Which of these statement indicated the clients’s understanding for nitroglycerin self care practice? 1 A- I should wait until I have taken 3 nitros before I call for help.B- I should stop what I’m doing and sit down before I take nitroglycerin for chest pain.C- I should keep unopened bottle of nitroglycerin in the freezerD- I can take nitroglycerin three time, but I need to spaced them three minute apart.What statement by the client taking levothyroxine indicates a need for further teaching ? 2 A- I should report in Sonya tremors on an increased hardware to my provider.B- If I take a Muti-vitamin with iron I should take it for four hours after levothyroxine.C- I should not take heartburn medication without talking with my provider.D- If I take calcium supplement I may need to decrease my dose of levothyroxineWhich side effect of clindamycin causes the most concern? 3 A- DiarrheaB- HeadacheC-NauseaD- VomitingA nurse teaching a client who has asthma the appropriate use of inhaled fluticasone. What advice should the nurse give to help the client avoid complications with the use of inhaled steroid? 4 A- Check the pulse after taking the medicationB- Take the medication before eatingC- Rinse your mouth after inhaling the medicationD- Limits your caffeine intakeA Nurse is reviewing the chart of an adult male client who has been taking oral androgens. Which assessment would warrant notifying the provider? 5 A- Acne and increased facial hairB- Breast enlargementC- Increased libidoD- Jaundice.The nurse reinforce instruction regarding when to take levothyroxine and determine teaching was effective when the client sates the medication should be taken in which manner? 6 A- With an antacidB- At bedtimeC- When they feel fatigueD- 30 mins before breakfastA client has infection caused by pseudomonas aeruginosa, and the provider order intravenous piperacillin and amilkacan. What will the nurse do? 7 A- Make sure to administer the drugs using different intravenous tubingB- Suggest giving more substantial doses of pipercillin and discontinuing the amilkacan.C- Suggest a fixed dose combination of piperacillin and tazobactamD- Watch the client closely for allergic reaction because this risk increase with this combination.A client who is recovering from total knee surgery is preparing for discharge. Which of these statement indicates the client needs further teaching? 8 A- Taking acetaminophen often could mask any infection-related fever 1 might haveB- I can rate acetaminophen with ibuprofen if needed for pain control, so I don’t take too much of either oneC- Taking more than 4000 mg of acetaminophen in a day can cause liver problemD- If I still have pain 20 mins after taking 1000 mg of acetaminophen, I should take two of oxycodone- acetaminophen.Which of a client’s medication is the most likely cause of a persistent dry cough? 9 A- EnalaprilB- AtorvastatinC- NifedipineD- HydrochlorothiazideParent ask the nurse why an OTC cough suppressant with sedative side effect is not recommended for infants. Which response by the nurse is correct ? 11 A- Babies have a more rapid gastric emptying time and don’t absorb drugs wellB- Cough medication taste bad, and infants usually won’t take itC- Infants are more susceptible to control nervous system effect than are adults.D- Infant metabolize drugs too rapidly, so drug aren’t effectiveWhat should the nurse include in discharge teaching regarding self- care for a client taking loop or thiazide diuretics? 12 A- Avoid fruits and potatoesB- Weigh daily and report and loss or gain exceeding two pounds in 24 hours to your providerC- walk at least a mile a dayD- Take the medication after supper to avoid mid-day urgency.7The nurse will include which of the following information when teaching a client about hydroxyzine? 13 A- The drug will reduce redness and itching but not edemaB- This medication is not likely to causeC- The client should avoid drinking alcohol while taking the drugD- The client should report shortness pf breath while taking the medicationThe nurse working on high- acuity medical surgical unit is prioritizing care for four client who were just admitted. Which client should the nurse asses first? 14 A- The NPO client with a blood glucose level of 80 mg/DI who just received 20 units of insulin lispro.B- The client with a pulse of 62 beat/min, about to receive digoxinC- The client with blood pressure of 136/92 mm hg. Who complain of having a headacheD- The client with an allergy to penicillin who is receiving an infusion of vancomycinA client who is taking calcium supplements receives a prescription for ciprofloxacin for a respiratory infection. What must the nurse include in the client teaching. 15 A- Consume extra fluids while taking the ciprofloxacinB- Stop taking the calcium supplement while taking the ciprofloxacinC- Take the two medication together to increase the absorption of bothD- Take the calcium either six hours before or two hours after taking the ciprofloxacinThe nurse is caring for a client who is receiving vancomycin. The nurse notes the client is experiencing flushing, rush, pruritus, and urticaria. The client’s heart rates is 120beats/min, and BP is 92/57 mm hg. The nurse knows that these finding are consistent with: 16 A- Allergic reactionB- Redman syndromeC- RhabdomyolysisD- Stevens-Johnson syndromeA client is admitted to the hospital and will begin taking cephalexin. The nurse learns that the client also takes warfarin. The nurse will notify the provider to discuss the dose 17 A- reducing cephalexinB- Reducing warfarinC- increasing cephalexinD- Increasing warfarinInsulin lispro was given a client at 7am by a night nurse who needs to leave early. At 7:30 am the client is clammy and refusing breakfast , stating ” I don’t feel well. I need to lie down.” what is the nurse next best action. 18 A- Check the blood sugar convince the client to drink juice of possible.B- Document the finding and let the client sleep since the insulin won’t peak until later in the morningC- Call the night nurse at home and tell her to come back and deal with the situationD- Wait to offer breakfast until the client feel better.What should the nurse include in a client discharge teaching when going home with a prescription of digoxin 0.125mg by mouth once daily 19 A- Take the med at bedtimeB- You must be able to check your pulseC- Don’t take digoxin if your heart rate exceeds 90 beat per minD- Eat a diet high in Bram fiber and calciumA person with type 2 diabetes is starting metformin therapy. Which comments by the client indicates a need for further teachinng.Q20 A- This medication may bother my stomachB- I should not take metformin on the day I have contact or on the two days after the dye studyC- This medication may be hard on my kidney I should take it with plenty of waterD- This medication my pancreas put out more insulin.Which statement indicates an asthmatic client understands discharge teaching regarding leukotriene blockers? Q21 A- This medication could cause me to develop a thrush infectionB- I should take this medication whenever I suddenly have difficulty breathingC- I should expect this medication will make me agitated but I don’t need to report that effect.D- This medication is taking once daily for the prevention of asthma.a pregnant client stopped using a prescription medication she takes for asthma because she doesn’t want to harm her baby. What will the nurse tell the client q80 A- astha medication will not harm the fetusB- stopping the medications for asthma doubles the chances of a stillbirthC- avoid taking medications during her pregnancyD- resume the medications in her second trimesterWhich actions occur in fatal medication errors? (Select all that apply) q81 A- confusing drugs with similar packagingB- giving a drug intravenously instead of intramuscularlyC- complicated drugs with name that look or sound alikeD- using barcode scanning to verify patients name and birthdateE- writing a prescription illegiblyIn which situation would the nurse hold digoxin? q82 A- when the lab reports a digoxin level of 1.2 ng/mlB- when the client is edematousC- when the client is pacing and very thirstyD- when the pulse is 54 and the patient complains of nausea and altered visionA client with bronchitis is taking trimethoprim/ sulfamethoxazole, 160/800 mg orally, twice daily. Before administering the third dose, the nurse observes the client has a widespread rash, a temo of 103 F, and a heart rate of 100 beats/ min. The client looks ill and reports not feeling well. what is the nurse’s best response? q84 A- administer the does and request an order for an antiepyretic medicationB- withhold the dose and request an order of antihistamine to treat the rashC- withhold the treatment and notify the provider of the symptomsD- request an order for intravenous trimethoprim/ sulfamethoxazoleA client taking warfarin presents with bruises, dark tarry stool, and an INR of 4.3. What is the nurse’s best response? q83 A- give the warfarin with dark green salad and check the next stool for bloodB- give an ampule of vitamin K then call the physician to report client statusC- explain to the client you may ask the provider to order a test for leukemiaD- hold the warfarin and consult the provider regarding the next stepsA client who is pregnant has a recurrent genital herpes virus. The client ask the nurse what will be done to suppress an outbreak when she is near term. What is the nurse’s best response? 