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Senna works by changing the transport of water and electrolytes in the large
intestine, which causes the accumulation of water in the mass of stool and
increased peristalsis.
4. A client is being treated for acute congestive heart failure (CHF) and
the client’s vital signs are as follows: BP 85/50 mm Hg; pulse, 96
bpm; respirations, 26 cpm. The physician prescribes digoxin (Lanoxin).
To evaluate a therapeutic effectiveness of this medication, the nurse
would expect which of the following changes in the client’s vital signs?
a. incoordination
b. cough
c. tinnitus
d. hypertension
a. urinary output
b. fetal heart rate
c. central venous pressure
d. maternal blood glucose
a. hypothyroidism
b. insomnia
c. type 2 diabetes mellitus
d. renal failure
a. hypetension
b. diarrhea
c. nose bleeds
d. vaginal bleeding
11. A client has just been given a prescription for diphenoxylate with
atropine (Lomotil). The nurse teaches the client which of the following
about the use of this medication?
12. A nurse is gathering data from client about the client’s medication
history and notes that the client is taking tolterodine tartrate (Detrol
LA). The nurse determines that the client is taking the medication to
treat which disorder?
a. glaucoma
b. renal insufficiency
c. pyloric stenosis
d. urinary frequency and urgency
Tolterodine tartrate is an antispasmodic used to treat overactive bladder and
symptoms of urinary frequency, urgency, or urge incontinence. It is
contraindicated in urinary retention and uncontrolled narrow-angle glaucoma.
It is used with caution in renal function impairment, bladder outflow
obstruction, and gastrointestinal obstructive disease such as pyloric stenosis.
13. A client has an order to receive psyllium (Metamucil) daily. The nurse
administers this medication with:
a. signs of infection
b. hypotension
c. weight loss
d. hair loss
a. crackers
b. shrimp
c. apricots
d. popcorn
18. A client with anxiety disorder is taking buspirone (BuSpar) and tells
the nurse that it is difficult to swallow the tablets. The nurse tells the
client to:
19. A nurse is caring for a child with CHF provides instructions to the
parents regarding the administration of digoxin (Lanoxin). Which
statement by the mother indicates a need for further instructions?
a. “If my child vomits after I give the medication, I will not repeat
the dose”
b. “I will check my child’s pulse before giving the medication”
c. “I will check the dose of the medication with my husband before I
give the medication”
d. “I will mix the medication with food”
The medication should not be mixed with food or formula because this
method would not ensure that the child receives the entire dose of
medication. Options a, b, and c are correct. Additionally, if a dose is missed
and is not identified until 4 or more hours later, that dose is not
administered. If more than one consecutive dose is missed, the physician
needs to be notified.
a. “I will take one pill daily at the same time every day”
b. “I will not need to use an additional birth control method
once I start these pills”
c. “If I miss a pill I need to take it as soon as I remember”
d. “If I miss two pills I will take them both as soon as I remember
and I will take two pills the next day also”
The client needs to be instructed to use a second birth control method during
the first pill cycle. Options a, b, and c are correct. Additionally, the client
needs to be instructed that if she misses three pills, she will need to
discontinue use for that cycle and use another birth control method.
22. A client with Parkinson’s disease has begun therapy with levodopa (L-
dopa). The nurse determines that the client understands the action of
the medication if the client verbalizes that results may not be apparent
for:
a. 24 hours
b. Two to three days
c. One week
d. Two to three weeks
a. 3 mcg/ml
b. 8 mcg/ml
c. 15 mcg/ml
d. 24mcg/ml
a. hypertension
b. nausea
c. headache
d. watery diarrhea
25. A nurse is caring for a client with glaucoma who receives a daily dose
of acetazolamide (Diamox). Which of the following would indicate to
the nurse that the client is experiencing an adverse effect of the
medication?
