1.   Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which of the following would indicate the presence of systemic toxicity from this medication?

a.      Tinnitus

b.      Diarrhea

c.       Constipation

d.      Decreased respirations

1.      The client is diagnosed with herpes simplex type 1. The physician prescribes a topical medication for treatment. The nurse anticipates that which of the following medications will be prescribed?

a.      Salicylic acid

b.      Gentamicin sulfate

c.       Acyclovir (Overtax)

d.      Mupirocin calcium (Bactroban)

1.      The physician has prescribed coal tar treatments for the client with psoriasis, and the nurse provides information to the client about the treatments. Which statement made by the client indicates a lack of understanding about the treatments?

a.      “The medication has an unpleasant odor.”

b.      “The medication can cause phototoxicity.”

c.       “The medication can stain the skin and hair.”

d.      “The medication always causes systemic toxicity.”

1.      The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse reminds the children that chemical sunscreens are most effective when applied:

a.      Immediately before swimming

b.      15 minutes before sun exposure

c.       Immediately before exposure to the sun

d.      30 to 60 minutes before exposure to the sun

1.      Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury. When applying the medication, the client complains of local discomfort and burning. Which of the following is the most appropriate nursing action?

a.      Notify the physician.

b.      Discontinue the medication.

c.       Inform the client that this is normal

d.      Apply a thinner film than prescribed to the burn site.

1.      The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site of injury. The nurse monitors the client, knowing that which of the following indicates that a systemic effect has occurred?

a.      Hyperventilation

b.      Elevated blood pressure

c.       Local pain at the burn site

d.      Local rash at the burn site

1.      Sodium hypochlorite (Dakin’s solution) is prescribed for a client with a leg wound that is draining purulent material and the home health nurse teaches a family member how to perform wound treatments. Which statement, if made by the family member, indicates a need for further teaching?

a.      “A fresh solution needs to be prepared frequently.”

b.      “The solution should not come in contact with normal skin tissue.”

c.       “I should rinse the solution off immediately following the irrigation.”

d.      “I will soak a sterile dressing with solution and pack it into the wound.”

1.      The nurse has provided instructions to a client regarding the use of tretinoin (Retin-A). Which statement, if made by the client, indicates the need for further instructions?

a.      “I must apply a very thin layer to the skin.”

b.      “Optimal results will be seen after 6 weeks.”

c.       “I will wash my hands thoroughly after applying the medication.”

d.      “I will cleanse the skin thoroughly before applying the medication.”

1.      Isotretinoin (Accutane) is prescribed for a client with severe acne. Before the administration of this medication, the nurse anticipates that which laboratory test will be prescribed?

a.      Platelet count

b.      Triglyceride level

c.       Complete blood count

d.      White blood count

1.      A client with severe acne is seen in the clinic and the physician prescribes isotretinoin (Accutane). The nurse reviews the client’s medication record and would contact the physician if the client is taking which medication?

a.      Vitamin A

b.      Digoxin (Lanoxin)

c.       Furosemide (Lasix)

d.      Phenytoin (Dilantin)

1.      An outbreak of pediculosis capitus has occurred at the local school. The school nurse is providing instructions to the parents of the children attending the school regarding the application of permenthrin (Elimite, Nix, Acticin). The nurse tells the parents to:

a.      Apply before washing the hair.

b.      Apply at bedtime and rinse off in the morning.

c.       Avoid saturating the hair and scalp when applying.

d.      Allow to remain on the hair 10 minutes and then rinse with water.

1.      A client is seen in the clinic for complaints of skin itchiness that has persisted over the past several weeks. Following an assessment, the client has been determined to have scabies. Lindane is prescribed, and the nurse provides instructions to the client regarding the use of the medication. The nurse tells the client to:

a.      Apply the cream for 2 days in a row.

b.      Apply a thick layer of cream to the entire body.

c.       Apply to the entire body and scalp, excluding the face.

d.      Leave the cream on for 8 to 12 hours and then remove by washing.