85 A- antiviral medications are not safe during pregnancyB- Intravenous antiviral agents will be used if an outbreak occursC- oral acyclovir must be used to control outbreaksD- topical acyclovir must be use to control outbreaksWhich of these comments by a client taking a calcium channel blocker would indicate the need for addition teaching? q86 A- I will rise slowly from lying, sitting to standingB- I will take the medications with grapefruit juiceC- I will elevate my leg if edema occursD- I can limit my risk for constipation by increasing fluid and fiberA nurse is caring for a client who was recently started on lithium and is training a new nurse. What comment by the new nurse would require further teaching? q87 A- lithium is used to the treat bipolar depressionB- lithium is used to reduce euphoriaC- lithium will cause sedationD- lithium reduces hypersensitivityA nurse is preparing discharge teaching for a client who will be going home on warfarin. Which of these statements indicates the need for further instructions? q88 A- I should avoid alcohol and herbal remedies while I am taking warfarinB- I should be consistent with my intake of leafy green because they reverse warfarin effectsC- I should stop taking my warfarin if I get bruises or black stoolsD- I should have my bleeding time checking when I am taking antibioticsA third grader is starting methylphenidate. What counseling should the nurse provide for the child’s parents? q89 A- give the medications at bedtimeB- give the medication as neededC- store the medication in a safe place; it is a controlled substanceD- If you notice weight loss, switch dosing to every other dayA client with type 1 diabetes is eating breakfast at 7:30 AM, Which of these insulins would the nurse anticipate being ordered for a sliding scale and has an onset within 15 minutes? Q90 A- Insulin aspart protamine suspension 70% insulin aspart 30%B- NPHC- LantusD- Insulin lisproWhich of these self- care measures should be emphasized in the client education regarding phenytoin? Q92 A- Brush after every meal and floss teeth dailyB- Instill mineral oil into both ears once a weekC- gradually reduce prescribed dose if seizure do not occur for one monthD- expect green urine due to medication metabolitesA nurse is consent about renal function in an 84-year-old client who is taking several medications. what is a priority for the nurse to assess? Q22 A- specific GravityB- sodium levelC- troponin leveld- serum creatinineWhich of these findings from a client taking steroids should the nurse report immediately? Q23 A- temperature of 100.2 degree FahrenheitB- glucose 128mg/dlC heart rate of 92 beats per minuted- blood pressure of 144/68mm HgThe diabetic client receives a morning NPH insulin injection. What time should the client and nurse expect the NPH to reach its peak action? Q93 A- within 15 mins ( before breakfast)B- within two to four hrs ( before lunch)C- withing six to fourteen hrs ( before supper)D- within 18-24 hrs (in the middle of the night)A 50-year-old postmenopausal client who has had a hysterectomy has moderate to severe vasomotor symptoms and is discussing estrogen therapy with the nurse. What will the nurse tell the client regarding the adverse effect of estrogen therapy? Q94 A- the side effect will go away in exactly three day on their ownB- Why did you me? I don’t what you needC side effects of estrogen therapy are uncommon women of their age. You shouldn’t have any side effect. Are you sure these are side effects?D- please discuss this with your provider. There are transdermal preparations that lower the risk of side effectsA client with an infection is being treated with vancomycin. The nurse providing care reviews the clients lab reports and notes that the client’s blood urea nitrogen and serum creatine levels are newly elevated. What would be the priority nursing action? Q95 A- watch the client urine output and report it if it drops below 30ml/hrB- remind the provider to draw a peak and trough levelC- consult the provider about the need for less nephrotoxic medsD- instruct the client to notify you if they have any tingling in their toesA client presents with tinea corporis and the provider orders itraconazole. When education the client about this medication, the nurse will include which statement? Q96 A- apply the med over the entire body twice for two weeksB- sun exposure will minimize the drug’s effectsC- this drug is effective after a single applicationD- use the med for at least one week after the symptoms have clearedThe nurse is providing client education for a postmenopausal client, which risks associated with estrogen/ progestin therapy should the nurse discuss with the client? (SATA) Q97 A- increase colon cancerB- strokeC- deep vein thrombosisD- ovarian cancerdecreased bone densityA client has had emergency surgery for a ruptured appendix. Before surgery, the client was taking dexamethasone for three years. Since the client was on this med before surgery, the nurse would be most concerned about which complication in recovery phase? Q98 A- BradycardiaB- postoperative blood clotsC- pre-surgical dehydrationD- impaired would healingA male client tells the nurse he awakens once or twice each night to void and has difficulty starting his stream of urine. He describes these symptoms as “annoying”. The client’s provider examines him and notes that the prostate is moderately enlarged. The client is sexually active and tells the nurse that he does not want to take any meds that will interfere with sexual functions. The nurse anticipates the provider will order which of the following? Q99 A- DoxazosinB- FinasterideC- SilodosinD- A transurethral prostatectomyWhich factors can alter a client’s physiologic response to a med? (SATA) Q100 A- ability to swallow pillsB- ageC- genetic factorsD- genderE- heightA nurse is performing a preoperative drug history on a client who is admitted to the hospital for surgery. To evaluate the risk of bleeding, the nurse will ask the client about antiplatelet and anticoagulant medication as well as which dietary supplement? Q25 A- Coenzyme Q-10B- Ginkgo bilobaC- Ma HuangD- St. John’s Wortwhich side effect is most often cause by atenolol? q27 A- memory lossB- NeuropathyC- BradycardiaD- HyperglycemiaA client with type one diabetes who takes insulin reports taking propranolol for hypertension. why is the nurse concerned. q34 A- propranolol increase insulin requirement because of receptors blockingB- The beta blocker can mask the symptoms of hypoglycemiaC- The beta blocker can cause insulin resistanceD- Using the two agents together increase the risk of ketoacidosisA client who just took his first dose of glipizide is now experiencing tremors pallor and agitation. How should the nurse responds? q35 A- ask the clients family to come to sit with him until his panic attack subsidesB- Acknowledge how hard diagnosis of diabetes can be and offer to listen.C- Check the blood glucose and give carbohydrates if he is hypoglycemicD- give diphenhydramine per standing orderThe nurse is doing discharge teaching with the parent of an asthmatic child who will be going home on steroids. which of these comment by the parent would indicate as accurate understanding of discharge teaching regarding these medication. q36 A- Prolong steroid use causes children to grow prematurely tall because they enhance growthB- Prolong steroid use may lead to tolerance. Doses will need to increase over timeC- My child may need to take a gastric acids suppressor while taking steroidsD- Steroids cause weight loss and dehydration in children because they cause type 1 diabetesA client is discharge from the hospital with a prescription for trimethoprim/sulfamethoxazole. What must the nurse include in the discharge teaching? q38 A- Drink eight to ten glasses of water each dayB- Eat food that high in potassiumC- Rake the medication with foodD- Take folic acid supplementA client taking warfarin develops hyperurkemia and the provider orders prednisone for a flare up of gout. The nurse will contact the provider to discuss________the ________ dose q28 A- Increasing prednisoneB- Increasing warfarinC- Reducing prednisoneD- Reducing warfarinThe nurse is scheduled to administer insulin lispro per sliding scale before meal. The serum blood glucose reading before lunch is 280mg/dl. Given the following sliding scale, how much humalog insulin should be given before lunch? q33 A- if below 60 notify the providerB- if 60-124 no coverageC- if 125 -150 give two unitD- if 151-200 give four unitE- if 201 -205 give six unitF- if 251-300 give eight unitG- if over 300 notify the providerA client will being taking fexofenadine for hay fever. The nurse teaching this client which of the following? q 29 A- fexofenadine should be taken with food to prevent gastrointestinal symptomsB- The medication may be taken once or twice dailyC – Tolerance to sedation will occur in a few weeksD- With renal impairment, this drug should be taken every other dayThe nurse is caring for a pregnant client recently diagnose with hypothyroidism. The client tell the nurse