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PHARMACOLOGY DRUGS (FINAL HESI) EVOLVE
QUESTIONS WITH 100% ACCURATE ANSWERS
Ten minutes after the initiation of a blood transfusion, a client reports lumbar pain. What is the next nursing action? - Accurate answers Stop the transfusion. The healthcare provider prescribes an intravenous medication for a client who has been admitted for a chronic obstructive pulmonary disease exacerbation. When preparing to initiate an intravenous line, the nurse applies the tourniquet to select the site. When should the nurse release the tourniquet? - Accurate answers When the needle enters the vein A nurse is teaching an older adult client about managing chronic pain with acetaminophen. Which client statement indicates that the teaching is effective? - Accurate answers "I have to be careful about which over-the-counter cold preparations I take when I have a cold." Famotidine (Pepcid) is prescribed for a client with peptic ulcer disease. The client asks the nurse what this medication does. Which action does the nurse mention when replying? - Accurate answers Inhibits gastric acid secretion A client who had a kidney transplant develops leukopenia 3 weeks after surgery. What does the nurse conclude is the most probable cause of the leukopenia? - Accurate answers Antirejection medications After surgery a client develops a deep vein thrombosis and a pulmonary embolus. Heparin via a continuous drip is prescribed. Several hours later, vancomycin intravenously every 12 hours is prescribed. The client has one intravenous (IV) site: a peripheral line in the left forearm. What action should the nurse take? - Accurate answers Start another IV line for the vancomycin and continue the heparin as prescribed. A client is scheduled for a craniotomy to remove a brain tumor. To prevent the development of cerebral edema after surgery, the nurse anticipates the use of drugs from which class? - Accurate answers Steroids A health care provider prescribes ranitidine for a client with heartburn. During a teaching session, which information will the nurse share with the client about how this drug works? - Accurate answers Ranitidine reduces gastric acidity in the stomach A Total Parenteral Nutrition (TPN) solution is prescribed to infuse one liter every 12 hours for a malnourished client. What is most important for the nurse to monitor? - Accurate answers Serum glucose levels Which medication does the nurse anticipate will be prescribed to relieve anxiety and apprehension in a client with pulmonary edema? - Accurate answers Morphine
Hydrochlorothiazide, a thiazide diuretic, has been prescribed for a client with hypertension. The client reports hearing that furosemide is more effective and requests a prescription change. How should the nurse respond? - Accurate answers "HCTZ has fewer side effects." Which action should the nurse take first when a client's gravity flow IV rate is too slow? - Accurate answers Evaluate the appearance of the catheter insertion site A client is scheduled for discharge following surgery. The medical record indicates that the client has not had a bowel movement since before surgery, which was 4 days ago. During the hospital stay, the client received a stool softener daily and an oral laxative the day before discharge. Which one of the prescribed medications should the nurse administer to ensure a bowel movement prior to discharge? - Accurate answers Bisacodyl 10-mg suppository A nurse is instructing a group of volunteer nurses on the technique of administering the smallpox vaccine. What injection method should the nurse teach? - Accurate answers Intradermal scratch The health care provider prescribes propylthiouracil (PTU) for a client with the diagnosis of Graves' disease. What should the nurse teach the client when discussing the self-administration of this medication? - Accurate answers Observe for signs of infection A client is diagnosed with tuberculosis associated with human immunodeficiency virus infection. What crucial laboratory test results should the nurse review before antitubercular pharmacotherapy is started? - Accurate answers Liver function studies A nurse is administering an intradermal skin test injection to a client. What is the next action the nurse needs to do after the medication has been injected? - Accurate answers Withdraw the needle and place a piece of gauze over the injection site. The person with which type of blood is known to be the universal recipient? - Accurate answers AB A client is considered to be in septic shock when what changes are assessed in the client's labwork? - Accurate answers An increased serum lactate level A nurse is giving an educational program to paramedics who have volunteered to give the smallpox vaccine in a community vaccination drive. Which type of needle and method of administration should the nurse teach the volunteers to use when administering the smallpox vaccine? - Accurate answers Bifurcated needle for 15 injections within 5 mm A client is started on tetracycline antibiotic therapy. What should the nurse do when administering this drug? - Accurate answers Give the medication an hour before milk products are ingested. A healthcare provider prescribes ampicillin for a client with an infection. What information should the nurse include in the teaching plan about this medication? - Accurate answers Notify the healthcare provider if diarrhea develops. A client with a long history of alcohol abuse develops acute pancreatitis. What should be done to best prevent stimulation of the pancreas? - Accurate answers Administer the histamine H2-receptor antagonist as prescribed.