1.      A topical corticosteroid is prescribed for the client with dermatitis. The nurse provides instructions to the client regarding the use of the medication. Which of the following, if stated by the client, would indicate a need for further instruction?

a.      “I need to apply the medication in a thin film.”

b.      “I should gently rub the medication into the skin.”

c.       “The medication will help relieve the inflammation and itching.”

d.      “I should place a bandage over the site after applying the medication.”

1.      The nurse is applying a topical corticosteroid to a client with eczema. The nurse would be concerned about the potential for increased systemic absorption of the medication if the medication were being applied to which of the following body areas?

a.      Back

b.      Axilla

c.       Soles of the feet

d.      Palms of the hands

1.      The registered nurse is observing a newly hired nurse perform a dressing change on a client with a leg ulcer. Sutilains (Travase) is being used to treat the ulcer. Which observation by the registered nurse would indicate an inaccurate action by the newly hired nurse when performing the dressing change?

a.      The nurse cleans the wound with a sterile solution.

b.      The nurse places the sutilains in the refrigerator following use.

c.       The nurse dries the wound and covers the sutilains application with a dry sterile dressing.

d.      The nurse moistens the wound with sterile normal saline and then applies the sutilains.

1.      Dextranomer (Debrisan) is prescribed for a client with a pressure ulcer. The nurse instructor asks the nursing student preparing to perform the treatment about the medication and procedure. Which statement, if made by the student, indicates a need for further research?

a.      “It is effective in wet wounds only.”

b.      “It should be packed lightly into the wound.”

c.       “The wound bed must be dried thoroughly before applying the medication.”

d.      “Maceration of tissue surrounding the wound can occur from the medication.”

1.      brinolysin and desoxyribonuclease (Elase) is prescribed to treat a skin ulcer, and the nurse is observing a nursing student perform the treatment. The nurse intervenes if the nursing student is observed doing which of the following?

a.      Applies a thin layer of medication

b.      Cleans the wound with a sterile solution

c.       Places petrolatum gauze over the fibrinolysin and desoxyribonuclease

d.      Applies a thick layer of medication and covers with a dry sterile dressing

1.      The clinic nurse is performing an admission assessment on a client. The nurse notes that the client is taking azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect that the client is being treated for:

a.      Acne

b.      Eczema

c.       Hair loss

d.      Herpes simplex

1.      The physician has prescribed silver sulfadiazine (Silvadene) for the client with a partial-thickness burn, which has cultured positive for gram-negative bacteria, and the nurse provides information to the client about the medication. Which statement made by the client indicates a lack of understanding about the treatments?

a.      “The medication is an antibacterial.”

b.      “The medication will help heal the burn.”

c.       “The medication will permanently stain my skin.”

d.      “The medication should be applied directly to the wound.”

1.      The nurse notes necrotic tissue present in the wound bed of a client and reports the findings to the physician. The nurse anticipates that which medication will be prescribed to treat the wound?

a.      Dextranomer (Debrisan)

b.      Nitrofurazone (Furacin)

c.       Sliver sulfadiazine (Silvadene)

d.      Fibrinolysin and desoxyribonuclease (Elase)

1.      The nurse is monitoring the laboratory results of a client receiving an antineoplastic medication by the intravenous route. The nurse plans to initiate bleeding precautions if which laboratory result is noted?

a.      A clotting time of 10 minutes

b.      An ammonia level of 20mcg/dL

c.       A platelet count of 50,000/mm3

d.      A white blood cell count of 5,000/mm3

1.      The nurse is analyzing the laboratory results of a client with leukemia who has received a regimen of chemotherapy. Which of the following laboratory values would the nurse specifically note as a result of the massive cell destruction that occurred from the chemotherapy?

a.      Anemia

b.      Decreased platelets

c.       Increased uric acid level

d.      Decreased leukocyte count

1.      The nurse is providing medication instructions to a client with breast cancer who is receiving cyclophosphamide (Cytoxan, Neosar). The nurse tells the client to:

a.      Take the medication with food.

b.      Increase fluid intake to 2000 to 3000 mL daily.

c.       Decrease sodium intake while taking the medication.

d.      Increase potassium intake while taking the medication.

