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WorksheetsPharmacological and Parenteral Therapies
Total questions: 86
Worksheet time: 7hrs 10mins
A female client with liver cirrhosis and chronic anemia is hospitalized for a deep venous thrombosis. The client is receiving a heparin infusion and suddenly develops epistaxis. Which laboratory value would indicate that the heparin infusion needs to be turned off?
Hematocrit of 30%
Partial Thromboplastin time of 110 seconds
Platelet count of 80,000 /mm3
Prothrombin time of 11 seconds
An elderly client is admitted with chronic obstructive pulmonary disease (COPD) exacerbation. Pulse oximetry is 84% on room air. The client is restless, has expiratory wheezing and a productive cough, and is using his accessory muscles to breathe. Which prescription should the nurse question?
Albuterol 2.5 mg by nebulizer
Intravenous (IV) methylprednisolone 125 mg now and every 6 hours
IV morphine 2 mg now and may repeat every 2 hours
Oxygen at 2 L/min by nasal cannula
The health care provider prescribes clomiphene for 5 days, beginning on the fifth day of menses, for treatment of infertility. After the nurse provides medication teaching, which client statement would indicate a need for further teaching?
Clomiphene increases my risk of having more than one baby, such as twins or triplets.
Hot flashes, mood swings, nausea, and headache are possible side effects of this medication
My partner and I should have sexual intercourse on the days that I am taking the medication
This medication will help my body release eggs and increase my chance of becoming pregnant
An experienced nurse precepts a graduate nurse caring for a hospitalized client who has a prescription for a transfusion of packed red blood cells (RBCs) to be hung over 3 hours. Which statement by the graduate nurse indicates the correct rationale for asking the client to void prior to starting the transfusion?
A drop in blood pressure is expected during the transfusion and getting up to void may cause a fall.
Bedrest is required; therefore, voiding will prevent intermittent catheterization during the procedure.
If a transfusion reaction occurs, it will be important to collect a fresh urine specimen to check for hemolyzed RBCs.
The urine is collected and analyzed prior to starting the transfusion to assess the client's baseline results.
The oncology nurse is caring for a client with tumor lysis syndrome. Which prescription should the nurse question?
Allopurinol 200 mg PO every 24 hours
Normal saline IV at 150 mL/hr continuous
Sevelamer 800 mg PO 3 times daily with meals
Spironolactone 25 mg PO every 12 hours
A client with type 1 diabetes is prescribed NPH insulin before breakfast and dinner. Although the client reports feeling well, the 6 AM blood glucose level has averaged 60 mg/dL (3.3 mmol/L) over the past week. Which action is appropriate for the nurse to recommend to the client?
Collect urine sample to check for urine ketones
Consume a snack of milk and cereal at bedtime
Increase carbohydrate intake at each meal
Take only the prebreakfast dose of NPH
A client with coronary artery disease is being seen in the clinic for a follow-up examination. During medication reconciliation, the nurse identifies which reported medication as requiring further investigation?
10 mg isosorbide dinitrate twice daily
20 mg atorvastatin once daily
500 mg naproxen twice daily
2,000 mg fish oil once daily
The nurse is preparing to administer 40 mg of IV furosemide. Prior to administering the medication, the nurse should assess which parameters? Select all that apply.
Blood pressure
Blood urea nitrogen
Liver enzymes
Potassium
White blood cell count
The nurse is caring for a client with cardiomyopathy and coronary artery disease. The client is reporting increasing chest pain and has bilateral lung crackles on auscultation. The health care provider has written several new prescriptions. Which new prescription should the nurse clarify? Select all that apply.
Vital signs. Blood pressure84/58 mm Hg. Heart rate108/min. Respirations28/min. Oxygen saturation90%
Administer 2,000 mL normal saline bolus
Administer IV nitroglycerin
Apply 4 L oxygen by nasal cannula
Obtain a STAT 12-lead ECG
Obtain blood for cardiac enzyme testing
The nurse is reviewing new prescriptions from the health care provider. Which prescription would require further clarification?
Atorvastatin for hyperlipidemia in a client with angina pectoris
Bupropion for smoking cessation in a client with emphysema
Cyclobenzaprine for muscle spasms in a client with hepatitis
Metronidazole for trichomoniasis in a client with Crohn disease
A client receiving total parenteral nutrition complains of nausea, abdominal pain, and excessive thirst. What is the best action for the nurse to take?
