Pn Vati Pharmacology 2024 Completed With Accurate Questions And Answers, Exams of Nursing

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1.A nurse is assisting with the care of a client who has a myasthenia gravis and is experiencing a cholinergic crisis. Which of the following medications should the nurse expect the RN to administer? -8ethanechol -PYopranolol Atropine -Epinephrine Ans ANSWER Ans ATROPINE. Rationale Ans A cholinergic crisis is the result of too much cholinesterase inhibitor medication, which causes manifestations of excessive muscarinic stimulation, such as muscle weakness, bradycardia, vomiting, and paralysis. Atropine is a muscarinic antagonist that is administered IV to reverse anticholinergic effects. The nurse might need to assist with respiratory support to provide adequate oxygenation to the client until manifestations resolve. 2. A nurse is caring for a client who has bipolar disorder and a new prescrip- tion for lithium. Which of the following laboratory values should the nurse plan to monitor for potential adverse effects? Prothrombin Time Hematocrit Sodium Potassium Rationale ARS The nurse should monitor the client's sodium level while the client is 2/59 Rationale ARS When using the urgent vs. non-urgent approach to client care, the nurse should determine that the priority finding to report is muscle weakness (myalgia) or tenderness because it can be a manifestation of rhabdomyolysis, a rare but potentially fatal adverse effect of HMG-CoA reductase inhibitor (statin) thearpy. Rhabdomyolysis is a disintegration of muscle tissue that causes elevations in creatine kinase, potentially impairing renal function. 4. Anurse is reinforcing teaching with a newly licensed nurse regarding safe procedures for medication administration. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? —"I will identify the client by verifying the client's name using the room num- ber." —"I can administer antibiotics 1 hour before the scheduled time." —"I will check the label on the client's medication three times before adminis- tering it." —"| will leave the client's medication at the client's bedside." Alig ANSWER Ans" WILL CHECK THE LABEL ON THE CLIENT'S MEDICATION THREE TIMES BEFORE ADMINISTERING IT." Rationale ARS The nurse should check the label three times; when the medications is removed from the dispensing system, when the medication is being prepared for administration, and at the client's bedside before administering the medication. 5. A nurse is preparing to administer Lactated Ringer's solution 350 mL to infuse over 1 hr. The drop factor of the tubing is 10 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round answer to the nearest whole number.) Rationale Rationale Ans Morphine is an opioid analgesic. Naloxone, an opiate antagonist, reverses the effects of opioids, including respiratory depression and sedation. After adminis- tering naloxone, the nurse should continue to monitor the client's respiratory function and pain control. 7. A nurse is reinforcing teaching with a client who has a new prescription for insulin. The client is taking propranolol. The nurse should teach the client to monitor for which of the following findings as a manifestation of hypo- glycemia? —-Tachycardia -Difficulty breathing -Sleep disturbance —Hunger Ans ANSWER ARS HUNGER. Rationale 7/59 Ans Propranolol blocks the Beta 1 receptors, which suppresses the typical early signs of hypoglycemia, such as tachycardia, sweating, and tremors. The nurse should instruct clients who have diabetes mellitus and take propranolol to recognize alternative indications of hypoglycemia, such as hunger and fatigue. Adverse Effects of Propranolol Insomnia and nightmares, and can cause difficulty breathing. 8. A nurse is reinforcing dietary teaching with a client who is taking furosemide. Which of the following foods should the nurse recommend as the best source of potassium? —1 cup baked potatoes —1 cup fresh blueberries —1 cup fresh watermelon -1 cup raw chopped cabbage Ais ANSWER Ans 1 CUP BAKED POTATOES. Rationale —"I| should expect my urine to turn reddish in color." —"| will have a skin test to determine when | am no longer contagious." —"I should notify my provider if | develop numbness in my feet." —"I should expect to take this medication for 6 weeks." ARs ANSWER Ans"! SHOULD NOTIFY MY PROVIDER IF | DEVELOP NUMBNESS IN MY FEET." Rationale ARS The nurse should instruct the client to notify the provider for manifes- tations of peripheral neuropathy, such as tingling, numbness, burning, or pain in extremities. 10. A nurse is assisting with the care of a client who has oral benzodiazepine toxicity. The client has an IV infusing and is nonresponsive. Which of the following interventions should the nurse anticipate first? —Administering norepinephrine via continuous IV infusion —Administering IV flumazenil —Performing gastric lavage —Preparing the client for mechanical ventilation Ais ANSWER AAS ADMINISTERING IV FLUMAZENIL. Rationale Ans Evidence-based practice indicates that the priority action for a client who has benzodiazepine toxicity is to administer IV flumazenil. Flumazenil is a benzo- diazepine receptor antagonist used to reverse sedation caused by benzodiazepine toxicity. The lV medication begin working withing 1 to 2 min. Therefore, administering flumazenil is the first action the nurse should anticipate. 