a. constipation
b. difficulty swallowing
c. dark-colored urine and stools
d. irritability
a. nausea
b. decreased urinary output
c. muscle weakness
d. confusion
a. edema
b. weight gain
c. excitability
d. decreased libido
28. A nurse is caring for the client with a history of mild heart failure who
is receiving diltiazem hydrochloride (Cardizem) for hypertension. The
nurse would assess the client for:
a. bradycardia
b. wheezing
c. peripheral edema and weight gain
d. apical pulse rate lower than baseline
29. The wound of a client with an extensive burn injury is being treated
with the application of silver sulfadiazine (Silvadene). Which symptom
would indicate to the nurse that the client is experiencing a side effect
related to systemic absorption?
a. diarrhea
b. photophobia
c. fever
d. tingling in the extremities
31. The nurse notes that the client is receiving filgrastim (Neupogen). The
nurse checks which of the following to determine medication
effectiveness?
a. neutrophil count
b. platelet count
c. blood urea nitrogen
d. creatinine level
a. blurred vision
b. constipation
c. sore throat
d. dry mouth
34. A clinic nurse asks a client with diabetes mellitus being seen in the
clinic for the first time to list the medications that she is taking. Which
combination of medications taken by the client should the nurse report
to the physician?
36. A client has been taking fosinopril (Monopril) for 2 months. The nurse
determines that the client is having the intended effects of therapy if
the nurse notes which of the following?
a. lowered BP
b. lowered pulse rate
c. increased WBC
d. increased monocyte count
37. A client is taking labetalol (Normodyne). The nurse monitors the client
for which frequent side effect of the medication?
a. tachycardia
b. impotence
c. increased energy level
d. night blindness
38. An older client has been using cascara sagrada on a long-term basis.
The nurse determines that which laboratory result is a result of the
side effects of this medication?
40. Quinidine gluconate (Dura Quin) is prescribed for a client. The nurse
reviews the client’s medical record, knowing that which of the following
is a contraindication in the use of this medication?
a. nausea
b. diarrhea
c. anorexia
d. proteinuria
44. A female client tells the clinic nurse that her skin is very dry and
irritated. Which product would the nurse suggest that the client apply
to the dry skin?
a. glycerin emollient
b. aspercreame
c. myoflex
d. acetic acid solution
Glycerin is an emollient that is used for dry, cracked, and irritated skin.
Aspercreame and Myoflex are used to treat muscular aches. Acetic acid
solution is used for irrigating, cleansing, and packing wounds infected by
Pseudomonas aeruginosa.
45. A client with advanced cirrhosis of the liver is not tolerating protein
well, as eveidenced by abnormal laboratory values. The nurse
anticipates that which of the following medications will be prescribed
for the client?
a. lactulose (Chronulac)
b. ethacrynic acid (Edecrin)
c. folic acid (Folvite)
d. thiamine (Vitamin B1)
The client with cirrhosis has impaired ability to metabolize protein because of
liver dysfunction. Administration of lactulose aids in the clearance of
ammonia via the gastrointestinal (GI) tract. Ethacrynic acid is a diuretic. Folic
acid and thiamine are vitamins, which may be used in clients with liver
disease as supplemental therapy.
46. A nurse is planning dietary counseling for the client taking triamterene
(Dyrenium). The nurse plans to include which of the following in a list
of foods that are acceptable?
a. baked potato
b. bananas
c. oranges
d. pears canned in water
47. A client is taking famotidine (Pepcid) asks the home care nurse what
would be the best medication to take for a headache. The nurse tells
the client that it would be best to take:
a. chocolate milk
b. cranberry juice
c. coffee
d. cola
Cola, coffee, and chocolate contain xanthine and should be avoided by the
client taking a xanthine bronchodilator. This could lead to an increased
incidence of cardiovascular and central nervous system side effects that can
occur with the use of these types of bronchodilators.
49. A client with histoplasmosis has an order for ketoconazole (Nizoral).
The nurse teaches the client to do which of the following while taking
this medication?
50. A nurse is preparing the client’s morning NPH insulin dose and notices
a clumpy precipitate inside the insulin vial. The nurse should:
The nurse should always inspect the vial of insulin before use for solution
changes that may signify loss of potency. NPH insulin is normally uniformly
cloudy. Clumping, frosting, and precipitates are signs of insulin damage. In
this situation, because potency is questionable, it is safer to discard the vial
and draw up the dose from a new vial.