Adams Pharmacology Chapter 44-47

The patient with erectile dysfunction is being evaluated for the use of sildenafil (Viagra). Which question should the nurse ask before initiating therapy with sildenafil? 1. "Are you currently taking medications for angina?" 2. "Do you have a history of diabetes?" 3. "Have you ever had an allergic reaction to dairy products?" 4. "Have you ever been treated for migraines?"

1. "Are you currently taking medications for angina?"

The nurse is teaching a patient who has a new prescription for testosterone gel. Which instruction should the nurse give to this patient? 1. "Avoid exposing women to the gel or to areas of skin where the gel has been applied." 2. "Report any weight gain over 2 kg (5 lb) in 1 month." 3. "Avoid showering or swimming for at least 12 hours after applying the gel." 4. "Apply the gel to the scrotal and perineal areas daily."

1. "Avoid exposing women to the gel or to areas of skin where the gel has been applied."

Which patients would have a higher risk for adverse effects from estradiol and norethindrone (Ortho-Novum)? (Select all that apply.) 1. An 18-year-old with a history of depression 2. A 16-year-old with chronic acne 3. A 33-year-old with obesity per her body mass index (BMI) 4. A 24-year-old who smokes one pack of cigarettes per day 5. A 41-year-old who has delivered two healthy children

1. An 18-year-old with a history of depression 4. A 24-year-old who smokes one pack of cigarettes per day

A patient is given a prescription for finasteride (Proscar) for treatment of benign prostatic hyperplasia. Essential teaching for this patient includes which of the following? (Select all that apply.) 1. Full therapeutic effects may take 3 to 6 months. 2. Hair loss or male-pattern baldness may be an adverse effect. 3. The drug should not be handled by pregnant women, especially if it is crushed. 4. Blood donation should not occur while taking this drug. 5. Report any weight gain of over 2 kg (5 lb) in 1 week.

1. Full therapeutic effects may take 3 to 6 months. 3. The drug should not be handled by pregnant women, especially if it is crushed. 4. Blood donation should not occur while taking this drug.

A 63-year-old patient with type 2 diabetes is admitted to the nursing unit with an infected foot ulcer. Despite previous good control on glyburide (DiaBeta), his blood glucose has been elevated the past several days and he requires sliding-scale insulin. What is the most likely reason for the elevated glucose levels? 1. It is a temporary condition related to the stress response with increase glucose release. 2. He is converting to a type 1 diabetic. 3. The oral antidiabetic drug is no longer working for him. 4. Patients with diabetes who are admitted to the hospital are switched to insulin for safety and tighter control.

1. It is a temporary condition related to the stress response with increase glucose release.

The patient is scheduled to receive 5 units of Humalog and 25 units of NPH (Isophane) insulin prior to breakfast. Which nursing intervention is most appropriate for this patient? 1. Make sure the patient's breakfast is available to eat before administering the insulin. 2. Offer the patient a high-carbohydrate snack in 6 hours. 3. Hold the insulin if the blood glucose level is greater than 100 mg/dL. 4. Administer the medications in two separate syringes.

1. Make sure the patient's breakfast is available to eat before administering the insulin.

What patient education should the nurse provide to the patient with diabetes who is planning an exercise program? (Select all that apply.) 1. Monitor blood glucose levels before and after exercise. 2. Eat a complex carbohydrate prior to strenuous exercise. 3. Exercise may increase insulin needs. 4. Withhold insulin prior to engaging in strenuous exercise. 5. Take extra insulin prior to exercise.

1. Monitor blood glucose levels before and after exercise. 2. Eat a complex carbohydrate prior to strenuous exercise.

The nurse is talking with the parents of a child who will receive somatropin (Nutropin) about the drug therapy. Which important detail will the nurse include in the teaching for these parents? 1. The drug must be given by injection. 2. The drug must be given regularly throughout adolescence and young adulthood to achieve desired effects. 3. If the drug therapy is given throughout adolescence, it could add 6 (15 cm) to 8 inches (20 cm) to the child's height. 4. Daily laboratory monitoring will be required during the first weeks of therapy.

