Pharmacology Practice Quiz Part 1
This flashcard set focuses on cardiovascular and anticoagulant pharmacology, testing knowledge of expected outcomes and necessary lab monitoring. It includes assessment of nitroglycerin effectiveness and discharge teaching for clients on warfarin therapy.
Following the administration of sublingual nitroglycerin to a client experiencing an acute anginal attack, which assessment finding indicates to the nurse that the desired effect has been achieved?
A) Client states chest pain is relieved.
B) Client's pulse decreases from 120 to 90.
C) Client's systolic blood pressure decreases from 180 to 90.
D) Client's SaO2 level increases from 92% to 96%.
Client states chest pain is relieved.
Rationale: Nitroglycerin reduces myocardial oxygen consumption which decreases ischemia and reduces chest pain (A). (B and D) would also occur if the angina was relieved, but are not as significant as the client's subjective report of decreased pain. (C) may indicate a reduction in pain, or a potentially serious side effect of the medication.
Key Terms
Following the administration of sublingual nitroglycerin to a client experiencing an acute anginal attack, which assessment finding indicates to the nurse that the desired effect has been achieved?
A) Client states chest pain is relieved.
B) Client's pulse decreases from 120 to 90.
C) Client's systolic blood pressure decreases from 180 to 90.
D) Client's SaO2 level increases from 92% to 96%.
Client states chest pain is relieved.
Rationale: Nitroglycerin reduces myocardial oxygen consumption which decreases ischemia and reduces che...
Following heparin treatment for a pulmonary embolism, a client is being discharged with a prescription for warfarin Coumadin. In conducting discharge teaching, the nurse advises the client to have which diagnostic test monitored regularly after discharge?
A) Perfusion scan.
B) Prothrombin Time (PT/INR).
C) Activated partial thromboplastin (APTT).
D) Serum Coumadin level (SCL).
Prothrombin Time (PT/INR)
Rationale: When used for a client with pulmonary embolus, the therapeutic goal for warfarin therapy is a PT 1½ to 2...
A healthcare provider prescribes cephalexin monohydrate Keflex for a client with a postoperative infection. It is most important for the nurse to assess for what additional drug allergy before administering this prescription?
A) Penicillins.
B) Aminoglycosides.
C) Erythromycins.
D) Sulfonamides.
Penicillin
Rationale: Cross-allergies exist between penicillins (A) and cephalosporins, such as cephalexin monohydrate (Keflex), so checking ...
A client is admitted to the coronary care unit with a medical diagnosis of acute myocardial infarction. Which medication prescription decreases both preload and afterload?
A) Nitroglycerin.
B) Propranolol (Inderal).
C) Morphine.
D) Captopril (Capoten).
Nitroglycerin
Rationale: Nitroglycerin (A) is a nitrate that causes peripheral vasodilation and decreases contractility, thereby decreasing b...
Which dosing schedule should the nurse teach the client to observe for a controlled-release oxycodone prescription?
A) As needed.
B) Every 12 hours.
C) Every 24 hours.
D) Every 4 to 6 hours.
Every 12 hours
Rationale: A controlled-release oxycodone provides long-acting analgesia to relieve moderate to severe pain, so a dosing sched...
A peak and trough level must be drawn for a client receiving antibiotic therapy. What is the optimum time for the nurse to obtain the trough level?
A) Sixty minutes after the antibiotic dose is administered. B) Immediately before the next antibiotic dose is given.
C) When the next blood glucose level is to be checked.
D) Thirty minutes before the next antibiotic dose is given.
Immediately before the next antibiotic dose is given
Rationale: Trough levels are drawn when the blood level is at its lowest, which is typic...
