices is experiencing an adverse effect of vasopressin therapy? 1. Complaints of chest pain 2. Temperature of 102° F 3. Bounding peripheral pulses 4. Blood urea nitrogen (BUN) of 20 mg/dL adult client with hepatic encephalopathy has a serum ammonia level of 95 mcg/dL and receives treatment with lactulose (Chronulac). The nurse determines that the client had the best and most realistic response if the serum ammonia level changed to which value after medication administration? 1. 5 mcg/dL 2. 10 mcg/dL 3. 40 mcg/dL 4. 90 mcg/dL 1. A client with portal-systemic encephalopathy is receiving oral lactulose (Chronulac) daily. The nurse should check which item to determine the effectiveness of this medication? 1. Lung sounds 2. Blood pressure 3. Blood ammonia level 4. Serum potassium level The client has a prescription for sucralfate (Carafate) four times daily. The nurse teaches the client to administer the medication at which best times? 1. Every 6 hours starting at 6:00 am 2. With breakfast, lunch, dinner, and at bedtime 3. One hour before breakfast, lunch, dinner, and at bedtime 4. One hour after breakfast, lunch, dinner, and with an evening snack 1. A client is experiencing diarrhea. The nurse reviews the client's PRN medication prescription sheet and should plan to administer which medication for this problem? 1. Psyllium (Metamucil) 2. Sennosides (Senokot) 3. Loperamide (Imodium) 4. Bisacodyl (Dulcolax Bowel Prep Kit) bevacizumab (Avastin)- Monoclonal antibodies; colorectal cancer; stops cancer cell growth and increase cell death; THROMBOEMBOLISM, CVA, MI, alopecia, hemorrhage, hypertension, GASTRIC PERFORATION-notify HCP of ABD pain associated with vomiting and constipation, do not use with low WBC or liver/kidney failure sulfasalazine 5 ASA, take with food, avoid sun, urine and skin may appear yellow or brown, CONTRAINDICATED IN SULFA ALLERGY; decrease inflammation mesolamine 5ASA NONSULFA, report headache or GI probs, side effects not as bad as sulfasalazine 1. The nurse is teaching a client how to mix regular insulin and NPH insulin in the same syringe. Which action, if performed by the client, indicates the need for further teaching? 1. Withdraws the NPH insulin first 2. Withdraws the regular insulin first 3. Injects air into NPH insulin vial first 4. Injects an amount of air equal to the desired dose of insulin into each vial 2. The home care nurse visits a client recently diagnosed with diabetes mellitus who is taking Humulin NPH insulin daily. The client asks the nurse how to store the unopened vials of insulin. The nurse should tell the client to take which action? 1. Freeze the insulin. 2. Refrigerate the insulin. 3. Store the insulin in a dark, dry place. 4. Keep the insulin at room temperature. 3. Glimepiride (Amaryl) is prescribed for a client with diabetes mellitus. The nurse instructs the client to avoid consuming which food while taking this medication? 1. Alcohol 2. Organ meats 3. Whole-grain cereals 4. Carbonated beverages 4. Sildenafil (Viagra) is prescribed to treat a client with erectile dysfunction. The nurse reviews the client's medical record and should question the prescription if which data is noted in the client's history? 1. Insomnia 2. Neuralgia 3. Use of nitroglycerin 4. Use of multivitamins 5. The health care provider (HCP) prescribes exenatide (Byetta) for a client with type 1 diabetes mellitus who takes insulin. The nurse should plan to take which most appropriate intervention? 1. Withhold the medication and call the HCP, questioning the prescription for the client. 2. Administer the medication within 60 minutes before the morning and evening meal. 3. Monitor the client for gastrointestinal side effects after administering the medication. 4. Withdraw the insulin from the prefilled pen into an insulin syringe to prepare for administration. . 6. A client is taking Humulin NPH insulin and regular insulin every morning. The nurse should provide which instructions to the client? Select all that apply. 1. Hypoglycemia may be experienced before dinnertime. 2. The insulin dose should be decreased if illness occurs. 3. The insulin should be administered at room temperature. 4. The insulin vial needs to be shaken vigorously to break up the precipitates. 5. The NPH insulin should be drawn into the syringe first, then the regular insulin. 7. The home health care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client is prescribed repaglinide (Prandin) and metformin (Glucophage) and asks the nurse to explain these medications. The nurse should provide which instructions to the client? Select all that apply. 1. Diarrhea may occur secondary to the metformin. 2. The repaglinide is not taken if a meal is skipped. 3. The repaglinide is taken 30 minutes before eating. 4. A simple sugar food item is carried and used to treat mild hypoglycemia episodes. 5. Metformin increases hepatic glucose production to prevent hypoglycemia associated with repaglinide. 6.Muscle pain is an expected effect of metformin and may be treated with acetaminophen (Tylenol). 8. The community health nurse visits a client at home. Prednisone, 10 mg orally daily, has been prescribed for the client and the nurse teaches the client about the medication. Which statement, if made by the client, indicates that further teaching is necessary? 1. "I can take aspirin or my antihistamine if I need it." 2. "I need to take the medication every day at the same time." 3. "I need to avoid coffee, tea, cola, and chocolate in my diet." 4. "If I gain more than 5 pounds a week, I will call my health care provider (HCP)." 9. A client with hyperthyroidism has been given methimazole (Tapazole). Which nursing considerations are associated with this medication? Select all that apply. 1. Administer methimazole with food. 2. Place the client on a low-calorie, low-protein diet. 3. Assess the client for unexplained bruising or bleeding. 4. Instruct the client to report side/adverse effects such as sore throat, fever, or headaches. 5. Use special radioactive precautions when handling the client's urine for the first 24 hours following initial administration. 10. The nurse is monitoring a client receiving levothyroxine sodium (Synthroid) for hypothyroidism. Which findings indicate the presence of a side effect associated with this medication? Select all that apply. 1. Insomnia 2. Weight loss 3. Bradycardia 4. Constipation 5. Mild heat intolerance 11. The nurse provides instructions to a client who is taking levothyroxine (Synthroid). The nurse should tell the client to take the medication at which time? 1. With food 2. At lunchtime 3. On an empty stomach 4. At bedtime with a snack 12. The nurse provides medication instructions to a client who is taking levothyroxine (Synthroid) and should tell the client to notify the health care provider (HCP) if which problem occurs? 1. Fatigue 2. Tremors 3. Cold intolerance 4. Excessively dry skin 13. The nurse performs an admission assessment on a client who visits a health care clinic for the first time. The client tells the nurse that propylthiouracil (PTU) is taken daily. The nurse continues to collect data from the client, suspecting that the client has a history of which condition? 1. Myxedema 2. Graves' disease 3. Addison's disease 4. Cushing's syndrome 14. The nurse is instructing a client regarding intranasal desmopressin (DDAVP). The nurse should tell the client that which occurrence is a side effect of the medication? 1. Headache 2. Vulval pain 3. Runny nose 4. Flushed skin 15. A daily dose of prednisone is prescribed for a client. The nurse provides instructions to the client regarding administration of the medication and should instruct the client that which time is best to take this medication? 1. At noon 2. At bedtime 3. Early morning 4. Any time, at the same time, each day 16. Prednisone is prescribed for a client with diabetes mellitus who is taking Humulin NPH insulin daily. Which prescription change does the nurse anticipate during therapy with the prednisone? 1. An additional dose of prednisone daily 2. A decreased amount of daily Humulin NPH insulin 3. An increased amount of daily Humulin NPH insulin 4. The addition of an oral hypoglycemic medication daily 17. A client with diabetes mellitus visits a health care clinic. The client's diabetes mellitus previously had been well controlled with glyburide (DiaBeta) daily, but recently the fasting blood glucose level has been 180 to 200 mg/dL. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia? 1. Prednisone 2. Phenelzine (Nardil) 3. Atenolol (Tenormin) 4. Allopurinol (Zyloprim) 18. A client newly diagnosed with diabetes mellitus is instructed by the health care provider to obtain glucagon for emergency home use. The client asks a home care nurse about the purpose of the medication. What is the nurse's best response to the client's question? 1. "It will boost the cells in your pancreas if you have insufficient insulin." 2. "It will help promote insulin absorption when your glucose levels are high." 3. "It is for the times when your blood glucose is too low from too much insulin." 4. "It will help prevent lipoatrophy from the multiple insulin injections over the years." 19. Levothyroxine (Synthroid) is prescribed for a client diagnosed with hypothyroidism. Upon review of the client's record, the nurse notes that the client is taking warfarin (Coumadin). Which modification to the plan of care should the nurse review with the client's health care provider? 1. A decreased dosage of levothyroxine 2. An increased dosage of levothyroxine 3. A decreased dosage of warfarin sodium 4. An increased dosage of warfarin sodium 20. A client received 20 units of Humulin N insulin subcutaneously at 08:00. At what time should the nurse plan to assess the client for a hypoglycemic reaction? 1. 10:00 2. 11:00 3. 17:00 4. 23:00 21. The nurse teaches a client newly diagnosed with type 1 diabetes about storing Humulin N insulin. Which statement indicates to the nurse that the client understood the discharge teaching? 1. "I should keep the insulin in the cabinet during the day only." 2. "I know I have to keep my insulin in the refrigerator at all times." 3. "I can store the open insulin bottle in the kitchen cabinet for 1 month." 4. "The best place for my insulin is on the window sill, but in the cupboard is just as good." 22. Metformin (Glucophage) is prescribed for a client with type 2 diabetes mellitus. What is the most common side effect that the nurse should include in the client's teaching plan? 1. Weight gain 2. Hypoglycemia 3. Flushing and palpitations 4. Gastrointestinal disturbances 23. A client arrives at the clinic complaining of fatigue, lack of energy, constipation, and depression. Hypothyroidism is diagnosed, and levothyroxine (Synthroid) is prescribed. What is an expected outcome of the medication? 1. Alleviate depression 2. Increase energy levels 3. Increase blood glucose levels 4. Achieve normal thyroid hormone levels 24. A client is seen in the clinic for complaints of thirst, frequent urination, and headaches. After diagnostic studies, diabetes insipidus is diagnosed. Desmopressin (DDAVP) is prescribed. The client asks why this medication was prescribed. Which is a correct statement by the nurse? 1. It relieves the headaches. 2. It increases water reabsorption. 3. It stimulates the production of aldosterone. 4. It decreases the production of the antidiuretic hormone. 25. Growth hormone is prescribed for the client with pituitary dwarfism. Which statement is accurate related to the expected outcome of this medication? 1. Growth begins in 4 to 5 years. 2. Growth spurts will occur every 2 years. 3. There will be an immediate increase in growth. 4. An increase in height will begin in late adulthood. 26. Lispro insulin (Humalog) is prescribed for the client, and the client is instructed to administer the insulin before meals. When should the nurse instruct the client to administer the insulin? 1. 45 minutes before eating 2. 60 minutes before eating 3. 90 minutes before eating 4. Immediately before eating 27. The emergency department nurse is caring for a client admitted with diabetic ketoacidosis. The health care provider prescribes intravenous (IV) insulin. The nurse plans to prepare which type of insulin for the client? 1. Insulin glargine (Lantus) 2. Regular humulin (Humulin R) 3. Isophane insulin NPH (Humulin N) 4. 50% human insulin isophane/50% human insulin (Humulin 50/50) 28. Metformin (Glucophage) is prescribed for a client with type 2 diabetes mellitus. The nurse should tell the client that which is the mostcommon side effect of the medication? 