Assess the client's vital signs
Check the client's blood glucose
Report the findings to the health care provider
Slow down the rate of infusion
The nurse is evaluating a client with liver cirrhosis who received IV albumin after a paracentesis to drain ascites. Which assessment finding indicates that the albumin has been effective?
Abdominal circumference reduced from admission recording
Flapping tremor no longer visible with arm extension
Shortness of breath no longer experienced in supine position
Vital signs remain within the client's normal parameters
The nurse cares for a client with intractable nausea and vomiting after a total colectomy who has a new prescription for total parenteral nutrition (TPN). Which of the following nursing interventions are appropriate? Select all that apply.
Administer TPN through a central venous access device
Ensure that dextrose 10% in water IV solution is available
Obtain a prescription for blood glucose checks every 4-6 hours
Provide a loading dose so the client receives the necessary nutrients
Weigh daily with strict documentation of intake and output
The nurse administers lactulose to a client diagnosed with cirrhosis and hepatic encephalopathy. Which nursing action is inappropriate when administering this medication?
Assess mental status and orientation
Give on an empty stomach for rapid effect
Hold if 3 soft stools occur in a day
Mix with fruit juice to improve flavor
The nurse is caring for a female client newly diagnosed with epilepsy who has been prescribed phenytoin. Which of the following should the nurse include in client teaching? Select all that apply.
Avoid drinking alcoholic beverages.
Do not abruptly stop taking your phenytoin.
Go to the emergency department every time a seizure occurs.
Wear an epilepsy medical identification bracelet.
You may need to start using a nonhormonal birth control method.
The client has increased intracranial pressure with cerebral edema, and mannitol is administered. Which assessment should the nurse make to evaluate if a complication from the mannitol is occurring?
Auscultate breath sounds to assess for crackles
Monitor for >50 mL/hr urine output
Monitor Glasgow Coma Scale increasing from 8/15 to 9/15
Press over the tibia to assess for pitting edema
A client with a ventriculoperitoneal shunt has a dazed appearance and grunting and has not responded to the caregiver for 10 minutes. Status epilepticus is suspected. Which nursing intervention should be performed first?
Administer rectal diazepam
Assess for neck stiffness and Brudzinski sign
Draw blood for laboratory studies
Transport the client to CT for assessment of shunt malfunctio
A nurse discontinues patient-controlled analgesia per the health care provider's prescription, and notes that there is 10 mL of morphine sulfate left in the cartridge. All other nurses on the unit appear busy. What is the most appropriate action by the nurse?
Ask unlicensed assistive personnel to witness the wasting of the medication
Document that another nurse was not available to waste the medication
Wait until another nurse is available and then witness the waste together
Waste the morphine alone and then show the empty cartridge to the charge nurse
The nurse receives handoff report on 4 clients. Which client should the nurse assess first?
Client with chronic anxiety disorder taking buspirone and diphenhydramine who has a dry mouth
Client with chronic heart failure taking metoprolol and lisinopril who has dizziness when standing up
Client with major depressive disorder taking phenelzine and pseudoephedrine who has a headache
Client with type 2 diabetes taking metformin and lovastatin who has stomach upset and nausea
A client at 37 weeks gestation is receiving IV magnesium sulfate for preeclampsia with severe features. Which of the following signs indicate that the client has developed magnesium sulfate toxicity? Select all that apply.
0/4 patellar reflex
Blood pressure of 156/84 mm Hg
Client voiding 600 mL in 8 hours
Respiratory rate of 10/min
Somnolence
A nurse is preparing to administer an oxytocin IV infusion to a client for labor induction. The nurse recognizes that an oxytocin infusion may increase the client's risk for which of the following? Select all that apply.
Abnormal or indeterminate fetal heart rate patterns
Delayed breast milk production
Placenta previa
Postpartum hemorrhage
Uterine tachysystole
A client at 38 weeks gestation is in latent labor with ruptured membranes and is receiving an oxytocin infusion for labor augmentation. The client is requesting IV pain medication. When administering an IV narcotic during labor, which nursing action is appropriate?
