1. Penicillin V ( Veetids), 250mg PO every 8 hours , is prescribed for a child with a respiratory infection. The child’s weight is 45 lb.

The safe pediatric dosage is 25 to 50mg/kg per day. The nurse determines that 1. The dose prescribed is too low. 2. The dose prescribes is too high. 3. The dose prescribed is within the safe dosage range. 4. There is not enough information to determine the safe dose. Answer: 3 Rationale: Convert pounds to kilograms by dividing 2.2. 2. A physician has prescribed Phenobarbital sodium (Luminal), 25 mg PO bid, for a child with febrile seizures. The medication labels reads “Phenobarbital sodium, 20 mg per 5 ml.” A nurse has determined that the dosage prescribed is safe for the child. The nurse prepares to administer how many milliliters per dose to the child? 1. 2 mL 2. 4.5 mL 3. 6.25 mL 4. 7 mL Answer: 3 Rationale: 3. Cloxacillin (Tegopen), 100 mg PO every 8 hours, is prescribed for a child with an elevated temperature who is suspected of having a respiratory tract infection. The child weighs 17 lb. The safe pediatric dosage is 50 mg/kg per day. The nurse determines that 1. The dose prescribed is too low. 2. The dose prescribes is too high. 3. The dose prescribed is within safe. 4. There is not enough information to determine the safe dose. Answer: 3 Rationale: Convert pounds to kilograms by dividing 2.2. 4. Sulfisoxazole (Gantrisin), 1 g PO qid is prescribed for an adolescent with urinary tract infection. The medication label reads “500-mg tablets.” A nurse has determined that the dosage

prescribed is safe. The nurse administers how many tablets per dose to the adolescent? 1. ⁄ 2. 1 tablet 3. 2 tablets 4. 3 tablets Answer: 3 Rationale: Change 1 g to milligrams, knowing that 1000 mg = 1 g. 5. Diphenhyramine hydrochloride (Benadryl), 25 mg PO every 6 hours, is prescribed for a child with an allergic reaction. The child weighs 25 kg. The safe pediatric dosage is 5 mg/kg per day. The nurse determines that 1. The dose prescribed is too low. 2. The dose prescribes is too high. 3. The dose prescribed is within safe. 4. There is not enough information to determine the safe dose. Answer: 3 Rationale: Dosage parameters: 5 mg/kg per day x 25 kg = 125 mg/day Dosage frequency: 25 mg x 4 doses (every 6 hours) = 100 mg/day Dose is within the safe the safe range. 6. Penicillin G (Wycillin), 1,000,000 units 1M (intramuscularly), is prescribed for a child with an infection. The medication label read “1,200,000 units per 2 mL.” A nurse determined that the dose prescribed is safe. The nurse prepares to administer how many milliliters per dosew to the child? 1. 0.8 mL 2. 1.2 mL 3. 1.44 mL 4. 1.66 mL 7. Answer: 4 Rationale: 7. Morphine sulfate, 2.5 mg, IV piggyback, is prescribed for a child with cancer. The safe pediatric dose is 0.05 to 0.1 mg/kg per dose. The child weighs 50 kg. The nurse determines that

1. The dose prescribed is too low. 2. The dose prescribes is too high. 3. The dose prescribed is within safe dosage range. 4. There is not enough information to determine the safe dosage range. Answer: 3 Rationale: Dosage parameters: 0.05 mg/kg per dose x 50 kg = 2.5 mg/dose 0.1 mg/kg per dose x 50 kg = 5 mg dose Dosage is within the safe dosage range. 8. Morphine sulfate, 2.5 mg, IV piggyback, in 10 mL of normal saline is prescribed for a child postoperatively. The medication labels reads “ ⁄ .” The nurse has determined that

the dosage is safe. The nurse prepares to add how many milliliters of morphine sulfate to the 10 mL of normal saline solution? 1. 0.62 mL 2. 0.82 mL 3. 1.35 mL 4. 1.62 mL Answer: 1 Rationale: Convert grains to milligrams: 60 mg = 1 gr ⁄

9. A physician’s order reads “ampicillin (Omnipen), 125 mg IV every 6 hours.” The medication label reads “1g and reconstitute with 7.4 mL of bacteriostatic water.” A nurse prepares to draw up how many milliliters to adminster one dose? 1. 0.54 mL 2. 0.92 mL 3. 1.1 mL 4. 7.4 mL Answer: 2 Rationale: Convert 1 g to milligrams. In the metric system, to convert larger to samller, multiply by 1000 or move the decimal point three place to the right. 1g = 1000 mg

3. The school nurse is providing instructions to the mothers of the children attending the school regarding the application of permethrin (Elimite. 2. Nix). The physician has prescribed Myoflex topical cream for a client with a diagnosis of rheumatism who is complaining of muscular aches. sprains.5mg/day The physician orders digoxin twice daily. The nurse tells the mothers to 1. The dosage is 0. 0. Apply at bedtime and rinse off in the morning.07 mg/kg per day. 0.2 kg. local anesthetics. An outbreak of pediculosis capitus has occurred at the local school.5 mg 4. analgesics. These products contain combinations of antiseptics. and counterirritants. Allow to remain on the hair 10 minutes and then rinse with water. Apply before washing the hair. Which of the following information does the nurse provide to the client regarding this medication? 1. A pediatric client with ventricular septal defect repair is placed on a maintenance dosage of digoxin (lanoxin) elixir. 3. The medication will act as a local anesthetic Answer: 4 Rationale: Myoflex is one of the many products used for the temporary relief of muscular aches. 2. rheumatism.10. Apply a heating pad to the area after applying the medication. therefore two doses in 24 hours will be administered. 2.7 mg/day x 7.2 kg = 0.5 mg Answer: 1 Rationale: Calculate the dosage by weight first: 0.37 mg 3.25 mg 2. 0. 0. 4. and neuralgia.25 mg per dose 11. The medication acts by decreasing muscle spasms. arthritis. A nurse prepares how much digoxin to administer to the client at each dose? 1. 4. The medication is prescribed to cause the skin to peel. and the client’s weight is 7.50 mg/day 2 doses = 0. Avoid saturating the hair and scalp when applying. 12. Answer: 4 . The physician orders the digoxin to be given twice daily.

Which of the following. would indicate a need for further instruction? 1. No more than 30 g Should be used. Apply thick layer of cream to the entire body.Rationale: The instructions for the use of permethrin include wash. 13. The medication is removed by washing 8 to 12 hours later. Apply the cream for 2 days in a row 4. 3. And the nurse provides instructions to the client regarding the use of the medication. “I should place a bandage over the site after applying the medication” 4. allow remaining on hair 10 minutes. The nurse provides instructions to the client regarding the use of the medication. A client is seen in the clinic for complaints of the skin itchiness that has been persistent over the past several weeks. The nurse tells the client to 1. “The medication will help me to relieve the inflammation and itching Answer:3 Clients should be advised not to use occlusive dressing to cover the affected site following the application of the topical corticosteroid. Lindaine (Kwell) is prescribed. Following assessment.A Topical corticosteroid is prescribed for the client with dermatitis. and then rinsing with water. if stated by the client. and towel dry hair. 14. the client has been determined to have scabies. only one application is required. “I should gently rub the medication into the skin” 3. rinse. 2. apply sufficient volume to saturate hair and scalp. unless the physician specifically prescribed wound coverage. In most cases. “I need to apply the medication in a thin film” 2. and 4 are accurate statements related to the use of this medication . Answer: 1 Rationale: Kwell is applied in a thin layer to the entire body below the head. Options 1.2. Leave the cream on for about 8 to 12 hours and then remove by washing. Apply to the entire body and scalp. excluding the face.

Absorption is higher from regions where the skin is especially permeable. dizziness. The nurse would be concerned about the potential for systemic absorption of the medication if the medication were being applied to which of the following body ares? 1. Salicylic acid is prescribed for a client with a diagnosis of psoriasis. Acyclovir .Triple antibiotic 2. The client is diagnosed with herpes simplex type1. Back 2. Constipation 4. Axilla 3. Palms of the hands 4. Symptoms include tinnitus. The nurse monitors the client knowing that which of the following would indicate the presence of systemic toxicity from this medication? 1. and lower from regions where penetrability is poor 16. and psychological disturbances. hyperpnea. Diarrhea 3. Constipation and diarrhea are not associated with salicylism.15. Decreased respirations? 2. Tinnitus Answer 4 Salicylic acid is absorbed readily through the skin. and systemic toxicity can result. The nurse is applying a topical corticosteroid to a client with eczema. 17. The physician prescribes a topical medication for treatment. Soles of the feet Answer: 2 Topical corticosteroids can be absorbed into the systemic circulation. The nurse anticipates that which of the following medications will be prescribed? 1.

Which Statement made by the client indicates a lack of understanding about the treatements? 1. Masoprocol Answer 2 Acylovir is a topical antiviral agent that inhibits DNA replication in the virus.3. 19. and can cause phototoxicity. “ The medication can stain in the skin and hair” 3. The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. and the nurse provides information to the client about the treatments. mitotic activity and cell proliferation. The Physician has prescribed coal tar treatments for the client with psoriasis. Immediately before exposure to the sun 3. Immediately before swimming Answer. “ The medication can cause phototoxicity” Answer 3 Coal tar is used to treat psoriasis and other chronic disorders of the skin. before exposure to the sun 4. “ The medication can cause systemic toxicity” 4. frequently stains the skin and hair.1 . The nurse reminds the children that chemical sunscreens are most effective when applied. “The medication has unpleasant odor” 2. 15min. Coal tar suppresses DNA synthesis. 1. varicella zoster. Triple antibiotic would not be effective in treating herpes virus 18. Acyclovir has activity against herpes simplex types 1 and 2.Systemic toxicity does not occur. Epstein barr virus and cytomegalovirus. Mupirocin 4. Coal tar has unpleasant odor.30minutes to 1 hour before exposure to the sun 2.

2. Local rash at the burn site 3. Clients receiving this treatment should be monitored for acidbase imbalance. When applying the medication. Answer 4 Mafenide is bacteriostatic for gram-negative and gram-positive organisms and is used to treat burns to reduce bacteria present in avascular tissues. Apply a thinner film than prescribed to the burn site. The client should be informed that the medication will cause local discomfort and burning 21. All sunscreens should be reapplied after swimming or sweating. The burn client is receiving treatements of topical mafenide to the site of injury. the medication should be discontinues for 1 to 2 days. therey causing acidosis. the client complains of local discomfort and burning. 4. Discontinue the medication 2. Elevated blood pressure Answer 3 Mafenide is a carbonic anhydrase inhibitor and can suppress renal excretion of acid. Inform the client that this is normal.Sunscreens are most effective when applied about 30minutes to 1 hour before exposure to the sun so that they can penetrate the skin. Local pain at the burns site. 20. The nurse monitors the client knowing that which f the following indicates that a systemic effect has occurred? 1. . Hyperventilation 4. Notify the physician 3. Which of the following is the most appropriate nursing action? 1. Mafenide is prescribed for the client with a burn injury. If acidosis becomes severe.