A client, admitted to the cardiac care unit with a myocardial infarction, complains of chest pain. What intervention will be most effective in relieving the client's pain? - Accurate answers Morphine sulfate 2 mg intravenously (IV) Which drug does a nurse anticipate may be prescribed to produce diuresis and inhibit formation of aqueous humor for a client with glaucoma? - Accurate answers Acetazolamide The results of a biopsy indicate that a client has a malignant sarcoma of the liver, and chemotherapy via regional perfusion is the treatment of choice. What reason does the nurse provide to explain to the client why this method of drug administration probably was selected? - Accurate answers Larger doses of drugs can be delivered to the actual site of the tumor. After an acute episode of gastrointestinal (GI) bleeding, a client is diagnosed with a gastric ulcer. The client receives a prescription for ranitidine 150 mg twice a day. What concern prompts the nurse to contact the health care provider about the prescription? - Accurate answers An administration route is not specified. A healthcare provider prescribes simvastatin 20 mg daily for elevated cholesterol and triglyceride levels for a female client. Which is most important for the nurse to teach when the client initially takes the medication? - Accurate answers Inform the healthcare provider if the client wishes to become pregnant. A nurse in the surgical intensive care unit is caring for a client with a large surgical incision. The nurse reviews a list of vitamins and expects that which medication may be prescribed because of its major role in wound healing? - Accurate answers Vitamin C (ascorbic acid) A health care provider prescribes cholestyramine, an anion exchange resin, to treat a client's persistent diarrhea. What vitamin does the nurse anticipate may become deficient because cholestyramine reduces the absorption of fat? - Accurate answers Retinol (Vitamin A) A client with myasthenia gravis improves and is discharged from the hospital. The discharge medications include pyridostigmine bromide 10 mg every 6 hours. The nurse evaluates that the drug regimen is understood when the client makes which statement? - Accurate answers "I need to set an alarm so I take the medication on time." A nurse is administering a histamine H2 antagonist to a client who has extensive burns. The nurse explains to the client that this drug is given prophylactically during the first few weeks after extensive burns. What complication of burns will it prevent? - Accurate answers Stress ulcer A client with an intractable infection is receiving vancomycin. Which laboratory blood test result should the nurse report? - Accurate answers Blood urea nitrogen (BUN): 30 mg/dL (10.2 mmol/L) A nurse recalls that the shift of body fluids associated with the intravenous administration of albumin occurs by which process? - Accurate answers Osmosis A client newly diagnosed with type 1 diabetes receives information about insulin. The client states, "I hate shots. Why can't I take the insulin in tablet form?" What is the nurse's best response? - Accurate answers "Insulin is poorly absorbed orally so it is not available in a tablet."
