Final Exam 1 Pharm

A child is receiving Dextroamphetamine and amphetamine (Adderall XR). The mother tells the nurse the patient is having trouble sleeping while on the medication. What is the best response by the nurse? a. "Give the medication before 4:00 pm." b. "Add diphenhydramine at bedtime." c. "Stop the medication immediately and see the doctor." d. "Give the medication at 8:00 pm."

A

A nurse assesses a patient after administering a prescribed beta-blocker. Which assessment would the nurse expect to find? Question 21Answera. Pulse decreased from 100 to 80 beats/min b. Blood pressure increased from 98/42 to 132/60 mm Hg c. Oxygen saturation increased from 88% to 96% d. Respiratory rate decreased from 25 to 14 breaths/min

A

Parasympathomimetic drugs cause: a. Bradycardia b. Mydriasis c. Bronchodilation d. Constipation

A

Patients can exhibit alterations in the rate and extent of drug absorption because of various factors. All of the following factors might affect the rate and/or extent of drug absorption EXCEPT: a. A generic form of the drug b. Intestinal motility c. The presence of food in gut d. Gastric emptying time e. The formulation of the drug

A

The nurse is preparing to care for a patient who will be taking an antihypertensive medication. Which action by the nurse is part of the assessment step of the nursing process? a. Questioning the patient about over-the-counter medications b. Taking the patient's blood pressure throughout the course of treatment c. Asking the prescriber for an order to monitor serum drug levels d. Monitoring the patient for drug interactions after giving the medication

A

The symptoms of excessive stimulation of muscarinic receptors include all of the following EXCEPT: a. Weakness of all skeletal muscles b. Abdominal cramps, diarrhea c. Increased salivation, excessive bronchial secretion d. Miosis, bradycardia

A

Therapeutic index (TI) is: a. The ratio of the dose that produces toxicity to the dose that produces a clinically desired or effective response b. A ratio used to evaluate the bioavailability of a drug c. A ratio used to evaluate the effectiveness of a drug d. A ratio used to evaluate the elimination of a drug

A

When providing teaching for a patient who is prescribed a selective serotonin reuptake inhibitor(SSRI), which statement will the nurse include? a. The SSRI may take several weeks to have a beneficial effect. b. The SSRI will not work well for severe cases of depression. c. The SSRI will have an immediate beneficial effect on the patient's depression symptoms. d. The SSRI will work faster than the older tricyclic antidepressants.

A

Which of the following anti seizure drugs is a benzodiazepine receptor agonist: a. Lorazepam b. Phenobarbital c. Carbamazepine d. Phenytoin

A

Which of the following drugs is an non cardio-selective beta receptor antagonist? a. Propranolol b. Acebutolol c. Atenolol d. Metoprolol

A

Which of the following statements is correct for levodopa? a. All of the above b. Tolerance to both beneficial and adverse effects develops gradually c. Levodopa is most effective in the first 2-5 years of treatment d. After 5 years of therapy, patients have dose-related dyskinesia's, inadequate response or toxicity

A

A drug that is used for nerve pain (neuropathy) that is also a drug used as an anti-epileptic agent is / are: (Select all that apply) a. Gabapentin (Neurontin) b. Carbamazepine (Tegretol) c. Diazepam (Valium) d. Phenytoin (Dilantin)

A,B

A nurse recognizes that the actions of benzodiazepines include which findings? (Select all that apply.) a. Relief of general anxiety b. Suppression of seizures and/or seizure activity c. Increase in muscle spasms d. Development of tardive dyskinesia

A,B

Which groups of people are especially sensitive to medication effects? (Select all that apply.) a. Infants b. Older Adults c. Women d. Caucasians e. Minorities

A,B

Before administering a medication, what does the nurse need to know to evaluate how individual patient variability might affect the patient's physiologic response to the medication? (Select all that apply.) a. Patient's age b. Chemical stability of the medication c. Patient's diagnosis d. Family medical history e. Ease of administration

