WorksheetsNursing Pharm (Naxlex) Final
Total questions: 58
Worksheet time: 30mins
The nurse mixes diphenhydramine 25 mg in a 100 mL bag of 0.9% sodium chloride, which is to be administered IV over 30 minutes. The IV pump should be set to administer how many mL/hour?
200
100
50
400
The nurse assesses a client with intermittent claudication who is receiving pentoxifylline. Which assessment should the nurse perform to determine the effectiveness of the medication?
Evaluate the level of consciousness.
Auscultate bowel sounds.
Measure hourly urinary output.
Monitor numeric pain scale.
The nurse is preparing to administer the client's morning dose of digoxin. Which action should the nurse take prior to administering the digoxin?
Verify that the urine output exceeds 30 mL per hour.
Check the client for signs of orthostatic hypotension.
Listen to the heart at the left 5th intercostal space.
Obtain a left radial pulse rate for a full 30 seconds.
The nurse is providing instructions about a client's new medications. How should the nurse explain the purpose of probenecid, a uricosuric drug?
Promotes excretion of uric acid in the urine.
Prevents the formation of kidney stones.
Decreases pain and burning during urination.
Increases the strength of the urine stream.
A client with open-angle glaucoma is using pilocarpine ophthalmic solution, a miotic agent. Which action should the nurse at the eye clinic include in evaluating the effectiveness of the medication?
Use Snellen chart to assess visual acuity.
Check the amount of drainage from each eye.
Palpate eyelids for decreased swelling.
Review eye pressure measurements.
A client with type 2 diabetes mellitus is managed with glimepiride. The primary healthcare provider (HCP) adds a new prescription for injectable exenatide. Which information is most important for the nurse to teach this client?
Notify the healthcare provider if anorexia occurs.
Consume additional sources of potassium.
Watch for signs of jitteriness or diaphoresis.
Administer subcutaneously after meals.
A client who is newly diagnosed with erosive esophagitis secondary to gastroesophageal reflux disease (GERD) reports to the home health nurse that there has been only a minimal reduction in symptoms after taking lansoprazole PO for one full week. Which action should the nurse take?
Auscultate the client's bowel sounds and measure the abdominal girth.
Confirm that the client is taking the medication one hour after meals.
Notify the healthcare provider that the client may need a change in dosage.
Advise the client that healing typically takes several weeks to occur.
During a home visit, the nurse assesses a client with Alzheimer's Disease who recently started a new prescription for rivastigmine. The caregiver reports that the client seems to be thinking more clearly but is not sleeping well at night. Which action should the nurse take?
Instruct the caregiver to withhold the medication until the dosage can be decreased to ensure the client's safety.
Notify the healthcare provider that the dosage of the medication may need to be increased to manage the client's insomnia.
Advise the caregiver that the purpose of the medication is to promote sleep, so a change in medication may be needed.
A client who uses a transdermal contraceptive, calls to the clinic because she forgot to apply a new patch three days ago. Which instruction should the nurse provide to the client?
Apply the new patch today and use a backup method for 7 days.
Wait until Sunday to apply the new patch and use the same site.
If a pregnancy test is negative, apply the next patch immediately.
Wait until the last day of your next menstrual period to apply the patch.
While assessing a client who takes acetaminophen for chronic pain, the nurse observes that the client's skin looks yellow in color. Which action should the nurse take in response to this finding?
Check the client's capillary glucose level.
Use a pulse oximeter to assess oxygen saturation.
Report the finding to the healthcare provider.
Advise the client to reduce the medication dose.
A client who experiences migraine headaches reports having fewer headaches since using the herbal remedy feverfew. Which information is most important for the nurse to include in a teaching plan for this client?
Feverfew may interact with aspirin or nonsteroidal antiinflammatory drugs (NSAIDs).
Those with allergies to chamomile, ragweed, or yarrow should not take feverfew.
Abdominal pain, gas, nausea, vomiting, and diarrhea can occur when taking feverfew.
Increased anxiety and nervousness have been reported by those taking feverfew.
The nurse is preparing to administer alendronate to a client with osteoporosis. Which laboratory value indicates that the nurse should withhold the medication and contact the healthcare provider?
Calcium 13.0 mg/dL (3.3 mmol/L).
Magnesium 2.4 mEq/L (2.4 mmol/L).
Potassium 5.2 mEq/L (5.2 mmol/L).
Sodium 132 mEq/L (132 mmol/L).
The nurse is administering sevelamer during lunch to a client with chronic kidney disease (CKD). The client asks the nurse to bring the medication later. The nurse should describe which action of sevelamer as an explanation for taking it with meals?