1.      The client with non-Hodgkin’s lymphoma is receiving daunorubicin (DaunoXome). Which of the following would indicate to the nurse that the client is experiencing a toxic effect related to the medication?

a.      Fever

b.      Diarrhea

c.       Complaints of nausea and vomiting

d.      Crackles on auscultation of the lungs

1.      Chemotherapy dosage is frequently based on total body surface area (BSA), so it is important for the nurse to do which of the following before administering chemotherapy?

a.      Measure abdominal girth.

b.      Calculate body mass index.

c.       Ask the client about his or her height and weight.

d.      Weigh and measure the client on the day of drug administration.

1.      The client with squamous cell carcinoma of the larynx is receiving bleomycin (Blenoxane) intravenously. The nurse caring for the client anticipates that which diagnostic study will be prescribed?

a.      Echocardiography

b.      Electrocardiography

c.       Cervical radiography

d.      Pulmonary function studies

1.      Each chemotherapeutic agent has a specific nadir. The nurse administering a combination chemotherapy regimen understands the importance of:

a.      Giving two agents from the same medication class

b.      Giving two agents with like nadirs at the same time

c.       Testing the client’s knowledge about each agent’s nadir

d.      Avoid giving agents with the same nadirs and toxicities at the same time

1.      The clinic nurse prepares a teaching plan for the client receiving an antineoplastic medication. When implementing the plan, the nurse tells the client:

a.      To take aspirin as needed for headache

b.      Drink beverages containing alcohol in moderate amounts each evening

c.       Consult with health care providers before receiving immunizations

d.      That it is not necessary to consult health care providers before receiving a flu vaccine at the local heath fair

1.      The client with bladder cancer is receiving cisplatin (Platinol) and vincristine (Oncovin, Vincasar PFS). The nurse preparing to give the medication understands that the purpose of administering both these medications is to:

a.      Prevent alopecia

b.      Decrease the destruction of cells

c.       Increase the therapeutic response

d.      Prevent gastrointestinal side effects

1.      The client with lung cancer is receiving a high dose of methotrexate (Rheumatrex, Trexall). Leucovorin (citrovorum factor, folic acid) is also prescribed. The nurse caring for the client understand that the purpose of administering the leucovrin is to:

a.      Preserve normal cells.

b.      Promote DNA synthesis.

c.       Promote medication excretion.

d.      Promote the synthesis of nucleic acids.

1.      The client with ovarian cancer is being treated with vincristine (Oncovin, Vincasar PFS). The nurse monitors the client, knowing that which of the following indicates a side effect specific to this medication?

a.      Diarrhea

b.      Hair loss

c.       Chest pain

d.      Numbness and tingling in the fingers and toes

1.      The nurse is reviewing the history and physical examination of a client who will be receiving asparaginase (Elspar), an antineoplastic agent. The nurse contacts the physician before administering the medication if which of the following is documented in the client’s history?

a.      Pancreatitis

b.      Diabetes mellitus

c.       Myocardial infarction

d.      Chronic obstructive pulmonary disease

1.      Tamoxifen (Nolvadex) is prescribed for the client with metastatic breast carcinoma. The nurse administering the medication understands that the primary action of this mediation is to:

a.      Increase DNA and RNA synthesis.

b.      Promote the biosynthesis of nucleic acids.

c.       Increase estrogen concentration and estrogen response.

d.      Compete with estradiol for binding to estrogen in tissues containing high concentrations of receptors.

1.      The client with metastatic breast cancer is receiving tamoxifen (Nolvadex). The nurse specifically monitors which laboratory value while the client is taking this medication?

a.      Glucose level

b.      Calcium level

c.       Potassium level

d.      Prothrombin time

1.      Megestrol acetate (Megace), an antineoplastic medication, is prescribed for the client with metastatic endometrial carcinoma. The nurse reviews the client’s history and contacts the physician if which of the following is documented in the client’s history?

a.      Gout

b.      Asthma

c.       Thrombophlebitis

d.      Myocardial infarction

1.      A female client with carcinoma of the breast is admitted to the hospital for treatment with intravenously administered doxorubicin (Adriamycin). The client tells the nurse that she has been told by her friends that she is going to lose all her hair. The appropriate nursing response is which of the following?

a.      “Your friends are correct.”

b.      “You will not lose your hair.”

c.       “Hair loss may occur, but it will grow back just as it is now.”

d.      “Hair loss may occur, and it will grow back, but it may have a different color or texture.”

