Download ATI Pharmacology Quiz with answers and more Quizzes Nursing in PDF only on Docsity!
- 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? Click here for answers https://bit.ly/3aq6W3o
A. Constipation
Rationale: Rifampin does not cause constipation. More common gastrointestinal effects are diarrhea and nausea.
B. Black colored stools
Rationale: It is most commonly iron supplements that cause stools to turn black, not rifampin.
C. Staining of teeth Click here for answers https://bit.ly/3aq6W3o
Rationale: Teeth may be stained from taking liquid iron preparations, not from taking rifampin.
D. Body secretions turning a red-orange color
Rationale: Rifampin is used in combination with other medicines to treat TB. Rifampin will cause the urine, stool, saliva, sputum, sweat, and tears to turn reddish-orange to reddish-brown.
- 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. Check the client's vital signs.
Rationale: It is possible that the client's nausea is secondary to digoxin toxicity. By obtaining vital signs, the nurse can assess for bradycardia, which is 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.
Rationale: While the dietitian might be able to assist the client with making appropriate food choices, this is not the first action the nurse should take.
C. Suggest that the client rests before eating the meal.
Rationale: While this intervention might be appropriate, this is not the first action the nurse should take.
D. Request an order for an antiemetic. Click here for answers https://bit.ly/3aq6W3o
Rationale: While this intervention might relieve the client's nausea, this is not the first action the nurse should take.
- A nurse is caring for a client who has difficulty swallowing medications and is prescribed enteric-coated aspirin PO once daily. The client asks if the medication can be crushed to make it easier to swallow. Which of the following responses should the nurse provide?
A. "Crushing the medication might cause you to have a stomachache or indigestion."
Rationale: The pill is enteric-coated to prevent breakdown in the stomach and decrease the possibility of GI distress. Crushing the pill destroys that protection.
B. "Crushing the medication is a good idea, and I can mix it in some ice cream for you." Click here for answers https://bit.ly/3aq6W3o
Rationale: Crushing the pill will destroy the enteric coating, and the client should be advised against this. The client should be told not to break, crush, or chew enteric -coated tablets.
C. "Crushing the medication would release all the medication at once, rather than over time."
Rationale: Crushing the pill will destroy the enteric coating, and the client should be advised against this, but the enteric coating does not prevent the release of medication. Sustained release preparations disburse the medication over time.
D. "Crushing is unsafe, as it destroys the ingredients in the medication."
Rationale: Many medications can safely be crushed to make them easier to swallow. The client should check with his provider for information about which medications can be safely crushed.
- A nurse is caring for four clients for whom she has to administer oral medications in the morning. The nurse should administer which of the following medications before breakfast?
A. Alendronate Click here for answers https://bit.ly/3aq6W3o
Rationale: The client must take alendronate first thing in the morning on an empty stomach and wait at least 30 minutes before eating, drinking, or taking other medications.
B. Digoxin
Rationale: Digoxin treats hearts failure and dysrhythmias. While it is important that the client get the morning dose in a timely manner, the nurse does not have to administer it before a meal.
C. Mycostatin mouthwash
Rationale: Any mouthwash or rinse is most effective after a meal.
D. Divalproex Click here for answers https://bit.ly/3aq6W3o
Rationale: Divalproex, an anticonvulsant, helps control seizures and treats the manic phase of bipolar disorder. The client should take the dose on time, but not necessarily before a meal.
- A nurse is caring for a client who has bipolar disorder and has been taking lithium for 1 year. Before administering the medication, the nurse should check to see that which of the following tests have been completed?
A. Thyroid hormone assay
Rationale: Thyroid testing is important because long-term use of lithium may lead to thyroid dysfunction.
B. Liver function tests
Rationale:
Both albuterol and cromolyn are used to prevent exercise-induced bronchospasm, but administration should be made prior, not after, exercising.
D. "I will administer the medications 10 minutes apart."
Rationale: Inhalations of different medications should be administered 2 to 5 minutes apart.