“The solution should not come in contract with normal skin tissue” 2. The skin needs t be cleansed thoroughly before applying the medication 24. the nurse would anticipate that which laboratory test will be prescribed? . Which statement if made by the family member indicates a need for further teaching? 1. “I will wash my hands thoroughly after applying the medication” 2. “I will cleanse the skin thoroughly before applying the medication” Answer 3 Tretinoin is applied liberally to the skin. The solution should not come in contact with healing or normal tissue and should be rinsed off immediately if used for irrigation. 23. it cannot be used to pack purulent wounds because the solution is inactivated by copious pus. Before the administration of this medication. The hands are washed thoroughly immediately after applying. “I must apply a this layer to the skin” 4. “I will soak a sterile dressing with solution and pack it into the wound” 4. 3 Sodium hypochlorite is a solution that is used for irrigating and cleaning necrotic purulent wounds. Although sodium hypochlorite can be used for packing necrotic wounds. Which statement if made by client indicates the need for further instructions? 1. “Optimal results will be seen after 6 weeks” 3. The home health nurse teaches a family member how to perform these treatments. “I should rinse the solution off immediately following the irrigation” 3. Therapeutic results should be seen after to 3 weeks but may not be optimal until after 6 weeks.The nurse has provided instruction to a client regarding the use of tretinoin. Sodium hypochlorite is prescribed for a client with a leg wound that is draining purulent material. Isotretinoin is prescribed for a client with severe acne. “I will prepare the solution before use” Answer.22. Solutions are unstable and must be prepared fresh for each use.

Complete blood count 2. Sutilains is being used to treat the ulcer. The nurse dries the wound and cover the sutilains application with a dry sterile dressing . Which observation by the registered nurse would indicate an inaccurate action by the newly hired nurse when performing the dressing change? 1.A client with severe acne is seen in the clinic. The registered nurse is observing a newly hired nurse perform a dressing change on a client with a leg ulcer. being a relative isotretinoin. The nurse reviws the client’s medication record and would contact the physician if the client I taking which medication? 1. The physician prescribes isotretinoin.1. White blood cell count 3. Blood triglyceride content should be measured before treatement and periodically thereafter until the effect on the triglycerides hae been evaluated. 26. Vitamin A supplements should be discontinued before isotretinoin therapy. 25. The nurse cleanse the wound with a sterile solution 2. Platelet count Answer 3 Isotretinoin can elevate triglyceride levels. Phenytoin 3. Because of the potential for increased toxicity. VIt A 4. can produce generalized intensification of isotretinoin toxicity. Triglyceride level 4. Furosemide Answer 3 Vitamin A.Digoxin 2.

4. and then applies a lose thin dressing. The nurse moistens the wound with sterile normal saline and then applies the sutilains. The nurse places the sutilains in the refrigerator following use. Cleans the wound with a sterile solution before applying Elase 2. Ointment should be refrigerated. and the nurse is observing a nursing student perform the treatment. Answer 2 The wound should be cleansed with a sterile solution before treatment.” Answer 4 Dextranomer is a cleansing rathe than a deriding agent that is effective in wet wounds only. 27. The nursing instructor asks the nursing students preparing to perform the treatment about the medication and the procedure. Which statement if made by the student indicates a need for further research? 1 “It is effective in we wounds only” 2. Applies a thick layer of medication and covers with a dry sterile dressing 4. Dextranomer is prescribed for a client with a decubitus ulcer. Applies a thick layer of medication and covers with a petrolatum gauze. “ The wound bed must be dried thoroughly before applying the medication. “It should be packed lightly into the wound” 3. applies a this film of sutilains extendin ¼ to ½ inch beyond the area to be debrided. Prepares the solution just before use 3. Dextranomer is not packed tightly into the wound because macretion of surrounding tissue may result 28. The nurse then thoroughly moistens the wound with normal saline solution or sterile water. Maceration of tissue surrounding the wound can occur from the medication” 4. The nurse intervenes if the nursing student is observed doing which of the following? 1. Answer 3 . Fibrinolysin and desoxyribonuclease dry powder is rescribed to treat a skin ulcer.3.

for best effects. . newly gained hari is lost in 3 to 4 months. “ The hair will continue to grow” 2. Monoxidil is prescribed for the client to treat hair loss. 29.Acne 3. The nurse would suspect that the client is being treated for? 1.The wound should be cleansed with a sterile solution and gently patted dry/ A thin layer of elase is applied and covered with a petrolatum gauze. The client asks the nurse if the hair will continue to grow when the medication is stopped. the solution should be prepared just before use. On discontinuation of the medication. The most appropriate nursing response is? 1. The clinic nurse is performing an admission assessment on a client. Eczema 4. The nurse notes that the client is taking azelaic acid.2 Hair regrowth with the use of Rogaine is most likely to occur when baldness has developed recently and has been limited to a small area. and the natural progression of hair loss resumes. Hair loss Answer 2 Azlaic acid is a topical medication used to treat mild to moderate acne. you need to ask your physician” Answer. “ I’m not sure. Herpes simplex 2. The acid appears to work by suppressing growth of propinibacterium acnes and by decrasing proliferation of keratinocytes 30. Because of the medication prescription. “ Newly gained hair is lost in 3 to 4 months” 3. “It depends on how long you have been taking the Rogaine” 4. If a dry powder is used.

Decrease permeability in the kidney to water 2. Promote weigh gain 2. Decrease water reabsorption 3. Promote renal conservation of water Answer. A nurse monitors the client. stimulate linear growth 3.4 Desmopressin promotes renal conservation of water. Answer. increase renal excretion of water 4. The hormone accomplishes this by acting on the collecting ducts of the kidney to increase their permeability to water which results in increased water reabsoption 33. Decrease the mobilization of fats. The nurse administering the medication monitors the client. 2 Somatrem is a growth stimulator used in the long term treatment of growth failure resulting from endogenous growth hormone deficiency 32. Weight loss .31. Which of the following indicates the presence of an adverse reaction? 1. knowing that the primary action of the medication is to 1. Somatren is administred to a client with pituitary dwarfism. Increased urination 2. knowing that the epected therapeutic effect of this medication is to? 1. Increase bone density 4. A nurse is monitoring a client receiving desmopressin acetate for adverse reactions to the medication. Desmopressin acetate is prescribed for the treatement of diabetes insipidus.

Pheochromocytoma Answer 3 Because of its powerful vasoconstrictor actions. Coronary artery disease 4. 34. especially if administered to the clients with coronary artery disease 35. vasopressin can cause adverse cardiovascular effects. A nurse provides instructions to a client who is taking levothyroxin. Depression 2. Drowsiness 4. Insomnia Answer 3 Water intoxication or hyponatremia is an adverse reaction to desmopressin. Vasopressin is prescribed for a client with diabetes insipidus. . Early signs include drowsiness . A nurse is particularly cautious in monitoring the client receiving the medication if the client has which of the following preexisting conditions? 1. listlessness. and headache. The nurse tells the client to take the medication 1. With food 2. At lunchtime Answer 2 Oral doses of levothyroxine should be taken on an empty stomach to enhance absorption. Endometriosis 3.3. On an empty stomach 3. By constricting arteries of the heart. vasopressin can cause angina pectoris and even myocardial infarction. At bedtime with a snack 4.

The nurse instructs the client to notify the physician if which of the following occurs? 1. The client tells the nurse that propylthiouracil is taken daily.36. insomnia. The nurse tells the client that which of the following is a side effect of the medication? 1. Cushing’s syndrome and addison’s disease are disorders related to adrenal function 38. A nurse provides medication instructions to a client who is taking levothyroxin. tremors.Cushing’s syndrome 2. Addison’s disease 3. hyperthermia. The nurse continues to collect data from the client. 1. Grave’s disease Answer 4 PTU inhibits thyroid hormone synthesis and is used to treat hyperthyroidism or grave’s disease. A nurse instructing a client regarding intranasal desmopressin. suspecting that the client has a history of. Myxedema 4. Tremors 3. Excessively dry skin 4. nervousness. Myxedema indicates hypothyroidism. Fatigue Answer 2 Excessive doses of levothyroxine can produce signs and symptoms of hyperthyroidism. Cold intolerance 2. 37. A nurse performs an admission assessment on a client who visits a health care clinic for the first time. heat intolerance and sweating. angina. Flushed skin . There include tachycardia.

Blood urea nitrogen 4. Runny nose 4. Thyroid function is monitored throughout therapy. The nurse monitors which most significant laboratory study during therapy with this medication? 1. Thyroid-stimulating hormone Answer 4 An adverse reaction to somatropin is hypothyroidism. prevent the oxidation of iodide Answer 2 Lugol’s solution is administered to hyperthyroid individuals in preparation for thyroidectomy to suppress thyroid function. knowing that the therapeutic effect of this medication is to 1. Vulval pain Answer 3 Demopressin administered by the intranasal route can cause a runny or stuffy nose. replace thyroid hormone 4. Increase thyroid hormone production 2. 40. A client is receiving somatropin. . 39. Suppress thyroid hormone production 3. A client is scheduled for a subtotal thyroidectomy Strong iodine solution is prescribed.2. A nurse prepares to administer the medication. Headache 3. Lipase 3. Amylase 2.

Take half of the prescribed dose for the next 24 hours 3. A nurse instructs the client to take the medication. Fatigue Answer 3 Excessive doses of fludrocortisones cause retention of sodium and water and excessive excretion of potassium. 43. Weigh loss 2. Continue with the medication 2. stop the medication and notify the physician Answer 4 Chronic ingestion of iodine can produce iodism 42. The client calls a clinic nurse and complains of a brassy taste and burning sensations in the mouth. The most appropriate instruction to the client is which of the following? 1. 1. With meal 2.41. Nausea 3. resulting in expansion of blood volume. Swelling of the feet 4. hypertention. The nurse instructs the client to notufy the physician if which of the following occurs? 1. Strong iodine solution is prescribed for a client with thyrotoxic crisis. 1hour after meal 3. Calcium carbonate is prescribed for a client with hypocalemia. cardiac enlargement. A nurse provides instructions to a client taking fludrocortisones. Stop medication for the next 24 hours and then continue as prescribed 4. Just before meals . edema and hypokalemia.

. Administration at this time helps minimize adrenal insufficiency and mimic the burst of glucocorticoids released naturally but the adrenal glands each morning. brain and whole-grain cereal because they decrease calcium absorption.? 1. Which of the following food items would the nurse instruct the client to avoid while taking this medication. Every 4 hours Answer 2 The client should be instructed to take the medication exactly as prescribed. At bedtime 2 At noon 3 Early morning 4 Anytime at the same time each day Answer. A nurse provides dietary instructions to the client. rhubarb. Dark green. 45. 3 Glucocorticoids should be administered before 9am. Whole-grain cereals 4. Calcitriol is prescribed for a client with hypocalemia. The nurse instructs the client that the best time to take this medication is 1. A daily dose of prednisone is prescribed for a client.4. leafy vegetables 2.Milk 3. 44. A nurse provides instructions to the client regarding administration of the medication. Sardines Answer 3 The client who is taking an antihypocalcemic medication should be instructed to avoid eating too much spinach.

