Free ATI Capstone Pharmacology practice for ATI Capstone Pharmacology Assessment 1 (ATI RN). Answer 59 nursing exam-style questions with rationales, exam mode,

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Question 1 of 59
ATI Capstone Pharmacology
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A nurse is caring for a client prescribed ferrous sulfate for the treatment of anemia. Which of the following instructions should be included in client teaching about this medication?

Select the best answer.

Correct Answer: A. Take the medication on an empty stomach to maximize absorption

Explanation:

The correct answer is A. The nurse should instruct clients to take iron on an empty stomach, 1 hour before meals to maximize absorption. This enhances the medication's effectiveness. Option B is incorrect because dark green stool is a common side effect of iron supplements and does not necessarily indicate a problem. Option C is incorrect as dietary fiber intake does not need to be decreased while taking iron supplements. Option D is incorrect because antacids can interfere with the absorption of iron and should not be taken at the same time.

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A nurse is caring for a client who has been prescribed amoxicillin. Which of the following client history findings requires the nurse to clarify the medication prescription?

Select the best answer.

Correct Answer: C. Asthma

Explanation:

The correct answer is C. Clients with a history of asthma should avoid amoxicillin due to potential hypersensitivity reactions. Amoxicillin can trigger asthma exacerbations in some individuals. Hypertension (choice A), peptic ulcer disease (choice B), and gastroesophageal reflux disease (choice D) are not contraindications for amoxicillin use, so they do not require the nurse to clarify the medication prescription in this case.

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A client has been prescribed isosorbide mononitrate. Which of the following should the nurse include in the client education related to this medication?

Select the best answer.

Correct Answer: A. This medication is prescribed for long-term therapy prophylaxis against anginal attacks

Explanation:

The correct answer is A because isosorbide mononitrate is used for long-term prophylaxis against anginal attacks. Choice B is incorrect because isosorbide mononitrate should not be crushed. Choice C does not specify a particular time for medication administration. Choice D is incorrect because isosorbide mononitrate is not meant to be taken as needed for chest pain; it is part of a long-term therapy plan.

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A nurse is reviewing a client's new prescription for albuterol. What client education should the nurse provide?

Select the best answer.

Correct Answer: B. Use this medication only as a rescue inhaler

Explanation:

The correct answer is B. Albuterol is a rescue inhaler that should be used during asthma attacks to provide quick relief by opening the airways. Using it daily as a preventive measure is not recommended. Choice A is incorrect because a dry cough is not a common side effect of albuterol. Choice C is incorrect as albuterol does not need to be taken with food. Choice D is incorrect because albuterol is not meant to be used daily for asthma prevention.

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A 45-year-old client is taking methylprednisolone. What pharmacologic action should the nurse expect with this therapy?

Select the best answer.

Correct Answer: B. Suppression of airway mucus production

Explanation:

The correct answer is B: Suppression of airway mucus production. Corticosteroids like methylprednisolone are known to suppress airway mucus production. This action helps in reducing inflammation and swelling in the airways, making breathing easier for individuals with conditions like asthma or COPD. Choices A, C, and D are incorrect. Suppression of beta2 receptors is more related to beta-blockers, fortification of bones is associated with medications like bisphosphonates, and suppression of candidiasis is not a typical pharmacologic action of methylprednisolone.

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A nurse is caring for a client receiving IV vancomycin. The nurse notes flushing of the client's neck and chest. Which of the following actions should the nurse take?

Select the best answer.

Correct Answer: C. Slow the infusion rate

Explanation:

The correct action for the nurse to take when a client receiving IV vancomycin shows flushing of the neck and chest is to slow the infusion rate. Flushing is a common sign of Red Man Syndrome, which is associated with rapid infusions of vancomycin. Slowing down the infusion rate can help prevent further flushing and the development of Red Man Syndrome. Stopping the infusion (Choice A) may be too drastic if the symptoms are mild and can be managed by slowing the rate. Documenting the findings as a harmless reaction (Choice B) is incorrect because flushing should be addressed promptly to prevent complications. Administering diphenhydramine (Choice D) is not the initial or best intervention for flushing associated with vancomycin; slowing the infusion rate is the priority.

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A client is receiving a dopamine infusion via a peripheral IV. Which of the following actions should the nurse take if the IV site appears infiltrated?

Select the best answer.

Correct Answer: B. Stop the infusion

Explanation:

When an IV site appears infiltrated, it indicates that the medication is leaking into the surrounding tissues. In such a situation, the infusion should be stopped immediately to prevent further tissue damage. Choice A is incorrect because slowing the infusion would still allow the medication to leak into the tissues. Choices C and D are also incorrect as applying compresses can exacerbate the tissue damage caused by infiltration.

