Pharmacology Practice Quiz Part 2
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.
A client has myxedema, which results from a deficiency of thyroid hormone synthesis in adults. The nurse knows that which medication should be contraindicated for this client?
A) Liothyronine (Cytomel) to replace iodine.
B) Furosemide (Lasix) for relief of fluid retention.
C) Pentobarbital sodium (Nembutal Sodium) for sleep.
D) Nitroglycerin (Nitrostat) for angina pain.
Pentobarbital sodium (Nembutal Sodium) for sleep
Rationale: Persons with myxedema are dangerously hypersensitive to narcotics, barbiturates (C), and anesthetics. They do tolerate liothyronine (Cytomel) (A) and usually receive iodine replacement therapy. These clients are also susceptible to heart problems such as angina for which nitroglycerin (Nitrostat) (D) would be indicated, and congestive heart failure for which furosemide (Lasix) (B) would be indicated.
Key Terms
A client has myxedema, which results from a deficiency of thyroid hormone synthesis in adults. The nurse knows that which medication should be contraindicated for this client?
A) Liothyronine (Cytomel) to replace iodine.
B) Furosemide (Lasix) for relief of fluid retention.
C) Pentobarbital sodium (Nembutal Sodium) for sleep.
D) Nitroglycerin (Nitrostat) for angina pain.
Pentobarbital sodium (Nembutal Sodium) for sleep
Rationale: Persons with myxedema are dangerously hypersensitive to narcotics, barbiturates (...
A client is being treated for osteoporosis with alendronate Fosamax, and the nurse has completed discharge teaching regarding medication administration. Which morning schedule would indicate to the nurse that the client teaching has been effective?
A) Take medication, go for a 30 minute morning walk, then eat breakfast.
B) Take medication, rest in bed for 30 minutes, eat breakfast, go for morning walk.
C) Take medication with breakfast, then take a 30 minute morning walk.
D) Go for a 30 minute morning walk, eat breakfast, then take medication.
Take medication, go for a 30 minute morning walk, then eat breakfast
Rationale: Alendronate (Fosamax) is best absorbed when taken thirty minu...
The nitrate isosorbide dinitrate Isordil is prescribed for a client with angina. Which instruction should the nurse include in this client's discharge teaching plan?
A) Quit taking the medication if dizziness occurs.
B) Do not get up quickly. Always rise slowly.
C) Take the medication with food only.
D) Increase your intake of potassium-rich foods.
Do not get up quickly. Always rise slowly
Rationale: An expected side effect of nitrates is orthostatic hypotension and the nurse should addr...
The nurse is teaching a client with cancer about opioid management for intractable pain and tolerance related side effects. The nurse should prepare the client for which side effect that is most likely to persist during long-term use of opioids?
A) Sedation.
B) Constipation.
C) Urinary retention.
D) Respiratory depression
Constipation
Rationale: The client should be prepared to implement measures for constipation (B) which is the most likely persistent side eff...
A category X drug is prescribed for a young adult female client. Which instruction is most important for the nurse to teach this client?
A) Use a reliable form of birth control.
B) Avoid exposure to ultra violet light.
C) Refuse this medication if planning pregnancy.
D) Abstain from intercourse while on this drug.
Use a reliable form of birth control
Rationale: Drugs classified in the category X place a client who is in the first trimester of pregnancy ...
While taking a nursing history, the client states, "I am allergic to penicillin." What related allergy to another type of antiinfective agent should the nurse ask the client about when taking the nursing history?
A) Aminoglycosides.
B) Cephalosporins.
C) Sulfonamides.
D) Tetracyclines.
Cephalosporins
Rationale: Cross allergies exist between penicillins and cephalosporins (B). Penicillin allergies are unrelated to allergies a...