1.      The clinic nurse prepares instructions for a client who developed stomatitis following the administration of a course of antineoplastic medications. The nurse tells the client to:

a.      Rinse the mouth with baking soda or saline.

b.      Avoid foods and fluids for the next 24 hours.

c.       Swab the mouth daily with lemon and glycerin pads.

d.      Brush the teeth and use waxed dental floss three times a day.

1.      The client with acute myelocytic leukemia is being treated with busulfan (Myleran, Busulfex). Which of the following laboratory values would the nurse specifically monitor during treatment with this medication?

a.      Clotting time

b.      Blood glucose level

c.       Uric acid level

d.      Potassium level

1.      The client with small cell lung cancer is being treated with etoposide (VePesid). The nurse monitors the client during administration, knowing that which of the following indicates a side effect specific to this medication?

a.      Alopecia

b.      Chest pain

c.       Pulmonary fibrosis

d.      Orthostatic hypotension

1.      The nurse is assigned to care for several male and female clients who take estrogen or progestins. The nurse knows that this group of clients is a increased risk for which complication of the medication?

a.      Sepsis

b.      Dehydration

c.       Deep vein thrombosis

d.      Electrocardiographic changes

1.      A client is taking NPH insulin daily every morning. The nurse instructs the client that the most likely time for a hypoglycemic reaction to occur is:

a.      2 to  4 hours after administration

b.      4 to  12 hours after administration

c.       16 to 18 hours after administration

d.      18 to 24 hours after administration

1.      A client with diabetes mellitus visits a health care clinic. The client’s diabetes mellitus previously had been well controlled with glyburide (DiBeta), 5mg orally daily, but recently the fasting blood glucose level has been 180 to 200 mg/dL. Which medication, if added to the client’s regimen, may have contributed to the hyperglycemia?

a.      Phenelzine (Nardil)

b.      Atenolol (Tenormin)

c.       Prednisone (Deltasone)

d.      Allopurinol (Zyloprim)

1.      A community health nurse visits a client at home. Prednisone (Deltasone), 10mg orally daily, has been prescribed for the client and the nurse teaches the client about the medication. Which statement, if made by the client, indicates that further teaching is necessary?

a.      “I can take aspirin or my antihistamine if I need it.”

b.      “I need to take the medication every day at the same time.”

c.       “I need to avoid coffee, tea, cola, and chocolate in my diet.”

d.      “If I gain more than 5 pounds a week, I will call my doctor.”

1.      Somatrem (Protropin) is administered to a client with growth failure. A nurse monitors the client, knowing that the expected therapeutic effect of this medication is to:

a.      Promote weight gain.

b.      Increase bone density.

c.       Stimulate linear growth.

d.      Decrease the mobilization of fats.

1.      Desmopressin acetate (DDAVP) is prescribed for the treatment of diabetes insipidus. The nurse administering the medication monitors the client for which therapeutic response?

a.      Decreased blood glucose level

b.      Decreased urinary output

c.       Decreased blood pressure

d.      Decreased peripheral edema

1.      A nurse is monitoring a client receiving desmopressin acetate (DDAVP) for adverse effects to the medication. Which of the following indicates the presence of an adverse effect?

a.      Insomnia

b.      Drowsiness

c.       Weight loss

d.      Increased urination

1.      Vasopressin (Pitressin) is prescribed for a client with diabetes insipidus. A nurse is particularly cautious in monitoring the client receiving this medication if the client has which of the following preexisting conditions?

a.      Depression

b.      Endometriosis

c.       Pheochromocytoma

d.      Coronary artery disease

1.      A nurse provides instructions to a client who is taking levothyroxine (Synthroid). The nurse tells the client to take the medication:

a.      With food

b.      At lunchtime

c.       On an empty stomach

d.      At bedtime with a snack

1.      A nurse provides medication instructions to a client who is taking levothyroxine (Synthroid). The nurse instructs the client to notify the physician if which of the following occurs?

