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22 Cards in this Set
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1. The 34 year old female client who has children is prescribed the narcotic antitussive hydrocodone (Hycodan). Which information should the nurse discuss with the client?
A) Explain that this medication can be taken when pregnant. B) Teach them that this medication will not cause any type of addiction. C) Instruct the client to take 1 teaspoon after each cough. D) Discuss keeping the medication away from children. |
Answer-D:
This medication is a narcotic and, because the client is 34 years old and has at least 1 child, the nurse should discuss proper storage of the medication to prevent accidental poisoning of any children. This medication is pregnancy category C, has addictive properties because it is a narcotic, and should be taken every 4-6 hours. (SE: drowsiness, constipation, and nausea) |
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2. The client with asthma asks the nurse, “Why should I use the corticosteroid inhaler instead of prednisone?” Which statement by the nurse would be most appropriate?
A) “The lungs are incapable of utilizing prednisone to decrease inflammation.” B) “The inhaler costs less than prednisone, which is why it should be used.” C) “The inhaler will not cause the systemic problems that prednisone does.” D) “Prednisone is not on your insurance formulary and the inhaler is.” |
Answer-C:
The steroid inhaler does not cause the systemic problem of suppression of the adrenal gland and exposure of cells of the body to excess cortisol. The inhaler delivers the anti-inflammatory medication directly to the lungs, where effects are desired. -Prednisone causes Cushing’s Syndrome-HTN, hyperglycemia, petechiae, thin skin, truncal obesity, thin extremities, etc. |
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3. A client has a prescription to take guaifenesin (Mucinex). The nurse determines that the client understands the proper administration of this medication if the client states he or she will:
A) Take an extra dose if a fever develops B) Take the medication with meals only C) Take tablet with a full glass of water D) Decrease the amount of daily fluid intake |
Answer-C:
Mucinex is an expectorant and should be taken with a full glass of water to decrease the viscosity of secretions. Extra doses should not be taken. The client should contact the physician if the cough lasts longer than 1 week or is accompanied by fever, rash, soar throat, or persistent headache. Fluids are needed to decrease the viscosity of secretions. The medication does not have to be taken with meals. |
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4. A nurse is preparing to administer a dose of naloxone hydrochloride (Narcan) IV to a patient with an IV opioid overdose. Which supportive medical equipment would the nurse plan to have at the client’s bedside if needed?
A) Nasogastric tube B) Paracentesis tray C) Resuscitation equipment D) Central line insertion tray |
Answer-C:
The nurse administering Narcan for suspected opioid overdose should have resuscitation equipment readily available to support Narcan therapy if needed. Other adjuncts that may have been needed include oxygen, mechanical ventilator, and vasopressors. |
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5. A nurse teaches a client about the effects of diphenhydramine (Benadryl), which has been prescribed as a cough suppressant. The nurse determines that the client needs further instruction if the client states he or she will:
A) Take the medication on an empty stomach B) Avoid using alcohol while taking this medication C) Use sugarless gum, candy, or oral rinses to decrease dry mouth D) Avoid activities requiring mental alertness while taking this medication |
Answer-A:
Benadryl has several uses, including antihistamine, antitussive, antidyskinetic, and sedative-hypnotic. Instructions for use include taking with food or milk to decrease GI upset and using oral rinses or sugarless gum or hard candy to minimize dry mouth due to its anticholinergic effects. Because the medication causes drowsiness, the client should avoid use of alcohol or central nervous depressants, operating a car or heavy machinery, or engaging in other activities requiring mental awareness during use. |
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6. A cromolyn sodium (Intal) inhaler is prescribed for a client with allergic asthma. A nurse provides instructions regarding the side effects of this medication. The nurse tells the client that which undesirable effect is associated with this medication?
A) Insomnia B) Constipation C) Hypotension D) Bronchospasm |
Answer-D:
Intal is an inhaled nonsteroidal antiallergy agent and mast cell stabilizer. Undesirable effects associated with inhalation therapy of cromolyn sodium are bronchospasm, cough, nasal congestion, throat irritation, and wheezing. Clients receiving this medication orally may experience pruritus, nausea, diarrhea, and myalgia. |
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7. Terbutaline (Brethine) is prescribed for a client with bronchitis. A nurse understands that this medication should be used with caution if which of the following medical conditions is present in the client?