Related Flashcard Decks
Study Tips
- Press F to enter focus mode for distraction-free studying
- Review cards regularly to improve retention
- Try to recall the answer before flipping the card
- Share this deck with friends to study together
| Term | Definition |
|---|---|
Following the administration of sublingual nitroglycerin to a client experiencing an acute anginal attack, which assessment finding indicates to the nurse that the desired effect has been achieved? A) Client states chest pain is relieved. B) Client's pulse decreases from 120 to 90. C) Client's systolic blood pressure decreases from 180 to 90. D) Client's SaO2 level increases from 92% to 96%. | Client states chest pain is relieved. Rationale: Nitroglycerin reduces myocardial oxygen consumption which decreases ischemia and reduces chest pain (A). (B and D) would also occur if the angina was relieved, but are not as significant as the client's subjective report of decreased pain. (C) may indicate a reduction in pain, or a potentially serious side effect of the medication. |
Following heparin treatment for a pulmonary embolism, a client is being discharged with a prescription for warfarin Coumadin. In conducting discharge teaching, the nurse advises the client to have which diagnostic test monitored regularly after discharge? A) Perfusion scan. B) Prothrombin Time (PT/INR). C) Activated partial thromboplastin (APTT). D) Serum Coumadin level (SCL). | Prothrombin Time (PT/INR) Rationale: When used for a client with pulmonary embolus, the therapeutic goal for warfarin therapy is a PT 1½ to 2½ times greater than the control, or an INR of 2 to 3 (B). A perfusion might be performed to monitor lung function, but not monthly (A). APTT is monitored for the client receiving heparin therapy (C). A blood level for Coumadin cannot be measured (D). |
A healthcare provider prescribes cephalexin monohydrate Keflex for a client with a postoperative infection. It is most important for the nurse to assess for what additional drug allergy before administering this prescription? A) Penicillins. B) Aminoglycosides. C) Erythromycins. D) Sulfonamides. | Penicillin Rationale: Cross-allergies exist between penicillins (A) and cephalosporins, such as cephalexin monohydrate (Keflex), so checking for penicillin allergy is a wise precaution before administering this drug. |
A client is admitted to the coronary care unit with a medical diagnosis of acute myocardial infarction. Which medication prescription decreases both preload and afterload? A) Nitroglycerin. B) Propranolol (Inderal). C) Morphine. D) Captopril (Capoten). | Nitroglycerin Rationale: Nitroglycerin (A) is a nitrate that causes peripheral vasodilation and decreases contractility, thereby decreasing both preload and afterload. (B) is a beta adrenergic blocker that decreases both heart rate and contractility, but only decreases afterload. Morphine (C) decreases myocardial oxygen consumption and preload. Capoten (D) is an angiotensin converting enzyme (ACE) inhibitor that acts to prevents vasoconstriction, thereby decreasing blood pressure and afterload. |
Which dosing schedule should the nurse teach the client to observe for a controlled-release oxycodone prescription? A) As needed. B) Every 12 hours. C) Every 24 hours. D) Every 4 to 6 hours. | Every 12 hours Rationale: A controlled-release oxycodone provides long-acting analgesia to relieve moderate to severe pain, so a dosing schedule of every 12 hours (B) provides the best around-the-clock pain management. Controlled-release oxycodone is not prescribed for breakthrough pain on a PRN or as needed schedule (A). (C) is inadequate for continuous pain management. Using a schedule of every 4 to 6 hours (D) may jeopardize patient safety due to cumulative effects. |
A peak and trough level must be drawn for a client receiving antibiotic therapy. What is the optimum time for the nurse to obtain the trough level? A) Sixty minutes after the antibiotic dose is administered. B) Immediately before the next antibiotic dose is given. C) When the next blood glucose level is to be checked. D) Thirty minutes before the next antibiotic dose is given. | Immediately before the next antibiotic dose is given Rationale: Trough levels are drawn when the blood level is at its lowest, which is typically just before the next dose is given (B). (A, C, and D) do not describe the optimum time for obtaining a trough level of an antibiotic. |