1. Weight gain 2. Hypoglycemia 3. Flushing and palpitations 4. Gastrointestinal (GI) disturbances 29. The diabetes nurse specialist conducts a teaching session to a group of nursing students regarding sulfonylureas, oral hypoglycemic medications used for type 2 diabetes mellitus. Which statement, describing the primary action of these medications, should the nurse include in the teaching session? 1. "Sulfonylureas decrease insulin resistance." 2. "Sulfonylureas inhibit carbohydrate digestion." 3. "Sulfonylureas decrease glucose production by the liver." 4. "Sulfonylureas promote insulin secretion by the pancreas." 30. A client with diabetes mellitus calls the clinic and tells the nurse that he has been nauseated during the night. The client asks the nurse if the morning insulin should be administered. Which is the most appropriate nursing response? 1. Omit the insulin. 2. Administer half the prescribed dose. 3. Administer the full dose as prescribed. 4. Wait until noon before making a decision. 31. Fludrocortisone acetate (Florinef) is prescribed for a client with Addison's disease. The nurse prepares to administer the medication. What is the primary action of this medication? 1. It promotes the excretion of water in the distal tubules of the kidney. 2. It promotes the retention of potassium in the distal tubules of the kidney. 3. It promotes the retention of hydrogen ions in the distal tubules of the kidney. 4. It enhances the reabsorption of sodium and chloride ions in the distal tubules of the kidney. 32. The clinic nurse develops a plan of care for a client with emphysema who will be started on long-term corticosteroid therapy. Which specific instruction should the nurse include in the plan of care? 1. Instruct the client to maintain a low-potassium diet. 2. Encourage the client to consume a fluid intake of 3000 mL/day. 3. Encourage the client to increase the amounts of sodium intake in the diet. 4. Instruct the client to return to the clinic for monitoring of blood glucose levels. 33. The health care provider has prescribed Humulin R insulin 6 units and Humulin N insulin 20 units subcutaneously to be administered every morning. How should the nurse prepare to administer insulin? 1. Shaking the Humulin N insulin vial to distribute the suspension 2. Administering Humulin R and Humulin N insulin in separate syringes 3. Drawing up the Humulin R first and then the Humulin N insulin in the same syringe 4. Drawing up the Humulin N insulin first and then the Humulin R in the same syringe 34. A female client scheduled to undergo subtotal thyroidectomy is taking a potassium iodide solution (Lugol's solution). The client complains to the nurse that she experiences a brassy taste in her mouth when taking the medication. Which instruction should the nurse provide to the client? 1. Dilute the medication in 8 ounces of water. 2. Report the symptom to the health care provider (HCP). 3. Continue to take the medication because the symptoms are normal. 4. Take one half dose of the prescribed medication for the next 2 days. 35. The nurse is providing instructions to a client with a diagnosis of Addison's disease regarding the administration of prescribed glucocorticoids. The nurse should provide which instruction to the client? 1. To stop the medication if side effects occur 2. To avoid taking the medication if nausea occurs 3. That minimal side effects will occur with use of this medication 4. That an increased dose of medication may be needed during times of stress 36. The nurse administers 20 units of Humulin N insulin to a hospitalized client with diabetes mellitus at 7:00 am. The nurse should monitor the client most closely for a hypoglycemic reaction at which time? 1. 4:00 pm 2. 9:00 am 3. 10:00 am 4. 12:00 midnight 37. A client is started on tolbutamide (Orinase) once daily. The nurse should instruct the client to monitor for which intended effect of this medication? 1. Weight loss 2. Resolution of infection 3. Decreased blood glucose 4. Decreased blood pressure 38. A client with diabetes insipidus asks the nurse about the purpose of a new medication, vasopressin (Pitressin). The nurse explains that this medication works by which mechanism? 1. Decreasing peristalsis 2. Producing vasodilation 3. Decreasing urinary output 4. Inhibiting contraction of smooth muscle 39. A client with previously well-controlled diabetes mellitus has had fasting blood glucose levels ranging from 180 to 200 mg/dL. The client takes glyburide (Diabeta) 5 mg orally daily. In reviewing the client's medication list, the home health care nurse suspects that which newly added medications could be contributing to the elevated blood glucose levels? 1. Prednisone 2. Ranitidine (Zantac) 3. Ciprofloxacin (Cipro) 4. Cimetidine (Tagamet) 40. A client must learn how to mix Humulin R and Humulin N insulin in the same syringe. The nurse should include which teaching point in the instructions to the client? 1. Keep both bottles in the refrigerator at all times. 2. Take all of the air out of the bottle before mixing. 3. Draw up the Humulin N insulin into the syringe first. 4. Rotate the Humulin N insulin bottle in the hands before mixing. 41. A client with aldosteronism is being treated with spironolactone (Aldactone). Which finding indicates to the nurse that the medication is effective? 1. A decrease in body metabolism 2. A decrease in sodium excretion 3. A decrease in potassium excretion 4. A decrease in aldosterone production 42. The nurse in the health care clinic is reviewing the record of a client with diabetes mellitus who was just seen by the health care provider (HCP). The nurse notes that the HCP has prescribed metformin (Glucophage). What preexisting disorder, if noted in the client's record, would indicate a need to collaborate with the HCP before instructing the client to take the medication? 1. Foot ulcer 2. Emphysema 3. Hypertension 4. Hypothyroidism 43. A client is started on tolbutamide (Orinase) once daily. When should the nurse tell the client to take the medication? 1. At breakfast 2. At suppertime 3. Before going to bed at night 4. Between breakfast and lunch 44. The nurse is monitoring a client receiving glipizide (Glucotrol). The nurse knows that which finding would indicate a therapeutic outcome for this client? 1. A decrease in polyuria 2. An increase in appetite 3. A glycosylated hemoglobin of 10% 4. A fasting blood glucose of 220 mg/dL 45. A sulfonamide is prescribed for a client with a urinary tract infection. The client has diabetes mellitus and is receiving tolbutamide (Orinase). Because the client will be taking these two medications, which prescription should the nurse anticipate for this client? 1. Increased dosage of tolbutamide 2. Decreased dosage of tolbutamide 3. Increased dosage of sulfonamide 4. Decreased dosage of sulfonamide 46. A medication has been prescribed for a client with hypoparathyroidism for management of hypocalcemia. The client arrives at the clinic for follow-up evaluation and complains of chronic constipation since beginning the medication. The nurse provides information to the client regarding measures to alleviate the constipation and determines that the client needs additional information when the client makes which statement? 1. "I will increase my daily fluid intake." 2. "I will increase my activity level as tolerated." 3. "I will increase my daily intake of high-fiber foods." 4. "I will add ½ ounce of mineral oil to my daily diet." 47. An adult client with hypothyroidism is admitted to the hospital. On admission assessment, the nurse notes that the client is taking a maintenance dose of levothyroxine (Synthroid). The nurse transcribes the medication prescription knowing that which is the normal adult maintenance dose range of this medication? 1. 0.025 to 0.05 mg daily 2. 0.05 to 0.075 mg daily 3. 0.075 to 0.1 mg daily 4. 0.1 to 0.2 mg daily 48. The nurse is preparing a dose of 10 units of Humulin R and 35 units of Humulin N insulin for a client with type 1 diabetes mellitus. The nurse obtains an insulin syringe, gently rotates the insulin solutions, cleanses the tops of the vials of insulin, and injects an amount of air equal to the dose prescribed into each vial. What is the next nursing action? 1. Draws up 10 units of Humulin R and checks the syringe contents with another nurse before drawing up the Humulin N insulin 2. Draws up 10 units of Humulin R, draws up 35 units of Humulin N insulin, and checks the syringe contents with another nurse 3. Draws up 35 units of Humulin N insulin and checks the syringe contents with another nurse before drawing up the Humulin R 4. Draws up 35 units of Humulin N insulin, draws up 10 units of Humulin R, and checks the syringe contents with another nurse 49. The nurse is preparing to care for a client admitted to the emergency department with a diagnosis of diabetic ketoacidosis (DKA). The nurse gathers supplies and obtains which type of insulin, anticipating that it will be initially prescribed for the client? 1. A 2. B 3. C 4. D 50. The nurse is preparing the client's morning Humulin N insulin dose. The nurse notices a clumpy precipitate inside the insulin vial. What is the most appropriate nursing action related to this finding? 1. Draw the dose from a new vial. 2. Draw up and administer the dose. 3. Shake the vial in an attempt to disperse the clump. 4. Warm the bottle under running water to dissolve the clump. 51. A client has been taking glucocorticoids to control rheumatoid arthritis. Which laboratory abnormality is the client at risk for as a result of taking this medication? 1. Increased serum glucose 2. Decreased serum sodium 3. Elevated serum potassium 4. Increased white blood cells 52. The nurse is completing a health history for an insulin dependent client who has been self-administering insulin for 40 years. The client reports experiencing periods of hypoglycemia followed by periods of hyperglycemia. What is the most likely cause for this pattern of blood glucose fluctuation? 1. Eating snacks between meals 2. Initiating the use of the insulin pump 3. Injecting insulin at a site of lipodystrophy 4. Adjusting insulin according to blood glucose levels 53. Glyburide (DiaBeta) daily is prescribed for a client. What instruction will the nurse include in the client's teaching plan? 1. The medication is used to prevent foot infections. 2. Take the medication in the morning before breakfast. 3. Expect skin color change from pink to yellow and also pale-colored stools. 4. Contact the health care provider (HCP) immediately if an altered taste sensation is noted. 54. The client with a head injury has begun excreting copious amounts of dilute urine through the Foley catheter. The client's urine output for the previous shift was 3000 mL. The nurse expects that the health care provider will prescribe which medication? 1. Dexamethasone 2. Mannitol (Osmitrol) 3. Desmopressin (DDAVP) 4. Ethacrynic acid (Edecrin) 55. Propylthiouracil (PTU) is prescribed for a client with hyperthyroidism. The nurse provides instructions to the client regarding the medication and informs the client to notify the health care provider if which sign/symptom occurs? 1. Fever 2. Dry mouth 3. Drowsiness 4. Increased urination 56. A client who has been taking iodine solution (Lugol's solution, potassium iodide solution) is admitted to the emergency department, and an iodine overdose is suspected. Gastric lavage is initiated to remove the iodine from the stomach. In addition to treatment with gastric lavage, the nurse anticipates that which medication will be administered? 1. Vitamin K 2. Calcium gluconate 3. Sodium thiosulfate 4. Acetylcysteine (Mucomyst) 57. Octreotide acetate (Sandostatin) is prescribed for a client with acromegaly. The nurse monitors the client, knowing that which side effect is associated with the administration of this medication? 1. Polyuria 2. Hypotension 3. Constipation 4. Abdominal pain 58. Cortisone acetate is prescribed for a client with adrenal insufficiency. The nurse provides instructions to the client regarding the medication. Which statement, if made by the client, indicates a need for further instruction? 1. "I will limit my sodium intake." 2. "I will avoid people with colds." 3. "I will eat a good breakfast every day." 4. "I will stop the medication when I feel better." 59. A hospitalized client with diabetes mellitus receives Humulin N insulin in the morning. The nurse monitors the client for hypoglycemia, knowing that the peak action is expected to occur how soon after the medication administration? 1. 2 to 4 hours after administration 2. 4 to 12 hours after administration 3. 12 to 16 hours after administration 4. 