Seizure
Meds
Meds
A nurse is performing discharge teaching for a client who has seizures and a new prescription for phenytoin. Which of the following statements by the client indicates a need for further teaching?
A. "I will notify my doctor before taking any other medications."
B. "I have made an appointment to see my dentist next week."
C. "I know that I cannot switch brands of this medication."
D. "I'll be glad when I can stop taking this medicine."
D. "I'll be glad when I can stop taking this medicine."
Phenytoin is an anticonvulsant used to treat various types of seizures. Clients on anticonvulsant medications commonly require them for lifetime administration, and phenytoin should not be stopped without the advice of the client's provider.
A nurse is providing teaching to a client who has a new diagnosis of Parkinson's disease. On which of the following medications should the nurse prepare to instruct the client?
A. Piperacillin/tazobactam
B. Levothyroxine
C. Levodopa/carbidopa
D. Carbamazepine
C. Levodopa/carbidopa
Levodopa/carbidopa is the cornerstone of Parkinson's treatment. The nurse should prepare to instruct the client on the use of this medication.
A nurse is teaching a client who has chronic kidney disease and a new prescription for epoetin alfa. The nurse should instruct the client to increase dietary intake of which of the following substances?
A. Iron
B. Protein
C. Potassium
D. Sodium
A. Iron
Epoetin alfa is a synthetic form of erythropoietin, a substance produced by the kidneys that stimulates the bone marrow to produce red blood cells. Increased iron is needed for the production of hemoglobin and red blood cells by the bone marrow.
A nurse is providing teaching for a client who is newly diagnosed with type 2 diabetes mellitus and has a prescription for glipizide. Which of the following statements by the nurse best describes the action of glipizide?
A. "Glipizide absorbs the excess carbohydrates in your system."
B. "Glipizide stimulates your pancreas to release insulin."
C. "Glipizide replaces insulin that is not being produced by your pancreas."
D. "Glipizide prevents your liver from destroying your insulin."
B. "Glipizide stimulates your pancreas to release insulin."
Glipizide is an oral antidiabetic medication in the pharmacological classification of sulfonylurea agents. These medications help to lower blood glucose levels in clients who have type 2 diabetes mellitus using several methods, including reducing glucose output by the liver, increasing peripheral sensitivity to insulin, and stimulating the release of insulin from the functioning beta cells of the pancreas.
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
B. Constipation
C. Drowsiness
D. Hypoactive deep-tendon reflexes
A. Insomnia
Levothyroxine overdose will result in manifestations of hyperthyroidism, which include insomnia, tachycardia, and hyperthermia.
A nurse is caring for a client who has cancer and a new prescription for ondansetron to treat chemotherapy-induced nausea. For which of the following adverse effects should the nurse monitor?
A. Headache
B. Dependent edema
C. Polyuria
D. Photosensitivity
D. Headache
Headache is a common adverse effect of ondansetron. Analgesic relief is often required.
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. "Monitor for muscle pain."
C. "Expect to have increased bruising."
D. "Increase your intake of grapefruit juice."
B. Monitor for muscle pain."
This medication can cause rhabdomyolysis. The client should monitor and report muscle pain.
A nurse is caring for a client who is taking naproxen following an exacerbation of rheumatoid arthritis. Which of the following statements by the client requires further discussion by the nurse?
A. "I signed up for a swimming class."
B. "I've been taking an antacid to help with indigestion."
C. "I've lost 2 pounds since my appointment 2 weeks ago."
D. "The naproxen is easier to take when I crush it and put it in applesauce."
B. I've been taking an antacid to help with indigestion."
NSAIDs, like naproxen, can cause serious adverse gastrointestinal reactions such as ulceration, bleeding, and perforation. Warning manifestations such as nausea or vomiting, gastrointestinal burning, and blood in the stool reported by the client require further investigation by the nurse. The client might be taking an antacid because he is experiencing one or more of these manifestations
A nurse is preparing to administer a dose of lactulose to a client who has cirrhosis. The client states, "I don't need this medication. I am not constipated." The nurse should explain that in clients who have cirrhosis, lactulose is used to decrease levels of which of the following components in the bloodstream?
