Module 3 Week 12 Pharmacology Exam V1

The nurse must identify which client symptoms are expected side effects and which are serious adverse effects that require intervention. Select whether it is more likely to be a side effect or an adverse effect of the associated medication. Dry cough in a client taking lisinopril. Facial swelling after starting enalapril. Tardive dyskinesia in a client on haloperidol. Nausea in a client taking metformin. Hyperglycemia in a client receiving TPN. Flushing after taking niacin.

A 72-year-old client with a history of heart failure is receiving IV furosemide 40 mg in 100 mL of normal saline via an electronic infusion device (EID) to be infused over 30 minutes. Thirty minutes later, the nurse checks the infusion and notes that only 50 mL had been infused. The client reports shortness of breath, and lung auscultation reveals bilateral crackles in the lower lobes. Which action should the nurse take first?. Increase the infusion rate to deliver the remaining medication rapidly. Notify the primary healthcare provider of the incomplete infusion. Stop the infusion and document the total volume administered. Check the electronic infusion device for kinks or malfunctioning.

A nurse is caring for a 64-year-old client receiving IV antibiotics via an electronic infusion device (EID). Mid-shift, the EID alarm sounds, indicating a possible occlusion. While at the medication preparation area, the nurse hears the alarm from the client's room. Which action should the nurse take first?. Silence the alarm and inspect the pump screen. Check the tubing connections and flush the IV line. Assess the client and inspect the IV site for signs of infiltration or complications. Reset the alarm and reprogram the pump to resume infusion.

A nurse is caring for a 56-year-old client who suddenly develops generalized hives, facial swelling, difficulty breathing, and hypotension shortly after receiving IV antibiotics. The nurse recognizes that the client is experiencing anaphylaxis. Which nursing action should the nurse take first?. Administer epinephrine intramuscularly into the mid-outer thigh. Elevate the client's legs to support blood pressure. Administer diphenhydramine IV as prescribed. Place the client in a high Fowler's position to facilitate breathing.

The nurse on a medical-surgical unit receives reports on four clients. The nurse must determine which client should the nurse see first?. A client with heart failure who received IV furosemide 45 minutes ago and reports muscle cramps. A client with diabetes scheduled to receive insulin, who has a blood glucose of 185 mg/dL and is waiting for breakfast. A client who received morphine 30 minutes ago for postoperative pain and is now snoring with oxygen saturation of 94%. A client with atrial fibrillation prescribed a new dose of warfarin who has not yet received today's medication.

The nurse receives shift reports on four clients. After reviewing their conditions and medications, which client should the nurse see first?. A client receiving IV vancomycin who reports flushing of the face and neck with mild itching at the infusion site. A client with COPD who is due for a scheduled albuterol nebulizer and currently reports mild shortness of breath with an oxygen saturation of 93%. A client who received their morning dose of digoxin and is now resting with a heart rate of 60 bpm and new-onset nausea. A client with type 1 diabetes who has a blood glucose of 240 mg/dL and reports feeling shaky while eating breakfast.

A nurse is assessing clients who have recently started new medications. For each of the following symptoms, select whether it is more likely to be a side effect or an adverse effect of the associated medication. Severe Diarrhea in a client taking clindamycin. Headache in a client receiving nitroglycerin. Muscle pain in a client taking atorvastatin. Metallic taste in a client taking metronidazole. Bruising in a client on warfarin with stable INR. Sudden vision changes in a client taking sildenafil.

A nurse is caring for a critically ill client receiving IV norepinephrine for septic shock. The medication is being administered through a central line. Mid-shift, the IV site becomes swollen and pale, and the client reports burning pain at the site. Which nursing action is most appropriate?. Remove the IV catheter and apply a warm compress. Call the healthcare provider to report extravasation and continue the infusion. Stop the infusion and infiltrate the site with phentolamine as prescribed. Monitor the site hourly for further changes before intervening.

A nurse is responding to a client in the intensive care unit who suddenly becomes unresponsive. The cardiac monitor shows ventricular tachycardia (VT) and the client does not have a pulse. Which action should the nurse take first?. Notify the primary healthcare provider. Begin cardiopulmonary resuscitation (CPR) and prepare for defibrillation. Administer IV epinephrine 1 mg immediately. Confirm the rhythm with a 12-lead electrocardiogram.

A nurse is caring for a client in the intensive care unit with septic shock who is receiving vasopressor therapy. The nurse reviews the different agents and their nursing implications before administering the next dose. Which of the following statements about vasopressor agents are accurate? Select all that apply. Norepinephrine (Levophed) is first line for septic shock and must be administered via a central line. Epinephrine is typically avoided in cardiac arrest due to risk of reflex bradycardia. Phenylephrine increases blood pressure without increasing heart rate due to its alpha-agonist effects. Vasopressin is a vasoconstrictor often added to norepinephrine during septic shock. Dopamine at high doses causes vasoconstriction but must be used cautiously due to arrhythmia risk. Norepinephrine is safe to administer via peripheral IV and does not require monitoring of extremities.