she does not want to take medication while she is pregnant. What should the nurse explain to this client? q32 A- Hypothyroidism is a normal effect of pregnancy and usually is of no consequenceB- Neuropsychologic deficits in the fetus can occur if the condition is not treatedC- No danger to the fetus exists until the third trimesterD- Treatment is required if the client is experiencing symptomsThe parent of child with asthma ask the nurse why their child an not use oral corticosteroids more often because they are so effective. What is correct response by the nurse ? q30 A- chronic steroid use can inhibit growthB- Frequent use of this drug may lead to decrease responseC- A hypersensitivity reaction to drug may occurD- systemic steroids are more toxic in childrenWhen administering medication to infants it is essential to remember which of the following? ( Select all that apply) Q31 A- Breast feeding infants are more likely to develop toxicity when given lipid-soluble drugsB- Immaturity of renal function infancy causes infant to excrete drug less efficientlyC- Infant have immature livers, which slow drug metabolismD- Infant are more sensitive to medications that act on the central nervous systemsE- Oral medication are contraindicated in infants because the administration requires a cooperative client.A client is taking immunosuppressant medication develops a urinary tract infection. The causative organism is sensitive to sulfonamides and another, more expensive antibiotic. The prescriber orders the more expensive antibiotic. The nursing student assigned to this client ask the nurse why use more expensive medicine. Which response by the nurse is correct. Q26 A- immunosuppressed clients are folate deficientB- Client who ate immunosuppressed are more likely to develop resistanceC- sulfonamides are bacteriostaticD- Sulfornamides intensify the effects of immunosuppressionA client with cancer has been taking opioid analgesic for four times daily for several months and reports needing increased for dose for pain. What will the nurse tell the client? Q24 A- dosing of the drug be more effective on an as-needed basisB- The risk of respiratory depression increases with the providerC- The client should discuss increasing the dose with the providerD- The client should request the addition of benzodiazepine to assist with pain reliefWhat should a nurse advise a client on spironolactone regarding necessary self-care? q39 A- continue taking this medication even if you feel wellB- Avoid salt substitutesC- Add as many fruit and vegetables to your diet as possibleD- check your pulse before taking this medicationThe nurse will caution a client taking immunosuppressant drug to avoid which dietary supplement? q40 A- black cohoshB- EchinaceaC- FeverfewD- GlucosamineA young client with type 2 diabetes is receiving insulin glargine (Lantus) once a day when with the nurse anticipate administering this drug? q42 A- Approximately 15 to 30 minutes before each mealB- After meal and bedtimeC- At bedtimeD- In the morning and at 4:00 p.m.A will receive oral ciprofloxacia to treat urinary tract infection. The nurse provides teaching for client. Which statement by the client indicates a need for further teaching? q43 A- I may have abdominal pain and nausea, but these are usually mildB- I should take this medication with food or milk to improve absorptionC- I should stop taking the medication immediately if I experience heel painD- I will need to use sunscreen every time I go outdoorsA client has been taking a glococorticoid for several months arrives in the clinic. The nurse notes client chicks appear full and a prominent hump of fat is present on the upper back. The nurse will ask the provider to order which of these laboratory tests? q44 A- Liver function testB- Serum electrolytesC- Tuberculosis skin testD- Vitamin D levelsA client who takes 324mg of aspirin daily is schedule for surgery next week. Which of the following would the nurse expect the provider to order? q45 A- Continue to use aspirin as scheduledB- Reduce the aspirin dosage by half unit after surgeryC- Stop using aspirin immediatelyD- Stop using aspirin three days before surgery.A client who is receiving a final dose of intravenous cephalosporin complain of pain and irritation at the infusion site. The nurse observes signs of redness at the intravenous insertion site and along the vein. What is the nurse’s priority action? q46 A- Apply warm packs to the arm and infuse the medication at a slower rateB- Continue the infusion while elevating the armC- Select an alternate intravenous siteD- Request central venous accessWhich of these situations would cause the nurse to hold a dose of morphine? q47 A- The heat rate is above 90 beat by manyB- The blood pressure is above 140mmHg systolicC- Respiratory rate of 10 breath per minute with an oxygen saturation level of 86%D- The temperature is above 38ﾟCWhich statement by the client indicates an understanding of safe care precautions when taking warfarin? q48 A- I should eat spinach to increase my iron count if my INR goes below twoB- Herbal remedies are fine but I shouldn’t take aspirin without consulting my providerC- My coumadin dose may need to be reinjected when I take a course of antibioticsD- I should expect pink urine due to metabolic bi-products of the dye used in this medicationNaloxone is effective because of which action? q49 A- Countering the effects of morphine sulfate by agonistB- Increasing the excretion of morphine sulfate by altering serum PHC- Preventing activations of opioid receptors through antagonist actionsD- Regulating the sensitivity of opioid receptors by neurochemical alterationsA prescriber order cefoxitin for a client who has an infection caused by grams negative bacteria. The nurse notes in the medication history the client experienced a maculopapular rash when taking amoxicillin several years earlier. what is the nurse best response? q50 A- administer the cefoxitin and observe for any side effectsB- Give the cefoxitin and have epinephrine and respiratory support availableC- Request an order for a different non-penicillin, non-cephalosporin antibioticD- Request an order to administer a skin test before giving the cefoxitinThe nurse is explaining why epidural analgesia is the recommended route for pain medication during labor. Which of these factors pertaining to infant kinetics explain the need to keep analgesia confined to the maternal neurological system? (Select all that apply) q 51 A- The infant blood-brain barrier is underdevelopedB- The infants liver and renal system are underdevelopedC- The infant will experience withdrawal syndrome when born, even if the mother is opiate naiveD- The infant will be less able to tolerate respiratory suppressionE- the infant will develop a detachment syndrome that will affect its life-long developmentA prescriber has ordered medication for a newborn that is eliminated primarily by hepatic metabolism. What would the nurse expect the prescriber to ordere? q52 A- Order a dose that is lower than an adult doseB- Order a dose that is higher than an adult doseC- Increase the frequency of the medicationD- Discontinue the drug after one or two treatmentsQ61) A client who has type 2 diabetes begin taking glipizide. Which statement by the client CONCERNS the nurse? A-I will begin taking this once daily with breakfastB- I should not take this medication if I have a sulfate allergyC- I will need to check my blood sugar once daily or moreD- I may continue to have a glass of wine with dinnerDQ62) A client with NKDA is receiving amoxicillin PO twice daily. Twenty minutes after being given a dose, the client complains of SOB with a blood pressure of 100/58mm Hg. What will the nurse do? A- Contact the provider and prepare to administer epinephrineB- Notify the provider if the client develops a rashC- Request an order for a skin test to evaluate possible penicillin allergyD- Withhold the next drugs until symptoms subsideAQ63) What must a nurse include in a client education for an arthritic client taking high doses of aspirin? (select all that apply) A- Aspirin causes gastric erosion, so take it with food.B- Report bruises, bleeding gums, tarry stools, and pink urineC- Call your provider for ringing in the earsD- Aspirin is nephrotoxicE_ Aspirin is preferred to acetaminophen in the control of fevers in childrenA,B,DQ64) A nurse is educating a client regarding the use of pantoprazole. What statement by the client shows proper understanding of how to take the medicine? A- I should chew the medication when my heartburn is bad, so it absorbs more rapidlyB- I should plan to take this medication for the rest of my life.C- I should take this medication on an empty stomach before I eatD- I Should take this medication with an antacid to maximize its effects.CQ65) A nurse is providing client education for the application of transdermal estrogen spray. Where should the client be advice to apply the topical spray? A- Apply it to the axillaB- Apply it to the breastC- Apply it to the genitalsD- Apply it to the inner forearm.DQ66) A nurse is talking with a client who has peptic ulcer disease and starting therapy with sucralfate. What must the nurse include in the client’s education? A- Take it with an antacidB- Take 