A. Glucose
B. Ammonia
C. Potassium
D. Bicarbonate
B. Ammonia
Lactulose, a disaccharide, is a sugar that works as an 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.
A nurse is preparing to administer phenytoin IV to a client who has a seizure disorder. Which of the following actions should the nurse plan to take?
A. Administer the medication at 100 mg/min.
B. Administer a saline solution after injection.
C. Hold the injection if seizure activity is present.
D. Dilute the medication with dextrose 5% in water.
B. Administer a saline solution after injection.
The nurse should flush the injection site with a saline solution after the injection of phenytoin to reduce and prevent venous irritation.
Name 4 nursing interventions when administering antimyasthenic medications?
-Assess neuromuscular status (reflexes, muscle strength and gait)
-Monitor for signs and symptoms of medication overdose (cholinergic crisis) and underdose (myasthenic crisis).
-Instruct client to take medications on time to maintain therapeutic level, thus preventing weakness. Weakness can impair the client's ability to breathe and swallow.
-Take with small amount of food to prevent GI symptoms
-Instruct the client to eat 30 to 60 minutes after taking medications to decrease risk for aspiration
-Instruct to wear a Medic-Alert bracelet.
-Instruct patient that therapy for myasthenia gravis is lifelong.
-Evaluate for medication effectiveness, which is based on improvement of neuromuscular symptoms or strength without cholinergic signs and symptoms.
-When administering edrophonium chloride (Tensilon), have emergency resuscitations equipment on hand and atropine sulfate available for a cholinergic crisis
A nurse is providing teaching to a client who has renal failure and an elevated phosphorous level. The provider instructed the client to take aluminum hydroxide 300 mg PO three times daily. For which of the following adverse effects should the nurse inform the client?
A. Constipation
B. Metallic taste
C. Headache
D. Muscle spasms
A. Constipation
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.
A nurse is teaching a client who has a new prescription for regular insulin and NPH insulin. Which of the following instructions should the nurse include in the teaching?
A. Keep the open vial of insulin at room temperature.
B. Inject the insulin into a large muscle.
C. Aspirate the medication prior to administration.
D. Administer the insulin in two separate injections.
A. Keep the open vial of insulin at room temperature.
The client should keep the vial in use at room temperature to minimize tissue injury and to reduce the risk for lipodystrophy.
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 thyroxine (T4)
B. Increase in weight
C. Increase in hr of sleep per night
D. Decrease in level of thyroid stimulating hormone (TSH).
D. Decrease in level of thyroid stimulating hormone (TSH). In hypothyroidism, the nonfunctioning thyroid gland is unable to respond to the TSH, and no endogenous thyroid hormones are released. This results in an elevation of the TSH level as the anterior pituitary continues to release the TSH to stimulate the thyroid gland. Administration of exogenous thyroid hormones, such as levothyroxine, turns off this feedback loop, which results in a decreased level of TSH.
A nurse on an oncology unit is preparing to administer doxorubicin to a client who has breast cancer. Prior to beginning the infusion, the nurse verifies the client's current cumulative lifetime dose of the medication. For which of the following reasons is this verification necessary?
A. An excess amount of doxorubicin can lead to myelosuppression.
B. Exceeding the lifetime cumulative dose limit of doxorubicin might cause extravasation.
C. An excess amount of doxorubicin can lead to cardiomyopathy.
D. Exceeding the lifetime cumulative dose limit of doxorubicin might produce red tinged urine and sweat.
C. An excess amount of doxorubicin can lead to cardiomyopathy.
Doxorubicin is an antineoplastic antibiotic used in the treatment of various cancers. Irreversible cardiomyopathy with congestive heart failure can result from repeated doses of doxorubicin, and prolonged use can also cause severe heart damage, even years after the client has stopped taking it.
A nurse in a provider's clinic is assessing a client who has cancer and a prescription for methotrexate PO. Which of the following actions should the nurse take when the client reports bleeding gums?