18 to 24 hours after administration 60. A client with diabetes mellitus is self-administering Humulin N insulin from a vial that is kept at room temperature. The client asks the nurse about the length of time an unrefrigerated vial of insulin will maintain its potency. What is the most appropriateresponse to the client? 1. 2 weeks 2. 1 month 3. 2 months 4. 6 months 61. Somatropin (Humatrope), a growth hormone, is prescribed for a client. The nurse reviews the assessment data in the client's health record, knowing that the medication would be contraindicated for which client? 1. A child with growth failure 2. A child with pituitary dwarfism 3. A 20-year-old with growth failure 4. A child with growth hormone deficiency 62. The nurse is caring for a client who is receiving growth hormone replacement therapy. The nurse monitors the client for which option as an adverse effect of this therapy? 1. Hypocalciuria 2. Hypoglycemia 3. Hyperglycemia 4. Hyperthyroidism 63. A client arrives at the clinic complaining of fatigue, lack of energy, constipation, and depression. Following diagnostic studies, hypothyroidism is diagnosed and levothyroxine (Synthroid) is prescribed. The nurse informs the client that which is the expected outcome of the medication? 1. Alleviate depression 2. Increase energy levels 3. Increase blood glucose levels 4. Achieve normal thyroid hormone levels 64. A client diagnosed with hypothyroidism is taking levothyroxine (Synthroid). The client returns to the clinic 1 week after beginning the medication and tells the nurse that the medication has not helped. What is the appropriate nursing response to the client? 1. A higher dosage is required. 2. The medication may need to be changed. 3. Full therapeutic effect may take 1 to 3 weeks. 4. Full therapeutic effect may take up to 4 months. 65. The nurse is preparing to administer an intravenous (IV) insulin injection. The vial of Regular insulin has been refrigerated. On inspection of the vial, the nurse finds that the medication is frozen. Which should the nurse do? 1. Discard the insulin and obtain another vial. 2. Wait for the insulin to thaw at room temperature. 3. Check the temperature settings of the refrigerator. 4. Rotate the vial between the hands until the medication becomes liquid. 66. The nurse is preparing to discharge a client who has had a parathyroidectomy. The discharge instructions include medication administration of oral calcium supplements that the client will need daily. Which statement by the nurse would be most appropriateregarding the oral calcium supplement therapy? 1. Take the tablets following a meal. 2. Store the tablets in the refrigerator to maintain potency. 3. Avoid sunlight because the medication can cause skin color changes. 4. Check the pulse daily; if it is less than 60 beats/min, do not take the tablets. 67. Thyroid replacement therapy is prescribed for the client diagnosed with hypothyroidism. The client asks the nurse when the medication will no longer be needed. Which is the appropriate nursing response? 1. "It depends on the results of the laboratory tests." 2. "Most clients require medication for about 1 year." 3. "The medication will need to be continued for life." 4. "You will need to ask your health care provider." 68. A nurse is caring for a client with a diagnosis of hyperthyroidism. Laboratory studies are performed and the serum calcium level is 12.0 mg/dL. Which medication should the nurse anticipate to be prescribed for the client? 1. Calcitonin 2. Calcium chloride 3. Calcium gluconate 4. Large doses of vitamin D 69. A client newly diagnosed with diabetes mellitus is instructed by the health care provider to obtain glucagon for emergency home use. The client asks the home care nurse about the purpose of the medication. The nurse should instruct the client that the purpose of the medication is to treat which problem? 1. Lipoatrophy from insulin injections 2. Hypoglycemia from insulin overdose 3. Hyperglycemia from insufficient insulin 4. Lipohypertrophy from inadequate insulin absorption 70. A client with hyperthyroidism is scheduled for a subtotal thyroidectomy, and potassium iodide (SSKI) is prescribed. The nurse prepares to administer the medication, knowing that which is the therapeutic effect of this medication? 1. Replaces thyroid hormone 2. Prevents the oxidation of iodide 3. Increases thyroid hormone production 4. Suppresses thyroid hormone production 71. Potassium iodide (SSKI) is prescribed for a client with thyrotoxic crisis. The client calls a clinic nurse and complains of a brassy taste in the mouth. Which instruction should the nurse provide the client? 1. Continue with the medication. 2. Take half of the prescribed dose for the next 24 hours. 3. Withhold the medication and notify the health care provider (HCP). 4. Withhold the medication for the next 24 hours and then continue as prescribed. 72. A nurse provides instructions to a client taking fludrocortisone acetate (Florinef acetate). The nurse instructs the client to notify the health care provider (HCP) if which manifestation occurs? 1. Nausea 2. Fatigue 3. Weight loss 4. Swelling of the feet 73. Acarbose (Precose) is prescribed to treat a client with type 2 diabetes mellitus. Which instruction should the nurse provide when teaching the client about this medication? 1. Take the medication at bedtime. 2. Take the medication with the first bite of each regular meal. 3. The medication will be used to treat symptoms of hypoglycemia. 4. Headache and dizziness are the most common side effects of this medication. 74. A client is receiving somatropin (Humatrope). The nurse should monitor which most significant laboratory study during therapy with this medication? 1. Lipase level 2. Amylase level 3. Blood urea nitrogen level 4. Thyroid-stimulating hormone level 75. Vasopressin (Pitressin) is prescribed for a client with diabetes insipidus. The nurse should be particularly cautious in monitoring a client receiving this medication if the client has which preexisting condition? 1. Depression 2. Endometriosis 3. Pheochromocytoma 4. Coronary artery disease 76. Somatropin (Humatrope) is administered to a client with growth failure. A nurse monitors the client, knowing that which is the expected therapeutic effect of this medication? 1. Promote weight gain. 2. Increase bone density. 3. Stimulate linear growth. 4. Decrease the mobilization of fats. 77. A nurse caring for a 23-year-old client newly diagnosed with type 1 diabetes mellitus teaches the client insulin administration. Which statement by the client indicates a need for further teaching? 1. "It is not necessary for me to aspirate before injecting my insulin." 2. "I will rotate my insulin injection between my arms, thighs, and abdomen on a daily basis." 3. "I will perform a capillary blood glucose measurement before I administer my insulin regimen." 4. "My glargine insulin is long-acting and should be administered once a day, but lispro insulin is given just before I eat." 78. The nurse is assigned to care for several male and female clients who take estrogen or progestins. The nurse knows that this group of clients is at increased risk for which complication of the medications? 1. Sepsis 2. Dehydration 3. Deep vein thrombosis (DVT) 4. Electrocardiographic changes 79. The nurse is instructing a client who is taking levothyroxine (Synthroid) and tells the client that full therapeutic benefits will be seen when? 1. Immediately 2. In 1 to 3 weeks 3. Within 24 hours 4. Within 3 to 5 days 80. The nurse is educating a client about medroxyprogesterone (Depo-Provera). The nurse should provide the client with which information about the medication? 1. Should be taken once daily by mouth 2. Should be administered intramuscularly every 3 months 3. Should be taken immediately following sexual intercourse 4. Provides some protection against sexually transmitted infections 81. The nurse understands that which is the action of rosiglitazone (Avandia)? 1. Reduces insulin resistance. 2. Increases glucose secretion. 3. Delays absorption of dietary carbohydrates. 4. Increases insulin release from the pancreas. 82. A nurse is providing teaching regarding nateglinide (Starlix). A portion of the teaching involves time of administration, and the nurse should tell the client to take the medication at which time? 1. Bedtime 2. During lunch 3. During breakfast 4. Before each meal 83. A nurse is providing teaching regarding acarbose (Precose). The nurse should tell that client that which expected side effect(s) may occur with this medication? 1. Tachycardia 2. Hypoglycemia 3. Tinnitus and decreased hearing 4. Abdominal distention and diarrhea 84. The nurse understands that which is an advantage of insulin glargine (Lantus) over other extended-release insulins? 1. Has a distinct peak 2. Can be administered intravenously 3. Carries a decreased risk of hypoglycemia 4. Does not require finger-stick glucose monitoring 85. An 8-year-old boy is being treated with desmopressin (DDAVP). Understanding the purpose of this medication, the nurse should set which client goal? 1. The boy will have 5 nights in sequence without enuresis. 2. The boy will have increased urine output to 2400 mL per day. 3. The boy will have an increase in white blood cell count to 4000 cells/mm3. 4. The boy will have decreased use of the metered dose inhaler to three times per week. 86. A nurse is caring for a client recently diagnosed with type 2 diabetes mellitus who has been prescribed glipizide (Glucotrol XL). What is the most important point for the nurse to include in teaching this client about this medication? 1. Take the medication at least 1 hour after eating. 2. Make sure to take the medication every 12 hours. 3. Take measures to prevent and treat hyperglycemia. 4. Swallow the medication whole and never crush or chew it. 87. Insulin glargine (Lantus) is prescribed for a client with diabetes mellitus. The nurse should tell the client that it is best to take the insulin at which time? 1. At bedtime 2. 1 hour after each meal 3. 15 minutes before the morning and evening meal 4. Before each meal, on the basis of the blood glucose level 88. A client with diabetes mellitus taking daily Humulin N insulin has been started on therapy with dexamethasone (Decadron). The nurse anticipates that which adjustments in medication dosage will be made? 1. A change to oral diabetic medications 2. An increased dose of Humulin N insulin 3. An increase in the amount of daily dietary calories 4. A lower dose of dexamethasone (Decadron) than usual 89. The nurse monitors the blood glucose level of the client who received Humulin N insulin at 7 am with an understanding that the client may experience a hypoglycemic reaction during which time frame? 1. 9 am to 11 am 2. 11 am to 7 pm 3. 7 pm to 11 pm 4. Midnight to 6 am 90. The nurse evaluates that the family of a client newly diagnosed with diabetes mellitus correctly understands the reason for having glucagon on hand for emergency home use if the family indicates that the purpose of the medication is to treat which complication? 1. Diabetic ketoacidosis 2. Hypoglycemia from insulin overdose 3. Hyperglycemia from insufficient insulin 4. Hyperglycemia occurring on "sick days" 91. The nurse is teaching a client with hyperthyroidism regarding the prescribed medication propylthiouracil (PTU). The nurse determines that teaching has been successful if the client states to report which symptom to the health care provider (HCP)? 1. Fever 2. Fatigue 3. Excitability 4. Nervousness 92. The nurse teaches the client being discharged to home with a prescription for a daily dose of prednisone to take the medication at which best time? 1. Any time of the day 2. In the early morning 3. In the middle of the day 4. An hour before bedtime 93. The nurse monitors the client taking octreotide acetate (Sandostatin) for acromegaly for which most common side effect of this medication? 1. Diarrhea 2. Dyspnea 3. Constipation 4. Bradycardia 94. A client with a history of coronary artery disease has developed diabetes insipidus as a result of cranial surgery. The client's medication therapy will include vasopressin (Pitressin). The nurse monitors this client most carefully for which sign/symptom that indicates an adverse effect of this medication? 1. Depression 2. Chest pain 3. Joint stiffness 4. Nagging cough 95. A client who has sustained an eye injury has been prescribed prednisolone. The nurse would most carefully monitor for side/adverse effects of this medication if the client has which health problem listed on the medical record? 1. Cirrhosis 2. Hypertension 3. Diabetes mellitus 4. Chronic constipation 96. A nurse is administering a prescribed dose of dexamethasone (Decadron) to a client following cranial surgery. Which would the nurse implement to assess for a common side effect of this medication? 