Discontinue the oxytocin infusion prior to giving the medication
Give the medication slowly during the peak of the next contraction
Hold until contractions are occurring at least every 4 minutes for an hour
Withdraw 5 mL of lactated Ringer from the IV tubing to dilute the medication
The nurse reviews the external fetal monitoring tracing of a client receiving an oxytocin infusion for labor augmentation. The health care provider (HCP) asks the nurse to increase the oxytocin infusion rate. Which action by the nurse is appropriate at this time? Click the exhibit button for additional information.
Ask the charge nurse to speak with the HCP
Increase the oxytocin infusion rate as requested by the HCP
Recommend to the HCP that the infusion rate be decreased at this time
Request that the current infusion rate be maintained due to the client's contraction pattern
Four clients in labor are requesting pain relief. The nurse understands that which client can safely receive a dose of IV butorphanol tartrate, an opioid agonist-antagonist, at this time?
Multipara at 6 cm dilation with recent heroin use
Multipara at 9 cm dilation with an urge to push
Nullipara at 3 cm dilation desiring to ambulate
Nullipara at 7 cm dilation moaning with contractions
Which prescription should the nurse clarify with the health care provider?
0.45% sodium chloride continuous IV infusion for a client with acute postinfectious glomerulonephritis and a sodium level of 147 mEq/L (147 mmol/L)
0.9% sodium chloride IV bolus for a client in diabetic ketoacidosis with a BUN of 28 mg/dL (10 mmol/L)
Dextrose 10% in water IV bolus for a client who is unresponsive with a fingerstick blood glucose of 50 mg/dL (2.8 mmol/L)
Lactated Ringer solution continuous IV infusion for a client with acute appendicitis who has a WBC count of 15,500/mm3 (15.5 x109/L)
The mother of a 6-year-old child with cystic fibrosis (CF) has received instruction on the use of pancreatic enzymes. Which statement made by the mother indicates a need for further teaching?
I need to monitor the total amount of this medication that I give to my child every day.
I should give this medication with or just before my child has a meal or snack.
It is okay for my child to chew this medication.
It is okay to open the capsule and sprinkle the medicine on a tablespoon of applesauce.
The nurse is assessing a client with hypertension and essential tremor 2 hours after receiving a first dose of propranolol. Which assessment is most concerning to the nurse?
Client reports a headache
Current blood pressure is 160/88 mm Hg
Heart rate has dropped from 70/min to 60/min
Slight wheezes auscultated during inspiration
The nurse is preparing to administer 160 mg of furosemide via IV piggyback to a client with chronic kidney disease and fluid overload. The nurse plans to give the dose slowly over 40 minutes to prevent which adverse effect?
Bradycardia
Hypokalemia
Nephrotoxicity
Ototoxicity
The nurse is caring for a client on IV heparin infusion and oral warfarin. Current laboratory values indicate that the client's aPTT is 5 times the control value and the PT/INR is 2 times the control value. What action does the nurse anticipate?
Clarify vegetable consumption with client
Decrease the heparin rate
Decrease the warfarin dose
Obtain an order for vitamin K injection
The nurse is assessing a client 15 minutes after initiating nitroglycerin infusion for suspected acute coronary syndrome. Which clinical finding is the priority?
The client reports a headache
The client reports feeling dizzy and lightheaded
The client reports feeling flushed
The client reports feeling nervous
A newly admitted client describes symptoms of dizziness and feeling faint on standing. The client has a history of type 2 diabetes, coronary artery disease, and bipolar disorder. Which medications may be contributing to the client's symptoms? Select all that apply.
Atorvastatin
Metformin
Metoprolol
Olanzapine
Omeprazole
A male client with hypertension was prescribed amlodipine. Which of these adverse effects is most important to teach the client to watch for?
Erectile dysfunction
Dizziness
Dry cough
Leg edema
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?
Instruct client to report for monthly blood work to monitor drug levels
Review foods high in potassium that client should include in diet
Teach client to count own pulse for 1 minute; hold medication if pulse <60/min
Teach client to rise slowly and sit on side of bed for several minutes before rising
A nurse teaches a client who is being discharged on warfarin for atrial fibrillation. Which client statements indicate that teaching has been effective? Select all that apply.
Antibiotics can affect my INR value.
I am going to eat more leafy greens.
I will shoot for my INR value to be between 4 and 5.
I will take warfarin at the same time daily.
If I miss a dose, I can double it on the following day.
