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Nursing Medication Education: Client Teaching and Adverse Effects, Exams of Pharmacology

A.T. Still University of Health Sciences (ATSU)Pharmacology

A series of questions and answers related to nursing medication education. It covers topics such as client teaching about various medications, medication interactions, adverse effects, and appropriate positions for administering certain medications. Useful for nursing students and professionals to understand the correct procedures for administering medications and educating clients about their use.

Typology: Exams

2022/2023

Available from 04/14/2024

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PHARMACOLOGY PRE-EVALUATION TEST
A client has been prescribed metoclopramide. Which of the following should the nurse include in
client education regarding this
medication?
Select one:
a. Notify your provider if you experience restlessness or spasms of the face or neck. An
adverse effect of Reglan is extrapyramidal symptoms. The client should stop the
medication and notify the provider if these occur.
b. This medication can cause urinary frequency.
c. Decrease your fluid intake while taking this medication.
d. This medication can cause insomnia.
A 52-year-old client with a history of angina has been prescribed transdermal nitroglycerin.
Which of the following adverse effects is not
seen with this therapy?
Select one:
a. Headache
b. Orthostatic hypotension
c. Tolerance
d. Productive cough Correct – Nitroglycerin therapy does not directly have an effect lung
function. Physiologically, vasodilation
should effect capillary perfusion and decrease lung secretions.
A nurse is caring for a client prescribed montelukast. Which of the following should the nurse
include in teaching related to this
medication?
Select one:
a. Advise client to take the medication once daily at bedtime. Clients should take
montelukast once daily at bedtime.
b. If the client forgets to take the medication for a few days he can double up on doses to catch
up.
c. Avoid dairy products while taking this medication.
d. This medication is for acute management of asthma
A nurse is caring for a client prescribed ferrous sulfate for the treatment of anemia. Which of the
following instructions should be included
in client teaching about this medication?
Select one:
a. Take the medication on an empty stomach to maximize absorption.
The nurse should instruct the clients to take iron on an empty stomach, such as 1 hr
before meals to maximize absorption. Stomach acid
increases absorption. If GI adverse effects occur, the client can take with food to
increase adherence to therapy even though absorption is also
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Download Nursing Medication Education: Client Teaching and Adverse Effects and more Exams Pharmacology in PDF only on Docsity!

PHARMACOLOGY PRE-EVALUATION TEST

A client has been prescribed metoclopramide. Which of the following should the nurse include in client education regarding this medication? Select one: a. Notify your provider if you experience restlessness or spasms of the face or neck. An adverse effect of Reglan is extrapyramidal symptoms. The client should stop the medication and notify the provider if these occur. b. This medication can cause urinary frequency. c. Decrease your fluid intake while taking this medication. d. This medication can cause insomnia. A 52-year-old client with a history of angina has been prescribed transdermal nitroglycerin. Which of the following adverse effects is not seen with this therapy? Select one: a. Headache b. Orthostatic hypotension c. Tolerance d. Productive cough Correct – Nitroglycerin therapy does not directly have an effect lung function. Physiologically, vasodilation should effect capillary perfusion and decrease lung secretions. A nurse is caring for a client prescribed montelukast. Which of the following should the nurse include in teaching related to this medication? Select one: a. Advise client to take the medication once daily at bedtime. Clients should take montelukast once daily at bedtime. b. If the client forgets to take the medication for a few days he can double up on doses to catch up. c. Avoid dairy products while taking this medication. d. This medication is for acute management of asthma A nurse is caring for a client prescribed ferrous sulfate for the treatment of anemia. Which of the following instructions should be included in client teaching about this medication? Select one: a. Take the medication on an empty stomach to maximize absorption. The nurse should instruct the clients to take iron on an empty stomach, such as 1 hr before meals to maximize absorption. Stomach acid increases absorption. If GI adverse effects occur, the client can take with food to increase adherence to therapy even though absorption is also