1. Monitor for hair loss. 2. Assess for decreased skin turgor. 3. Perform blood glucose monitoring. 4. Monitor laboratory test results for hyperkalemia. 97. When teaching the client with adrenal insufficiency about cortisone (Cortone Acetate) the nurse should include which items? Select all that apply. 1. Increase intake of sodium. 2. Take the medication with food. 3. Increase intake of potassium-rich foods. 4. Stay away from people with active infections. 5. Discontinue the medication when symptoms subside. 6. Notify the health care provider if illness occurs or surgery is anticipated. 1. A client has been on treatment for rheumatoid arthritis for 3 weeks. During the administration of etanercept, which is most important for the nurse to assess? 1. The injection site for itching and edema 2. The white blood cell counts and platelet counts 3. Whether the client is experiencing fatigue and joint pain 4. Whether the client is experiencing a metallic taste in the mouth, and a loss of appetite 2. Allopurinol (Zyloprim) is prescribed for a client and the nurse provides medication instructions to the client. Which instruction should the nurse provide? 1. Drink 3000 mL of fluid a day. 2. Take the medication on an empty stomach. 3. The effect of the medication will occur immediately. 4. Any swelling of the lips is a normal expected response. 3. Colchicine (Colcrys) is prescribed for a client with a diagnosis of gout. The nurse reviews the client's record, knowing that this medication would be used with caution in which disorder? 1. Myxedema 2. Kidney disease 3. Hypothyroidism 4. Diabetes mellitus 4. Alendronate (Fosamax) is prescribed for a client with osteoporosis and the nurse is providing instructions on administration of the medication. Which instruction should the nurse provide? 1. Take the medication at bedtime. 2. Take the medication in the morning with breakfast. 3. Lie down for 30 minutes after taking the medication. 4. Take the medication with a full glass of water after rising in the morning. 5. The nurse is preparing discharge instructions for a client receiving baclofen. Which instruction should be included in the teaching plan? 1. Restrict fluid intake. 2. Avoid the use of alcohol. 3. Stop the medication if diarrhea occurs. 4. Notify the health care provider (HCP) if fatigue occurs. 6. The nurse is analyzing the laboratory studies on a client receiving dantrolene sodium (Dantrium). Which laboratory test would identify an adverse effect associated with the administration of this medication? 1. Platelet count 2. Creatinine level 3. Liver function tests 4. Blood urea nitrogen level 7. Cyclobenzaprine hydrochloride (Flexeril) is prescribed for a client for muscle spasms and the nurse is reviewing the client's record. Which disorder, if noted in the record, would indicate a need to contact the health care provider about the administration of this medication? 1. Glaucoma 2. Emphysema 3. Hypothyroidism 4. Diabetes mellitus 8. In monitoring a client's response to disease-modifying antirheumatic drugs (DMARDs), which assessment findings would the nurse consider acceptable responses? Select all that apply. 1. Symptom control during periods of emotional stress 2. Normal white blood cell, platelet, and neutrophil counts 3. Radiological findings that show no progression of joint degeneration 4. An increased range of motion in the affected joints 3 months into therapy 5. Inflammation and irritation at the injection site 3 days after the injection is given 6. A low-grade temperature on rising in the morning that remains throughout the day 9. The nurse is administering an intravenous dose of methocarbamol (Robaxin) to a client with multiple sclerosis. For which side/adverse effect should the nurse monitor? 1. Tachycardia 2. Rapid pulse 3. Bradycardia 4. Hypertension 10. A client is taking large doses of acetylsalicylic acid (aspirin) for rheumatoid arthritis. Which assessment finding indicates that the client is experiencing ototoxicity as a result of the medication? 1. Dizziness, sore throat, and purpura 2. GI bleeding, ecchymosis, and dizziness 3. Gastrointestinal (GI) upset and dizziness 4. Tinnitus, hearing loss, dizziness, and ataxia 11. A client is seen in the hospital emergency department after injury to his right ankle. The client tells the nurse that he twisted his ankle while playing volleyball. The health care provider (HCP) has prescribed a topical analgesic cream for the injury. The nurse providing instruction about the medication should provide the client with which information? 1. To avoid hazardous activities while using the cream because it causes drowsiness 2. To apply the medication three times a day and place a heating pad on top of the area 3. That the medication contains a combination of medications, one of which is an analgesic 4. That the onset of headache indicates a systemic reaction and the HCP must be notified 12. Oral dantrolene sodium (Dantrium) has been prescribed to a client for the treatment of spasticity. The nurse understands that the usual maintenance adult dosage of this medication is which dosage? 1. 50 mg daily 2. 100 mg daily 3. 100 mg twice daily 4. 200 mg four times daily 13. A client with gout has begun to take allopurinol (Zyloprim). The home health nurse provides which instruction to the client when using the medication? 1. Drink at least 8 glasses of fluid every day. 2. Take the medication one hour before eating. 3. Put ice on the upper and lower lips if they swell. 4. Use an antihistamine lotion if an itchy rash develops. 14. The home health nurse is providing dietary instructions to a client who is taking probenecid (Benemid) for the treatment of gout. Which food should the nurse instruct the client to continue to eat? 1. Liver 2. Shrimp 3. Scallops 4. Spinach 15. Auranofin (Ridaura) has been prescribed for a client with rheumatoid arthritis. The nurse provides instructions to the client about the medication and tells the client to notify the health care provider (HCP) if which occurs? 1. Nausea 2. Diarrhea 3. Loss of appetite 4. Metallic taste in the mouth 16. An older client with rheumatoid arthritis has been instructed by the health care provider to take ibuprofen (Motrin IB) 300 mg orally (PO) four times daily. The home care nurse reading the medication prescription knows that the instruction has been effective when the client states the instructed dose is which? 1. The normal adult dose 2. Higher than the normal adult dose 3. An unusual dosage for this diagnosis 4. Two times higher than the normal adult dose 17. A client with multiple sclerosis is receiving baclofen (Lioresal). The nurse assessing the client monitors for which finding as an indication of a primary therapeutic response to the medication? 1. Decreased nausea 2. Decreased muscle spasms 3. Increased muscle tone and strength 4. Increased range of motion of all extremities 18. The nurse is providing medication instructions to a client with multiple sclerosis receiving baclofen (Lioresal). Which information should the nurse include in the instructions? 1. Watch for urinary retention as a side effect. 2. Stop taking the medication if diarrhea occurs. 3. Restrict fluid intake while taking this medication. 4. Notify the health care provider (HCP) if fatigue occurs. 19. The nurse overhears the health care provider (HCP) tell a client with rheumatoid arthritis that the condition needs to be treated with gold therapy. The nurse interprets that the HCP is referring to which medication? 1. Prednisone 2. Pentostatin (Nipent) 3. Auranofin (Ridaura) 4. Fludarabine (Fludara) 20. The home care nurse is visiting a client who sustained a severe muscle sprain to the back. Carisoprodol (Soma) is prescribed for the client. The nurse provides instructions to the client regarding the medication and should teach the client to take which measure? 1. To avoid driving until the reaction to the medication is known 2. To understand that muscle spasms will be reduced but the pain may increase 3. To limit alcohol consumption to two drinks daily while taking the medication 4. To try to avoid missing doses, but if a dose is missed to take it as soon as it is remembered 21. A client with muscle spasms in the lumbar area of the spine has been started on cyclobenzaprine (Flexeril). The nurse should monitor for which most frequent side effect of the medication? 1. Weakness 2. Confusion 3. Excitability 4. Drowsiness 22. Etanercept (Enbrel) is prescribed for a client with rheumatoid arthritis. The nurse should monitor the client for which adverse effect of the medication following administration? 1. Dyspnea 2. Headache 3. Dizziness 4. Abdominal discomfort 23. The nurse gives a dose of diazepam (Valium) to an assigned client. What is the most important action to be taken by the nurse before leaving the room? 1. Instituting safety measures 2. Closing the curtains in the room 3. Lowering the volume on the television set 4. Giving the client the remote control for the television set 24. The nurse notes that a client has been taking colchicine. The nurse assesses the client for which finding that is an indication for the use of this medication? 1. Double vision 2. Difficulty urinating 3. Migraine headaches 4. Joint inflammation and pain 25. A clinic nurse is performing an assessment on a client with rheumatoid arthritis who has been taking acetylsalicylic acid (aspirin) for the disorder. The nurse assesses the client for signs of aspirin toxicity. Which finding should alert the nurse to the possibility of toxicity? 1. Fever and signs of hyperventilation 2. Constipation and abdominal bloating 3. Client complaint of visual disturbances 4. A decreased respiratory rate and client complaint of diarrhea 26. Dantrolene (Dantrium) is prescribed for a client experiencing discomfort caused by spasticity. In providing instructions to the client regarding the medication, what should the nurse emphasize? 1. Return to the clinic in 1 month for an eye examination. 2. Expect that periodic liver function studies will be required. 3. Return to the clinic weekly for blood pressure measurements. 4. Expect that the medication may take 8 weeks to begin to have an effect. 27. A client has been administered cyclobenzaprine (Flexeril) for the management of muscle spasms in the cervical spine. The client is experiencing drowsiness, dizziness, and dry mouth. How should the nurse interpret these findings? 1. Represent an allergic reaction to the medication 2. Are related to the problem with the cervical spine 3. Are the most common side effects of this medication 4. Are dose related, so the client should cut the medication dose in half 28. The health care provider (HCP) has prescribed trolamine salicylate (Myoflex) topical cream for a client with a diagnosis of rheumatism who is complaining of muscular aches. Which should the nurse tell the client regarding this medication? 1. The medication will act as a local anesthetic. 2. The medication acts by decreasing muscle spasms. 3. The medication is prescribed to cause the skin to peel. 4. Apply a heating pad to the area after applying the medication. 29. Dantrolene (Dantrium) is prescribed for a client with spinal cord injury for discomfort caused by spasticity. Which laboratory measure should the nurse monitor while the client is taking this medication? 1. Creatinine 2. Sedimentation rate 3. Liver function studies 4. White blood cell count 30. A client with multiple sclerosis is receiving diazepam (Valium), a centrally acting skeletal muscle relaxant. Which finding, if noted during the nursing assessment, would indicate that the client is experiencing a side effect of this medication? 1. Headache 2. Drowsiness 3. Urinary retention 4. Increased salivation 31. A client with a diagnosis of rheumatoid arthritis is taking sulindac (Clinoril). The health care provider prescribes misoprostol (Cytotec) for the client. The nurse explains that this medication has been prescribed for which purpose? 1. To enhance the effects of the sulindac 2. To prepare the client for weaning off the sulindac 3. To prevent further development of arthritic nodules 4. To prevent gastric complications such as ulcer disease 32. Diclofenac (Voltaren) is prescribed for a client with osteoarthritis. Which medication, if noted on the client's record, would alert the nurse to consult with the health care provider? 1. Phenytoin (Dilantin) 2. Primidone (Mysoline) 3. Acetaminophen (Tylenol) 4. Warfarin sodium (Coumadin) 33. The home health nurse is reviewing medications with a client receiving colchicine for the treatment of gout. The nurse evaluates that the medication is effective if the client reports a decrease in which measure? 