1. The drug must be given by injection.

A patient has started taking clomiphene (Clomid, Serophene) after an infertility workup and asks the nurse why she is not having in-vitro fertilization. Which statement would be most helpful in explaining the use of clomiphene to the patient? 1. The patient's diagnostic workup suggested that infrequent ovulation may be the cause for her infertility, and clomiphene increases ovulation. 2. In-vitro fertilization is expensive and because clomiphene is less expensive, it is always tried first. 3. There is less risk of multiple births with clomiphene. 4. The patient's past history of oral contraceptive use has prevented her from ovulating. Clomiphene is given to stimulate ovulation again in these conditions.

1. The patient's diagnostic workup suggested that infrequent ovulation may be the cause for her infertility, and clomiphene increases ovulation.

A patient is interested in taking levonorgestrel and estradiol (Seasonique) and asks how it is taken. Which explanation by the nurse is correct? 1. "Seasonique is taken year-round without a break and without a period." 2. "Seasonique is taken for 84 days and then followed by 7 days of a lower dose contained in the same package." 3. "Seasonique is a vaginal ring that is inserted monthly." 4. "Seasonique is taken for 2 months then off for 1 month using regular oral contraceptives."

2. "Seasonique is taken for 84 days and then followed by 7 days of a lower dose contained in the same package."

Which of the following nursing assessments would be appropriate for the patient who is receiving testosterone? (Select all that apply.) 1. Monitor for a decrease in hematocrit. 2. Assess for signs of fluid retention. 3. Assess for increased muscle mass and strength. 4. Check for blood dyscrasias. 5. Assess for muscle wasting.

2. Assess for signs of fluid retention. 3. Assess for increased muscle mass and strength.

A nurse is preparing the teaching plan for a patient who will be discharged on methylprednisolone (Medrol Dosepak) after a significant response to poison ivy. The nurse will include instruction on reporting which adverse effects to the healthcare provider? (Select all that apply.) 1. Tinnitus 2. Edema 3. Eye pain or visual changes 4. Abdominal pain 5. Dizziness upon standing

2. Edema 3. Eye pain or visual changes 4. Abdominal pain

The nurse is initiating discharge teaching with the newly diagnosed patient with diabetes. Which statement indicates that the patient needs additional teaching? 1. "If I am experiencing hypoglycemia, I should drink 1/2 cup of apple juice." 2. "My insulin needs may increase when I have an infection." 3. "I must draw the NPH insulin first if I am mixing it with regular insulin." 4. "If my blood glucose levels are less than 60 mg/dL, I should notify my healthcare provider."

3. "I must draw the NPH insulin first if I am mixing it with regular insulin."

A woman consults the nurse about Plan B (levonorgestrel) after unprotected intercourse that occurred 2 days earlier. Which instruction will the nurse give to this patient? 1. "You must wait 7 days before taking the pills for Plan B to be effective." 2. "Plan B is effective only within 24 hours of unprotected intercourse." 3. "You will take one pill of Plan B at first, followed by another pill 12 hours later." 4. "You will need to obtain a prescription for Plan B."

3. "You will take one pill of Plan B at first, followed by another pill 12 hours later."