A client is 6 hours postoperative from hip surgery after receiving regional anesthesia and has epidural continuous anesthesia in place. Which is the most important reason for the nurse to contact the health care provider?
Client reports paresthesia bilaterally since the surgery
Fondaparinux is prescribed for STAT administration
Lower-extremity muscle strength is 3/5 bilaterally
Postoperative laboratory results show hemoglobin of 9.9 g/dL (99 g/L)
A client is in the cardiovascular clinic for a 3-month follow-up visit. At the first visit, the client was prescribed hydrochlorothiazide and amlodipine for hypertension. Which statement by the client would be concerning to the nurse and should be reported to the primary health care provider (PHCP)?
I like to have a banana every morning with my breakfast.
I occasionally experience slight dizziness when I get up in the morning.
I started taking licorice root for my occasional heartburn.
I usually take my hydrochlorothiazide first thing in the morning.
A client is being discharged with a prescription for apixaban after being treated for a pulmonary embolus. Which clinical data is most concerning to the nurse?
Client eats a vegetarian diet
Client has chronic atrial fibrillation
Client takes indomethacin for osteoarthritis
Client's platelet count is 176 x103/mm3 (176 x109/L)
The clinic nurse is reviewing telephone messages from four clients. Which client's call should the nurse return first?
Client who has just taken albuterol and reports a heart rate of 108/min and a coarse tremor in both arms
Client who is prescribed azithromycin and reports frequent, foul-smelling, liquid stools and abdominal cramping
Client who is prescribed metformin and reports a blood glucose of 284 mg/dL (15.76 mmol/L) and frequent urination
Client who takes amiodarone and reports a dry cough and increased dyspnea when walking around the house
The nurse provides instructions to a client discharged on warfarin, after being treated for a pulmonary embolism (PE) following surgery. Which statements made by the client indicate the need for further teaching? Select all that apply.
I will need to take my blood thinner for about 3-6 months.
I will place small rugs on my wood floors to cushion a fall.
I will take a baby aspirin if I have mild chest pain.
I will use a soft-bristled toothbrush to clean my teeth
I will wear a blood thinner MedicAlert tag
The nurse is preparing medications for a group of clients. Which prescription should the nurse clarify with the health care provider before administering?
Client diagnosed with cirrhosis had 2 stools today; laxative lactulose prescribed daily
Client is prescribed lisinopril PO daily; serum potassium level is 5.6 mEq/L (5.6 mmol/L)
Client is receiving vancomycin IV; mild facial flushing noted after 30 minutes
Client with diabetes has insulin glargine prescribed; current blood glucose is 100 mg/dL (5.6 mmol/L)
A client with hypertension and type 2 diabetes has recently started taking chlorthalidone. Which report by the client is most concerning to the nurse?
Dizziness on standing
Fasting blood glucose of 160 mg/dL (8.9 mmol/L)
Presence of muscle cramps
Sunburn on both arms
A home health nurse visits a client 2 weeks after the client is discharged from treatment for an acute myocardial infarction and heart failure. After a review of the home medications, which symptom reported by the client is most concerning to the nurse? Click on the exhibit button for additional information.
Bruising easily, especially on the arms
Fatigue
Feeling depressed
Muscle cramps in the legs
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?
Adenosine is contraindicated for SVT. Verify the order with the health care provider
Administer medication only through a central venous access
Administer medication rapidly over 1-2 seconds followed by a saline flush
Mix medication in 50 mL normal saline and administer over 10 minutes
The nurse prepares to administer 9:00 AM medications to a client. Which data should the nurse evaluate prior to administration? Select all that apply. Click the exhibit button for additional information.
Blood pressure
Blood sugar
Heart rate
International Normalized Ratio
Potassium level
The nurse is preparing to administer medications to a client admitted with atrial fibrillation. The nurse notes the vital signs shown in the exhibit. Which medications due at this time are safe to administer? Select all that apply. Click on the exhibit button for additional information.
Diltiazem extended-release PO
Heparin subcutaneous injection
Lisinopril PO
Metoprolol PO
Timolol ophthalmic
A client with atrial fibrillation is being discharged home after being stabilized with medications, including digoxin. Which of the following statements regarding digoxin toxicity indicates that further teaching is needed?
I must visit my health care provider (HCP) to check my drug levels.
I should report to my HCP if I develop nausea and vomiting.