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| Term | Definition |
|---|---|
A client has myxedema, which results from a deficiency of thyroid hormone synthesis in adults. The nurse knows that which medication should be contraindicated for this client? A) Liothyronine (Cytomel) to replace iodine. B) Furosemide (Lasix) for relief of fluid retention. C) Pentobarbital sodium (Nembutal Sodium) for sleep. D) Nitroglycerin (Nitrostat) for angina pain. | Pentobarbital sodium (Nembutal Sodium) for sleep Rationale: Persons with myxedema are dangerously hypersensitive to narcotics, barbiturates (C), and anesthetics. They do tolerate liothyronine (Cytomel) (A) and usually receive iodine replacement therapy. These clients are also susceptible to heart problems such as angina for which nitroglycerin (Nitrostat) (D) would be indicated, and congestive heart failure for which furosemide (Lasix) (B) would be indicated. |
A client is being treated for osteoporosis with alendronate Fosamax, and the nurse has completed discharge teaching regarding medication administration. Which morning schedule would indicate to the nurse that the client teaching has been effective? A) Take medication, go for a 30 minute morning walk, then eat breakfast. B) Take medication, rest in bed for 30 minutes, eat breakfast, go for morning walk. C) Take medication with breakfast, then take a 30 minute morning walk. D) Go for a 30 minute morning walk, eat breakfast, then take medication. | Take medication, go for a 30 minute morning walk, then eat breakfast Rationale: Alendronate (Fosamax) is best absorbed when taken thirty minutes before eating in the morning. The client should also be advised to remain in an upright position for at least thirty minutes after taking the medication to reduce the risk of esophageal reflux and irritation. (A) is the best schedule to meet these needs. (B, C, and D) do not meet these criteria. |
The nitrate isosorbide dinitrate Isordil is prescribed for a client with angina. Which instruction should the nurse include in this client's discharge teaching plan? A) Quit taking the medication if dizziness occurs. B) Do not get up quickly. Always rise slowly. C) Take the medication with food only. D) Increase your intake of potassium-rich foods. | Do not get up quickly. Always rise slowly Rationale: An expected side effect of nitrates is orthostatic hypotension and the nurse should address how to prevent it--by rising slowly (B). Dizziness is expected, and the client should not quit taking the medication without notifying the healthcare provider (A). (C and D) are not indicated when taking this medication. |
The nurse is teaching a client with cancer about opioid management for intractable pain and tolerance related side effects. The nurse should prepare the client for which side effect that is most likely to persist during long-term use of opioids? A) Sedation. B) Constipation. C) Urinary retention. D) Respiratory depression | Constipation Rationale: The client should be prepared to implement measures for constipation (B) which is the most likely persistent side effect related to opioid use. Tolerance to opiate narcotics is common, and the client may experience less sedation (A) and respiratory depression (D) as analgesic use continues. Opioids increase the tone in the urinary bladder sphincter, which causes retention (C) but may subside. |
A category X drug is prescribed for a young adult female client. Which instruction is most important for the nurse to teach this client? A) Use a reliable form of birth control. B) Avoid exposure to ultra violet light. C) Refuse this medication if planning pregnancy. D) Abstain from intercourse while on this drug. | Use a reliable form of birth control Rationale: Drugs classified in the category X place a client who is in the first trimester of pregnancy at risk for teratogenesis, so women in the childbearing years should be counseled to use a reliable form of birth control (A) during drug therapy. (B) is not a specific precaution with Category X drugs. The client should be encouraged to discuss plans for pregnancy with the healthcare provider, so a safer alternative prescription (C) can be provided if pregnancy occurs. Although the risk of birth defects during pregnancy explains the restriction of these drugs during pregnancy, (D) is not indicated. |
While taking a nursing history, the client states, "I am allergic to penicillin." What related allergy to another type of antiinfective agent should the nurse ask the client about when taking the nursing history? A) Aminoglycosides. B) Cephalosporins. C) Sulfonamides. D) Tetracyclines. | Cephalosporins Rationale: Cross allergies exist between penicillins and cephalosporins (B). Penicillin allergies are unrelated to allergies associated with (A, C, or D). |