Which assessment findings would cause the nurse to withhold the patient s regularly scheduled dose of levothyroxine (Synthroid)? 1. A 1-kg (2-lb) weight gain 2. A blood pressure reading of 90/62 mmHg 3. A heart rate of 110 beats/minute 4. A temperature of 37.9°C (100.2°F)

3. A heart rate of 110 beats/minute

A patient is being treated with methimazole (Tapazole) for hyperthyroidism, pending thyroidectomy. While the patient is taking this drug, what symptoms will the nurse teach the patient to report to the healthcare provider? 1. Tinnitus, altered taste, thickened saliva 2. Insomnia, nightmares, night sweats 3. General weakness, muscle cramps, and dry skin 4. Dry eyes, decreased blinking, reddened conjunctiva

3. General weakness, muscle cramps, and dry skin

The nurse is teaching a patient about the use of tadalafil (Cialis). What will the nurse teach him about the effects of tadalafil? 1. It should always result in a penile erection within 10 minutes. 2. It may heighten female sexual response. 3. It is not effective if sexual dysfunction is caused by psychologic conditions. 4. It will result in less intense sensation with prolonged use.

3. It is not effective if sexual dysfunction is caused by psychologic conditions.

A patient will be started on desmopressin (DDAVP) for treatment of diabetes insipidus. Which instruction should the nurse include in the teaching plan? 1. Drink plenty of fluids, especially those high in calcium. 2.Avoid close contact with children or pregnant women for 1 week after administration of the drug. 3. Obtain and record your weight daily. 4. Wear a mask if around children and pregnant women.

3. Obtain and record your weight daily.

The nurse is assisting a patient with chronic adrenal insufficiency to plan for medication consistency while on a family vacation trip. He is taking hydrocortisone (Cortef) and fludrocortisones (Florinef) as replacement therapy. What essential detail does this patient need to remember to do? 1. Take his blood pressure once or twice daily. 2. Avoid crowded indoor areas to avoid infections. 3. Have his vision checked before he leaves. 4. Carry an oral and injectable form of both drugs with him on his trip.

4. Carry an oral and injectable form of both drugs with him on his trip.

A patient with type 2 diabetes has been NPO since midnight for surgery in the morning. He has been on a combination of oral type 2 antidiabetic drugs. What would be the best action for the nurse to take concerning the administration of his medications? 1. Hold all medications as per the NPO order. 2. Give him the medications with a sip of water. 3. Give him half the original dose. 4. Contact the healthcare provider for further orders.

4. Contact the healthcare provider for further orders.

The nurse completes an assessment of a patient in labor who is receiving an intravenous infusion of oxytocin. Which assessment indicates the need for prompt intervention? 1. There is no vaginal bleeding noted. 2. The patient is managing her pain through breathing techniques. 3. Fetal heart rate remains at baseline parameters. 4. Contractions are sustained for 2 minutes in duration.

4. Contractions are sustained for 2 minutes in duration.

A 43-year-old patient is receiving medroxyprogesterone (Depo-Provera) for treatment of dysfunctional uterine bleeding. Because of related adverse effects, which condition may indicate a potential adverse effect? 1. Breakthrough bleeding between periods 2. Insomnia or difficulty falling asleep 3. Eye, mouth, or vaginal dryness 4. Joint pain or pain on ambulation

4. Joint pain or pain on ambulation

A patient with a history of benign prostatic hyperplasia is complaining of feeling like he "cannot empty his bladder." He has been taking finasteride (Proscar) for the past 9 months. What should the nurse advise this patient to do? 1. Continue to take the drug to achieve full therapeutic effects. 2. Discuss the use of a low-dose diuretic with the healthcare provider. 3. Decrease the intake of coffee, tea, and alcohol. 4. Return to the healthcare provider for laboratory studies and a prostate exam.

4. Return to the healthcare provider for laboratory studies and a prostate exam.

A patient receives NPH and regular insulin every morning. The nurse is verifying that the patient understands that there are 2 different peak times to be aware of for this insulin regimen. Why is this an important concept for the nurse to stress? 1. The patient needs to plan the next insulin injection around the peak times. 2. Additional insulin may be needed at peak times to avoid hyperglycemia. 3. It is best to plan exercise or other activities around peak insulin activity. 4. The risk for hypoglycemia is greatest around the peak of insulin activity.

4. The risk for hypoglycemia is greatest around the peak of insulin activity.