A. Explain to the client that this is an expected adverse effect.
B. Check the value of the client's current platelet count.
C. Instruct the client to use an electric toothbrush.
D. Have the client make an appointment to see the dentist.
B. Check the value of the client's current platelet count.
The nurse should recognize that the bleeding is likely due to the adverse effect of the chemotherapy and needs to be evaluated further. Bleeding gums is a sign of thrombocytopenia (decreased platelet count) secondary to bone marrow suppression, which can be life-threatening in a client who is receiving chemotherapy.
ALSO Drink 2 to 3 L of water per day. Methotrexate can cause renal toxicity. The client should drink 2 to 3 L of water per day to promote excretion of the medication.
A nurse is reviewing the medication administration records from the previous shift. Which of the following findings should indicate to the nurse a need for an incident report?
A. A client received gentamicin intermittent IV bolus over 1 hr.
B. A nurse used a 25-gauge 3/8 inch needle to administer a heparin injection.
C. A nurse injected Demerol IM into the vastus lateralis site of adult.
D. A client received a crushed bupropion XL tablet mixed with applesauce
D. A client received a crushed bupropion XL tablet mixed with applesauce.
Extended or sustained release medications are intended to release medication levels over a long period of time to sustain therapeutic relief. Crushing, breaking, or chewing an extended release medication releases the medication at once into the bloodstream and could be life-threatening. Mixing this medication in applesauce deviates from standard of care and requires the nurse to complete an incident report.
A nurse is caring for a female client who has rheumatoid arthritis and asks the nurse if it is safe for her to take aspirin. The nurse should recognize which of the following findings in the client's history is a contraindication to this medication?
A. Report of recent migraine headaches
B. History of gastric ulcers
C. Current diagnosis of glaucoma
D. Prior reports of amenorrhea
B. History of gastric ulcers
Aspirin is contraindicated for clients who have a history of gastrointestinal bleeding and peptic ulcer disease because it impedes platelet aggregation. An adverse effect of aspirin is gastric bleeding.
An 8-year-old child, who is not responding to anti-seizure medications, is prescribed to start a ketogenic diet. This diet will include:
A. High carbohydrates and high fat
B. Low fat, high salt, and high carbohydrates
C. High fat and low carbohydrates
D. High glucose, high fat, and low carbohydrates
C.
This is a type of diet used in the pediatric population with epilepsy whose seizures cannot be controlled by medication. It is a high-fat and low-carb diet.
What is the major neurotransmitter involved with Parkinson's Disease?
Dopamine!
-Parkinson's disease is a degenerative disease caused by depletion of dopamine, which interferes with the inhibition of excitatory impulses, resulting in a dysfunction of the extrapyramidal system.
-It is a slow, progressive disease that results in a crippling disability.
-The debilitation can result in falls, self-care deficits, failure of body systems, and depression.
A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication?
A. The leukocyte count
B. The platelet count
C. The hematocrit (Hct)
D. The erythrocyte sedimentation rate (ESR)
C. The hematocrit (Hct)
Epoetin alfa is an antianemic medication that is indicated in the treatment of clients who have anemia due to reduced production of endogenous erythropoietin, which may occur in clients who have end-stage renal disease or myelosuppression from chemotherapy. The therapeutic effect of epoetin alfa is enhanced red blood cell production, which is reflected in an increased RBC, Hgb, and Hct.
A nurse is teaching a client how to draw up regular insulin and NPH insulin into the same syringe. Which of the following instructions should the nurse include?
A. Draw up the NPH insulin into the syringe first.
B. Inject air into the regular insulin first.
C. Shake the NPH insulin until it is well mixed.
D. Discard regular insulin that appears cloudy.
D. Discard regular insulin that appears cloudy.
The nurse should teach the client to discard any regular insulin that appears cloudy, as regular insulin should be clear. NPH insulin has a cloudy appearance.
A nurse is caring for a client who has diabetes insipidus and is receiving vasopressin. The nurse should identify which of the following findings as an indication that the medication is effective?