- A nurse is completing a medication history for a client who reports using over-the-counter calcium carbonate antacid. Which of the following recommendations should the nurse make about taking this medication?
A. Decrease bulk in the diet to counteract the adverse effect of diarrhea. Click here for answers https://bit.ly/3aq6W3o
Rationale: The major adverse effect of calcium carbonate is constipation. The nurse should recommend the client increase bulk in the diet.
B. Take the medication with dairy products to increase absorption.
Rationale: Taking calcium carbonate with milk predisposes the client to milk alkali syndrome, which is characterized by headache, confusion, nausea, vomiting, alkalosis, and hypercalcemia.
C. Reduce sodium intake.
Rationale: Clients who take aluminum hydroxide, not calcium carbonate, antacids should be advised against excessive sodium intake in the diet.
D. Drink a glass of water after taking the medication.
Rationale: Calcium carbonate is a dietary supplement used when the amount of calcium taken in t he diet is not enough. Calcium carbonate may also be used as an antacid to relieve heartburn, acid indigestion, and stomach upset. The client should drink a full glass of water after taking an antacid to enhance its effectiveness.
- A nurse is caring for a client who has deep vein thrombosis and has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make?
A. "Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level."
Rationale: Heparin and warfarin are both anticoagulants that decrease the clotting ability of the blood and help prevent thrombosis formation in the blood vessels. However, these medications work in different ways to achieve therapeutic coagulation and must be given together until therapeutic levels of anticoagulation can be achieved by warfarin alone, which is usually within 1 to 5 days. When the client's PT and INR are within therapeutic range, the heparin can be discontinued.
B. "I will call the provider to get a prescription for discontinuing the IV heparin today." Click here for answers https://bit.ly/3aq6W3o
Rationale: Discontinuing the IV heparin is not indicated at this time.
C. "Both heparin and warfarin work together to dissolve the clots."
Rationale:
Neither medication dissolves clots that have already formed.
D. "The IV heparin increases the effects of the warfarin and decreases the length of your hospital stay."
Rationale: Neither medication increases the effects of the other.
- A nurse is providing teaching to a client who has asthma and a new prescription for inhaled beclomethasone. Which of the following instructions should the nurse provide?
A. Check the pulse after medication administration.
Rationale: Beclomethasone, an inhaled glucocorticoid, does not cause cardiac side effects.
B. Take the medication with meals.
Rationale: Oral, not inhaled, glucocorticoids should be administered with food.
C. Rinse the mouth after administration.
Rationale: Use of glucocorticoids by metered dose inhaler can allow a fungal overgrowth in the mouth. Rinsing the mouth after administration can lessen the likelihood of this complication.
D. Limit caffeine intake. Click here for answers https://bit.ly/3aq6W3o
Rationale: Caffeine does not interact with beclomethasone and is not contraindicated.
- A nurse caring for a client who has hypertension and asks the nurse about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients who have a history of which of the following conditions?
A. Asthma
Rationale: Propranolol, a beta-blocker, is contraindicated in clients who have asthma because it can cause bronchospasms. Propranolol blocks the sympathetic stimulation, which prevents smooth muscle relaxation.
B. Glaucoma
Rationale: Beta-blockers are contraindicated in clients who have cardiogenic shock, but are not contraindicated in a client who has glaucoma.
C. Depression
Rationale: Beta-blockers are contraindicated in clients who have AV heart block, but are not contraindicated in clients who have depression.
D. Migraines
Rationale: Beta-blockers are used for prophylactic treatment of migraine headaches.
A. The client not been taking the medication properly.
Rationale: The nurse should not document the client has not been taking the medication properly without further investigation. The client is able to tell the nurse that he had to increase the dose, which does not indicate taking the medication improperly.
B. The client is experiencing episodes of confusion. Click here for answers https://bit.ly/3aq6W3o
Rationale: The nurse should not document the client is experiencing confusion. The client is clearly able to tell the nurse that that he had to increase the dose to achieve pain relief. This does not indicate the client is confused.
