no bacteria
A nurse is administering Cefepime intravenously. The client reports pain and swelling at the IV insertion site. What is the priority nursing intervention?
A. Request an order for a cold compress to reduce swelling.
B. Stop the infusion and assess the site for thrombophlebitis.
C. Slow the rate of the infusion and continue to monitor the site.
D. Administer the remaining dose as a slow IV bolus over 5 minutes.
B. Stop the infusion and assess the site for thrombophlebitis.
Thrombophlebitis is plaque build up at the IV line that impacts the vein
s/s- redness, warmth, tenderness, and swelling over the affected vein
A client is prescribed Isoniazid for latent tuberculosis. Which health history finding would alert the nurse to use this medication with caution?
A. Asthma
B. Myasthenia Gravis
C. Alcohol use disorder
D. Hypertension
C. Alcohol use disorder
Hepatotoxicity is a complication associated with isoniazid since it is metabolized in the liver.
The nurse is reviewing insulin orders for a client receiving continuous parenteral nutrition. The nurse prepares to administer a continuous intravenous infusion because this is the only type of insulin that can be safely administered via the IV route. Double points if you can say which type of insulin it is.
A. Lispro
B. NPH
C. Glargine U-300
D. Regular
D. Regular; short acting
A client with heart failure is newly prescribed Metoprolol. The nurse should instruct the client to notify the provider and monitor for signs of worsening heart failure, which include:
A. Headache and tinnitus.
B. Increased appetite and weight loss.
C. Shortness of breath, edema, weight gain, and fatigue.
D. Bradycardia and improved cardiac output.
C. Shortness of breath, edema, weight gain, and fatigue.
A client with a respiratory infection is prescribed Guaifenesin. The nurse should include which instruction in the client's teaching to ensure the medication works effectively?
A. Take the medication at bedtime to prevent sedation.
B. Drink a full glass of water with each dose and increase daily fluid intake.
C. Decrease activity to reduce the risk of bronchospasm.
D. Use a combination cough suppressant for maximum relief.
B. Drink a full glass of water with each dose and increase daily fluid intake.
A client is prescribed Docusate Sodium. The nurse explains that this medication is primarily used to:
A. Stimulate intestinal motility for rapid relief of acute constipation.
B. Prevents and treats constipation
C. Block muscarinic receptors to decrease GI spasms.
D. Treat C. difficile infection by restoring normal gut flora.
B. Prevents and treats constipation
A nurse is educating a client on the safe use of Acetaminophen for pain relief. The nurse stresses that adults should not exceed which maximum daily dose to prevent the risk of liver toxicity?
A. 2g
B. 3g
C. 4g
D. 5g
C. 4g
Which of the following laboratory tests should be monitored in patients taking doxycycline?
A. Potassium levels
B. Glucose levels
C. PT/INR
D. Magnesium levels
C. PT/INR
Hepatotoxicity is a complications associated with doxycycline.
The nurse is teaching a client taking Rifampin and highlights the potential for drug-drug interactions. The nurse should explain that Rifampin reduces the effectiveness of which client medications?
A. Warfarin
B. Acetaminophen
C. HIV medications
D. Penicillin
C. HIV medications
Rifampin will increase the metabolism of HIV medications that causes a decrease in the medications effectiveness. Increasing HIV dosages might be necessary.
A client is prescribed NPH insulin. The nurse finds the client's blood glucose is 200 mg/dL. What is the prioritynursing action before drawing up and administering the NPH insulin?
A. Ensure a snack is readily available for the client.
B. Verify the vial appears uniformly cloudy.
C. Assess the client's heart rate for signs of tachycardia.
D. Check the client's potassium level.
B. Verify the vial appears uniformly cloudy.
A client with atrial fibrillation is receiving both Verapamil and a beta-blocker. The nurse monitors the client closely for signs of a significantly suppressed cardiac function, such as bradycardia and heart failure. The nurse understands this interaction intensifies both drugs' effects by:
A. Increasing the metabolism of the beta-blocker in the liver.
B. Decreasing the heart rate and slowing conduction through the AV node.
C. Promoting excessive vasodilation of peripheral arterioles.
D. Reducing the synthesis of clotting factors in the blood.
B. Decreasing the heart rate and slowing conduction through the AV node.
An older adult client is taking Diphenhydramine for a mild allergic reaction. The nurse should instruct the client to use caution when performing which activity due to the combined risks of sedation and anticholinergic effects?
A. Eating tyramine-rich foods
B. Using a humidifier at night
C. Driving or operating machinery
D. Increasing dietary fiber
C. Driving or operating machinery
A client is prescribed Sucralfate and is also taking a medication for a heart dysrhythmia (Digoxin) and an antibiotic (Ciprofloxacin). To prevent decreased absorption of the other two drugs, the nurse should instruct the client to:
A. Take all three medications together 30 minutes before meals.
B. Administer Sucralfate and the other two medications separately with a 2-hour interval.
C. Take the Digoxin and Ciprofloxacin first, followed immediately by Sucralfate.
D. Take the Sucralfate at bedtime and the other medications in the morning.
B. Administer Sucralfate and the other two medications separately with a 2-hour interval.
A nurse is preparing to administer Morphine via the intravenous (IV) route. Which is the most important safety intervention the nurse must perform during this administration?