I should tell my HCP if I feel my heart skip a beat.
I will need to increase my potassium intake.
The nurse is providing discharge teaching to a client with a new prescription for warfarin. The nurse should instruct the client to avoid excess or inconsistent intake of which foods? Select all that apply.
Bananas
Broccoli
Liver
Oranges
Spinach
The home health nurse visits a client with atrial fibrillation who is newly prescribed digoxin 0.25 mg orally on even-numbered days. Which of the following client statements show that teaching has been effective? Select all that apply.
I need to call the health care provider (HCP) if I have trouble reading.
I need to check my blood pressure before taking my medicine.
I should call the HCP if I develop nausea and vomiting.
I should check my heart rate prior to taking this medication.
I will call the HCP if I feel dizzy and lightheaded.
The nurse is caring for a client with chronic, stable angina. The client takes the long-acting nitrate isosorbide mononitrate. Which client outcome indicates that the drug is effective?
Client is able to shower, dress, and fix hair without any chest pain
Client reports a reduction in stress level and anxiety
Client reports being able to sleep through the night
Client's blood pressure is 128/78 mm Hg and heart rate is 82/min
A nurse in the cardiac intermediate care unit is caring for a client with acute decompensated heart failure (ADHF). The client also has a history of coronary artery disease and peripheral vascular disease. The nurse is preparing to administer medications. Based on the assessment data, the nurse should question which medication?
Aspirin
Atorvastatin
Furosemide
Metoprolol
A client diagnosed with stable angina is being discharged home on the cholesterol-lowering drug rosuvastatin. The nurse should teach the client to report which side effect to the health care provider (HCP) immediately?
Abdominal discomfort
Insomnia
Morning headache
Muscle aches or weakness
The nurse is caring for a child with Kawasaki disease who is receiving IV immunoglobulin. The child's parent wants to know why this treatment is required. The nurse explains that this therapy is given to:
Fight the infection
Minimize rash
Prevent heart disease
Reduce spleen size
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?
Furosemide 20 mg IV push twice daily
Maintenance IV line of 0.9% normal saline at 85 mL/h
Potassium chloride 20 mEq orally twice daily
Sodium-restricted diet
The nurse reinforces teaching a client on prescribed dabigatran for chronic atrial fibrillation. Which statement by the client indicates a need for further teaching?
I will call my health care provider if I notice red urine or blood in my stool.
I will not stop taking dabigatran even if I get a stomachache.
I will place capsules in my pill box so I will not forget to take a dose.
I will swallow the capsule whole with a full glass of water.
A 45-year-old client with atrial fibrillation has been prescribed diltiazem. Which client outcome would best indicate that the medication has had its intended effect?
Atrial fibrillation is converted to sinus rhythm
Blood pressure is 126/78 mm Hg
No signs or symptoms of stroke
Ventricular rate decreased from 158/min to 88/min
A client is admitted to the cardiac care unit with atrial fibrillation. Vital signs are shown in the exhibit. Which prescription should the nurse perform first? Click on the exhibit button for additional information.
Administer diltiazem 20 mg IVP
Administer rivaroxaban 20 mg PO
Draw blood for a thyroid function test
Send the client for echocardiogram
A client is receiving a continuous heparin infusion and the most recent aPTT is 140 seconds. The nurse notices blood oozing at the surgical incision and IV insertion sites. What interventions should the nurse implement? Select all that apply.
1.
Continue heparin infusion and recheck aPTT in 6 hours
Prepare to administer vitamin K
Redraw blood for laboratory tests
Review guidelines for administration of protamine
Stop infusion of heparin and notify the health care provider (HCP)
A client with chronic heart failure developed an intractable cough and an incident of angioedema after starting enalapril. Which prescription does the nurse anticipate for this client?
Alprazolam
Dextromethorphan
Lisinopril
Valsartan
The nurse prepares to administer clozapine to a client with schizophrenia. Which client statement would require priority investigation before administering the medication?
I have gained a few pounds since I started this medication.
I have had a sore throat for 3 days and feel feverish today.
I have noticed increased salivation and drooling.
I often feel sleepy when I take this medication.
A child with attention-deficit hyperactivity disorder (ADHD) has been taking methylphenidate for a year. What are the priority nursing assessments when the client comes to the clinic for a well-child visit?