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A nurse is caring for a client prescribed digoxin. Which of the following should alert the nurse to possible digitalis toxicity?

Select the best answer.

Correct Answer: A. Anorexia and weakness

Explanation:

The correct answer is A: Anorexia and weakness. These symptoms are early indicators of potential digitalis toxicity. Anorexia refers to a loss of appetite, which can be a sign of toxicity, and weakness can indicate an issue with digoxin. Choices B, C, and D are incorrect. Hyperactivity and hunger, tachycardia and increased urination, as well as polyphagia and polydipsia are not typically associated with digitalis toxicity.

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A nurse is caring for a client who is prescribed warfarin. Which of the following laboratory tests should the nurse review to evaluate the therapeutic effect of this medication?

Select the best answer.

Correct Answer: B. INR

Explanation:

The correct answer is B: INR. The International Normalized Ratio (INR) is the most reliable test for evaluating the therapeutic effects of warfarin therapy. INR measures the clotting ability of the blood and helps determine if the dosage of warfarin is within the therapeutic range. Choice A, aPTT, is not typically used to monitor the effects of warfarin. Choice C, Serum glucose, and choice D, Bilirubin, are not relevant to monitoring the therapeutic effect of warfarin.

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A nurse is preparing to administer morphine sulfate 2 mg IV bolus. Available is morphine sulfate 10 mg/mL. How many mL should the nurse administer per dose?

Select the best answer.

Correct Answer: A. 0.2 mL

Explanation:

The nurse should administer 0.2 mL of morphine sulfate. To calculate this, divide the desired dose (2 mg) by the concentration of the available solution (10 mg/mL). 2 mg / 10 mg/mL = 0.2 mL. Therefore, the nurse should administer 0.2 mL of morphine sulfate. Choices B, C, and D are incorrect as they do not reflect the accurate calculation based on the provided concentration and desired dose.

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A client is prescribed digoxin 0.125 mg daily for heart failure. Which of the following client reports should concern the nurse as a sign of digoxin toxicity?

Select the best answer.

Correct Answer: B. Visual disturbances

Explanation:

Visual disturbances such as blurred vision or seeing halos around lights are common signs of digoxin toxicity. Increased appetite, weight gain, and constipation are not typically associated with digoxin toxicity. Weight gain could be a sign of worsening heart failure rather than digoxin toxicity. Increased appetite and constipation are not specific signs of digoxin toxicity and are less likely to be related.

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A healthcare provider is preparing to administer heparin sodium to a client with deep vein thrombosis (DVT). Which of the following laboratory values should the provider monitor during therapy?

Select the best answer.

Correct Answer: C. aPTT

Explanation:

The correct answer is C: aPTT. The healthcare provider should monitor the activated partial thromboplastin time (aPTT) value during heparin therapy to assess the client's coagulation status. Heparin affects the intrinsic pathway of the coagulation cascade, and monitoring aPTT helps ensure that the client is within the therapeutic range to prevent bleeding or clotting issues. INR (Choice A) is used to monitor warfarin therapy, not heparin. Serum creatinine (Choice B) is not directly related to monitoring heparin therapy. Bilirubin (Choice D) is related to liver function, not heparin therapy.

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A client prescribed hydromorphone for severe pain has a decreased respiratory rate from 16 breaths per minute to 6. Which of the following medications should the nurse prepare to administer?

Select the best answer.

Correct Answer: B. Naloxone

Explanation:

Naloxone is the correct answer as it is used to reverse opioid-induced respiratory depression. Hydromorphone is an opioid medication that can cause respiratory depression at high doses. Naloxone is an opioid antagonist that competes with opioids at receptor sites, reversing the effects of opioids like hydromorphone. Flumazenil (Choice A) is a benzodiazepine antagonist used for benzodiazepine overdose, not opioid overdose. Activated charcoal (Choice C) is used for toxin ingestion to prevent absorption in the gastrointestinal tract, but it is not indicated for opioid overdose. Aluminum hydroxide (Choice D) is an antacid and would not be the appropriate intervention for respiratory depression caused by opioid overdose.

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When administering amlodipine to a client with hypertension, what adverse effect should the nurse monitor for?

Select the best answer.

Correct Answer: C. Hypotension

Explanation:

The correct answer is C, Hypotension. Amlodipine is a calcium channel blocker commonly used to treat hypertension. One of the main adverse effects of amlodipine is hypotension, leading to low blood pressure. The nurse should monitor the client for signs of hypotension such as dizziness, lightheadedness, or fainting. Choices A, B, and D are incorrect because constipation, facial flushing, and jaundice are not typically associated with amlodipine administration.