C. The client has become addicted to the medication.
Rationale: Addiction is the compulsive need for and use of a habit-forming substance, such as a narcotic. However, this client is not describing addiction, and addiction is not a concern when treating a terminal client who has cancer pain.
D. The client developed a tolerance to the medication.
Rationale: The nurse should document that the client has developed a tolerance to the medication. Morphine is a narcotic analgesic used for the treatment of severe pain. Tolerance is an adverse effect of narcotic analgesics in which a larger dose is needed to produce the same response.
Click here for answers https://bit.ly/3aq6W3o
- A nurse is assessing a client who is receiving IV vancomycin. The nurse notes a flushing of the neck and tachycardia. Which of the following actions should the nurse take?
A. Document that the client experienced an anaphylactic reaction to the medication.
Rationale: The nurse should document that this client is experiencing Red man syndrome, which can lead to anaphylaxis if not resolved.
B. Change the IV infusion site.
Rationale: This client is experiencing Red man syndrome. Changing the IV site will not alter this phenomenon, which is due to a reaction to the medication.
C. Decrease the infusion rate on the IV.
Rationale: This client is experiencing Red man syndrome, which includes a flushing of the neck, face, upper body, arms and back along with tachycardia, hypotension and urticaria. This can lead to an anaphylactic reaction if the IV infusion rate is not slowed down to run greater than 1 hour.
D. Apply cold compresses to the neck area.
Rationale: This client is experiencing Red man syndrome. Applying a cold compress to the flushed area of the neck will not resolve this phenomenon, which can lead to anaphylaxis if not addressed.
- A nurse is teaching a client who has a urinary tract infection (UTI) and is taking ciprofloxacin. Which of the following instructions should the nurse give to the client?
A. "If the medicine causes an upset stomach, take an antacid at the same time."
Rationale: Ciprofloxacin is best absorbed on an empty stomach with a full glass of water. Antacids containing either magnesium or aluminum can decrease the absorption of ciprofloxacin. If an antacid is taken, the nurse should instruct the client to wait at least 2 hr after administering the ciprofloxacin.
B. "Limit your daily fluid intake while taking this medication."
Rationale: The nurse should instruct the client that ciprofloxacin is a fluoroquinolone antibiotic used in the treatment of mild to severe infections. It is excreted primarily via the kidneys, and drinking extra fluids will reduce the risk of crystallization in the kidneys.
C. "This medication can cause photophobia, so be sure to wear sunglasses outdoors."
Rationale: Ciprofloxacin can cause phototoxicity, putting the client at risk for extreme sunburn from minimal sun exposure. The client should wear protective clothing when out in the sun. Photophobia is eye sensitivity to light.
D. "You should report any tendon discomfort you experience while taking this medication."
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.
- 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
Rationale: Dependent edema is not an adverse effect of ondansetron.
C. Polyuria
Rationale: Urinary retention, not polyuria, is a common adverse effect of ondansetron.
D. Photosensitivity
Rationale: Photosensitivity is not an adverse effect of ondansetron.
- 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
Rationale: Temperature is not affected by verapamil.
B. Hypotension
Rationale:
Headache is not an adverse effect of aluminum hydroxide.
D. Muscle spasms
Rationale: Muscle spasms are not an adverse effect of aluminum hydroxide.
- 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
Rationale: Levothyroxine overdose will result in manifestations of hyperthyroidism, which include insomnia, tachycardia, and hyperthermia.
B. Constipation
Rationale: Constipation is a manifestation of hypothyroidism and indicates an inadequate dose of levothyroxine.
C. Drowsiness
Rationale: Drowsiness is a manifestation of hypothyroidism and indicates an inadequate dose of levothyroxine.
D. Hypoactive deep-tendon reflexes
Rationale: Hypoactive deep-tendon reflexes are manifestations of hypothyroidism and indicate an inadequate dose of levothyroxine.
