Pharmacology Review for Nurses, Assignments of Nursing

Download Pharmacology Review for Nurses and more Assignments Nursing in PDF only on Docsity! ATI NR293 Pharm Final Review 1) A nurse is assessing a client who is taking levothyroxine. The nurse should recognize that which of the following findings is a manifestation of levothyroxine overdose? a) Insomnia i) Rationale: Levothyroxine overdose will result in manifestations of hyperthyroidism, which include Insomnia, tachycardia, and hyperthermia. b) Constipation i) Rationale: Constipation is a manifestation of hypothyroidism and indicates an inadequate dose of levothyroxine. c) Drowsiness i) Rationale: Drowsiness is a manifestation of hypothyroidism and indicates an inadequate dose of levothyroxine. d) Hypoactive deep-tendon reflexes i) Rationale: Hypoactive deep-tendon reflexes are manifestations of hypothyroidism and indicate an inadequate dose of levothyroxine. 2) A nurse is reviewing the medical record of a client who has been on levothyroxine for several months. Which of the following findings indicates a therapeutic response to the medication? a) Decrease in level of thyroxine (T4) i) Rationale: If the dose of this medication has been adequate, the nurse should see an increase in the T4. b) Increase in weight i) Rationale: If the dose of this medication has been adequate, the nurse should see a decrease in weight, as hypothyroidism causes a decrease in metabolism with weight gain. c) Increase in hr of sleep per night i) Rationale: If the dose of this medication has been adequate, the nurse should see a decrease in the hr of sleep per night, as hypothyroidism causes sluggishness with increased hr of sleep. d) Decrease in level of thyroid stimulating hormone (TSH). i) Rationale: In hypothyroidism, the nonfunctioning thyroid gland is unable to respond to the TSH, and no endogenous thyroid hormones are released. This results in an elevation of the TSH level as the anterior pituitary continues to release the TSH to stimulate the thyroid gland. Administration of exogenous thyroid hormones, such as levothyroxine, turns off this feedback loop, which results in a decreased level of TSH. 3) A nurse is reviewing the medication list for a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize which of the following medications can cause glucose intolerance? a) Ranitidine i) Serum creatinine levels b) Guafenesin i) Drowsiness and dizziness c) Prednisone i) Glucose intolerance and hyperglycemia, patient might require increased dosage of hypoglycemic med. d) Atorvastatin i) Thyroid function tests. 4) A nurse is caring for a client receiving mydriatic eye drops. Which of the following clinical manifestations indicates to the nurse that the client has developed a systemic anticholinergic effect? ATI NR293 Pharm Final Review a) Seizures b) Tachypnea c) Constipation i) Mydriatic eye drops can cause systemic anticholinergic effects such as constipation, dry mouth, photophobia, and tachycardia. d) Hypothermia ATI NR293 Pharm Final Review b) Ammonia i) Rationale: Lactulose, a disaccharide, is a sugar that works as an osmotic diuretic. It prevents absorption of ammonia in the colon. Accumulation of ammonia in the bloodstream, which occurs in pathologic conditions of the liver, such as cirrhosis, may affect the central nervous system, causing hepatic encephalopathy or coma. c) Potassium d) Bicarbonate 9) A nurse is educating a group of clients about the contraindications of warfarin therapy. Which of the following statements should the nurse include in the teaching? a) "Clients who have glaucoma should not take warfarin." b) "Clients who have rheumatoid arthritis should not take warfarin." c) "Clients who are pregnant should not take warfarin." i) Rationale: Warfarin therapy is contraindicated in the pregnant client because it crosses the placenta and places the fetus at risk for bleeding. d) "Clients who have hyperthyroidism should not take warfarin." 10) A nurse is teaching a client who takes warfarin daily. Which of the following statements by the client indicates a need for further teaching? a) "I have started taking ginger root to treat my joint stiffness." i) Rationale: Ginger root can interfere with the blood clotting effect of warfarin and place the client at risk for bleeding. This statement indicates the client needs further teaching. b) "I take this medication at the same time each day." i) Rationale: The client should take warfarin at the same time each day to maintain a stable blood level. c) "I eat a green salad every night with dinner." i) Rationale: Green leafy vegetables are a good source of vitamin K, which can interfere with the clotting effects of warfarin. Clients who are taking warfarin do not need to restrict dietary vitamin K intake but rather should maintain a consistent intake of vitamin K in order to control the therapeutic effect of the medication. d) "I had my INR checked three weeks ago. i) " Rationale: Clients who have been taking warfarin for more than 3 months should have their INR level checked every 2 to 4 weeks. 