After abdominal surgery, a male client is prescribed low molecular weight heparin LMWH. During administration of the medication, the client asks the nurse why he is receiving this medication. Which is the best response for the nurse to provide? A) This medication is a blood thinner given to prevent blood clot formation. B) This medication enhances antibiotics to prevent infection. C) This medication dissolves any clots that develop in the legs. D) This abdominal injection assists in the healing of the abdominal wound. | This medication is a blood thinner given to prevent blood clot formation Rationale: Unfractionated heparin or low molecular weight heparin (LMWH) is an anticoagulant that inhibits thrombin-mediated conversion of fibrinogen to fibrin and is given prophylactically to prevent postoperative venous thrombosis (A) or to treat pulmonary embolism or deep vein thrombosis following knee and abdominal surgeries. Heparin does not dissolve clots but prevents clot extension or further clot formation (C). The anticoagulant heparin does not prevent infection (B) or influence operative wound healing (D). |
A client with Parkinson's disease is taking carbidopa-levodopa (Sinemet). Which observation by the nurse should indicate that the desired outcome of the medication is being achieved? A) Decreased blood pressure. B) Lessening of tremors. C) Increased salivation. D) Increased attention span. | Lessening of tremors Rationale: Sinemet increases the amount of levodopa to the CNS (dopamine to the brain). Increased amounts of dopamine improve the symptoms of Parkinson's, such as involuntary movements, resting tremors (B), shuffling gait, etc. (A) is a side effect of Sinemet. Decreased drooling would be a desired effect, not (C). Sinemet does not affect (D). |
A client is receiving metoprolol Lopressor SR. What assessment is most important for the nurse to obtain? A) Temperature. B) Lung sounds. C) Blood pressure. D) Urinary output. | Blood pressure Rationale: It is most important to monitor the blood pressure (C) of clients taking this medication because Lopressor is an antianginal, antiarrhythmic, antihypertensive agent. While (A and B) are important data to obtain on any client, they are not as important for a client receiving Lopressor as (C). Intake and output ratios and daily weights should be monitored while taking Lopressor to assess for signs and symptoms of congestive heart failure, but (D) alone does not have the importance of (C). |
The nurse is assessing a client who is experiencing anaphylaxis from an insect sting. Which prescription should the nurse prepare to administer this client? A) Dopamine B) Ephedrine C) Epinephrine D) Diphenhydramine. | Epinephrine Rationale: Epinephrine (C) is an adrenergic agent that stimulate beta receptors to increase cardiac automaticity in cardiac arrest and relax bronchospasms in anaphylaxis. Dopamine (A) is a vasopressor used to treat clients with shock. Ephedrine (B) causes peripheral vasoconstriction and is used in the treatment of nasal congestion. Diphenhydramine (D) is an antihistamine decongestant used in the treatment of mild allergic reactions and motion sickness. |
A medication that is classified as a beta-1 agonist is most commonly prescribed for a client with which condition? A) Glaucoma B) Hypertension C) Heart Failure D) Asthma | Heart failure Rationale: Beta-1 agonists improve cardiac output by increasing the heart rate and blood pressure and are indicated in heart failure (C), shock, atrioventricular block dysrhythmias, and cardiac arrest. Glaucoma (A) is managed using adrenergic agents and beta-adrenergic blocking agents. Beta-1 blocking agents are used in the management of hypertension (B). Medications that stimulate beta-2 receptors in the bronchi are effective for bronchoconstriction in respiratory disorders, such as asthma (D). |
Which nursing intervention is most important when caring for a client receiving the antimetabolite cytosine arabinoside Arc-C for chemotherapy? A) Hydrate the client with IV fluids before and after infusion. B) Assess the client for numbness and tingling of extremities. C) Inspect the client's oral mucosa for ulcerations. D) Monitor the client's urine pH for increased acidity. | Inspect the client's oral mucosa for ulcerations Rationale: Cytosine arabinoside (Arc-C) affects the rapidly growing cells of the body, therefore stomatitis and mucosal ulcerations are key signs of antimetabolite toxicity (C). (A, B, and D) are not typical interventions associated with the administration of antimetabolites. |
