Unit 7
A nurse is preparing to administer IV amphotericin B (Fungizone). To minimize the risk of the most common and immediate adverse effects, the nurse should anticipate which of the following orders?
a) Administer the infusion rapidly over 30 minutes.
b) Pre-medicate the client with an antihistamine and antipyretic.
c) Monitor the client's urine output for the first hour only.
d) Ensure the client drinks a glass of orange juice before the infusion.
b) Pre-medicate the client with an antihistamine and antipyretic.
A client on long-term therapy with procainamide (Pronestyl) reports joint pain, fever, and a facial rash. The nurse suspects a lupus-like syndrome. What is the nurse's priority action?
a) Administer an antihistamine for the rash.
b) Obtain an order for a CBC and ANA titer.
c) Increase the client's fluid intake.
d) Reassure the client that these symptoms are temporary.
b) Obtain an order for a CBC and ANA titer.
A client is prescribed amiodarone (Cordarone) for a resistant atrial dysrhythmia. Before initiating therapy, the nurse should ensure which of the following actions has been completed?
a) A 12-lead ECG has been performed.
b) The client has been NPO for at least 6 hours.
c) Any electrolyte imbalances have been corrected.
d) The client has been tested for a lidocaine allergy.
c) Any electrolyte imbalances have been corrected.
A nurse is reviewing a client's medication list. The nurse should recognize that administering nitroglycerin concurrently with which of the following medications is strictly contraindicated?
a) Furosemide
b) Sildenafil
c) Metoprolol
d) Lisinopril
b) Sildenafil
Which assessment is a priority for the nurse to perform before administering a dose of verapamil?
a) Checking for peripheral edema
b) Assessing heart rate and blood pressure
c) Monitoring serum potassium levels
d) Asking the client about the presence of a headache
b) Assessing heart rate and blood pressure
A client receiving a multi-day course of IV amphotericin B has a serum creatinine level that has increased from 1.0 mg/dL to 2.5 mg/dL. What is the nurse's priority action?
a) Reassure the client that this is a normal fluctuation.
b) Discontinue the client's oral fluid restriction.
c) Hold the next dose and notify the healthcare provider.
d) Obtain an order for a trough drug level.
c) Hold the next dose and notify the healthcare provider.
A nurse is monitoring a client receiving an IV infusion of procainamide. The nurse notes that the QRS complex on the ECG has widened by 60% from the baseline measurement. What is the nurse's immediate action?
a) Increase the rate of the infusion.
b) Check the client's blood pressure.
c) Stop the infusion and notify the provider.
d) Administer a bolus of IV lidocaine.
c) Stop the infusion and notify the provider.
A client develops a lupus-like syndrome while taking hydralazine. The nurse would expect the client to exhibit which of the following symptoms?
a) Severe hypertension and anxiety
b) Nausea, vomiting, and diarrhea
c) Rash, myalgia, and fever
d) Pinpoint pupils and respiratory depression
c) Rash, myalgia, and fever
A nurse is providing discharge teaching for a client prescribed metronidazole (Flagyl). Which statement by the client indicates a correct understanding of the instructions?
a) "I must avoid all alcoholic beverages while taking this medication."
b) "It's normal to have a small amount of blood in my urine."
c) "I should take this medication on an empty stomach for best results."
d) "A metallic taste in my mouth means I'm having an allergic reaction."
a) "I must avoid all alcoholic beverages while taking this medication."
A nurse is teaching a client about a new prescription for amiodarone. Which teaching point is most important given the properties of this drug?
a) "The effects of this drug will be gone within 24 hours of stopping it."
b) "You may need follow-up appointments for several months after you stop taking this drug."
c) "This medication has very few interactions with other drugs."
d) "You should take this medication with grapefruit juice to increase its effect."
b) "You may need follow-up appointments for several months after you stop taking this drug."
A client who takes warfarin for atrial fibrillation is prescribed oral fluconazole (Diflucan) for a fungal infection. The nurse should prioritize monitoring the client for which of the following?
a) Increased signs of bleeding
b) An increase in fungal symptoms
c) Signs of hypoglycemia
d) A sudden rise in blood pressure
a) Increased signs of bleeding
A client receiving an IV lidocaine infusion for ventricular dysrhythmias suddenly becomes confused and anxious and begins having muscle tremors. The nurse should recognize these as signs of what condition?
a) A therapeutic response to the medication
b) Lidocaine toxicity
c) An anaphylactic reaction
d) A hypertensive crisis
b) Lidocaine toxicity
A client is receiving a continuous IV infusion of nitroprusside sodium (Nitropress) for a hypertensive crisis. Which of the following is the most critical nursing intervention?
a) Monitoring the client's urine output every 4 hours.
b) Continuously monitoring the client's blood pressure.
c) Checking the client's deep tendon reflexes hourly. d) Obtaining a daily serum creatinine level.
b) Continuously monitoring the client's blood pressure.