a.      Fatigue

b.      Tremors

c.       Cold intolerance

d.      Excessively dry skin

1.      A nurse performs an admission assessment on a client who visits a health care clinic for the first time. The client tells the nurse that propylthiouracil (PTU) is taken daily. The nurse continues to collect data from the client, suspecting that the client has a history of:

a.      Myxedema

b.      Graves’ disease

c.       Addison’s disease

d.      Cushing’s syndrome

1.      A nurse is instructing a client regarding intranasal desmopressin (DDAVP). The nurse tells the client that which of the following is a side effect of the medication?

a.      Headache

b.      Vulval pain

c.       Runny nose

d.      Flushed skin

1.      A client is receiving somatropin (Humatrope). The nurse monitors which most significant laboratory study during therapy with this medication?

a.      Lipase level

b.      Amylase level

c.       Blood urea nitrogen level

d.      Thyroid-stimulating hormone level

1.      A client is scheduled for a subtotal thryroidectomy and potassium iodide (Lugol’s solution) is prescribed. A nurse prepares to administer the medication, knowing that the therapeutic effect of this medication is to:

a.      Replace thyroid hormone.

b.      Prevent the oxidation of iodide.

c.       Increase thyroid hormone production.

d.      Suppress thyroid hormone production.

1.      Potassium iodide (Lugol’s solution) is prescribed for a client with thyrotoxic crisis. The client calls a clinic nurse and complains of a brassy taste in the mouth. The appropriate instruction to the client is which of the following?

a.      Continue with the medication.

b.      Withhold the medication and notify the physician.

c.       Take half of the prescribed dose for the next 24 hours.

d.      Withhold the medication for the next 24 hours and then continue as prescribed.

1.      A nurse provides instructions to a client taking fludrocortisones acetate (Florinef Acetate). The nurse instructs the client to notify the physician if which of the following occurs?

a.      Nausea

b.      Fatigue

c.       Weight loss

d.      Swelling of the feet

1.      Calcium carhbonate (Os-Cal) is prescribed for a client with hypocalcemia. A nurse instructs the client to take the medication:

a.      With meals

b.      Every 4 hours

c.       Just before meals

d.      1 hour after meals

1.      A daily dose of prednisone (Deltasone) is prescribed for a client. A nurse provides instructions to the client regarding administration of the medication and instructs the client that the best time to take this medication is:

a.      At noon

b.      At bedtime

c.       Early morning

d.      Any time, at the same time, each day

1.      Acarbose (Precose) is prescribed to treat a client with type 2 diabetes mellitus. Which instruction should the nurse include when teaching the client about this medication?

a.      Take the medication at bedtime.

b.      Take the medication with the first bite of each regular meal.

c.       The medication will be used to treat symptoms of hypoglycemia.

d.      Headache and dizziness are the most common side effects of this medication.

1.      The nurse is caring for a 23-year-old client newly diagnosed with type 1 diabetes mellitus and teaches the client insulin administration. Which statement by the client indicates a need for further teaching?

a.      “It is not necessary for me to aspirate before injecting my insulin.”

b.      “I will rotate my insulin injection between my arms, thighs, and abdomen on a daily basis.”

c.       “I will perform a capillary blood glucose measurement before I administer my insulin regimen.”

d.      “My glargine insulin is long-acting and should be administered once a day, but lispro insulin is given just before I eat.”

1.      Prednisone (Deltasone) is prescribed for a client with diabetes mellitus who is taking NPH insulin daily. Which of the following prescription changes does the nurse anticipate during therapy with the prednisone?

a.      An additional dose of prednisone daily

b.      A decreased amount of daily NPH insulin

c.       An increased amount of daily NPH insulin

d.      The addition of an oral hypoglycemic medication daily

1.      A nurse is teaching a client how to mix regular insulin and NPH insulin in the same syringe. Which of the following actions, if performed by the client, indicates the need for further teaching?

a.      Withdraws the NPH insulin first

b.      Withdraws the regular insulin first

c.       Injects air into NPH insulin vial first

d.      Injects an amount of air equal to the desired dose of insulin into the vial

1.      A home care nurse visits a client recently diagnosed with diabetes mellitus who is taking NPH insulin daily. The client asks the nurse how to store the unopened vials of insulin. The nurse tells the client to:

a.      Freeze the insulin.

b.      Refrigerate the insulin.

c.       Store the insulin in a dark, dry place.

d.      Keep the insulin at room temperature.