47. Freeze the insulin . A nurse is teaching a client how to mix regular insulin and NPH insulin in the same syringe.46. Which of the following prescriptions does the nurse anticipate during therapy with the prednisone? 1 A decreased amount of daily NPH insulin 2 An increased amount of daily NPH insulin 3 n additional dose of prednisone daily 4. The client asks the nurse how to store the unopened vials of insulin. Injects an amount of air equal to the desired dose of insulin into the vial. This sequence will avoid contaminating the vial of regular insulin with insulin of another type. Which of the following actions if performed by the client indicates the need for further teaching 1. The nurse tells the client to? 1. Injects air into NPH insulin vial first 2. 3. Prednisone is prescribed for a client with diabetes mellitus who is taking NPH insulin daily. A home care nurse visits a client recently diagnosed with diabetes mellitus. Withdraws the NPH insulin first 4. draw the regular insulin into the syringe first. Clients with diabetes mellitus may need their dosage of insulin or oral hypoglycemic medications increased during glucocorticoid therapy. Answer 3 When preparing a mixture of regular insulin with another insulin preparation. The addition of an oral hypoglycemic medication daily Answer 2 Glucocorticoids can elevate blood glucose levels. 48. The client is taking NH insulin daily. Withdraws the regular insulin first.

Keep the insulin at room temperature 4 Store the insulin in a dark dry place/ Answer 2 Insulin in unopened vials should be stored under refrigeration until needed. A nurse instructs the client to avoid which of the following while taking this medication. Tolbutamine is prescribed for a client with diabetes mellitus. Sildenafil citrate is prescribed to treat a client with erectile dysfunction. Vials should not be frozen 49. Use of nitroglycerin 3. Alcohol 4. a disulfiram-like reaction may occur. This syndrome includes flushing. 1 Carbonated beverages 2 Organ meats 3. palpation.2. Whole grain cereals Answer 3 When alcohol is combined with tolbutamide. and nausea. Insomia Answer. Refrigerate the insulin 3. 2 . A nurse reviews the client’s medical record and would question the prescription if which of the following is noted in the client’s history? 1. Use of Multivitamins 4. Neuralgia 2. 50.

it is contraindicated with concurrent use of organic nitrates and nigtroglycerin. 51. absence of abdominal pain 2. The client is receiving propantheline bromide as adjunctive treatment for peptic ulcer disease.Sildenafil citrate enhances the asodilation effect of nitric oxide in the corpus cavernosum of the penis. with antacids Answer 3 Propantheline bromide Is an antimuscarinic anticholinergic medication that decreases gastrointestinal secritions. producing a softer consistency of stool. The client is taking cascara sagrada and develops abdominal craps. The intended effect is relief or prevention of constipation 53. The client is taking docusate sodium. The nurse should administer this medication 1. The nurse interprets that the client is most likely experiencing . The nurse monitors for which of the following to determine whether the client is having a therapeutic effect from this medication? 1. hematest negative stools 3. reduction in steatorrhea 4. Thus sustaining an erection. 52. With meals 2 just after meals 3 30mins before meals 4. Because of the effect of the medication . Regular bowel movements Answer 4 Docusate sodium is a stool softener that promotes absorption of water into the stool.

Senna stimulates the vagus nerve to improve bowel tone Answer 3 Senna works by changing the transport of water and electrolytes in the large intestine. Senna coats the bowel wall and makes it slippery. Other health problems are not determined based on a single symptom 54. ON an empty stomach 3 at bedtime 4. 55. 2. Senna accumulates water and increases presistalis 4. A case of influenza 4. A common side effect of this medication 2. With two glasses of juice Answer 2 Mot rapid results from bisacodyl occur when it is taken on an empty stomach. The nurse then tells the client to take the medication 1. The client taking bisacodyl wants to achieve rapid effect from the medication. Senna adds fiber an blk to the stool 3. which causes accumulation of water n the mass of stool and increased peristalsis . Peptic ulcer disease Answer 1 Cascara sagrada is a laxative that cause nausea and abdominal craps as the most frequent side effects. The client who is advised to take senna to treat constipation asks the nurse how this medication works. With large meal 2. The nurse would incorporate which of the following when formulating a response? 1. Partial bowel obstruction 3.1.

58. Stay within the prescribed dose because it can be habit-forming. Anticipate side effects of nervous system excitability Answer 1 The client should not exceed the recommended dose because it may be habit-forming. The nurse has given instructions to the client who just received a prescriptions to the client who just received a prescription for diphenoxylate with atropine. Take the medication with a bulk-forming laxative. The nurse determines that the client understands the use of the medication and its properties if the client states to 1.56. Hematest positive nasogastric tue drainage 2 Abdominal pain 3 Constipation 4 An episode of diarrhea Answer4 Loperamide is an antidiarrheal agent. or pudding . The nurse should plan to administer this medication if the client has 1. The client has been started on psyllium The nurse would teach this client to take this medication with 1. The client has a PRN order for loperamide.Gelatin. Lperamide is used to manage acute diarrhea and also chronic diarrhea in conditions such as inflammatory bowel disease 57. The medication is an antidiarrheal and therefore should not be taken with a laxative. 3 Expect increased salivation while taking the medication 4. 2. applesauce.

Anxiety or irritability 2. This helps to prevent impaction of the medication 59 The nurse teaches the client taking metoclopramide to discontinue the medication immediately and call the physician if which of th following occurs with long-term use? 1. irritability and dry mouth are side effects that are not so harmful to the client. Anxiety. Constipation Answer 1 Tigan is an antiemetic agent that is used to treat nausea and vomiting . Uncontrolled rhythmic movements of the face or limbs Answer.Dry mouth not minimized by the use of sugar free hard candy 3. the client should stop the medication and call the physician. A multivitamin and mineral supplement. The nurse monitors the client for relief of 1. followed by a second 3. 4 If the client experiences tardive dyskinesia. 60. The client just taken a dose of trimethobenzamide. A full glass of liquid. These side effect of this medication. Followed by another glass of liquid. A dose of an antacid Answer 2 Metamucil is a bulf-forming laxative and should be taken with a full glass of water or juice. 4.2. Nausea and vomiting 2 Abdominal pain 3 Heart burn 4. Excessive drowsiness or excitability 4.

Urinary retention 2. The nurse would administer this medication to the postoperative client for relief of 1.Incisional pain 3 Nausea and vomiting 4. Answer 3 Ondansetron is an antiemetic that is used to treat postoperative nausea and vomiting as well as nausea and vomiting associated with chemotherapy. Diarrhea 2. With a full glass of water 2. The nurse is administering a dose of prochlorperazine to a client for nausea and vomiting. The nurse would assess the client for which of the following frequent side effects of this medication? 1. The nurse plans t administer this medication 1. 62. Excessive lacrimation 4. The client has a PRN order for ondansetron. With fruit juice only 3 With ice 4 at room temperature Answer 3 Magnesium citrate is available as an oral solution and is used commonly as a laxative in preparation for or following certain studies of the gastrointestinal tract. Drooling 3. Blurred vision . Paralytic ileus.61. 63.The client has an order to take magnesium citrate to prevent constipation following a barium study of the upper gastrointestinal tract.

The medication should reduce the amount of fatty stools. The client has begun medication therapy with pancrelipase. 65. The nurse would evaluate that the medication is having the optimal intended benefit if which of the following effects is observed? 1 Reduction of steatorrhea 2. 64. Other frequent side effects of this phenothiazine-type antiemetic and antipsychotic are dry eyes. A calcium carbonate antacid has been prescribed for client an the nurse provides instructions to the client about the medication. Weigh loss Answer 1 Pancrease is a pancreatic enzyme used in clients with pancreatitis as a digestive ais. A vitamin D supplement 3. . Absence of abdominal pain 3. Relief of heartburn 4. dry mouth and constipation. The nurse tells the client that it is best to take the antacid with 1 Milk 2.Answer 4 The nurse would assess the client for blurred vision as a frequent side effect of prochlorperazine. Yogurt 4. Water Answer 4 Calcium carbonate antacids should not be taken with milk. milk products or foods or supplements high in vitamin D because milk-alkali syndrome can occur.

Muscle twitching stops 2. The hospitalized client asks the nurse for sodium bicarbonate to relieve heartburn following a meal. Serum phosphorus levels decrease Answer 2 Calcium carbonate can be used as an antacid for the relief of heartburn and indigestion. The nurse is giving the client directions for proper use of aluminum hydroxide tablets.66. Calcium carbonate also can be used as calcium supplement or to bind phosphorus in the gastrointestinal tract with the renal failure. Take each dose with a laxative to prevent constipation Answer 1 Aluminum hydroxide tablets should be chewed thoroughly before swallowing. The nurse reviews the client’s medical record. Swallow the tablets whole with a full glass of water 3. The client with history of duodenal ulcr is taking calcium carbonate chewable tablets. Take the tablets at the same time as other medications 4. 68. 67. knowing that the medications is contraindicated in which of the following conditions? 1. The nurse would evaluate that the client is experiencing optimal effects of the medication if 1. This prevents them from entering the small intestine undissolved. 1. Heartburn is relived 3. Chew the tablets thoroughly and follow with 4oz of water 2. Urinary calculuses 2 Chronic bronchitis . The nurse tells the client to. Serum calcium levels rise 4.

3. Droperidol 3 Acetaminophen 4 Simethicone Answer 4 Simethicone is an antiflatulent used to relieve pain caused by excessive gas in the gastrointestinal tract. which is a difficult acid-base imbalance to correct 69. Respiratory acidosis Answer 3 Sodium bicarbonate is an electrolyte modifier and antacid and it would aggravate metabolic alkalosis. Hallucinations Answer 1 Older clients are especially susceptible to central nervous system side effects of cimetidine. The nurse elects which of the following medications from the PRN medication list to give to the client? 1. The most frequent of these is confusion. Magnesium hydroxide 2. 70 An older client recently has been taking cimetidine. Tremors 4. Dizziness 3. Magnesium hydroxide is an antacid and laxative. The nurse monitors the client for which of the following most frequent central nervous system side effects of this medication? 1. Metabolic alkalosis 4. The client is complaining of gas pains following surgery and requests medication. Confusion 2. .

The nurse assesses respiratory pattern. indicating a need for a stronger type of bronchodilator. Paradoxical bronchospasm. which needs to be increased 2.71. The nurse administers the medication by giving the. A home care nurse has observed a client self administer a dose of metaproterenol sulfate via metered dose inhaler. The nurse assesses which of the following parameters before and during therapy? 1.Urine output and blood urea nitrogen 2. The nurse interprets that this is due to. 1. Answer 4 The client taking adrenergic bronchodilators may experience paradoxical bronchospasm. A nurse has an order to give a client metaproterenol sulfate. pulse and blood pressure before and during therapy.Probable interaction of this medication with an over-the-counter cold remedy. 3 Albuterol is a bronchodilator of the adrenergic type. Lung sounds and presence of dyspnea 4. Beclomethasone first and then the metaproterenol 2. Insufficient dosage of the medication. which must be reported to the physician. lung sounds. 4. which is evidenced by the client’s wheezing. two puffs by metered dose inhaler. This occur with excessive use of inhalers 73. 1. Tolerance to the medication. 3. 72. the client begins to wheeze loudly. Nausea and vomiting 3.A nurse is preparing to administer albuterol to a client. Metaproterenol first and then the beclomethasone . Headache and level of consciousness Answer. Within a short time.

