NCLEX Pharmacology Final Exam: 2024/Actual Exam with 350 Questions and Solutions, Exams of Pharmacology

Download NCLEX Pharmacology Final Exam: 2024/Actual Exam with 350 Questions and Solutions and more Exams Pharmacology in PDF only on Docsity!

NCLEX PHARMACOLOGY FINAL EXAM

2024/ACTUAL EXAM WITH 350 EXAM QUESTIONS

AND CORRECT SOLUTIONS/GRADED A+/ 2024- 2025

One of the most common side effects of Enalapril (Vasotec) is:

1. Dry hacking cough.
2. Hypertension.
3. Constipation.
4. Irritability. - SOLUTION- 1. Dry hacking cough. EXPLANATION: A cough is commonly associated with angiotensin- converting enzymeinhibitors, resulting from increased sensitivity of cough reflex. A student caregiver questions the caregiver about why the client has 20mEq of Potassium Chloride (KCl) in his IV. The caregiver explains the purpose and then refers the studentto which laboratory tests?
5. Electrolytes.
6. Glucose.
7. Hemoglobin.
8. Arterial blood gases. - SOLUTION- 1. Electrolytes. EXPLANATION: It measures potassium, among other things. A client asks the caregiver why he is receiving patches of Nitroglycerin instead of justtaking it under the tongue when he needs it. The caregiver explains that:

1. " Given in this manner, the medication is absorbed at a slow, steady rate."

2. "This manner is effective in acute situations."
3. "This manner allows for more accurate dosage." "Patches administer a day's to a week's worth of medications." - SOLUTION- 1. "Given in this manner, the medication is absorbed at a slow, steady rate." EXPLANATION: After application to the skin, the medication is absorbed at a slow, constantrate, allowing for the maintenance of a therapeutic level. A client with cancer has been receiving high doses of Morphine for several days. During an assessment, the side effect that the caregiver would be likely to see is:
4. Constipation.
5. Respiratory Depression.
6. Pain Relief.
7. Diarrhea. - SOLUTION- 1. Constipation. EXPLANATION: These clients need to be on a bowel program. Constipation is the only sideeffect for which clients do not develop a tolerance. The physician has ordered Mycostatin 5ml, swish and swallow twice daily. The caregiver should instruct the client to:
8. "Swallow the medication quickly, and follow with 8oz of water."
9. "Shake the bottle before administering to help mix the suspension."
10. "Brush your teeth carefully before each dose." 4." Maintain contact with the mucosa as long as possible before swallowing. - SOLUTION- 4. "Maintain contact with the mucosa as long as possible before swallowing." EXPLANATION: This allows for maximal contact with impaired oral mucosa.

The caregiver will know that the client understands teaching about self- administration of Oral Corticosteroids when the client states that she will take the medications:

1. Before meals.
2. With or after meals.
3. At bedtime.
4. With orange juice.
   • SOLUTION- 2. With or after meals EXPLANATION: the medication is considered ulcerogenic. A caregiver is making a home visit to care for a client with COPD. When she arrivesat the home, she finds that the couple has a big box of medications all mixed together, and some of them are outdated. The first priority should be to:
5. Examine all the labels to determine which ones are still viable.
6. Question the couple to see what medications they are taking.
7. Report the situation to her supervisor so that she can contact the physician.
8. Contact the social worker to begin placement proceedings for the couple. - SOLUTION- 3. Report the situation to her supervisor so that she can contact the physician. EXPLANATION: The physician needs to know to verify any needed prescription. Prioritize the following concerns from highest to lowest priority for a caregiver visitinga childless couple:
9. Household cleaners stored under the sink.