30-60 minutes before mealsC- Take it whenever indigestion occursD- Take it immediately after mealsBQ67) A client who has erectile dysfunction asks a nurse whether sidena… would be a suitable medication. Which aspect of this client’s history would be of concern? A- benign prostate hypertrophyB- Mild hypertensionC- occasional use of nitroglycerinD- Taking finasteride.CQ68). A client is starting to take furosemide and ask the nurse, “when is the best time to take this medication” A-2200B- 1600C- 0800D- 1900Q69) A nurse is providing teaching for an adult client with arthritis who is been instructed to take ibuprofen for discomfort. Which statement by the client indicates a need for further instructions ? A- I may experience tinnitus with higher doses of this medicationB- I may take up to 800 mg four times daily for painC- I should limit alcohol intake to fewer than three drinks a dayD- I will take this medication with meal to help prevent stomach upsetCQ70) A nurse understands that a bronchodilator would be most therapeutic in which situation? A- Shallow breath sounds with wheezing sound in the upper lobesB- Course crackles in the right lower lobesC- Fine, scattered crackles heard bilaterally in the basesD- irregular respiration, snoring and intermittent episodes of apneaAQ71) A client with chronic gout has been taking colchicine for several months and is admitted for acute gout pain. The prescriber plans to begin therapy with probenecid. What will the nurse do? A- Give the medication as ordered and observe the client for gastrointestinal side effectB- Request an order to lower the colchicineC- Restrict the client’s fluid intake to minimize the risk of renal injuryD- Suggest delaying probenecid therapy until the acute episode has subsidedE- Suggest delaying probenecid therapy until the acute episode has subsidedD,EQ72) A nurse tells a nursing student glucocorticoids given for rheumatoid arthritis are nearly identical to substances produced naturally by the body. The student remarks that the drugs must be very safe. Which response by the nurse is correct? A- As long as the drug is take as prescribe, side effects usually do not occurB- By interrupting the inflammatory process, these drugs inhibits side effectsC- Side effects can occur and are dependent on the dose and duration of treatmentD- The negative feedback loop prevents side effects.CQ73) The nurse is talking with a new mother about medications that can safely be resumed now that she is no longer pregnant. All of the following medications are forbidden during pregnancy, but which one may be ingested while breastfeeding, without causing known infants harms? A- methotrexateB-IbuprofenC- LithiumD- NicotineBQ74) The nurse is caring for a client receiving intravenous acyclovir. To prevent nephrotoxicity. What is the nurse’s best action? A- Hydrate the client during the infusion and after the infusion.B- Increase the client’s intake of foods rich in vitamin CC- Monitor urinary output every 30 minutesD- Provide a low protein diet for one a dayE- Provide a low protein diet for one day before and two day days after the acyclovir infusion.AQ75) A client is taking a drug that has known toxic side effects. What will the nurse do? A- Discontinue the drug at the first signs of toxicityB- Ensure that CBC are ordered periodicallyC- Monitor the function of all organs potentially affected by the drugD- Teach the client how to treat the symptoms if they developCQ76) A nurse is teaching a client who has taken glucocorticoids for over a year for glucocorticoids withdrawal. Which statement by the client indicates a need for further teaching? A- I should the dose by half each day until I stop taking the drugB- I will need to have cortisol levels monitored during the withdrawal processC- The withdrawal schedule may take several monthsD- If I have surgery, I may need to resume taking the drugAQ77) A client receiving a cephalosporin develops a secondary intestinal infection caused by clostridium difficile. What is an appropriate treatment for this client? A-Adding an antibiotic, such as tobramycin, to the client’s regimenB- Discontinuing the cephalosporin and beginning metronidazoleC- Stopping all antibiotic and providing fluid replacementD- Increasing the dose of the cephalosporin and providing isolation measures.BQ78) A nurse is giving discharge instruction to a client who is beginning theophylline. The nurse should tell the client that this medication might cause which of the following adverse effects? A- DrowsinessB- ConstipationC- OliguriaD- TachycardiaDQ79) The nurse is teaching a group of nursing students about administering medication to older adult clients. Which statement by a student indicate a need for further teaching? A- Alteration in hepatic function requires more frequent drug dosingB- Changes in gastrointestinal function in older adult clients lead to lower serum drug levelsC- Adverse drug reaction in older adult clients are related to altered renal functionD- Nonadherence for medication among older clients is due to the cost of the medicationsAQ80) A pregnant woman stopped using a prescription medication she takes for asthma because she doesn’t want to harm her baby. What will the nurse tell the client? A- Asthma medication will not affect the fetusB- Stopping medications for asthma doubles the chances of a stillbirthC-Avoid taking medication during her pregnancyD- Resume the medications in her second trimesterBA nurse is caring for a client and newborn immediately after delivery. The client’s medication history includes prenatal vitamins throughout pregnancy, one or two glasses of wine before knowing she was pregnant, occasional use of an albuterol inhaler in her last trimester, and intravenous morphine during labor. What is the nurse’s most appropriate action? q53 A- Administer opioid to the infant to prevent withdrawal syndromeB- Monitor the infant respiratory and prepare to administer naloxone if neededC- Note a high-pitched cry and irritability in the infant and observe for seizuresD- prepare the client for motor delays in the infant caused by alcohol useWhich of these statements best describes the concept of half-life?q54 A- It is the time it takes for half of the medication to be metabolized for elimination of the medicationB- It is the time it takes for half of the medication effect effects to be achievedC- it is the time it takes for half of the medication to be distributed to receptorsD- The term refers to the half life of the drugA pregnant client asked the nurse if she can take antihistamines for seasonal allergies during her pregnancy. What will the nurse tell the client? q55 A- Antihistamines should be avoided in pregnancy unless absolutely necessaryB- Second-generation Antihistamines are completely safe to take during the first trimesterC- Antihistamines are safe to take during breastfeeding, but they cause spina bifida in pregnancyD- the margin of safety for Antihistamines is clearly understood for pregnant clients.A client who report routine consumption more than three alcoholic beverages per day ask about taking acetaminophen when needed for occasional recurrent pain. what will the nurse tell the client? Q56 A- Do not take more than 2 mg of acetaminophen a dayB- D not take more than 3 mg of acetaminophen a dayC- Do not take more than 4 mg of acetaminophen a dayD- do not take a fixed dose preparation acetaminophen with opioid analgesic.A cardiac client has bee given a prescription or nifedipine extended release. which statement provide in the discharge teaching is incorrect. Q57 A- You crush the tablet and dissolve the particles under your tongue if chest pain occurs.B- Expect constipation with this medicationC- This medication can make your feet retain fluidD- Limit your intake of grapefruit when taking this medicine to avoid toxicityA client who has abdominal surgery has been receiving morphine sulfate via client- controlled analgesia. The nurse assess the client and notes that the clients pupils are constricted and the client is drowsy and lethargic. The client’s heart rate is 84 beats/min, their respiratory rate is 10 beat per minutes, and their blood pressure is 90/50 mm hg. What is the nurse’s best action? Q58 A- Encourage the client to turn over and cough and take deep breaths.B- Discuss possible oplate dependence with the client’s providerC- Note the effectiveness of the analgesia in the clients chartD- prepare to administer naloxone and provide ventilatory support.which of these findings would cause the nurse to hold the administration of oral metoprolol ?Q60 A- Heart rate of 92 beat per minuteB- Respiratory rate of 26 breath per minutesC- Blood pressure of 92/44 mmhgD- Oxygen saturation level of 95% on room air.A nurse is administering morphine sulfate to a postoperative client. Which are the appropriate routine nursing action when giving this drug? select all that apply 59 A- Requesting an order for methynaltrexone to prevent constipationB- Facilitating physical activity and offer fluid if GI function have returnedC – Monitoring the client’s blood pressure closely for hypertensionD- Counting respiration before and after giving the medicationE – Assessing GI function every 4 to 6 hours