11) A patient is starting warfarin (Coumadin) therapy as part of treatment for atrial fibrillation. The nurse will follow which principles of warfarin therapy? (Select all that apply.) a) Teach proper subcutaneous administration b) Administer the oral dose at the same time every day c) Assess carefully for excessive bruising or unusual bleeding d) Monitor laboratory results for a target INR of 2 to 3 e) Monitor laboratory results for a therapeutic aPTT value of 1.5 to 2.5 times the control value ATI NR293 Pharm Final Review 12) Atorvastatin can elevate LFT a) Baseline total cholesterol, LDL and HDL level, triglycerides, and liver and renal function test obtained and then monitored periodically throughout treatment ATI NR293 Pharm Final Review 13) The nurse teaches a client who is recovering from acute kidney disease to avoid which type of medication? a) NSAIDS i) NSAIDs may be nephrotoxic to a client with acute kidney disease, and should be avoided. ACE inhibitors are used for treatment of hypertension and to protect the kidneys, especially in the diabetic client, from progression of kidney disease. Opiates may be used by clients with kidney disease if severe pain is present; however, excretion may be delayed. Calcium channel blockers can improve the glomerular filtration rate and blood flow within the kidney. b) ACE inhibitors c) Opiates d) Calcium channel blockers 14) Which of the following are adverse reactions related to the use of CELECOXIB? Select all that apply a) Rhinitis b) Neutropenia c) Oliguria d) Stomatitis 15) A nurse is caring for a client who has active pulmonary tuberculosis (TB) and is to be started on intravenous rifampin therapy. The nurse should instruct the client that this medication can cause which of the following adverse effects? a) Constipation b) Black colored stools c) Staining of teeth d) Body secretions turning a red-orange color i) Rationale: Rifampin is used in combination with other medicines to treat TB. Rifampin will cause the urine, stool, saliva 16) A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first? a) A. Check the client's vital signs. i) Rationale: It is possible that the client's nausea is secondary to digoxin toxicity. Assess for bradycardia, a symptom of digoxin toxicity. The nurse should withhold the medication and call the provider if the client's heart rate is less than 60 bpm. b) Request a dietitian consult. c) Suggest that the client rests before eating the meal. d) Request an order for an antiemetic. ATI NR293 Pharm Final Review following instructions should the nurse give to the client? a) "If the medicine causes an upset stomach, take an antacid at the same time." b) "Limit your daily fluid intake while taking this medication." ATI NR293 Pharm Final Review c) "This medication can cause photophobia, so be sure to wear sunglasses outdoors." d) "You should report any tendon discomfort you experience while taking this medication." i) Rationale: The nurse should instruct the client to report any tendon discomfort as well as swelling or inflammation of the tendons due to the risk of tendon rupture. 23) 17. A nurse is caring for a client who has cancer and a new prescription for ondansetron to treat chemotherapy- induced nausea. For which of the following adverse effects should the nurse monitor? a) Headache Rationale: Headache is a common adverse effect of ondansetron. Analgesic relief is often required. b) Dependent edema c) Polyuria. d) Photosensitivity 24) A nurse is preparing to administer verapamil by IV bolus to a client who is having cardiac dysrhythmias. For which of the following adverse effects should the nurse monitor when giving this medication? a) Hyperthermia b) Hypotension i) Rationale: Verapamil, a calcium channel blocker, can be used to control supraventricular tachyarrhythmias. It also decreases blood pressure and acts as a coronary vasodilator and antianginal agent. A major adverse effect of verapamil is hypotension; therefore, blood pressure and pulse must be monitored before and during parenteral administration. c) Ototoxicity d) Muscle pain 25) A nurse is providing teaching to a client who has renal failure and an elevated phosphorous level. The provider instructed the client to take aluminum hydroxide 300 mg PO three times daily. For which of the following adverse effects should the nurse inform the client? a) Constipation i) Rationale: Constipation is a common side effect of aluminum-based antacids. The nurse should instruct the client to increase fiber intake and that stool softeners or laxatives may be needed ATI NR293 Pharm Final Review b) B. Metallic taste c) Headache d) Muscle spasms ATI NR293 Pharm Final Review 30) A nurse is caring for a client who has poison ivy and is prescribed diphenhydramine. Which of the following instructions should the nurse give regarding the adverse effect of dry mouth associated with diphenhydramine? a) Administer the medication with food b) Chew on sugarless gum or suck on hard, sour