2. Insulin syringes on the kitchen cabinet.
3. Husband and wife's medication stored together on the bedside table.
4. Two empty bottles of wine in the trash bin. SOLUTION- 3. Husband and wife's medication stored together on the bedside table.
5. Household cleaners stored under the sink. 2. Insulin syringes on the kitchen cabinet.
6. Two empty bottles of wine in the trash bin. A caregiver is assessing signs of alcohol withdrawal in one of her clients. Theseassessments would include:

• SOLUTION- - Tremors. Anxiety. Increased blood pressure All of these are signs of alcohol withdraw. Along with tachycardia, diaphoresis, anorexia, nausea, vomiting, insomnia. hallucinations and seizures. Items that would be appropriate to teach a client being treated with Warfarin (Coumadin): - SOLUTION-
• "It is important to avoid eating excessive amounts of broccoli." "It is important to monitor for any signs of bleeding in urine and stool." "The physician will regulate your medication according to your blood work." Broccoli contains large amounts of Vitamin K. Bleeding may occur if the dosage is not regulated properly. Dosage is managed by monitoring therapeutic levels. An 89 year old man is complaining of urinary retention during the medication history. Which assessment would be a priority to report to the physician?

1. Baclofen (Lioresal).
2. Diazepam (Valium).
3. Benstropine (Cogentin).
4. Cyclobenzaprine hydrochloride (Flexeril). – SOLUTION- 3. Benstropine (Cogentin). This is a cholinergic-blocking agent. Urinary retention is an adverse effect. A client is receiving Aminophylline. The caregiver knows the medication acts to:
5. Dilate blood vessels, increasing capillary permeability.
6. Increase contraction of the bronchi and alveolar.
7. Decrease contraction of the smooth muscles of the bronchioles.
8. Decrease the amount of mucus secretion from the bronchi. - SOLUTION- 2.Increase contraction of the bronchi and alveolar. When a caregiver is giving dietary instructions appropriate to a person taking Ibandronate Sodium (Boniva), it would be especially important to include which of the following:
9. "Maintain adequate intake of Calcium and Vitamin D."
10. "Increase fiber, whole grains, and rhubarb."
11. "Increase intake of Vitamin C"
12. "Maintain appropriate calories to avoid gaining weight." - SOLUTION- 1."Maintain adequate intake of Calcium and Vitamin D." Clients being treated with Boniva require calcium supplements to maintain blood levels.

The caregiver in a physicians office interviews a client being treated for asthma. Theclient is jittery and complains of nausea. A statement that might indicate a cause for the jitteriness would be:

1. "I have been taking Diazepam (Valium) for my nerves."
2. "I am overdue to have a Theophylline level drawn."
3. "I am taking Cimetidine (Tagamet) for my epigastric pain."
4. "I take a laxative when I am constipated." - SOLUTION- 2. "I am overdue to havea Theophylline level drawn." Theophylline can cause these effects; a level is necessary to determine if the medication is in the therapeutic range. Indicate in which order of priority the caregiver should administer the medications tothese clients:
5. A cardiac client receiving a daily dose of Digoxin (Lanolin).
6. An asthmatic client receiving a daily dose of Montelukast (Singulair).
7. A client receiving an antibiotic four times per day for a wound infection.
8. A client with diabetes receiving a daily dose of insulin. - SOLUTION- 4. Aclient with diabetes receiving a daily dose of insulin.
9. A client receiving an antibiotic four times per day for a wound infection.
10. An asthmatic client receiving a daily dose of Montelukast (Singulair).
11. A cardiac client receiving a daily dose of Digoxin (Lanolin). During an admission interview, the caregiver learns that a client has been taking Dipyridamole (Persantine) for several months. This assessment is an indication for:
12. Assessing respirations after activity.
13. Monitoring blood pressure sitting, standing, and lying.
14. Assessing temperature every 4 hours.

4. Monitoring white blood cells to check for infection. - SOLUTION- 2. Monitoringblood pressure sitting, standing, and lying. This medicine is used to treat TIA; orthostatic hypotension is a common side effect. Clients who are receiving Vancomycin (Vancocin) by IV infusion should be assessed before and during the administration for:
5. Blurred vision.
6. Constipation.
7. Hearing damage.
8. Muscle cramps. - SOLUTION- 3. Hearing damage. Vancomycin is both ototoxic and nephrotoxic. A caregiver assesses that a client with diabetes is reporting increased episodes of hypoglycemia. What is the likely explanation?
9. Decreasing usual exercise patterns without changing insulin.
10. Increasing caloric intake without changing insulin.
11. Increased exercise patterns with a decreased insulin dosage.
12. Decreased caloric intake and increased exercise pattern. - SOLUTION- 4.Decreased caloric intake and increased exercise pattern. Less food and more exercise are most likely to cause decreased blood sugar. A client is being started on Isoniazid (INH) Therapy for the treatment of Tuberculosis. Identify all items that should be included in his discharge instructions: - SOLUTION- - Avoid smoked fish, tuna, and milk products.

