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Pharmacy NURS- 6521 Administer a tablet under his tongue and repeat the action in 5 and 10 minutes if the pain has not subsided โโA 62-year-old man is admitted to the hospital with a diagnosis of chest pain. He has an order for 0.3 mg of sublingual nitroglycerin prn for chest pain. Which of the following actions should the nurse do first when he complains of chest pain? increased HR and decrease BP โโAn expected outcome for a patient who has just taken sublingual nitroglycerin should be 10 mg โโA patient is to take nifedipine (Procardia) 10 mg PO tid. How many milligrams will he take per dose? Nitrate tolerance โโA nurse explains to a patient that nitroglycerin patches should be applied in the morning and removed in the evening. This medication schedule reduces the potential for ... Blood pressure โโA patient is admitted to the emergency department with severe chest pain. The emergency department physician orders intravenous nitroglycerin 5 mcg/min, titrate dose by 5 mcg/min every 3 to 5 minutes per infusion pump as needed. Before administering the nitroglycerin, the nurse should prioritize which of the following assessments? Dizziness โโA nurse is caring for a patient with chronic angina. The patient is receiving ranolazine (Ranexa) 500 mg PO bid. Which of the following signs or symptoms would the nurse attribute to being a common adverse effect of this medication? crush the capsule and ask the patient to inhale the vapors โโA 45-year-old man enters the emergency department complaining of chest pain. The nurse has an order to administer amyl nitrite. The nurse will... keep the tablets in the original dark bottle. โโA patient is being discharged home with a prescription for sublingual nitroglycerin. The nurse will instruct the patient and family to... don a pair of gloves โโA nurse has an order to apply nitroglycerin topically, twice a day. The nurse's initial action will be to... have the patient go into his house and sit or lie down โโA patient calls the clinic and reports that he is having chest pain. The patient states that รฌ'm scared that I am going to die and I've been pacing up and down my driveway.รฎ After calming the patient, the initial instruction by the nurse would be to...
The patient's angina may necessitate the use of a calcium channel blocker โโA recent episode of chest pain while doing yard work prompted a 70-year-old man to seek care and he has been subsequently diagnosed with chronic stable angina. The nurse should recognize what guiding principle in the treatment of this patient's angina? The woman will be more susceptible to hypotension than a young patient. โโFrequent episodes of exercise-related chest pain have caused a 79-year-old woman to use her prescribed nitroglycerin spray several times in recent weeks. This patient's age will have what effect on her use of nitroglycerin? Acute Pain, headache, related to adverse effects of drug therapy โโA nurse is creating a plan of care for a 68-year-old woman with a recent diagnosis of unstable angina and new prescription for nitroglycerin. Which of the following nursing diagnoses should the nurse prioritize in the planning of this patient's care? Put your patch on a part of your skin that doesn't have too much hair on it. โโA man has left his most recent visit to his primary care provider with a new prescription for a transdermal nitroglycerin patch. What patient education should the nurse provide to this patient? Mr. Penny requires concurrent treatment with a beta blocker, nitrate, or a calcium channel blocker. โโMr. Penny, age 67, was diagnosed with chronic angina several months ago and has been unable to experience adequate relief of his symptoms. As a result, his physician has prescribed ranolazine (Ranexa). Which of the following statements is true regarding the use of ranolazine for the treatment of this patient's angina? Determine if the drug is going to make you drowsy before you drive. โโA patient is in the clinic for seasonal allergic rhinitis. Loratadine (Claritin) is prescribed. Which of the following statements will the nurse include when providing patient education concerning this drug? Taking too many laxatives can make your bowels dependent on them, making you more susceptible to constipation. โโA 73-year-old woman has scheduled an appointment with her nurse practitioner to discuss her recurrent constipation. The woman states that she experiences constipation despite the fact that she takes docusate on a daily basis and performs cleansing enemas several times weekly. How should the nurse best respond to this patient's statements? 15 to 30 minutes. โโA 68-year-old man complains of a chronic, nonproductive cough. He states that he has to have relief, that he has been coughing every 2 to 3 minutes, and he is worn out. Dextromethorphan is prescribed for him. Before he leaves the clinic he asks how long it will take for the medicine to work. The nurse will advise him that he should experience therapeutic effects in