1.      Glimepiride (Amaryl) is prescribed for a client with diabetes mellitus. A nurse instructs the client to avoid which of the following while taking this medication?

a.      Alcohol

b.      Organ meats

c.       Whole-grain cereals

d.      Carbonated beverages

1.      Sildenafil (Viagra) is prescribed to treat a client with erectile dysfunction. A nurse reviews the client’s medical record and would question the prescription if which of the following is noted in the client’s history?

a.      Neuralgia

b.      Insomnia

c.       Use of nitroglycerin

d.      Use of multivitamins

1.      The health care provider orders exenatide (Byetta) for a client with type 1 diabetes mellitus who takes insulin. The nurse plans to take which appropriate intervention?

a.      Administer the medication within 60 minutes before the morning and evening meal.

b.      Hold the medication and call the health care provider, questioning the order for the client.

c.       Monitor the client for gastrointestinal side effects after administering the medication.

d.      Withdraw the insulin from the penlet into an insulin syringe to prepare for administration.

1.      The client has a new order for metoclopramide (Reglan). On review of the chart, the nurse identifies that this medication can be safely administered with which condition?

a.      Intestinal obstruction

b.      Peptic ulcer with melena

c.       Diverticulitis with perforation

d.      Vomiting following cancer chemotherapy

1.      The nurse has given instructions to a client who has just been prescribed cholestyramine (Questran). Which statement by the client indicates a need for further instructions?

a.      I will continue taking vitamin supplements.

b.      This mediation will help lower my cholesterol.

c.       This medication should only be taken with water.

d.      A high-fiber diet is important while taking this medication.

1.      A client with Crohn’s disease is scheduled to receive an infusion of infliximab (Remicade). What intervention by the nurse will determine the effectiveness of treatment?

a.      Carrying out a Hematest on gastric fluids after the infusion is completed

b.      Checking the frequency and consistency of bowel movements

c.       Monitoring the leukocyte count for 2 days after the infusion

d.      Checking serum liver enzyme levels before and after the infusion

1.      The client is taking docusate sodium (Colace). The nurse monitors for which sign or symptom to determine whether the client is having a therapeutic effect from this medication?

a.      Reduction in steatorrhea

b.      Hematest-negative stools

c.       Regular bowel movements

d.      Absence of abdominal pain

1.      The client is taking cascara sagrada and develops abdominal cramps. What interpretation by the nurse is most likely correct?

a.      The client has peptic ulcer disease.

b.      The client is experiencing a case of influenza.

c.       The client may have a partial bowel obstruction.

d.      This is a common side effect of this medication.

1.      The client taking bisacodyl (Dulcolax) wants to obtain a rapid effect from the medication. How should the nurse instruct the client to take the medication?

a.      At bedtime

b.      With a large meal

c.       On an empty stomach

d.      With two glasses of juice

1.      The client has a PRN order for loperamide hydrochloride (Imodium). For which condition should the nurse plan to administer this medication?

a.      Constipation

b.      Abdominal pain

c.       An episode of diarrhea

d.      Hematest-positive nasogastric tube  drainage

1.      The nurse teaches the client taking metoclopramide (Reglan) to withhold the medication immediately and call the physician if which sign or symptom occurs with long-term use?

a.      Anxiety or irritability

b.      Excessive drowsiness or excitability

c.       Uncontrolled rhythmic movements of the face or limbs

d.      Dry mouth not relieved by sugar-free hard candy

1.      The client has just taken a dose of trimethobenzamide hydrochloride (Tigan). What indicates that this client has had a therapeutic response to the medication?

a.      Relief of constipation

b.      Decrease in heartburn

c.       Absence of abdominal pain

d.      Relief of nausea and vomiting

1.      The client has a PRN order for ondansetron (Zofran). For which condition should the nurse administer this medication to the postoperative client?