• Do you not drink alcohol.

• Maintain follow-up contact with the physician. Identify diagnosis that are appropriate indications for antihistamine therapy: - SOLUTION- - Upper respiratory tract infections.
• Anaphylactic reactions. These drugs block histamines at their receptor sites, therefore decreasing the symptoms of these conditions. A caregiver is administering an antibiotic to a client at midnight. The client refuses to take the medication, stating," I already received my pills before I went to sleep." The most appropriate action for the caregiver to take is:

1. Verify that the medication order is current and correct.
2. Explain to the client that the physician has ordered the medication to cure his infection.
3. Explain to the client that he received his sleeping pill before going to sleep.
4. Check previous documentation to be certain that the time of administration was not change during the previous shift. - SOLUTION- 4. Check previous documentation to be certain that the time of administration was not change during the previous shift. It is possible that the evening shift obtained permission to give the medications early so the client would not be awakened.

A clinic caregiver is concerned when a client diagnosed with active Tuberculosis (TB) returns to the clinic after two weeks of treatment and reports a worsening cough and recurring night sweats. These findings most likely indicate:

1. Noncompliance with medication regimen.
2. Additional exposure to infected individuals.
3. The need for additional medication.
4. The need for follow-up care for family members. - SOLUTION- 1.Noncompliance with medication regimen. TB medications must be taken over an extended period (6 months to 2 years) to ensure effective treatment. (50) A client is taking Gantrisin. Which statement would indicate that the client understands the purpose of this medication?
5. "I have had urinary frequency and burning for the last two days."
6. "I am allergic to penicillin."
7. "I have had a runny nose for 3 days."
8. "I have loose, four-smelling diarrhea." - SOLUTION- 1. "I have had urinaryfrequency and burning for the last two days." Most common antibiotic to treat UTI's. The caregiver knows that an 80 - year-old client taking medication would be prone to:
9. Developing a tolerance to medication.

2. Metabolizing medications more rapidly.
3. Developing more frequent adverse reactions.
4. Experiencing more cumulative effects - SOLUTION- 4. Experiencing morecumulative effects. Elderly persons metabolize drugs more slowly because of declining body function, thus prolonging the half life of the drug, resulting in drug accumulation. A client is being treated with Pyridostigmine (Mestinon) for Myasthenia Gravis. How would the caregiver evaluate the therapeutic effectiveness of this medication?
5. Decreased arrhythmias.
6. Decrease nausea and vomiting.
7. Increased perspiration.
8. Increased muscle strength. - SOLUTION- 4. Increased muscle strength. Increased muscle strength would indicate an improvement in the symptoms. A caregiver is administering Amoxycillin PO to a three year old child diagnosed withan ear infection. The most appropriate approach with the child would be to:
9. Give a detail explanation to the child about why he needs this medicine.
10. Explain that it is time to take your "pink medicine."
11. Have the parent hold the client in his or her arms, and inject it quickly into the child's mouth.
12. Administer the medication in 240 mL of apple juice. - SOLUTION- 2. Explain that it is time to take your "pink medicine."

Explanations should be geared to the child's ability to understand. Atropine, 1/150 grain, is ordered as a preoperative medication. On hand 0. mg/ML. The appropriate amount of fluid to be administered is: - SOLUTION- 1 mL 0.4mg = 1/150 grain A caregiver is assigned to administer morning medications to four clients. Place theclient in order of priority from highest to lowest for those medications.