Which instructions should the nurse give to a female client who just received a prescription for oral metronidazole Flagyl for treatment of trichomonas vaginalis? Select all that apply A) Increase fluid intake, especially cranberry juice. B) Do not abruptly discontinue the medication; taper use. C) Check blood pressure daily to detect hypertension. D) Avoid drinking alcohol while taking this medication. E) Use condoms until treatment is completed. F) Ensure that all sexual partners are treated at the same time. | Correct selections are A, D, E, and F Rationale: Correct selections are (A, D, E, and F). Increased fluid intake and cranberry juice (A) are recommended for prevention and treatment of urinary tract infections, which frequently accompany vaginal infections. It is not necessary to taper use of this drug (B) or to check the blood pressure daily (C), as this condition is not related to hypertension. Flagyl can cause a disulfiram-like reaction if taken in conjunction with ingestion of alcohol, so the client should be instructed to avoid alcohol (D). All sexual partners should be treated at the same time (E) and condoms should be used until after treatment is completed to avoid reinfection (F). |
Which action is most important for the nurse to implement prior to the administration of the antiarrhythmic drug adenosine Adenocard? A) Assess pupillary response to light. B) Instruct the client that facial flushing may occur. C) Apply continuous cardiac monitoring. D) Request that family members leave the room. | Apply continuous cardiac monitoring Rationale: Adenosine (Adenocard) is an antiarrhythmic drug used to restore a normal sinus rhythm in clients with rapid supraventricular tachycardia. The client's heart rate should be monitored continuously (C) for the onset of additional arrhythmias while receiving adenosine. (A and B) are valuable nursing interventions, but are of less importance than monitoring for potentially fatal arrhythmias. Family members may be asked to leave the room because of the potential for an emergency situation (D), however, this is also of less priority than (C). |
Which symptoms are serious adverse effects of beta-adrenergic blockers such as propranolol Inderal? A) Headache, hypertension, and blurred vision. B) Wheezing, hypotension, and AV block. C) Vomiting, dilated pupils, and papilledema. D) Tinnitus, muscle weakness, and tachypnea. | Wheezing, hypotension, and AV block Rationale: (B) represents the most serious adverse effects of beta-blocking agents. AV block is generally associated with bradycardia and results in potentially life-threatening decreases in cardiac output. Additionally, wheezing secondary to bronchospasm and hypotension represent life-threatening respiratory and cardiac disorders. (A, C, and D) are not associated with beta-blockers. |
An antacid Maalox is prescribed for a client with peptic ulcer disease. The nurse knows that the purpose of this medication is to: A) decrease production of gastric secretions. B) produce an adherent barrier over the ulcer. C) maintain a gastric pH of 3.5 or above. D) decrease gastric motor activity. | maintain a gastric pH of 3.5 or above Rationale: The objective of antacids is to neutralize gastric acids and keep pH of 3.5 or above (C) which is necessary for pepsinogen inactivity. (A) is the purpose of H2 receptor antagonists (cimetidine, ranitidine). (B) is the purpose of sucralfate (Carafate). (D) is the purpose of anticholinergic drugs which are often used in conjunction with antacids to allow the antacid to remain in the stomach longer. |
Which nursing diagnosis is important to include in the plan of care for a client receiving the angiotensin-2 receptor antagonist irbesartan Avapro? A) Fluid volume deficit. B) Risk for infection. C) Risk for injury D) Impaired sleep patterns. | Risk for injury Rationale: Avapro is an antihypertensive agent, which acts by blocking vasoconstrictor effects at various receptor sites. This can cause hypotension and dizziness, placing the client at high risk for injury (C). Avapro does not act as a diuretic (A), impact the immune system (B), or alter sleep patterns (D). |
A client with osteoarthritis receives a new prescription for celecoxib Celebrex orally for symptom management. The nurse notes the client is allergic to sulfa. Which action is most important for the nurse to implement prior to administering the first dose? A) Review the client's hemoglobin results. B) Notify the healthcare provider. C) Inquire about the reaction to sulfa. D) Record the client's vital signs. | Notify the healthcare provider Rationale: Celebrex contains a sulfur molecule, which can lead to an allergic reaction in individuals who are sensitive to sulfonamides, so the healthcare provider should be notified of the client's allergies (B). Although (A, C, and D) are important assessments, it is most important to notify the healthcare provider for an alternate prescription. |