Beclomethasone is a glucocorticoid. cream cheese. A nurse plans to teach the client to limit the intake of which of the following while taking this medication 1. the client should avoid taking in foods or beverages that contain xanthine. and diary creamers . Before drawing of a serum level of the medication. such as colas. 4. A client receiving theophylline is due to have a theophylline level drawn. lobsters and shrimp 2. and chocolate 3. Cottage cheese. A nurse questions the client to ensure that all the client has no ingested which of the following substances before the blood sample is drawn? 1. 75. coffee or chocholate. Sedatives 2 Narcotics 3. beginning with the beclomethasone. Coffee.3 Alternating a single puff of each. Alternating a single puff of each. Thus the client is told to avoid caffeine intake before the test.Oysters. Answer 2 Metaproterenol sulfate is an adrenergic type of bronchodilator. cola. beginning with the metaproterenol. Bronchodilators are always administered before glucocorticoids when both are to be given on the same time schedule 74. Gkycise 4 Caffeine Answer 4 Theophylline is an xanthine bronchodilators. A client has begun therapy with oxtriphylline.

77. uricaria. The nurse teaches the client to limit the intake of xanthinecontaining foods while taking this medication. and the eyelids begin to swell. or it may be given by inhalation for use as a mucolytic . lips or eyelids. The client develops a generalized rash and urticaria. epinephrine. Assess the clients vision with a snellen chart. Intubation tray 4.4. an swelling of the face. grapefruit. Ambu bag Answer 1 Acetylcysteine can be given orally or by a nasogastric tube to treat acetaminophen overdose. Signs and symptoms include rash. 4. 76. Suction equipment 2. Apply a lanolin-based cream to the rash. oranges and pineapple Answer 2 Oxtriphylline is an xanthine bronchodilator. A nurse has administered a dose of salmeterol to a client. Call the physician immediately. isoproterenol or salmeterol. To drink fluids quickly 3. Encourage the client. Answer 1 Hypersensitivity reaction can occur in clients taking ephedrine. The nurse should 1. Nasogastric tube 3. A nurse should have which of the following items available for possible use after giving this medication? 1. A client is receiving acetylcysteine by nebulizer. 2.

Take an extra dose if the cough is accompanied by fever 3 Watch irritability as a side effect. Paracetesis tray 3. Crush the sustained-release tablet if immediate relief is needed Answer 1 Guaifenesin is an expectorant and should be taken with a full glass of water to decrease viscosity f secretions. The nurse plans to have which of the following available as supportive equipment in case it is needed? 1. Other adjuncts that may be needed include oxygen. Nasogastric tube 2. which has been ordered as a cough suppressant. Central line insertion tray 4. A client has an order to take guaifenesin. A nurse is preparing to administer a dose of naloxone hydrochloride intravenously to a client with an intravenous narcotic overdose. 4. Resuscitation equipment Answer 4 The nurse administering naloxone for suspected narcotic overdose should have resuscitation equipment readily available to support naloxone therapy if it is needed. mechanical ventilator. A nurse concludes that the client nderstands the most effective use of this medication if the client states to 1. an vasopressors. The nurse determines that the client needs further instructions if the client states to. crushed or chewed. Sustained-release preparations should not be broken open. A nurse teaches a client aout the effects of dipenhydramine hydrochloride. 80.78. 79. Take the tablet with a full glass of water 2. .

Use sugarless gum. The nurse concludes that eh client understands the instructions if the client verbalizes to self-assess for 1. Constipation 3 Rapid pulse 4. antitussive. confusion. Avoid using alcohol while taking this medication 4.1. The client has been prescribed a cough formula containing codeine sulfate. 82. Avoid driving or other activities requiring mental alertness while taking this medication 2. Which of the following undesireable side effects is associated with this medication? 1. A cromolyn sodium inhaler is prescribed for a client with allergic asthma. antidyskenetic. and sedative/hypnotic. nausea and vomiting and constipation. including antihistamine.Constipation 2. Excitability 2. 81. or rinses to decrease dry mouth 3. Hypotension 3. The most common side effects include drowsiness. Insomnia . A nurse provides instructions regarding the side effects of this medication. A nurse has given the client instructions for its use. hypotension. Excessive urination Answer 2 The client is taught about side effects that could occur with the use of codeine sulfate. Take the medication on an empty stomach Answer 4 Diphenhydramine has several uses. Candy.

Diabetes mellitus Answer 4 Terbutaline sulfate is contraindicated in clients with hypersensitivity to sympathomimetics and should be used with caution in clients with impared cardiac function. The medication may increase blood glucose levels. Polycystic disease 3.Hypothyroidism 2. Bronchospasm Answer 4 The most common undesired side effects associated with inhalation therapy of cromolyn sodium are bronchospasm. Which laboratory test does the nurse expect to be prescribed before the administration of this medication? 1. 84.4. Neutropil count Answer 3 . hypertension or hyperthyroidism. and clients with a history of seizures. Platelet count 2. cough. diabetes mellitus. A nurse understands that this medication should be used with caution if which of the following existing medical conditions is present in the client? 1. 83. Zafirlukast is prescribed for a client with bronchial asthma. throat irritation. Terbutaline sulfate is for a client with bronchitis. and wheezing. Complete blood count 3 Liver function tests 4. nasal congestion. Osteoarthritis 4.

Zafirlukast is a leukotriene receptors antagonist used in the prophylaxis and long-term treatment of bronchial asthma. A nurse plans to teach the client to 1. A client has been taking isoniazid for a month and a half. A client is to begin a 6. This is manifested by numbness. peripheral neuritis Answer 4 A common side effect of isoniazid is peripheral neuritis. 85.month course of therapy with isoniazid. 86. This isde effect can be minimized with pyridoxine intake. alcohol shouldbe avoided during therapy. The client complains to a nurse about numbness. tingling and paresthesias in the extremeties . Hypercalcemia 4. Liver function laboratory test should be performed to obtain a baseline . and tingling in the extremities. paresthesias. Zafirlukast is used with caution in clients with impaired hepatic function. and the levels thould be monitored during administration of the medications. Impaired peripheral circulation 3. Use alcohol in small amounts only 2 Report yellow eyes or skin immediately 3 Increase intake of swiss or aged cheeses 4 Avoid vitamin supplements during therapy Answer isoniazid is hepatotoxic and therefore the client is taught to report signs and symptoms Of hepatitis immediately. Small blood vessel spasm 2. For the same reason. The nurse interprets that the client is experiencing. 1. .

Should always be taken with food or antacids Answer 3 Rifampin should be taken exactly as directed.Should be double dosed if one dose is forgotten 2. Impaired sense of hearing 3 Orange-rd discoloration of body secretions. Difficulty in discriminating the color red from green Answer 4 Ethambutol causes optic neuritis.Take the medication before meals 2. Return to the clinic weekly for serum drug levels .87. 88. which decreases visual acuity and the ability to discriminate between the colors red and green. The client is taught to report this symptom immediately. A client has been started on long-term therapy with rifampin. may be discontinues independently if symptoms are gone in 3 months. Cycloserine is added to the medication regimen for a client with tuberculosis. 89. Gastrointestinal side effects. tears. 4. A nurse has given a client taking ethambutol information about the medication. Doses should not be doubled or skipped. 1. and feces 4. This poses a potential safety hazard when a client is driving a motor vehicle. 3 Causes orange discoloration of sweat. The nurse determines that the client states to immediately report.. urine . 2. Which of the following would the nurse include in the client teaching plan regarding this medication? 1. A nurse teaches the client that the medication 1.

91.3 It is not necessary to call the physician if a skin rash occurs. Serum creatinine 4. Liver enzymes Answer. Before going the client the first dose. piggybacked into the peripheral line containing total parenteral nutrition Answer 1 Trimethoprin-sulfamethoxazole may be administered by intravenous infusion but should not be mixed with any other medications or solutions . Over 60 to 90 mins 2. Therefore liver enzymes are monitored when therapy is initiated and during the first 3 months of therapy. A nurse would administer this medication 1. 90. a nurse ensures that which of the following baseline studies has been completed? 1 Coagulation times 2. Electrolytes 3. 4. Answer 2 Cycloserine is an antibuercular medication that requires weekly serum drug level determinations to monitor for the potential of neurotoxicity. It is not necessary to restrict alcohol intake with this medication. Trimethoprin-sulfamethoxazole is prescribed to be administered by intravenous infusion to a client with a recurrent urinary tract infection. A client with tuberculosis is being started on anti tuberculosis therapy with isoniazid. Over 30 mins 3 Piggybacked into the existing infusion of normal saline and potassium chloride 4. 4 Izoniazid therapy can cause an elevation of hepatic enzymes and hepatitis.

A decrease in the anticoagulation dosage 3. which of the following would the nurse anticipate might be prescribed? 1. Which prescription would the nurse anticipate because the client is taking this anticoagulant orally? 1. A decreased dosage of the tolbutamide . When an oral anticoagulant is combined with nalidixic acid. The need to administer an alternative medication to treat the urinary tract infection Answer 2 Nalidixic acid can intensify the effects of oral anti coagulants by displacing these agents from binding sites on plasma protein.. a decrease in the anticoagulant dosage may be needed. If the urine turn dark brown.. Sulfamethoxazole is prescribed for a client with a urinary tract infection. call the physician immediately Answer 2 Each dose of sulfisoxazole should be administered with a full glass of water and the client should maintain a high fluid intake. 94. Based on the administration of these two medications in combination.92. a nurse notes that the client is taking warfarin sodium daily. An increase in the anticoagulation dosage 2. 93. Which of the following would be included in the list of instructions? 1 restrict fluid intake 2. A nurse is providing discharge instructions to a client receiving sulfisoxazole. The need to discontinue the anticoagulant 4. maintain a high fluid intake 3 decrease the dosage when symtoms are improving to prevent all allergic response 4. The client has diabetes mellitus and is receiving tolbutamide. Nalidixic acid is prescribed for a client with a urinary tract infection. On review of the client ‘s record .

The nurse teaches the client 1. That a reddish orange discoloration of the urine may occur. Phenazopyridine hydrochloride is prescribed for a client for symptomatic relief of pain resulting from a lower urinary tract infection. When combined with sulfonamides these medications may require a reduction in dosage. palor . 96. Nausea 3 Diarrhea 4 Sore throat Answer 4 Clients taking trimethoprim-sulfamethoxazole should be informed about early signs of blood disorders that can occur from this medication. Trimethoprin-sulfametoxazole is prescribe for a client.2 an increased dosage of the tolbutamide 3 a decrease dosage of the sulfamethaxazole 4. A nurse would instruct the client to report which symptom if it developed during the course of this medication therapy? 1 Headache 2. 1 Sulfonamides can intensify the effects of warfarin sodium. These signs include sore throat. and the client should be instructed to notify the physician if these symptoms occur. an increased dosage of the sulfamethaxozole Answer. 3 To discontinue the medication f a headache occurs . phenytoin.fever. and orally aministered hypoglycemic such as tolbutamin. To Take the medication before meals 2. 95.

