Exam 8: Pharmacology

The nurse administers 8 units of regular insulin subcutaneously at 11:30 AM to a client with type 1 diabetes mellitus and serves the client lunch 30 minutes later.  The client eats a few bites, becomes nauseated, and is unable to finish the meal.  When is the client at highest risk for experiencing an insulin-related hypoglycemic reaction?

The nurse assesses pitting edema of the extremities, dyspnea, bilateral crackles posteriorly, and a serum sodium level of 130 mEq/L (130 mmol/L) in a client with chronic heart failure.  The nurse should question which prescription?

The graduate nurse (GN) is reinforcing teaching for a client who is initiating contraception with the etonogestrel and ethinyl estradiol vaginal ring.  Which statement by the GN would require the nurse preceptor to intervene?

The nurse is preparing to administer the fourth dose of vancomycin IVPB to a client with infective endocarditis.  Which intervention does the nurse anticipate?

The nurse is preparing medications for a group of clients.  Which prescription should the nurse clarify with the health care provider before administering?

A client with a history of cirrhosis has a new prescription for lactulose 30 mL four times a day.  What does the nurse explain to the client about this medication?

A client recently diagnosed with heart failure is being discharged with a prescription for lisinopril.  Which client teaching related to this new medication is important to review at discharge?

The home health nurse prepares to give benztropine to a 70-year-old client with Parkinson disease.  Which client statement is most concerning and would warrant health care provider notification?

A client is admitted with palpitations.  The ECG shows supraventricular tachycardia (SVT) with a rate of 220/min.  The nurse has received an order to administer adenosine 6 mg IV.  Which action should the nurse take?

A pediatric client is diagnosed with an acute asthma attack.  Which immediate-acting medications should the nurse prepare to administer to this client?  Select all that apply.

The home health nurse reviews the serum laboratory test results for a client with seizures.  The phenytoin level is 27 mcg/mL.  The client makes which statement that may indicate the presence of dose-related drug toxicity and prompt the nurse to notify the health care provider?

A hospitalized client with thyrotoxicosis receives atenolol 50 mg PO daily.  Which statement by the nurse accurately reinforces the client's understanding of this medication's purpose?

The nurse receives telephone messages from the following 4 clients.  Which client should the nurse call back first?

A client having an ischemic stroke arrives at the emergency department.  The health care provider prescribes tissue plasminogen activator (tPA).  Which client statement would be most important to clarify before administering tPA?

The nurse is administering IV hydromorphone to a client every 3-4 hours as needed for postoperative pain.  Which interventions should the nurse implement?  Select all that apply.

Which prescriptions for these clients does the nurse question?  Select all that apply.

A client with generalized anxiety disorder has received a new prescription for sertraline.  The nurse should teach this client about which possible side effect?

The nurse has just completed discharge teaching about sublingual nitroglycerin (NTG) tablets to a client with stable angina.  Which statement by the client indicates the need for further teaching?

The parent of a child diagnosed with attention-deficit hyperactivity disorder (ADHD), predominantly inattentive type, says to the nurse, "I hate the idea of my child taking a drug that's a stimulant.  How will I know that the methylphenidate is even working?"  Which is the best response by the nurse?

A client is taking morphine sulfate for acute pain.  Which statement will best assist the client worried about nausea and vomiting while taking this medication?