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A client has been prescribed metoclopramide. Which of the following should the nurse include in client education regarding this medication?

Select the best answer.

Correct Answer: A. Notify your provider if you experience restlessness or spasms of the face or neck

Explanation:

The correct answer is A: 'Notify your provider if you experience restlessness or spasms of the face or neck.' Metoclopramide can lead to extrapyramidal symptoms such as restlessness or facial spasms, which are serious and require immediate medical attention. Choices B, C, and D are incorrect. Insomnia is not a common side effect of metoclopramide. Increasing fluid intake is usually recommended to prevent dehydration caused by potential side effects like diarrhea. Urinary frequency is not a typical side effect associated with metoclopramide.

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A nurse has provided education to a client regarding prescribed levothyroxine sodium. Which of the following client statements demonstrates understanding of medication administration?

Select the best answer.

Correct Answer: C. I should take the medication in the morning to prevent insomnia

Explanation:

Levothyroxine should be taken once in the morning to prevent insomnia and maintain therapeutic levels.

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A nurse is caring for a client prescribed methotrexate for rheumatoid arthritis. Which of the following client history findings requires the nurse to question the administration of this medication?

Select the best answer.

Correct Answer: C. Peptic ulcer disease

Explanation:

The correct answer is C: Peptic ulcer disease. Methotrexate can exacerbate peptic ulcer disease, leading to serious complications. This finding warrants questioning the administration of methotrexate to prevent harm to the client. Choices A, B, and D are not directly contraindicated with methotrexate use. Osteoporosis, hypertension, and immunosuppression are not typically reasons to question the administration of methotrexate for rheumatoid arthritis.

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A client is prescribed HMG CoA reductase inhibitor, atorvastatin. Which of the following should be monitored while this medication is prescribed?

Select the best answer.

Correct Answer: A. Liver function tests

Explanation:

The correct answer is A: Liver function tests. Atorvastatin, an HMG CoA reductase inhibitor, can lead to hepatotoxicity, making it essential to monitor liver function tests regularly. Choices B, C, and D are incorrect because atorvastatin primarily affects the liver, not the kidneys, vision, or hearing.

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A healthcare provider is preparing to administer a measles, mumps, and rubella (MMR) vaccine to an adult client. Which of the following is a contraindication to this vaccine?

Select the best answer.

Correct Answer: A. The possibility of pregnancy within 4 weeks

Explanation:

The correct answer is A. Pregnancy or the possibility of pregnancy within 4 weeks is a contraindication for receiving the MMR vaccine. Choice B, client allergy to strawberries, is not a contraindication to the MMR vaccine. Choice C, client history of genital herpes, is not a contraindication for the MMR vaccine. Choice D, the possibility of overseas travel in the next month, is not a contraindication to the MMR vaccine.

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A nurse is preparing to administer metoprolol to a client with hypertension. Which of the following should the nurse assess prior to administering this medication?

Select the best answer.

Correct Answer: D. Blood pressure

Explanation:

The correct answer is D: Blood pressure. Before administering metoprolol, a beta-blocker commonly used to treat hypertension, the nurse should assess the client's blood pressure. Metoprolol works by lowering blood pressure and reducing the workload on the heart. Assessing the blood pressure is crucial to ensure it is within the acceptable range to administer the medication safely. Choices A, B, and C (Temperature, Heart rate, Respiratory rate) are important assessments in general patient care but are not specifically required before administering metoprolol for hypertension.

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A client has been prescribed lisinopril. Which of the following medication interactions should the nurse instruct this client about?

Select the best answer.

Correct Answer: A. Potassium supplements

Explanation:

The correct answer is A: Potassium supplements. Clients taking lisinopril should avoid potassium supplements and potassium-sparing diuretics due to the risk of hyperkalemia. This interaction can lead to dangerously high levels of potassium in the blood, which can be harmful. Choice B, Ciprofloxacin, is not typically associated with a significant interaction with lisinopril. Choice C, Escitalopram, is an antidepressant and does not have a known significant interaction with lisinopril regarding potassium levels. Choice D, Magnesium supplements, are generally safe to take with lisinopril and do not pose a significant risk of hyperkalemia.

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A nurse is preparing to administer nitroglycerin ointment to a client. Which of the following actions should the nurse take?

Select the best answer.

Correct Answer: A. Apply the ointment to the client's hairless chest

Explanation:

The correct action is to apply the nitroglycerin ointment to a hairless area of the client's chest, back, or upper arms. This allows for better absorption of the medication. Choice B is incorrect because rubbing the ointment gently into the skin may be appropriate, but the primary action is to ensure application on a hairless area. Choice C is incorrect as covering the ointment with a transparent dressing is not a standard practice for nitroglycerin ointment administration. Choice D is incorrect because massaging the ointment into the skin is not recommended, as it can alter absorption rates.