candies i) Rationale: Clients who report dry mouth can get the most effective relief by sucking on hard candies (especially the sour varieties that stimulate salivation), chewing gum, or rinsing the mouth frequently. It is the local effect of these actions that provides comfort to the client. c) Place a humidifier at your bedside every evening d) Discontinue the medication and notify your provider 31) A nurse on an oncology unit is preparing to administer doxorubicin to a client who has breast cancer. Prior to beginning the infusion, the nurse verifies the client's current cumulative lifetime dose of the medication. For which of the following reasons is this verification necessary? a) An excess amount of doxorubicin can lead to myelosuppression. b) Exceeding the lifetime cumulative dose limit of doxorubicin might cause extravasation. c) An excess amount of doxorubicin can lead to cardiomyopathy. i) Rationale: Doxorubicin is an antineoplastic antibiotic used in the treatment of various cancers. Irreversible cardiomyopathy with congestive heart failure can result from repeated doses of doxorubicin, and prolonged use can also cause severe heart damage, even years after the client has stopped taking it. The maximum cumulative dose a client should receive is 550 mg/m or 450 mg/m with a history of radiation to the mediastinum. d) Exceeding the lifetime cumulative dose limit of doxorubicin might produce red tinged urine and sweat. 32) A nurse on an oncology unit is preparing to administer doxorubicin to a client who has breast cancer. Prior to beginning the infusion, the nurse verifies the client's current cumulative lifetime dose of the medication. For which of the following reasons is this verification necessary? a) An excess amount of doxorubicin can lead to myelosuppression. b) Exceeding the lifetime cumulative dose limit of doxorubicin might cause extravasation. c) An excess amount of doxorubicin can lead to cardiomyopathy. i) Rationale: Doxorubicin is an antineoplastic antibiotic used in the treatment of various cancers. Irreversible cardiomyopathy with congestive heart failure can result from repeated doses of doxorubicin, and prolonged use can also cause severe heart damage, even years after the client has ATI NR293 Pharm Final Review stopped taking it. The maximum cumulative dose a client should receive is 550 mg/m or 450 mg/m with a history of radiation to the mediastinum. d) Exceeding the lifetime cumulative dose limit of doxorubicin might produce red tinged urine and sweat. ATI NR293 Pharm Final Review 33) A nurse at an ophthalmology clinic is providing teaching to a client who has open angle glaucoma and a new prescription for timolol eye drops. Which of the following instructions should the nurse provide? a) The medication is to be applied when the client is experiencing eye pain. b) The medication will be used until the client's intraocular pressure returns to normal. c) The medication should be applied on a regular schedule for the rest of the client's life. i) Rationale: Medications prescribed for open angle glaucoma are intended to enhance aqueous outflow, or decrease its production, or both. The client must continue the eye drops on an uninterrupted basis for life to maintain intraocular pressure at an acceptable level. d) The medication is to be used for approximately 10 days, followed by a gradual tapering off. 34) A nurse is providing teaching to a client who has emphysema and a new prescription for theophylline. Which of the following instructions should the nurse provide? a) Consume a high-protein diet. i) Rationale: The nurse should instruct the client that a high-protein diet should be avoided, as it decreases theophylline's duration of action. b) Administer the medication with food. i) Rationale: The nurse should instruct the client that theophylline should be administered with 8 oz of water if GI upset occurs. It should not be administered with food. c) Avoid caffeine while taking this medication. i) Rationale: The nurse should instruct the client that caffeine should be avoided while taking theophylline, as it can increase central nervous system stimulation. d) Increase fluids to 1L/per day. i) Rationale: The nurse should instruct the client to increase fluid intake to 2L/day while taking theophylline to decrease the thickness of mucous secretions related to emphysema. 35) A nurse is caring for a client who is taking naproxen following an exacerbation of rheumatoid arthritis. Which of the following statements by the client requires further discussion by the nurse? a) "I signed up for a swimming class." b) "I've been taking an antacid to help with indigestion." i) NSAIDs, like naproxen, can cause serious adverse gastrointestinal reactions such as ulceration, ATI NR293 Pharm Final Review i) Rationale: The client should always use the bronchodilator (albuterol) prior to using the leukotriene modifier (cromolyn). Using the bronchodilator first allows the airways to be opened, ensuring that the maximum dose of medication will get to the client's lungs. c) “I will use both medications immediately after exercising.” d) “I will administer the medications 10 minutes apart.” ATI NR293 Pharm Final Review 39) A nurse is caring for a client who has heart failure and a prescription for digoxin. Which of the following statements by the client indicates an adverse effect of the medication? a) "I can walk a mile a day." b) "I've had a backache for several days." c) "I am urinating more frequently." d) "I feel nauseated and have no appetite." Rationale: Anorexia, nausea, vomiting, and abdominal discomfort are early signs of digoxin toxicity. 