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Saunders Pharmacology
Jeremiah
Terms in this set (117)
1) A nurse is caring for a client with 3. Calcitonin (Miacalcin)
hyperparathyroidism and notes that the Rationale:
client's serum calcium level is 13 mg/dL. The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing
Which medication should the nurse prepare hypercalcemia. Calcium gluconate and calcium chloride are medications used for the
to administer as prescribed to the client? treatment of tetany, which occurs as a result of acute hypocalcemia. In hypercalcemia,
1. Calcium chloride large doses of vitamin D need to be avoided. Calcitonin, a thyroid hormone, decreases
2. Calcium gluconate the plasma calcium level by inhibiting bone resorption and lowering the serum calcium
3. Calcitonin (Miacalcin) concentration.
4. Large doses of vitamin D
3.) Salicylic acid is prescribed for a client 1. Tinnitus
with a diagnosis of psoriasis. The nurse Rationale:
monitors the client, knowing that which of Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can
the following would indicate the presence of result. Symptoms include tinnitus, dizziness, hyperpnea, and psychological
systemic toxicity from this medication? disturbances. Constipation and diarrhea are not associated with salicylism.
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased respirations
22.) A nurse is caring for a client after 3. Treat hypocalcemic tetany.
thyroidectomy and notes that calcium Rationale:
gluconate is prescribed for the client. The Hypocalcemia can develop after thyroidectomy if the parathyroid glands are
nurse determines that this medication has accidentally removed or injured during surgery. Manifestations develop 1 to 7 days after
been prescribed to: surgery. If the client develops numbness and tingling around the mouth, fingertips, or
1. Treat thyroid storm. toes or muscle spasms or twitching, the health care provider is notified immediately.
2. Prevent cardiac irritability. Calcium gluconate should be kept at the bedside.
3. Treat hypocalcemic tetany.
4. Stimulate the release of parathyroid
hormone.
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23.) A client who has been newly diagnosed 2. Rotate the insulin injection sites systematically.
with diabetes mellitus has been stabilized Rationale:
with daily insulin injections. Which Insulin dosages should not be adjusted or increased before unusual exercise. If
information should the nurse teach when acetone is found in the urine, it may possibly indicate the need for additional insulin. To
carrying out plans for discharge? minimize the discomfort associated with insulin injections, the insulin should be
1. Keep insulin vials refrigerated at all times. administered at room temperature. Injection sites should be systematically rotated from
2. Rotate the insulin injection sites one area to another. The client should be instructed to give injections in one area,
systematically. about 1 inch apart, until the whole area has been used and then to change to another
3. Increase the amount of insulin before site. This prevents dramatic changes in daily insulin absorption.
unusual exercise.
4. Monitor the urine acetone level to
determine the insulin dosage.
24.) A nurse is reinforcing teaching for a 1. Withdraws the NPH insulin first
client regarding how to mix regular insulin Rationale:
and NPH insulin in the same syringe. Which When preparing a mixture of regular insulin with another insulin preparation, the regular
of the following actions, if performed by the insulin is drawn into the syringe first. This sequence will avoid contaminating the vial of
client, indicates the need for further regular insulin with insulin of another type. Options 2, 3, and 4 identify the correct
teaching? actions for preparing NPH and regular insulin.
1. Withdraws the NPH insulin first
2. Withdraws the regular insulin first
3. Injects air into NPH insulin vial first
4. Injects an amount of air equal to the
desired dose of insulin into the vial
25.) A home care nurse visits a client recently 2. Refrigerate the insulin.
diagnosed with diabetes mellitus who is Rationale:
taking Humulin NPH insulin daily. The client Insulin in unopened vials should be stored under refrigeration until needed. Vials
asks the nurse how to store the unopened should not be frozen. When stored unopened under refrigeration, insulin can be used
vials of insulin. The nurse tells the client to: up to the expiration date on the vial. Options 1, 3, and 4 are incorrect.
1. Freeze the insulin.
2. Refrigerate the insulin.
3. Store the insulin in a dark, dry place.
4. Keep the insulin at room temperature.
26.) Glimepiride (Amaryl) is prescribed for a 1. Alcohol
client with diabetes mellitus. A nurse Rationale:
reinforces instructions for the client and tells When alcohol is combined with glimepiride (Amaryl), a disulfiram-like reaction may
the client to avoid which of the following occur. This syndrome includes flushing, palpitations, and nausea. Alcohol can also
while taking this medication? potentiate the hypoglycemic effects of the medication. Clients need to be instructed to
1. Alcohol avoid alcohol consumption while taking this medication. The items in options 2, 3, and 4
2. Organ meats do not need to be avoided.
3. Whole-grain cereals
4. Carbonated beverages
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28.) The health care provider (HCP) 2. The medication is withheld and the HCP is called to question the prescription for the
prescribes exenatide (Byetta) for a client client.
with type 1 diabetes mellitus who takes Rationale:
insulin. The nurse knows that which of the Exenatide (Byetta) is an incretin mimetic used for type 2 diabetes mellitus only. It is not
following is the appropriate intervention? recommended for clients taking insulin. Hence, the nurse should hold the medication
1. The medication is administered within 60 and question the HCP regarding this prescription. Although options 1 and 3 are correct
minutes before the morning and evening statements about the medication, in this situation the medication should not be
meal. administered. The medication is packaged in prefilled pens ready for injection without
2. The medication is withheld and the HCP is the need for drawing it up into another syringe.
called to question the prescription for the
client.
3. The client is monitored for gastrointestinal
side effects after administration of the
medication.
4. The insulin is withdrawn from the Penlet
into an insulin syringe to prepare for
administration.
29.) A client is taking Humulin NPH insulin 2. 4 to 12 hours after administration
daily every morning. The nurse reinforces Rationale:
instructions for the client and tells the client Humulin NPH is an intermediate-acting insulin. The onset of action is 1.5 hours, it peaks
that the most likely time for a hypoglycemic in 4 to 12 hours, and its duration of action is 24 hours. Hypoglycemic reactions most
reaction to occur is: likely occur during peak time.
1. 2 to 4 hours after administration
2. 4 to 12 hours after administration
3. 16 to 18 hours after administration
4. 18 to 24 hours after administration
31.) A community health nurse visits a client at 1. "I can take aspirin or my antihistamine if I need it."
home. Prednisone 10 mg orally daily has Rationale:
been prescribed for the client and the nurse Aspirin and other over-the-counter medications should not be taken unless the client
reinforces teaching for the client about the consults with the health care provider (HCP). The client needs to take the medication at
medication. Which statement, if made by the the same time every day and should be instructed not to stop the medication. A slight
client, indicates that further teaching is weight gain as a result of an improved appetite is expected, but after the dosage is
necessary? stabilized, a weight gain of 5 lb or more weekly should be reported to the HCP.
1. "I can take aspirin or my antihistamine if I Caffeine-containing foods and fluids need to be avoided because they may contribute
need it." to steroid-ulcer development.
2. "I need to take the medication every day at
the same time."
3. "I need to avoid coffee, tea, cola, and
chocolate in my diet."
4. "If I gain more than 5 pounds a week, I will
call my doctor."
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