A,C,D

What are the properties of an ideal drug? (Select all that apply) a. Predictability b. Irreversible action c. Chemical stability d. Ease of administration

A,C,D

A provider prescribed phenobarbital for a patient who has seizure disorder. This medication has a long half life of 4 days. How many times per day should the nurse expect to administer this drug? a. Three times per day b. Once daily c. Four times daily d. Twice daily

B

Following oral administration, a drug is absorbed into the body, wherein it can exert its action. For a drug given orally, the primary site of drug absorption is: a. Liver b. The upper portion of the small intestine c. The stomach d. The esophagus

B

If two drugs with the same effect, taken together, produce an effect that is equal in magnitude to the sum of the effects of the drugs given individually, it is called as: a. Synergism b. Additive effect c. Antagonism d. Tolerance

B

Lithium carbonate is useful in the treatment of: a. Petit mal seizures b. Bipolar disorder c. Trigeminal neuralgia d. Parkinson's disease

B

The mechanism of action of cholinesterase inhibitors: Question 51Answera. Stimulation of the action of acetylcholinesterase b. block the normal breakdown of the neurotransmitter, acetylcholine c. Releasing acetylcholine from storage sites d. Binding to and activation of muscarinic or nicotinic receptor

B

When patients are taking selective SSRIs for the first time for depression, which is most important to monitor for during the first few weeks of therapy? a. Hypertensive crisis b. Suicidal thoughts c. Convulsions d. Orthostatic hypotension

B

Which of the following agents is the precursor of dopamine? a. Amantadine b. Levodopa c. Bromocriptine d. Selegiline

B

Which of the following drug is a selective serotonin reuptake inhibitor(SSRI) drug class that is most commonly prescribed to treat depression? Question 56Answera. Haloperidol b. Fluoxetine c. Amitriptyline d. Selegiline

B

Which of the following side effects is the most common after prolonged use of SSRIs? a. weight loss b. Sexual dysfunction c. Nausea d. Headache

B

Which of the following sympathomimetic agent is combined with a local anesthetic agent(like Lidocaine) to prolong the duration of anesthesia and to reduce the risk of bleeding during procedures(suturing)? a. Isoproterenol b. Epinephrine c. Dobutamine d. Dopamine

B

The nurse is administering morning medications. The nurse gives a patient multiple medications, two of which compete for plasma albumin receptor sites. As a result of this concurrent administration, the nurse can anticipate that what might occur? (Select all that apply.) Question 33Select one or more:a. The increase in bound drug will intensify effects. b. Plasma levels of free drug will rise. c. The increase in free drug will intensify effects. d. Binding of one or both agents will be reduced. e. Plasma levels of free drug will fall.

B,D

Which statement below is true regarding a catecholamine? Question 55Select one or more:a. Catecholamines are cholinergic in their effect b. Catecholamines cannot cross the blood brain barrier c. Catecholamines are metabolized slowly d. Catecholamines are commonly given by the enteral route e. Catecholamines must be given by parenteral route

B,E

A nurse is giving an enteral medication. The patient asks why this method is preferable for this drug. How will the nurse reply? a. "This route prevents inactivation of the drug by digestive enzymes b. "This route is the best way to control serum drug levels." c. "This route is safer, less expensive, and more convenient." d. "This route allows more rapid absorption of the drug."

C

A nurse is preparing to administer medications. Which patient would the nurse consider to have the greatest predisposition to an adverse reaction? a. A 50-year-old man with an upper respiratory tract infection b. A 9-year-old boy with an ear infection c. A 30-year-old man with kidney disease d. A 75-year-old woman with cystitis

C

A patient is receiving Interferon Beta for treatment of multiple sclerosis. As the nurse you will stress the importance of? a. Low fat diet b. Physical exercise to improve fatigue c. Hand hygiene to avoid infection d. Reporting feelings of severe depression of suicidal thoughts

C

A patient is to begin taking phenytoin [Dilantin] for seizures. The patient tells the nurse that she is taking oral contraceptives. What will the nurse tell the patient? a. She should stop taking oral contraceptives, because they reduce the effectiveness of phenytoin. b. She should remain on oral contraceptives, because phenytoin causes birth defects. c. She should consider a different form of birth control(condoms or IUD) while taking phenytoin. d. She may need to increase her dose of phenytoin while taking oral contraceptives.