QuestionWhich of these statement indicated the clients’s understanding for…Which of these statement indicated the clients’s understanding for nitroglycerin self care practice? 1 A- I should wait until I have taken 3 nitros before I call for help.B- I should stop what I’m doing and sit down before I take nitroglycerin for chest pain.C- I should keep unopened bottle of nitroglycerin in the freezerD- I can take nitroglycerin three time, but I need to spaced them three minute apart.What statement by the client taking levothyroxine indicates a need for further teaching ? 2 A- I should report in Sonya tremors on an increased hardware to my provider.B- If I take a Muti-vitamin with iron I should take it for four hours after levothyroxine.C- I should not take heartburn medication without talking with my provider.D- If I take calcium supplement I may need to decrease my dose of levothyroxineWhich side effect of clindamycin causes the most concern? 3 A- DiarrheaB- HeadacheC-NauseaD- VomitingA nurse teaching a client who has asthma the appropriate use of inhaled fluticasone. What advice should the nurse give to help the client avoid complications with the use of inhaled steroid? 4 A- Check the pulse after taking the medicationB- Take the medication before eatingC- Rinse your mouth after inhaling the medicationD- Limits your caffeine intakeA Nurse is reviewing the chart of an adult male client who has been taking oral androgens. Which assessment would warrant notifying the provider? 5 A- Acne and increased facial hairB- Breast enlargementC- Increased libidoD- Jaundice.The nurse reinforce instruction regarding when to take levothyroxine and determine teaching was effective when the client sates the medication should be taken in which manner? 6 A- With an antacidB- At bedtimeC- When they feel fatigueD- 30 mins before breakfastA client has infection caused by pseudomonas aeruginosa, and the provider order intravenous piperacillin and amilkacan. What will the nurse do? 7 A- Make sure to administer the drugs using different intravenous tubingB- Suggest giving more substantial doses of pipercillin and discontinuing the amilkacan.C- Suggest a fixed dose combination of piperacillin and tazobactamD- Watch the client closely for allergic reaction because this risk increase with this combination.A client who is recovering from total knee surgery is preparing for discharge. Which of these statement indicates the client needs further teaching? 8 A- Taking acetaminophen often could mask any infection-related fever 1 might haveB- I can rate acetaminophen with ibuprofen if needed for pain control, so I don’t take too much of either oneC- Taking more than 4000 mg of acetaminophen in a day can cause liver problemD- If I still have pain 20 mins after taking 1000 mg of acetaminophen, I should take two of oxycodone- acetaminophen.Which of a client’s medication is the most likely cause of a persistent dry cough? 9 A- EnalaprilB- AtorvastatinC- NifedipineD- HydrochlorothiazideParent ask the nurse why an OTC cough suppressant with sedative side effect is not recommended for infants. Which response by the nurse is correct ? 11 A- Babies have a more rapid gastric emptying time and don’t absorb drugs wellB- Cough medication taste bad, and infants usually won’t take itC- Infants are more susceptible to control nervous system effect than are adults.D- Infant metabolize drugs too rapidly, so drug aren’t effectiveWhat should the nurse include in discharge teaching regarding self- care for a client taking loop or thiazide diuretics? 12 A- Avoid fruits and potatoesB- Weigh daily and report and loss or gain exceeding two pounds in 24 hours to your providerC- walk at least a mile a dayD- Take the medication after supper to avoid mid-day urgency.7The nurse will include which of the following information when teaching a client about hydroxyzine? 13 A- The drug will reduce redness and itching but not edemaB- This medication is not likely to causeC- The client should avoid drinking alcohol while taking the drugD- The client should report shortness pf breath while taking the medicationThe nurse working on high- acuity medical surgical unit is prioritizing care for four client who were just admitted. Which client should the nurse asses first? 14 A- The NPO client with a blood glucose level of 80 mg/DI who just received 20 units of insulin lispro.B- The client with a pulse of 62 beat/min, about to receive digoxinC- The client with blood pressure of 136/92 mm hg. Who complain of having a headacheD- The client with an allergy to penicillin who is receiving an infusion of vancomycinA client who is taking calcium supplements receives a prescription for ciprofloxacin for a respiratory infection. What must the nurse include in the client teaching. 15 A- Consume extra fluids while taking the ciprofloxacinB- Stop taking the calcium supplement while taking the ciprofloxacinC- Take the two medication together to increase the absorption of bothD- Take the calcium either six hours before or two hours after taking the ciprofloxacinThe nurse is caring for a client who is receiving vancomycin. The nurse notes the client is experiencing flushing, rush, pruritus, and urticaria. The client’s heart rates is 120beats/min, and BP is 92/57 mm hg. The nurse knows that these finding are consistent with: 16 A- Allergic reactionB- Redman syndromeC- RhabdomyolysisD- Stevens-Johnson syndromeA client is admitted to the hospital and will begin taking cephalexin. The nurse learns that the client also takes warfarin. The nurse will notify the provider to discuss the dose 17 A- reducing cephalexinB- Reducing warfarinC- increasing cephalexinD- Increasing warfarinInsulin lispro was given a client at 7am by a night nurse who needs to leave early. At 7:30 am the client is clammy and refusing breakfast , stating ” I don’t feel well. I need to lie down.” what is the nurse next best action. 18 A- Check the blood sugar convince the client to drink juice of possible.B- Document the finding and let the client sleep since the insulin won’t peak until later in the morningC- Call the night nurse at home and tell her to come back and deal with the situationD- Wait to offer breakfast until the client feel better.What should the nurse include in a client discharge teaching when going home with a prescription of digoxin 0.125mg by mouth once daily 19 A- Take the med at bedtimeB- You must be able to check your pulseC- Don’t take digoxin if your heart rate exceeds 90 beat per minD- Eat a diet high in Bram fiber and calciumA person with type 2 diabetes is starting metformin therapy. Which comments by the client indicates a need for further teachinng.Q20 A- This medication may bother my stomachB- I should not take metformin on the day I have contact or on the two days after the dye studyC- This medication may be hard on my kidney I should take it with plenty of waterD- This medication my pancreas put out more insulin.Which statement indicates an asthmatic client understands discharge teaching regarding leukotriene blockers? Q21 A- This medication could cause me to develop a thrush infectionB- I should take this medication whenever I suddenly have difficulty breathingC- I should expect this medication will make me agitated but I don’t need to report that effect.D- This medication is taking once daily for the prevention of asthma.a pregnant client stopped using a prescription medication she takes for asthma because she doesn’t want to harm her baby. What will the nurse tell the client q80 A- astha medication will not harm the fetusB- stopping the medications for asthma doubles the chances of a stillbirthC- avoid taking medications during her pregnancyD- resume the medications in her second trimesterWhich actions occur in fatal medication errors? (Select all that apply) q81 A- confusing drugs with similar packagingB- giving a drug intravenously instead of intramuscularlyC- complicated drugs with name that look or sound alikeD- using barcode scanning to verify patients name and birthdateE- writing a prescription illegiblyIn which situation would the nurse hold digoxin? q82 A- when the lab reports a digoxin level of 1.2 ng/mlB- when the client is edematousC- when the client is pacing and very thirstyD- when the pulse is 54 and the patient complains of nausea and altered visionA client with bronchitis is taking trimethoprim/ sulfamethoxazole, 160/800 mg orally, twice daily. Before administering the third dose, the nurse observes the client has a widespread rash, a temo of 103 F, and a heart rate of 100 beats/ min. The client looks ill and reports not feeling well. what is the nurse’s best response? q84 A- administer the does and request an order for an antiepyretic medicationB- withhold the dose and request an order of antihistamine to treat the rashC- withhold the treatment and notify the provider of the symptomsD- request an order for intravenous trimethoprim/ sulfamethoxazoleA client taking warfarin presents with bruises, dark tarry stool, and an INR of 4.3. What is the nurse’s best response? q83 A- give the warfarin with dark green salad and check the next stool for bloodB- give an ampule of vitamin K then call the physician to report client statusC- explain to the client you may ask the provider to order a test for leukemiaD- hold the warfarin and consult the provider regarding the next stepsA client who is pregnant has a recurrent genital herpes virus. The client ask the nurse what will be done to suppress an outbreak when she is near term. What is the nurse’s best response? 