A client who was prescribed atorvastatin Lipitor one month ago calls the triage nurse at the clinic complaining of muscle pain and weakness in his legs. Which statement reflects the correct drug-specific teaching the nurse should provide to this client? A) Increase consumption of potassium-rich foods since low potassium levels can cause muscle spasms. B) Have serum electrolytes checked at the next scheduled appointment to assess hyponatremia, a cause of cramping. C) Make an appointment to see the healthcare provider, because muscle pain may be an indication of a serious side effect. D) Be sure to consume a low-cholesterol diet while taking the drug to enhance the effectiveness of the drug. | Make an appointment to see the healthcare provider, because muscle pain may be an indication of a serious side effect Rationale: Myopathy, suggested by the leg pain and weakness, is a serious, and potentially life-threatening, complication of Lipitor, and should be evaluated immediately by the healthcare provider (C). Although electrolyte imbalances such as (A or B) can cause muscle spasms in some cases, this is not the likely cause of leg pain in the client receiving Lipitor, and evaluation by the healthcare provider should not be delayed for any reason. A low-cholesterol diet is recommended for those taking Lipitor since the drug is used to lower total cholesterol (D), but diet is not related to the leg pain symptom. |
A client who has been taking levodopa PO TID to control the symptoms of Parkinson's disease has a new prescription for sustained release levodopa/carbidopa Sinemet 25/100 PO BID. The client took his levodopa at 0800. Which instruction should the nurse include in the teaching plan for this client? A) Take the first dose of Sinemet today, as soon as your prescription is filled. B) Since you already took your levodopa, wait until tomorrow to take the Sinemet. C) Take both drugs for the first week, then switch to taking only the Sinemet. D) You can begin taking the Sinemet this evening, but do not take any more levodopa. | You can begin taking the Sinemet this evening, but do not take any more levodopa Rationale: Carbidopa significantly reduces the need for levodopa in clients with Parkinson's disease, so the new prescription should not be started until eight hours after the previous dose of levodopa (D), but can be started the same day (B). (A and C) may result in toxicity. |
A client is receiving methylprednisolone Solu-Medrol 40 mg IV daily. The nurse anticipates an increase in which laboratory value as the result of this medication? A) Serum glucose. B) Serum calcium. C) Red blood cells. | Serum glucose Rationale: Solu-Medrol is a corticosteroid with glucocorticoid and mineralocorticoid actions. These effects can lead to hyperglycemia (A), which is reflected as an increase in the serum glucose value. The client taking Solu-Medrol is at risk for hypocalcemia (B) and hypokalemia (D), which result in a decrease, not an increase, in the serum calcium and serum potassium levels. This medication does not adversely affect the RBC count (C). |
A client with hyperlipidemia receives a prescription for niacin Niaspan. Which client teaching is most important for the nurse to provide? A) Expected duration of flushing. B) Symptoms of hyperglycemia. C) Diets that minimize GI irritation. D) Comfort measures for pruritis. | Expected duration of flushing Rationale: Flushing of the face and neck, lasting up to an hour, is a frequent reason for discontinuing niacin. Inclusion of this effect in client teaching (A) may promote compliance in taking the medication. While (B, C, and D) are all worthwhile instructions to help clients minimize or cope with normal side effects associated with niacin (Niaspan), flushing is intense and causes the most concern for the client. |
When assessing an adolescent who recently overdosed on acetaminophen Tylenol, it is most important for the nurse to assess for pain in which area of the body? A) Flank. B) Abdomen. C) Chest. D) Head. | Abdomen Rationale: Acetaminophen toxicity can result in liver damage; therefore, it is especially important for the nurse to assess for pain in the right upper quadrant of the abdomen (B), which might indicate liver damage. (A, C, and D) are not areas where pain would be anticipated. |