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A client has been prescribed vasopressin for the treatment of diabetes insipidus. What is the expected pharmacologic action of this medication?

Select the best answer.

Correct Answer: C. To increase reabsorption of water in the renal tubules

Explanation:

The correct answer is C: To increase reabsorption of water in the renal tubules. Vasopressin, also known as antidiuretic hormone (ADH), works by increasing the reabsorption of water in the renal tubules, which helps to concentrate urine and reduce excessive urination in diabetes insipidus. Choice A is incorrect as vasopressin does not stimulate the pancreas to secrete insulin. Choice B is incorrect as vasopressin does not affect the absorption of glucose in the intestine. Choice D is incorrect as vasopressin's primary action is not to increase blood pressure, although it can have some vasoconstrictive effects.

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Before administering blood products, which action should be taken?

Select the best answer.

Correct Answer: A. Assess the client's temperature

Explanation:

Correct answer: Before administering blood products, the client's temperature must be assessed to establish a baseline and monitor for transfusion reactions. Choice B is incorrect because documenting client response should occur after administering the blood products. Choice C is incorrect as priming IV tubing with 0.45% sodium chloride is not directly related to assessing the client before administering blood products. Choice D is incorrect because administering epinephrine is not a routine action before administering blood products.

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A nurse is caring for a client prescribed montelukast. Which of the following should the nurse include in teaching related to this medication?

Select the best answer.

Correct Answer: A. Advise the client to take the medication once daily at bedtime

Explanation:

The correct answer is to advise the client to take montelukast once daily at bedtime to maintain therapeutic effects. Choice B is incorrect because montelukast is not typically used for acute asthma management but for chronic treatment. Choice C is incorrect as there are no known interactions between montelukast and dairy products. Choice D is incorrect as it is not safe to double up on doses if the client forgets to take the medication; the missed dose should be skipped and the regular dosing schedule maintained.

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A nurse is preparing to administer ondansetron to a client. Which of the following therapeutic effects should the nurse expect from this medication?

Select the best answer.

Correct Answer: A. Decreased nausea

Explanation:

The correct answer is A: Decreased nausea. Ondansetron is classified as an antiemetic medication, which means it is used to relieve nausea and vomiting by blocking serotonin in the chemoreceptor trigger zone. Therefore, the nurse administering ondansetron should expect a therapeutic effect of decreased nausea. Choice B, increased appetite, is incorrect as ondansetron does not affect appetite. Choice C, increased heart rate, is incorrect as ondansetron does not have a direct effect on heart rate. Choice D, relief of headache, is also incorrect as the primary therapeutic effect of ondansetron is to alleviate nausea and vomiting, not headaches.

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A healthcare provider is preparing to administer bisacodyl suppository to a client. Which of the following actions should the healthcare provider take?

Select the best answer.

Correct Answer: B. Lubricate index finger

Explanation:

The correct action when administering a bisacodyl suppository is to lubricate the index finger for easier insertion. Using a rectal applicator for insertion is not recommended for bisacodyl suppositories. Positioning the client supine with knees bent is not necessary for the administration of a bisacodyl suppository. While wearing gloves is important for infection control, sterile gloves are not required for this procedure.

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A nurse is preparing to administer furosemide to a client. Which of the following findings indicates the client may be at risk for an adverse effect of the medication?

Select the best answer.

Correct Answer: B. Hypokalemia

Explanation:

The correct answer is B: Hypokalemia. Furosemide is a loop diuretic that can cause potassium depletion, leading to hypokalemia, which is a common adverse effect. Hypokalemia can result in serious complications like cardiac arrhythmias. Choices A, C, and D are not directly associated with the adverse effects of furosemide. Hypertension is a condition that furosemide is often used to treat, increased urine output is an expected effect of furosemide, and hyperglycemia is not a typical adverse effect of this medication.

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A nurse is caring for a client with diabetes and a new prescription for 14 units of regular insulin and 28 units of NPH insulin subcutaneously at breakfast daily. What is the total number of units of insulin that the nurse should prepare in the insulin syringe?

Select the best answer.

Correct Answer: D. 42 units

Explanation:

The nurse should combine both orders of insulin in the same syringe. To prepare the correct dose, the nurse should withdraw the regular insulin first (14 units) and then the NPH insulin (28 units), totaling 42 units. This combination ensures the client receives the prescribed doses of both types of insulin. Choices A, B, and C are incorrect because the nurse needs to prepare and administer both types of insulin as prescribed, resulting in a total of 42 units in the syringe.

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A nurse is caring for a client newly prescribed doxazosin mesylate. Which of the following instructions should the nurse include in client education regarding taking the first dose of this medication?