Promotes stomach emptying and prevents gastric reflux.
Buffers hydrochloric acid and prevents gastric erosion.
Prevents indigestion associated with ingestion of spicy foods.
Binds with phosphorus in foods and prevents absorption.
The nurse is teaching a client with type 1 diabetes mellitus about the onset, peak, and duration of a new prescription for glargine insulin. If the insulin is self administered at 0800, when is the client most likely to experience hypoglycemia?
Midmorning
shortly after midnight
no peak occurs
midafternoon
A client with myasthenia gravis receives a new prescription for pyridostigmine. Which information should the nurse obtain prior to administering the medication?
Trouble sleeping
Difficulty with urination
Unexplained weight loss
Recent oral intake
A client with a history of chronic obstructive pulmonary disease (COPD) receives a new prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?
Attaches spacer device to the inhaler.
Stores the medication at room temperature.
Primes the inhaler with 7 pumps.
Rinses mouth after each use.
A client receives a prescription for allopurinol. Which information provided by the client requires additional instruction by the nurse?
Double the dose if a dose is missed.
Reduce caffeine and acidic intake.
Avoid taking on an empty stomach.
Consume 2. liters of water daily.
A client with irritable bowel syndrome starts a new prescription for dicyclomine, an anticholinergic medication. The client reports the onset of sensitivity to bright sunlight and a dry mouth. How should the nurse respond?
Determine if the medication is being taken correctly.
Advise stopping the medication until the unpleasant effects wear off.
Schedule an appointment for evaluation by the healthcare provider.
Provide instructions in managing these side effects.
The nurse determines that a client has been taking antidepressants for the past six months. Which symptoms are common side effects of this medication classification?
Headache, jaundice, and diarrhea.
Bradycardia, delirium, and sedation.
Insomnia, hypertension, and vomiting.
Dry mouth, blurred vision, and constipation.
The nurse notes that a client has been receiving hydromorphone (Dilaudid) every six hours for four days. What assessment is most important for the nurse to complete?
Auscultate the client’s bowel sounds
Observe for edema around the ankles
Measure the client’s capillary glucose level
Count the apical and radial pulses simultaneously
A client receives a new prescription for somatropin. Which information provided by the client indicates a need for further education by the nurse?
Store unused vials at room temperature.
Rotate injection sites to minimize discomfort.
Discard the medication if the solution is cloudy.
Administer the medication subcutaneously.
The nurse prepares to administer a scheduled dose of labetalol by mouth to a client with hypertension. The client’s vital signs are temp 99F (37.2C), heart rate 48 beats/min, respirations 16 breaths/min, and blood pressure 150/90. Which action should the nurse take?
administer the dose and monitor the client's bp regularly
withhold the scheduled dose and notify the hip
Assess for orthostatic hypotension before administering the dose
apply a telemetry monitor before administering the dose
A client has a prescription for clonidine 0.1 mg PO twice daily. The nurse notes that the client's blood pressure is 88/50 mm Hg. Which action should the nurse take?
Withhold the scheduled dose and notify the hcp
Assess for orthostatic hypotension before administering the dose
Apply a telemetry monitor before administering the dose
Apply a telemetry monitor before administering the dose
To evaluate the effectiveness of a client's prescription for rosuvastatin, which action should the nurse implement?
Evaluate the client's serum cholesterol level results
Measure skin folds for body mass index (BMI) calculations
Obtain the client's heart rate and blood pressure
Review the client's daily food and weight log
A client has a prescription for clopidogrel bisulfate 75 mg by mouth daily at 0900. In which situation should the nurse hold this medication?
The client's platelet level is high
Breakfast has not been eaten
Elective surgery is scheduled in 2 hrs
An abdominal sonogram is scheduled
A male client with a newly diagnosed seizure disorder starts a prescription for clonazepam. One week later, the nurse observes that his speech is slurred and he has an ataxic gait. Which action should the nurse implement?
Advise the client to discontinue the medication immediately
Report these side effects to the HCP
Explain the need to refrain from alcohol use while taking the drug
Document the client's continued seizure activity
The nurse administers risedronate to a client with osteoporosis at 0700. The client asks for a glass of milk to drink with medication. Which action should the nurse take?
Withhold the medication until the client's breakfast tray is available on the unit
Consult with a pharmacist about scheduling the dose one hour after the client eats
Assign an unlicensed assistive personnel (UAP) to bring the client a glass of low fat milk
Instruct the client that it is necessary to take nothing but water with the medication
The nurse administers naloxone to a client with opioid-induced respiratory depression. One hour later, nursing assessment reveals that the client has a respiratory rate of 4 breaths/min, SpaO2 of 75%, and is unable to be aroused. What action should the nurse implement?