1. Headaches 2. Blood glucose 3. Blood pressure 4. Joint inflammation 34. A nurse is collecting data from a client and notes that the client is taking acetylsalicylic acid (ASA), or aspirin, 5 g daily in divided doses. The nurse determines that this medication has been prescribed to treat which condition? 1. Backache 2. Muscle aches 3. Frequent headaches 4. Rheumatoid arthritis 35. Acetylsalicylic acid (ASA), or aspirin, has been prescribed for a client with rheumatoid arthritis. The nurse tells the client that a blood test to assess the serum aspirin level will be done periodically. Which is the therapeutic serum level for an antiarthritic effect? 1. 5 to 10 mg/dL 2. 10 to 20 mg/dL 3. 20 to 30 mg/dL 4. 30 to 40 mg/dL 36. Acetylsalicylic acid (ASA), or aspirin, has been prescribed for a client, and the client asks the nurse about the side effects of the medication. The nurse responds that which is an occasional side effect of ASA? 1. Heartburn 2. Muscle aches 3. Constipation 4. Burning on urination 37. A client is admitted to the hospital, and the nurse notes that the client is taking acetylsalicylic acid (ASA), or aspirin, to treat a chronic rheumatoid disorder. The nurse should monitor the client for which sign or symptom that indicates a toxic effect of the medication? 1. Jaundice 2. Peripheral edema 3. Ringing in the ears 4. Bilateral lung crackles 38. Acetylsalicylic acid (ASA), or aspirin, has been prescribed for a client with rheumatoid arthritis, and the nurse provides instructions to the client about the medication. Which statement by the client indicates the need for further teaching? 1. "I should not crush or break the enteric-coated form of aspirin." 2. "I need to take this medication on an empty stomach for it to work." 3. "It may take 1 to 3 weeks for a therapeutic anti-inflammatory effect to occur." 4. "I should call my health care provider (HCP) if I experience stomach pain that will not go away." 39. What should the nurse anticipate when evaluating for the effects of raloxifene (Evista) in an older client? 1. Increased bone density 2. Relief of leg cramps and tenderness 3. A decrease in severity of hot flashes 4. A resumption of the menstrual cycle 40. Dantrolene sodium (Dantrium) is prescribed for the client experiencing flexor spasms. The nurse monitors the client, knowing that which is the therapeutic action of this medication? 1. Depresses spinal reflexes 2. Acts on the central nervous system to suppress spasms 3. Acts directly on the skeletal muscle to relieve spasticity 4. Acts within the spinal cord to suppress hyperactive reflexes 41. The health care provider is planning to administer a skeletal muscle relaxant to a client with a spinal cord injury. The medication will be administered intrathecally (within the spinal column). Which medication should the nurse expect to be prescribed and administered by this route? 1. Baclofen (Lioresal) 2. Chlorzoxazone (Parafon Forte) 3. Dantrolene sodium (Dantrium) 4. Cyclobenzaprine hydrochloride (Amrix) 42. The nurse is reviewing the health care provider's (HCP) prescriptions for an adult client who has been admitted to the hospital after a back injury. Carisoprodol (Soma) is prescribed for the client to relieve the muscle spasms. The HCP has prescribed 350 mg to be administered four times a day. Which should the nurse conclude? 1. The prescription is the normal adult dosage. 2. The prescription is lower than normal dosage. 3. The prescription is higher than normal dosage. 4. The dosage prescribed requires further clarification with the HCP. 43. A client who has rheumatoid arthritis has begun treatment with anakinra (Kineret) and has received the first injection. What finding would indicate that the health care provider (HCP) should be notified and that the medication should be discontinued? 1. Irritation and erythema at the injection site 2. Concurrent therapy with a tumor necrosis factor inhibitor 3. No relief of arthritic symptoms during the first week of treatment 4. White blood cell count of 12,000 cells/mm3 and a temperature of 99.9° F 44. A film-coated form of diflunisal, a nonsteroidal anti-inflammatory medication, has been prescribed for a client to treat chronic rheumatoid arthritis. The client calls the clinic nurse because of difficulty swallowing the tablets. Which instruction should the nurse provide to the client? 1. Crush the tablets and mix with food. 2. Open the tablet and mix the contents with food. 3. Swallow the tablets with large amounts of water or milk. 4. Notify the health care provider (HCP) for a medication change. 45. A client with muscle spasms is taking an oral maintenance dose of baclofen (Lioresal). Which represents a safe maintenance dose for this medication? 1. 15 mg four times daily 2. 25 mg four times daily 3. 30 mg four times daily 4. 40 mg four times daily 46. A client is to receive a prescription for methocarbamol (Robaxin). The nurse provides instructions to the client about the medication. Which client statement would indicate a need for further education? 1. "My urine may turn brown or green." 2. "I might get some nasal congestion from this medication." 3. "This medication is prescribed to help relieve my muscle spasms." 4. "If my vision becomes blurred, I don't need to be concerned about it." 47. A client is receiving baclofen (Lioresal) for muscle spasms because of a spinal cord injury. Which side/adverse effect related to this medication should the nurse monitor the client for? 1. Muscle pain 2. Hypertension 3. Slurred speech 4. Photosensitivity 48. Calcium carbonate (Os-Cal) is prescribed for a client with hypocalcemia. How should the nurse instruct the client to take the medication? 1. With meals 2. Every 4 hours 3. Just before meals 4. 1 hour after meals 49. A nurse is teaching a client who will be discharged on alendronate (Fosamax) about the medication. Which should be included in the teaching plan? Select all that apply. 1. Take the medication at the same time. 2. Report musculoskeletal pain immediately. 3. Take the medication on an empty stomach. 4. Consume coffee when taking the medication. 5. Remain upright for 30 minutes following ingestion. 50. The nurse asks a nursing student about the uses of the medication dantrolene (Dantrium). The nursing student correctly states that dantrolene is used to manage hypermetabolism of skeletal muscle that occurs in which condition? 1. Low back pain 2. General anesthesia 3. Malignant hyperthermia 4. Hyperplasia of the prostate 51. The nurse teaches the client with hypocalcemia to take calcium carbonate (Os-Cal) at which time? 1. With breakfast 2. At lunch time 3. Just before a meal 4. One hour after a meal 52. A client with a history of spinal cord injury is beginning medication therapy with baclofen (Lioresal). The nurse determines that the client understands the side effects of the medication if the client makes which statement? 1. "The medication may make me drowsy." 2. "The medication can cause high blood pressure." 3. "The medication may cause me to have some muscle pain." 4. "The medication may increase my sensitivity to bright light." 53. A client with a new medication prescription for allopurinol (Zyloprim) asks the nurse, "I know this is for gout, but how does it work?" In formulating a response, the nurse understands that which is the action of allopurinol? 1. Decreases uric acid production 2. Reduces the production of fibrinogen 3. Lowers the risk of sulfa crystal formation in the urine 4. Prevents influx of calcium ions during cell depolarization 54. A client newly diagnosed with gout has been prescribed allopurinol (Zyloprim). The nurse would be concerned if the client was also currently taking which medication? 1. Digoxin (Lanoxin) 2. Warfarin (Coumadin) 3. Adenosine (Adenocard) 4. Ergonovine maleate (Ergotrate) 55. A client tentatively diagnosed with gout has received a prescription for colchicine. The nurse understands that colchicine is which type of medication? 1. Analgesic that relieves pain 2. Anti-inflammatory agent specific for gout 3. Nonsteroidal anti-inflammatory drug (NSAID) 4. Osmotic diuretic that facilitates the removal of uric acid 56. A client with osteoarthritis is receiving diclofenac sodium (Voltaren). The nurse would be concerned about the administration of this medication if the client's history and physical included a diagnosis of which condition? 1. Graves' disease 2. Peptic ulcer disease 3. Coronary artery disease 4. Benign prostatic hypertrophy 57. Baclofen (Lioresal) is prescribed for the client with multiple sclerosis. The nurse determines that the medication is having the intended effect if which finding is noted in the client? 1. Increased muscle tone 2. Increased range of motion 3. Decreased muscle spasms 4. Decreased local pain and tenderness 58. Dantrolene sodium (Dantrium) is prescribed for the client experiencing flexor spasms. The client asks the nurse how the medication is going to help. The nurse replies that this medication acts in which way? 1. To depress the spinal reflexes causing the spasms 2. Directly on the skeletal muscle to relieve the spasms 3. Within the spinal cord to suppress excess reflex activity 4. On the central nervous system (CNS) to suppress spasms 59. A nurse is reviewing laboratory results for a client taking dantrolene sodium (Dantrium). The nurse should notify the health care provider (HCP) if which finding is noted on the laboratory report sheet? 1. Creatinine level 0.6 mg/dL 2. Platelet count 290,000 cells/mm3 3. Blood urea nitrogen (BUN) level 9 mg/dL 4. Lactic dehydrogenase (LDH) level 600 units/L 60. A nurse is reviewing the medical record of a newly assigned client and notes that the client is receiving cyclobenzaprine hydrochloride (Flexeril) for the treatment of muscle spasms. The nurse questions the prescription if which disorder is noted in the admission history? 1. Hypothyroidism 2. Chronic bronchitis 3. Recurrent pneumonia 4. Angle-closure glaucoma 61. A nurse is assigned to care for a client with multiple sclerosis who is receiving an intravenous (IV) dose of methocarbamol (Robaxin). The nurse monitors the client knowing that which is an expected side effect? 1. Insomnia 2. Excitability 3. Hypertension 4. Dark green–colored urine 1. The client with acquired immunodeficiency syndrome and Pneumocystis jiroveci infection has been receiving pentamidine (Pentam 300). The client develops a temperature of 101° F. The nurse continues to assess the client, knowing that this sign most likely indicates which condition? 1. That the dose of the medication is too low 2. That the client is experiencing toxic effects of the medication 3. That the client has developed inadequacy of thermoregulation 4. That the client has developed another infection caused by leukopenic effects of the medication 2. The nurse caring for a client who is taking an aminoglycoside should monitor the client for which adverse effects of the medication? Select all that apply. 1. Seizures 2. Ototoxicity 3. Renal toxicity 4. Dysrhythmias 5. Hepatotoxicity 3. Ketoconazole is prescribed for a client with a diagnosis of candidiasis. Which interventions should the nurse include when administering this medication? Select all that apply. 1. Restrict fluid intake. 2. Monitor liver function studies. 3. Instruct the client to avoid alcohol. 4. Administer the medication with an antacid. 5. Instruct the client to avoid exposure to the sun. 6. Administer the medication on an empty stomach. 4. The nurse is caring for a client who has been taking a sulfonamide and should monitor for signs/symptoms of which side/adverse effects of the medication? Select all that apply. 1. Ototoxicity 2. Palpitations 3. Nephrotoxicity 4. Bone marrow depression 5. Gastrointestinal (GI) effects 6. Increased white blood cell (WBC) count 5. The nurse is reviewing the results of serum laboratory studies drawn on a client with acquired immunodeficiency syndrome who is receiving didanosine (Videx). The nurse interprets that the client may have the medication discontinued by the health care provider if which elevated result is noted? 1. Serum protein level 2. Blood glucose level 3. Serum amylase level 4. Serum creatinine level 6. The nurse is caring for a postrenal transplantation client taking cyclosporine (Sandimmune). The nurse notes an increase in one of the client's vital signs and the client is complaining of a headache. What vital sign is most likely increased? 1. Pulse 2. Respirations 3. Blood pressure 4. Pulse oximetry 7. Amikacin (Amikin) is prescribed for a client with a bacterial infection. The nurse instructs the client to contact the health care provider (HCP) immediately if which occurs? 