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When administering a prescribed drug to a client, which action would be completely inappropriate? (Select one that does not apply.)
- A. Charting immediately on the MAR after drug administration
- B. Removing a drug from an unlabeled container
- C. Giving a drug that someone else prepared
- D. Crushing tablets or opening capsules
Correct Answer: A
Rationale: The nurse should always record immediately on the MAR after drug administration. The nurse should never remove a drug from an unlabeled container, give a drug that someone else prepared, or crush tablets or open capsules without consulting a pharmacist. The drug's unit dose wrapper should remain on until the nurse arrives at the client's bedside.
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A nurse is assessing a client who is taking Digoxin to treat heart failure. Which of the following findings is a manifestation of digoxin toxicity?
- A. Bruising
- B. Report of metallic taste
- C. Muscle pain
- D. Report of anorexia
Correct Answer: D
Rationale: Anorexia is a common early sign of digoxin toxicity.
The following cholinesterase inhibitor is used in anaesthesia:
- A. Neostigmine
- B. Physostigmine
- C. Endrophonium
- D. Donepezil
Correct Answer: A
Rationale: Neostigmine reverses non-depolarizing neuromuscular blockers in anesthesia.
A 68-year-old patient who must take antihistamines for severe allergies is planning a vacation to Mexico. The nurse will encourage the patient to:
- A. Avoid sightseeing during the hottest part of the day
- B. Discontinue the antihistamines if he becomes extremely restless
- C. Decrease the dosage of the drugs if he experiences excessive thirst
- D. Continue taking the antihistamines even if he begins to hallucinate
Correct Answer: A
Rationale: Antihistamines can decrease sweating by blocking cholinergic receptors, placing the patient at high risk for heat stroke. Avoiding the hottest part of the day will help prevent dehydration and heat prostration. Extreme restlessness could indicate Parkinson-like syndrome not usually associated with antihistamines. Excessive thirst is characteristic of hyperglycemia, and hallucinations are associated with drugs that affect neurologic functioning. Nurses should never tell patients to decrease or discontinue a drug unless the prescriber has instructed them to do so.
The nurse is reviewing the patient's medication orders and finds an order stating amoxicillin 250 mg every 8 hours. What would the nurse question regarding this order?
- A. Dose
- B. Route
- C. Frequency of administration
- D. Allowance for generic substitution
Correct Answer: B
Rationale: The order lacks the route (e.g., oral, IV), which is essential for safe administration.
Jim is being treated for hypertension. Because he has a history of heart attack, the drug chosen is atenolol. Beta blockers treat hypertension by:
- A. Increasing heart rate to improve cardiac output
- B. Reducing vascular smooth muscle tone
- C. Increasing aldosterone-mediated volume activity
- D. Reducing aqueous humor production
Correct Answer: B
Rationale: Beta blockers like atenolol reduce vascular tone and heart rate, lowering blood pressure.