A client with diabetes experiences tremors, pallor, and diaphoresis. What should the nurse consider is a possible cause of these clinical manifestations? - Accurate answers Aerobic exercise A nurse teaches a client about Coumadin and concludes that the teaching is effective when the client agrees not to drink which juice? - Accurate answers Cranberry juice A client who is hospitalized after a myocardial infarction asks the nurse why morphine was prescribed. What will the nurse include in the reply? - Accurate answers Relieves pain and reduces cardiac oxygen demand When a client has gluteal edema, why should the nurse avoid using the gluteus maximus muscle for administration of intramuscular medications? - Accurate answers Blood supply is likely insufficient for adequate absorption. An older adult with cerebral arteriosclerosis is admitted with atrial fibrillation and is started on a continuous heparin infusion. What clinical finding enables the nurse to conclude that the anticoagulant therapy is effective? - Accurate answers An activated partial thromboplastin twice the usual value A health care provider prescribes daily docusate sodium for a client. The nurse explains to the client that this drug has what action? - Accurate answers Lowers the surface tension of feces A client is admitted to the emergency department with profuse vomiting. The client reports that the vomitus was bright red in color. What does the nurse identify as the priority intervention? - Accurate answers Draw blood for typing and crossmatching A nurse provides instruction when the beta-blocker atenolol is prescribed for a client with moderate hypertension. What action identified by the client indicates to the nurse that the client needs further teaching? - Accurate answers Take the medication before going to bed. The practitioner prescribes a regular diet, gait training, elastic stockings, and benztropine mesylate for a client. The client experiences orthostatic hypotension, a side effect of benztropine mesylate. What should the nurse anticipate as the priority nursing action? - Accurate answers Apply elastic stockings A client is prescribed metformin extended release to control type 2 diabetes mellitus. Which statement made by this client indicates the need for further education? - Accurate answers "I will stop taking metformin for 24 hours before and after having a test involving dye." A nurse administers sodium polystyrene sulfonate to a client with chronic renal failure. Which finding provides evidence that the intervention is effective? - Accurate answers Potassium decreases to 4.2 mEq/L (4.2 mmol/L) A client is receiving total parenteral nutrition (TPN) through a central venous access device. What important nursing intervention should be included? - Accurate answers Placing the client in the supine position before changing the tubing
A nurse is caring for a client with pulmonary tuberculosis who is to receive several antitubercular medications. Which of the first-line antitubercular medications is associated with damage to the eighth cranial nerve? - Accurate answers Streptomycin Twenty minutes after the start of an intravenous (IV) vancomycin infusion, the client appears flushed and complains of palpitations. What action should the nurse take? - Accurate answers Contact the primary healthcare provider to obtain a prescription to decrease the infusion rate. When a client exhibits severe bradycardia, which type of drug should the nurse be prepared to administer? - Accurate answers Anticholinergic Which instructions should the nurse include in the teaching plan for a client with hyperlipidemia who is being discharged with a prescription for cholestyramine? - Accurate answers "Increase your intake of fiber and fluid." Before a cholecystectomy, vitamin K is prescribed. The nurse recognizes that this is ordered because vitamin K contributes to the formation of which substance? - Accurate answers Prothrombin In addition to clients who are receiving insulin for type 1 diabetes, the nurse should assess for signs and symptoms of hypoglycemia in clients who have which diagnosis? - Accurate answers Liver disease A client requires intravenous fluids postoperatively. The healthcare provider has prescribed D5W to infuse at 125 mL/hr. To deliver the solution at the correct drip rate, what must the nurse calculate first?
- Accurate answers Drops per milliliter delivered by the infusion set Which medication requires the nurse to monitor the client for signs of hyperkalemia? - Accurate answers Spironolactone A nurse evaluates that a client understands appropriately how to take the antacids prescribed by the primary health care provider when the client makes which statement? - Accurate answers "I will take this antacid 30 minutes after meals." The nurse is caring for a client hospitalized with a myocardial infarction. Which analgesic is the drug of choice for this client? - Accurate answers Morphine sulfate Neomycin is prescribed for a client with cirrhosis. What should the nurse explain is the reason for taking this medication? - Accurate answers Reduces the blood ammonia level A healthcare provider prescribes phenobarbital sodium for a client who had a tonic-clonic seizure. The nurse assesses the client's knowledge after teaching about the adverse effects of this drug. What responses should the client identify as a reason for calling the healthcare provider? - Accurate answers Loss of appetite or persistent fatigue A client with tuberculosis asks the nurse why vitamin B6 (pyridoxine) is given with isoniazid. What explanation should the nurse provide? - Accurate answers "Isoniazid interferes with the synthesis of this vitamin."