1. Nausea 2. Lethargy 3. Hearing loss 4. Muscle aches 8. The nurse is assigned to care for a client with cytomegalovirus retinitis and acquired immunodeficiency syndrome who is receiving foscarnet, an antiviral medication. The nurse should monitor the results of which laboratory study while the client is taking this medication? 1. CD4 cell count 2. Lymphocyte count 3. Serum albumin level 4. Serum creatinine level 9. A client who is human immunodeficiency virus seropositive has been taking stavudine (d4T, Zerit). The nurse should monitor which most closely while the client is taking this medication? 1. Gait 2. Appetite 3. Level of consciousness 4. Gastrointestinal function 10. The nurse is caring for a client with leukemia who has cytomegalovirus retinitis and is receiving foscarnet (Foscavir). Which assessment finding, if reported by the client, indicates a need for follow-up? 1. Intact hearing capacity 2. Urine noted to be clear yellow 3. Urinary output of 30 mL per hour 4. Impaired balance while ambulating 11. The client with acquired immunodeficiency syndrome (AIDS) has been prescribed raltegravir (Isentress). The nurse determines that the client may be experiencing an adverse effect related to this medication if which assessment finding is noted? 1. Itching sensation 2. Nausea and diarrhea 3. Headache and fatigue 4. Temperature of 101.2° F 12. The nurse is caring for a client with acquired immunodeficiency syndrome (AIDS) who is receiving Didanosine (Videx). The nurse understands that adverse effects associated with this medication include which findings? Select all that apply. 1. Fatigue 2. Diarrhea 3. Pancreatitis 4. Lactic acidosis 5. Peripheral neuropathy 13. A client is taking brompheniramine maleate (BroveX). The nurse assesses for which side effect of this medication? 1. Diarrhea 2. Drowsiness 3. Excitability 4. Excess salivation 14. Intravenous (IV) antithymocyte globulin (Atgam) is prescribed to a client for treatment of transplant rejection. Which intervention is the priority in planning the administration of this medication? 1. Assess bowel sounds. 2. Assess the neurovascular status. 3. Plan for a skin test dose to identify hypersensitivity. 4. Premedicate the client with acetylsalicylic acid (aspirin). 15. Tacrolimus (Prograf) is prescribed to a client for prevention of organ rejection after renal transplantation. Which prescription should the nurse anticipate to be prescribed, along with the tacrolimus, for this client? 1. Prednisone 2. Phenytoin (Dilantin) 3. Fluconazole (Diflucan) 4. Erythromycin (Erythrocin) 16. The nurse is monitoring a client receiving muromonab-CD3 (Orthoclone OKT3). Which finding is a priority assessment required in monitoring for adverse effects of this medication? 1. Assessing pedal pulses 2. Assessing lung sounds 3. Assessing for pain in the calf 4. Assessing for positive bowel sounds 17. zathioprine (Imuran) is prescribed for a client to suppress rejection of a renal transplant. In planning for administration of the medication, the nurse understands that which description is the mechanism of action of this medication? 1. It cross-links DNA. 2. It blocks all T-cell functions. 3. It inhibits the proliferation of B and T lymphocytes. 4. It decreases the activity of thymus-derived lymphocytes. 18. A client who is receiving nitrofurantoin (Macrodantin) calls the clinic complaining of side effects related to the medication. Which side effect indicates the need to stop treatment with this medication? 1. Nausea 2. Anorexia 3. Diarrhea 4. Cough and chest pain 19. Itraconazole (Sporanox) is prescribed for a client with a fungal infection of the hands. A nurse provides instructions to the client about the medication. Which statement by the client indicates an understanding of the instructions? 1. "I should take the medication on an empty stomach." 2. "I should decrease my fluid intake while taking the medication." 3. "I may become unusually fatigued while taking this medication." 4. "If my urine becomes very dark in color, I should contact my health care provider (HCP)." 20. Kanamycin sulfate (Kantrex), given by intermittent intravenous infusion, is prescribed for a client with a respiratory tract infection. Which finding would indicate to the nurse that the client is experiencing an adverse effect of the medication? 1. Visual disturbances 2. Gastrointestinal disturbances 3. Decreased blood urea nitrogen (BUN) 4. Elevated white blood cell (WBC) count 21. The nurse is providing discharge instructions to the mother of a child who has been prescribed tetracycline hydrochloride. The nurse stresses to the mother the importance of which measure in giving this medication to the child? 1. Give the medication with milk. 2. Use a straw when giving the medication. 3. Give the medication with chocolate milk. 4. Dilute the medication with water in a Styrofoam cup. 22. A client with acquired immunodeficiency syndrome who is taking zidovudine (Retrovir) 200 mg orally three times daily has severe neutropenia noted on follow-up laboratory studies. The nurse interprets that which change is likely to occur at this point? 1. The medication dose probably will be reduced. 2. Prednisone probably will be added to the medication regimen. 3. Epoetin alfa (Epogen) probably will be added to the medication regimen. 4. The medication probably will be discontinued until laboratory results indicate bone marrow recovery. 23. A client with acquired immunodeficiency syndrome experiences nausea, vomiting, and abdominal pain radiating to the back after taking didanosine (Videx). The ambulatory care nurse should provide which response as telephone advice to this client? 1. "Take crackers and milk with each dose of the medication." 2. "Decrease the dose of the medication until the next clinic visit." 3. "This is an uncomfortable but expected side effect of the medication." 4. "Report to the health care clinic to be seen by the health care provider (HCP)." 24. A client with acquired immunodeficiency syndrome is taking zalcitabine. The nurse interprets that the client is experiencing an adverse effect of this medication if which is reported by the client? 1. Diarrhea 2. Ringing in the ears 3. Burning with urination 4. Numbness or burning sensations in the arms or legs 25. A client with human immunodeficiency virus infection is taking indinavir (Crixivan). The nurse plans to provide the client with which direction when providing instructions about the use of this medication? 1. Store the medication in the refrigerator. 2. Take the medication with a high-fat snack. 3. Take the medication with the large meal of the day. 4. Take the medication with water on an empty stomach. 26. A client is receiving acyclovir (Zovirax) by the intravenous (IV) route for treatment of cytomegalovirus infection. After reconstituting the powder dispensed by the pharmacy, the nurse should administer this medication via which method? 1. Slow IV infusion over 1 hour 2. Rapid IV bolus over 5 minutes 3. Continuous IV infusion over 24 hours 4. Continuous IV infusion over 12 hours 27. The nurse is monitoring a client with herpes simplex virus who is receiving intravenous (IV) acyclovir (Zovirax). Which laboratory result would be of concern as a possible adverse effect of this medication? 1. Platelet count of 300,000 cells/mm3 2. Blood urea nitrogen (BUN) of 36 mg/dL 3. White blood cell count of 6000 cells/mm3 4. Red blood cell count of 5.2 million cells/mm3 28. A pediatric nurse has obtained ribavirin (Virazole) in powder form from the pharmacy to administer to a child with respiratory syncytial virus (RSV) infection. After preparing the medication, the nurse should administer it by which route? 1. Inhalation 2. Intravenous 3. Subcutaneous 4. Oral, in the formula 29. A client with candidiasis is receiving amphotericin B by the intravenous route (IV). The nurse determines that the client is having an adverse effect to the medication if which laboratory study result is noted? 1. Elevated platelet count 2. Elevated serum creatinine 3. Low white blood cell count 4. Lowered hemoglobin and hematocrit 30. A client who has been diagnosed with pneumonia has been given a prescription for erythromycin (E-mycin). Client teaching about this medication should include which best instruction? 1. Take the medication with juice. 2. Take the medication with a meal. 3. Take the medication on an empty stomach. 4. Take the medication at bedtime with a snack. 31. A client has been diagnosed with chlamydial infection, and azithromycin (Zithromax) has been prescribed. The nurse should instruct the client to take the medication in which way? 1. With meals 2. 1 hour before meals 3. With an aluminum-containing antacid 4. With a magnesium-containing antacid 32. The nurse is collecting subjective and objective data from a client and notes that the client is taking abacavir (Ziagen). The nurse determines that this medication has been prescribed to treat which condition? 1. Otitis media 2. Heart failure 3. Urinary tract infection 4. Human immunodeficiency virus (HIV) infection 33. The home care nurse is visiting a client with a skin infection who is receiving amoxicillin (Amoxil) orally every 8 hours. Which finding would indicate to the nurse that the client is experiencing a frequent side effect related to the medication? 1. Fever 2. Vaginal drainage 3. Severe watery diarrhea 4. Severe abdominal cramps 34. The nurse is developing a plan of care for a client who is receiving amphotericin B intravenously to treat a severe fungal infection. A main component of the plan of care is monitoring for adverse effects related to the administration of this medication. Which should the nurse include in a list of manifestations to watch for? 1. Fatigue 2. Confusion 3. Visual difficulties 4. Increased urinary output 35. A client with disseminated candidiasis has a prescription for amphotericin B by the intravenous (IV) route. During ongoing therapy with this medication, the nurse should most closely assess the client for which finding that indicates a complication? 1. Decreased pulse 2. Decreased urine output 3. Decreased body temperature 4. Decreased blood urea nitrogen level 36. The nurse is providing discharge instructions to a client who will be taking tacrolimus (Prograf) daily following allogenic liver transplantation. The nurse instructs the client that which is a frequent side effect related to this medication? 1. Diarrhea 2. Confusion 3. Loss of memory 4. A decrease in urine output 37. Tobramycin sulfate is prescribed for a client with a diagnosis of cellulitis. The nurse is administering the medication by intermittent intravenous infusion every 8 hours. The nurse monitors the client for signs of an adverse effect related to this medication and determines that which, if noted on assessment, would indicate the presence of an adverse effect? 1. Client complaint of diarrhea 2. Client complaint of ringing in the ears 3. A blood urea nitrogen (BUN) of 10 mg/dL 4. A white blood cell count of 6000 cells/mm3 38. A client is receiving ganciclovir to treat acquired immunodeficiency syndrome and cytomegalovirus retinitis. Which nursing action is appropriate during the time the client is receiving this medication? 1. Monitoring blood glucose levels for elevation 2. Administering the medication on an empty stomach only 3. Applying pressure to venipuncture sites for at least 1 minute 4. Providing the client with a soft toothbrush and an electric razor 39. A client has been receiving foscarnet sodium as part of therapy for the treatment of cytomegalovirus retinitis and acquired immunodeficiency syndrome (AIDS). The home care nurse should periodically review results of which laboratory blood test to assess for adverse effects to this medication? 1. CD4+ cell count 2. Lymphocyte count 3. Albumin concentration 4. Creatinine concentration 40. A health care provider has just prescribed foscarnet (Foscavir) to be given intravenously to a client with acquired immunodeficiency syndrome (AIDS). The nurse should obtain which piece of equipment to administer this medication? 1. A glass bottle 2. An infusion pump 3. A microdrip tubing set 4. Special manufacturer's tubing 41. Quinupristin-dalfopristin (Synercid) is prescribed as an intermittent intravenous (IV) infusion for a client with a skin infection. The nurse should adjust the drip rate so that the dose is administered over what period of time? 1. 1 hour 2. 4 hours 3. 15 minutes 4. 30 minutes 42. A client is scheduled to receive a first dose of pentamidine (Pentam 300) intravenously. What should the nurse plan to carefully monitor as the priority during administration of the first dose? 1. Pulse rate 2. Breath sounds 3. Blood pressure 4. Respiratory rate 43. A client has been given a prescription for a course of azithromycin (Zithromax). The nurse should tell the client that this medication will relieve which problem? 