- A nurse is teaching a client who has been taking prednisone to treat asthma and has a new prescription to discontinue the medication. The nurse should explain to the client to reduce the dose gradually to prevent which of the following adverse effects?
A. Hyperglycemia
Rationale: Hyperglycemia is an adverse effect of prednisone, especially for clients who have a history of diabetes mellitus. Once the medication is discontinued, however, this adverse effect should not occur.
B. Adrenocortical insufficiency
Rationale: Prednisone, a corticosteroid, is similar to cortisol, the glucocorticoid hormone produced by the adrenal glands. It relieves inflammation and is used to treat certain forms of arthritis, severe allergies, autoimmune disorders, and asthma. Administration of glucocorticoids can suppress production of glucocorticoids, and an abrupt withdrawal of the drug can lead to a syndrome of adrenal insufficiency.
C. Severe dehydration Click here for answers https://bit.ly/3aq6W3o
Rationale: Fluid retention is an adverse effect of prednisone. Once the medication is discontinued, however, this adverse effect should not occur.
D. Rebound pulmonary congestion
Rationale: Fluid retention is an adverse effect of prednisone. Rebound pulmonary congestion should not occur with withdrawal of prednisone. Prednisone has no direct effect on the client's pulm onary congestion.
- A nurse is preparing a client for surgery. Prior to administering the prescribed hydroxyzine, the nurse should explain to the client that the medication is for which of the following indications? (Select all that apply.)
A. Controlling emesis
B. Diminishing anxiety
C. Reducing the amount of narcotics needed for pain relief
D. Preventing thrombus formation
F. Drying secretions
Rationale: Controlling emesis is correct. Hydroxyzine is an effective antiemetic that may be used to control nausea and vomiting in preoperative and postoperative clients.Diminishing anxiety is correct. Hydroxyzine is an effective antianxiety agent that may be used to diminish anxiety in surgical clients, as well as in clients who have moderate anxiety.Reducing the amount of narcotics needed for pain relief is correct. Hydroxyzine potentiates the actions of narcotic pain medications; therefore, narcotic requirements may be significantly reduced.Preventing thrombus formation is incorrect. Hydroxyzine, an antihistamine, has no role in the prevention of thrombi.Drying secretions is correct. Hydroxyzine, an antihistamine, commonly causes drying of the oral mucous membranes.
- A nurse is caring for a client who has streptococcal pneumonia and a prescription for penicillin G by intermittent IV bolus. 10 minutes into the infusion of the third dose, the client reports that the IV site itches and that he feels dizzy and short of breath. Which of the following actions should the nurse take first?
A. Stop the infusion.
Rationale: When using the airway, breathing, circulation approach to client care, the nurse should place the priority on stopping the infusion. The client is exhibiting signs of penicillin anaphylaxis and the first action that should be taken is to withdraw the medication.
B. Call the client's provider.
Rationale: The nurse should call the client's provider; however, another action is the priority.
C. Elevate the head of the bed.
Rationale: The nurse should elevate the head of the bed; however, another action is the priority.
D. Auscultate the client's breath sounds.
Rationale: The nurse should auscultate the client's breath sounds; however, another action is the priority.
instructions should the nurse give regarding the adverse effect of dry mouth associated with diphenhydramine?
A. "Administer the medication with food."
Rationale: Administering diphenhydramine with food might minimize gastrointestinal effects, but will not relieve dry mouth.
B. "Chew on sugarless gum or suck on hard, sour candies."
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."
Rationale: This action might help to ease the work of breathing when the client has congestion, but it will not relieve the manifestation of dry mouth.
D. "Discontinue the medication and notify your provider."
Rationale: It is not necessary for the client to discontinue the use of diphenhydramine for dry mouth. The nurse should inform the client to notify the provider of any confusion, sedation, or hypotension. Click here for answers https://bit.ly/3aq6W3o
- A nurse is caring for a client who has an infection and a prescription for gentamicin intermittent IV bolus every 8 hr. A peak and trough is required with the next dose. Which of the following actions should the nurse take to obtain an accurate gentamicin serum level?