decreased. b. Take prescribed antacids at the same time as this medication. c. Decrease dietary fiber intake while taking this medication. d. Notify your provider if your stool becomes dark green. A nurse is caring for a client who has diabetes and a new prescription for 14 units of regular insulin and 28 units of NPH insulin subcutaneously at breakfast daily. What is the total number of units of insulin that the nurse should prepare in the insulin syringe? 42 Units Each order of for units of insulin is combined in the same syringe. The nurse should withdraw the regular insulin into the syringe first. A nurse is caring for a client receiving patient-controlled analgesia (PCA). Which of the following interventions should the nurse take while caring for this client? Select one: a. Increase client's 4-hr limit as needed. b. Encourage the client to use the PCA before dressing changes. The nurse should encourage the client to use the PCA prophylactically prior to activities that are likely to augment pain levels. c. Advise the client to use the pump sparingly to prevent addiction. d. Encourage the client's family to administer PCA while client is sleeping. A nurse is reviewing the medication class, benzodiazepines. The nurse would use caution when administering benzodiazepines to which of the below clients? Select one: a. A client with insomnia. b. A client with renal failure. c. A client with hypertension. d. A client with glaucoma. Correct – benzodiazepines can increase intraocular pressure due to the pupil-dilating effects of the Medication. A client has been prescribed lisinopril. Which of the following medication interactions should the nurse instruct this client about? Select one: a. Escitalopram b. Potassium supplements Correct. Potassium supplements and potassium-sparing diuretics increase the risk of hyperkalemia in clients taking ACE inhibitors such as lisinopril. Clients should only take potassium supplements if prescribed by the provider. Clients should also avoid salt substitutes that contain potassium.

b. "I should take the medication on a full stomach." c. "I should take the medication in the morning to prevent insomnia." Synthroid should be taken once in the morning to preventinsomnia. d. "I should take the medication in divided doses to ensure therapeutic drug levels." A 55-year-old client has levothyroxine ordered. Which of the below past medical history concerns may contraindicate with her medication management of hypothyroidism? Select one: a. Peripheral Vascular Disease b. Osteoporosis Correct: There is an increased risk for fractures, especially in older adults. c. Asthma d. Scleroderma A nurse is preparing to administer an intramuscular injection to an adult client. At what angle should the nurse administer the medication using the ventrogluteal site? Select one: a. a 45 degree angle b. A 90 degree angle IM injections should be administered at a 90 degree angle. c. a 75 degree angle d. a 60 degree angle A nurse has just administered a wrong medication to a client. Which of the following actions should the nurse take next? Select one: a. Report error to the provider. Correct. The nurse should acknowledge the error and report it to the provider for further orders. The nurse should also monitor the client for adverse effects. b. No action is needed. c. Complete an institutional incident report. d. Inform the client that the wrong medication was given. A 45-year-old client is taking methylprednisolone. What pharmacological action should the nurse expect with this therapy? Select one: a. Suppression of airway mucus production. Correct – Corticosteroids, such as methylprednisolone (Solu-Medrol) will suppress airway mucus production. b. Suppression of candidiasis. c. Fortification of bones. d. Suppression of beta receptors.

Before administering blood products, which action should be taken? Select one: a. Prime IV tubing with 0.45% sodium chloride. b. Administer epinephrine. c. Document client response. d. Assess the client’s temperature. Correct: Assess the client’s vital signs, obtain consent for the procedure and ensure compatibility. Prime the IV tubing with 0.9% sodium chloride. The nurse would not document client response or administer epinephrine prior to starting the transfusion. A client has been prescribed isosorbide mononitrate. Which of the following should the nurse include in this client's education related to this medication? Select one: a. You can crush this medication if needed. b. Take an additional tablet if you experience chest pain. c. This medication is prescribed for long-term prophylaxis against anginal attacks. Isosorbide mononitrate (Imdur) is used forlong-term prophylaxis against anginal attacks. d. Take the medication in the evening after dinner. A nurse is caring for a client prescribed the HMG CoA reductase inhibitor, atorvastatin. Which of the following should be monitored while this medication is prescribed? Select one: a. Hearing screenings b. Visual acuity screenings c. Renal function tests d. Liver function tests Correct. Statins (HMG CoA reductase inhibitors) like atorvastatin (Lipitor) can cause hepatotoxicity. Prior to initiating therapy the client's baseline liver function should be determined then liver function tests should be checked after 12 weeks of therapy and then every 6 months. The nurse should advise the client to observe for symptoms of liver dysfunction (anorexia, vomiting, nausea, jaundice) and to notify the provider if these occur. A nurse is caring for a client prescribed hydromorphone for severe pain. The client's respiratory rate has decreased from 16 breaths per minute to 6. Which if the following medications should the nurse prepare to administer? Select one: a. Naloxone Correct. This client is experiencing respiratory depression likely related to over administration of hydromorphone (Dilaudid). Naloxone (Narcan) and nalmefene (Revex) are opioid antagonists used to reverse an overdose of opioids.