A. Administer the dose slowly over 4 to 5 minutes.
B. Give the medication via a large-bore IV line.
C. Hold the dose if the client's blood pressure is 110/70
D. Dilute Morphine in an NS solution
A. Administer the dose slowly over 4 to 5 minutes.
Which of the following risk factors are contraindicated for erythromycin?
A. Allergies to penicillin
B. Heart failure
C. CKD stage 2
D. Prolonged QT intervals on the EKG
D. Prolonged QT intervals on the EKG
A prolonged QT interval is a complications associated with erythromycin, when given in high dosages. This predisposes patients to fatal ventricular dysrhythmias.
A client with active tuberculosis is being treated with Isoniazid and Rifampin. The nurse determines that the client is demonstrating clinical improvement when noting:
A. An increase in excessive night sweats.
B. An increase in temperature in the afternoon.
C. Clear breath sounds and increased appetite.
D. Sputum culture results pending after 2 days.
C. Clear breath sounds and increased appetite.
A nurse is providing discharge teaching to a client starting Glipizide. The nurse warns the client that consuming alcohol can lead to a disulfiram-like reaction. The nurse identifies that the client understands this teaching when they state this reaction is characterized by:
A. Hypertension, fever, and confusion.
B. Intense nausea, vomiting, flushing, and palpitations.
C. Severe peripheral neuropathy and ataxia.
D. Deepened voice, decreased libido, and gynecomastia.
B. Intense nausea, vomiting, flushing, and palpitations.
A client taking Hydrochlorothiazide for hypertension asks the nurse about the long-term benefits of the medication. The nurse explains that this diuretic reduces the risk for postmenopausal osteoporosis by promoting which action?
A. Increased excretion of phosphorus.
B. Retention of calcium.
C. Increased excretion of potassium.
D. Inhibition of the NKCC2 transporter.
B. Retention of calcium.
A client is prescribed Theophylline. The nurse reviews the client's current medication list and should report the concurrent use of which medication, as it is known to decrease theophylline levels?
A. Caffeine
B. Verapamil
C. Phenytoin
D. Diltiazem
C. Phenytoin
A client taking Omeprazole for an extended period reports new onset of shakiness, twitching, and overall muscle weakness. The nurse should recognize these signs as manifestations of which electrolyte imbalance?
A. Hyperkalemia
B. Hyponatremia
C. Hypomagnesia
D. Hypocalcemia
C. Hypomagnesia
A nurse is administering Naloxone to a client with suspected opioid dependency who is experiencing respiratory depression. The nurse is titrating the dose carefully to minimize the risk of abstinence syndrome, which is characterized by:
A. Bradycardia and fixed pupils.
B. Decreased pain and continued sedation.
C. Tachycardia, vomiting, and diaphoresis.
D. Hypotension and confusion.
C. Tachycardia, vomiting, and diaphoresis.
The provider orders a divided daily dose of Gentamicin. The nurse prepares to obtain a blood sample for the peak level at which precise time?
A. 30 minutes before the next dose.
B. 30 minutes after completion of the dose.
C. Immediately before the next dose is administered.
D. 6 hours after the dose is infused.
B. 30 minutes after completion of the dose.
Peak levels are only used for divided doses and are are measured 30 minutes after completion of the dose to assess for therapeutic ranges.
A client taking Ganciclovir for CMV prevention asks if it's okay to start planning a pregnancy after treatment is complete. Which is the nurse's most important teaching point?
A. Ganciclovir can be taken safely during the second and third trimesters.
B. Ganciclovir may cause infertility.
C. Ganciclovir is only contraindicated in the first trimester.
D. Ganciclovir is safe if a non-hormonal barrier method is used.
B. Ganciclovir may cause infertility.
Pregnancy should be tested before and during Ganciclovir therapy. Instruct patients to use barrier contraceptives during treatment and for 90 days following treatment.
A nurse is administering a large dose of long-acting insulin to a client. Which is the most important subtle sign the nurse should monitor for that indicates the client may be experiencing hypokalemia as a complication of the insulin administration?
A. Palpitations and diaphoresis
B. Leg cramps and cardiac dysrhythmias
C. Headache and lethargy
D. Pain and swelling at the injection site
B. Leg cramps and cardiac dysrhythmias
A client has been taking Atorvastatin for 12 weeks. The nurse reviews the lab results and notes the client's AST level is significantly elevated. What is the nurse's priority intervention based on this finding?
A. Instruct the client to take the medication on an empty stomach to improve absorption.
B. Notify the provider and anticipate the need to discontinue the medication.
C. Instruct the client to report muscle pain or weakness immediately.
D. Recommend the client take Acetylcysteine as an antidote.
B. Notify the provider and anticipate the need to discontinue the medication.
A client using an Albuterol inhaler for acute asthma relief reports a fine hand tremor after taking the medication. Which is the nurse's most appropriate response?