A. Draw a trough level at 0900 and a peak level at 2100.
Rationale: This is not the correct schedule for obtaining peak and trough serum levels.
B. Draw a peak level 90 min prior to administering the medication and a trough level 90 min after the dose.
Rationale: This is not the correct schedule for obtaining peak and trough serum levels.
C. Draw a trough level immediately prior to administering the medication and a peak level 30 min after the dose.
Rationale: Timing of the peak and trough is based on the pharmacokinetics of absorption and the half-life of the medication. The trough level is the lowest serum level after pharmacokinetic effects have taken place. For divided doses, correct timing for the trough is just before administering the next dose. The peak is the highest serum level of the medication; if this level is too low, then the medication will not be effective. Correct timing for the peak is between 30 and 60 min after the dose has finished infusing.
D. Draw a peak level at 0900 and a trough level at 2100.
Rationale: This is not the correct schedule for obtaining peak and trough serum levels.
Click here for answers https://bit.ly/3aq6W3o
- 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?
A. The client demonstrated an allergic response to the medication.
Rationale: An allergic response to disulfiram presents as dermatitis.
B. The client experienced a common side effect to the medication.
Rationale: Common side effects of disulfiram are drowsiness, headache, and a metallic aftertaste.
C. The client consumed alcohol while taking the medication.
Rationale: Disulfiram is given to clients who have a history of alcohol abuse. It produces a sensitivity to alcohol that results in a highly unpleasant reaction when the client ingests even small amounts of alcohol. When combined with alcohol, disulfiram produces nausea and vomiting.
D. The client took an overdose of the medication.
Rationale: An overdose might result in a severe reaction such as respiratory depression, cardiovascular collapse, arrhythmias, myocardial infarction, acute congestive heart failure, unconsciousness, convulsions, or death.
- 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)
Rationale: If the dose of this medication has been adequate, the nurse should see an increase in the T4.
B. Increase in weight
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
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).
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.
- 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.
Rationale:
A. Relief of heartburn
Rationale: Histamine 2 receptor antagonists are used to treat duodenal ulcers and prevent their return. In over-the-counter strengths, these medications, such as cimetidine and ranitidine, are used to relieve or prevent heartburn, acid indigestion, and sour stomach.
B. Cessation of diarrhea
Rationale: This is not a therapeutic effect of taking H 2 RA.
C. Passage of flatus
Rationale: This is not a therapeutic effect of taking H 2 RA.
D. Absence of constipation
Rationale: This is not a therapeutic effect of taking H 2 RA.
Click here for answers https://bit.ly/3aq6W3o
- 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.
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.
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.
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.
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.
- 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."
Rationale: Daily exercise can relieve soreness caused by stiff, unused muscles and helps to maintain joint range of motion.
B. "I've been taking an antacid to help with indigestion."
Rationale: Click here for answers https://bit.ly/3aq6W3o
NSAIDs, like naproxen, can cause serious adverse gastrointestinal reactions such as ulceration, bleeding, and perforation. Warning manifestations such as nausea or vomiting, gastrointestinal burning, and blood in the stool reported by the client require further investigation by the nurse. The client might be taking an antacid because he is experiencing one or more of these manifestations.
C. "I've lost 2 pounds since my appointment 2 weeks ago."
Rationale: This rate of weight loss is acceptable and indicates that the client is aware that decreased weight will decrease joint stress.
D. "The naproxen is easier to take when I crush it and put it in applesauce."
Rationale: Naproxen can be crushed or swallowed whole.
- A nurse is performing discharge teaching for a client who has seizures and a new prescription for phenytoin. Which of the following statements by the client indicates a need for further teaching?
A. "I will notify my doctor before taking any other medications."
Rationale: Many medication interactions can occur with phenytoin; therefore, the client's provider should be notified that the client is taking phenytoin.