**- Inject air into NPH insulin vial: This creates a pressure in the vial for accuracy in measuring the amount prescribed.

  • Inject air into regular insulin vial: The amount of air injected into the vial of short-acting insulin is equal to the amount to be administered.
  • Withdraw short-acting insulin into syringe: When the prescription requires the administration of two types of insulin, it is preferable to mix the solutions into one syringe if they are compatible to prevent the client from receiving two injections. Of the longer-acting insulin available, only NPH insulin is mixed with short-acting insulin. When two insulins are to be mixed, withdraw the short-acting insulin first to avoid contaminating the stock vial with NPH insulin.
  • Add intermediate insulin to syringe: The mixture is stable for 28 days.** A client is prescribed propranolol. Which of the following client history findings would require the nurse to clarify this medication prescription? Select one: a. Tachydysrhythmias b. Asthma Correct. Clients with asthma should avoid Beta2 Blockade agents such as propranolol. Bronchoconstriction can occur. Clients with asthma should be administered a beta1selective agent. c. Hypertension d. Urolithiasis Which of the following are contraindications to aspirin therapy? Select all that apply. Select one or more: a. Coronary artery disease b. Deep vein thrombus c. Thrombocytopenia Correct. Aspirin is contraindicated in clients with bleeding disorders and thrombocytopenia. d. Third trimester pregnancy Correct. Aspirin is pregnancy risk category D in the third trimester. e. Adolescents with chickenpox Correct. Aspirin should not be given to children or adolescents with fever or recent chickenpox due to the risk of Reye syndrome. A nurse is preparing to administer a bisacodyl (Dulcolax) 10 mg suppository. Which of the following are correct administration guidelines for the nurse to implement? (Select all that apply.) Don sterile gloves is incorrect. The nurse should wear clean gloves for the procedure. Gloves prevent the transmission of pathogens by direct and indirect contact. The nurse should wear

clean gloves when touching blood, body fluid, secretions, excretions, most mucous membranes, nonintact skin, and contaminated items or surfaces. Lubricate index finger is correct. The rounded end of the suppository is lubricated with a sterile water-soluble lubricating jelly. Use a rectal applicator for insertion is incorrect. The nurse should administer the suppository with the dominant index finger, which is lubricated. The nurse should not use an applicator to insert a suppository. Position client supine with knees bent is incorrect. To avoid the rupturing the rectum, the client is positioned on the left lateral side. Insert suppository just beyond internal sphincter is correct. The nurse should gently retract the buttocks with the nondominant hand. Insert the suppository gently through the anus, past the internal sphincter, and against the rectal wall. Following the administration of the medication, the nurse should apply gentle pressure to hold the buttocks together momentarily if needed to keep medication in place. A nurse is providing care to a client with staphylococcus epidermidis, who is prescribed vancomycin. Identify the adverse effect associate with this antibiotic therapy? Select one: a. Infusion reaction Correct – Red Man Syndrome or an infusion reaction that results in rashes, flushing, tachycardia and hypotension can occur as an adverse reaction. For this reason, vancomycin should be administered over a 60 minute period. b. Immunosuppression c. Hepatotoxicity d. Constipation A nurse is preparing to administer a measles, mumps, and rubella vaccine (MMR) to an adult client. Which of the following is a contraindication to this vaccine? Select one: a. The possibility of overseas travel in the next month b. Client allergy to strawberries c. The possibility of pregnancy within 4 weeks Pregnancy or the possibility of pregnancy with 4 weeks is a contraindication to the MMR vaccine. d. Client history of genital herpes Disulfiram is taken by a client daily for abstinence maintenance. What is an adverse effect of this therapy?