A. A decrease in blood sugar
B. A decrease in blood pressure
C. A decrease in urine output
D. A decrease in specific gravity
C. A decrease in urine output
The major manifestations of diabetes insipidus are excessive urination and extreme thirst. Vasopressin is used to control frequent urination, increased thirst, and loss of water associated with diabetes insipidus. A decreased urine output is the desired response.
A nurse is teaching a client about the adverse effects of cisplatin. Which of the following adverse effects should the nurse include in the teaching?
A. Tinnitus
B. Constipation
C. Hyperkalemia
D. Weight gain
A. Tinnitus
Tinnitus and hearing loss are adverse effects of cisplatin.
A nurse is caring for a client who has developed gout. Which of the following medications should the nurse prepare to administer?
A. Zolpidem
B. Alprazolam
C. Spironolactone
D. Allopurinol
D. Allopurinol
Allopurinol is a xanthene oxidase inhibitor that reduces uric acid synthesis. The medication is prescribed to treat gout.
A nurse is preparing to administer a medication to a client who states, "That looks different from the pill I usually take." Which of the following responses should the nurse make?
A."Describe what the pill looks like."
B."This is the medication prescribed by your provider."
C."This pill is probably from a different lot number than yours at home."
D."This hospital might use a different manufacturer, but the medication is the sam
A.Describe what the pill looks like."
The nurse must collect more data prior to administering the medication. There is a chance that this is not the correct dose or medication. The nurse should clarify the prescription with the provider in order to ensure safe and effective administration of therapy.
A nurse is reviewing the laboratory results of a client who has liver failure with ascites and is receiving spironolactone. Which of the following findings should the nurse expect?
A. Decreased sodium level
B. Decreased phosphate level
C. Decreased potassium level
D. Decreased chloride level
A. Decreased sodium level
The nurse should expect a decreased sodium level. Spironolactone is a potassium-sparing diuretic that inhibits the action of aldosterone, resulting in an increased excretion of sodium.
A nurse is providing teaching to a client who has seizures and a new prescription for phenytoin. Which of the following information should the nurse provide?
A. Phenytoin turns urine blue.
B. Alcohol increases the chance of phenytoin toxicity.
C. Avoid flossing the teeth to prevent gum irritation.
D. Take an antacid with the medication if indigestion occurs.
B. Alcohol increases the chance of phenytoin toxicity.
The nurse should include in the home instructions that alcohol alters the blood level of phenytoin.
The nurse should instruct the client to floss the teeth to prevent gingival hyperplasia, which is associated with the use of phenytoin.
The nurse should instruct the client to avoid taking an antacid within 2 hr of administering phenytoin.
A nurse is teaching a client who has a new prescription for alprazolam to treat insomnia. Which of the following instructions should the nurse included?
A. "Take this medication every night before sleep."
B. "Take this mediation with a high fat meal."
C. "Avoid activities that require alertness such as driving."
D. "Monitor for urinary retention."
C "Avoid activities that require alertness such as driving."
Rationale: The client should avoid activities that require alertness. Diazepam is a benzodiazepine that causes sedation and dizziness.
A nurse is caring for a client who is to start taking cyclosporine following a kidney transplant. The nurse should instruct the client that which of the following foods can have an adverse interaction with this medication?
A. Pepperoni
B. Orange juice
C. Grapefruit juice
D. Smoked salmon
C. Grapefruit juice
Clients taking cyclosporine should avoid drinking grapefruit juice because it can increase the therapeutic effect leading to renal and hepatic toxicity.
A nurse is reviewing the medication list for a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize which of the following medications can cause glucose intolerance?
A. Ranitidine
B. Guaifenesin
C. Prednisone
D. Atorvastatin
C. Prednisone
Corticosteroids such as prednisone can cause glucose intolerance and hyperglycemia. The client might require increased dosage of a hypoglycemic medication.
A nurse is caring for a client who has developed agranulocytosis as a result of taking propylthiouracil to treat hyperthyroidism. The nurse should understand that this client is at increased risk for which of the following conditions?