1. Ascirbic Acid (Vitamin C), Os-Cal, Furosemide (Lasix).
2. Metformin, Digoxin (Lanoxin).
3. Escitalopram (Lexapro), Multivitamin, Ascorbic Acid.
4. Metoprolol, Multivitamins, Aspirin. - SOLUTION- 2. Metformin, Digoxin(Lanoxin).
5. Ascirbic Acid (Vitamin C), Os-Cal, Furosemide (Lasix).
6. Metoprolol, Multivitamins, Aspirin.
7. Escitalopram (Lexapro), Multivitamin, Ascorbic Acid. Metformin is an oral hypoglycemic agent that should be given before breakfast. Lasix should be given before breakfast. The remaining medications are not time sensitive. The caregiver will administer thyroid drugs:
8. In a single dose, usually before breakfast.

2. In divided doses before meals.
3. In divided doses after meals.
4. As the client's energy level decreases. - SOLUTION- 1. In a single dose, usuallybefore breakfast. This allows peak drug activity (better absorption) during daytime hours. A client with asthma has been placed on a metered dose inhaler. Which statement indicates a need for further teaching?
5. "I need to press down on the inhaler to release one puff while inhaling slowly."
6. "The inhalers can be used on a multi dose basis."
7. "I should inhale both puffs in quick succession."
8. "After each puff I should hold my breath for approximately 10 seconds." - SOLUTION- 3. " I should inhale both puffs in quick succession." One minute should be allowed between puffs. A 20-year-old male client is taking Ciprofloxacin for urinary tract infection. He also takes Theophylline for asthma. In teaching him about his medication, the caregiver knows that:
9. Fluids should be restricted while taking Ciprofloxacin.
10. The client should not be started on Ciprofloxacin until culture results have been obtained.
11. Theophylline levels may be elevated and can become toxic.
12. The two medications should be given at alternate times. - SOLUTION- 3.Theophylline levels may be elevated and can become toxic.

Cipro can increase theophylline levels. A 64-year-old client with congestive heart failure takes a Digitalis preparation every day. Before administering the medication, the caregiver will:

1. Weigh the client.
2. Check the apical pulse.
3. Take the client's pressure.
4. Monitor the client's clotting time. - SOLUTION- 2. Check the apical pulse. Check apical pulse for one full minute and hold medication if it is below 60. Identify substance interactions that are antagonistic to one another: - SOLUTION- - Antacids and bran.

• Erythromycin and citrus foods.
• Warfarin and Vitamin K. Bran interferes with the ability of the antacid to coat and protect the stomach. Citrus foods are antagonist to erythromycin and therefore decrease effectiveness. Vitamin K is the antidote for warfarin. A client diagnosed with cancer is taking Erythropoietin (Epogen). The blood tests that should be checked to indicate the effectiveness of this medication would be:

1. Blood glucose level.

2. Blood urea nitrogen and creatinine.
3. Hemoglobin and hematocrit.
4. White blood cell count. - SOLUTION- 3. Hemoglobin and hematocrit. Epogan is indicated for treating low hemoglobin and hematocrit in anemia. While taking a medication history on a pre-operative client, the caregiver is concerned when she discovers that the client is being treated with Acetazolamide (Diamox) for narrow angle glaucoma. She knows that this is important to communicate to the physician because the client should not receive which medication?
5. Meperidine (Demerol).
6. Atropine Sulfate (Isopto Atropine).
7. Pentazocine (Talwin).
8. Naloxone hydrochloride (Narcan). - SOLUTION- 2. Atropine Sulfate (Isopto Atropine). This is a cholinergic-blocking agent that increases pupil dilation. A client is admitted for the treatment of gastroesophageal reflux disease. His treatment has not responded to first-line medications, so the physician is planning to place him on regimen of Metoclopramide (Regalan) for a short period. The caregiver should instruct the client on all items except:
9. Advise the client to avoid alcohol and other central nervous system (CNS) depressants.
10. Monitor carefully for signs of hyperglycemia because the food is more efficiently absorbed into the bloodstream.