STEP 3: What is the dose available? Dose available = Have 10 mg STEP 4: What is the dose the nurse should administer? Dose to administer= Desired 2 mg STEP 5: Should the nurse convert the units of measurement? No STEP 6: Set up an equation and solve for X. X = Quantity/Have x Conversion (Have)/Conversion (Desired) x Desired/ X mL = 1 mL/10 mg x 2 mg/ X = 0. STEP 7: Round if necessary. STEP 8: Reassess to determine whether the amount to administer makes sense. If there are 10 mg/mL and the prescription reads 2 mg, it makes sense to administer 0.2 mL. The nurse should administer morphine sulfate 0. 2 mL IV bolus.

Pharmacology Actual Assessment 1

-A nurse is monitoring a client who received an excessive dose of morphine. Which of the

following adverse effects should the nurse identify as the priority?

-nausea and vomiting

-urinary retention

-decreased respirations

-increased drowsiness

-A nurse is caring for a client who has a prescription for a hypotonic IV fluid. Which of the

following solutions should the nurse expect to administer?

0.45% sodium chloride

0.9% sodium chloride

3% sodium

chloride

Lactated

ringers

-A nurse is caring for a client who refuses a prescribed dose of Valproic acid 250 mg PO. The

client states I don’t want to take that pill because it makes me feel nauseated. Which of the

following actions should the nurse take? Select all that apply.

Educate the client about the possible consequences of

not taking the medication. *** Suggest the client take

food with the medication to minimize GI effects. ****

Document the clients refusal in the medication

administration record. ****

Offer to administer the medication I am.

Recommend a client ask the provider to prescribe and enteric-coated medication.****

-A nurse is caring for a client who has open angle glaucoma and a new prescription for

acetazolamide. Prior to administering the first dose the nurse should ask the client if they have an

allergy to which of the following medication classifications?

Nitrates

sulfa-based

medications

antilipemic

agents proton

pump inhibitors

-A nurse in an emergency department is caring for a client who has a new prescription for

acetylcysteine. For which of the following conditions should the nurse expect to administer this

medication?

Gastrointestinal

bleed acute

bronchospasm

morphine

toxicity

acetaminophen

toxicity

blood pressure

decreased pulmonary congestion

decreased anginal pain

-A nurse is reviewing laboratory results prior to administering ketorolac to a client. Which of the

following findings should the nurse report to the provider prior to administration?

Sodium 140 MEQ/L

creatinine 1.6 MG/DL

aspartate aminotransferase

AST 33 units/Llactic acid 6

mg/DL

-A nurse is assessing a client who has heart failure and is taking digoxin. Which of the following

manifestations should the nurse report to the provider as an indication for digoxin toxicity?

Vomitin

g dilated

pupils

bruising

peripheral edema

-A nurse is providing teaching to a client who has neuropathic pain and a new prescription for

optyline once per day. Which of the following information should the nurse include in the

teaching?

Increase fluids while taking the medication.

Expect an elevation in blood pressure with initial

doses of the medication. Stop the medication

immediately if urine becomes orange in color.

Take the medication in the morning.

-A nurse is providing teaching to a client who has a new prescription for transdermal

nitroglycerin patches to treat angina pectoris. Which of the following instructions should the

nurse include in the teaching?

Remove the patch for 2 to

4 hours daily. Cover the

patch with plastic wrap.

Apply a new patch each day after waking up.

Replace the existing patch with a new patch as soon as angina pain begins.

c or d ???? look up ********

-A nurse is teaching a partner of a client who has diabetes mellitus how to manage episodes of

severe hypoglycemia when the client is unresponsive. Which of the following actions should the

nurse instruct a partner to take first?

Administer glucagon IM

to the client. Call

emergency medical

services.

Check the client's blood glucose level.

Transport a client to the emergency department.

Could be A or B?? Look up*******

-A nurse is caring for a client who has HIV and is starting therapy with ritonavir and

zidovudine. The client asked why must they take both medications. Which of the following

responses should the nurse make?

If you take the two medications together it will shorten the

duration of your antiviral therapy. Taking the two

medications together keeps you from becoming resistant to

either of them. Taking the two medications together keeps

you from developing toxicity from either of them. zidovudine

will help protect you from the possible adverse effects of right

on ritonavir.

-A nurse is caring for a client who refuses a prescribed influenza immunization. Which of the

following actions should the nurse take first?

Contact the provider who prescribed the immunization.

Ask the client to describe their concerns.

Provide the client with education about the

immunization. Document the client's refusal

of the immunization.