a.      Paralytic ileus

b.      Incisional pain

c.       Urinary retention

d.      Nausea and vomiting

1.      The client has begun medication therapy with pancrelipase (Pancrease). The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed?

a.      Weight loss

b.      Relief of heartburn

c.       Reduction of steatorrhea

d.      Absence of abdominal pain

1.      A calcium carbonate antacid has been prescribed for a client and the nurse provides instructions to the client about the medication. The nurse tells the client that it is best to take the antacid with which of the following?

a.      Milk

b.      Water

c.       Yogurt

d.      A vitamin D supplement

1.      The nurse is giving the client directions for proper use of aluminum hydroxide tablets (Alu-Tabs). What should the nurse tell the client?

a.      Swallow the tablets whole with a full glass of water.

b.      Take the tablets at the same time as other medications.

c.       Take each dose with a laxative to prevent constipation.

d.      Chew the tablets thoroughly and follow with 4 oz of water.

1.      The client with a history of duodenal ulcer is taking calcium carbonate chewable tablets. Which finding indicates that the client is experiencing optimal effects of the medication?

a.      Heartburn is relieved.

b.      Muscle twitching stops.

c.       The serum calcium level increases.

The serum phosphorus level decreases.

1.      The hospitalized client asks the nurse for sodium bicarbonate to relieve heartburn following a meal. The nurse reviews the client’s medical record, knowing that the medication is contraindicated in which condition?

a.      Urinary calculi

b.      Chronic bronchitis

c.       Metabolic alkalosis

d.      Respiratory acidosis

1.      An older client recently has been taking cimetidine (Tagamet). The nurse monitors the client for which most frequent central nervous system side effect of this medication?

a.      Tremors

b.      Dizziness

c.       Confusion

d.      Hallucinations

1.      The client with a gastric ulcer has an order for sucralfate (Carafate), 1 gm by mouth four times daily. The nurse schedules the medication for which times?

a.      With meals and at bedtime

b.      Every 6 hours around the clock

c.       One hour after meals and at bedtime

d.      One hour before meals and at bedtime

1.      The client who chronically uses nonsteroidal anti-inflammatory drugs has been taking misoprostol (Cytotec). The nurse determines that the medication is having the intended therapeutic effect if the client does not experience which sign or symptom?

a.      Diarrhea

b.      Epigastric pain

c.       Decreased platelet count

d.      Decreased white blood cell count

1.      The physician has written an order for ranitidine (Zantac), 300 mg once daily. The nurse schedules the medication for which time?

a.      At bedtime

b.      After lunch

c.       With supper

d.      Before breakfast

1.      The client is taking lansoprazole (Prevacid) for the chronic management of peptic ulcer disease. The nurse advises the client to take which product if needed for a headache?

a.      Naproxen (Aleve)

b.      Ibuprofen (Motrin)

c.       Acetaminophen (Tylenol)

d.      Acetylsalicylic acid (aspirin)

1.      The client has been taking omeprazole (Prilosec) for 4 weeks. The ambulatory care nurse evaluates that the client is receiving optimal intended effect of the medication if the client reports the absence of which symptom?

a.      Diarrhea

b.      Heartburn

c.       Flatulence

d.      Constipation

1.      A client with peptic ulcer is diagnosed with a Helicobacter pylori infection. The nurse is teaching the client about the medications prescribed, including metronidazole (Flagyl), omeprazole (Prilosec), and clarithromycin (Biaxin). Which statement by the client indicates the best understanding of the medication regimen?

a.      “My ulcer will heal because these medications will kill the bacteria.”

b.      “These medications are only taken when I have pain from my ulcer.”

c.       “The medications will kill the bacteria and stop the acid production.”

d.      “These medications will coat the ulcer and decrease the acid production in my stomach.”