40) A nurse is caring for a client who has HIV-1 infection and is prescribed zidovudine as part of antiretroviral therapy. The nurse should monitor the client for which of the following adverse effects of this medication? a) Cardiac dysrhythmia b) Metabolic alkalosis c) Renal failure d) Aplastic anemia 41) A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication? a) The leukocyte count b) The platelet count c) The hematocrit (Hct) i) Rationale: Epoetin alfa is an antianemic medication that is indicated in the treatment of clients who have anemia due to reduced production of endogenous erythropoietin, which may occur in clients who have end-stage renal disease or myelosuppression from chemotherapy. The therapeutic effect of epoetin alfa is enhanced red blood cell production, which is reflected in an increased RBC, Hgb, and Hct. d) The erythrocyte sedimentation rate (ESR) 42) A nurse is providing teaching for a client who is newly diagnosed with type 2 diabetes mellitus and has a prescription ATI NR293 Pharm Final Review for glipizide. Which of the following statements by the nurse best describes the action of glipizide? a) "Glipizide absorbs the excess carbohydrates in your system." b) "Glipizide stimulates your pancreas to release insulin." ATI NR293 Pharm Final Review d) Relieves pain 46) A nurse is providing teaching for a client who has anemia and a new prescription for ferrous sulfate liquid. Which of the following instructions should the nurse provide? a) Take the medication on an empty stomach to decrease gastrointestinal irritation. b) Take the medication with orange juice to enhance absorption. i) Take between meals for optimal absorption ii) Rationale: Ascorbic acid (vitamin C), which is found in orange juice, will enhance the absorption of iron and increase its bioavailability. This will also help to decrease the gastrointestinal side effects of iron. c) Take the medication with milk. d) Rinse the mouth before taking the iron. 47) nurse is caring for a child who has asthma and a prescription for montelukast granules. Which of the following instructions should the nurse provide the client's parent on administering the medication? a) Give the medication in the morning daily. i) Rationale: Montelukast is a leukotriene receptor antagonist that is used to prevent asthma symptoms. It works by blocking the action of leukotrienes (substances that cause inflammation, fluid retention, mucous secretion, and constriction) in the client's lungs. Due to the side effect of drowsiness, it is usually taken once a day in the evening. b) Administer the medication 2 hr before exercise. i) Rationale: Montelukast should be given daily during the evening, except when being used for exercise-induced bronchospasm. It should then be given 2 hr before exercise, and not given again for 24 hr. c) Give the medication at the onset of wheezing. i) Rationale: Montelukast is ineffective as a rescue medication. d) Administer the granules mixed with 20 oz of water. i) Rationale: Montelukast granules should be taken directly or mixed with certain soft foods (applesauce, carrots, rice or ice cream). 48) A nurse in a provider's clinic is assessing a client who has cancer and a prescription for methotrexate PO. Which of the following actions should the nurse take when the client reports bleeding gums? a) Explain to the client that this is an expected adverse effect. b) Check the value of the client's current platelet count. c) Instruct the client to use an electric toothbrush. ATI NR293 Pharm Final Review d) Have the client make an appointment to see the dentist. 49) A nurse is teaching a client who has bipolar disorder and a prescription for lithium to recognize the manifestations of toxicity. Which of the following statements by the client indicates an understanding of the teaching? ATI NR293 Pharm Final Review a) "I will report any loss of appetite." b) "Increased flatulence is an indication of toxicity." c) "Vomiting is an indication of toxicity." d) "I will call my provider if I experience any headaches." 