A nurse is reviewing a client's medication administration record and identifies that several high-risk medications are scheduled for administration. The nurse must ensure appropriate safety measures based on the medication category and potential complications. Which of the following correctly matched high-risk medications and their associated risks? Select all that apply. Potassium chloride - Can cause arrhythmias or cardiac arrest if given too fast or in incorrect doses. Regular insulin - Can cause severe hyperglycemia. Morphine - Can cause respiratory depression and overdose. Warfarin - Can cause rebound hypertension and electrolyte imbalance. Methotrexate - Requires close monitoring due to cytotoxic effects and dosing precision. Fentanyl - May cause renal failure and crystallization at room temperature. Enoxaparin - Can cause bleeding, hemorrhage, and thrombocytopenia.

A nurse is reviewing new symptoms reported by clients recently started on different medications. For each of the following symptoms, select whether it is more likely to be a side effect or an adverse effect of the associated medication. Tingling in fingers after albuterol inhalation. Sudden onset of chest tightness after IV metoclopramide. Sudden onset of chest tightness after IV metoclopramide. Peripheral edema in a client taking amlodipine. Yellow vision in a client taking digoxin. Worsening depression in a client on fluoxetine.

A nurse is caring for a client with schizophrenia who was started on risperidone (Risperdal) three days ago. Which of the following findings may indicate the client is experiencing an adverse effect of risperidone? Select all that apply. New-onset tremors and muscle rigidity. Mild dizziness upon standing. Restlessness and inability to sit still. Improved organization of thought processes. Fever and elevated creatine kinase level. Weight gain of 2 lbs over three days.

A nurse is preparing to administer an IV medication using an electronic infusion device (EID). The medication is classified as high-risk. The nurse reviews safety practices before beginning the infusion. Which actions are appropriate safety measures for IV medication administration using an electronic infusion device? Select all that apply. Double-check the medication order and pump settings with another nurse before initiating a high-alert medication. Rely on the EID alarm system to detect infiltration at the IV site. Confirm medication compatibility with IV fluids before programming the device. Monitor the infusion site regularly for signs of infiltration or phlebitis. Program the pump accurately based on ordered rate, volume, and concentration. Assume that programmed doses do not need to be re-verified after pump setup.

The nurse receives shift report on four clients, all of whom are scheduled to receive medication. Which client should the nurse prioritize for immediate medication administration?. A client with deep vein thrombosis (DVT) who reports mild calf tenderness scheduled for the first dose of enoxaparin. A client with a history of seizures who missed their morning dose of levetiracetam and now reports a mild headache. A client with bacterial pneumonia who is due for their first dose of IV antibiotics and has a temperature of 102.4°F (39.1C). A client with ulcerative colitis who is due for their daily corticosteroid and reports mild lower abdominal cramping.

A nurse is caring for a client with Parkinson's disease who has been receiving carbidopa-levodopa for several weeks. Which findings should the nurse recognize as possible adverse effects of carbidopa-levodopa? Select all that apply. Involuntary facial grimacing and head nodding. Dizziness when changing positions. Improved ability to initiate movement. Dark-colored urine and sweat. New onset of hallucinations and confusion. Increased appetite and weight gain.

The nurse receives shift handoff on four clients who are all reporting pain. The nurse must determine which client to assess and medicate with first. A client post-hip replacement reporting incisional pain rated 8 out of 10, requesting prescribed morphine. A client with metastatic bone cancer reporting chronic leg pain rated 6 out of 10, awaiting long-acting opioid medication. A client with chest trauma reporting chest pain rated 7 out of 10 and shallow breathing. A client with pancreatitis reporting abdominal pain rated 9 out of 10.

The nurse receives shift handoff on four clients. Each client is scheduled to receive medications this morning. The nurse must determine who requires immediate assessment and medication administration. A client with chronic kidney disease with a hemoglobin of 7.9 g/dL who is due for epoetin alfa and reports dizziness and fatigue. A client with asthma who is due for a dose of methylprednisolone and reports moderate wheezing and shortness of breath when walking across the room. A client with a new diagnosis of bacterial meningitis who is due for their first dose of IV ceftriaxone and has a temperature of 101.9°F (38.8C). A client with heart failure who is due for their morning dose of furosemide and reports a 3-pound weight gain overnight and shortness of breath when lying flat.

The nurse is caring for four clients on a medical-surgical unit. Several are due to receive medications, and the nurse must determine who requires immediate pharmacologic intervention. Which client should receive medication first. A client with newly diagnosed hypertension who is due for a first dose of lisinopril and has a BP of 148/92 mm Hg. A client post-thyroidectomy who reports tingling around the mouth and fingers requering IV calcium gluconate. A client with chronic pain who is requesting their scheduled dose of oral morphine reports pain at 7 out of 10. A client with Parkinson's disease who is due for their next dose of carbidopa/levodopa and is experiencing increasing muscle rigidity.

A nurse is providing education to a client recently prescribed lisinopril for hypertension. The client is asking about what to expect while taking this medication. The nurse reviews common side effects of the medication. Which of the following are expected side effects of lisinopril? Select all that apply. Dry, persistent cough. Lightheadedness when standing up. Facial swelling and difficulty breathing. Elevated potassium level. Rash on chest and back. Fatigue.