1.      A nurse has an order to give a client salmeterol (Serevent), two puffs, and beclomethasone dipropionate (Qvar), two puffs, by metered-dose inhaler. The nurse administers the medication by giving the:

a.      Beclomethasone first and then the salmeterol

b.      Salmeterol first and then the beclomethasone

c.       Alternating a sing puff of each, beginning with the salmeterol

d.      Alternating a sing puff of each, beginning with the beclomethasone

1.      A client receiving oral theophylline is due to have a theophylline level drawn. A nurse questions the client to ensure that that the client has not ingested which of the following substances before the blood sample is drawn?

a.      Glucose

b.      Caffeine

c.       Sedatives

d.      Opioids

1.      The nurse is caring for a client with a diagnosis of influenza who first began to experience symptoms yesterday. Antiviral therapy is prescribed and the nurse provides instructions to the client about the therapy. Which statement by the client indicates an understanding of the instructions?

a.      “I must take the medication exactly as prescribed.”

b.      “Once I start the medication, I will no longer be contagious.”

c.       “I will not get any colds or infections while taking this medication.”

d.      “This medication has minimal side effects and I can return to normal activities.”

1.      A client has begun therapy with theophylline (Theo-24). A nurse plans to teach the client to limit the intake of which of the following while taking this medication?

a.      Coffee, cola, and chocolate

b.      Oysters, lobster, and shrimp

c.       Melons, oranges, and pineapple

d.      Cottage cheese, cream cheese, and dairy creamers

1.      A nurse has administered a dose of salmeterol (Serevent Diskus) to a client. The client develops a generalized rash and urticaria, and the eyelids begin to swell. The nurse should:

a.      Call the physician immediately.

b.      Apply a lanolin-based cream to the rash.

c.       Encourage the client to drink fluids quickly.

d.      Assess the client’s vision with a Snellen chart.

1.      The nurse is preparing to administer the first dose of omalizumab (Xolair) to a client. The nurse should have which of the following items available for possible use during the administration of this medication?

a.      Emesis basin

b.      Nasogastric tube

c.       Suction equipment

d.      Medications for severe anaphylactic reactions

1.      A client has an order to take guaifenesin (Humibid). A nurse concludes that the client understands the most effective use of this medication if the client states that he or she will:

a.      Watch for irritability as a side effect.

b.      Take the tablet with a full glass of water.

c.       Take an extra dose if the cough is accompanied by fever.

d.      Crush the sustained-release tablet if immediate relief is needed.

1.      A nurse is preparing to administer a dose of naloxone hydrochloride (Narcan) intravenously to a client with an intravenous opioid overdose. The nurse plans to have which of the following available as supportive equipment in case it is needed?

a.      Nasogastric tube

b.      Paracentesis tray

c.       Resuscitation equipment

d.      Central line insertion tray

1.      A nurse teaches a client about the effects of diphenhydramine (Benadryl), which has been ordered as a cough suppressant. The nurse determines that the client needs further instructions if the client states that he or she will:

a.      Take the medication on an empty stomach.

b.      Avoid using alcohol while taking this medication.

c.       Use sugarless gum, candy, or oral rinses to decrease dry mouth.

d.      Avoid driving or other activities requiring mental alertness while taking this medication.

1.      A client has been prescribed a cough formula containing codeine sulfate. A nurse has given the client instructions for its use. The nurse concludes that the client understands the instructions if the client verbalizes to self-assess for:

a.      Excitability

b.      Rapid pulse

c.       Constipation

d.      Excessive urination

1.      A cromolyn sodium (Intal) inhaler is prescribed for a client with allergic asthma. A nurse provides instructions regarding the side effects of this medication. Which of the following undesirable side effects is associated with this medication?

a.      Insomnia

b.      Constipation

c.       Hypotension

d.      Bronchospasm

1.      Terbutaline (Brethine) is prescribed for a client with bronchitis. A nurse understands that this medication should be used with caution if which of the following medical conditions is present in the client?

a.      Osteoarthritis

b.      Hypothyroidism

c.       Diabetes mellitus

d.      Polycystic disease

1.      Zafirlukast (Accolate) is prescribed for a client with bronchial asthma. Which laboratory test does the nurse expect to be prescribed before the administration of this medication?

a.      Platelet count

b.      Neutrophil count

c.       Liver function tests

d.      Complete blood count