The healthcare provider prescribes finasteride for a client with benign prostatic hyperplasia. What information does the nurse provide to the client? - Accurate answers Protection should be worn during intercourse with a pregnant female. A nurse is planning care for a client with cancer who is receiving the plant alkaloid vincristine. In contrast to the side effects of most chemotherapeutic agents, what is a common side effect of vincristine that the nurse must address in the client's care plan? - Accurate answers Constipation A client is prescribed epoetin injections. To ensure the client's safety, which lab value should the nurse assess before administration? - Accurate answers Hemoglobin Warfarin is prescribed for a client who has been receiving intravenous (IV) heparin for a partial occlusion of the left common carotid artery. The client expresses concern about why both drugs are needed at the same time. What rationale does the nurse include to address the client's concern? - Accurate answers Heparin provides anticoagulant effects until warfarin reaches therapeutic levels. What should the nurse monitor to evaluate the effectiveness of carbamazepine in the management of a client's trigeminal neuralgia? - Accurate answers Pain intensity A client steps on a rusty nail, and the puncture site becomes swollen and painful. Tetanus immune globulin is prescribed. What does the nurse identify as an action of this drug? - Accurate answers Provides antibodies The nurse is caring for a client who is experiencing side effects from high doses of methotrexate. Leucovorin calcium is prescribed and is to be administered immediately after the infusion of methotrexate. What is the best indicator that leucovorin calcium is effective? - Accurate answers Methotrexate level less than 0.05 micromole A client is admitted with 50% of the body surface area burned after an industrial explosion and fire. The client's serum albumin is 1.5 g/dL (150 mg/dL), the hematocrit is 30%, the urine specific gravity is 1.025, and the serum globulin is 3 g/dL (300 mg/dL). When evaluating the client's response to fluid replacement, what determines when the nurse should prepare to administer a colloid? - Accurate answers Albumin is below 2 g/dL (200 mg/dL) A client with Hodgkin disease enters a remission period and remains symptom free for 6 months before a relapse occurs. The client is diagnosed at stage IV. What therapy option does the nurse expect to be implemented? - Accurate answers Combination chemotherapy A client with type 1 diabetes tells the nurse, "I take guaifenesin cough syrup when I have a cold." What important instruction does the nurse include in client teaching about this medication? - Accurate answers Include the glucose in the cough syrup when calculating daily carbohydrate allowance. A nurse administers carbidopa-levodopa to a client with Parkinson disease. Which therapeutic effect does the nurse expect the medication to produce? - Accurate answers Replacement of a neurotransmitter in the brain
A client who is receiving phenytoin asks why folic acid (Folate) was prescribed. What is the best explanation by the nurse? - Accurate answers Absorption of folate from foods is inhibited. Ampicillin 250 mg by mouth every 6 hours is prescribed for a client who is to be discharged. Which statement indicates to the nurse that the client understands the teaching about ampicillin? - Accurate answers "The medicine should be taken one hour before or two hours after meals." When administering albumin intravenously, what fluid shifts does the nurse anticipate? - Accurate answers Interstitial compartment to the intravascular compartment A client being treated for hypertension reports having a persistent hacking cough. What class of antihypertensive should the nurse identify as a possible cause of this response when reviewing a list of this client's medications? - Accurate answers Angiotensin-converting enzyme (ACE) inhibitors A client is receiving metoprolol. Which side effect should the nurse teach the client to expect? - Accurate answers Dizziness with strenuous activity After surgery for cancer, a client is to receive chemotherapy. When teaching the client about the side effects of chemotherapy, what advice should the nurse share about alopecia characteristics? - Accurate answers Not permanent At 4:30 pm, a client who is receiving NPH insulin every morning states, "I feel very nervous." The nurse observes that the client's skin is moist and cool. What is the nurse's most accurate interpretation of what the client is likely