A client is taking both diltiazem (Cardizem) and digoxin. The nurse should prioritize monitoring for which of the following complications?
a) Hypertensive crisis
b) Heart block
c) Severe tachycardia
d) Acute kidney injury
b) Heart block
A client is receiving a high-dose IV infusion of acyclovir (Zovirax). The nurse should prioritize which of the following interventions to prevent a common adverse effect?
a) Administering an antiemetic before the infusion.
b) Ensuring the client is well-hydrated before, during, and after the infusion.
c) Monitoring the client's liver function tests daily.
d) Applying a topical anesthetic to the IV site.
b) Ensuring the client is well-hydrated before, during, and after the infusion.
An immunosuppressed client taking fluconazole (Diflucan) develops a widespread rash with blistering and mucous membrane involvement. The nurse recognizes this as a sign of which potential life-threatening condition?
a) Anaphylaxis
b) Ototoxicity
c) Nephrotoxicity
d) Stevens-Johnson syndrome
d) Stevens-Johnson syndrome
The nurse should question a new prescription for propranolol (Inderal) for a client with a history of which of the following conditions?
a) Hypertension
b) Migraine headaches
c) Asthma
d) Angina pectoris
c) Asthma
A client has been receiving an infusion of nitroprusside sodium for 4 days. The nurse should be alert for signs of thiocyanate poisoning, which would include which of the following?
a) Severe hypertension and tachycardia
b) Flushing, headache, and palpitations
c) Lethargy, blurred vision, and metabolic acidosis
d) Productive cough and pulmonary edema
c) Lethargy, blurred vision, and metabolic acidosis
A client taking metronidazole (Flagyl) reports new onset of dizziness and peripheral neuropathy in their hands and feet. What is the nurse's best action?
a) Reassure the client that these are expected side effects.
b) Instruct the client to take the next dose with a full meal.
c) Advise the client to discontinue the medication and notify the provider.
d) Recommend the client take an over-the-counter pain reliever.
c) Advise the client to discontinue the medication and notify the provider.
A nurse is preparing a client for the administration of adenosine (Adenocard) for paroxysmal supraventricular tachycardia. Which statement by the nurse best prepares the client for the experience?
a) "This medication works slowly, so you will not feel any different."
b) "You will need to be sitting upright when we give you this medicine."
c) "You might feel a brief flushing sensation or some pressure in your chest."
d) "We will give this through a small IV in your hand."
c) "You might feel a brief flushing sensation or some pressure in your chest."
A nurse is instructing a client on how to use nystatin (Nystop) oral suspension for the treatment of oral candidiasis (thrush). Which instruction is most appropriate?
a) "Swallow the medication immediately with a full glass of water."
b) "Mix the medication with food to mask the taste." c) "Swish the medication in your mouth, coating all surfaces, then swallow."
d) "Use the suspension to brush your teeth twice daily."
c) "Swish the medication in your mouth, coating all surfaces, then swallow."
A nurse is providing discharge education to a client with a new prescription for propranolol (Inderal). Which statement by the client indicates a correct understanding of the teaching?
a) "I should stop taking this medication if I feel dizzy."
b) "This medication may mask the symptoms of low blood sugar."
c) "I will need to take this medication on an empty stomach."
d) "I can stop taking the drug abruptly once my blood pressure is normal.
b) "This medication may mask the symptoms of low blood sugar."
A client taking nitroglycerin IV for acute myocardial infarction develops a severe headache. What is the nurse's best action?
a) Stop the nitroglycerin infusion immediately.
b) Administer an analgesic as ordered.
c) Increase the rate of the nitroglycerin infusion.
d) Place the client in a high-Fowler's position.
b) Administer an analgesic as ordered.
A client is receiving an IV infusion of magnesium sulfate. Which assessment finding would be the earliest indicator of a potential overdose?
a) Respiratory paralysis
b) Circulatory collapse
c) Loss of deep tendon reflexes
d) Flushing and sedation
d) Flushing and sedation
A nurse is preparing to administer IV potassium chloride (KCl) to a client with hypokalemia. Which prescription would require the nurse to intervene and contact the provider?
a) Infuse 10 mEq of KCl in 100 mL NS over 1 hour.
b) Infuse 20 mEq of KCl in 100 mL NS over 1 hour.
c) Monitor cardiac rhythm during the infusion.
d) Administer the KCl infusion via an IV pump.
b) Infuse 20 mEq of KCl in 100 mL NS over 1 hour.
(Infusing K+ sould be slow)