Dry skin 3. Urinary strictures 3. bradycardia and sever hypotension. The nurse checks the client for which sign of toxicity? 1. . To take the medication at bedtime Answer 2 The nurse should instruct the client that a reddish orange discoloration of urine may occur. Bradycardia 4 Signs of dehydration Answer 3 Toxicity produces manifestations of excessive muscarinic stimulation such as salivation. involuntary urination and defecation. Gastroesphageal reflux 4.4. 98. Which disorder would be a contraindication to the administration of this medication? 1 Neurogenic atony 2. The medication should be taken after a meals to reduce the possibility of gastrointestinal upset. Bethanechol chloride is prescribed for a client with a urinary retention. The nurse also should instruct the client that this discoloration can stain fabric. 97. Gastric atony Answer 2 Bethanechol chloride can be hazardous to clients with urinary tract obstruction or weakness of the bladder wall. A nurse who is administering bethanechol chloride is monitoring for acute toxicity associated with the medication. The medication has the ability to contract the bladder and thereby increase pressure within the urinary tract. Elevation of pressure within the urinary tract could rupture the bladder in clients with these conditions. Dry mouth 2. sweating.

or ulcerative colitis. 101. 100. Hypthyroidism 3 myxedema 4. Decreased white blood cell count 2 Decreased hemoglobin . hallucinations. and irritability. Propantheline bromide is prescribed for a client with bladder spasm. Glaucoma 2.Pallor 3 estlessness 4 Drowsiness Answer 3 Toxicity of this medication produces central nervous system excitation. if noted in the clients record. such as nervousness. Which of the following disorders.Following kidney transplant. Which sign would indicate a possible toxic effect relate to this medication? 1. Bradycardia 2. would alert a nurse to question the prescription for this medication 1. gastrointestinal disease. cyclosporine is prescribed for a client. coronary artery disease Answer 1 Propantheline bromide is contraindicated in clients with narrow-angle glaucoma. restlessness. Oxybutynin hloride is prescribed for a client with neurogenic bladder.99. obstructive uropathy. Which laboratory result would indicate an adverse effect from the use of this medication? 1.

Which prescription would the nurse anticipate to be prescribed for this client during the administration of these medications concurrently? 1. Nephrotoxicity is evaluated by monitoring for elevated blood urea nitrogen and serum creatinine levels. 103. Decreased creatinine Answer 3 Nephrotoxicity can occur from the use of cyclosporine. An incrased amount of cyclosporine 4. As a result. a Decreased amount of cyclosporine. A nurse is providing dietary instructions to a client who has been prescribed cyclosporine. 102. A nurse is caring for a client who will be receiving amphotericin B. a decreased amount of amphotericin B 3.3 Elevated blood urea nitrogen 4. Green leafy vegetables Answer 2 A compound present in grapefruit juice inhibits metabolism of cyclosporine. The nurse notes that the client is also taking cyclosporine to prevent rejection of a kidney transplant performed 2 years ago. Grapefruit juice 3. Which food item would the nurse instruct the client to avoid? 1. Answer 4 . Red meats 4. an increased amount of amphotericin B 2. consumption of grapefruit juice can raise cyclosporine levels by 50% to 100% thereby greatly increasing the risk of toxicity. Orange juice 2.

When either of these medications is combined with cyclosporine. The nurse tells the client to 1. 104. tremors. Which sign or symptom would indicate to the nurse that the client is experiencing an adverse effect from this medication? 1. Tremors 4. A nurse provides instructions to a client who will be taking cyclosporine oral solution. Which disorder if noted in the client’s record. Alopecia 3. and hirsuitsm. infection. Hypotension . the dosage of cyclosporine must be reduced to prevent accumulation to toxic levels. 105 A nurse is monitoring a client receiving cyclosporine. erythromycin. Dilute the concentrate in a Styrofoam cup before administration 2 avoid diluting the concentrate for administration 3 mix the concentrate with chocolate milk 4 mix the concentrate with grapefruit juice Answer 3 To improve palatability. Nausea 2. Answer 3 The most common adverse effect of cyclosporine are nephrotoxcicity .Amphotericin B . the client should be taught to mix the concentrated medication solution with chocolate milk or orange juice just before administration. Grapefruit is avoided because it can raise cyclosporine levels. would indicate that the medication needs to be administered with caution? . Tacrolimus is prescribed for a client.hypertension. and ketoconazole can elevate cyclosporine levels. 106.

107. Other common reactions include neurotoxicity evidenced by headache. hyperkalemia.8 mEq/L 4 Platelet count of 300. tremor . Which laboratory result would indicate to the nurse that the client is experiencing an adverse effect of the medication? 1 White blood cell count of 6000 cells/uL 2 Blood glucose of 200 mg/dL 3 Potassium level of 3. Administer following meals 2. A nurse is reviewing the laboratory results for a client receving tacrolimus. Which instruction would a nurse provide to the client regarding administration of this medication? 1. Pancreatitis 4. and hyperglycemia 108 Mycophenolate mofetil is prescribed for a client for prophylaxis of organ rejection following allogenic renaltransplant. Open the capsule and mix with food for administration 3 Contact the physician if a sore throat occurs 4 Take the medication with a magnesium-type antacid . and vomiting hypertension. Ulcerative colitis Answer 3 Tacrolimus is used with caution in immunosuppressed clients and in clients with renal.1. hepatic or pancreatic function impairement. Coronary artery disease 3.000 cells/uL Answer 2 Nephrotoxicity is a mjor concern with this medication.Diabetes insipidus 2.

Freeze the mediation before use 3. sure throat. White blood cell count of 6000 cells/uL 2 Hematocrit of 32% 3. 111. .000 cells/uL 4 Blood urea nitrogen of 15mg/dL Answer 2 Epoetin alfa is used to reverse anemia associated with chronic renal failure. The medication should not be frozen. Syringes with a 5/8 –inch needle are used for subcutaneous injection. The nurse tells the client to 1. A client with chronic renal failure is receiving epoetin alfa. Which laboratory result would indicate a therapeutic effect of the medication? 1. Shake the bottle before use 2. A nurse is instructing a client to administer epoetin alfa by the subcutaneous route.Answer 3 Mycophenolate mofetil should be administered on an empty stomach. The capsules should not be opened or crushed. 109. Knowing that the purpose of this medication is to. Platelet count of 400. 110. In preparation for cataract surgery the nurse is to administer cyclopentolate eye drops. The client should contact the physician if unusual bleeding or bruising. Refrigerate the medication 4 Obtain syringes with 1 ½ inch needles from the pharmacy Answer The client should be instructed not to shake the bottle. A 1 ½ -inch needle may be used for intramascular injection. The nurse administers the eye drops. mouth sores abdominal pain or fever occurs. The medication should be refrigerated at all times.

. The lower lid should be pulled downward with thumb or fingers. 3 Dilate the pupil of the operative eye 4. Produce miosis of the operative eye. The home health nurse visits a client at home and instructs the client on the administration of the prescribed eye drops.” I can lie down. pull down on the lower lid. Pull down and back on the pinna and direct the solution toward the wall of the canal .Provide lubrication to the operative eye. and accommodation returns in 6 to 24 hours. “I can sit and tilt my head back.1. Put the drop in the corner of the lid nearest my nose then slowly turn to my other side while blinking. Ear drops prescribed for an infant with otitis media. Pull down and back on the pinna and direct the solution onto the eardrum 3. Cylopentolate is a rapidly acting mydriatic and cycloplegic medication. “ I can lie down. Pull up and back on the pinna and direct the solution onto the eardrum 2. The client holds the bottle like a pencil with the tip downward and squeezes the bottle gently allowing 1 drop to fall into the sac. 113. “ I can lie on my side opposite to the eye I am going to place the drop. pull down on the lower lid and place the drop in the lower lid” 3. Answer 3 . Constrict the pupil of the operative eye. Which of the following statements byt eh client indicates a need for further education? 1.” Answer 3 The client can lie down or sit with the head tilted back. and place the drop in the lower lid” 2. The most appropriate method to administer the ear drops to the infant is to 1. 112. 2. Cyclopentolate is effective in 25 to 75mins. pull up on the upper lid and place the drop in the lower lid” 4.

The client is receiving an eye drop and an eye ointment to the right eye. Eat before instilling the drops 2 Swallow several times after instilling the drops 3 Blink vigorously to encourage tearing after instilling the drops 4. Occlude the nasolacrimal duct with a finger for several minutes after instilling the drops Answer 4 Applying pressure on the nasolacrimal duct prevents systemic absorption of the medication 115. and administer the eyedrop Answer 1 When an eye drop and an eye ointment are scheduled to be administered at the same time. To minimize the systemic effects that eye drops can produce.4. Pull up and back on the ear lobe and direct the solution toward the wall of the canal. followed by the eye ointment 2. Which of the following medications. Administer the eye ointment. the nurse instructs the client 1. The nurse is caring for a client with glaucoma. the pinna is pulled down and straight back. Answer 3 In a child younger than 3 years. 114. The nurse would most appropriately 1. The infant should be turned on the side with the affected ear uppermost. The nurse is providing instructions to a client who will be self-administering eye drops. 116. And administer the eye ointment 4. the eye drop is administered first. Administer the eye drop first. wait 10mins. Administered the eye ointment first followed by the eye drop 3 Administered the eye drop. wait 10mins. if prescribed for the client would the nurse question? .

The medication will help to dilate the eye to prevent pressure from occurring” 3 “ The medication will relax the muscles of the eyes and prevent blurred vision” 4.1. “The medication will help to block the responses that are sent to the muscle in the eye” Answer 1 Miotics cause papillary constriction and are used to treat glaucoma. Pilocarpine hydrochloride is prescribed for the client with glaucoma. “The medication causes the pupil to constrict and will lower the pressure in the eye” 2. They lower the intraocular pressure. The client asks the nurse about the purpose of the medication.Naloxone hydrochloride (narcan) 2. Carbachol(Carboptic) 2. and 3 are miotic agents used to treat glaucoma Option 4 Is a mydriatic and cycloplegic medication. Pilocarpine hydrochloride (Isopto Carpine) 3. The nurse tlls the client that 1. Pilocarpine nitrate 4 Atropine sulfate (Isopto Atropine) Answer 4 Option 1. Mesoridazine besylate ( Serentil) Answer 3 . Which of the following medications does the nurse plan to have available in the event of systemic toxicity? 1. and its use is contraindicated in clients with glaucoma. Atrpine sulfate 4.2. 117.A miotic medication has been prescribed for the client with glaucoma. increasing blood flow to the retina and decreasing retinal damage and loss of vision 118. thereby. Pindolol ( VIsken) 3.

Answer 2 Irrigation solutions that are not close to the client’s body temperature can be uncomfortable and may cause injury. In performing the procedure the nurse 1. dizziness. Positions the client with the affected side up following the irrigation. syncope. Assessing peripheral pulses Answer 2 Hypotension . The nurse is caring for a client in the emergency room diagnosed with Bell’s palsy. The nurse anticipates that the antidote to be prscribed is . Monitoring Blood pressure 3 Assessing blood glucose level 4. nausea and vertigo. diaphoresis . bradycardia. constipation.Systemic. 4. headache fatigue. The client has been taking acetaminophen ( Tylenol) and a Tylenol overdose is suspected . 121. and diarrhea are systemic effets of the medication. 119. cardiac dysrhythymias and seizures. nausea. The nurse prepares the client for an ear irrigation as prescribed by the physician. Monitoring temperature 2. tremors. 120. Which of the following nursing actions is most appropriate related to monitoring for the side effects of this medication? 1. Betaxolol hydrochloride (Betoptic) eye drops have been prescribed for the client with glaucoma. Assist the client to turn his or her head so that the ear to be irrigated is facing upward 2 Warms the irrigating solution to 98 degrees F 3 Directs a slow steady stream of irrigation solution toward the eardrum. absorption of pilocarpine hydrochloride can produce toxicity and includes manifestations of vertigo. hypotension.