experiencing? - Accurate answers Hypoglycemia A client with heart failure is to receive digoxin and asks the nurse why the medication is necessary. What physiologic response will the nurse include when answering the client's question? - Accurate answers Slows and strengthens cardiac contractions A terminally ill client in a hospice unit for several weeks is receiving a morphine drip. The dose is now above the typical recommended dosage. The client's spouse tells the nurse that the client is again uncomfortable and needs the morphine increased. The prescription states to titrate the morphine to comfort level. What should the nurse do? - Accurate answers Assess the client's pain before increasing the dose of morphine. A nurse is administering erythropoietin three times a week to a client receiving chemotherapy for cancer. Which client response is considered most significant? - Accurate answers Elevated hematocrit level The healthcare provider prescribes enoxaparin to be administered subcutaneously daily to a client who had a total knee replacement. To ensure client safety, which measure would the nurse take when administering this medication? - Accurate answers Administer in the abdomen area only A healthcare provider prescribes enalapril for a client. Which is the most important nursing action? - Accurate answers Monitor the client's blood pressure during therapy
The nurse is caring for a client who is receiving intermittent intravenous piggyback doses of vancomycin every 12 hours. The primary healthcare provider prescribes trough levels of the antibiotic. The nurse schedules the blood sample to be obtained at what time? - Accurate answers Just before the medication is administered A nurse is preparing to teach a client to apply a nitroglycerin patch as prophylaxis for angina. Which instruction should the nurse include in the teaching plan? - Accurate answers Remove a previous patch before applying the next one. A blood donor whose blood type is O negative is known as a "universal donor." What does the nurse consider about O negative blood that accounts for this classification? - Accurate answers It does not have any of the antigens that can cause a reaction. After administering a loop diuretic, a nurse monitors the client for increased urine output. What principle explains the secondary water loss (diuresis) of a loop diuretic? - Accurate answers Osmosis A client with gastric ulcer disease asks the nurse why the health care provider has prescribed metronidazole. What purpose does the nurse provide? - Accurate answers To treat Helicobacter pylori infection After being hospitalized for a transient ischemic attack (TIA) related to hypertension, a client is discharged with a prescription of hydrochlorothiazide. What should the nurse instruct the client to do when taking this medication? - Accurate answers Increase the intake of potassium-rich foods. A client with Hodgkin disease is to receive the cyclic antineoplastic vincristine as part of a therapy protocol. The client asks how this medication works. What mechanism of action does the nurse consider when responding to the client's question? - Accurate answers Arresting mitosis in metaphase A client who has been experiencing double vision, drooping of the eyelids, and fatigue visits the neurologic clinic. A diagnosis of myasthenia gravis is made, and the healthcare provider prescribes pyridostigmine. The nurse should teach the client that it is important to take this drug based on what schedule? - Accurate answers At the exact time intervals prescribed A client is admitted with head trauma after a fall. The client is being prepared for a supratentorial craniotomy with burr holes, and an intravenous infusion of mannitol is instituted. The nurse concludes that this medication primarily is given to do what? - Accurate answers Decrease fluid in the brain A client had surgery for a ruptured appendix. Postoperatively, the health care provider prescribes an antibiotic to be administered intravenously twice a day. The nurse administers the prescribed antibiotic via a secondary line into the primary infusion of 0.9% sodium chloride. During the administration of the antibiotic, the client becomes restless and flushed, and begins to wheeze. What should the nurse do after stopping the antibiotic infusion? - Accurate answers Assess the client's respiratory status After the nurse provides education about hydrochlorothiazide, the client will agree to notify the healthcare provider regarding the development of which symptom? - Accurate answers Generalized weakness