Prepare to assist with chest tube insertion
Administer a second dose of naloxone
Determine Glasgow Coma score
Initiate cardiopulmonary resuscitation(CPR)
A client who is obtunded arrives in the emergency department with a suspected drug overdose. The client becomes responsive after the administration of IV naloxone, but within a short period, the client's level of consciousness decreases again, and the respiratory rate decreases to 6 breaths/minute. Which action should the nurse take first?
Administer an additional dose of naloxone.
Initiate a second intravenous access site.
Prepare to initiate cardiopulmonary resuscitation (CPR).
Determine if results of the drug toxicity screen are available.
The nurse administers acetylcysteine to a client with a thick and nonproductive cough. To evaluate the effectiveness of the medication, what question should the nurse ask the client?
Are you experiencing any pain when you cough?
Are you still coughing?
How much phlegm are you coughing up?
A female client with mild depression reports to the nurse recently starting St. John's wort. Which information provided by the client requires further instruction?
Hard candy can be used for a dry mouth.
Another form of contraception is not needed.
Insomnia may occur while taking the medication.
sensitivity to the sun can develop
A client with eczema receives a prescription for betamethasone cream. Which client statement indicates to the nurse that further teaching is needed?
Use the cream only on intact skin.
Apply the cream to the area for 2 weeks.
Cover the site with an occlusive dressing.
Limit exposure to direct sunlight.
A male client who has erectile dysfunction (ED) recently received a new prescription for sildenafil citrate. During a clinic visit the client reports the onset of nasal congestion, dizziness, and dyspepsia. Which nursing assessment takes priority?
Measure blood pressure while lying and standing
Assess for the presence of chest pain
Determine if the client has taken nitroglycerin
Review the client's medication list for drug interactions
The healthcare provider prescribes streptomycin 200 mg IM every 12 hours. The vial is labeled, "Streptomycin 1 gram/2.5 mL." How many milliliters should the nurse administer?
0.5
1.0
2.0
0.25
The nurse is monitoring a client who has liver failure and is taking lactulose. Which findings indicate that the medication is having the desired effect?
Increased urine output.
Increased serum ammonia.
Improved level of consciousness.
Increased bowel movements.
Decreased serum potassium.
A client receives a prescription for IV famotidine. Which finding indicates to the nurse the medication is effective?
Reduced epigastric pain
Decreased in nighttime awakenings
Positive stool antigen test
Loss of 3 lbs (1.36 kg) in a month
A client receives a new prescription for levothyroxine. Which statement made by a client indicates to the nurse that the education was effective?
Take medication on an empty stomach
Avoid the use iron supplements
Administer levothyroxine at bedtime
Consume foods that are high in iodine?
The nurse is planning to administer sucralfate to a client with peptic ulcer disease. Which action should the nurse include in this patient's plan of care?
Administer sucralfate once a day, preferably at besides
Monitor for electrolyte imbalance
Assess for secondary Candida infection
Give sucralfate on an empty stomach
A client with a history of angina reports the onset of chest pain. The nurse determines that the heart rate is 104 beats/minute and the blood pressure is 138/86 mmHg. A transdermal nitroglycerin patch was applied 30 minutes ago to the right upper chest. Which action should the nurse take?
Reassure the client that the patch will begin to take effect within a few minutes.
Withhold further doses of nitroglycerin until contacting the healthcare provider.
Leave the patch in place and administer a PRN dose of sublingual nitroglycerin.
Obtain another transdermal patch and position it on the client's left upper chest.
A client receives a prescription for methotrexate. Which information provided by the client requires additional instruction by the nurse?
Take the medication during pregnancy.
Use folic acid to protect the liver.
Store the medication at room temperature.
The nurse is administering sodium polystyrene sulfonate to a client in acute kidney injury (AKI). Which laboratory finding indicates that the medication has been effective?
Serum potassium level of 3.8 mEq/L (3.8 mmol/L)
Serum ammonia level of 30 ug/dL (17.62 umol/dL)
Hemoglobin level of 13.5 g/dL (135 g/L)
Serum glucose level of 120 mg/dL (6.7 mmol/L)
The nurse is caring for a client who is taking diclofenac for rheumatoid arthritis. During a clinic visit, the client appears pale and reports increasing fatigue. Which of the client’s serum laboratory values is most important for the nurse to review?