A. Excessive bleeding
B. Ecchymosis
C. Infection
D. Hyperglycemia
C. Infection
Agranulocytosis is a failure of the bone marrow to make enough white blood cells, causing neutropenia and lowering the body defenses against infection.
A client is receiving chemotherapy for acute myeloid leukemia. The health care provider prescribes allopurinol to prevent tumor lysis syndrome (TLS). Which laboratory value indicates a therapeutic response to the medication?
A. Serum calcium 9.5 mg/dL (2.38 mmol/L)
B. Serum phosphate 4.0 mg/dL (1.29 mmol/L)
C. Serum potassium 4.5 mEq/L (4.5 mmol/L)
D. Serum uric acid level 6.0 mg/dL (357 umol/L
D
A potential complication of chemotherapy is acute tumor lysis syndrome (TLS), a rapid release of intracellular components into the bloodstream. Massive cell lysis releases intracellular ions (potassium and phosphorus) and nucleic acids into the bloodstream. Catabolism of the nucleic acids produces uric acid, resulting in severe hyperuricemia. Released phosphorus binds calcium, producing calcium phosphate mixture but lowering serum calcium levels. Both calcium phosphate and uric acid are deposited into the kidneys, causing renal injury.
A nurse is caring for a client who is postoperative following hip arthroplasty. The nurse should anticipate which of the following prescriptions for this client?
A. Aspirin
B. Clopidogrel
C. Enoxaparin
D. Alteplase
C. Enoxaparin
The nurse should anticipate a prescription for enoxaparin as prophylaxis therapy for venous thromboembolism. Clients following hip arthroplasty are usually on anticoagulants for 3 to 6 weeks after surgery.
A nurse is teaching a client who takes acetaminophen daily to manage mild knee pain. The nurse should instruct the client to monitor for which of the following adverse reactions to this medication?
A.Tinnitus
B. Muscle pain
C.Hyperglycemia
D. Jaundice
D. Jaundice
Acetaminophen can cause hepatotoxicity. The client should monitor and report jaundice, abdominal pain, clay colored stools, and fever.
A nurse is caring for a client who has cirrhosis and a new prescription for lactulose. Which of the following manifestations indicates an adverse effect of the medication?
A. Dry mouth
B. Vomiting
C. Headache
D. Peripheral edema
B. Vomiting
The nurse will monitor for vomiting as an adverse effect of lactulose.
The nurse is ordered to administer Lorazepam to a patient experiencing status epilepticus. As a precautionary measure, the nurse will also have what reversal agent on standby?
A. Narcan
B. Flumazenil
C. Calcium Chloride
D. Idarucizumab
B.
Flumazenil is the reversal agent for Lorazepam, which is a benzodiazepine.
A nurse is teaching a client who has multiple sclerosis about a new prescription for baclofen. Which of the following instructions should the nurse include in the teaching?
A. "Do not take antihistamines with this medication."
B. "Take the medication on an empty stomach."
C. "Stop taking the medication immediately for a headache."
D. "Expect to develop diarrhea initially."
A. "Do not take antihistamines with this medication."
Rationale: The nurse should instruct the client not to take antihistamines while taking baclofen. Antihistamines will intensity the depressant effects of baclofen.
A nurse is assessing an older adult client who is receiving IV therapy. The nurse should recognize that which of the following findings indicates fluid volume excess? (Select all that apply.)
A. Bounding pulse
B. Pitting edema
C. Swelling at the IV site
D. Urine-specific gravity greater than 1.030
E. Crackles upon auscultation
A, B, E
Bounding pulse due to excessive fluid intake or inadequate fluid excretion. Manifestations include increased blood pressure, pulse, and respirations. With fluid volume excess, the pulse is full and bounding.
Pitting edema is correct. Excess extracellular fluid can lead to pitting edema in dependent areas of the body.
Crackles upon auscultation is correct. Pulmonary edema can occur with fluid volume excess.
A nurse is providing teaching for a client who has diabetes and a new prescription for insulin glargine. Which of the following instructions should the nurse provide regarding this type of insulin?
