Pharmacological and Parenteral Therapies

The nurse is caring for a 48-year-old male patient who is receiving 20 mg of furosemide (Lasix) OD. Which information is most important to tell the oncoming nurse?

The nurse teaching the patient with major depressive disorder taking tranylcypromine (Parnate) about necessary diet modifications. Which food, if selected by the patient, indicates a need for further teaching?  

The nurse is providing medication teaching to a patient receiving lithium for management of bipolar disorder. The nurse instructs the patient to take in similar levels of which nutrient each day?

The patient with cystic fibrosis has been ordered to receive pancreatic enzymes. The nurse collaborates with the clinical pharmacist to create which dosing schedule?

Which of the following is the immediate drug of choice for an adult patient who has symptomatic sinus bradycardia with a pulse?

A nurse is caring for a 47-year-old man who is admitted in the substance abuse unit for alcohol detoxification. The patient exhibits signs and symptoms of alcohol withdrawal, including hallucinations. Which of the following medications do you anticipate will be ordered for alcohol withdrawal?

A nurse is caring for a 34-year-old postpartum patient with deep vein thrombosis who is receiving heparin. Which of the following should the nurse prepare as bedside emergency for patients receiving heparin?

A nurse is caring for a 59-year-old woman who is receiving heparin. Which of the following can be used to track the effectiveness of heparin therapy?

An 18-year-old patient asks the nurse for assistance in choosing a birth control method. She tells the nurse that she smokes infrequently and has trouble remembering to take her daily vitamins. Which method does the nurse recommend to the patient?

A nurse is taking care of a patient who has been on longstanding total parenteral nutrition (TPN). The provider orders the TPN to be discontinued. Shortly after the TPN is stopped, the patient becomes altered and combative. The nurse attributes the change in this patient to which condition?

The 70-kg patient has an order to receive vancomycin 10 mg/kg intravenously every 12 hours. Pharmacy dispenses the vancomycin in 25 mL vials, which contain 100 mg of vancomycin each. How many milliliters of medication does the nurse administer per dose?

The nurse provides counseling to a client with atrial fibrillation (AF) who is starting on rivaroxaban. Which statement, if made by the client, indicates the teaching is effective?

The patient presents to the emergency department complaining of lightheadedness and states, “I feel like my heart is racing.” Upon assessment, the nurse notes the patient is diaphoretic and pale. Vital signs are significant for a heart rate of 220 bpm, blood pressure of 70/50 mm Hg, and oxygen saturations of 96%. The 12-lead EKG indicates supraventricular tachycardia. Which medication does the nurse prepare to administer?

The telemetry monitor for a patient who chronically abuses alcohol sounds and the provider requests a dose of magnesium. The nurse understands the patient has likely experienced which arrhythmia?

The 35-year-old patient presents to the emergency department with nausea, vomiting, and diarrhea for the past week. Vital signs are significant for a heart rate of 135 bpm and a blood pressure of 75/40 mmHg. The nurse anticipates which order?

The patient presents to the clinic following being bitten by a bat while cleaning out a barn. The nurse anticipates administering which vaccine?

A 54-year-old client admitted with new-onset atrial fibrillation is prescribed warfarin. Which instruction does the nurse include when teaching the client about warfarin?

A client with chronic liver disease is admitted with community-acquired pneumonia and is prescribed ceftriaxone 2 g IV every 12 hours. Which intervention does the nurse perform first?

A patient that has been clinically diagnosed with Rocky Mountain spotted fever (RMSF) is prescribed doxycycline. The patient states, “My blood tests didn’t prove I have RMSF. I don’t want to take antibiotics unless I know for sure I have it.” Which response by the nurse is the most appropriate?

Which of the following may benefit from inhaled surfactant therapy? Select all that apply.

The provider tells the nurse that the goal of therapy for a patient with congestive heart failure (CHF) and acute pulmonary edema is preload reduction. To accomplish this, the nurse anticipates administering which of the following medications?

The patient receiving inhaled anesthesia for a surgical procedure develops malignant hyperthermia. Which of the following medications should the nurse expect to administer?

The patient with a T4 spinal cord injury that occurred 4 weeks ago has been prescribed terazosin. The nurse informs the patient this medication is prescribed to prevent which of the following conditions?

A 15 mL/kg transfusion of packed red blood cells has been ordered for a premature neonate with a hemoglobin of 6.4 g/dL. The neonate is 4 days old and weighs 14 ounces. How many milliliters of blood does the nurse administer? Enter your response as a whole number.

The nurse is assessing a patient with a 20-gauge intravenous catheter is the right hand through which vancomycin is infusing. The nurse notes the IV insertion site is edematous and erythematous. Which of the following is the most appropriate next course of action?

The nurse assesses the insertion site of an intravenous catheter through which the patient is receiving amphotericin. The nurse notes erythema, edema, and tenderness immediately proximal to the insertion site. Which of the following terms is most appropriate for the nurse to use to document this finding?

The nurse is preparing to administer hyaluronidase to a patient who experienced an IV extravasation. Which of the following statements should the nurse use to describe the rationale for using this drug to the patient?

The nurse is caring for a patient who requires four intravenous drugs with four different pHs to be infused through an intravenous catheter that was just placed. In which order must they be administered to help prevent extravasation? Place the answers in the correct order.

The patient with acute kidney injury due to hypovolemic shock has been effectively fluid resuscitated but remains oliguric. Which of the following medications does the nurse administer to prevent fluid volume overload?

The nurse is caring for a patient newly diagnosed with tuberculosis. Which medication(s) will the nurse most likely administer to this patient for his condition? Select all that apply.