-A nurse is preparing to administer a second unit of packed red blood cells RBCs to a client who is

experiencing hemorrhagic shock. The nurse should monitor the client for which of the following

manifestations as an indication of circulatory overload?

Chills

wheez

-A nurse is caring for a client who has a prescription for vancomycin 1 g IV intermittent infusion

over 30 minutes every 12 hours. Which of the following actions should the nurse take?

Request a serum trough level blood draw for 60 minutes after

completion of infusion. Change that infusion site after each

dose administration.

Contact the provider for prescription clarification.

Request a serum peak level to be drawn 30 minutes prior to infusion.

-A nurse is providing teaching to a client who has a new prescription for folic acid. The client

states I thought that was only given during pregnancy. Which of the following statements

should the nurse make?

Folic acid is important for stimulating the immune system.

Folic acid is given to increase the absorption of other medications.

Folic acid is administered to minimize the manifestation of benign prostatic hyperplasia.

Folic acid is important for the building of blood cells.

-A nurse is caring for a client who is receiving a continuous intravenous infusion of heparin. The

nurse should expect to administer which of the following medications if the client experiences

acute heparin toxicity?

Vitamin K

physostigmi

ne

protamine

calcium

gluconate

-A nurse is planning care for a client who has neutropenia. Which of the following medications

should the nurse expect to administer?

Epoeti

n

Filgras

tim

Enoxap

arin

Oprelv

ekin

-A nurse is teaching a client who has asthma about using a beclomethasone inhaler along with an

albuterol inhaler. Which of the following instructions should the nurse include about

beclomethasone inhaler?

You should gargle with water after each use of this inhaler.

There is no need to use a spacer for this inhaler.

You should use this inhaler for any acute incident of shortness of breath.

Use the beclomethasone inhaler before using your albuterol inhaler to increase absorption.

-A nurse is providing teaching to a client who has a new prescription for levothyroxine. Which of

the following statements by the client indicates an understanding of the teaching?

I should take this

medication with food. I

will take three doses each

day.

I might not realize the full effect of the medication for several weeks.

I might gain weight while taking this medication if I do not exercise.

-A nurse is reviewing the medical record of a client who receives medications one hour ago and

reports having chest pain. The nurse should recognize that chest pain can be an adverse effect of

which of the following medications?

Albute

rol

Furose

mide

Digoxi

n

Atenolo

l

-A nurse is teaching a group of newly licensed nurses about the prevention of medication errors.

Which of the following factors should the nurse identify as the most frequent cause of fatal

medication errors?

Incorrect packaging such as a topical medication

packaged as an oral medication. Delivery device

problems such as an infusion pump malfunction.

Name confusion between two medications with similar sounding names.

Incorrect labeling of a medication dispensed by the pharmacy.

-A nurse is planning a staff education session about adverse effects of medications. Which of the

following information should the nurse include when discussing the adverse effects of

anticholinergic medications? Select all that apply.

indicates an understanding of the teaching? a) “I will discard the open injector pen after two months”

b) “I will inject the medication into the muscle of my thigh” c) “I will store open injector pens at room temperature” d) “I will take this medication one hour before morning and evening meals”--- correct

34. A nurse is teaching a client who has a new prescription for brimonidine to treat open- angle glaucoma. Which of the following client statements indicated an understanding of the teaching? a) “It’s okay to put the drops in my eyes while Im weaing my contacts” b) “I can expect to feel some irritation when I put these drops in my eyes”--- correct c) “I should expec to stop taking the medication after 3 weeks” d) “At least these drops will help clear up the redness I get in my eyes **sometimes”

  1. While assessing a client at the beginning of the shift, a nurse notes that the client received a medication in error from the nurse on the previous shift. At which of the following times should the nurse plan to complete an incident report about the error?** **a) After the end of the current shift b) After contacting risk management---Nikki thinks it could also be this c) As soon as the assessment is complete---Nikki put this d) As soon as the nurse from the previous shift has been informed
  2. A nurse is providing teaching to a client who has a new prescription for oral extended-release potassium chloride tablets. Which of the following instructions should the nurse include in the teaching?** a) “do not crush this medication”---correct b) “dissolve the tablet in your mouth” c) “Take this medication on an empty stomach” d) “Take this medication every other day”