1. Pain 2. Joint inflammation 3. High blood pressure 4. Signs and symptoms of infection 44. A client with a respiratory tract infection is receiving intravenous tobramycin sulfate (Tobrex). The nurse should assess for which adverse effect of this medication? 1. Nausea 2. Vertigo 3. Vomiting 4. Hypotension 45. A nurse is caring for a client with a urinary tract infection. The culture report reveals the presence of Pseudomonas aeruginosa. The nurse anticipates that which medication will be prescribed to treat the infection? 1. Isoniazid 2. Rifampin (Rifadin) 3. Ciprofloxacin (Cipro) 4. Ethambutol (Myambutol) 46. The home health nurse is visiting a client who has been started on therapy with clotrimazole (Lotrimin AF). The nurse should monitor which item to monitor the effectiveness of this medication with each visit? 1. Rash 2. Fever 3. Pain relief 4. Sore throat 47. Levofloxacin (Levaquin) is prescribed for a client with gonorrhea. While teaching the client about the medication, what should the nurse tell the client to take the medication with? 1. Water 2. An antacid 3. A zinc preparation 4. An iron supplement 48. A child with human immunodeficiency virus (HIV) infection is receiving zidovudine (ZDV). The nurse monitors which laboratory study to determine whether the child is experiencing an adverse effect from the medication? 1. Serum calcium level 2. Serum potassium level 3. Complete blood cell (CBC) count 4. Erythrocyte sedimentation rate (ESR) 49. The clinic nurse is providing medication instructions to a client who will be receiving hydroxychloroquine sulfate (Plaquenil) to treat systemic lupus erythematosus. The nurse instructs the client about the importance of returning to the clinic in 6 months for which follow-up test? 1. Sigmoidoscopy 2. Eye examination 3. Chest radiograph 4. Dental examination 50. Pyrimethamine (Daraprim) has been added to the medication regimen for a client with acquired immunodeficiency syndrome. On review of the client's record, the nurse notes this new prescription and plans care knowing that it has been prescribed to treat which condition? 1. Toxoplasmosis 2. Kaposi's sarcoma 3. Cardiac irregularities 4. Nausea and vomiting 51. Dapsone is prescribed to treat toxoplasmosis in a client with acquired immunodeficiency syndrome. The nurse reinforces medication instructions and tells the client to perform which action? 1. Report to the clinic weekly for the injections. 2. Plan to take the medication every 6 hours around the clock. 3. Discontinue the medication if nausea and vomiting develop. 4. Contact the health care provider (HCP) if fever or a sore throat occurs. 52. Cyclosporine (Sandimmune) is prescribed for a client who received a kidney transplant. The nurse would be most concerned if a review of the medical record revealed that the client currently is taking which prescribed medications? 1. Prednisone 2. Digoxin (Lanoxin) 3. Propranolol (Inderal) 4. Phenytoin (Dilantin) 53. Cyclosporine (Sandimmune) is prescribed to be administered by the intravenous (IV) route. Which option indicates an inappropriate action in regard to preparing and administering this medication? 1. Mixing the solution and covering it with a paper bag 2. Administering the medication over a period of 2 to 6 hours 3. Mixing 1 mL of concentrate in 50 mL of 0.9% sodium chloride and administering by infusion 4. Mixing 1 mL of concentrate in 10 mL of 0.9% sodium chloride and administering by bolus injection 54. Muromonab-CD3 (Orthoclone OKT3) is prescribed for a client to manage allograft rejection after renal transplantation. The nurse plans care, knowing that the primary mechanism of action of this medication is what? 1. Suppresses B lymphocytes 2. Inhibits the proliferation of B lymphocytes 3. Cross-links DNA, causing cell injury and death 4. Binds to the CD3 site and blocks all T-cell functions 55. The nurse is preparing to administer a prescribed dose of cyclosporine (Sandimmune) by intravenous (IV) administration. Which priority item would the nurse have available during administration of this medication? 1. A code cart 2. Oral airway 3. A suction catheter 4. Epinephrine (Adrenalin) 56. A client taking an antihistamine is scheduled for allergy skin testing and tells the nurse in the health care provider's office that a dose was taken this morning. The nurse interprets this to mean that which adjustment needs to be made? 1. A lower dose of allergen should be injected. 2. A higher dose of allergen should be injected. 3. The client should reschedule the appointment. 4. The client should have the skin test read a day later than usual. 57. Abacavir succinate (Ziagen) has been prescribed for a client, and the client asks the nurse about the action of the medication. How should the nurse respond? 1. Promotes viral DNA growth 2. Prevents the production of DNA 3. Splits DNA to prevent its production 4. Inhibits activity of HIV-1 reverse transcriptase 58. Abacavir (Ziagen) has been prescribed for a client. The nurse tells the client that which blood test will be done periodically while the client is taking this medication? 1. Platelet count 2. Liver function tests 3. Serum creatinine assay 4. Blood urea nitrogen determination 59. Abacavir (Ziagen) has been prescribed for a client, who asks the nurse about the side effect of the medication. What should the nurse tell the client is a frequent side effect of this medication? 1. Nausea 2. Sleepiness 3. Constipation 4. Increased appetite 60. A client admitted to the hospital is taking abacavir (Ziagen). The nurse should monitor the client for which adverse effect of the medication? 1. Insomnia 2. Diarrhea 3. Hypotension 4. Decreased appetite 61. Abacavir (Ziagen) has been prescribed for a client, and the nurse provides instructions about the medication. Which statement by the client indicates the need for further instruction? 1. "This medication will not cure my infection." 2. "Eating small, frequent meals will help offset the nausea." 3. "This medication will reduce the risk of transmitting the infection to others." 4. "I should check with my health care provider before taking any over-the-counter medications." 62. The nurse is collecting subjective and objective data from a client and notes that the client is taking zidovudine (Retrovir). The nurse determines that this medication has been prescribed to treat which condition? 1. Ulcerative colitis 2. Hyperthyroidism 3. Addison's disease 4. Human immunodeficiency virus (HIV) infection 63. Zidovudine (Retrovir) has been prescribed for a client who asks the nurse about the action of the medication. The nurse responds that this medication performs which function? 1. Increases neutrophils 2. Kills bacteria and fungi 3. Promotes the function of natural killer cells 4. Slows the replication of human immunodeficiency virus (HIV) 64. A client seen in the health care clinic is diagnosed with syphilis, and the health care provider prescribes an intramuscular injection of penicillin G benzathine (Bicillin). After administering the intramuscular injection of medication, the nurse should perform which action? 1. Monitor the client for 30 minutes. 2. Encourage the client to ambulate. 3. Administer subcutaneous epinephrine. 4. Apply a topical anesthetic spray to the injection site. 65. Azithromycin (Zithromax) is prescribed for a client with a respiratory tract infection. The nurse provides instructions to the client about the medication and emphasizes that it is bestto take the medication with which item? 1. Milk 2. Antacid 3. The evening meal 4. Water on an empty stomach 66. The health care provider (HCP) writes a prescription for zidovudine (Retrovir) for a client who was admitted to the hospital. The nurse should contact the HCP to verify the prescription if which finding is noted in the assessment data? 1. History of renal calculi 2. Complaints of diarrhea 3. Bone marrow depression 4. Complaints of abdominal discomfort 67. Zidovudine (Retrovir) has been prescribed for a client. The nurse should tell the client that which blood test will be done periodically while the client is taking this medication? 1. Potassium level determination 2. Magnesium level determination 3. Complete blood cell count (CBC) 4. Sedimentation rate determination 68. Zidovudine (Retrovir) has been prescribed for a client, and the client asks the nurse about the side effects of the medication. The nurse responds that which is a common side effect of this medication? 1. Lethargy 2. Weakness 3. Headache 4. Constipation 69. A client admitted to the hospital is taking zidovudine (Retrovir). The nurse monitors the client for which adverse effect of the medication? 1. Colitis 2. Ototoxicity 3. Neurotoxicity 4. Visual disturbances 70. Zidovudine (Retrovir) has been prescribed for a client, and the nurse provides instructions to the client about expected effects with this medication. Which statement by the client indicates the need for further instruction? 1. "I need to monitor my temperature." 2. "This medication can cause some nausea." 3. "I will have to have blood tests done periodically." 4. "If I experience diarrhea, I need to contact my health care provider (HCP)." 71. A nurse has a prescription to administer foscarnet sodium intravenously to a client with acquired immunodeficiency syndrome (AIDS). What should the nurse plan to do before administering this medication? 1. Obtain a sputum culture. 2. Obtain folic acid (Folvite) as an antidote. 3. Place the solution on a controlled infusion pump. 4. Ensure that liver enzyme levels have been drawn as a baseline. 72. The nurse is about to administer an intravenous dose of tobramycin when the client complains of vertigo and a ringing in the ears. What is the most appropriate nursing action? 1. Hang the dose immediately. 2. Check the client's pupillary responses. 3. Give a dose of droperidol with the tobramycin. 4. Withhold the dose and call the health care provider (HCP). 73. The nurse is caring for a client diagnosed with a skin infection. The client is receiving tobramycin sulfate intravenously every 8 hours. Which finding would indicate to the nurse that the client is experiencing an adverse medication effect? 1. A sedimentation rate of 15 mm/hr 2. A total bilirubin level of 0.5 mg/dL 3. A white blood cell count of 6000 cells/mm3 4. A blood urea nitrogen (BUN) level of 30 mg/dL 74. A client has been given a prescription for sulfasalazine (Azulfidine) for the treatment of ulcerative colitis. Which allergy should the nurse assess for in the client prior to administration? 1. Sulfonamides or salicylates 2. Salicylates or acetaminophen 3. Shellfish or calcium channel blockers 4. Histamine receptor antagonists or β-blockers 75. A client receiving a dose of intravenous vancomycin (Vancocin) begins to experience chills, tachycardia, syncope, and flushing of the face and trunk. What is the nurse's best interpretation of these findings? 1. The medication is infusing too rapidly. 2. The client is allergic to the medication. 3. The client is experiencing upper airway obstruction. 4. The medication has interacted with another medication the client is receiving. 76. A client is receiving tobramycin (Tobrex). The nurse evaluates that the medication therapy iseffective if which laboratory test result is noted? 1. Sodium level of 145 mEq/L and chloride level of 106 mEq/L 2. Sodium level of 140 mEq/L and potassium level of 3.9 mEq/L 3. WBC count of 15,000 cells/mm3 and a blood urea nitrogen level of 38 mg/dL 4. White blood cell (WBC) count of 8000 cells/mm3 and creatinine level of 0.9 mg/dL 77. A client with histoplasmosis has a prescription for ketoconazole. Which instruction should the nurse include in the client's teaching plan? 1. Avoid exposure to sunlight. 2. Take the medication with an antacid. 3. Take the medication on an empty stomach. 4. Limit alcohol consumption to 2 ounces per day. 78. A 2-year-old with Pneumocystis jiroveci pneumonia is to begin treatment with highly active antiretroviral therapy (HAART). The nurse anticipates that the health care provider will prescribe which combination? 1. One immunoglobulin and one nucleoside analogue 2. Two nucleoside analogues and one protease inhibitor 3. Two protease inhibitors and one broad-spectrum antibiotic 4. One nucleoside reverse transcriptase inhibitor and one non-nucleoside reverse transcriptase inhibitor 79. A nurse provides instructions to a client who will be taking cyclosporine (Sandimmune) oral solution. Which action should nurse tell the client to do? 1. Mix the concentrate with orange juice. 2. Mix the concentrate with grapefruit juice. 