85 A- antiviral medications are not safe during pregnancyB- Intravenous antiviral agents will be used if an outbreak occursC- oral acyclovir must be used to control outbreaksD- topical acyclovir must be use to control outbreaksWhich of these comments by a client taking a calcium channel blocker would indicate the need for addition teaching? q86 A- I will rise slowly from lying, sitting to standingB- I will take the medications with grapefruit juiceC- I will elevate my leg if edema occursD- I can limit my risk for constipation by increasing fluid and fiberA nurse is caring for a client who was recently started on lithium and is training a new nurse. What comment by the new nurse would require further teaching? q87 A- lithium is used to the treat bipolar depressionB- lithium is used to reduce euphoriaC- lithium will cause sedationD- lithium reduces hypersensitivityA nurse is preparing discharge teaching for a client who will be going home on warfarin. Which of these statements indicates the need for further instructions? q88 A- I should avoid alcohol and herbal remedies while I am taking warfarinB- I should be consistent with my intake of leafy green because they reverse warfarin effectsC- I should stop taking my warfarin if I get bruises or black stoolsD- I should have my bleeding time checking when I am taking antibioticsA third grader is starting methylphenidate. What counseling should the nurse provide for the child’s parents? q89 A- give the medications at bedtimeB- give the medication as neededC- store the medication in a safe place; it is a controlled substanceD- If you notice weight loss, switch dosing to every other dayA client with type 1 diabetes is eating breakfast at 7:30 AM, Which of these insulins would the nurse anticipate being ordered for a sliding scale and has an onset within 15 minutes? Q90 A- Insulin aspart protamine suspension 70% insulin aspart 30%B- NPHC- LantusD- Insulin lisproWhich of these self- care measures should be emphasized in the client education regarding phenytoin? Q92 A- Brush after every meal and floss teeth dailyB- Instill mineral oil into both ears once a weekC- gradually reduce prescribed dose if seizure do not occur for one monthD- expect green urine due to medication metabolitesA nurse is consent about renal function in an 84-year-old client who is taking several medications. what is a priority for the nurse to assess? Q22 A- specific GravityB- sodium levelC- troponin leveld- serum creatinineWhich of these findings from a client taking steroids should the nurse report immediately? Q23 A- temperature of 100.2 degree FahrenheitB- glucose 128mg/dlC heart rate of 92 beats per minuted- blood pressure of 144/68mm HgThe diabetic client receives a morning NPH insulin injection. What time should the client and nurse expect the NPH to reach its peak action? Q93 A- within 15 mins ( before breakfast)B- within two to four hrs ( before lunch)C- withing six to fourteen hrs ( before supper)D- within 18-24 hrs (in the middle of the night)A 50-year-old postmenopausal client who has had a hysterectomy has moderate to severe vasomotor symptoms and is discussing estrogen therapy with the nurse. What will the nurse tell the client regarding the adverse effect of estrogen therapy? Q94 A- the side effect will go away in exactly three day on their ownB- Why did you me? I don’t what you needC side effects of estrogen therapy are uncommon women of their age. You shouldn’t have any side effect. Are you sure these are side effects?D- please discuss this with your provider. There are transdermal preparations that lower the risk of side effectsA client with an infection is being treated with vancomycin. The nurse providing care reviews the clients lab reports and notes that the client’s blood urea nitrogen and serum creatine levels are newly elevated. What would be the priority nursing action? Q95 A- watch the client urine output and report it if it drops below 30ml/hrB- remind the provider to draw a peak and trough levelC- consult the provider about the need for less nephrotoxic medsD- instruct the client to notify you if they have any tingling in their toesA client presents with tinea corporis and the provider orders itraconazole. When education the client about this medication, the nurse will include which statement? Q96 A- apply the med over the entire body twice for two weeksB- sun exposure will minimize the drug’s effectsC- this drug is effective after a single applicationD- use the med for at least one week after the symptoms have clearedThe nurse is providing client education for a postmenopausal client, which risks associated with estrogen/ progestin therapy should the nurse discuss with the client? (SATA) Q97 A- increase colon cancerB- strokeC- deep vein thrombosisD- ovarian cancerdecreased bone densityA client has had emergency surgery for a ruptured appendix. Before surgery, the client was taking dexamethasone for three years. Since the client was on this med before surgery, the nurse would be most concerned about which complication in recovery phase? Q98 A- BradycardiaB- postoperative blood clotsC- pre-surgical dehydrationD- impaired would healingA male client tells the nurse he awakens once or twice each night to void and has difficulty starting his stream of urine. He describes these symptoms as “annoying”. The client’s provider examines him and notes that the prostate is moderately enlarged. The client is sexually active and tells the nurse that he does not want to take any meds that will interfere with sexual functions. The nurse anticipates the provider will order which of the following? Q99 A- DoxazosinB- FinasterideC- SilodosinD- A transurethral prostatectomyWhich factors can alter a client’s physiologic response to a med? (SATA) Q100 A- ability to swallow pillsB- ageC- genetic factorsD- genderE- heightA nurse is performing a preoperative drug history on a client who is admitted to the hospital for surgery. To evaluate the risk of bleeding, the nurse will ask the client about antiplatelet and anticoagulant medication as well as which dietary supplement? Q25 A- Coenzyme Q-10B- Ginkgo bilobaC- Ma HuangD- St. John’s Wortwhich side effect is most often cause by atenolol? q27 A- memory lossB- NeuropathyC- BradycardiaD- HyperglycemiaA client with type one diabetes who takes insulin reports taking propranolol for hypertension. why is the nurse concerned. q34 A- propranolol increase insulin requirement because of receptors blockingB- The beta blocker can mask the symptoms of hypoglycemiaC- The beta blocker can cause insulin resistanceD- Using the two agents together increase the risk of ketoacidosisA client who just took his first dose of glipizide is now experiencing tremors pallor and agitation. How should the nurse responds? q35 A- ask the clients family to come to sit with him until his panic attack subsidesB- Acknowledge how hard diagnosis of diabetes can be and offer to listen.C- Check the blood glucose and give carbohydrates if he is hypoglycemicD- give diphenhydramine per standing orderThe nurse is doing discharge teaching with the parent of an asthmatic child who will be going home on steroids. which of these comment by the parent would indicate as accurate understanding of discharge teaching regarding these medication. q36 A- Prolong steroid use causes children to grow prematurely tall because they enhance growthB- Prolong steroid use may lead to tolerance. Doses will need to increase over timeC- My child may need to take a gastric acids suppressor while taking steroidsD- Steroids cause weight loss and dehydration in children because they cause type 1 diabetesA client is discharge from the hospital with a prescription for trimethoprim/sulfamethoxazole. What must the nurse include in the discharge teaching? q38 A- Drink eight to ten glasses of water each dayB- Eat food that high in potassiumC- Rake the medication with foodD- Take folic acid supplementA client taking warfarin develops hyperurkemia and the provider orders prednisone for a flare up of gout. The nurse will contact the provider to discuss________the ________ dose q28 A- Increasing prednisoneB- Increasing warfarinC- Reducing prednisoneD- Reducing warfarinThe nurse is scheduled to administer insulin lispro per sliding scale before meal. The serum blood glucose reading before lunch is 280mg/dl. Given the following sliding scale, how much humalog insulin should be given before lunch? q33 A- if below 60 notify the providerB- if 60-124 no coverageC- if 125 -150 give two unitD- if 151-200 give four unitE- if 201 -205 give six unitF- if 251-300 give eight unitG- if over 300 notify the providerA client will being taking fexofenadine for hay fever. The nurse teaching this client which of the following? q 29 A- fexofenadine should be taken with food to prevent gastrointestinal symptomsB- The medication may be taken once or twice dailyC – Tolerance to sedation will occur in a few weeksD- With renal impairment, this drug should be taken every other dayThe nurse is caring for a pregnant client recently diagnose with hypothyroidism. The client tell