Platelet count of 400. 1. 123 The client is suspected of having myasthenia gravis. 122. Which lab value would indicate toxicity associated with the medication. Acetylcysteine (Mucomyst) 4. Which of the following indicates that the client has myasthenia gravis. and levels of greater than 200 mcg/ml could indicate hepatotoxicity. Joint pain following administration of the medication 4.1. Direct bilirubin level of 2 mg/dL 3. hypotension. The client with trigeminal neuralgia tells the nurse that acetaminophen is taken daily for the relief of generalized discomfort. A decrease in muscle strength within 30 to 60 seconds following administration of the medication 3. Feelings of faintness. The normal therapeutic serum level of acetaminophen is 10 to 20 mcg/ml. Fludarabine (Fludara) 3. dizziness. Edrophoium(Tensilon) 2mg is administered intravenously to determine the diagnosis. overdose of acetaminophen cause liver damage. and signs of flushing in the client Answer 1 . Auranofin (Ridaura) 2. An increase in muscle strength within 30 to 60 seconds following administration of the medication 2. Prothrombin tie of 12 seconds 4 sodium of 140 mEq/L Answer 2 In adults. A toxic level is greater than 50 mcg/ml.000 cell/uL 2. 1. Pntostatin (Nipent) Answer 3 The antidote for acetaminophen is acetylcysteine(Mucomyst).

Which of the following would indicate that the client is in cholinergic crisis? 1. A temporary worsening of the condition 3. Complaints of muscle spasm Answer 2 An Edrophonium injection makes the client in cholinergic crisis temporarily worse This in known as a negative Tensilon test 125. An increase in muscle spasms Answer3 Edrophonium is administered to determine weather the client is reacting to an ovedose of a medication(cholinergic crisis) or an increasing severity of the disease (myasthenic crisis).The physician administers edrophonium (Tensilon) .Edrophonium is a short-acting acetylcholinesterase inhibitor used as a diagnostic agent 124. The physician prepares to identify whether the client is reacting to an overdose of the medication (cholinergic crisis) or an increasing severity of the disease (myasthenic crisis). The client with myasthenia gravis verbalizes complaints of feeling much weaker than normal. No change in the condition 4. An injection of edrophonium (Tensilon) is administered. The physician plans to implement a diagnostic test to determine whether the client is experiencing a mysthenic crisis. . The client with myasthenia gravis becomes increasingly weaker. An improvement of the weakness 2. Increasing weakness 2 No change in the condition 3 A temporary improvement in the condition 4. Which of the following would indicate that the client is experiencing myasthenic crisis? 1.

dizziness. it’s a normal effect of the medication. Imapired voluntary movements Answer 4 Dyskinesia and impaired voluntary movement may occur with high levodopa dosages.126. anorexia. Pruritus 2. Hypertension 3. I can wait until the next dose and eliminate the dose” 4. 128. A serum drug level is drawn. The home health nurse visits the client and provides teaching regarding the medication. Which of the following would indicate that the client is experiencing an adverse reaction? 1. “I will use a soft toothbrush to brush my teeth” 3. swelling. Carbidopa-levodopa (Sinemet) is prescribed for the client with Parkinson’s disease. The nurse monitors the client for adverse reactions to the medication. orthostatic hypotension. Which of the following statements. and the nurse reviews the results. Phenytoin (Dilantin) 100mg PO 3 times daily.off phenomena”. has been prescribed for the client for seizur control. The client is taking phenytoin (Dilantin) for seizure control. ) 127. “its okay to break the capsules to make it easier for me to swallow them” 2. Tachycardia 4. and tenderness of the gums can occur with the use of this medication. “ If I forget to take my medication. would indicate effective teaching? 1. bleeding. Nausea. “ If my throat becomes sore. if made by the client. and it’s nothing to be concerned about” Answer 2 Phenytoin is an anticonvulsant. also known as “on. bradycardia and akinesia ( the temporary muscle weakness that lasts 1 mins to 1 hour. Which of the following would indicate a therapeutic serum drug range? . Gingival hyperplasia.

The home health nurse visits a client who is taking phenytoin for control of seizures. dextrose solution should be avoided because of medication precipitation. During the assessment. however. Which of the following solutions will be nurse plan to use to dilute this medication? 1 Lactated Ringer’s solution 2. The nurse is preparing an intravenous infusion of phenytoin as prescribed by the physician for the client with seizures. 5% dextrose 3 5% dextrose and ½ normal saline 4. The potential decreased effectiveness of the birth control pills while taking phanytoin 3 That the client may stop the medication if it is causing severe gastrointestinal effects 4 That pregnancy should be avoided while taking phanytoin Answer 2 . the nurse notes that the client is taking birth control pills. Which of the following information should the nurse include in the teaching plan? 1. The increased risk of thrombophlebitis while taking phanytoin and birth control pills together 2.1. The medication may be diluted in normal saline solution. Normal saline solution Answer 4 Intravenous infusion of phenytoin should be administered by injection into a large vein. 5 to 10 mcg/ml 2 10 to 20 mcg/ml 3 20 to 30 mcg/ml 4 30 to 40 mcg/ml Answer 2 The therapheutic serum drug level range for phanytoin is 10 to 20 mcg/ mL 129. 130.

thrombophlebitis. 132. Which of the ff would the nurse monitor for as a side effect of this medication? . Meperidine hydrochloride (Demerol) is prescribed for the client with pain. dysrhythmias. 400mg PO daily.Phnytoin enhances the rate of estrogen metabolism which can decrease the effectiveness of some birth control pills 131. Maintain the client in a supine position 4 Encourage the client to cough and deep breath Answer 4 Morphine sulfate suppresses the cough reflex. White blood cell count. Which nursing action would be included in the plan of care? 1. 133. 3000cells u/L 2. A client with trigeminal neuralgia is being treated with carbamazepine (Tegretol). and dermatological effects. including aplitic anemia agranulocytosis thrombocytopenia. 5mg/ dL Answer 1 Adverse effects of carbamazepine appear as blood dysrasias. leukemia. Blood urea nitrogen . cardiovascular disturbances. 140mEq/L 4 Uric acid. Monitors the client’s temp 2. Which of the following indicates that the client is experiencing an adverse reaction to the medication? 1. Clients need to be encouraged to cough and deep breath to prevent pneumonia. The nurse is caring for a client receiving morphine sulfate 10mg subcutaneously every 4 hours for pain because this medication has been prescribed for this client. Encourage fluids 3. 15mg /dL 3 Sodium.

Which of the following lab values would the nurse monitor while the client is taking this medication. Bradycardia 3. Which of the following does the nurse specifically include in the plan of care while the client is taking this medication? 1. Monitor bowel activity 4.1. Codeine sulfate has been prescribed for the client. Urinary retention Answer 4 Side effects of this medication include respiratory depression. Creatinine . drowsiness and mental clouding. The nurse is caring for a client with sever back pain. 135. constipation. 1. orthostatic hypotension. and urinary retention 134. Monitor for hypertension 2 Monitor fluid balance 3. Monitor peripheral pulses Answer 3 While the client is taking codeine sulfate. Diarrhea 4. Sedimenatation rate 2. Dantrolene (Dantrium) is prescribed for a client with spinal cord injury for discomfort caused by spasticity. Hypertension 2. the nurse would monitor vital signs and assess for hypotension. Whide blood cell count 3. tachycardia. Liver function studies 4.

Answer 3 Dantrolene can cause liver damage. 4. thereby inhibiting tubular reabsorption of water and solutes] . The client with epilepsy is taking the prescribed dose of phenytoin(Dilantin) to control seizures. Prevent the filtration of sodium and water through the kidneys. and the nurse should monitor the liver fnction studies. 3. Which of the following symptoms would be expected as a result of this laboratory result? 1. Induce dieresis by raising the osmotic pressure of glomerular filtrate. Nystagmus Answer 2 The therapeutic phenytoin level is 10 to 20 mcg/mL. 136. thereby inhibiting tubular reabsorption of water and solutes 2 Induce dieresis by promoting the reabsorption of sodium and water in the loop of Henle. Results of a phenytoin blood level study reveal a level of 35 mcg/mL. Mannitol is prescribed for the client with increased intracranial pressure following a head injury. Slurred speech 3 Tachycardia 4. Answer 1 Mannitol is an osmotic diuretic that induces dieresis by raising the osmotic pressure Of glomerular filtrate. No symptoms because this is a normal therapeutic level 2. The nurse prepares to administer the medification knowing that the therapeutic action is to 1. Prevent the filtration of sodium and potassium through the kidneys. at greater than 20mcg/ mL involuntary movements of the eyeballs appears 137.

Answer 3 Dexamethasone may be given by direct intravenous injection or intravenous infusion.Headache 2. client with multiple sclerosis is receiving diazepam (Valium). Mix the medication in 1000mL of 5% dextrose 3.138 Dexamethasone IV is prescribed for the client with cerebral edema. Increased saliation . Which of the following. and it hasn’t helped my back. 140. Photosensitivity Answer 3 Mild intoxication with acetylsalicylic acid (aspirin) is called salicylism and is experienced commonly when the daily dosage is more than 4g. Tinnitus 4. The Client states “I have been taking two to three aspirin every 4 hours for the last week. 4. The nurse prepares the medication for administration and plans to 1.9% sodium chloride or 5% dextrose 139.” Aspirin intoxication is suspected. Diarrhea 2 Constipation 3. Mix the medication in 100Ml Of lactated Ringer’s solution 2. if noted during assessment of the client. It may be mix with 0. would indicate that the client is experiencing a side effect related to this medication? 1. and the nurse assesses the client for which of the fllowing 1. Prepare an undiluted direct injection of the medication. an centrally acting skeletal muscle relaxant. The client arrives at the emergency department complaining of back spasm. Dilute the medication in lactated Ringer’s solution and administer as a direct injection.

3. Allopurinol is used for the lysis of thrombin obstructing coronary arteries. Than if swelling of the lips occurs. Answer 2 Clients taking allopurinol are encouraged to drink 3000mL of fluid daily . To take the medication on an empty stomach 4. 142. Urinary retention 4 Drowsiness. The nurse instructs the client 1. this is a normal expected response. 2.A community health nurse visits a client at home. Answer 4 In coordination and drowsiness are common side effects resulting from this medication. an enzyme. Allopurinol prevents calcium ions entry across cells membranes of the cardiac smooth muscle 3 Allopurinol decreases sympathetic outflow from the central nervous system 4. The nurse prepares to administer this medication . knowing that which of the following information is accurate about this medication? 1. Answer 4 Allopurinol is an antigout medication. and reduces uric acid concentrations in serum and urine. 141 Allopurinol (Zyloprim) has been prescribed for a client. Allopurinol decreases uric acid productions and reduces uric acid concentrations in the serum and urine. To drink 3000mL of fluid per day. 3. That the effect of the medication will occur immediately 2. The client is taking Allopurinol 400mg PO daily. Allopurinol decrease uric acid production by inhibiting xanthine oxidase.