50) Bacterial conjunctivitis, know to apply a) Thin line into the conjunctival sac 51) A nurse in a public clinic is planning a health fair for older adult clients in the community. In teaching medication safety, which of the following foods should the nurse advise the clients to avoid when taking their prescriptions? a) Carbonated beverage b) Milk c) OJ d) Grapefruit juice 52) A nurse is caring for a client who has nausea and a prescription for metoclopramide intermittent IV bolus every 4 hr as needed. The client asks the nurse how metoclopramide will relieve her nausea. Which of the following explanations should the nurse provide? a) "The medication relieves nausea by promoting gastric emptying." i) Rationale: Reglan is a gastrointestinal stimulant used to relieve nausea, vomiting, heartburn, stomach pain, bloating, and a persistent feeling of fullness after meals. Reglan works by promoting gastric emptying. b) "The medication works by decreasing gastric acid secretions." i) Rationale: Reglan does not decrease gastric acid secretions. c) "The medication relieves nausea by slowing peristalsis." i) Rationale: Reglan does not slow peristalsis. d) "The medication works by relaxing gastric muscles. i) Rationale: Metoclopramide increases gastric muscle contraction. 53) A nurse is caring for a client who has developed gout. Which of the following medications should the nurse prepare to administer? a) Zolpidem b) Alprazolam ATI NR293 Pharm Final Review 57) Ophthalmic ointment for pre-k age child w pink eye, what should nurse include in instructions a) Discard first few drops ATI NR293 Pharm Final Review 58) A nurse is teaching a client who takes warfarin daily. Which of the following statements by the client indicates a need for further teaching? a) "I have started taking ginger root to treat my joint stiffness." i) Rationale: Ginger root can interfere with the blood clotting effect of warfarin and place the client at risk for bleeding. This statement indicates the client needs further teaching. b) "I take this medication at the same time each day." i) Rationale: The client should take warfarin at the same time each day to maintain a stable blood level. c) "I eat a green salad every night with dinner." i) Rationale: Green leafy vegetables are a good source of vitamin K, which can interfere with the clotting effects of warfarin. Clients who are taking warfarin do not need to restrict dietary vitamin K intake but rather should maintain a consistent intake of vitamin K in order to control the therapeutic effect of the medication. d) "I had my INR checked three weeks ago." i) Rationale: Clients who have been taking warfarin for more than 3 months should have their INR level checked every 2 to 4 weeks. 59) A nurse is teaching a client about the adverse effects of cisplatin. Which of the following adverse effects should the nurse include in the teaching? a) Tinnitus b) Constipation c) Hyperkalemia d) Weight gain 60) nurse is caring for a client who is experiencing severe nausea and vomiting after a course of chemotherapy. The nurse should monitor the client for which of the following clinical manifestations? a) Metabolic acidosis b) Metabolic alkalosis i) Rationale: Metabolic alkalosis can occur in clients who have excessive vomiting because of the loss of hydrochloric acid. c) Respiratory acidosis d) Respiratory alkalosis 61) A nurse is completing a medical interview with a client who has elevated cholesterol levels and takes warfarin. The nurse should recognize that which of the following actions by the client can potentiate the effects of warfarin? ATI NR293 Pharm Final Review a) The client follows a low-fat diet to reduce cholesterol. b) The client drinks a glass of grapefruit juice every day. c) The client sprinkles flax seeds on food 1 hr before taking the anticoagulant. ATI NR293 Pharm Final Review 66) A charge nurse is supervising a newly licensed nurse care for a client who is receiving a transfusion of packed RBC. The nurse suspects a possible hemolytic reaction. After stopping the blood transfusion, which of the following actions by the new nurse requires intervention by the charge nurse? a) The nurse initiates an infusion of 0.9% sodium chloride. b) The nurse collects a urine specimen. c) The nurse sends a blood specimen to the laboratory. d) The nurse starts the transfusion of another unit of blood product. i) When suspecting a hemolytic reaction, the nurse should immediately stop the transfusion of all blood products. The transfusion of additional products can increase the client's risk for further complication 67) A nurse is assessing a client who is receiving a unit of packed red blood cells. Which of the following findings is a manifestation of acute hemolytic reaction? a) Client report of low back pain i) Rationale: Manifestations of an acute hemolytic reaction include apprehension, tachypnea, hypotension, chest pain, and lower back pain. b) Client report of tinnitus i) Rationale: Tinnitus is a manifestation of ototoxicity and is an adverse effect of aminoglycoside antibiotics. c) A productive cough i) Rationale: A cough is a manifestation of circulatory overload. d) Distended neck veins i) Rationale: Distended neck veins are a manifestation of circulatory overload. 