A. Insulin glargine has a duration of 3 to 6 hr.
B. Insulin glargine has a duration of 6 to 10 hr.
C. Insulin glargine has a duration of 16 to 24 hr.
D. Insulin glargine has a duration of 18 to 24 hr.
D. Insulin glargine has a duration of 18 to 24 hr.
Insulin glargine is a long duration insulin that has a duration of 18 to 24 hr. It is only dosed once a day.
A nurse is providing teaching to a client who has a new prescription for levothyroxine for hypothyroidism. The nurse should instruct the client to avoid which of the following herbal supplements?
A. Saw palmetto
B. Cranberry
C. Soy
D. Garlic
C. Soy
The nurse should instruct the client to avoid soy because soy can reduce the effectiveness of the levothyroxine.
The client with an ovarian cancer is receiving Tamoxifen (Nolvadex). Which of the following indicates a side effect specific to this medication?
A. Weak and brittle nails.
B. Facial twitching.
C. Convulsions.
D. Constipation
D. Tamoxifen (Nolvadex) is an antineoplastic medication that may increase calcium levels. Signs of hypercalcemia includes include constipation, abdominal pain, hypotonicity of muscle, nausea and vomiting.
Options A, B, and C are signs of hypocalcemia.
A nurse is assessing a client who has systemic lupus erythematosus and is taking hydroxychloroquine. The nurse should report which of the following adverse effects to the provider immediately?
A. Diarrhea
B. Blurred vision
C. Pruritus
D. Fatigue
B. Blurred vision
When using the urgent vs non-urgent approach to client care, the nurse should determine that the priority finding to report to the provider is blurred vision, as this is a manifestation of hydroxychloroquine toxicity and can be an indication of retinal damage.
A nurse is preparing to administer 10 units of regular insulin and 20 units of NPH insulin to a client. What is the sequence of events the nurse should follow? (Move the steps of mixing insulin on the left into the box on the right, placing them in the selected order of performance. All steps must be used.)
A. Inject air into NPH insulin vial.
B. Withdraw short-acting insulin into syringe.
C. Roll NPH vial between palms of hands.
D. Inspect vials for contaminants.
E. Inject air into regular insulin vial.
F. Add intermediate insulin to syringe.
D. Inspect vials for contaminants.
C. Roll NPH vial between palms of hands.
A. Inject air into NPH insulin vial.
E. Inject air into regular insulin vial.
B. Withdraw short-acting insulin into syringe.
F. Add intermediate insulin to syringe.
A nurse is caring for a client who has cirrhosis and a prothrombin time of 30 seconds. Which of the following medications should the nurse plan to administer?
A. Vitamin K
B. Heparin
C. Warfarin
D. Ferrous sulfate
A. Vitamin K
A prothrombin time of 30 seconds indicates the clotting time is prolonged and bleeding could occur. Vitamin K injection increases the synthesis of prothrombin by the liver; therefore, the nurse should plan to administer vitamin k.
A nurse is teaching a client who has a new prescription for diazepam. Which of the following information should the nurse include in the teaching?
A. Diazepam can cause drowsiness.
B. This medication must be swallowed whole.
C. It is important to avoid foods that contain tyramine.
D. Grapefruit juice inactivates this medication.
A. Diazepam can cause drowsiness.
Rationale: Diazepam has sedative properties, so the client should not engage in potentially hazardous activities after receiving diazepam
A nurse is caring for a client who has Wernicke–Korsakoff psychosis as a result of chronic alcohol use disorder. Which of the following interventions should the nurse anticipate?
A. Laboratory analysis of cardiac enzymes
B. Monitoring for the presence of esophageal varices
C. Administration of thiamine
D. Placing the client in protective isolation
B. Monitoring for the presence of esophageal varices
Answer Rationale:
Monitoring for the presence of esophageal varices is appropriate for the client who has cirrhosis of the liver rather than Wernicke-Korsakoff psychosis.
A nurse is teaching a client who has chronic kidney disease and a new prescription for epoetin alfa. The nurse should instruct the client to increase dietary intake of which of the following substances?