B. "I have made an appointment to see my dentist next week."
Rationale: The client understands that phenytoin causes an overgrowth of the gums that makes dental monitoring important.
C. "I know that I cannot switch brands of this medication."
Rationale: The client understands that bioavailability varies with different brands, so no substitutions should be made.
D. "I'll be glad when I can stop taking this medicine."
Rationale: Phenytoin is an anticonvulsant used to treat various types of seizures. Clients on anticonvulsant medications commonly require them for lifetime administration, and phenytoin should not be stopped without the advice of the client's provider.
- A nurse is teaching a client who has asthma about how to use an albuterol inhaler. Which of the following actions by the client indicates an understanding of the teaching? Click here for answers https://bit.ly/3aq6W3o
A. The client holds his breath for 10 seconds after inhaling the medication.
Rationale: The medication should be retained in the lungs for a minimum of 10 seconds so the maximum amount of the dosage can be delivered properly to the airways. To use the inhaler, the client exhales normally just prior to releasing the medication, inhales deeply as the medication is released, then holds the medication in the lungs for approximately 10 seconds prior to exhaling.
B. The client takes a quick inhalation while releasing the medication from the inhaler.
Rationale:
Ferrous sulfate provides the iron needed by the body to produce red blood cells. Taking iron supplements between meals helps to increase the bioavailability of the iron.
D. "The medication can cause nausea if taken with food."
Rationale: Taking ferrous sulfate with food can reduce the GI symptoms associated with it. However, taking the medication between meals maximizes absorption.
- A nurse is preparing to administer a dose of lactulose to a client who has cirrhosis. The client states, "I don't need this medication. I am not constipated." The nurse should explain that in clients who have cirrhosis, lactulose is used to decrease levels of which of the following components in the bloodstream?
A. Glucose
Rationale: Lactulose does not decrease serum glucose.
B. Ammonia
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
Rationale: Lactulose has no effect on the potassium level.
D. Bicarbonate
Rationale: Lactulose has no effect on the bicarbonate level.
- 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
Rationale: Zidovudine has no documented adverse effects on the heart.
B. Metabolic alkalosis
Rationale: Lactic acidosis, not metabolic alkalosis, is an adverse effect of zidovudine.
C. Renal failure
Rationale: Zidovudine is not known as a nephrotoxic agent.
D. Aplastic anemia
Rationale: Severe myelosuppression that results in anemia (decreased red blood cells), agranulocytosis (decreased white blood cells), and thrombocytopenia (decreased platelets) is a life-threatening adverse reaction to zidovudine therapy. Consequently, zidovudine must be used cautiously in
clients already experiencing myelosuppression, and the client must be monitored with a CBC performed every few weeks for early detection of marrow failure, which may lead to aplastic anemia.
- A nurse is providing teaching to a client who has oral candidiasis and a new prescription for nystatin suspension. Which of the following statements by the client indicates an understanding of the teaching?
A. "I will store the medication at room temperature."
Rationale: Nystatin oral suspension should be stored at room temperature.
B. "I will take the medicine every morning on an empty stomach."
Rationale: The action of nystatin is local, and it is not absorbed through intact skin or mucous membranes. There is no reason to take the medication on an empty stomach.
C. "I will spit the medication out after swishing it around my mouth."
Rationale: Nystatin must be swallowed to maximize the medication's local effects on the mucosal lining of the upper gastrointestinal tract.
D. "I will only need to take this medication for a few days."
Rationale: Long-term therapy may be needed to clear candidiasis. The client should be instructed to complete the entire dose of medication.
- 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
Rationale: Epoetin alfa does not affect the leukocyte, or WBC, count.
B. The platelet count
Rationale: An increase in platelets is not the therapeutic or desired effect of epoetin alfa.
C. The hematocrit (Hct)
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)
Rationale: Epoetin alfa does not affect the ESR, which is a measurement of inflammation.