3. Avoid tasks that require concentration.
4. Administer the oral dose 30 minutes before meals and at bedtime. - SOLUTION-
5. Monitor carefully for signs of hyperglycemia because the food is more efficiently absorbed into the bloodstream. Reglan is more likely to cause hypoglycemia because the food moves more rapidly through the GI tract. Protease inhibitors should be taken:
6. With meals to improve absorption.
7. 1 hour before or 2 hours after meals.
8. With only a small sip of water.
9. With the scheduled vitamins. - SOLUTION- 2. 1 hour before or 2 hours after meals. These medications are better absorbed on an empty stomach. Zidovudine (Retrovir) is commonly prescribed for clients with HIV. The caregiver knows that the ideal time for beginning treatment is:
10. When symptoms of immune deficiency first begin to appear.
11. After other antiviral medicines have been tried.
12. Before symptoms of immunodeficiency appear.
13. At the end stage of the disease. - SOLUTION- 3. Before symptoms ofimmunodeficiency appear.

The aim of this therapy is to reduce the viral load as much as possible. A student caregiver is worried that a client with a terminal illness is receiving toohigh a dose of Morphine in her continuous morphine drip. The oncology caregiverexplains that: - SOLUTION- 3. "Clients with cancer pain can be administered gradually increasing doses without side effects of respiratory depression and sedation." Client's develop a tolerance to all side effects except constipation. A postoperative client is reluctant to take pain medication, even though he is rating his pain as an 8 on a scale of 1 to 10. The caregiver assessed the clients feelingsand concludes that he has a fear of addiction. She explains to him that: - SOLUTION- 3. Addiction is minimal in hospitalized clients. The caregiver in an outclient clinic is concerned because a client comes to the cliniccomplaining of heartburn that she has been experiencing for the last 2 weeks. She has been experiencing for the last 2 weeks. She has been self-medicating with Sodium Bicarbonate. The caregiver anticipates that the physician will order which blood test? - SOLUTION- 3. Electrolytes. Older clients on long term use of alkalizing agents are especially susceptible to electrolyte disorders. A client asks the caregiver why his Aluminum Hydroxide (Amphojel) is always given1 hour before meals. the caregiver replies: - SOLUTION- 2. "An empty stomach allows the medication to decrease hydrochloric acid secretions more effectively." Is has a protective effect and is better able to work if it can come into contact with the lining of the stomach.

A caregiver is taking a medication history of a client diagnosed with a UTI. Thephysician has prescribed Ciprofloxacin (Cipro) to treat the infection. Which medication taken by the client would be of most concern to the caregiver? - SOLUTION- 1. Mylanta. This binds with Cipro and may decrease effectiveness. A client at a walk in clinic has been on an extended overseas trip. He is complaining of diarrhea. The physician prescribes Polycarbophil (FiberCon). Thecaregiver also instructs the client to: - SOLUTION- 4. Report back to the physician if diarrhea persists more than 2 days. The cause of diarrhea needs to be investigated if it persists beyond 2 days. A student caregiver asks her instructor why Sucralfate (Carafate) has to be given 1 hour before meals and 2 hours after other medications. The instructor explains that:

• SOLUTION- 1. Sucralfate is better able to protect the lining of the stomach if it isable to come in contact with it. The action of this is to line and protect the stomach; it is better able to do so if the medications can come in contact with the stomach. A client is being discharged on Warfarin Sodium (Coumadin). Which of these instructions is appropriate for the caregiver to give him? - SOLUTION- 3. Report anysigns of bleeding to your health care provider. It is critical that clients taking Warfarin (Coumadin) report any signs of bleeding, including any blood observe in excreta.