teaching plan will include a basic explanation of how the drug produces its therapeutic effect. The nurse will explain that lovastatin lowers cholesterol levels because it... Albuterol Sulfate โโThe parents of a 7-year-old boy who has just been diagnosed with allergic asthma are being taught about their son's medication regimen by the nurse. The nurse is currently teaching the parent's about the appropriate use of a "rescue drug" for acute exacerbations of their son's asthma. What drug should the nurse suggests the parents to use in these situations? protein binding โโWhich of the following affects drug distribution throughout the body? respiratory rate, depth, and rhythm. โโBefore the administration of morphine to a 65-year-old man who has cancer, the initial action of the nurse would be to check the patient's Cilia sweep foreign material and mucus upward toward the trachea and larynx where they can then be swallowed. โโThe lower respiratory system utilizes a number of different mechanisms that confer protection and maintain homeostasis. Which of the following physiological processes protects the lower respiratory system? "I broke out in hives and got terribly itchy when I started a new prescription last year." โโThe nurse's assessment of a community-dwelling adult suggests that the client may have drug allergies that have not been previously documented. What statement by the client would confirm this? A 78-year-old man who is unable to swallow following an ischemic stroke โโFor which of the following patients would a nasogastric tube most likely be considered to aid in the administration of medications? constipation โโA 29-year-old woman has been prescribed alosetron (Lotronex) for irritable bowel syndrome. Before starting the drug therapy, the nurse will advise the patient about which of the following adverse effect(s)? fatigue โโA nurse is developing a care plan for a patient who has multiple sclerosis. An expected outcome for the patient who is receiving glatiramer would be a decrease in increased blood pressure โโA diabetic patient being treated for obesity tells the nurse that he is having adverse effects from his drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which of the following adverse effects would need the nurse's immediate attention?
decreasing the influx of sodium into neurons. โโA patient has a history of tonic-clonic seizures that have been successfully treated with phenytoin (Dilantin) for several years. Phenytoin achieves a therapeutic effect by Impaired physical mobility โโA 90-year-old frail, elderly woman has arrived at the emergency department with a broken hip and in acute respiratory distress. Succinylcholine will be used because of the need for rapid endotracheal intubation, and then the woman will be sent to surgery. Due to the woman's frail condition, she is at risk for skin breakdown. Which of the following nursing diagnoses would be most appropriate? To convert the patient's atrial fibrillation to normal sinus rhythm โโA nurse is the cardiac care unit is preparing to hang an intravenous dose of dofetilide (Tikosyn) for a patient who has just been admitted. What is the most likely goal of this intervention? Wear appropriate clothing and sunscreen whenever he is in direct sunlight โโA nurse is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which of the following instructions? Is there a need for the drug in treating the presenting problem? Is this the best drug for the presenting problem? Can the patient take the prescribed drug? โโA nurse practitioner understands when prescribing a medication that there are certain questions to address. Check all that apply. Furosemide (Lasix) โโAn elderly patient with a history of congestive heart failure has been admitted to hospital with failure to thrive and admission blood work reveals a hemoglobin level of 6.9 g/dL. The care team has consequently administered two units of packed red blood cells, but auscultation of the client's lungs now reveals diffuse crackles. Administration of what drug is likely to resolve the patient's pulmonary edema? take their medication at the prescribed times. โโIn order to promote therapeutic drug effects, the nurse should always encourage patients to 1500 mg โโThe nurse practitioner orders Amoxicillin 500 mg tid? What is the total amount of medication patient will take per day? liver damage โโA patient with mild low back pain has been advised to take acetaminophen. The nurse will inform him that excessive intake of acetaminophen may result in Taking several drugs simultaneously โโA nurse is teaching an older adult patient about polypharmacy. Which of the following statements best describe this term?