68) A nurse is caring for a client who is receiving a transfusion of packed red blood cells and suspects that the client is experiencing a hemolytic reaction. Which of the following interventions is the priority? a) Collect a urine specimen. b) Administer 0.9% sodium chloride through the IV line. c) Stop the transfusion. i) Rationale: The greatest risk to the client is injury due to further hemolysis; therefore, the priority action is to stop the transfusion. When suspecting a hemolytic reaction, the priority action by the nurse is to immediately stop the transfusion to prevent further hemolysis. d) Notify the blood bank. ATI NR293 Pharm Final Review 69) A nurse is preparing to administer phenytoin IV to a client who has a seizure disorder. Which of the following actions should the nurse plan to take? a) Administer the medication at 100 mg/min. i) Rationale: The nurse should administer phenytoin IV slowly, not faster than 50 mg/min, to reduce the risk of hypotension. b) Administer a saline solution after injection. i) Rationale: The nurse should flush the injection site with a saline solution after the injection of phenytoin to reduce and prevent venous irritation. ATI NR293 Pharm Final Review c) Hold the injection if seizure activity is present. i) Rationale: The nurse should administer phenytoin to prevent and to abort seizure activity. d) Dilute the medication with dextrose 5% in water. i) Rationale: The nurse should dilute phenytoin in 0.9% sodium chloride solution to prevent precipitation of the medication. 70) A nurse is planning care for a client who has a detached retina and is preoperative for a surgical repair. The nurse should prepare to administer which of the following medications? a) Phenylephrine i) Mydriatic medications, such as phenylephrine, are used preoperatively to dilate pupils to facilitate intraocular surgery. b) Latanoprost c) Pilocarpine d) Timolol 71) A nurse is assessing a client who is receiving a parental lipid infusion. Which of the following findings is a manifestation of fat overload syndrome? a) Elevated temperature i) Rationale: An elevated temperature is an early manifestation of fat overload syndrome. The client is at risk for coagulopathy and multi-organ system failure due to fat overload syndrome. b) Hypertension c) Peripheral edema d) Erythema at the insertion site 72) A nurse is caring for a female client who has rheumatoid arthritis and asks the nurse if it is safe for her to take aspirin. The nurse should recognize which of the following findings in the client's history is a contraindication to this medication? a) Report of recent migraine headaches b) History of gastric ulcers ATI NR293 Pharm Final Review 76) A nurse is teaching a client who has a new prescription for fluoxetine to treat depression. Which of the following statements by the client indicates an understanding of the teaching? a) "I should expect to feel better after 24 hours of starting this medication." b) "I should not take this medicine with grapefruit juice." c) "I'll take this medicine with food." ATI NR293 Pharm Final Review d) "I'll take this medicine first thing in the morning." 77) A nurse is instructing the parents of a client who has a new prescription for methylphenidate. Which of the following instructions should the nurse include? a) Avoid activities that require alertness such as driving. i) Rationale: The client should avoid driving and other activities that require alertness until the effects of this medication are known. b) Increase caffeine intake. c) Take this medication before bedtime. d) Reduce calorie intake. 78) A client has begun medication therapy with pancrelipase (Pancrease). The nurse determines that the medication is having the optimal intended benefit if which effect is observed? a) Weight loss b) Relief of heartburn c) Reduction of steatorrhea d) Absence of abdominal pain 79) A nurse is teaching a client who has a new prescription for pancrelipase to aid in digestion. The nurse should inform the client to expect which of the following GI changes? a) Decreased fat in stools, as this medication is used to increase digestions of fats, carbs, and proteins. 80) A nurse is teaching a client how to draw up regular insulin and NPH insulin into the same syringe. Which of the following instructions should the nurse include? a) Discard regular insulin that appears cloudy. Regular insulin is clear. NPH is cloudy. 81) A HCP should question the use of dimenhydrinate for a patient who has which of the following disorders? a) Angle-closure glaucoma. An antihistamine is inappropriate for patients who have this condition because it has anticholinergic properties, which increase intraocular pressure. 82) A HCP is caring for a patient who is about to begin using dimenhydrinate to prevent motion sickness. Which of the following instructions should the HCP include when talking with the patient? (select all that apply) a) Take the drug 30-60 minutes before activities that trigger nausea; avoid activities that require alertness, as this medication can cause sedation; and increase fluid and fiber intake, as this medication can cause dry mouth and constipation. 