The nurse is preparing the 0900 dose of losartan Cozaar, an angiotensin II receptor blocker ARB, for a client with hypertension and heart failure. The nurse reviews the client's laboratory results and notes that the client's serum potassium level is 5.9 mEq/L. What action should the nurse take first? A) Withhold the scheduled dose. B) Check the client's apical pulse. C) Notify the healthcare provider. D) Repeat the serum potassium level. | Withhold the scheduled dose Rationale: The nurse should first withhold the scheduled dose of Cozaar (A) because the client is hyperkalemic (normal range 3.5 to 5 mEq/L). Although hypokalemia is usually associated with diuretic therapy in heart failure, hyperkalemia is associated with several heart failure medications, including ARBs. Because hyperkalemia may lead to cardiac dysrhythmias, the nurse should check the apical pulse for rate and rhythm (B), and the blood pressure. Before repeating the serum study (D), the nurse should notify the healthcare provider (C) of the findings. |
The healthcare provider prescribes digitalis Digoxin for a client diagnosed with congestive heart failure. Which intervention should the nurse implement prior to administering the digoxin? A) Observe respiratory rate and depth. B) Assess the serum potassium level. C) Obtain the client's blood pressure. D) Monitor the serum glucose level. | Assess the serum potassium level Rationale: Hypokalemia (decreased serum potassium) will precipitate digitalis toxicity in persons receiving digoxin (B). (A and C) will not affect the administration of digoxin. (D) should be monitored if he/she is a diabetic and is perhaps receiving insulin. |
A client with coronary artery disease who is taking digoxin Lanoxin receives a new prescription for atorvastatin Lipitor. Two weeks after initiation of the Lipitor prescription, the nurse assesses the client. Which finding requires the most immediate intervention? A) Heartburn. B) Headache. C) Constipation. D) Vomiting. | Vomiting Rationale: Vomiting, anorexia and abdominal pain are early indications of digitalis toxicity. Since Lipitor increases the risk for digitalis toxicity, this finding requires the most immediate intervention by the nurse (D). (A, B and C) are expected side effects of Lipitor. |
A client is receiving digoxin for the onset of supraventricular tachycardia SVT. Which laboratory findings should the nurse identify that places this client at risk? A) Hypokalemia B) Hyponatremia C) Hypercalcemia D) Low uric acid levels | Hyporkalemia Rationale: Hypokalemia affects myocardial contractility, so (A) places this client at greatest risk for dysrhythmias that may be unresponsive to drug therapy. Although an imbalance of serum electrolytes, (B and C), can effect cardiac rhythm, the greatest risk for the client receiving digoxin is (A). (D) does not cause any interactions related to digoxin therapy for supraventricular tachycardia (SVT). |
A client with giardiasis is taking metronidazole Flagyl 2 grams PO. Which information should the nurse include in the client's instruction? A) Notify the clinic of any changes in the color of urine. B) Avoid overexposure to the sun. C) Stop the medication after the diarrhea resolves. D) Take the medication with food. | Take the medication with food Rationale: Flagyl, an amoebicide and antibacterial agent, may cause gastric distress, so the client should be instructed to take the medication on a full stomach (D). Urine may be red-brown or dark from Flagyl, but this side effect is not necessary to report (A). Photosensitivity (B) is not a side effect associated with Flagyl. Despite the resolution of clinical symptoms, antiinfective medications should be taken for their entire course because stopping the medication (C) can increase the risk of resistant organisms. |
A client's dose of isosorbide dinitrate Imdur is increased from 40 mg to 60 mg PO daily. When the client reports the onset of a headache prior to the next scheduled dose, which action should the nurse implement? A) Hold the next scheduled dose of Imdur 60 mg and administer a PRN dose of acetaminophen (Tylenol). B) Administer the 40 mg of Imdur and then contact the healthcare provider. C) Administer the 60 mg dose of Imdur and a PRN dose of acetaminophen (Tylenol). D) Do not administer the next dose of Imdur or any acetaminophen until notifying the healthcare provider. | Administer the 60 mg dose of Imdur and a PRN dose of acetaminophen (Tylenol) Rationale: Imdur is a nitrate which causes vasodilation. This vasodilation can result in headaches, which can generally be controlled with acetaminophen (C) until the client develops a tolerance to this adverse effect. (A and B) may result in the onset of angina if a therapeutic level of Imdur is not maintained. Lying down (D) is less likely to reduce the headache than is a mild analgesic. |