Cyclobenzaprine (Flexeril) โโA nurse is assessing a patient who has come to the emergency department complaining of back spasms. The patient states that he has a history of opioid addiction and does not want to take any drug that "puts me at risk of becoming physically dependent." Which of the following medications would the nurse question, if ordered? Take it on an empty stomach, 1 hour before or 2 hours after meals โโA patient with bronchial asthma is prescribed a sustained-release preparation of theophylline. To help minimize the adverse effects of the drug, which of the following should the nurse suggest? Risk for Injury related to drug-drug interactions or drug-nutrient interactions โโA middle-aged patient was diagnosed with major depression after a suicide attempt several months ago and has failed to respond appreciably to treatment with SSRIs. As a result, his psychiatrist has prescribed phenelzine. When planning this patient's subsequent care, what nursing diagnosis should the nurse prioritize? BULK-FORMING (fiber) LAXATIVES โโMr. Tan is a 69-year-old man who prides himself in maintaining an active lifestyle and a healthy diet that includes adequate fluid intake. However, Mr. Tan states that he has experienced occasional constipation in recent months. What remedy should be the nurse's first suggestion? Routes of Administration โโWhat critical piece of information is missing from the following medication order: Amoxicillin 250 mg every 8 hours? 150 ml โโThe nurse practitioner orders Amoxicillin 250 mg/5 ml tid for 10 days? The nurse practitioner would expect the pharmacist to fill the prescription bottle with how many ml? Assess the reasons behind the patient's poor nutritional status โโA 77-year-old woman who is 5 feet 3 inches tall and weighs 89 lbs has been admitted to the hospital with a diagnosis of failure to thrive. What action should the nurse prioritize when addressing the woman's apparent lack of nutrition? Hypertension โโA 60-year-old African-American man lives with a number of chronic health problems. Genetic factors are likely to influence his etiology and/or treatment of swallow the tablet with milk or food. โโA 49-year-old woman has been diagnosed with myalgia. The physician has recommended aspirin. The patient is concerned that the aspirin will upset her stomach. The nurse will encourage the patient to... an adrenergic antagonist โโA patient has recently been prescribed a drug that treats his hypertension by
blocking the sympathetic receptors in his sympathetic nervous system. This action is characteristic of Slow the rate of the infusion โโA patient is brought to the emergency department in hypertensive crisis. Nitroprusside is administered intravenously. The patient experiences diaphoresis and dizziness. Which of the following is the appropriate action by the nurse? Acute Pain, Headache, related to adverse effects of drug therapy โโA nurse is creating a plan of care for a 68-year-old woman with a recent diagnosis of unstable angina and new prescription for nitroglycerin. Which of the following nursing diagnoses should the nurse prioritize in the planning of this patient's care? This schedule allows rest periods so that adverse effects are decreased but the anti-inflammatory effects continue. โโA 53-year-old man has been treated for severe asthma for several years with prednisone. Recently, his physician initiated alternate-day therapy for him. The patient tells the nurse that he would rather take the medication every day to prevent confusion. Which of the following would be the best response by the nurse? The man may be experiencing nephrotoxic effects of aspirin โโA 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man's most recent visit to his care provider, routine blood work was ordered and the results indicated an unprecedented rise in the man's serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings? An obese male client who is a heavy alcohol user and who has cirrhosis of the liver โโA nurse who provides care in a busy clinic is aware of the high incidence and prevalence of hyperlipidemia and the consequent need for antihyperlipidemics in many patients. Treatment of high cholesterol using statins would be contraindicated in which of the following patients? "Quitting smoking will significantly increase the chance that this drug will heal your ulcer." โโA woman with numerous chronic health problems has been diagnosed with a benign gastric ulcer has begun treatment with ranitidine (Zantac). Which of the following teaching points should the nurse provide to this patient? remove the contact lenses before applying the drops. โโA 47-year-old woman has been diagnosed with open-angle glaucoma.