A. Iron
B. Protein
C. Potassium
D. Sodium
A. Iron
Rationale: Epoetin alfa is a synthetic form of erythropoietin, a substance produced by the kidneys that stimulates the bone marrow to produce red blood cells. Increased iron is needed for the production of hemoglobin and red blood cells by the bone marrow.
A nurse is caring for a client who has diabetes and plans to administer his regular insulin subcutaneously before he eats breakfast at 0800. After checking the client's morning glucose level, which of the following actions should the nurse take?
A. Give the insulin at 0700.
B. Give the insulin when the breakfast tray arrives.
C. Give the insulin 30 min after breakfast with the client's other routine medicines.
D. Give the insulin at 0730.
D. Give the insulin at 0730.
Regular insulin has an onset of 30 to 60 minutes and should be given at a specific time before meals, usually within 30 min. The nurse should always check the blood glucose levels prior to administering short-acting insulin.
A nurse is providing teaching to a client who has a new diagnosis of hypothyroidism. On which of the following medications should the nurse prepare to instruct the client?
A. Radioactive iodine
B. Levothyroxine
C. Sumatriptan
D. Levofloxacin
B. Levothyroxine
Levothyroxine is a synthetic thyroid hormone that is chemically identical to thyroxine (T4). It is used in the treatment of hypothyroidism. The nurse should prepare to instruct the client on the use of this medication.
The nurse is caring for of a client who is receiving a chemotherapy. Which of the following would be expected as a result of the massive cell destruction that occurred from the chemotherapy?
A. Leukopenia.
B. Anemia.
C. Thrombocytopenia.
D. Hyperuricemia
D. Increase level of uric acid (Hyperuricemia) in the body is common following the treatment for leukemias and lymphomas because chemotherapy results in massive cell destruction.
Options A, B, and C are usually noted, but an increase uric acid level is specifically related to massive cell destruction.
A nurse is teaching a client who has multiple sclerosis about a new prescription for baclofen. Which of the following instructions should the nurse include in the teaching?
A. "Do not take antihistamines with this medication."
B. "Take the medication on an empty stomach."
C. "Stop taking the medication immediately for a headache."
D. "Expect to develop diarrhea initially."
A. "Do not take antihistamines with this medication."
The nurse should instruct the client not to take antihistamines while taking baclofen. Antihistamines will intensity the depressant effects of baclofen.
A nurse is teaching a class about safe medication administration. The nurse should include in the teaching that which of the following references are acceptable for safe medication administration? (Select all that apply.)
A. A website that ends in .com
B. Published journals
C. Pharmacists
D. Physicians' Desk Reference
E. Pharmaceutical sales representatives
B, C, D
B.Published journals and reputable newsletters, such as The Medical Letter on Drugs and Therapeutics, and the Prescriber's Letter, are bimonthly and monthly publications that present current information on medications.
C.Pharmacists provide expert information about medications, expected versus unexpected side effects, contraindications, compatibilities, and indications for use.
D. Physicians' Desk Reference(PDR) is a reference work financed by the pharmaceutical industry. The information on each drug is identical to the information on the package insert. The PDR is updated annually to reflect current recommendations.
The physician orders Lactulose 30 mL by mouth per day for a patient with cirrhosis. What findings below demonstrates the medication is working effectively? Select all that apply:
A. Decrease albumin levels
B. Decrease in Fetor hepaticus
C. Patient is stuporous.
D. Decreased ammonia blood level
E. Presence of asterixis
B and D.
A patient with cirrhosis may experience a complication called hepatic encephalopathy. This will cause the patient to become confused (they may enter into a coma), have pungent, musty-smelling breath (fetor hepaticus), asterixis (involuntary flapping of the hands), etc. This is due to the buildup of ammonia in the blood, which affects the brain. Lactulose can be prescribed to help decrease ammonia levels. Therefore, if the medication is working properly to decrease the level of ammonia the patient would have improving mental status (NOT stuporous), decreased ammonia blood level, decreasing or absence of asterixis, and decreased ammonia blood level.