A) Osteoarthritis B) Hypothyroidism C) Diabetes mellitus D) Polycystic disease |
Answer-C:
Terbutaline is a bronchodilator and is contraindicated in patients with hypersensitivity to sympathomimetics. It should be used in caution in clients with impaired cardiac function, DM, HTN, hyperthyroidism, and or a history of seizures. The medication may increase blood glucose levels. A sympathomimetic is a drug that mimics the effects of the sympathetic nervous system like EPI -> so you would want to use caution in patients who have vascular diseases such as DM. |
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8. The nurse is preparing to administer the following medications. Which client would the nurse question administering the medication to?
A) The client receiving prednisone, a glucocorticoid, who has a glucose level of 140 mg/dL. B) The client receiving ceftriaxone (Rocephin), an antibiotic, who has a white blood cell count of 15,000. C) The client receiving heparin, an anticoagulant, who has a PTT level of 78 seconds with a control of 39. D) The client receiving theophylline who has a theophylline level of 25 mg/dL. |
D.
The therapeutic serum theophylline level is 10-20 mg/dL, and the client has a higher level. Therefore, the nurse should question administering this medication and holding the dose. |
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9. The client with an acute exacerbation of asthma is being treated with asthma medications. Which assessment data indicates the medication is effective?
A) The client has bilateral wheezing B) The client’s lung sounds are clear C) The client’s pulse oximeter reading is 90% D) The client has no peripheral clubbing |
Answer-B:
Clear lung sounds would indicate the medication has been effective. |
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10. A client has begun therapy on theophylline. A nurse plans to teach the client to limit the intake of which of the following while taking the medication?
A) Coffee, cola, and chocolate B) Oysters, lobster, and shrimp C) Melons, oranges, and pineapple D) Cottage cheese, cream cheese, and dairy creamers |
Answer-A:
Theophylline is a methylxanthine bronchodilator. The nurse teaches the client to avoid the intake of any xanthine containing foods while taking this medication -> anything that causes vasoconstriction, tachycardia, etc. May cause palpitations, arrhythmias, severe HTN, tachycardia, etc. |
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11. A nurse has an order to give client salmeterol, two puffs, and beclomethasone dipropionate, two puffs, by metered dose inhaler. The nurse administers the medication by giving the:
A) Beclomethasone first then the salmeterol B) Salmeterol first then the beclomethasone C) Alternating a single puff of each, beginning with the salmeterol D) Alternating a single puff of each, beginning with the beclomethasone |
Answer-B:
Salmeterol is an adrenergic type of bronchodilator and beclomethasone is a glucocorticoid. Bronchodilators are always administered before glucocorticoids when both are to be given on the same time schedule. This allows for widening of the air passages by the bronchodilator, which makes the glucocorticoid more effective. |
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12. The client has a PRN prescription for loperamide hydrochloride (imodum). For which condition should the nurse plan to administer this medication?
A) Constipation B) Abdominal pain C) An episode of diarrhea D) Hematest-positive nasogastric tube drainage |
Answer-C:
Loperamide is an antidiarrheal agent. It is used to manage acute and chronic diarrhea in conditions such as inflammatory bowel disease. Loperamide can aslo be used to reduce the volume of drainage from an ileostomy. |
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13. The client has a PRN prescription for ondansetron (Zofran). For which condition should the nurse administer this medication to the post-op client?
A) Paralytic ileus B) Incisional pain C) Urinary retention D) Nausea and vomiting |
Answer-D:
Zofran is an antiemetic used to treat post-op N/V. It also treats N/V associated with chemo. |
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14. An older client recently has been taking cimetidine (Tagamet). The nurse monitors the client for which of the most frequent CNS side effects of this medication?