Sodium
Glucose
Total protein
Hemoglobin
A postoperative male client asks the nurse to bring the largest possible dose of a prescribed narcotic. Which action should the nurse implement first?
Review the history for past use of recreational drugs.
Ask the client to describe his current pain using a pain scale.
Encourage the client to use diversional thoughts to manage pain.
Determine when the last dose was administered.
A client receives a new prescription for montelukast. Which information should the nurse include in the client’s teaching?
The medication will contract the smooth muscles located in the respiratory tract.
Montelukast will help repair damaged tissue in the base of the lungs.
The medication will prophylactically limit the inflammatory response to allergens.
Montelukast will increase the production of mucus in the lungs.
A client with myasthenia gravis is experiencing a cholinergic crisis. Which symptoms are associated with this condition? (Select all that apply.)
bradycardia
rash
vomiting
fever
drooling
Based on the scenario, what is the most appropriate action to take for the client experiencing a run of ventricular tachycardia (VT)?
Administer another dose of theophylline
Hold theophylline & Assess medication interactions
Increase the dose of albuterol
Start oral antibiotics
Which parameters should be monitored in this client?
Cardiac Rhythm, Theophylline blood levels
Blood glucose, Potassium levels
Liver enzymes, Renal function
Oxygen saturation, Blood pressure
The client is at immediate risk for _________.
CARDIAC ARREST, ANAPHYLAXIS, and ARRHYTHMIAS
HYPERTENSION, DIABETES, and OBESITY
FRACTURES, SPRAINS, and STRAINS
DEHYDRATION, MALNUTRITION, and FATIGUE
The nurse is evaluating the client's progress and nursing implementations. Bold the words to highlight the findings that would indicate the client has recovered from the adverse drug reactions. (Shaking is lessened. Client is no longer flushed. No longer itching. Anxiety has decreased. Skin warm and dry. Heart rate 62 beats/minute, blood pressure 130/72 mmHg. No chest pain noted. Respirations are even and unlabored. Drowsy.) Which of the following findings indicate recovery?
Shaking is lessened. Client is no longer flushed. No longer itching. Anxiety has decreased. Skin warm and dry. Heart rate 62 beats/minute, blood pressure 130/72 mmHg. No chest pain noted. Respirations are even and unlabored.
Client is flushed. Itching persists. Heart rate 110 beats/minute. Blood pressure 150/90 mmHg. Anxiety increased. Skin cool and clammy.
Shaking increased. Client is still itching. Heart rate 120 beats/minute. Blood pressure 90/60 mmHg. Chest pain noted. Respirations labored.
Client is drowsy. Heart rate 100 beats/minute. Blood pressure 140/88 mmHg. Skin moist. Anxiety present. Flushed appearance.
The nurse determines that the client is experiencing and the blood pressure changes are the results of .
Hypertension
Vasoconstriction
Hypotension
Vasodilation
CLIENT'S PLAN OF CARE: Which of the following are included in the client's plan of care? Select all that apply.
Potassium 4.4 mEq/L
No known allergies
Dosage in safe range
Used for prophylaxis
Peripheral IV in large vein
BODY SYSTEMS: SELECT ALL THAT APPLY. Respiratory:
Chest xray
Assess lung sounds
Provide a calm environment
Pain medication
The client is a 26-year-old female with acute appendicitis. She has a 12-year history of type 1 diabetes mellitus and no other significant medical history. The appendectomy was completed without issue, and the client will be admitted to the surgical floor to recover. The nurse prepares to give 2 units of Insulin lispro. What should the nurse double-check with a second nurse?
The sliding scale insulin lispro order
The insulin concentration
The expiration date on the insulin vial
The dose of insulin drawn up in the syringe
The insulin vial for color and clarity
Select the two lab orders that would be most appropriate for this client to complete on their return visit.
CBC and fasting blood glucose
Urinalysis and chest X-ray
Liver function test and ECG
Stool culture and pregnancy test
Which of the following questions can the nurse ask the client based on the laboratory results? Select all that apply.
Questions related to recent medication changes
Questions about dietary habits
Questions about family medical history
Questions about travel history only
What angiotensin converting enzyme (ACE) inhibitors can only be given once per day? SATA
TRANDOLAPRIL
LISINOPRIL
QUINAPRIL
RAMIPRIL
Body Systems: select all that apply. Cardiovascular
monitor vital signs continuously
provide warmth
defibrillator at bedside
echocardiogram
Body Systems: SATA: Immunological
Administer antihistamines
IV Fluid
Assess rash
Administer steroids