Which drug is used as a palliative treatment for a client with tumor-induced spinal cord compression? A) Morphine Sulfate (Duromorph). B) Ibuprofen (Advil). C) Amitriptyline (Amitril). D) Dexamethasone (Decadron). | Dexamethasone (Decadron) Rationale: Dexamethasone (D) is a palliative treatment modality to manage symptoms related to compression due to tumor growth. Morphine sulphate (A) is an opioid analgesic used in oncology to manage severe or intractable pain. Ibuprofen (B), a nonsteroidal antiinflammatory drug (NSAID), provides relief for mild to moderate pain, suppression of inflammation, and reduction of fever. Amitriptyline (C), a tricyclic antidepressant, is often prescribed for pain related to neuropathic origin and provides a reduction in opioid dosage. |
Which change in data indicates to the nurse that the desired effect of the angiotensin II receptor antagonist valsartan Diovan has been achieved? A) Dependent edema reduced from +3 to +1. B) Serum HDL increased from 35 to 55 mg/dl. C) Pulse rate reduced from 150 to 90 beats/minute. D) Blood pressure reduced from 160/90 to 130/80. | Blood pressure reduced from 160/90 to 130/80 Rationale: Diovan is an angiotensin receptor blocker, prescribed for the treatment of hypertension. The desired effect is a decrease in blood pressure (D). (A, B, and C) do not describe effects of Diovan. |
Which antidiarrheal agent should be used with caution in clients taking high dosages of aspirin for arthritis? A) Loperamide (Imodium). B) Probanthine (Propantheline). C) Bismuth subsalicylate (Pepto Bismol). D) Diphenoxylate hydrochloride with atropine (Lomotil). | Bismuth subsalicylate (Pepto Bismol) Rationale: Bismuth subsalicylate (Pepto Bismol) contains a subsalicylate that increases the potential for salicylate toxicity when used concurrently with aspirin (acetylsalicylic acid, another salicylate preparation). (A, B, and D) do not pose the degree of risk of drug interaction with aspirin as Pepto Bismol would. |
A client receiving Doxorubicin Adriamycin intravenously IV complains of pain at the insertion site, and the nurse notes edema at the site. Which intervention is most important for the nurse to implement? A) Assess for erythema. B) Administer the antidote C) Apply warm compresses. D) Discontinue the IV fluids. | Discontinue the IV fluids Rationale: Doxorubicin is an antineoplastic agent that causes inflammation, blistering, and necrosis of tissue upon extravasation. First, all IV fluids should be discontinued at the site (D) to prevent further tissue damage by the vesicant. Erythema is one sign of infiltration and should be noted, but edema and pain at the infusion site require stopping the IV fluids (A). Although an antidote may be available (B), additional fluids contribute to the trauma of the subcutaneous tissues. Depending on the type of vesicant, warm or cold compresses (C) may be prescribed after the infusion is discontinued. |
The nurse is transcribing a new prescription for spironolactone Adactone for a client who receives an angiotensin-converting enzyme ACE inhibitor. Which action should the nurse implement? A) Verify both prescriptions with the healthcare provider. B) Report the medication interactions to the nurse manager. C) Hold the ACE inhibitor and give the new prescription. D) Transcribe and send the prescription to the pharmacy. | Verify both prescriptions with the healthcare provider Rationale: The concomitant use of an angiotensin-converting enzyme (ACE) inhibitor and a potassium-sparing diuretic such as spironolactone, should be given with caution because the two drugs may interact to cause an elevation in serum potassium levels. Although the client is currently receiving an ACE inhibitor, verifying both prescriptions (A) alerts the healthcare provider about the client's medication regimen and provides the safest action before administering the medication. (B) is not necessary at this time. Holding the prescribed antihypertensive medication (C) places the client at risk. The nurse should inform the healthcare provider of the client's medication history before proceeding with the fulfillment of the prescription (D). |