A client is admitted for the treatment of CHF. He is started on Digoxin (Lanoxin) and Furosemide (Lasix) A loading dose of digoxin is given for the purpose of: - SOLUTION- 3. Giving the client an adequate blood level. To achieve therapeutic relief as quickly as possible, clients are given a loading dose. A maintenance dose is given to maintain the therapeutic stage. A client has been given Gabapentin (Neurontin) over the last year after having had a craniotomy for a subdural hematoma. The directions given him at this time would be: - SOLUTION- 2. "This medication needs to be discontinued on a gradualschedule initiated by the physician." The medication can not be discontinued abruptly, to protect against possible seizures after the surgery. A student caregiver asks why a client is taking insulin when no history of diabetes isin her chart. The caregiver explains that one of the medications she is taking sometimes causes hyperglycemia. This medication would be:

1. Dexamethasone (Decadron).
2. Rosiglitazone (Avandia).
3. Digoxin (Lanoxin).
4. Glucophage (Metformin). - SOLUTION- 1. Dexamethasone (Decadron). Steroids causer hyperglycemia as an adverse effect. A child is being treated with Methylphenidate (Ritalin) for ADHD. The parent should be instructed to schedule the medication:

1. At bedtime.
2. Before dinnertime.
3. After meals.
4. In the early morning. - SOLUTION- 3. After meals. This time would minimize impact on nutrition and growth and development. A postpartum client complains of dysuria. the physician prescribes which of these medications to ease symptoms?
5. Phenazopyridine (Pyridium).
6. Furosemide (Lasix).
7. Loperamide (Imodium).
8. Sulfisoxazole (Gantrisin). - SOLUTION- 1. Phenazopyridine (Pyridium). It is urinary tract analgesic that is prescribed for these symptoms. An adverse side effect of Oxybutynin (Ditropan) that needs to be reported immediately is:
9. Jaundice.
10. Restlessness.
11. Bradycardia.
12. Fatigue. - SOLUTION- 1. Jaundice. This may indicate liver damage.

A client is being discharged taking Biphosphonates Alendronate (Fosamax). Which instructions are not appropriate?

1. "Drinking 3000 to 4000 ml of fluid will help your kidneys excrete the medication."
2. "Increasing your intake of dairy products will help this medication to work better."
3. "Remember to take your other vitamins at least 30 minutes after this pill."
4. "Laboratory work needs to be scheduled to make sure this medication is working." - SOLUTION- 2. "Increasing your intake of dairy products will help this medication to work better." Clients should limit intake of dairy products because of their high calciumcontent. (111) which is a sign of salicylate toxicity? - SOLUTION- (1) tinnitus (2) Headache (3) Dizziness (4) Irritability A client is receiving Bisphosphonates-Alendronate (Fosomax). The proper time to schedule this medication is:
5. With meals.

2. With other medications early in the day.
3. 30 minutes before other medications.
4. 30 minutes before uncomfortable procedures. - SOLUTION- 3. 30 minutes beforeother medications. This medication is more effective if taken by itself. Which dietary pattern would be contraindicated for the administration of Enoxaparin (Lovenox)?
5. Hyperalimentation.
6. A kosher diet.
7. A vegitarian diet.
8. A low sodium diet. - SOLUTION- 2. A kosher diet. This product is partially made from pork. Identify all of the instruction that are necessary for a client starting antibiotic therapy: - SOLUTION- - The doctor will prescribe medicine based on the results ofthe culture and sensitivity.

• Always monitor renal and liver functions for any long term use.
• Monitor for signs of superinfection. A client with Type 2 Diabetes is hospitalized for surgery. He has been maintaining glycemic control using an oral hypoglycemic agent. He is concerned that his blood sugar has been elevated and that he has been needing to receive insulin. The best response for the caregiver at this time would be:

1. "Don't worry about that now. Ask your doctor after you have recovered."
2. "As you get older, very often the resistance of your cells to insulin increases."
3. "Stress often temporarily increases blood glucose levels in your body."
4. "We are carefully monitoring your blood glucose levels" - SOLUTION- 3. "Stressoften temporarily increases blood glucose levels in your body." A client receiving Clonazepam (Klonopin) should be taught: - SOLUTION- - Makesure seizures are controlled before driving.

• Monitor for decreased effectiveness.
• Check carefully for the development of secondary infections. A client is brought into the ER after having taken an overdose of Sacobarbital (Seconal). Which of these is the priority for the caregiver?