Attention span and activity level
Dental health and mouth dryness
Height/weight and blood pressure
Progress with schoolwork and in making friends
The nurse working on the inpatient psychiatric unit is preparing to administer 9:00 AM medications to a client. The medication administration record is shown in the exhibit. On assessment, the client is tremulous, exhibits muscle rigidity, and has a temperature of 101.1 F (38.4 C). Which action should the nurse take? Click on the exhibit button for additional information.
Give all medications, including acetaminophen, and reassess in 30 minutes
Hold the haloperidol, give acetaminophen, and reassess in 30 minutes
Hold the haloperidol and notify the health care provider (HCP) immediately
Hold the hydrochlorothiazide and notify the HCP immediately
A behavioral health clinic nurse assesses a 23-year-old client who started taking paroxetine 3 weeks ago. Which statement made by the client is most important for the nurse to investigate?
I don't have much of an appetite since starting this medication.
I have a lot more energy, but I'm feeling just as depressed.
I have been feeling dizzy when I walk around at home.
I have experienced frequent headaches lately.
The health care provider (HCP) prescribes paroxetine to a client with depression. What statement by the client indicates proper understanding of the medication?
I can discontinue the medication if my symptoms improve.
I need a healthy diet and regular exercise to combat weight gain.
If I don't feel better in 1-2 weeks, then the medication is not working.
This medication might increase my sexual performance.
The nurse reviews a client's medical record and notes the following PRN medication prescriptions: acetaminophen, haloperidol, and benztropine. The nurse would administer a dose of benztropine on assessing which client behavior?
Muscle rigidity and shuffling gait
Nihilistic delusions
Tangentiality
Waxy flexibility
The nurse is caring for a client admitted with serotonin syndrome after taking citalopram and tramadol. Which assessment findings does the nurse expect to find? Select all that apply.
Absent deep tendon reflexes
Cold, clammy skin
Muscle rigidity
Restlessness and agitation
Sinus tachycardia
The nurse reinforces teaching for a client newly prescribed buspirone for generalized anxiety disorder. Which client statement indicates that teaching has been effective?
Driving is not recommended until I stop taking this medication.
If I experience a panic attack I should take an extra dose of medication.
It will be 2-4 weeks before I feel the full effect of this medication.
Withdrawal symptoms will occur if I abruptly stop taking this medication.
The client is brought to the emergency department in handcuffs by the police. Witnesses said that the client became violent and confused after consuming large amounts of alcohol at a party. The client is placed in 4-point restraints, and ziprasidone hydrochloride is administered. The client is sleeping 30 minutes later. What is a priority action for the nurse at this time?
Check for a history of bipolar disease
Determine if restraints can now be removed
Monitor for widened QT intervals and hypotension
Obtain blood for the current blood alcohol level
The nurse in an ambulatory care center is teaching a client with a diagnosis of persistent depressive disorder (dysthymia) about the appropriate use of bupropion hydrochloride SR. Which statement made by the client indicates a need for further teaching?
If I have a sudden change in my mood, I should call my physician immediately.
If I have trouble swallowing the tablet, I can cut it in half.
If I miss a dose, I should not double the next dose to catch up
It may take several weeks before I get better.
The nurse reviews an elderly client's medication administration record and identifies which prescriptions as having the potential for injury in the elderly? Select all that apply.
Amitriptyline
Chlorpheniramine
Docusate
Donepezil
Lorazepam
The nurse provides teaching for a client who is newly prescribed Clonazepam and regularly takes herbal supplements. What supplement taken by the client is most important to discuss?
Echinacea
Garlic
St. John wort
Valerian root
The nurse provides teaching for a client who is newly prescribed Warfarin and regularly takes herbal supplements. What supplement taken by the client is most important to discuss?
Ginseng
Garlic
St. John wort
Valerian root
Ginkgo
A nurse has completed teaching a client who is being discharged on lithium for a bipolar disorder. Which statement by the client indicates a need for further teaching?
I need to drink 1-2 liters of fluid daily.
I need to have my blood levels checked periodically.
I should not limit my sodium intake.
I should use ibuprofen for pain relief.
A nurse on the behavioral health unit is reviewing medication prescriptions for 4 clients. Which combination of medications does the nurse question?