C

Alpha 1-Adrenoceptors are prominently involved in which one of the following? a. Cardiac contractility b. Presynaptic inhibition c. Vasoconstriction d. Cardiac acceleration e. Intestinal relaxation

C

Beta-receptor antagonists cause: a. Stimulation of lipolysis b. Stimulation of gluconeogenesis c. Inhibition of glycogenolysis d. Stimulation of insulin secretion

C

Drug Half life (t 1⁄2) is the time required to: a. Metabolize a half of an introduced drug into the active metabolite b. Absorb a half of an introduced drug c. Change the amount of a drug in plasma by half during elimination d. Bind a half of an introduced drug to plasma proteins

C

Patient is ordered ibuprofen 200 mg, you have enteric-coated tablets, but patient says she can't swallow the pills. What does the RN do? Question 50Select one:a. Encourage the patient to try to swallow the tablets. b. Crush the tablets and mix them with applesauce or pudding. c. Call the pharmacy and ask for the liquid form of the medication. d. Call the pharmacy and ask for the IM form of the medication.

C

Pharmacokinetics is: a. The study of biological and therapeutic effects of drugs b. The study of mechanisms of drug action c. The study of absorption, distribution, metabolism and excretion of drugs d. The study of methods of new drug development

C

The nurse is teaching a patient about home administration of insulin to treat diabetes mellitus. As part of the teaching, the patient and nurse identify goals to maintain specific blood glucose ranges. This represents which aspect of the nursing process? a. Implementation b. Evaluation c. Planning d. Assessment

C

What is the definition for therapeutic dose: a. The amount of a substance to produce effects hazardous for an organism b. The amount of a substance to accelerate an increase of concentration of medicine in an organism c. The amount of a substance to produce the required effect in most patients d. The amount of a substance to produce the minimal biological effect

C

When monitoring a patient who is taking a low-dose cholinergic drug, the nurse will watch for which cardiovascular effect? a. palpitations b. tachycardia c. bradycardia d. vasoconstriction

C

Which of the following agents is an alpha1, alpha 2, beta1, beta2 receptor agonist? a. Isoproterenol b. Dopamine c. Epinephrine d. Albuterol

C

A 30 year old asthmatic patient is having mild to moderate hypertension. Which one of these beta-blockers is most appropriate for this patient? a. Nadolol. b. Timolol. c. Propranolol. d. Atenolol.

D

A nurse is caring for an intubated patient who is receiving pancuronium (Pavulon) for neuromuscular blockade. The patient's eyes are closed, and the patient is not moving any extremities. The patient's heart rate is 76 beats per minute, and the blood pressure is 110/70 mm Hg. The nurse caring for this patient will do what? a. Review the patient's chart for a history of myasthenia gravis (MG). b. Request an order for serum electrolytes to evaluate for hyperkalemia. c. Request and order for an antihistamine to prevent a further drop in blood pressure. d. Talk to the patient while giving care and explain all procedures

D

A nursing student is preparing to give a medication that has a "High Alert" or "Black Boxed Warning". The student asks the nurse what this means. What will the nurse explain about boxed warnings? a. They provide detailed information about the adverse effects of the drug. b. They indicate that a drug should not be given except in life-threatening circumstances. c. They provide information about antidotes in the event that toxicity occurs. d. They alert prescribers to measures to mitigate potential harm from side effects.

D

A patient is taking an First generation antipsychotics(FGA) for schizophrenia. The nurse notes that the patient has trouble speaking and chewing and observes slow, worm-like movements of the patient's tongue. The nurse recognizes which adverse effect in this patient? a. Acute dystonia b. Akathisia c. Parkinsonism d. Tardive dyskinesia

D

A patient receives a drug that has a narrow therapeutic range. The nurse administering this medication will expect to do what? a. Administer the drug at intervals longer than the drug half-life. b. Administer this medication intravenously. c. Teach the patient that maximum drug effects will occur within a short period. d. Monitor plasma drug levels.