1. Maintain clients safety (e.g. elevate side rails) to prevent injuries because of agitation upon awakening.
2. Prepare for the initiation of dialysis.
3. Prepare to draw blood work to determine if level is toxic.
4. Prepare for the intravenous administration of Phenytoin (Dilantin). - SOLUTION-
5. Prepare for the initiation of dialysis. Barbiturate poisoning is treated with dialysis to cleanse the blood. A client with a diagnosis of congestive heart failure (CHF) is admitted to the emergency room. the doctor orders digoxin and the caregiver knows that important considerations for this drug include: - SOLUTION- - Checking for signs of toxicity.

• Monitoring for a steady decrease in the rate and increase in the strength of the heartbeat.

• Monitoring for visual disturbance.
• Checking the pulse rate before administration. Most important action of Digoxin is to slow and strengthen the heartbeat. A 30-year old female client with a diagnosis of varicose veins visits the doctors office. She said that surgery for her varicose veins is scheduled at the time of her vacation (in 6 months). She wants a prescription for birth control pills. the most effective thing for the caregiver to say is:

1. "Varicose veins can be aggravated during pregnancy, so it is a good thing that you are planning ahead."
2. "An alternative form of birth control would be safer because of the potential side effects of birth control pills."
3. "We can only give you a 3 month supply of birth control pills."
4. "An IUD (Intrauterine device) would be the preferred choice of birth control right now for you." - SOLUTION- 2. "An alternative form of birth control would besafer because of the potential side effects of birth control pills." Birth control pills should not be used with a client who has a history of circulatory conditions. A student caregiver is accompanying a visiting caregiver on a home visit. a 70 year old woman is complaining of what she calls "Indigestion." She says she has been experiencing this symptom for about 2 weeks. Her husband says she has been "popping" Prevacid (Lansoprasole) three or four times a day. In addition to assessing symptoms and encouraging medical care, the caregiver should be concernedwith which medication(s)? - SOLUTION- - Digoxin.

• Coumadin.
• Dilantin.

The effects of these medications is enhanced because it interferes with the body's metabolism of the medication. A client is experiencing seizures. the physician has prescribed the anticonvulsant Carbamazepine (Tegretol). the caregiver understands that this drug can be used to treatall except:

1. The treatment of trigeminal nerve pain.
2. Grand mal seizures.
3. Petit mal seizures.
4. Pain caused by neuritis. - SOLUTION- 3. Petit mal seizures. A postoperative client is refusing any medication for pain. Which intervention would be a priority for the caregiver?
5. Assess the severity of the clients pain on a scale of 1 to 10.
6. Praise the client for his tolerance of pain.
7. Try nuring measures (e.g. repositioning, back rub).
8. Determine what information the client understands concerning his medications.

• SOLUTION- 4. Determine what information the client understands concerning his medications. A client enters a clinic. The student caregiver is assigned to assist the caregiver with a physical assessment and history taking. The client complains of decreased energy levels, inability to concentrate, and increased sensitivity to cold. The student caregiver might expect to see which physical signs? - SOLUTION- - Puffy hands and feet.
• Dry or leathery skin.

These symptoms are commonly associated with hypothyroidism. Thyroid hormones promote metabolism, growth, and development are complete. After the physician has made a diagnosis of hypothyroidism in the previous scenario, the student caregiver asks the physician about the clients prognosis. the physicians response would be:

1. After surgery, she has 50% chance of recovery.
2. With surgery and radiation treatment, the prognosis is good.
3. With the administration of thyroid hormones, the prognosis is good.
4. Methimazole (Tapazole) inhibits synthesis of the thyroid hormones. - SOLUTION-
5. With the administration of thyroid hormones, the prognosis is good. It is generally successful because unlike with children, growth and development are complete. A client is halfway through a 10 day course of Bactrim (Co-trimoxazole). She is complaining of itching on her extremities. Which questions should be included in the assessment interview? - SOLUTION- - What other medications have you taken inthe week?

• Are there any other symptoms that you have noticed recently?
• Have you obtained relief from this medication? There are many medications that interfere with sulfa drugs. Ask if there is additional symptoms or any relief.