The healthcare provider prescribes naloxone Narcan for a client in the emergency room. Which assessment data would indicate that the naloxone has been effective? A) statement that the chest pain is better. B) respiratory rate is 16 breaths/minute. C) seizure activity has stopped temporarily. D) pupils are constricted bilaterally. | The client's respiratory rate is 16 breaths/minute Rationale: Naloxone (Narcan) is a narcotic antagonist that reverses the respiratory depression effects of opiate overdose, so assessment of a normal respiratory rate (B) would indicate that the respiratory depression has been halted. (A, C, and D) are not related to naloxone (Narcan) administration. |
The nurse is assessing the effectiveness of high dose aspirin therapy for an 88-year-old client with arthritis. The client reports that she can't hear the nurse's questions because her ears are ringing. What action should the nurse implement? A) Refer the client to an audiologist for evaluation of her hearing. B) Advise the client that this is a common side effect of aspirin therapy. C) Notify the healthcare provider of this finding immediately. D) Ask the client to turn off her hearing aid during the exam. | Notify the healthcare provider of this finding immediately Rationale: Tinnitus is an early sign of salicylate toxicity. The healthcare provider should be notified immediately (C), and the medication discontinued. (A and D) are not needed, and (B) is inaccurate. |
A client is taking hydromorphone Dilaudid PO q4h at home. Following surgery, Dilaudid IV q4h PRN and butorphanol tartrate Stadol IV q4h PRN are prescribed for pain. The client received a dose of the Dilaudid IV four hours ago, and is again requesting pain medication. What intervention should the nurse implement? A) Alternate the two medications q4h PRN for pain. B) Alternate the two medications q2h PRN for pain. C) Administer only the Dilaudid q4h PRN for pain. D) Administer only the Stadol q4h PRN for pain. | Administer only the Dilaudid q4h PRN for pain Rationale: Dilaudid is an opioid agonist. Stadol is an opioid agonist-antagonist. Use of an agonist-antagonist for the client who has been receiving opioid agonists may result in abrupt withdrawal symptoms, and should be avoided (C). (A, B, and D) do not reflect good nursing practice. |
The nurse is reviewing the use of the patient-controlled analgesia PCA pump with a client in the immediate postoperative period. The client will receive morphine 1 mg IV per hour basal rate with 1 mg IV every 15 minutes per PCA to total 5 mg IV maximally per hour. What assessment has the highest priority before initiating the PCA pump? A) The expiration date on the morphine syringe in the pump. B) The rate and depth of the client's respirations. C) The type of anesthesia used during the surgical procedure. D) The client's subjective and objective signs of pain. | The rate and depth of the client's respirations Rationale: A life-threatening side effect of intravenous administration of morphine sulfate, an opiate narcotic, is respiratory depression (B). The PCA pump should be stopped and the healthcare provider notified if the client's respiratory rate falls below 12 breaths per minute, and the nurse should anticipate adjustments in the client's dosage before the PCA pump is restarted. (A, C, and D) provide helpful information, but are not as high a priority as the assessment described in (B). |
A client has a continuous IV infusion of dopamine Intropin and an IV of normal saline at 50 ml/hour. The nurse notes that the client's urinary output has been 20 ml/hour for the last two hours. Which intervention should the nurse initiate? A) Stop the infusion of dopamine. B) Change the normal saline to a keep open rate. C) Replace the urinary catheter. D) Notify the healthcare provider of the urinary output. | Notify the healthcare provider of the urinary output Rationale: The main effect of dopamine is adrenergic stimulation used to increase cardiac output, which should also result in increased urinary output. A urinary output of less than 20 ml/hour is oliguria and should be reported to the healthcare provider (D) so that the dose of dopamine can be adjusted. Depending on the current rate of administration, the dose may need to be increased or decreased. If the dose is decreased, it should be titrated down, rather than abruptly discontinued (A). Fluid intake may need to be increased, rather than (B). The urinary catheter is draining and does not need to be replaced (C). |