The nurse reviews the client’s record knowing that this medication would be contraindicated in which of the following disorders? 1. The client has been instructed to restrict the diet to low-purine foods. Constipation 2. Potatoes 2.A physician prescribes auranofin (Ridaura) for a client with rheumatoid arthritis.143. A metallic taste in the mouth 3. Which of the following would indicate to the nurse that the client is experiencing toxicity related to the medication? 1. Hypothyroidism 3. 145. Myxedema Answer 1 Colchicine is contraindicated in clients with severe gastrointestinal. Ice cream 3Spinach 4 Scallops Answer 4 Uric acid is produced when purine is catabolized. Ringing in the ears . 144 A home health nurse is caring for a client who is taking prbenecid (Benemid). renal. Which of the following foods would the nurse instruct the client to avoid? 1. Renal failure 2. Diabetes mellitus 4. Colchicine is prescribed for a client with a diagnosis of gout. hepatic. or cardiac disorders and in clients with blood dyscrasias. Probenecid is medication used for clients with gout to inhibit the reabsorption of uric acid by the kidney and promote excretion of uric acid in the urine.

147. Alendronate (Fosamax) is prescribed for a client with osteoporosis. To lie down for 30 minutes after taking the medication. Answer 2 Precautions need to be taken with administration of alendronate to prevent gastrointestinal side effects and increase absorption of the medication. Which of the following instructions would the nurse provide to the client? 1. . Take the medication with a full glass of water after rinsing in the morning 3. The nurse instructs the client to 1. Gastrointestinal reactions including diarrhea. a non-steroidal anti-inflammatory medication has been prescribed for a client to treat chronic rheumatoid arthritis. Take the medication in the morning with breakfast 4. Take the medication at bedtime 2. Answer 3 Dolobid may be given with water.4. 3. A film-coated form of diflunisal (Dolobid). 146. abdominal pain. The tablet should not be crushed or broken open. Swallow the tablets with large amounts of water or milk 4. Open the tablet and mix the contents with food. milk or meals. Joint pain Answer 2 Auranofin is the one gold preparation that is given orally rather than by injection. and loss of appetite are common early in therapy but usually subside in the first 3 months. Crush the tablets and mix with food 2. The client calls the clinic nurse because of difficulty swallowing the tablets. Notify the physician for a medication change. nausea.

knowing that the primary therapeutic effect of this medication is which of the following? 1. A nurse is providing discharge instructions to a client receiving baclofen. weakness. A nurse is monitoring client receiving baclofen (Lioresal) for side effects related to the medication.148. Diarrhea 3. 149. Restrict fluid intake 2. Which of the following would indicate that the client is experiencing a side effect? 1. Polyuria 4. 150. Avoid the use of alcohol . dizziness. Drowsiness 2. Decreased muscle spasm 3. Muscular excitability Answer 1 Baclofen is a skeletal muscle relaxant and frequently causes drowsiness. Which of the following would be included in the teaching plan? 1. Decreased local pain an tenderness 4. Baclofen (Lioresal) is prescribed for a client with multiple sclerosis. Increased range of motion Answer 2 Baclofen is a skeletal muscle relaxant and acts at the spinal cord level to decrease the frequency and amplitude of muscle spasms in clients with spinal cord injuries or debilitating disease such as multiple sclerosis. and fatigue. The nurse monitors the client. Increased muscle tone 2.

Notify the physician if fatigue occurs Answer 2 Baclofen is a skeletal muscle relaxant. Stop the medication if diarrhea occurs. 4. “ It is best that you taper the dose if you intend to stop the medication” 2. Maintenance doses range from 15 to 20 mg administered 3 to 4 times a day. 151.3. “Weakness and fatigue commonly occur and will diminish with continued medication use” 3. weakness and fatigue are more intense in the early phase of therapy and diminish with continued medication use. An adult client with muscle spasms is taking an oral maintenance dose of baclofen. The client should be cautioned against the use of alcohol and other CNS depressants because baclofen potentiates the depressant activity of these agents. 25 mg qid 3 30mg qid 4 40 mg qid Answer 1 Baclofen is dispensed in tablet of 10 to 20mg for oral use. A client with acute muscle spasms has been taking baclofen(Lioresal). 152. 15 mg qid 2. “You should never stop the medication” Answer 2 The client should be instructed that symptoms such as drowsiness. Which of the following responses to the client would be most appropriate? 1. Which of the following represents a safe maintenance dose for this medication? 1. The client calls the clinic nurse fatigue and asks the nurse about discontinuing the medication. . “It is all right to stop the medication if you think that you can tolerate the muscle spasms” 4. Dosages are low initially and then are increased gradually.

A physician is planning to administer a skeletal muscle relaxant to a client with a spinal cord injury. The nurse monitors the client.153. Blood urea nitrogen 2. Chlorozaxazone (Paraflex) 3. Dantrolene sodium (Dantrium) is prescribed for the client experiencing flexor spasms. Platelet count Answer 3 Dose-related liver damage is the most serious adverse effect of dantrolene. A nurse is analyzing the laboratory studies on a client receiving dantrolene sodium (Dantrium). 4. Liver function tests 4. Which of the following laboratory tests would identify and adverse effect associated with the administration of this medication? 1. 155. Cyclobenzaprine hydrochloride(Flexeril) 2. Answer 3 Dantrolene (Dantrium) acts directly on skeletal muscle to relieve muscle spasticity 154. Creatinine 3. knowing that which of the following is the therapeutic action of this medication? 1. Dantrolene acts within the spinal cord to suppress hyperactive reflexes. The medication is going to be administered intrathecally. Dantrolene depresses spinal reflexes. Which of the following medications would the nurse expect? 1. Baclofen (Lioresal) . 2 Dantrolene acts on the central nervous system to suppress spasms 3 Dantrolene acts directly on the skeletal muscle to relieve spasticity. Dantrolene sodium (Dantrium) 4.

Which of the following disorders. and increased intraocular pressure. 157. Cyclobenzaprine hydrochloride is prescribed for a client for muscle spasms. would alert the nurse to contract the physician? 1. Which of the following disorders. would indicate a need to contact the physician about the administration of this medication? 1. Hypothyroidism 3. Emphysema 4. Coronary artery disease 2. The nurse is reviewing the client’s record. Diabetes mellitus 3.Answer 4 Baclofen is the only skeletal muscle relaxant that can be administered intrathecally within the spinal column. glaucoma . it should be used with caution in clients with a history of urinary rentention. A nurse is reviewing the record of a client who has been prescribed baclofen. if noted in the client’s history. Seizure disorders 4. if noted in the record. 156. Diabetes mellitus Answer 1 Because cyclobenzaprine(Flexeril) has anticholinergenic effects.Glaucoma 2. . Hyperthyroidism Answer 3 Clients with seizure disorders may have a lowered seizure threshold when baclofen is administered.

“This medication is prescribed to help relieve my muscle spasms” Answer 2 The client needs to be told that the urine may turn brown. The nurse provides instructions to the client about the medication. 2. I don’t need to be concerned about it” 3 “I might get some nasal congestion from this medication” 4. A client is to receive a prescription for methocarbamol (Robaxin).158. “My urine may turn brown or green” 2. The nurse determines that this dosage is 1. The nurse needs to monitor for these side effects. Carisoprodol (Soma) is prescribed for the client to relieve the muscle spasms. black. Tachycardia 3. Which of the following client statements would indicate a need for further education? 1. A nurse is administering an intravenous dose of methocarbamol (Robaxin) to a client with multiple sclerosis. 159. For which of the following adverse effects would the nurse monitor? 1. or green. “If my vision becomes blurred.The normal adult dosage. 160. Hypertension 2. Rapid pulse 4. A nurse is reviewing a physician’s orders for an adult client who has been admitted to the hospital following a back injury. A lower than normal dosage . Bradycardia Answer 4 Intravenous administration of methacarbamol can cause hypotension and bradycardia. The physician has prescribed 350mg to be administered 4 times a day.

Answer 1 Pyrimethamine (Daraprim) is an antimalarial and an antirotozoal medication used to treat toxoplasmosis or Pneumocytis Carinii pneumonia. 4.Toxoplasmosis 2. A dosage requiring further clarification. 162. Dapsone (Avlosulfon) is prescribed for a client with acquired immunodeficiency syndrome to treat toxoplasmosis. Answers 1 Dapsone may be prescribed to treat toxoplasmosis. Nausea and vomiting. Cardiac irregularities 3 Kaposi’s sarcoma. 4. Report to the clinic weekly for the injections. Contact the physician if fever or a sore throat occurs. Plan to take the medication every 6hours around the clock. 3. 4. Discontinue the medication if nausea and vomiting develops 2. Pyrimenthamine (Daraprim) has been added to the medication regimen for the client with acquired immunodeficiency syndrome.3. 161. Answer 1 The normal adult dosage for carisprodol (Soma) is 350 mg PO 3 to 4 times daily. . On review of the client’s record. The nurse reinforces medication instructions and tells the client to. A higher than normal dosage. 1. the nurse notes this new prescription and plans care knowing that this has been prescribed to treat 1.

Saquinavir (Fortovase) is prescribed for the client who is human immunodeficiency virus seropositiv. Take the medication on an empty stomach 2. Sigmoidoscopy Answer 2 Ocular toxicity is an adverse reaction to use of hydroxychloroquine sulfate. Gastrointestinal function . The nurse reinforces medication instructions and tells the client to 1.163. The clininc is providing medication instructions to a client who will be receiving hydroxychloroquine Sulfate (Plaquenil) to treat systemic lupus erythematosus. Eat foods that are low in fat 4. The nurse instructs the client about the importance of returning to the clinic in 6 months for which of the following? 1.Zerit). Dental examination 2. 165. 164. Chest radiograph 4. Eye examination 3. Eat low-calorie foods 3. The client who is human immunodeficiency virus seropositive has been taking Stavudine (d4t. The nurse monitors which of the following most closely while the client is taking this medication? 1 Appetite 2 Gait 3. Avoid sun exposure Answer 4 Saquinavir is an antiretroviral used with other antiretroviral medications to manage human immunodeficiency virus infection.

Liver function studies 2. Serum albumin 2. The client who is human immunodeficiency virus seropositive has been taking Stavudine (d4t.Serum creatinine 3 CD4 cell count 4. Level of consciousness Answer 2 Stavudine is an antiretroviral used to manage immunodeficiency virus infection in clients who do not respond to or who cannot tolerate convention therapy. The nurse checks the latest results of which of the following lab studies while the client is taking the medication? 1. Lymphocyte count Answer 2 .Zerit). The nurse plans to monitor which of the following most closely while the client is taking this medication? 1. Glucose level Answer 1 Zalcitabine is an antiretroviral( Nucleoside reverse transcriptase inhibitor) used to manage human immunodeficiency virus infection with other antiretrovirals. The nurse is assigned to car for a client with cytomegalovirus retinitis and acquired immunodeficiency syndrome who is receiving fasocarnet (Fasocavir). 167. 166. As a component of treatment. Platelet count 3 Red blood cell count 4.4.