A. "This is a sign of a toxic reaction; you need to stop the medication immediately."
B. "The tremor is a sign your asthma is worsening; you should use the inhaler more frequently."
C. "This is an expected side effect that usually resolves with continued use; we can discuss a dosage reduction if it persists."
D. "This is a sign of a severe allergic reaction; you should come to the emergency room right away."
C. "This is an expected side effect that usually resolves with continued use; we can discuss a dosage reduction if it persists."
A nurse is reviewing the medication administration record for an older adult client who is prescribed Cimetidine. The nurse should use caution and monitor the client closely due to an increased risk of which complication in this age group?
A. Blood dyscrasia
B. Constipation
C. Peripheral edema
D. Hepatotoxicity
A. Blood dyscrasia
A nurse is reviewing a new prescription for Morphine for a client who sustained a severe head injury. The nurse contacts the provider to question the order because Morphine is contraindicated in this client due to its effect of:
A. Promoting respiratory secretion retention.
B. Increasing the risk of constipation.
C. Increasing intracranial pressure (ICP).
D. Causing orthostatic hypotension.
C. Increasing intracranial pressure (ICP).
A client taking Ciprofloxacin reports sudden tenderness and pain in their heel area. The nurse's priority instruction to the client is to:
A. Apply a heating pad to the site to promote circulation.
B. Continue the medication but avoid wearing restrictive shoes.
C. Instruct the client to avoid exercise and stop taking ciprofloxacin immediately.
D. Increase fluid intake to promote excretion of the medication.
C. Instruct the client to avoid exercise and stop taking ciprofloxacin immediately.
A complication associated with ciprofloxacin is achilles tendon rupture. s/s include pain, swelling, and redness at the achilles tendon. This is most commonly associated in older adults who are taking glucocorticoids.
A client taking Metronidazole for C. difficile infection reports a new onset of gait unsteadiness, confusion, and a pins-and-needles sensation in the hands and feet. The nurse recognizes these findings as early manifestations of which serious central nervous system (CNS) effect, requiring the immediate priority nursing intervention?
A. Pseudomembranous colitis; monitor stool output and notify the provider.
B. Disulfiram effect; assess for recent alcohol intake and administer IV fluids.
C. Peripheral neuropathy; supplement with Pyridoxine (Vitamin B6) as prescribed.
D. Encephalopathy and ataxia; stop the medication and notify the provider.
D. Encephalopathy and ataxia; stop the medication and notify the provider.
A client is taking Metoprolol for hypertension and Glipizide for Type 2 Diabetes Mellitus. The nurse knows to educate the client that if they develop hypoglycemia, they will likely not experience which typical signs due to the drug interaction?
A. Headache and lethargy
B. Tachycardia and tremors
C. Weakness and disorientation
D. Hunger and blurred vision
B. Tachycardia and tremors
A client taking Atorvastatin for 3 months reports new onset of muscle aches and severe weakness in their legs, accompanied by dark-colored urine. The nurse recognizes these findings as the classic triad of which life-threatening complication?
A. Myopathy; discontinue the drug and increase fluid intake.
B. Rhabdomyolysis; monitor Creatine Kinase CK levels and prepare for IV fluid resuscitation.
C. Hepatotoxicity; monitor ALT/AST and prepare to administer Acetylcysteine.
D. Thrombophlebitis; assess for pain at injection sites and rotate administration sites.
B. Rhabdomyolysis; monitor Creatine Kinase CK levels and prepare for IV fluid resuscitation.
A client presents to the clinic with signs of severe Theophylline toxicity (dysrhythmias and seizures). The nurse prepares to administer which two interventions to treat these manifestations?
A. Activated charcoal and Protamine.
B. Lidocaine for dysrhythmias and Diazepam for seizures.
C. Acetylcysteine and Epinephrine
D. Pyridoxine (Vitamin B6) and IV Fluids.
B. Lidocaine for dysrhythmias and Diazepam for seizures.
A client who has been taking Omeprazole for 18 months plans to stop the medication. To prevent rebound acid hypersecretion and mitigate the long-term risk of osteoporosis, which is the most appropriate combined discharge instruction from the nurse?
A. Taper the dose gradually while concurrently increasing Vitamin D and Calcium intake.
B. Stop the medication immediately and take an antacid as needed for discomfort.
C. Switch to Cimetidine for 3 months, then discontinue all acid-suppressing drugs.
D. Take the medication only as needed (PRN) while avoiding lying down after eating.
A. Taper the dose gradually while concurrently increasing Vitamin D and Calcium intake.
The nurse reviews the health history of a client with severe pain who is prescribed an Opioid Agonist. The nurse should question the order if the client has a history of which acute or surgical condition, as opioids can exacerbate it by causing spasms?
A. Chronic renal failure
B. Increased intracranial pressure
C. Biliary colic or recent biliary surgery
D. Inflammatory bowel disease
C. Biliary colic or recent biliary surgery