A) Tremors B) Dizziness C) Confusion D) Hallucinations |
Answer-C:
Tagamet is a H2 receptor antagonist. Older clients are especially susceptible to CNS side effects of this medication. The most frequent of those is confusion. Less common CNS side effects include HA, dizziness, drowsiness, and hallucinations. |
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15. The client with a gastric ulcer has a prescription for sucralfate (Carafate), 1 g by mouth 4 times a daily. The nurse schedules the medication for which times?
A) With meals and at bedtime B) Every 6 hours around the clock C) One hour after meals and at bedtime D) One hour before meals and at bedtime |
Answer-D:
Carafate is a gastric protectant. The medication should be scheduled for administration 1 hour before meals and at bedtime. The medication is timed to allow it to form a protective coating over the ulcer before food intake stimulates gastric acid production and mechanical irritation. |
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16. The client with gastroenteritis is being discharged from the ER with a prescription for Phenergan, antiemetic. Which information should the nurse discuss with the client?
A) Explain that a sore throat and mouth sores are expected side effects. B) Tell the client to call the doctor if the urine turns a light amber color. C) Encourage the client to drink carbonated beverages D) Instruct the client not to drink alcohol with this medication |
Answer-D:
The patient should not consume alcohol with antiemetics because they intensify the sedative effect. |
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17. The charge nurse notices that the primary nurse is going to administer the antacid Maalox to the client along with his routine morning medications. Which action should the charge nurse take first?
A) Take no action because this is acceptable standard of practice. B) Discuss changing the administration time with the pharmacist. C) Inform the primary nurse not to administer the Maalox. D) Instruct the primary nurse to shake the Maalox container. |
Answer-C:
The client should not receive any oral medications 1-2 hours before or after taking an antacid because the antacid may interfere with absorption of the other medications. |
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18. Which of the following outcomes would indicate the intended response after administering lactulose, a laxative, to a client with end-stage liver disease? Choose all the apply.
A) The client’s decrease in pruritus B) The client’s abdominal girth has decreased C) The client is experiencing more than usual frequency in bowel movements D) The client’s ammonia level is decreased |
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19. The client has been taking Prilosec for 4 weeks. The ambulatory care nurse evaluates that the client is receiving optimal intended effect of the medication in the absence of which symptoms?
A) Diarrhea B) Heartburn C) Flatulence D) Constipation |
Answer-B:
Prilosec is a PPI classified as an antiulcer agent. The intended effect of the medication is relief of pain from gastric irritation, often called heartburn by clients. |
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20. Nurse Joy is preparing to administer medication through a nasogastric tube that is connected to suction. To administer the medication, the nurse would:
A) Position the client supine to assist in medication absorption B) Aspirate the nasogastric tube after medication administration to maintain patency C) Clamp the nasogastric tube for 30 minutes following administration of the medication D) Change the suction setting to low intermittent suction for 30 minutes after medication administration |
Answer-C
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21. The client who chronically uses NSAIDs has been taking Cytotec. The nurse determines that the medication is having the intended therapeutic effect if which of the following is noted?
A) Resolved Diarrhea B) Relief of epigastric pain C) Decreased platelet count D) Decreased WBC count |
Answer-B
The client who chronically uses NSAIDS is prone to gastric mucosal injury. Cytotec is a gastric protectant and is given specifically to prevent this occurrence. Diarrhea can be a side effect of the medication but is not an intended effect. |
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22. A client with a peptic ulcer is diagnosed with an H. Pylori infection. The nurse is teaching the client about the medications prescribed, including Biaxin, Nexium, and Amoxicillin. Which statement by the client indicates the best understanding of a medication regimen?
A) “My ulcer will heal because these medications will kill the bacteria.” B) “These medications are only taken when I have pain from my ulcer.” C) “The medications will kill the bacteria and stop the acid production.” D) “These medications will coat the ulcer and decrease the acid production in my stomach.” |
Answer-C.
Triple therapy for H. Pylori infection usually includes two antibacterial drugs and a PPI. Biaxin and Amoxicillin are antibacterials. Nexium is a PPI. These medications will kill the bacteria and decrease acid production. |