83) A nurse is teaching a client who has a new prescription for dimenhydrinate. Which of the following instructions should the nurse include in the teaching? a) Monitor for dizziness. Dimenhydrinate can cause dizziness and drowsiness. ATI NR293 Pharm Final Review 84) A nurse in a substance abuse clinic is assessing a client who recently started taking disulfiram. The client reports having discontinued the medication after experiencing severe nausea and vomiting. Which of the following reasons should the nurse suspect to be a likely cause of the client's distress? ATI NR293 Pharm Final Review Urticaria i) Rationale: For clients who have previously had allergic reactions to blood transfusions, administering an antihistamine such as diphenhydramine prior to the transfusion might prevent future reactions. Allergic reactions typically include urticaria (hives). b) Fever i) Rationale: An antihistamine will not prevent a febrile, non-hemolytic reaction to a blood transfusion. A possible preventive measure is transfusing leucocyte-poor blood products to avoid sensitization to the donor's WBC. c) Fluid overload i) Rationale: An antihistamine will not prevent fluid overload. Transfusing the blood product slowly and not exceeding the volume that is necessary can reduce this risk. d) Hemolysis i) Rationale: An antihistamine will not prevent hemolysis, which results from incompatibility between the donor and the recipient. 91) A nurse is preparing to administer nalbuphine to a postoperative client who is experiencing pain. The nurse should monitor the client for which of the following potential adverse effects of this medication? a) Miosis i) Rationale: Adverse effects of nalbuphine include visual disturbances such as miosis, blurred vision, and diplopia. b) Joint pain c) Diarrhea d) Oliguria 92) A HCP is caring for a patient who is about to begin taking dantrolene for skeletal muscle spasms. The HCP should tell the patient to report which of the following adverse effects? a) Diarrhea. Other adverse effects include nausea and vomiting. 93) A HCP is caring for a patient who is about to begin taking dantrolene (Dantrium) for skeletal muscle spasms. The HCP should recognize that which of the following laboratory tests requires monitoring? a) Liver function, as liver toxicity is a serious side effect of dantrolene. 94) A nurse is teaching a client who has a duodenal ulcer about his new prescription for cimetidine. The nurse should include a) ATI NR293 Pharm Final Review which of the following instructions in the teaching? a) Your doctor might need to reduce your theophylline dose while taking this medication. 95) A nurse is reviewing the laboratory results of a client who has liver failure with ascites and is receiving spironolactone. Which of the following findings should the nurse expect? ATI NR293 Pharm Final Review a) Decreased sodium level i) Rationale: The nurse should expect a decreased sodium level. Spironolactone is a potassium-sparing diuretic that inhibits the action of aldosterone, resulting in an increased excretion of sodium. b) Decreased phosphate level c) Decreased potassium level d) Decreased chloride level 96) A patient recovering from a total knee arthroplasty has been prescribed acetaminophen for mild discomfort that does not require an opioid. The health care professional should tell the patient to report which of the following early indications of acetaminophen overdose? a) Diaphoresis, nausea, and diarrhea. 97) Someone had a arthroplasty for hip, the nurse should anticipate which of the following px: a) aspirin, lovenox/enoxaparin 98) A health care professional is caring for a patient who is about to begin taking celecoxib (Celebrex) to treat RA. The health care professional should tell the patient to report which of the following adverse reactions? a) Chest pain. COX-2 inhibitors can cause cardiovascular or cerebrovascular events. 99) A nurse is assessing a client who has heart failure and is prescribed furosemide. Which of the following findings is an adverse effect of this medication? a) Leg cramps, which is a manifestation of hypokalemia. 100) A nurse is caring for a client who has heart failure and a new prescription for furosemide. Which of the following laboratory values should the nurse review before administering furosemide? a) Potassium. 101) A nurse is planning to apply a transdermal analgesic cream prior to inserting an IV for a preschool-age child. Which of the following actions should the nurse plan to take? a) Apply to intact skin, apply the medication 1 hour before the procedure begins, cleanse the skin prior to procedure, and use a visual pain rating scale to evaluate the effectiveness of the treatment 102) A nurse is caring for a 2-year-old child who has seizures and is receiving phenytoin in suspension form. Which of the following actions should the nurse take before administering each dose? a) Shake the container vigorously. This ensures the particles of the medication are evenly distributed.