A client receiving albuterol Proventil tablets complains of nausea every evening with her 9 p.m. dose. What action should the nurse take to alleviate this side effect? A) Change the time of the dose. B) Hold the 9 p.m. dose. C) Administer the dose with a snack. D) Administer an antiemetic with the dose. | Administer the dose with a snack Rationale: Administering oral doses with food (C) helps minimize GI discomfort. (A) would be appropriate only if changing the time of the dose corresponds to meal times while at the same time maintaining an appropriate time interval between doses. (B) would disrupt the dosing schedule, and could result in a nontherapeutic serum level of the medication. (D) should not be attempted before other interventions, such as (C), have been proven ineffective in relieving the nausea. |
Which method of medication administration provides the client with the greatest first-pass effect? A) Oral. B) Sublingual. C) Intravenous. D) Subcutaneous | Oral Rationale: The first-pass effect is a pharmacokinetic phenomenon that is related to the drug's metabolism in the liver. After oral (A) medications are absorbed from the gastrointestinal tract, the drug is carried directly to the liver via the hepatic portal circulation where hepatic inactivation occurs and reduces the bioavailability of the drug. Alternative method of administration, such as sublingual (B), IV (C), and subcutaneous (D) routes, avoid this first-pass effect. |
In evaluating the effects of lactulose Cephulac, which outcome should indicate that the drug is performing as intended? A) An increase in urine output. B) Two or three soft stools per day. C) Watery, diarrhea stools. D) Increased serum bilirubin. | Two or three soft stools per day Rationale: Lactulose is administered to reduce blood ammonia by excretion of ammonia through the stool. Two to three stools a day indicate that lactulose is performing as intended (B). (A) would be expected if the patient received a diuretic. (C) would indicate an overdose of lactulose and is not expected. Lactulose does not affect (D). |
Upon admission to the emergency center, an adult client with acute status asthmaticus is prescribed this series of medications. In which order should the nurse administer the prescribed medications? Arrange from first to last. A) Prednisone (Deltasone) orally. B) Gentamicin Garamycin IM. C) Albuterol (Proventil) puffs. D) Salmeterol (Serevent Diskus). | The best sequence of administration is C, D, A and B Rationale: The best sequence of administration is (C, D, A and B). Status asthmaticus is potentially a life-threatening respiratory event, so albuterol (C), a beta2 adrenergic agonist and bronchodilator, should be administered by inhalation first to provide rapid and deep topical penetration to relieve bronchospasms, dilate the bronchioles, and increase oxygenation. In stepwise management of persistent asthma, a long-action bronchodilator, such as salmeterol (Serevent Diskus) (D) with a 12-hour duration of action should be given next. Prednisone (A), an oral corticosteroid, provides prolonged anti-inflammatory effects and should be given after the client's respiratory distress begins to resolves. Gentamicin (B), an antibiotic, is given deep IM, which can be painful, and may require repositioning the client, so should be last in the sequence. |
An older client with a decreased percentage of lean body mass is likely to receive a prescription that is adjusted based on which pharmacokinetic process? A) Absorption B) Metabolism C) Elimination D) Distribution | Distribution Rationale: A decreased lean body mass in an older adult affects the distribution of drugs (D), which affects the pharmacokinetics of drugs. Decreased gastric pH, delayed gastric emptying, decreased splanchnic blood flow, decreased gastrointestinal absorption surface areas and motility affect (A) in the older adult population. Decreased hepatic blood flow, decreased hepatic mass, and decreased activity of hepatic enzymes affect (B) in older adults. Decreased renal blood flow, decreased glomerular filtration rate, decreased tubular secretion, and decreased number of nephrons affects (C) in an older adult. |
Which medications should the nurse caution the client about taking while receiving an opioid analgesic? A) Antacids. B) Benzodiazepines. C) Antihypertensives D) Oral antidiabletics | Benzodiazepines Rationale: Respiratory depression increases with the concurrent use of opioid analgesics and other central nervous system depressant agents, such as alcohol, barbiturates, and benzodiazepines (B). (A and D) do not interact with opiates to produce adverse effects. Antihypertensives (C) may cause morphine-induced hypotension, but should not be withheld without notifying the healthcare provider. |