very low body mass index. How are this patient's characteristics likely to influence possible treatment with phenytoin? Height โโA clinic nurse is following a 9-year-old boy who is taking somatropin. Which of the following will the nurse monitor periodically? As long as the ritual does not interfere with the patient's preoperative care, it will be okay. โโA Native American man who lives a traditional lifestyle is scheduled to have heart surgery. The tribal chief has requested that the tribe's medicine man perform a ritual before the patient goes to surgery. The nurse's response to this request should be dizziness โโA 30-year-old woman is taking phenelzine (Nardil) 30mg PO tid. The nurse knows that at that dosage, the patient will need to be carefully monitored for Carefully assess the patient for infections โโA nurse is overseeing the care of a young man whose ulcerative colitis is being treated with oral prednisone. Which of the following actions should the nurse take in order to minimize the potential for adverse drug effects and risks associated with prednisone treatment? "It's important to discuss what herbs you'll be taking with your doctor or the pharmacist to make sure there aren't any interactions." โโA patient with a diagnosis of nonsmall cell lung cancer is currently undergoing chemotherapy. At the encouragement of a family member, the patient has announced to the nurse his intention to complement this treatment with a regimen of herbal remedies. How should the nurse respond to this patient's statement? potential adverse effects of the drugs that Mr. Nguyen will be taking. โโMr. Nguyen, age 71, will soon be discharged home from the hospital after a successful coronary artery bypass graft (CABG). During patient education about his drug regimen, Mr. Nguyen's nurse should prioritize teach about The amount of alcohol consumption โโA 24-year-old factory worker has been prescribed guaifenesin for the first time. Which of the following will be a priority assessment by the nurse before the patient's first dose? Many medications can be potentially harmful if taken by someone other than the person the medication was prescribed. โโA patient will begin three new medications as part of her treatment plan. The nurse practitioner understands that proper disposal of medications is key when the nurse practitioner states oxidizing cholesterol to bile acids. โโSeveral months of treatment with a statin accompanied by lifestyle modifications have failed to appreciably improve a patient's cholesterol levels. Consequently,
the patient has been prescribed cholestyramine. The nurse should recognize that this drugs achieves its therapeutic effect by skin surrounding the potential IV site. โโA patient has been prescribed several drugs and fluids to be given intravenously. Before the nurse starts the intravenous administration, a priority assessment of the patient will be to note the Digoxin immune fab โโA 58-year-old man is admitted to the emergency department. A diagnosis of severe digoxin toxicity is made. Bradycardia is present, and an electrocardiogram (ECG) confirms toxicity. The nurse will administer which of the following drugs? her history of emphysema. โโA 76-year-old woman has a complex medical history that includes emphysema, osteoporosis, malnutrition, and hypothyroidism. Recently, the woman fell outside her home as a result of weakness and suffered a fracture to her femoral head. The woman's subsequent hip-replacement surgery has been scheduled and the care team recognizes that the use of isoflurane will be most significantly influenced by Medication History โโA 75-year-old woman is prescribed magnesium hydroxide for constipation. The nurse's assessment reveals that the patient is being treated for rheumatoid arthritis and hypertension. The patient lives in assisted living and is on a low- sodium diet. Before the magnesium hydroxide therapy begins, it will be most important for the nurse to assess the patient's monitor the patient's blood pressure โโA clinic nurse has been assigned a 49-year-old female patient who has a history of diabetes. A recent diagnosis of hypertension has been made, and the patient has been prescribed a thiazide diuretic and labetalol. The patient will be scheduled to return to the clinic once a month for the next 6 months. A priority action by the nurse will be to The amount of grapefruit or orange juice she has during the day โโA female patient calls the clinic and reports that since she has been taking dextromethorphan (Robitussin), she has been extremely drowsy and dizzy. The nurse will question the patient about which of the following? intranasal โโA 79-year-old woman with a medical history that includes osteoporosis has recently moved to a long-term care facility. Medication reconciliation indicates that the woman has been taking calcitonin, salmon for several years. The nurse should recognize that the most likely route for the administration of this drug is falls โโAn older adult who lives in a long-term care facility has recently begun taking losartan (Cozaar) for the treatment of hypertension. The nurse who provides