The patient with hemochromatosis has a hemoglobin of 8 g/dL. The nurse prepares the patient for which therapy?

The patient with hemochromatosis and anemia has been prescribed deferasirox. Prior to prescribing the medication, the nurse reviews the patient’s chart and notes the patient also takes metronidazole. Which of the following actions by the nurse is most appropriate?

The patient with hemochromatosis has been prescribed deferasirox. Which of the following instructions should the nurse include in discharge teaching?

The patient presents to the emergency department with altered mental status and myoclonic jerking. Although the nurse notes that the patient is flushed and his face is red, his skin and mucous membranes are dry and warm to the touch. The nurse also notes decreased bowel sounds and palpates a distended bladder. Vital signs are significant for a temperature of 39.9°C (103.8°F), heart rate of 122 bpm and a blood pressure of 165/92 mm Hg. The nurse prepares to administer which of the following medications to this patient?

The patient is a 5-year-old boy who presents with anticholinergic toxicity and has been prescribed physostigmine 0.02 mg/kg q10min until the patient’s heart rate drops to 100 beats per minute. The patient’s heart rate is 132 bpm and he weighs 42 pounds. It takes 40 minutes after the first dose for the patient’s heart rate to decrease to 100 bpm. How much total physostigmine, in mg, does the nurse administer? Input your answer to the nearest hundredth decimal place.

The patient is a 5-year-old child who presents with anticholinergic toxicity and who has been prescribed 0.02 mg/kg of physostigmine. The patient weighs 56 pounds. The pharmacy dispenses the medication in 1 mg/mL vials. How many milliliters will the nurse administer per dose? Input your answer to the nearest hundredth decimal place.

A 5-year-old boy presents with recent ingestion of an entire bottle of chewable pediatric acetaminophen. The child’s mother learned of the ingestion two hours after it occurred and immediately brought the child to the closest emergency department an hour away. The patient weighs 41 pounds. Which of the following prescriptions should the nurse most likely anticipate initially?

The patient is a 5-year-old boy who presents having ingested an entire bottle of acetaminophen 2 hours ago. The provider has prescribed acetylcysteine 150 mg/kg intravenously in 3ml/kg D5W. The patient weighs 35 pounds. How many grams of acetylcysteine in how many milliliters of D5W does the nurse administer to this patient? Input your answer to the nearest tenth decimal place in this exact format (X.X g in XX.X mL).

A nurse made a medication error and administered 50000 units instead of 500 units of unfractionated heparin and the patient begins oozing blood from his IV site. Which of the following does the nurse anticipate will be ordered for this patient?

The patient is receiving lorazepam for conscious sedation for a procedure. The nurse notes the patient’s respiratory rate has decreased to 4 breaths per minute. The nurse anticipates administering which of the following medications?

The patient presents to the emergency department following ingestion of an entire bottle of alprazolam. Upon review of the patient’s chart, the patient has been taking alprazolam for 2 years. Vital signs are significant for an oxygen saturation of 84% on room air, respiratory rate of 8 breaths per minute, a blood pressure of 88/64 mmHg, and a heart rate of 64 bpm. The nurse anticipates the provider to prescribe which of the following therapies?

The patient is receiving intravenous gentamicin to treat a gram-negative infection. The nurse draws a gentamicin trough level immediately prior to the 4th dose; the result is 2.2 µg/mL. Which of the following conclusions would be most appropriate given this result?

The pediatric patient presents with prolonged fever, a red, strawberry tongue, desquamation of the soles and palms, and lymphadenopathy. The nurse anticipates administering which of the following medication(s)? Select all that apply.

The nurse administers intravenous immunoglobulin (IVIG) to a patient with Kawasaki disease. The nurse assesses the patient continuously for which life-threatening complication of IVIG?

A patient is brought to the emergency department by ambulance immediately after being rescued from a house fire. It is determined he has suffered third-degree burns to 34% of his body. The nurse is ordered to begin fluid resuscitation. The patient weighs 186 pounds. Using the Parkland formula, determine the rate (in mL/hr) the nurse will use to program the pump for fluid infusion during the first 8 hours. Enter your answer as a whole number.

The nurse is administering fluid resuscitation to a patient who sustained fourth-degree burns to 25% of the body and third-degree burns to 15% of the body. The patient weighs 210 pounds. Using the Parkland formula, how many milliliters should the nurse plan for the patient to receive in the first 24 hours of resuscitation?

The provider has instructed the nurse to begin fluid resuscitation of a burn patient using the Parkland formula. The patient’s weight is 84 kg and the total body surface area burned is 32%. The pharmacy provides lactated Ringers (LR) in 1,000 mL bags. How many bags of LR should the nurse request from the pharmacy to ensure the patient can be properly fluid resuscitated? Input your answer using a whole number.

The nurse is instructed to begin fluid resuscitation for the patient with extensive full-thickness burns. Which of the following fluids will the nurse most likely utilize?

A patient with septicemia acutely develops a deep vein thrombosis and pulmonary embolism. No evidence of hemorrhage is noted. Laboratory studies have revealed prolonged clotting times, moderate thrombocytopenia, and an elevated D-dimer level. A diagnosis of disseminated intravascular coagulation is made. Administration of which of the following therapies will be most effective at resolving this patient’s DIC?

A child with acute myelogenous leukemia is scheduled to receive chemotherapy at 0800 on Tuesday. When should the nurse administer the first dose of antiemetic to best prevent chemotherapy-induced nausea and vomiting?