170. The client should be monitored routinely for signs and symptoms of infection. The nurse is reviewing the results of serum laboratory studies drawn on a client with acquired immunodeficiency syndrome who is receiving didanosine (Videx). Blood culture 4 Blood glucose level Answer 1 A common side effect of this medication therapy is agranulocytopenia and anemia. 2 to 3.Foscarnet (Foscavir) is toxic to the kidneys. The nurse carefully monitors which of the following laboratory results during treatment with this medication? 1. and last weekly during maintenance therapy. AZT). The client is experiencing toxic effects of the medication 3. The client with acquired immunodeficiency syndrome has begun therapy with zidovudine (Retrovir. The nurse does further monitoring of the client. knowing that this sign would most likely indicate 1 The dose of the medication is too low. thrombocytopenia. The nurse monitors the complete blood count results for these changes. and anemia. Answer 4 Frequent side effects of this medication include leucopenia.Blood urea nitrogen 3. The nurse interprets that the client . Complete Blood count 2. 168. The client has developed inadequacy of thermoregulation 4 The result of another infection caused by leukopenic effects of the medication. 169. The client dveopls a temp of 101 degrees F. times per week during induction therapy. Serum creatinine is monitored before therapy. The client with acquired immunodeficiency syndrome and Pneumocystitis carinii infection has been receiving pentamidine (Pentam 300). 2.

171. The nurse would expect the serum lithium level to be which of the following. 1. Serum creatinine 2. diarrhea. 1. A serum lithium level of 1. Start during the first week of administration 2. 0. antaxia.5 to 2.5 mEq/L may produce vomiting.2 mEq/L. The nurse informs the client that the maximum desired effects may 1. muscle twitching. Serum amylase 3 Blood glucose 4 Serum protein Answer 2 A serum amylase level that is increased 1. Serum lithium concentrations of 1. and difficulty walking. and slurred speech.may have the medication discontinued by the physician if which of the following significantly elevated results is noted? 1.8 mEq/L indicates moderate toxicity. Start during the second week of administration .8 mEq/L Answer 4 The therapeutic serum level of lithium is 0. 1. A client receiving lithium carbonate (Lithobid ) complains of loose.7 mEq/L 2. incoordination. watery stools.3 mEq/L 4.5 to 2 times normal may signify pancreatitis in the client with acquired immunodeficiency syndrome and is potentially fatal.6 to 1. 1 mEq/L 3. 172 The nurse is teaching a client wh is being started on imipramine hydrochloride(Tofranil) about the medication.

174. The client needs to be taught to get out of bed slowly and to rise from a sitting position slowly because of this untoward effect related to the medication. an antipsychotic can cause postural hypotention. The nurse recognizes this complaints as a symptom of 1. A client receiving thioridazine hydrochloride (Mellaril) complains of feeling “faint” when trying to get out of bed in morning. Pscyhcosmomatic dysrhythmias 2. Not occur until after 2 months of administration. Answer 3 The maximum therapeutic effects of imipramine hydrochloride may not occur for 2 to 3 weeks after anti depressant therapy has been initiated 173. Which observation would indicate that the client is following the medication plan correctly? 1. The client receiving tryclic antidepressants arrives at the mental health clinic. 4.Cardiac dysrhythmias 3 Respiratory insufficiency 4.Client reports sleeping 12 hours per night and 3 to 4 hours during the day 2. Postural hypotension Answer 4 Thioridazine hydrochloride (Mellaril). Client reports not going to work for this past week 4. Not occur for 2 to 3 weeks of administration. Client arrives at the clinic neat and appropriate in appearance 3.3. Client complains of not being able to “do anything” anymore Answer 2 .

Depressed individuals will sleep for long perioids. Once they have had some therapeutic effect from their medication. Busipron hydrochloride most often is indicated for the treatment of anxiety . The nurse is performing a follow-up teaching session with a client discharged 1 month ago. The client is taking fluoxetine (Prozac). and feel as if they cannot “do anything”.3 Busipron hydrochloride is not recommended for the treatment of drug or alcohol withdrawal. Problems with excessive sweating 2. Cardiovascular symptoms 4. or schizophrenia. Alcohol withdrawal symptoms 2. Thought broadcasting or delusions Answer. Problems with mouth dryness Answer 2 The most common side effects related to this medication include central nervous system and gastrointestinal system dysnfunction. are not able to go to work. they will report resolution of many of these complaints and demonstrate an improvement in their appearance. 176 The client who has been taking busiprone hydrochloride (BuSpar) for 1 month returns to the clinic for a follow-up assessment. Gastrointestinal dysfunctions 3. Paranoid thought process 3 Rapid heartbeat or anxiety 4. The nurse determines that the medication is effective if the absence of which manifestation(S) has occurred? 1. though disorders. What information would be important for the nurse to obtain during this client visit regarding the side effects related to the medication? 1. 175.

177. A client taking lithium carbonate (Eskalith) reports vomiting, abdominal pain, diarrhea, blurred vision, tinnitus, and tremors. The lithium level is 2.5 mEq/L The nurse interprets this level as 1. Normal 2. Slightly above normal 3. Excessively below normal 4. Toxic Answer 4 Maintenance serum levels of lithum are 0.6 to 1.2 mEq/L. Symptoms of toxicity begin to appear at levels of 1.5 mEq/L to 2 mEq/L. Lithium toxicity requires immediate medical attention with lavage and possible peritoneal dialysis or hemodialysis.

178. A hospitalized client is prescribed chloral hydrate (Noctec). The nurse includes which action in the plan of care? 1. Monitor apical heart rate every 2 hours 2. Monitor blood pressure every 4 hours 3. Instruct the client to call for ambulation assistance 4. Clear a path to the bathroom at bedtime Answer 3 Chloral hydrate is sedative. This medication does not affect cardiac function.

179. The home health nurse visits the client. The client gives the nurse a bottle of clomipramine hydrochloride (Anafranil). The nurse notes that the medication has not been taken by the client in 2 months. What behaviors observed in the client would validate noncompliance with this medication? 1.Frequent hand washing with hot, soapy water 2. Complaints of hunger fatigue

3. A pulse rate fewer than 60 beats per minute 4. Complaints of insomnia Answer 1 Clomipramine hydrochloride is a tricyclic antidepressant used to treat obsessive compulsive disorder.

180 The mental health clinic nurse is discussing the activities of the past week with a client receiving amitriptyline hydrochloride (Elavil). The nurse evaluates that the medication is most effective for this client if the client reports which of the following? 1. Ability to get to work on time each day 2. Having difficulty concentrating on an activity 3. Sleeping 14 to 16 hours a day 4. Decrease in appetite Answer 1 Amitiriptyline is a tricyclic antidepressant. Depressed individuals sleep for extended periods, have difficulty concentrating. They may also experience increase fatigue, feelings of guilt or worthlessness, loss of interest in activities, and possible suicidal tendencies.

181. The client with schizophrenia has been started on medication therapy with haloperidol (Haldol). The nurse determines that the client is experiencing the intended effects of the medication if which of the following clients behaviors is observed? 1 Decreased appetite and food intake 2 Taking sips of water for dry mouth 3 Presence of a fixed stare 4 Absence of delusional statements Answer 4 Haloperidol (Haldol) is an antipsychotic used to manage psychotic disorder.

182. The hospitalized client has begun taking bupropion ( Wellbutrin) as an antidepressant agent. The nurse monitors this client for which adverse effect that indicates that the client is taking an excessive amount of medication? 1. Dizziness when getting upright 2 Seizure activity 3. Increased weight 4 Constipation Answer 2 The nurse monitors for signs of toxicity. Seizure activity is common in bupropion dosage greater than 450 mg daily. This medication does not cause significant orthostatic blood pressure changes.

183. The client has been started on medication therapy with alprazolam (Xanax). When the nurse teaches the client that the medication should not be discontinued abruptly, the client asks why. The nurse incorporates which of the following in formulating a reply? 1. Rebound central nervous system excitation could occur, causing feelings of restlessness and irritability 2. Abruptly stopping the medication will make the medication much less effective if it must be restarted. 3. The client is likely to become resistant to medication effects. 4. The client is likely to suffer irreversible damage to the kidneys Answer 1 The abrupt withdrawal of alprazolam could result in seizure activity from rebound central nervous system excitation. All clients receiving this medication should be warned of this danger.

184. The client’s medication sheet contains an order for sertraline hydrochloride (Zoloft). To ensure safe administration of the medication, the nurse would administer the dose. 1. Evenly spaced around the clock

which is monitored by reviewing the results of the white blood cell count. Agranulocytosis could be fatal if undetected and untreated 186. At the same time each evening 3. Liver function studies Answer 1 The client taking clozapine may experience agranulocytosis. 185. Blood glucose 4. Platelet count 3. A client is scheduled for discharge and will be taking Phenobarbital sodium (Luminal) for an extended period of time. 3 Take medication at the same time each day 4. White blood cell count 2.2. The client with schizophrenia has been started on medication therapy with clozapine (Clozaril). Use a dose container to help prevent missed doses. On an empty stomach 4. Avoid drinking alcohol while taking this medication 2. The nurse assess the results of which laboratory study to monitor for adverse effects from this medication? 1. Take the medication only with meals. The nurse Would place highest priority on teaching the client which of the following points that directly relates to client safety? 1. As needed when the client complains of depression Answer 2 Sertraline (Zoloft) is classified as an antidepressant sertraline generally is administered once every 24 hours may be administered in the morning or evening. . but evening administration may be preferable because drowsiness is a side effect. Treatment is interrupted if the white blood cell count drops below 3000 cells/mm3.

Eat snacks at midmorning and at bedtime. The client should avoid taking any other central nervous system depressants ( such as alcohol) while taking this medication. A client is receiving fluhenazine hydrochloride (Prolixin) daily. The 26-year-old female client with schizophrenia has been prescribed chlorpromazine (Throazine). Have the blood pressure checked once a week 2. Monitor the temperature daily 3. 187. Answer 4 Dry mouth is a common side effect. That this indicates medication toxicity. 4. 188. and chewing sugarless gum will alleviate this common side effect. The client calls for mental health clinic and tells the nurse that her urine has become dark. The client has no other urinary symptoms. That this is an expected side effect of the medication. and frequent snacks will worsen the problem. Hypotension and hypertension are rare side effects of fluphenazine. The nurse would teach the client to do which of the following to minimize common side effects of this medication? 1. Frequent mouth rinsing with water. 4. 2 To seek treatment for urinary tract infection 3. The client should be aware that this effect is harmless.Answer 1 Phenobarbital sodium is an anticonvulsant and a hypnotic agent. sucking on hard candy. Weigh gain is a common side effect. Mild leucopenia may occur but the temperatures does not need to be taken daily. The nurse tells the client 1 To increase intake of acid-ash foods and liquids. . A side effect of this medication is that the color of urine may darken. Use hard sour candy of sugarless gum. Answer 3 Chlorpromazine is an antipsychotic medication.

Additionally. the physician is notified 190. 2.189. The other options are incorrect. TEA 2 Fruit Juice 3 Pudding 4 Applesauce Answer 2 The oral concentrate form of thioridazine (Mellaril) should be diluted in water or fruit just before administration to the client. Take antidiarrheal agents if diarrhea occurs. and the client is instructed to increase fluid intake and bulk (high fiber) in the diet. The nurse is describing the medication side effects to a client who is taking oxazepam (Serax). Consume a low-fiber diet 4. The nurse incorporates in discussions with the client the need to 1. The nurse prepares this medication by mixing it in which of the following just before giving it to the client? 1. The nurse is administering thioridazine hydrochloride(Mellaril) in oral concentrate form. diarrhea could indicate an incomplete intestinal obstruction and if this occurs . . Answer 4 Oxazepam causes constipation. the physician is notified because this could indicate overdose. Increase fluids and bulk in the diet. If the heart begins to beat fast. Rest if the heart begins to beat rapidly 3.

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