Pharmacology - Proctored Assesment

A patient newly diagnosed with hypothyroidism is prescribed Levothyroxine (Synthroid) 0.25 mg PO daily. After 6 weeks of treatment the nurse dtermines that the medication was effective if the: 1) Thyroid stimulating hormone (TSH) level is 2 microunits/mL 2) Total t4 level is 2 mcg/dL A nurse providing teaching to a client who has just been prescribed prazosin (Minipress) which of the following client statement indicates understanding of teaching: 1) I will not use a salt substitute while taking meds 2) I will move slowly from sitting to standing to prevent falls A nurse is providing teaching to a patient who is prescribed phenytoin (Dilantin). Which statement by the patient indicates further teaching: 1) I should expect a rash to develop 2) I may develop hair or face or chest A nurse is receiving a telephone prescription for an antibiotic from a client's provider. Which of the following is the nurse required to do: 3) Read the prescription back to the provider after transcribing 4) Write the trade name for the prescribed medicine A nurse is providing teaching to an adolescent and her family regarding a new prescription of phenytoin (Dilantin) for a newly diagnosed seizure disorder. Which of the following client statements indicates the understanding of the teaching: 1) I will keep a seizure frequency chart 2) I will skip a dose if I am experiencing nausea A nurse is caring for a client who has heart failure and is receiving furosemide (Lasix) and digoxin (Lanoxin). Routine laboratory results reveal a potassium level of 2.6 mEq/L. Which of the following actions should the nurse take first: 1) Apply a cardiac monitor 2) Provides foods high in potassium A nurse administers ceftazidime (Fortaz) to a client who has a severe penicillin allergy. Which of the following client findings requires an incident report: 1) The client is also taking linsinophrel (Prinivil) 2) The client reports shortness of breath A nurse is providing teaching to a female client who has been newly diagnosed with a seizure disorder and has begun phenytoin (Dilantin). The nurse should tell the client that phenytoin can decrease the effectiveness of which of the following: 1) Ethunyl estradiol/desogestrel (Cyclessa) 2) Fluroxetine (Prozac) A nurse providing teaching to a client who is diagnosed with migrane headaches. The client is prescribed ergotamine (Ergostat) sublingual (SL). Which of the following should the nurse include in her instructions: 1) Take 1SL tablet three times a day before meals 2) Take 1SL tablet at onset of migrane A nurse is reviewing a client's daily laboratory findings before administering 0.125 mg of digoxin (Lanoxin). The client's serum digoxin level is 0.7 ng/mL. Which of the following actions should the nurse take: 1) Give the medication 2) Request a dose increase A nurse is planning to provide medication education for a client who will begin a course of therapy with metronidazole (Flagyl). Which of the following should the nurse instruct the client to avoid during the course of therapy: 3) Coffee 4) Beer A nurse is teaching a client who has heart failure about a new prescription for captopril (Capoten). Which of the following statements by the client indicates a need for further teaching: 3) I will take the medication 1 hr before my meals 4) I will use a salt substitute with my meals A client is experiencing acute angle closure glaucoma and IV mannitol (Osmitrol) 25% is prescribed. Which of the following client findings should the nurse recognize as being the best indication that the medication is achieving it's therapeutic effect: 3) Decrease in intraocular pressure 4)Lung fluids clear to ausculatation A nurse is educating a client who has a new prescription for simvastatin (Zacor). Which of the following instructions should the nurse include in the teaching plan: (Select all that apply): 3) Take the medication in the early morning A client taking IV heparin and oral warfarin (coumadin) for deep thrombosis. The client aPTT is 4x the normal value and his INR is 2. Which of the following actions should the nurse plan to take: 1) Decrease the heparin 2) Increase the warfarin 1) Report muscle pain to provider 2) Do not take the medication with grapefruit juice 4) Minimize intake of alcoholic beverages 5) Expect therapy with this medication to be life long The nurse is caring for a client who is in labor. The client is receiving oxytocin (pitocin) by continuous IV infusion, piggy backed into a maintenance IV solution. The external FHR monitor indicates late decelerations. Which of the following actions should the nurse take first: 1) Turn the client to side lying position 2) Discontinue the client's IV meds A nurse is providing teaching to a client taking bupropion (Zyban) as an aid to quit smoking. For which of the following side effects should the nurse assess the client: 3) Insomnia 4) Tinnitus A nurse is teaching a client about the use of resedronate (Actonel) to treat osteoporasis. Which of the following client statements indicates a need for further teaching: 3) I need to set up or stand after taking the risedronate 4) I need to take the risdronate with food A nurse is caring for a client who is receiving haloperidol (Haldol). For which of the following adverse effects should the nurse be observing: 1) vomiting 2) Akathesia A nurse is caring for a client who is receiving oprelvekin (Interleukin ll). which should the nurse document to indicate the effectiveness of the therapy: 1) Increased platelet count 2) Increased RBC count A nurse is administering baclofen (Lioresal) for a client with a spinal cord injury. Which of the following should the nurse document as a therapeutic outcome: 1) Increase in seizure threshold 2) Decrease flexor & extension spasticity A nurse is assessing a client who is receiving epoetin alfa (Procit) to treat anemia. For which should the nurse monitor related to this medication: 1) Paresthesias 2) Increased BP A nurse is planning teaching for a client who has depression and is to start a new prescription for tranylcypromine (Parnate). Which should be included in teaching: 1) Avoid eating citrus fruits while taking this