Select the best answer.

Correct Answer: A. Change positions slowly and lie down if dizziness occurs

Explanation:

Corrected Rationale: First-dose orthostatic hypotension can occur with doxazosin. The nurse should advise the client to change positions slowly and lie down if dizziness occurs. Choice B is incorrect because it does not address the potential side effect of dizziness. Choice C and D are also incorrect as there is no specific dietary restriction related to doxazosin mesylate.

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A nurse is reviewing a client's medication regimen. Which of the following medications places the client at increased risk for digoxin toxicity?

Select the best answer.

Correct Answer: D. Loop diuretics

Explanation:

The correct answer is D, Loop diuretics. Loop diuretics can lead to hypokalemia, which increases the risk for digoxin toxicity. Loop diuretics cause potassium loss, and hypokalemia can potentiate the toxic effects of digoxin. Choices A, B, and C are incorrect because calcium channel blockers, potassium-sparing diuretics, and beta blockers do not directly increase the risk of digoxin toxicity.

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A nurse is caring for a client receiving theophylline for chronic obstructive pulmonary disease (COPD). Which of the following client findings indicates the need for immediate intervention?

Select the best answer.

Correct Answer: D. Polyuria

Explanation:

Polyuria is a sign of theophylline toxicity and requires immediate intervention. Theophylline toxicity can lead to serious complications, and polyuria is a concerning symptom that indicates the need for urgent medical attention. Productive cough, drowsiness, and vomiting are common side effects of theophylline but are not typically indicative of immediate life-threatening issues like polyuria in the context of theophylline toxicity.

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A client with an artificial heart valve is prescribed warfarin therapy. Which of the following laboratory values should the nurse monitor to assess the therapeutic effect of warfarin?

Select the best answer.

Correct Answer: B. Prothrombin time (PT)

Explanation:

The correct answer is B: Prothrombin time (PT). Warfarin is an anticoagulant medication that works by inhibiting the clotting factors dependent on vitamin K, such as factors II, VII, IX, and X. The prothrombin time (PT) measures the extrinsic pathway and is used to monitor the therapeutic effects of warfarin therapy. Monitoring PT helps assess the time it takes for the blood to clot, ensuring that the anticoagulant effect is within the desired range. Choices A, C, and D are incorrect because hemoglobin (Hgb) measures the amount of hemoglobin in the blood, bleeding time assesses the time it takes for bleeding to stop, and activated partial thromboplastin time (aPTT) is used to monitor heparin therapy, not warfarin therapy.

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A healthcare professional is caring for a client receiving gentamicin therapy. Which of the following client assessments is a priority for the healthcare professional to monitor for an adverse effect of this medication?

Select the best answer.

Correct Answer: D. Hearing acuity

Explanation:

The correct answer is D: Hearing acuity. Gentamicin is known to be ototoxic, which means it can cause damage to the auditory system leading to hearing loss. Monitoring hearing acuity is crucial to detect early signs of hearing impairment. Monitoring urinary output (choice A) is important for assessing kidney function but is not directly related to gentamicin's adverse effects. Monitoring serum glucose (choice B) and respiratory rate (choice C) are not specifically associated with gentamicin therapy.

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A client is receiving magnesium sulfate for the management of preeclampsia. Which of the following client assessments should the nurse monitor to prevent complications of therapy?

Select the best answer.

Correct Answer: B. Deep tendon reflexes

Explanation:

The correct answer is deep tendon reflexes. Monitoring deep tendon reflexes is crucial to assess for magnesium toxicity during therapy for preeclampsia. Magnesium sulfate can lead to neuromuscular blockade, reflected by decreased or absent deep tendon reflexes. Assessing bowel sounds (choice A) is important for gastrointestinal function but is not directly related to magnesium sulfate therapy. Oxygen saturation (choice C) is vital for respiratory status but is not specifically linked to magnesium sulfate administration. Fluid balance (choice D) is essential but does not directly correlate with monitoring for complications of magnesium sulfate therapy in the context of preeclampsia.

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A nurse is reviewing the medical record of a client who is prescribed acetaminophen for pain. Which of the following lab values should the nurse monitor to identify an adverse effect of the medication?

Select the best answer.

Correct Answer: B. Serum creatinine

Explanation:

The correct answer is B: Serum creatinine. Acetaminophen is metabolized by the liver, so serum creatinine levels should be monitored for potential hepatotoxicity. Monitoring serum creatinine can help detect liver damage, a potential adverse effect of acetaminophen. Choices A, C, and D are incorrect because serum glucose is not directly affected by acetaminophen, serum potassium is not typically monitored for acetaminophen adverse effects, and serum bilirubin is more related to bile metabolism rather than acetaminophen-induced hepatotoxicity.