A client with anxiety prescribed escitalopram and alprazolam
A client with bipolar disorder prescribed risperidone and lithium
A client with depression prescribed escitalopram and selegiline
A client with depression prescribed sertraline and zolpidem
The clinic nurse evaluates a client who was prescribed lithium therapy a month ago for bipolar disorder. Which client statement would cause the most concern?
I've felt the need for an afternoon nap most days this week.
I've gained 3 lb (1.36 kg) since I began taking this medication."
I've had the stomach flu for the past couple of days.
My mouth seems to be drier than usual lately
The registered nurse is counseling the parent of a child who was diagnosed with attention-deficit hyperactivity disorder and received a prescription for methylphenidate immediate-release tablet. Which statement by the parent demonstrates that teaching has been effective?
An additive-free, low-sugar diet will reduce my child's symptoms.
I can now manage my child's condition on my own.
My child should not take the last daily dose after 6 PM.
Once medication is started, I will not have to monitor my child anymore.
The nurse provides teaching to an adolescent client prescribed extended-release methylphenidate for attention deficit hyperactivity disorder. What client statement indicates that teaching has been effective?
If I miss a dose, I should take an extra dose at the next meal.
I may initially gain some weight when starting this medication.
I should drink caffeine-containing beverages if I get tired while studying.
I will take this medication in the morning before school.
A 21-year-old client is being evaluated in the outpatient psychiatric clinic after starting isocarboxazid 2 weeks ago. Which of the client's statements needs to be addressed first?
I am not sleeping well at night and would like a sleeping aid.
I do not know how well I will do on this restricted diet.
I have been having quite a bit of nausea and constipation.
This medicine is not working; I am so tired of being depressed.
A client recently diagnosed with Asthma and anaphylaxis reports use of herbal supplements. It is most important for the nurse to provide education about which supplement reported by the client?
Echinacea
Garlic
Glucosamine
St John's wort
The nurse provides discharge teaching for the parent of a child newly prescribed methylphenidate for attention-deficit hyperactivity disorder (ADHD). The nurse advises the parent that the child might experience which side effects?
Decreased blood pressure and growth delays
Heart palpitations and weight gain
Loss of appetite and restlessness
Trouble sleeping and a dry cough
A 10-year-old client with autism spectrum disorder is hospitalized for a diagnostic workup. Which is the most appropriate nursing action?
Encouraging visits by friends to decrease social isolation
Giving the client a schedule of daily activities
Placing the client in restraints during invasive procedures
Providing the client with a variety of toys
A nursing home client with major depressive disorder reports difficulty going to sleep until late at night. The client gets up, paces the hallway, wrings the hands, and appears teary. What interventions should be included in the client's nursing care plan? Select all that apply.
Allow the client to receive at least 20 minutes of natural sunlight each day
Encourage the client to take naps during the day to make up for lost sleep
Have the client engage in strenuous physical exercise just before bedtime
Spend time with the client in a quiet environment just before bedtime
Suggest that the client take a warm bath before going to bed
A client with schizophrenia is started on clozapine. Which periodic measurements take priority in this client?
Complete blood count and absolute neutrophil count
ECG and blood pressure
Fasting blood glucose and fasting lipid panel
Height, weight, and waist circumference
The nurse provides teaching for a client newly prescribed disulfiram for alcohol abstinence. Which information is the priority for the nurse to include?
Disulfiram is not a cure for alcoholism
Importance of continuing to see a therapist
List of everyday items containing hidden alcohol
Medical alert bracelet should identify disulfiram therapy
A client with moderate Alzheimer disease is started on memantine. In evaluating the effectiveness of this medication, the registered nurse should assess the client for which of the following?
Improved ability to perform activities of daily living
Indications that disease progression has stopped
Rapid improvement in cognitive functioning
Reversal of the disease
A 12-year-old with moderate intellectual disability and an intelligent quotient of 45 is hospitalized. What will the nurse recommend as the best recreational activity for this child?
Child's favorite stuffed animal
Connect-the-dots puzzle book
Putting together a 300-piece jigsaw puzzle
Writing in a journal about the hospital stay
The health care provider has just prescribed tetracycline for an adolescent with acne vulgaris. The client takes oral contraceptive pills.
Not taking tetracycline with dairy products
Taking tetracycline at bedtime
Taking tetracycline with food
Using additional contraceptive techniques
Using sunblock