A female client with rheumatoid arthritis take ibuprofen Motrin 600 mg PO 4 times a day. To prevent gastrointestinal bleeding, misoprostol Cytotec 100 mcg PO is prescribed. Which information is most important for the nurse to include in client teaching? A) Use contraception during intercourse. B) Ensure the Cytotec is taken on an empty stomach. C) Encourage oral fluid intake to prevent constipation. D) Take Cytotec 30 minutes prior to Motrin. | Use contraception during intercourse Rationale: Cytotec, a synthetic form of a prostaglandin, is classified as pregnancy Category X and can act as an abortifacient, so the client should be instructed to use contraception during intercourse (A) to prevent loss of an early pregnancy. (B) is not necessary. A common side effect of Cytotec is diarrhea, so constipation prevention strategies are usually not needed (C). Cytotec and Motrin should be taken together (D) to provide protective properties against gastrointestinal bleeding. |
A client is receiving clonidine Catapres 0.1 mg/24hr via transdermal patch. Which assessment finding indicates that the desired effect of the medication has been achieved? A) Client denies recent episodes of angina. B) Change in peripheral edema from +3 to +1. C) Client denies recent nausea or vomiting. D) Blood pressure has changed from 180/120 to 140/70. | Blood pressure has changed from 180/120 to 140/70 Rationale: Catapres acts as a centrally-acting analgesic and antihypertensive agent. (D) indicates a reduction in hypertension. Catapres does not affect (A, B, or C), so these findings do not indicate desired outcomes of Catapres. |
A client is admitted to the hospital for diagnostic testing for possible myasthenia gravis. The nurse prepares for intravenous administration of edrophonium chloride Tensilon. What is the expected outcome for this client following administration of this pharmacologic agent? A) Progressive difficulty with swallowing. B) Decreased respiratory effort. C) Improvement in generalized fatigue. D) Decreased muscle weakness. | Decreased muscle weakness Rationale: Administration of edrophonium chloride (Tensilon), a cholinergic agent, will temporarily reduce muscle weakness (D), the most common complaint of newly-diagnosed clients with myasthenia gravis. This medication is used to diagnose myasthenia gravis due to its short duration of action. This drug would temporarily reverse (A and B), not increase these symptoms. (C) is not a typical complaint of clients with myasthenia gravis, but weakness of specific muscles, especially after prolonged use, is a common symptom. |
Dobutamine (Dobutrex) is an emergency drug most commonly prescribed for a client with which condition? A) Shock B) Asthma C) Hypotension D) Heart failure | Heart failure Rationale: Dobutamine is a beta-1 adrenergic agonist that is indicated for short term use in cardiac decompensation or heart failure (D) related to reduced cardiac contractility due to organic heart disease or cardiac surgical procedures. Alpha and beta adrenergic agonists, such as epinephrine and dopamine, are sympathomimetics used in the treatment of shock (A). Other selective beta-2 adrenergic agonists, such as terbutaline and isoproterenol, are indicated in the treatment of asthma (B). Although dobutamine improves cardiac output, it is not used to treat hypotension (C). |
A postoperative client has been receiving a continuous IV infusion of meperidine Demerol 35 mg/hr for four days. The client has a PRN prescription for Demerol 100 mg PO q3h. The nurse notes that the client has become increasingly restless, irritable and confused, stating that there are bugs all over the walls. What action should the nurse take first? A) Administer a PRN dose of the PO meperidine (Demerol). B) Administer naloxone (Narcan) IV per PRN protocol. C) Decrease the IV infusion rate of the meperidine (Demerol) per protocol. D) Notify the healthcare provider of the client's confusion and hallucinations. | Decrease the IV infusion rate of the meperidine, Demerol per protocol Rationale: The client is exhibiting symptoms of Demerol toxicity, which is consistent with the large dose of Demerol received over four days. (C) is the most effective action to immediately decrease the amount of serum Demerol. (A) will increase the toxic level of medication in the bloodstream. Naloxone (B) is an opioid antagonist that is used during an opioid overdose, but it is not beneficial during Demerol toxicity and can precipitate seizures. The healthcare provider should be notified (D), but that is not the initial action the nurse should take; first the amount of drug infusing should be decreased. |
The healthcare provider prescribes naproxen Naproxen twice daily for a client with osteoarthritis of the hands. The client tells the nurse that the drug does not seem to be effective after three weeks. Which is the best response for the nurse to provide? A) The frequency of the dosing is necessary to increase the effectiveness. B) Therapeutic blood levels of this drug are reached in 4 to 6 weeks. C) Another type of nonsteroidal antiinflammatory drug may be indicated. D) Systemic corticosteroids are the next drugs of choice for pain relief. | Another type of nonsteroidal antiinflammatory drug may be indicated Rationale: Individual responses to nonsteroidal antiinflammatory drugs are variable, so (C) is the best response. Naproxen is usually prescribed every 8 hours, so (A) is not indicated. The peak for naproxen is one to two hours, not (B). Corticosteroids are not indicated for osteoarthritis (D). |
