Module 2 Week 8 Exam Pharmacology II

A nurse is caring for a 68-year-old client prescribed theophylline for chronic bronchitis, with a recent theophylline serum level of 21 mcg/mL. Which of the following findings should the nurse report immediately to the healthcare provider?. Heart rate of 102 beats per minute. Mild hand tremors. Nausea and persistent vomiting. Fasting blood glucose of 130 mg/dL.

The nurse is preparing to administer a newly prescribed dose of ipratropium bromide via inhaler to a client diagnosed with chronic obstructive pulmonary disease (COPD). During the assessment, the client states, "I have a severe allergy to peanuts." What action should the nurse take first?. Contact the healthcare provider to report the client's allergy. Administer the medication as prescribed and observe for a reaction. Hold the dose and document the allergy in the medical record. Educate the client about common side effects of ipratropium.

The nurse is providing discharge teaching to a client who has been prescribed an over-the-counter nasal decongestant spray. Which client statements indicate the need for further teaching? Select all that apply. "I will use this spray when my nasal congestion becomes severe.". "If I don't feel better, I'll keep using the spray for the rest of the week.". "I will stop using the spray after two days, even if I still feel stuffy.". "This medication can help relieve my nasal stuffiness.". "If one spray doesn't work, I'll just use more until I can breathe.". "I'll use the spray every few hours for the next several days to stay clear.".

A 52-year-old client is being treated for active tuberculosis with isoniazid, rifampin, and pyrazinamide, which the client started six weeks ago. The client presents to the clinic with complaints of persistent fatigue, dark-colored urine, and yellowing of the eyes that began three days ago. The client reports difficulty concentrating, reduced appetite, and mild nausea. What is the nurse's priority action?. Reassure the client that these are common side effects and document the findings. Instruct the client to increase fluid intake to promote renal clearance of toxins. Contact the healthcare provider to report possible hepatotoxicity. Schedule the client for routine follow-up visits in one week.

he nurse receives an order to administer 2 puffs of salmeterol and 2 puffs of beclomethasone dipropionate via metered-dose inhaler. What is the appropriate sequence for administering these inhaled medications?. Give beclomethasone before administering salmeterol. Give salmeterol before administering beclomethasone. Alternate puffs between the two medications, starting with salmeterol. Alternate puffs between the two medications, starting with beclomethasone.

A client is receiving a continuous IV infusion of heparin sodium for treatment of a pulmonary embolism. The client has been on the infusion for 24 hours. The nurse reviews the most recent activated partial thromboplastin time (aPTT) result, which is 110 seconds. The client's baseline aPTT prior to therapy was 32 seconds. Which action should the nurse take next?. Continue the infusion at the current rate and recheck aPTT in 4 hours. Stop the infusion and prepare to administer vitamin K as an antidote. Decrease the rate of the infusion per protocol and notify the healthcare provider. Administer an additional bolus of heparin and continue the infusion.

The nurse is teaching a client who is beginning anticoagulant therapy. Which of the following substances should the nurse instruct the client to avoid? Select all that apply. Ginkgo biloba supplements. Cimetidine. Acetaminophen. Green, leafy vegetables. Ibuprofen. Docusate sodium. Salicylates.

The nurse is reviewing client histories to identify those for whom thrombolytic therapy (e.g., alteplase) would be contraindicated. Select all that apply. Recent ischemic stroke 2 weeks ago. Active internal bleeding. History of peptic ulcer disease, currently asymptomatic. Blood pressure of 185/110 mm Hg at time of assessment. Use of anticoagulants with INR of 3.5. Acute myocardial infarction within past 3 hours. Postoperative hip replacement, 10 days ago.

A client arrives at the emergency department with chest pain that started 2 hours ago. The healthcare provider prescribes alteplase. Upon assessment, the nurse notes that the client underwent a hip replacement 10 days ago, has a blood pressure of 186/112 mm Hg, and reports mild hematuria. What is the nurse's priority action?. Prepare the client for immediate administration of alteplase. Notify the healthcare provider of findings before administering the medication. Administer the alteplase while monitoring the client closely. Administer a lower dose of alteplase.

The healthcare provider prescribes ampicillin 375 mg PO every 6 hours for a pediatric client who weighs 44 lb. The available concentration is 250 mg per 5 mL. How many milliliters should the nurse administer per dose? Record your answer using one decimal place. 7.5. 7.0. 8.5.

A healthcare provider prescribes acetaminophen 15 mg/kg PO for a child who weighs 33 lb. The available medication concentration is 160 mg per 5 mL. How many milliliters should the nurse administer? Round to the nearest tenth. 8.5 mL. 7.0 mL. 7.5 mL.