Which client should the nurse identify as being at highest risk for complications during the use of an opioid analgesic? A) An older client with Type 2 diabetes mellitus. B) A client with chronic rheumatoid arthritis. C) A client with a open compound fracture. D) A young adult with inflammatory bowel disease. | A young adult with inflammatory bowel disease Rationale: The principal indication for opioid use is acute pain, and a client with inflammatory bowel disease (D) is at risk for toxic megacolon or paralytic ileus related to slowed peristalsis, a side effect of morphine. Adverse effects of morphine do not pose as great a risk for (A, B, and C) as the client with bowel disease. |
A client is being treated for hyperthyroidism with propylthiouracil PTU. The nurse knows that the action of this drug is to: A) decrease the amount of thyroid-stimulating hormone circulating in the blood. B) increase the amount of thyroid-stimulating hormone circulating in the blood. C) increase the amount of T4 and decrease the amount of T3 produced by the thyroid. D) inhibit synthesis of T3 and T4 by the thyroid gland. | inhibit synthesis of T3 and T4 by the thyroid gland Rationale: PTU is an adjunct therapy used to control hyperthyroidism by inhibiting production of thyroid hormones (D). It is often prescribed in preparation for thyroidectomy or radioactive iodine therapy. Thyroid-stimulating hormone (TSH) is produced by the pituitary gland, and PTU does not affect the pituitary (A and B). PTU inhibits the synthesis of all thyroid hormones--both T3 and T4(C). |
A 43-year-old female client is receiving thyroid replacement hormone following a thyroidectomy. What adverse effects associated with thyroid hormone toxicity should the nurse instruct the client to report promptly to the healthcare provider? A) Tinnitus and dizziness. B) Tachycardia and chest pain. C) Dry skin and intolerance to cold. D) Weight gain and increased appetite. | Tachycardia and chest pain Rationale: Thyroid replacement hormone increases the metabolic rate of all tissues, so common signs and symptoms of toxicity include tachycardia and chest pain (B). (A, C, and D) do not indicate a thyroid hormone toxicity. |
A client is receiving ampicillin sodium Omnipen for a sinus infection. The nurse should instruct the client to notify the healthcare provider immediately if which symptom occurs? A) Rash. B) Nausea. C) Headache. D) Dizziness | Rash Rationale: Rash (A) is the most common adverse effect of all penicillins, indicating an allergy to the medication which could result in anaphylactic shock, a medical emergency. (B, C, and D) are common side effects of penicillins that should subside after the body adjusts to the medication. These would not require immediate medical care unless the symptoms persist beyond the first few days or become extremely severe. |
In teaching a client who had a liver transplant about cyclosporine Sandimmune, the nurse should encourage the client to report which adverse response to the healthcare provider? A) Changes in urine color. B) Presence of hand tremors. C) Increasing body hirsutism. D) Nausea and vomiting. | Presence of hand tremors Rationale: Neurological complications, such as hand tremors (B), occur in about 50% of clients taking cyclosporine and should be reported. Although this drug can be nephrotoxic, (A) typically does not occur. (C and D) are common side effects, but are not usually severe. |
A client with congestive heart failure CHF is being discharged with a new prescription for the angiotensin-converting enzyme ACE inhibitor captopril Capoten. The nurse's discharge instruction should include reporting which problem to the healthcare provider? A) Weight loss. B) Dizziness. C) Muscle cramps. D) Dry mucous membranes | Dizziness Rationale: Angiotensin-converting enzyme (ACE) inhibitors are used in CHF to reduce afterload by reversing vasoconstriction common in heart failure. This vasodilation can cause hypotension and resultant dizziness (B). (A) is desired if fluid overload is present, and may occur as the result of effective combination drug therapy such as diuretics with ACE inhibitors. (C) often indicates hypokalemia in the client receiving diuretics. Excessive diuretic administration may result in fluid volume deficit, manifested by symptoms such as (D). |