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A nurse is caring for a client with hypothyroidism. Which of the following findings indicates that the client is experiencing an adverse effect from the prescribed levothyroxine?

Select the best answer.

Correct Answer: A. Tachycardia

Explanation:

Tachycardia is the correct answer as it is an adverse effect of levothyroxine. Levothyroxine is a medication used to treat hypothyroidism by supplementing the body with thyroid hormone. Tachycardia, or a fast heart rate, can indicate an overdosage or increased sensitivity to levothyroxine. Bradycardia, slow heart rate, weight loss, and increased appetite are not typically associated with adverse effects of levothyroxine. Bradycardia may actually be a symptom of untreated hypothyroidism.

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A client is receiving chemotherapy and develops stomatitis. Which of the following interventions should the nurse include in the client's plan of care?

Select the best answer.

Correct Answer: A. Apply warm compresses to the mouth

Explanation:

The correct answer is to apply warm compresses to the mouth. Stomatitis is an inflammation of the mucous lining in the mouth and can be a side effect of chemotherapy. Warm compresses can help soothe the affected area and promote healing. Choice B is incorrect because alcohol-based mouthwash can further irritate the mouth. Choice C is also a good intervention as increasing fluid intake can help keep the mouth moist and promote healing. However, the most direct intervention for soothing and healing the affected area is applying warm compresses. Choice D is incorrect because using a firm toothbrush can be too harsh and cause further irritation.

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A healthcare provider is reviewing the client's history before administering opioid pain medication. Which of the following conditions is a contraindication to opioid therapy?

Select the best answer.

Correct Answer: B. Renal failure

Explanation:

Renal failure is a contraindication to opioid therapy due to the risk of drug accumulation and toxicity. Asthma, diabetes mellitus, and obesity are not contraindications to opioid therapy. Asthma is a respiratory condition that can be managed alongside opioids, diabetes mellitus and obesity do not directly contraindicate opioid therapy.

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A nurse is providing client education on how to administer insulin. Which of the following instructions should the nurse include?

Select the best answer.

Correct Answer: B. Rotate injection sites to prevent lipodystrophy

Explanation:

The correct instruction for administering insulin is to rotate injection sites to prevent lipodystrophy, a common complication of insulin therapy. Injecting into the deltoid muscle (Choice A) is not recommended for insulin injections. Massaging the site after injection (Choice C) is not necessary and can potentially increase the risk of lipodystrophy. Using the same site for each injection (Choice D) can lead to localized tissue damage and absorption irregularities, making it an incorrect choice.

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A client is prescribed propranolol. Which of the following client history findings would require the nurse to clarify this medication prescription?

Select the best answer.

Correct Answer: A. Asthma

Explanation:

The correct answer is A: Asthma. Clients with asthma should avoid Beta2 Blockade agents like propranolol as they can lead to bronchoconstriction, potentially worsening asthma symptoms. Choice B, hypertension, is not a contraindication for propranolol; in fact, it is commonly prescribed for hypertension. Choice C, tachydysrhythmias, is often an indication for propranolol due to its antiarrhythmic properties. Choice D, urolithiasis, does not directly impact the use of propranolol.

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A client prescribed lisinopril for hypertension may experience which of the following side effects that the nurse should monitor for?

Select the best answer.

Correct Answer: A. Cough

Explanation:

A persistent dry cough is a common side effect of lisinopril. Lisinopril is an ACE inhibitor that can cause a cough due to the accumulation of bradykinin. Weight gain, dry mouth, and hyperglycemia are not typically associated with lisinopril use, making them incorrect choices in this scenario.

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A nurse is caring for a client receiving patient-controlled analgesia (PCA). Which of the following interventions should the nurse take while caring for this client?

Select the best answer.

Correct Answer: B. Encourage the client to use the PCA before dressing changes

Explanation:

The correct answer is B because encouraging the client to use the PCA before dressing changes helps in managing pain proactively. Choice A is incorrect as PCA is a safe method of pain control when used appropriately, and the nurse should not suggest using it sparingly. Choice C is incorrect as only the client should operate the PCA to ensure they are in control of their pain management. Choice D is incorrect as changing the PCA limit without proper assessment and orders from the healthcare provider can lead to adverse effects.

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A nurse is preparing to administer potassium chloride IV to a client. Which of the following actions should the nurse take to prevent complications?