3. Avoid diluting the concentrate for administration. 4. Dilute the concentrate in a Styrofoam cup before administration. 80. A nurse is monitoring a client receiving cyclosporine (Sandimmune). Which sign or symptom should indicate to the nurse that the client is experiencing an adverse effect from this medication? 1. Nausea 2. Tremors 3. Alopecia 4. Hypotension 81. Mycophenolate mofetil (CellCept) is prescribed for a client for prophylaxis of organ rejection following allogenic renal transplantation. Which instruction should the nurse provide to the client regarding administration of this medication? 1. Administer following meals. 2. Take the medication with a magnesium-type antacid. 3. Open the capsule and mix with food for administration. 4. Contact the health care provider (HCP) if a sore throat occurs. 82. A client is diagnosed with herpes simplex type 1. The health care provider prescribes a topical medication for treatment. The nurse anticipates that which medication will be prescribed? 1. Salicylic acid 2. Gentamicin sulfate 3. Acyclovir (Zovirax) 4. Mupirocin calcium (Bactroban) 83. An outbreak of pediculosis capitus has occurred at a local school. The school nurse is providing instructions to the parents of the children attending the school regarding the application of permethrin (Nix). Which action should the nurse tell the parents to take? 1. Apply permethrin before washing the hair. 2. Apply permethrin at bedtime and rinse it off in the morning. 3. Avoid saturating the hair and scalp when applying permethrin. 4. Allow permethrin to remain on the hair 10 minutes and then rinse with water. 84. The nurse is caring for a client with a diagnosis of Chlamydia. Because the client has a history of noncompliance with medication administration, the health care provider prescribes azithromycin (Zithromax). When educating the client about azithromycin, the nurse should make which statement? 1. "One dose of this medication will be needed." 2. "This medication is only given every 72 hours." 3. "You will need to take this medication every 6 hours." 4. "You will need to return tomorrow for your second dose." 85. A client with a severe allergic reaction is prescribed intravenous corticosteroids. The nurse should expect that which desired effect will be achieved? 1. Decreased inflammation 2. Increased serum glucose 3. Enhanced immunity 4. Pain relief 86. A nurse is caring for a client receiving gentamicin intravenously. What statement made by the client should most concern the nurse? 1. "I am experiencing dizziness." 2. "I am experiencing heartburn." 3. "I am experiencing abdominal pain." 4. "I am experiencing ringing in my ears." 87. A nurse is caring for a client admitted to the hospital for an infection who is receiving an aminoglycoside twice a day, intravenously. The nurse is planning to obtain blood for a peak aminoglycoside level. When should the blood be drawn? 1. A peak level is not indicated. 2. 1 hour after completing the infusion 3. 1 hour before administration of the infusion 4. 15 minutes before administration of the infusion 88. A nurse is preparing to administer ticarcillin. An abnormal elevation in which laboratory value should prompt the nurse to withhold the medication and notify the health care provider before administering the medication? 1. Hematocrit and hemoglobin 2. Blood urea nitrogen and creatinine 3. Prothrombin time and partial thromboplastin time 4. Aspartate aminotransferase and alanine transaminase 89. The nurse is presenting information regarding treatment of influenza and the use of oseltamivir (Tamiflu). The nurse should provide which information regarding the use of Tamiflu? Select all that apply. 1. Tamiflu is effective for all types of influenza. 2. The incidence of flu complications is reduced. 3. Dosing must begin within 2 days after symptom onset. 4. No interactions with other medications have been reported. 5. It is best to begin dosing within the first 12 hours after symptom onset. 6. Tamiflu is highly toxic to the liver, and liver function studies must be performed. 90. The nurse asks the student nurse, "What does it mean that an antibiotic is classified as a bactericidal agent?" Which response by the nursing student indicates an understanding of a bactericidal agent? 1. Has low efficacy 2. Has a very low potency 3. Kills the infectious agent 4. Slows the growth of the infectious agent 91. A client asks the nurse why the health care provider (HCP) changed to a different antibiotic for treating streptococcal throat infection. The nurse should make which bestresponse? 1. "Antibiotics all have the same method of action." 2. "You probably misunderstood what the health care provider (HCP) said." 3. "Try this medicine, and if you're not better in 5 to 7 days, return to the office." 4. "Bacteria are capable of developing resistance to frequently used antibiotics." 92. The nurse understands that which is correct about tetracycline (Sumycin)? 1. It is classified as a narrow-spectrum antibiotic. 2. It is identified as safe for use during pregnancy. 3. It is used to treat a wide variety of disease processes. 4. It is contraindicated in children younger than 8 years of age. 93. A nurse reviews the medication history of a client and notes that the client is taking leflunomide (Arava). During assessment of the client, the nurse should ask which question to determine the effectiveness of this medication? 1. "Do you have any joint pain?" 2. "Are you having any diarrhea?" 3. "Are you experiencing heartburn?" 4. "Do you have frequent headaches?" 94. The nurse notes that a client is receiving lamivudine (Epivir). The nurse determines that this medication has been prescribed to treat which condition? 1. Pancreatitis 2. Pharyngitis 3. Tonic-clonic seizures 4. Human immunodeficiency virus (HIV) 95. A nurse reinforces medication instructions to a client who has received a kidney transplant about therapy with cyclosporine (Sandimmune). Which statement by the client would indicate a need for further instruction? 1. "I need to obtain a yearly influenza vaccine." 2. "I need to have dental checkups every 3 months." 3. "I need to self-monitor my blood pressure at home." 4. "I need to call the health care provider if my urine volume decreases or it becomes cloudy." 96. A client who has received a kidney transplant is taking azathioprine (Imuran), and the nurse provides instructions about the medication. Which statement by the client would indicate a need for further instruction? 1. "I need to watch for signs of infection." 2. "I need to discontinue the medication after 14 days of use." 3. "I can take the medication with meals to minimize nausea." 4. "I need to call the health care provider if more than one dose is missed." 97. A pregnant client who has human immunodeficiency virus (HIV) infection is being seen in the antenatal clinic. The nurse recalls that zidovudine (AZT) therapy will be initiated when the fetus has reached how many weeks of gestation? 1. 4 2. 14 3. 24 4. 34 98. A child has been prescribed to take tetracycline hydrochloride. The nurse providing medication information to the mother should plan to emphasize which instruction about giving this medication to the child? 1. Give the medication with milk. 2. Give the medication with ice cream. 3. Mix the medication in a Styrofoam cup. 4. Use a straw when giving the medication. 99. A client with a urinary tract infection (UTI) has been prescribed to take ciprofloxacin (Cipro). The nurse notes that the client also has a prescription for theophylline written by a pulmonologist. Based on this information, the nurse should take which action? 1. Encourage intake of antacids. 2. Clarify the medication prescriptions. 3. Schedule the doses to be given together. 4. Schedule the doses to be given at the same time. 100. A client who has undergone renal transplant is receiving ongoing therapy with cyclosporine (Sandimmune). The nurse would be sure to immediately report which abnormal finding? 1. Decreased creatinine level 2. Decreased hemoglobin level 3. Decreased white blood cell (WBC) count 4. Elevated blood urea nitrogen (BUN) level 101. A client is receiving tacrolimus (Prograf) to prevent organ rejection. Which is a nursing consideration associated with this medication? 1. Assess for hypoglycemia. 2. Give with grapefruit juice. 3. Give with cyclosporine (Sandimmune). 4. Assess platelet count for thrombocytopenia. 102. A client must begin medication therapy with mycophenolate mofetil (CellCept) to prevent organ rejection following renal transplantation. The nurse should provide which important teaching point to the client? 1. Take the dose following meals. 2. Open the capsule and mix with food before use. 3. Take the medication with an aluminum-based antacid. 4. Notify the health care provider (HCP) if a fever develops. 103. A nurse is collecting data from a client with a history of renal transplantation. The nurse understands that which medication is the medication of choice for preventing organ rejection? 1. Probenecid 2. Prednisone 3. Indomethacin (Indocin) 4. Cyclosporine (Sandimmune) 104. Cyclosporine (Sandimmune) is prescribed for the client following allogenic kidney transplantation. The nurse should provide which instruction to the client regarding the medication? 1. There are no known adverse effects of the medication. 2. The medication will need to be taken for a period of 6 months. 3. Blood levels of the medication will need to be measured periodically. 4. The medication is administered by the intravenous (IV) route on a monthly basis. 105. Blood work has been drawn on a client who has been taking cyclosporine (Sandimmune) following allogenic liver transplantation. The nurse should check the results of which test to determine the presence of an adverse effect related to this medication? 1. Hematocrit level 2. Cholesterol level 3. Hemoglobin level 4. Blood urea nitrogen (BUN) level 106. Dapsone is prescribed for a client with acquired immunodeficiency syndrome (AIDS) for the treatment of toxoplasmosis. The nurse provides medication instructions and determines that the client understands the instructions if the client states that which action is necessary? 1. Discontinue the medication if nausea develops. 2. Report a sore throat to the health care provider (HCP). 3. Plan to take the medication every 4 hours around the clock. 4. Expect that abdominal pain and jaundice will occur as normal side effects. 107. The client who is seropositive for human immunodeficiency virus (HIV) has been taking ritonavir (Norvir). The nurse tells the client that which follow-up laboratory study will be necessary while taking this medication? 1. Platelet count 2. Triglyceride level 3. Prothrombin time (PT) 4. International normalized ratio (INR) 108. A client who is seropositive for human immunodeficiency virus (HIV) has been taking stavudine (d4T, Zerit XR). The nurse assesses which most closely while the client is taking this medication? 1. Appetite 2. Presence of paresthesia 3. Gastrointestinal function 4. Level of consciousness (LOC) 109. A nurse is assigned to care for a client with cytomegalovirus retinitis and acquired immunodeficiency syndrome (AIDS) who is receiving foscarnet. The nurse reviews the health care provider's (HCP) prescriptions, expecting to note a prescription for which laboratory test while this client is taking the medication? 1. CD4+ cell count 2. Lymphocyte count 3. Serum albumin level 4. Serum creatinine level 110. The client with acquired immunodeficiency syndrome (AIDS) and Pneumocystis jiroveci infection has been receiving pentamidine (Pentam 300). The nurse caring for the client should monitor the client most closely for signs of which adverse effect of the medication? 1. Nausea 2. Fatigue 3. Vomiting 4. Infection 111. The client with human immunodeficiency virus (HIV) infection has been started on therapy with zidovudine (Retrovir). The nurse reviews the health care provider's (HCP) prescriptions, expecting to note that which laboratory test has been prescribed? 1. Blood culture 2. Blood glucose level 3. Blood urea nitrogen level (BUN) 4. Complete blood cell count (CBC) 112. The nurse is preparing to administer pentamidine (Pentam 300) to an assigned client by the intravenous route. The nurse plans to monitor which item most closely after administering this medication? 1. Capillary refill 2. Peripheral pulses 3. Blood pressure (BP) 4. Level of consciousness 113. Ketoconazole is prescribed for an assigned client. The nurse prepares to administer the medication by which method? 1. With food 2. With an antacid 3. With 8 oz of water 4. On an empty stomach [Show More]

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