A client with heart failure is prescribed spironolactone Aldactone. Which information is most important for the nurse to provide to the client about diet modifications? A) Do not add salt to foods during preparation. B) Refrain for eating foods high in potassium. C) Restrict fluid intake to 1000 ml per day. D) Increase intake of milk and milk products. | Refrain for eating foods high in potassium Rationale: Spironolactone (Aldactone), an aldosterone antagonist, is a potassium-sparing diuretic, so a diet high in potassium should be avoided (B), including potassium salt substitutes, which can lead to hyperkalemia. Although (A) is a common diet modification in heart failure, the risk of hyperkalemia is more important with Aldactone. Restriction of fluids (C) or increasing milk and milk products (D) are not indicated with this prescription. |
A client asks the nurse if glipizide Glucotrol is an oral insulin. Which response should the nurse provide? A) "Yes, it is an oral insulin and has the same actions and properties as intermediate insulin." B) "Yes, it is an oral insulin and is distributed, metabolized, and excreted in the same manner as insulin." C) "No, it is not an oral insulin and can be used only when some beta cell function is present." D) "No, it is not an oral insulin, but it is effective for those who are resistant to injectable insulins." | "No, it is not an oral insulin and can be used only when some beta cell function is present." Rationale: An effective oral form of insulin has not yet been developed (C) because when insulin is taken orally, it is destroyed by digestive enzymes. Glipizide (Glucotrol) is an oral hypoglycemic agent that enhances pancreatic production of insulin. (A, B, and D) do not provide accurate information. |
A client with a dysrhythmia is to receive procainamide Pronestyl in 4 divided doses over the next 24 hours. What dosing schedule is best for the nurse to implement? A) q6h. B) QID. C) AC and bedtime. D) PC and bedtime. | q6h Rationale: Pronestyl is a class 1A antidysrhythmic. It should be taken around-the-clock (A) so that a stable blood level of the drug can be maintained, thereby decreasing the possibility of hypotension (an adverse effect) occurring because of too much of the drug circulating systemically at any particular time of day. (B, C, and D) do not provide an around-the-clock dosing schedule. Pronestyl may be given with food if GI distress is a problem, but an around-the-clock schedule should still be maintained. |
An adult client is given a prescription for a scopolamine patch Transderm Scop to prevent motion sickness while on a cruise. Which information should the nurse provide to the client? A) Apply the patch at least 4 hours prior to departure. B) Change the patch every other day while on the cruise. C) Place the patch on a hairless area at the base of the skull. D) Drink no more than 2 alcoholic drinks during the cruise. | Apply the patch at least 4 hours prior to departure Rationale: Scopolamine, an anticholinergic agent, is used to prevent motion sickness and has a peak onset in 6 hours, so the client should be instructed to apply the patch at least 4 hours before departure (A) on the cruise ship. The duration of the transdermal patch is 72 hours, so (B) is not needed. Scolopamine blocks muscarinic receptors in the inner ear and to the vomiting center, so the best application site of the patch is behind the ear, not at the base of the skull (C). Anticholinergic medications are CNS depressants, so the client should be instructed to avoid alcohol (D) while using the patch. |
An adult client has prescriptions for morphine sulfate 2.5 mg IV q6h and ketorolac Toradol 30 mg IV q6h. Which action should the nurse implement? A) Administer both medications according to the prescription. B) Hold the ketorolac to prevent an antagonistic effect. C) Hold the morphine to prevent an additive drug interaction. D) Contact the healthcare provider to clarify the prescription. | Administer both medications according to the prescription Rationale: Morphine and ketorolac (Toradol) can be administered concurrently (A), and may produce an additive analgesic effect, resulting in the ability to reduce the dose of morphine, as seen in this prescription. Toradol is an antiinflammatory analgesic, and does not have an antagonistic effect with morphine (B), like an agonist-antagonist medication would have. An additive analgesic effect is desirable (C), because it allows a reduced dose of morphine. This prescription does not require any clarification, and can be administered safely as written (D). |