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Correct Answer: B. Infuse the medication slowly using an IV pump

Explanation:

The correct action to prevent complications when administering potassium chloride IV is to infuse the medication slowly using an IV pump. Rapid administration of potassium chloride can lead to complications such as hyperkalemia and cardiac arrest. Options A, C, and D are incorrect as they do not promote the safe administration of potassium chloride. Administering the medication by IV bolus over 2 minutes is too rapid and can cause adverse effects. Adding the medication to an IV solution of D5W or diluting it in sterile water may not control the rate of administration, increasing the risk of complications.

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A nurse is administering metformin to a client with type 2 diabetes. Which of the following adverse effects should the nurse monitor for in this client?

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Correct Answer: D. Lactic acidosis

Explanation:

The correct answer is D, Lactic acidosis. Lactic acidosis is a rare but serious adverse effect of metformin use. Metformin is not known to cause hyperglycemia or hypoglycemia. Diarrhea is a common gastrointestinal side effect of metformin but is not as serious as lactic acidosis, which requires immediate medical attention.

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A nurse is providing care to a client with staphylococcus epidermidis who is prescribed vancomycin. Identify the adverse effect associated with the antibiotic therapy.

Select the best answer.

Correct Answer: C. Infusion reaction

Explanation:

The correct answer is C: Infusion reaction. Vancomycin can cause infusion reactions like 'Red Man Syndrome,' which involves rashes, flushing, tachycardia, and hypotension. Hepatotoxicity (choice A) is not a common adverse effect of vancomycin. Constipation (choice B) is not typically associated with vancomycin use. Immunosuppression (choice D) is not a direct adverse effect of vancomycin therapy.

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Disulfiram is taken by a client daily for abstinence maintenance. What is an adverse effect of this therapy?

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Correct Answer: A. Hepatotoxicity

Explanation:

The correct answer is A: Hepatotoxicity. Disulfiram is known to cause hepatotoxicity as a severe adverse effect. This occurs due to the inhibition of aldehyde dehydrogenase, leading to the accumulation of acetaldehyde when alcohol is consumed. Wernicke's aphasia (Choice B) is a language disorder unrelated to disulfiram therapy. Suicidal ideations (Choice C) may be associated with certain medications, but it is not a common adverse effect of disulfiram. Diarrhea (Choice D) is not a typical adverse effect of disulfiram.

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A nurse is caring for a client prescribed clopidogrel. Which of the following client histories is a contraindication to the administration of this medication?

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Correct Answer: D. Uncontrolled hypertension

Explanation:

The correct answer is D: Uncontrolled hypertension. Clopidogrel should not be administered to clients with uncontrolled hypertension due to the increased risk of bleeding. Recent surgery, peptic ulcer disease, and bleeding disorders are not absolute contraindications for clopidogrel administration.

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A nurse is providing client education regarding lithium therapy. Which of the following instructions should the nurse include?

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Correct Answer: B. Avoid excessive intake of caffeinated beverages

Explanation:

The correct answer is B. The nurse should instruct the client to avoid excessive intake of caffeinated beverages as they can interfere with lithium levels. Option A is incorrect as lithium is usually recommended to be taken on an empty stomach. Option C is not directly related to lithium therapy. Option D is not a typical instruction for lithium therapy.

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A client receiving epoetin alfa therapy for anemia is being monitored for therapeutic effects. Which of the following laboratory values indicates the medication is effective?

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Correct Answer: B. Hematocrit

Explanation:

The correct answer is B: Hematocrit. An increase in hematocrit levels indicates the effectiveness of epoetin alfa in treating anemia. Hematocrit reflects the percentage of red blood cells in the blood, so an increase in hematocrit signifies an improvement in the patient's red blood cell count and oxygen-carrying capacity. Choices A, C, and D are incorrect because white blood cell count, platelet count, and red blood cell count do not directly reflect the therapeutic effects of epoetin alfa in treating anemia.

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A 55-year-old client has levothyroxine ordered. Which of the below past medical history concerns may contraindicate with her medication management of hypothyroidism?

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Correct Answer: B. Osteoporosis

Explanation:

The correct answer is B: Osteoporosis. Osteoporosis is a concern with levothyroxine as it can increase the risk for fractures, particularly in older adults. Levothyroxine treatment can exacerbate bone loss in individuals with osteoporosis. Choices A, C, and D are not directly contraindicated with levothyroxine therapy for hypothyroidism.

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A healthcare provider has just administered a wrong medication to a client. Which of the following actions should the provider take next?

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Correct Answer: B. Report error to the provider

Explanation:

In the scenario where a wrong medication has been administered, it is crucial for the healthcare provider to report the error to the provider. This action is essential to ensure that the provider is informed promptly, corrective measures are taken, and the client's well-being is safeguarded. Choice A is incorrect as taking no action could lead to serious consequences and compromise patient safety. Choice C, while important, should come after reporting the error to the provider. Choice D is not the immediate priority as the provider should first focus on addressing the error internally.