A healthcare provider prescribes dopamine at 5 mcg/kg/min for a client who weighs 154 lb. The medication is supplied as 400 mg in 250 mL of D5W. The IV pump delivers mL/hr. How many mL/hr should the nurse set on the IV pum? Round to the nearest whole number. 13 mL/hr. 10 mL/hr. 15 mL/hr.

A healthcare provider prescribes ceftriaxone 1 g IV to be infused over 30 minutes. The available solution is 100 mL. The drop factor is 10 gtt/mL. How many drops per minute (gtt/min) should the nurse administer? Round to the nearest whole number. 33 gtt/min. 45 gtt/min. 30.5 gtt/min.

A provider prescribes 1000 mL of 0.9% NS to infuse over 8 hours. The drop factor of the IV tubing is 15 gtt/mL. How many drops per minute (gtt/min) should the nurse administer? Round to the nearest whole number. 31 gtt/min. 48 gtt/min. 30.5 gtt/min.

A provider prescribes 500 mL of D5W to be infused over 3 hours. The IV tubing has a drop factor of 20 gtt/mL. How many drops per minute (gtt/min) should the nurse administer? Round to the nearest whole number. 55 gtt/min. 56 gtt/min. 33 gtt/min.

A pediatric client is suspected of dehydration. The provider orders to monitor output. The dry diaper weighs 30 grams. After one hour, the wet diaper weighs 190 grams. How many milliliters of urine output did the client have in one hour? (Note: 1 gram = 1 mL of urine). 160 mL. 120 mL. 100 mL.

A provider prescribes oral amoxicillin 30 mg/kg/day for a child who weighs 55 lb. The dose is to be divided into two equal doses per day. The medication is available as 250 mg/5 mL. How many mL should the nurse administer per dose? Round to the nearest tenth. 3.3 mL. 7.5 mL. 5.0 mL.

A provider prescribes diphenhydramine 25 mg PO. The medication is available as 12.5 mg/5 mL. How many mL should the nurse administer? Round to the nearest tenth. 10 mL. 5 mL. 55 mL.

A provider prescribes vancomycin 15 mg/kg/dose IV every 12 hours for a child who weighs 40 lb. The pharmacy supplies vancomycin as 500 mg/10 mL. How many mL should the nurse administer per dose? Round to the nearest tenth. 2.5 mL. 3.3 mL. 5.5 mL.

A provider prescribes cefazolin 1 g IV to be infused over 20 minutes. The medication is diluted in 100 mL of NS. The IV tubing has a drop factor of 15 gtt/mL. How many drops per minute (gtt/min) should the nurse administer? Round to the nearest whole number. 55 gtt/min. 75 gtt/min. 15 gtt/min.

A nurse is caring for a client receiving digoxin 0.125 mg daily for heart failure. During morning assessment, the nurse notes that the client's apical pulse is 52 beats per minute, and the client reports feeling nauseated with blurred vision. Which of the following actions should the nurse take first?. Administer the medication and monitor the client's vision. Hold the dose and notify the healthcare provider. Encourage the client to drink more fluids and reassess in 1 hour. Document the findings and continue routine care.

The nurse is preparing discharge instructions for a client prescribed amlodipine for hypertension. Which of the following statements by the client indicate a correct understanding of the medication teaching? Select all that apply. "I will change positions slowly to avoid dizziness.". "I should avoid grapefruit juice while taking this medication.". "I can stop taking this medication once my blood pressure returns to normal.". "I should report swelling in my legs or feet to the provider.". "If I miss a dose, I can double the next one to catch up.". "This medication might make me feel tired at first.".

The nurse is caring for four clients on a medical-surgical unit. Which client should the nurse assess first?. A client with hypothyroidism who reports new onset chest pain after starting levothyroxine. A client with chronic hypothyroidism who reports fatigue and weight gain. A client who just received the first dose of levothyroxine and reports mild nausea. A client with a history of hypothyroidism who is asking when to schedule their next TSH blood draw.

The nurse is caring for four clients on a medical-surgical unit. Which medication should the nurse administer first?. A client newly diagnosed with atrial fibrillation prescribed digoxin who reports mild nausea and blurred vision. A client with asthma prescribed albuterol via nebulizer who reports chest tightness and is slightly anxious, with oxygen saturation of 95% on room air. A client with hypertension due to receive their scheduled dose of amlodipine who reports feeling dizzy and has a BP of 98/60 mm Hg. A client with type 2 diabetes scheduled to receive insulin glargine whose breakfast tray has been delayed by 45 minutes, with a blood glucose of 130 mg/dL.