D

A patient requires a high dose of antihypertensive medication because the medication has a significant first-pass effect. What does this mean? a. The medication must pass through the patient's bloodstream several times to generate a therapeutic effect. b. The medication passes through the renal tubules and is excreted in large amounts. c. The medication is ineffective following the first dose and increasingly effective with each subsequent dose. d. The medication is extensively metabolized in the patient's liver.

D

Dopamine is administered to a patient who has been experiencing hypotensive episodes. Other than an increase in blood pressure, which indicator would the nurse use to evaluate a successful response to the dopamine? a. Decrease in pulse. b. Weight gain c. Improved gastric motility d. Increase in urine output

D

Isoproterenol is a : Question 60Answera. beta1-selective agonist b. Both an alpha- and beta-receptor agonist c. beta2-selective agonist d. Nonselective beta receptor agonis

D

Parenteral (Intravenous) administration: a. Cannot be used with unconsciousness patients b. Is too slow for emergency use c. Generally results in a less accurate dosage than oral administration d. Usually produces a more rapid response than oral administration

D

The amount of a drug dose that reaches the systemic circulation will affect the plasma concentration and therapeutic effects observed. The fraction of a administered drug that reaches the systemic circulation in the unchanged form (i.e., intact) is defined as: a. Therapeutic index b. Therapeutic dose c. Theoretical dose d. Bioavailability

D

The body has developed defense mechanisms that reduce the amount of foreign chemicals, such as drugs, that enter the body. One of the more prominent of these mechanisms is an efflux transport system that pumps some drugs back into the intestinal lumen following absorption into the enterocytes and that is responsible for the lack of complete absorption of some drugs and removing drugs from the kidneys and liver into the urine and bile respectively. This efflux transport system is: a. Cytochrome P450 b. Pinocytosis c. Facilitated diffusion d. P glycoprotein

D

The nurse is caring for a child who has ingested a toxic amount of aspirin. The provider orders an intravenous drug(sodium bicarbonate) that will increase pH in the blood and urine. The nurse understands that this effect is necessary to: a. increase the serum protein binding of aspirin b. Increase the gastric absorption of aspirin c. increase the urinary excretion of aspirin. d. decrease the lipid solubility of aspirin.

D

What is the antidote for muscarinic(chollinergic) poisoning? a. Edrophonium b. Neostigmine c. Acetylcholine d. Atropine

D

Which of the following drugs is a depolarizing neuromuscular blocking agent? a. Vecuronium b. Pancuronium c. Scopolamine d. Succinylcholine

D

Which of the following is an accurate description of changes taking place in elderly individuals compared to younger adults? a. Diminished body fat as a relative percentage of total body mass b. Increase in the levels of plasma proteins c. General increase in hepatic drug metabolizing capacity d. Decrease in renal clearance of many drugs e. Increased lean body mass

D

Which one of the following neurologic drugs can cause diplopia and thickened gums with long term therapy? a. Valproic acid b. Phenobarbital c. Carbamazepine d. Phenytoin

D

Which route of drug administration is most likely to lead to the first-pass effect? a. Intravenous b. Sublingual c. Intramuscular d. Oral

D

Your patient is taking levodopa (Dopar), and you have been conducting an analysis of the patient's diet. You find that she eats three times the recommended amount of protein at each meal. Your best response to this is to tell her: a. that her protein intake is good, as protein increases the effect of levodopa. b. that protein in her diet will benefit the transport of levodopa throughout her body. c. that she is likely to damage her kidneys if she maintains this diet plan. d. that too much dietary protein could make the levodopa less effective.

D

tropine is frequently used as a preanesthetic agent to reduce: a. Muscle tone b. Nausea and vomiting c. Tachycardia d. Secretions

D