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A nurse is reviewing the medication class benzodiazepines. The nurse would use caution when administering benzodiazepines to which of the below clients?

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Correct Answer: A. A client with glaucoma

Explanation:

The correct answer is A. Benzodiazepines should be used cautiously in clients with glaucoma because these medications can increase intraocular pressure. Choices B, C, and D are incorrect because renal failure, hypertension, and insomnia are not contraindications for administering benzodiazepines.

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A 52-year-old client with a history of angina has been prescribed transdermal nitroglycerin. Which of the following adverse effects is not associated with this therapy?

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Correct Answer: D. Productive cough

Explanation:

The correct answer is D: Productive cough. Nitroglycerin therapy can lead to adverse effects such as tolerance, orthostatic hypotension, and headache. However, it is not known to cause a productive cough. Tolerance may develop over time, requiring dose adjustments. Orthostatic hypotension can occur due to vasodilation effects, leading to a sudden drop in blood pressure when changing positions. Headache is a common side effect due to vasodilation of cranial blood vessels. Productive cough is not a recognized adverse effect associated with transdermal nitroglycerin therapy.

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A nurse is caring for a client taking ciprofloxacin for an infection. Which of the following adverse effects should the nurse include in the client education?

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Correct Answer: B. Tendon rupture

Explanation:

The correct answer is B: Tendon rupture. Ciprofloxacin belongs to the fluoroquinolone class of antibiotics, which is associated with the adverse effect of tendon rupture. Tendon rupture is a severe but rare side effect that can occur with the use of ciprofloxacin. Educating the client about this potential adverse effect is crucial to promote awareness and early recognition of symptoms, such as tendon pain, swelling, or inflammation. Choices A, C, and D are not typically associated with ciprofloxacin use and are less relevant for client education in this scenario.

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A nurse is preparing to administer an intramuscular injection to an adult client. At what angle should the nurse administer the medication using the ventrogluteal site?

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Correct Answer: D. a 90-degree angle

Explanation:

Intramuscular injections in the ventrogluteal site should be administered at a 90-degree angle. This angle ensures that the medication reaches the muscle tissue effectively. Angles less than 90 degrees can cause subcutaneous injection instead of intramuscular, leading to slower absorption of the medication. Angles greater than 90 degrees risk hitting bone or nerves, causing unnecessary pain or injury. Therefore, the correct angle for administering intramuscular injections in the ventrogluteal site is 90 degrees.

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A client is prescribed spironolactone. Which of the following findings would indicate an adverse effect of this medication?

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Correct Answer: A. Hyperkalemia

Explanation:

Hyperkalemia is the correct answer as it is an adverse effect associated with spironolactone, a potassium-sparing diuretic. Spironolactone works by blocking the aldosterone receptor in the distal convoluted tubule, leading to decreased potassium excretion and potential hyperkalemia. Hypokalemia (choice B) and hyponatremia (choice C) are not typically associated with spironolactone use. Hypernatremia (choice D) is also an unlikely finding with spironolactone.

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A nurse is caring for a client prescribed enoxaparin for deep vein thrombosis prophylaxis. Which of the following client assessments requires immediate intervention?

Select the best answer.

Correct Answer: A. Platelet count of 95,000/mm³

Explanation:

A platelet count of 95,000/mm³ requires immediate intervention as it is low and increases the risk of bleeding, which is a potential complication of enoxaparin therapy. Low platelet counts can predispose the patient to hemorrhage, and administering anticoagulants like enoxaparin in such cases can further increase the bleeding risk. Monitoring platelet counts is crucial during anticoagulant therapy to prevent serious bleeding complications. The other options do not pose immediate risks related to enoxaparin therapy. A slightly elevated blood pressure, a heart rate of 95 beats per minute, and pain at the injection site are common findings that may not warrant immediate intervention in this context.

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A nurse is caring for a client prescribed enoxaparin for deep vein thrombosis prophylaxis. Which of the following client assessments requires immediate intervention?

Select the best answer.

Correct Answer: A. Platelet count of 95,000/mm³

Explanation:

A platelet count of 95,000/mm³ requires immediate intervention as it is low and increases the risk of bleeding, which is a potential complication of enoxaparin therapy. Low platelet counts can predispose the patient to hemorrhage, and administering anticoagulants like enoxaparin in such cases can further increase the bleeding risk. Monitoring platelet counts is crucial during anticoagulant therapy to prevent serious bleeding complications. The other options do not pose immediate risks related to enoxaparin therapy. A slightly elevated blood pressure, a heart rate of 95 beats per minute, and pain at the injection site are common findings that may not warrant immediate intervention in this context.

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