Exit hesi- Pharm questions and answers complete verified solution 2022.
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Exit hesi- Pharm
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Exit Hesi- Pharm
Exit hesi- Pharm questions and answers complete verified solution 2022.
A nurse is assessing the therapeutic action of drugs classified as tumor necrosis factor (TNF) inhibitors. What client response indicates to the nurse that a drug with this classification is effective?
Continued remi...
Exit hesi - Pharm questions and answers complete verified solution 2022 A nurse is assessing the therapeutic action of drugs classified as tumor necrosis factor (TNF) inhibitors. What client response indicates to the nurse that a drug with this classification is effective? Continued remission in a client with ovarian cancer Increased insulin production in a client with diabetes mellitus Reduction of inflammatory joint pain in a client with rheumatoid arthritis Vasodilation of coronary arteries in a client with ischemic heart disease - Reduction of inflammatory joint pa in in a client with rheumatoid arthritis TNF is produced mainly by macrophages in synovium; over time, through various mechanisms, the presence of TNF causes inflammation of synovium, destruction of bone and cartilage, joint stiffness, and pain. TNF inhib itors or blockers neutralize TNF, thereby interrupting the inflammatory cascade; this inhibits the inflammatory response and other mechanisms, thereby slowing tissue damage. TNF inhibitors are not prescribed for clients with ovarian cancer, diabetes mellit us, or ischemic heart disease. The nurse suspects serotonin syndrome in a client prescribed second -generation antidepressants for depression. Which assessment findings observed by the nurse would be beneficial in diagnosing the severity of the syndrome? Delirium Hyperreflexia Hyperthermia Muscle spasms Rhabdomyolysis - Hyperthermia Rhabdomyolysis Serotonin syndrome is a potentially hazardous adverse effect of second -generation antidepressants that are used to treat depression. Hyperthermia and rh abdomyolysis are symptoms observed in severe cases of serotonin syndrome. Delirium, hyperreflexia, and muscle spasms are common symptoms of this syndrome. A healthcare provider prescribes enoxaparin 30 mg subcutaneously daily. Which measure would the nurs e take when administering this medication? Push over 2 minutes. Administer in the abdomen. Rub site after administration. Remove air pocket from prepackaged syringe before administration. - Administer in the abdomen. Enoxaparin specifically targets blood clots throughout the body and carries a lower risk of hemorrhage than that associated with the drugs heparin and warfarin. Enoxaparin is administered once a day through a subcutaneous injection site around the naval. Enoxaparin should be injected into the fatty tissue only, which is why the abdomen is the recommended injection site. Avoid administering in a muscle. Manufacturer recommendations indicate the air pocket from prepackaged syringes not be removed before admin istration. Rubbing the site is contraindicated, as it can cause bruising. There are no recommendations to push this subcutaneous medication over 2 minutes. A client with cirrhosis of the liver and ascites has been taking chlorothiazide, a thiazide diureti c. Why did the provider add spironolactone to the client's medication regimen? To stimulate sodium excretion To help prevent potassium loss To increase urine specific gravity To reduce arterial blood pressure - To help prevent potassium loss Spiron olactone is a potassium -sparing diuretic often used in conjunction with thiazide diuretics. The provider was prompted to add spironolactone to the chlorothiazide to prevent potassium loss. Both medications stimulate sodium excretion. Both medications incre ase urine specific gravity and reduce arterial blood pressure. A client with myasthenia gravis improves and is discharged from the hospital. The discharge medications include pyridostigmine bromide 10 mg every 6 hours. The nurse evaluates that the drug re gimen is understood when the client makes which statement? "I will take the medication on an empty stomach." "I need to set an alarm so I take the medication on time." "It will be important to check my heart rate before taking the medication." "I should monitor for an increase in blood pressure after taking the medication." - "I need to set an alarm so I take the medication on time." Pyridostigmine is a vital drug that must be taken on time; a missed or late dose can result in severe respirator y and neuromuscular consequences or even death. Pyridostigmine should be taken with a small amount of food to prevent gastric irritation. It is unnecessary to take the pulse rate before taking pyridostigmine. Pyridostigmine may cause hypotension, not hyper tension, which is a sign of cholinergic crisis. A client has been taking 3 mg of risperidone twice a day for the past 8 days. At the follow -up appointment, the client reports tremors, shortness of breath, a fever, and sweating. What will the nurse do? Call 911 and have the client transported to the nearest psychiatric unit. Take the client's vital signs and arrange for immediate transfer to a hospital. Check the number of risperidone tablets left in the prescription bottle to see whether there was an overdose. Request a prescription for 2 mg of intramuscular benztropine stat and assess the client in 10 to 15 minutes for symptom relief. - Take the client's vital signs and arrange for immediate transfer to a hospital. These clinical manifestations sig nal the presence of neuroleptic malignant syndrome; the cardinal sign of this condition is a high body temperature. Therefore the nurse first should document the hyperthermia and then arrange for immediate hospitalization. Unless the client is experiencing impaired ventilation, it is important to complete a focused assessment before transfer. The care needed can be provided in an emergency department or medical unit, not a psychiatric unit. Neuroleptic malignant syndrome may occur without an overdose; this syndrome can occur when a high -
potency antipsychotic drug is prescribed, with typical onset within 3 to 9 days after initiation of the medication. Benztropine will have little or no effect on neuroleptic malignant syndrome. The health care provider prescr ibes an oral hypoglycemic for the patient with type 2 diabetes. What will the nurse need to consider when developing the teaching plan? Oral hypoglycemics work by decreasing absorption of carbohydrates. Oral hypoglycemics work by stimulating the pancre as to produce insulin. Clients taking oral hypoglycemics may subconsciously relax dietary rules to gain a sense of control. Clients with type 2 diabetes do not need to be concerned about serious adverse effects from oral hypoglycemics. - Clients taking oral hypoglycemics may subconsciously relax dietary rules to gain a sense of control. Taking a tablet may give the client a fa lse sense that the disease is under control, and this can lead to dietary indiscretions. Some oral hypoglycemics work by stimulating the pancreas to produce insulin, others work by decreasing carbohydrate absorption, and others work in a variety of other w ays; therefore teaching should be specific to the drug prescribed. Oral hypoglycemic drugs can have serious adverse effects. A pregnant client states to the nurse, "I have been advised to take an over -the-counter medication for the flu. The drug label say s it is a category B drug." How should the nurse respond to these statements? "Because this drug causes fetal abnormalities, you should not take this drug." "This drug causes fetal risks when administered and should not be used in pregnancy." "This d rug has been reported to have adverse effects in animal fetuses so this drug should be avoided." "This drug does not show risks to an animal fetus so you can safely take it while pregnant." - "This drug does not show risks to an animal fetus so you can s afely take it while pregnant." According to the Food and Drug Administration, category B drugs have no risk to an animal fetus. Therefore these medications are safe to take during pregnancy. Studies report that category X drugs cause fetal abnormalities a nd should be avoided. Category D drugs are reported to cause adverse effects in animal fetuses so pregnant clients should avoid these drugs. Category C drugs have been shown to have adverse effects in animal fetuses. A client who has an adenocarcinoma of the descending colon with a partial obstruction is receiving doxorubicin intravenously (IV) to reduce the tumor mass. The nurse monitors the client for signs and symptoms of doxorubicin toxicity. What clinical finding indicates that toxicity has occurred? Minor skin rash Blue tinge to the urine Alteration in cardiac rhythm
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