the nurse she does not want to take medication while she is pregnant. What should the nurse explain to this client? q32 A- Hypothyroidism is a normal effect of pregnancy and usually is of no consequenceB- Neuropsychologic deficits in the fetus can occur if the condition is not treatedC- No danger to the fetus exists until the third trimesterD- Treatment is required if the client is experiencing symptomsThe parent of child with asthma ask the nurse why their child an not use oral corticosteroids more often because they are so effective. What is correct response by the nurse ? q30 A- chronic steroid use can inhibit growthB- Frequent use of this drug may lead to decrease responseC- A hypersensitivity reaction to drug may occurD- systemic steroids are more toxic in childrenWhen administering medication to infants it is essential to remember which of the following? ( Select all that apply) Q31 A- Breast feeding infants are more likely to develop toxicity when given lipid-soluble drugsB- Immaturity of renal function infancy causes infant to excrete drug less efficientlyC- Infant have immature livers, which slow drug metabolismD- Infant are more sensitive to medications that act on the central nervous systemsE- Oral medication are contraindicated in infants because the administration requires a cooperative client.A client is taking immunosuppressant medication develops a urinary tract infection. The causative organism is sensitive to sulfonamides and another, more expensive antibiotic. The prescriber orders the more expensive antibiotic. The nursing student assigned to this client ask the nurse why use more expensive medicine. Which response by the nurse is correct. Q26 A- immunosuppressed clients are folate deficientB- Client who ate immunosuppressed are more likely to develop resistanceC- sulfonamides are bacteriostaticD- Sulfornamides intensify the effects of immunosuppressionA client with cancer has been taking opioid analgesic for four times daily for several months and reports needing increased for dose for pain. What will the nurse tell the client? Q24 A- dosing of the drug be more effective on an as-needed basisB- The risk of respiratory depression increases with the providerC- The client should discuss increasing the dose with the providerD- The client should request the addition of benzodiazepine to assist with pain reliefWhat should a nurse advise a client on spironolactone regarding necessary self-care? q39 A- continue taking this medication even if you feel wellB- Avoid salt substitutesC- Add as many fruit and vegetables to your diet as possibleD- check your pulse before taking this medicationThe nurse will caution a client taking immunosuppressant drug to avoid which dietary supplement? q40 A- black cohoshB- EchinaceaC- FeverfewD- GlucosamineA young client with type 2 diabetes is receiving insulin glargine (Lantus) once a day when with the nurse anticipate administering this drug? q42 A- Approximately 15 to 30 minutes before each mealB- After meal and bedtimeC- At bedtimeD- In the morning and at 4:00 p.m.A will receive oral ciprofloxacia to treat urinary tract infection. The nurse provides teaching for client. Which statement by the client indicates a need for further teaching? q43 A- I may have abdominal pain and nausea, but these are usually mildB- I should take this medication with food or milk to improve absorptionC- I should stop taking the medication immediately if I experience heel painD- I will need to use sunscreen every time I go outdoorsA client has been taking a glococorticoid for several months arrives in the clinic. The nurse notes client chicks appear full and a prominent hump of fat is present on the upper back. The nurse will ask the provider to order which of these laboratory tests? q44 A- Liver function testB- Serum electrolytesC- Tuberculosis skin testD- Vitamin D levelsA client who takes 324mg of aspirin daily is schedule for surgery next week. Which of the following would the nurse expect the provider to order? q45 A- Continue to use aspirin as scheduledB- Reduce the aspirin dosage by half unit after surgeryC- Stop using aspirin immediatelyD- Stop using aspirin three days before surgery.A client who is receiving a final dose of intravenous cephalosporin complain of pain and irritation at the infusion site. The nurse observes signs of redness at the intravenous insertion site and along the vein. What is the nurse’s priority action? q46 A- Apply warm packs to the arm and infuse the medication at a slower rateB- Continue the infusion while elevating the armC- Select an alternate intravenous siteD- Request central venous accessWhich of these situations would cause the nurse to hold a dose of morphine? q47 A- The heat rate is above 90 beat by manyB- The blood pressure is above 140mmHg systolicC- Respiratory rate of 10 breath per minute with an oxygen saturation level of 86%D- The temperature is above 38ﾟCWhich statement by the client indicates an understanding of safe care precautions when taking warfarin? q48 A- I should eat spinach to increase my iron count if my INR goes below twoB- Herbal remedies are fine but I shouldn’t take aspirin without consulting my providerC- My coumadin dose may need to be reinjected when I take a course of antibioticsD- I should expect pink urine due to metabolic bi-products of the dye used in this medicationNaloxone is effective because of which action? q49 A- Countering the effects of morphine sulfate by agonistB- Increasing the excretion of morphine sulfate by altering serum PHC- Preventing activations of opioid receptors through antagonist actionsD- Regulating the sensitivity of opioid receptors by neurochemical alterationsA prescriber order cefoxitin for a client who has an infection caused by grams negative bacteria. The nurse notes in the medication history the client experienced a maculopapular rash when taking amoxicillin several years earlier. what is the nurse best response? q50 A- administer the cefoxitin and observe for any side effectsB- Give the cefoxitin and have epinephrine and respiratory support availableC- Request an order for a different non-penicillin, non-cephalosporin antibioticD- Request an order to administer a skin test before giving the cefoxitinThe nurse is explaining why epidural analgesia is the recommended route for pain medication during labor. Which of these factors pertaining to infant kinetics explain the need to keep analgesia confined to the maternal neurological system? (Select all that apply) q 51 A- The infant blood-brain barrier is underdevelopedB- The infants liver and renal system are underdevelopedC- The infant will experience withdrawal syndrome when born, even if the mother is opiate naiveD- The infant will be less able to tolerate respiratory suppressionE- the infant will develop a detachment syndrome that will affect its life-long developmentA prescriber has ordered medication for a newborn that is eliminated primarily by hepatic metabolism. What would the nurse expect the prescriber to ordere? q52 A- Order a dose that is lower than an adult doseB- Order a dose that is higher than an adult doseC- Increase the frequency of the medicationD- Discontinue the drug after one or two treatmentsQ61) A client who has type 2 diabetes begin taking glipizide. Which statement by the client CONCERNS the nurse? A-I will begin taking this once daily with breakfastB- I should not take this medication if I have a sulfate allergyC- I will need to check my blood sugar once daily or moreD- I may continue to have a glass of wine with dinnerDQ62) A client with NKDA is receiving amoxicillin PO twice daily. Twenty minutes after being given a dose, the client complains of SOB with a blood pressure of 100/58mm Hg. What will the nurse do? A- Contact the provider and prepare to administer epinephrineB- Notify the provider if the client develops a rashC- Request an order for a skin test to evaluate possible penicillin allergyD- Withhold the next drugs until symptoms subsideAQ63) What must a nurse include in a client education for an arthritic client taking high doses of aspirin? (select all that apply) A- Aspirin causes gastric erosion, so take it with food.B- Report bruises, bleeding gums, tarry stools, and pink urineC- Call your provider for ringing in the earsD- Aspirin is nephrotoxicE_ Aspirin is preferred to acetaminophen in the control of fevers in childrenA,B,DQ64) A nurse is educating a client regarding the use of pantoprazole. What statement by the client shows proper understanding of how to take the medicine? A- I should chew the medication when my heartburn is bad, so it absorbs more rapidlyB- I should plan to take this medication for the rest of my life.C- I should take this medication on an empty stomach before I eatD- I Should take this medication with an antacid to maximize its effects.CQ65) A nurse is providing client education for the application of transdermal estrogen spray. Where should the client be advice to apply the topical spray? A- Apply it to the axillaB- Apply it to the breastC- Apply it to the genitalsD- Apply it to the inner forearm.DQ66) A nurse is talking with a client who has peptic ulcer disease and starting therapy with sucralfate. What must the nurse include in the client’s education? A- Take it with an