medication 2) Move slowly when changing to a standing position Provide teaching new prescription: exenatide (Byetta) for Type 2 Diabetes. What should the nurse monitor and report: 1) Abdominal pain 2) Increased thirst A nurse is reveiwing lab results, for a patient who has chronic asthma and is taking prednisone (Deltasome) every other day. Which of the following lab values should the nurse report to the doctor: 3) Blood glucose 200 mg/dL 4) BUN 14 mg/dL A nurse is caring for a client receiving zidovudine (Retrovir) for which of the following lab results should the nurse prepare to monitor: 3) Serum creatine 4) Hemoglobin A client informs the nurse at the primary care providers office that he received a prescription for timolol (timoptic) to treat glaucoma. Which of the following in the client's history should concern you: 3) The client has a history of bradycardia 4) The client reports that he is taking loratadine (Claritan) A mom of a newborn asks the nurse when her newborn should receive his 1st diptheria, tetanus, and pertusis vaccine (DTAP). Which of the following should the nurse say: 1) Birth 2) 2 months A nurse is preparing to administer warfarin (coumadin) to a client diagnosed with atrial fibrillation. Which action should the nurse take before administering warfarin: 1) Check INR results 2) Monitor the aPTT level A nurse caring for a client diagnosed with sickle cell anemia who is taking hydroxyurea (Droxia). Which findings should the nurse report- select all that apply: 1) hemoglobin 4.2 g/dL 2) Hematocrit 42% 3) RBC 4,700,000/ mm3 A nurse assesses a patient with chronic back pain who is receving 650 mg acetaminophen (Tylenol) every 4 hours for pain. PCP has prescribed oxycodone/acetaminophen (Percocet) every 4 to 6 hours PRN for breakthrough pain. Which action should the nurse take: 3) Place the client on seizure precautions 4) Notify the PCP A nurse is teaching a patient who has a peptic ulcer disease and is to start a new prescription for sucralfate (Carafate). The nurse explains to the patient this medication: 3) Forms a protective barriers over ulcers 4) Treats ulcers by eradicating H. pylor 4) Platelets 75,000/mm3 5) Neutrophils 1,400 /mm3 Which of the following statements made by a client after a teaching session about Warfarin (Coumadin) indicates a need for further teaching: 1) I may take aspirin as needed for pain 2) I should limit the amount of green, leafy vegetables A nurse is caring for a patient who has pneumonia. The patient tells the nurse that she is pregnant, but has not told her provider. Which of the following medication orders should the nurse question: 1) Acetaminophen (Tylenol) 2) Doxycycline (Doxycin) A nurse is providing teaching to a patient who has hypertension and is to start a new prescription for lisinopril (Zestril). For which of the following should the nurse instruct the client to monitor and report to the PCP: 3) Facial Flushing 4) Dry cough A nurse caring for the following patient with acute ST elevation myocardinal infarction. The patient is receiving nitroglycerin (Nitro-bid IV) by continuous IV infusion to maintain a systolic blood pressure between 130-10 mmHg: 1) Increase the dose when the Systolic BP is 120 mmHg 2) Increase the dose when the Systolic BP is 160 mmHg Older adult taking procainamide (Pronestyl) is admitted to ER with an acute myocardinal infarction and ventricular premature beats. Which finding should indicate to the nurse to withold medication and notify PCP: 1) Drowsiness 2) A QRS widening increase than 50% A nurse is caring for a client who is taking tamoxifen (Nolvadex) for treatment of breast cancer. The nurse should inform the client that which of the side effects can develop:(Slect all that apply) 1) Bradycardia 2) Menstrual irregularities 3) Petechia A nurse is providing teaching to a patient with chronic asthma, is prescribed beclomethsdone (QVAR). What instructions should be included in the nursing care plan: 1) Use inhaler as soon as asthma attack begins 2) Take extra Vitamin B & C when using medication A client with history of hypertension tells the nurse that he uses over-the counter oral decongestant for nasal congestion. The nurse should advise client that decongestions? 3) Can constrict blood vessels 4) Are less effective than antihistamines A nurse is providing teaching for a patient with acute cystitus and is prescribed phenazopyridine HCL (Pyridium). Which side effect will be normal for the patient to see: 1) Urine will turn red-orange color 2) A mild fever A patient has been prescribed trimethoprim/sulfamethoxazole (Bactrum DS). Which of the following should the nurse reort: 3) Photosensitivity 4) Vescular, crusty rash A client has been taking propylthiouracil (PTU) for 4 weeks- what should an outcome be: 3) Decrease heart rate 4) Increase body temp 4) Hot flashes 5) Vaginal discharge A nurse instructing on appropriate placement of the client's nitroglycerin transdermal patch (Minitran) understands teaching with this statement: 1) I should apply the patch to an area of body with minimal fat tissue 2) I will take the patch off right after my evening meal A nurse is to administer a new prescription for amoxicillin/clavulanic acid (Augmentin) IV bolus. The client tells the nurse allergy to penicillin. Which should be done first: 3) Withhold the medication 4) Inform the pharmacist of allergy to penicillin A nurse providing discharge teaching for patient has a prescription for morphine. The nurse should: 3) Increase fiber intake 4) Increase dosage to relieve pain A nurse is monitoring a patient who has been prescribed amphoterian B (Fungizone) intermittent IV bolus for histoplasmosis. What adverse effects should you notify PCP: 1) Bradycardia 2) Fever A patient has been receiving aspirin for treatment of arthritis. Which symptom should indicate the client beginning to exhibit salicylism: 3) Excessive bruising 4) Tinnitus A nurse is caring for a patient who has cancer and is experiencing breakthrough pain every 6 to 8 hours. The client report pain level of 8 on a scale of 0 to 10. Which of the following analgesics should the nurse anticipate administering: 3) Celecoxib (Celebrax) 4) Hydromorpine (Dilaudid)