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NURS 293 ATI Pharmacology Final Review Chamberlain
College of Nursing
- 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 i) Rationale: Levothyroxine overdose will result in manifestations of hyperthyroidism, which include Insomnia, tachycardia, and hyperthermia. b) Constipation i) Rationale: Constipation is a manifestation of hypothyroidism and indicates an inadequate dose of levothyroxine. c) Drowsiness i) Rationale: Drowsiness is a manifestation of hypothyroidism and indicates an inadequate dose of levothyroxine. d) Hypoactive deep-tendon reflexes i) Rationale: Hypoactive deep-tendon reflexes are manifestations of hypothyroidism and indicate an inadequate dose of levothyroxine.
- 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 thyroxin (T4) i) Rationale: If the dose of this medication has been adequate, the nurse
should see an increase in the T4.
increased dosage of hypoglycemic med. d) Atorvastatin i) Thyroid function tests.
- A nurse is caring for a client receiving mydriatic eye drops. Which of the following clinical manifestations indicates to the nurse that the client has developed a systemic anticholinergic effect? a) Seizures b) Tachypnea c) Constipation i) Mydriatic eye drops can cause systemic anticholinergic effects such as constipation, dry mouth, photophobia, and tachycardia. d) Hypothermia
- A nurse is caring for a client who has heart failure and is receiving IV furosemide. The nurse should monitor the client for which of the following electrolyte imbalances? a) Hypernatremia i) Rationale: The nurse should monitor the client who is receiving IV furosemide for hyponatremia. b) Hyperuricemia i) Rationale: The nurse should monitor the client who is receiving IV furosemide for hyperuricemia. The nurse should instruct the client to notify the provider for any tenderness or swelling of the joints. c) Hypercalcemia i) Rationale: The nurse should monitor the client who is receiving IV furosemide for hypocalcemia. d) Hyperchloremia i) Rationale: The nurse should monitor the client who is receiving IV furosemide for hypochloremia.
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 d) Bicarbonate
- A nurse is educating a group of clients about the contraindications of warfarin therapy. Which of the following statements should the nurse include in the teaching? a) "Clients who have glaucoma should not take warfarin." b) "Clients who have rheumatoid arthritis should not take warfarin." c) "Clients who are pregnant should not take warfarin." i) Rationale: Warfarin therapy is contraindicated in the pregnant client because it crosses the placenta and places the fetus at risk for bleeding. d) "Clients who have hyperthyroidism should not take warfarin."
- A nurse is teaching a client who takes warfarin daily. Which of the following statements by the client indicates a need for further teaching? a) "I have started taking ginger root to treat my joint stiffness." i) Rationale: Ginger root can interfere with the blood clotting effect of warfarin and place the client at risk for bleeding. This statement indicates the client needs further teaching. b) "I take this medication at the same time each day." i) Rationale: The client should take warfarin at the same time each day to maintain a stable blood level. c) "I eat a green salad every night with dinner." i) Rationale: Green leafy vegetables are a good source of vitamin K, which can interfere with the clotting effects of warfarin. Clients who are taking warfarin do not need to restrict dietary vitamin K intake but rather should maintain a consistent intake of vitamin K in order to control the therapeutic effect of the medication. d) "I had my INR checked three weeks ago.
a) Teach proper subcutaneous administration b) Administer the oral dose at the same time every day c) Assess carefully for excessive bruising or unusual bleeding d) Monitor laboratory results for a target INR of 2 to 3 e) Monitor laboratory results for a therapeutic aPTT value of 1.5 to 2.5 times the control value
- Atorvastatin can elevate LFT a) Baseline total cholesterol, LDL and HDL level, triglycerides, and liver and renal function test obtained and then monitored periodically throughout treatment
- The nurse teaches a client who is recovering from acute kidney disease to avoid which type of medication? a) NSAIDS i) NSAIDs may be nephrotoxic to a client with acute kidney disease, and should be avoided. ACE inhibitors are used for treatment of hypertension and to protect the kidneys, especially in the diabetic client, from progression of kidney disease. Opiates may be used by clients with kidney disease if severe pain is present; however, excretion may be delayed. Calcium channel blockers can improve the glomerular filtration rate and blood flow within the kidney. b) ACE inhibitors c) Opiates d) Calcium channel blockers
- Which of the following are adverse reactions related to the use of
CELECOXIB? Select all that apply a) Rhinitis b) Neutropeni a c) Oliguria d) Stomatitis
stomachache or indigestion.
i) Rationale: The pill is enteric-coated to prevent breakdown in the stomach and decrease the possibility of GI distress. Crushing destroys protection. b) "Crushing the medication is a good idea, and I can mix it in some ice cream for you.” c) "Crushing the medication would release all the medication at once, rather than over time." d) "Crushing is unsafe, as it destroys the ingredients in the medication."
- A nurse is caring for a client who has thrombophlebitis and is receiving heparin by continuous IV infusion. The client asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give? a) "It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level." b) "A pharmacist is the person to answer that question." c) "Heparin does not dissolve clots. It stops new clots from forming." i) Rationale: This statement accurately answers the client's question. d) "The oral medication you will take after this IV will dissolve the clot.
- 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 i) Rationale: Thyroid testing is important because long-term use of lithium may lead to thyroid dysfunction. b) Liver function tests: i) Rationale: LFTs must be monitored before and during valproic acid therapy
a) Asthma i) 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 c) Depression d) Migraines
- A nurse is teaching a client who has a new prescription for colchicine to treat gout. Which of the following instructions should the nurse include? a) "Take this medication with food if nausea develops." b) B. "Monitor for muscle pain." i) Rationale: This medication can cause rhabdomyolysis. The client should monitor and report muscle pain. c) "Expect to have increased bruising." d) "Increase your intake of grapefruit juice”
- 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." b) "Limit your daily fluid intake while taking this medication." c) "This medication can cause photophobia, so be sure to wear sunglasses outdoors." d) "You should report any tendon discomfort you experience while
taking this medication." i) 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.
aluminum hydroxide 300 mg PO three times daily. For which of the following adverse effects should the nurse inform the client? a) Constipation
i) Rationale: Constipation is a common side effect of aluminum- based antacids. The nurse should instruct the client to increase fiber intake and that stool softeners or laxatives may be needed b) B. Metallic taste c) Headache d) Muscle spasms
- 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 b) Adrenocortical insufficiency i) 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 d) Rebound pulmonary 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