11. Anurse is reinforcing teaching with a client who has chronic stable angina anda prescription for sublingual nitroglycerin tablets. Which of the following instructions should the nurse include in the teaching? —"Replace your bottle of tablets every 3 months for best effectiveness." —"Place one tablet under the tongue 30 minutes before exercise to prevent 11/59 working 1 to 3 min. Nitroglycerin works by causing vasodilation and decreasing venous return. Therefore, it can cause orthostatic hypotension and dizziness. The nurse should instruct the client to sit down when experiencing chest pain and to lie down if dizziness occurs. Headache is another adverse effect of nitroglycerin that occurs as a result of vasodilation. 12. A nurse is collecting data from a client who is scheduled to receive an initial dose of tobramycin. Which of the following findings should the nurse report to the provider? -The client reports taking acetaminophen for pain. -The client's potassium level is 4.1 mEq/L. -The client has an allergy to sulfonamides. -The client's creatinine level is 2.2 mg/dL. Ais ANSWER ARS THE CLIENT'S CREATI- NINE LEVEL IS 2.2 mg/dL. Rationale ARS This creatinine level is above the expected reference range for adults of 0.5 to 1.3 mg/dL, indicating impaired kidney function, which increases the risk for nephrotoxicity. Aminoglycoside antibiotics can cause kidney toxicity. Therefore, the nurse should monitor the client's urinalysis results, as well as BUN and Creatinine levels, for manifestations of kidney injury. 13. A nurse is administering ear drops into an adult client's right ear. Which of the following actions should the nurse take? -Straighten the ear canal by pulling the auricle down and back. —Assist the client into Fowler's position. —Place a cotton ball in the ear canal for 30 min after instilling the drops. Instill drops holding the dropper 1 cm (0.4 in.) above the ear canal. Ais ANSWER Ans INSTILL DROPS HOLDING THE DROPPER 1 cm (0.4 in.) ABOVE THE EAR CANAL. Rationale ARS The nurse should hold the dropper 1 cm (0.4 in.) above the ear canal to reduce the risk of contamination of the dropper. 14. A nurse is reinforcing teaching with a client who is taking rifampin. 14/59 Ais ANSWER ARS "you MIGHT BE UNABLE TO WEAR CONTACT LENSES WHEN TAKING THIS MEDICATION." Rationale ARS The nurse should instruct the client that rifampin can cause bodily fluids, such as tears and sweat, to turn orange or red. Clients who wear contact lenses might experience permanent staining and should check with an optometrist regard- ing alternatives. Rifampin is a medication that is commonly used in combination with other antimycobacterial agents to treat pulmonary tuberculosis. 15. A nurse is administering a varicella immunization to a young adult client who did not receive the immunization as a child. The client asks the nurse if they will need additional doses of the vaccine. Which of the following responses should the nurse make? —"You will require a total of three doses about 6 months apart." —"You should return for a second dose in 4 to 8 weeks." -"You can get a booster dose every 10 years." "You should get another dose in 2 weeks." Ans ANSWER ARS "You SHOULD RETURN FOR A SECOND DOSE IN 4 TO 8 WEEKS." Rationale ARS The nurse should tell the client that the varicella vaccine requires two doses and they should return for the second dose in 4 to 8 weeks. Ideally, toddlers should receive the first varicella vaccine between 12 and 15 months of age and the second dose at 4 to 6 years of age. For adolescents or adults who are not immune to varicella and who have not been immunized, two doses are required at least 28 days apart. 16. A nurse is reviewing the medical history of a client who requires oph- thalmic medication to treat glaucoma. Which of the following factors in the client's history is a contraindication for using beta-adrenergic blocking eye drops to treat this disorder? 17/59 17. Anurse is reinforcing teaching with a client who is prescribed an albuterol inhaler, two puffs every 4 hrs. Which of the following statements by the client indicates an understanding of the teaching? —"| will wait 5 seconds in between each puff." —"I will hold my breath for 10 seconds after inhaling the medication." —"| will experience a slowed heart rate after taking this medication." "| can increase my dosage if my asthma gets worse." Ais ANSWER "| WILL HOLD MY BREATH FOR 10 SECONDS AFTER INHALING THE MEDICATION." Rationale ARS The client should hold their breath for 10 seconds after inhaling to allow the medication to distribute throughout their lungs. The client should wait 1 min between each inhalation to allow for maximum absorption of the medication. The client can experience an increased heart rate after taking this medication due to cardiac stimulation. The client should not exceed prescribed dosages without first checking with the provider to reduce the risk for adverse effects. 18.A nurse is caring for a client who has diabetes mellitus. The client received a dose of regular insulin prior to an episode of vomiting and is now unable to eat. For which of the following manifestations should the nurse monitor? —Deep respirations —Polyuria -Increased thirst —Confusion Ans ANSWER Ans CONFUSION. Rationale ARS The nurse should monitor the client for manifestations of HYPOglycemia because the client received insulin and was then unable to eat a meal. A client who has HYPOglycemia can become confused due to the lack of glucose in the brain. Other manifestations of HYPOglycemia include hunger, diaphoresis (sweating), headache, weakness, and blurred vision. The nurse should check 20/59