antacidB- Take 30-60 minutes before mealsC- Take it whenever indigestion occursD- Take it immediately after mealsBQ67) A client who has erectile dysfunction asks a nurse whether sidena… would be a suitable medication. Which aspect of this client’s history would be of concern? A- benign prostate hypertrophyB- Mild hypertensionC- occasional use of nitroglycerinD- Taking finasteride.CQ68). A client is starting to take furosemide and ask the nurse, “when is the best time to take this medication” A-2200B- 1600C- 0800D- 1900Q69) A nurse is providing teaching for an adult client with arthritis who is been instructed to take ibuprofen for discomfort. Which statement by the client indicates a need for further instructions ? A- I may experience tinnitus with higher doses of this medicationB- I may take up to 800 mg four times daily for painC- I should limit alcohol intake to fewer than three drinks a dayD- I will take this medication with meal to help prevent stomach upsetCQ70) A nurse understands that a bronchodilator would be most therapeutic in which situation? A- Shallow breath sounds with wheezing sound in the upper lobesB- Course crackles in the right lower lobesC- Fine, scattered crackles heard bilaterally in the basesD- irregular respiration, snoring and intermittent episodes of apneaAQ71) A client with chronic gout has been taking colchicine for several months and is admitted for acute gout pain. The prescriber plans to begin therapy with probenecid. What will the nurse do? A- Give the medication as ordered and observe the client for gastrointestinal side effectB- Request an order to lower the colchicineC- Restrict the client’s fluid intake to minimize the risk of renal injuryD- Suggest delaying probenecid therapy until the acute episode has subsidedE- Suggest delaying probenecid therapy until the acute episode has subsidedD,EQ72) A nurse tells a nursing student glucocorticoids given for rheumatoid arthritis are nearly identical to substances produced naturally by the body. The student remarks that the drugs must be very safe. Which response by the nurse is correct? A- As long as the drug is take as prescribe, side effects usually do not occurB- By interrupting the inflammatory process, these drugs inhibits side effectsC- Side effects can occur and are dependent on the dose and duration of treatmentD- The negative feedback loop prevents side effects.CQ73) The nurse is talking with a new mother about medications that can safely be resumed now that she is no longer pregnant. All of the following medications are forbidden during pregnancy, but which one may be ingested while breastfeeding, without causing known infants harms? A- methotrexateB-IbuprofenC- LithiumD- NicotineBQ74) The nurse is caring for a client receiving intravenous acyclovir. To prevent nephrotoxicity. What is the nurse’s best action? A- Hydrate the client during the infusion and after the infusion.B- Increase the client’s intake of foods rich in vitamin CC- Monitor urinary output every 30 minutesD- Provide a low protein diet for one a dayE- Provide a low protein diet for one day before and two day days after the acyclovir infusion.AQ75) A client is taking a drug that has known toxic side effects. What will the nurse do? A- Discontinue the drug at the first signs of toxicityB- Ensure that CBC are ordered periodicallyC- Monitor the function of all organs potentially affected by the drugD- Teach the client how to treat the symptoms if they developCQ76) A nurse is teaching a client who has taken glucocorticoids for over a year for glucocorticoids withdrawal. Which statement by the client indicates a need for further teaching? A- I should the dose by half each day until I stop taking the drugB- I will need to have cortisol levels monitored during the withdrawal processC- The withdrawal schedule may take several monthsD- If I have surgery, I may need to resume taking the drugAQ77) A client receiving a cephalosporin develops a secondary intestinal infection caused by clostridium difficile. What is an appropriate treatment for this client? A-Adding an antibiotic, such as tobramycin, to the client’s regimenB- Discontinuing the cephalosporin and beginning metronidazoleC- Stopping all antibiotic and providing fluid replacementD- Increasing the dose of the cephalosporin and providing isolation measures.BQ78) A nurse is giving discharge instruction to a client who is beginning theophylline. The nurse should tell the client that this medication might cause which of the following adverse effects? A- DrowsinessB- ConstipationC- OliguriaD- TachycardiaDQ79) The nurse is teaching a group of nursing students about administering medication to older adult clients. Which statement by a student indicate a need for further teaching? A- Alteration in hepatic function requires more frequent drug dosingB- Changes in gastrointestinal function in older adult clients lead to lower serum drug levelsC- Adverse drug reaction in older adult clients are related to altered renal functionD- Nonadherence for medication among older clients is due to the cost of the medicationsAQ80) A pregnant woman stopped using a prescription medication she takes for asthma because she doesn’t want to harm her baby. What will the nurse tell the client? A- Asthma medication will not affect the fetusB- Stopping medications for asthma doubles the chances of a stillbirthC-Avoid taking medication during her pregnancyD- Resume the medications in her second trimesterBA nurse is caring for a client and newborn immediately after delivery. The client’s medication history includes prenatal vitamins throughout pregnancy, one or two glasses of wine before knowing she was pregnant, occasional use of an albuterol inhaler in her last trimester, and intravenous morphine during labor. What is the nurse’s most appropriate action? q53 A- Administer opioid to the infant to prevent withdrawal syndromeB- Monitor the infant respiratory and prepare to administer naloxone if neededC- Note a high-pitched cry and irritability in the infant and observe for seizuresD- prepare the client for motor delays in the infant caused by alcohol useWhich of these statements best describes the concept of half-life?q54 A- It is the time it takes for half of the medication to be metabolized for elimination of the medicationB- It is the time it takes for half of the medication effect effects to be achievedC- it is the time it takes for half of the medication to be distributed to receptorsD- The term refers to the half life of the drugA pregnant client asked the nurse if she can take antihistamines for seasonal allergies during her pregnancy. What will the nurse tell the client? q55 A- Antihistamines should be avoided in pregnancy unless absolutely necessaryB- Second-generation Antihistamines are completely safe to take during the first trimesterC- Antihistamines are safe to take during breastfeeding, but they cause spina bifida in pregnancyD- the margin of safety for Antihistamines is clearly understood for pregnant clients.A client who report routine consumption more than three alcoholic beverages per day ask about taking acetaminophen when needed for occasional recurrent pain. what will the nurse tell the client? Q56 A- Do not take more than 2 mg of acetaminophen a dayB- D not take more than 3 mg of acetaminophen a dayC- Do not take more than 4 mg of acetaminophen a dayD- do not take a fixed dose preparation acetaminophen with opioid analgesic.A cardiac client has bee given a prescription or nifedipine extended release. which statement provide in the discharge teaching is incorrect. Q57 A- You crush the tablet and dissolve the particles under your tongue if chest pain occurs.B- Expect constipation with this medicationC- This medication can make your feet retain fluidD- Limit your intake of grapefruit when taking this medicine to avoid toxicityA client who has abdominal surgery has been receiving morphine sulfate via client- controlled analgesia. The nurse assess the client and notes that the clients pupils are constricted and the client is drowsy and lethargic. The client’s heart rate is 84 beats/min, their respiratory rate is 10 beat per minutes, and their blood pressure is 90/50 mm hg. What is the nurse’s best action? Q58 A- Encourage the client to turn over and cough and take deep breaths.B- Discuss possible oplate dependence with the client’s providerC- Note the effectiveness of the analgesia in the clients chartD- prepare to administer naloxone and provide ventilatory support.which of these findings would cause the nurse to hold the administration of oral metoprolol ?Q60 A- Heart rate of 92 beat per minuteB- Respiratory rate of 26 breath per minutesC- Blood pressure of 92/44 mmhgD- Oxygen saturation level of 95% on room air.A nurse is administering morphine sulfate to a postoperative client. Which are the appropriate routine nursing action when giving this drug? select all that apply 59 A- Requesting an order for methynaltrexone to prevent constipationB- Facilitating physical activity and offer fluid if GI function have returnedC – Monitoring the client’s blood pressure closely for hypertensionD- Counting respiration before and after giving the medicationE – Assessing GI function every 4 to 6 hours  Health ScienceScienceNursingNURS 2750Share Question