final study guide PHARM

During the development of a new drug, which would be included in the study by the researcher to prevent any bias or unrealistic expectations of the new drug's usefulness?

A placebo

The nurse is reviewing instructions for a patient with type 2 diabetes who also takes insulin injections as part of the therapy. The nurse asks the patient, "What should you do if your fasting blood glucose is 47 mg/dL?" Which response by the patient reflects a correct understanding of insulin therapy?

I will take an oral form of glucose

When hanging a new infusion bag of a chemotherapy drug, the nurse accidentally spills a small amount of the solution onto the floor. Which action by the nurse is appropriate?

Use a spill kit to clean the area.

A patient is receiving heparin therapy as part of the treatment for a pulmonary embolism. The nurse monitors the results of which laboratory test to check the drug's effectiveness?

Activated partial thromboplastin time (aPTT)

A 78-year-old patient is in the recovery room after having a lengthy surgery on his hip. As he is gradually awakening, he requests pain medication. Within 10 minutes after receiving a dose of morphine sulfate, he is very lethargic and his respirations are shallow, with a rate of 7 per minute. The nurse prepares for which priority action at this time?

Administration of naloxone (narcan)

A patient who has been hospitalized for 2 weeks has developed a pressure ulcer that contains multidrug-resistant Staphylococcus aureus (MRSA). Which drug would the nurse expect to be chosen for therapy?

Vancomycin (vancocin)

Nurses have the ethical responsibility to tell the truth to their patients. What is this principle known as?

Veracity

The nurse is administering a stat dose of epinephrine. Epinephrine is appropriate for which situation?

Cardiac arrest

The nurse is preparing for a community education program on hypertension. Which of these parameters determine the regulation of arterial blood pressure?

Cardiac output and systemic vascular resistance

A 6-year-old child who has chickenpox also has a fever of 102.9° F (39.4° C). The child's mother asks the nurse if she should use aspirin to reduce the fever. What is the best response by the nurse?

"Acetaminophen (Tylenol) should be used to reduce his fever, not aspirin."

The nurse is providing teaching to a patient taking an oral tetracycline antibiotic. Which statement by the nurse is correct?

"Avoid direct sunlight and tanning beds while on this medication."

The nurse is teaching a patient who is taking colchicine for the treatment of gout. Which instruction will the nurse include during the teaching session?

"Call your doctor if you have increased pain or blood in the urine."

A patient calls the clinic to speak to the nurse about taking an herbal product that contains ginkgo (Ginkgo biloba) to "help my memory." He states that he has read much information about the herbal product. Which statement by the patient indicates a need for further education?

"I will take aspirin or ibuprofen (Motrin) if I have a headache."

A patient has been taking donepezil (Aricept) for 2 weeks as part of the treatment for early stages of Alzheimer's disease. Her daughter calls the prescriber's office and is upset because "Mother has not improved one bit!" Which response by the nurse is appropriate?

"It may take up to 6 weeks to see an improvement."

A patient who has a history of coronary artery disease has been instructed to take one 81-mg aspirin tablet a day. The patient asks about the purpose of this aspirin. Which response by the nurse is correct?

"It will help to prevent clot formation."

A 25-year-old woman is visiting the prenatal clinic and shares with the nurse her desire to go "natural" with her pregnancy. She shows the nurse a list of herbal remedies that she wants to buy so that she can "avoid taking any drugs." Which statement by the nurse is correct?

"It's important to remember that herbal remedies do not have proven safety ratings for pregnant women."

When given a scheduled morning medication, the patient states, "I haven't seen that pill before. Are you sure it's correct?" The nurse checks the medication administration record and verifies that it is listed. Which is the nurse's best response?

"Let me check on the order first before you take it."

When given an intravenous medication, the patient says to the nurse, "I usually take pills. Why does this medication have to be given in the arm?" What is the nurse's best answer?

"The action of the medication will begin sooner when given intravenously."

A patient with primary hypertension is prescribed drug therapy for the first time. The patient asks how long drug therapy will be needed. Which answer by the nurse is the correct response?

"Therapy for high blood pressure is usually lifelong."

A patient newly diagnosed with tuberculosis (TB) has been taking antitubercular drugs for 1 week calls the clinic and is very upset. He says, "My urine is dark orange! What's wrong with me?" Which response by the nurse is correct?

"This is an expected side effect of the medicine. Let's review what to expect."

A 14-year-old patient has been treated for asthma for almost 4 months. Two weeks ago, she was given salmeterol as part of her medication regimen. However, her mother has called the clinic to report that it does not seem to work when her daughter is having an asthma attack. Which response by the nurse is appropriate?

"This medication is indicated for prevention of bronchospasms, not for relief of acute symptoms."

The patient has been taking an over-the-counter (OTC) acid-reducing drug because he has had "stomach problems" for several months. He tells the nurse that the medicine helps as long as he takes it, but once he stops it, the symptoms return. Which statement by the nurse is the best advice for this patient?

"Using this drug may relieve your symptoms, but it does not address the cause. You should be seen by your health care provider."

A patient who has started drug therapy for tuberculosis wants to know how long he will be on the medications. Which response by the nurse is correct?

"You should expect to take these drugs for as long as 24 months."

The nurse can prevent medication errors by following which principles? (Select all that apply.)

-Use 2 pt identifiers before giving meds -Do not draw up medication that another nurse has drawn up in a syringe -Minimixe the use of verbal and telephone orders

A drug dose that delivers 250 mg has a half-life of 5 hours. Identify how much drug will remain in the body after one half-life. _______

125 mg

The nurse is administering insulin lispro (Humalog) and will keep in mind that this insulin will start to have an effect within which time frame?

15 minutes

The insulin order reads, "Check blood glucose levels before meals and at bedtime. For every 5 mg/dL over 150, give 1 unit of regular Humulin insulin, subcutaneously." The patient's blood glucose level at 11:30 co001-1.jpg., before lunch, was 233 mg/dL. In units, identify how much insulin will the nurse give. _______

16 units

A 7-year-old child will be receiving amoxicillin (Amoxil) 80 mg/kg/day in two divided doses. The child weighs 55 pounds. The medication, once reconstituted, is available as an oral suspension of 50 mg/mL. Identify how many milliliters will the child receive per dose.

20 mL

The nurse is reviewing medication errors. Which situation is an example of a medication error?

A patient receives a double dose of a medication because the nurse did not cut the pill in half.

A patient who has been taking antihypertensive drugs for a few months complains of having a persistent dry cough. The nurse knows that this cough is an adverse effect of which class of antihypertensive drugs?

Angiotensin-converting enzyme (ACE) inhibitors

A patient will be taking a 2-week course of combination therapy with omeprazole (Prilosec) and another drug for a peptic ulcer caused by Helicobacter pylori. The nurse expects a drug from which class to be ordered with the omeprazole?

Antibiotic

The nurse is writing a nursing diagnosis for a plan of care for a patient who has been newly diagnosed with type 2 diabetes. Which statement reflects the correct format for a nursing diagnosis?

Anxiety related to new drug therapy, as evidenced by statements such as "I'm upset about having to test my blood sugars."

A patient is experiencing diastolic heart failure. The nurse expects which beta blocker to be ordered for this patient?

Carvedilol (Coreg)

A patient was diagnosed with pancreatic cancer last month, and has complained of a dull ache in the abdomen for the past 4 months. This pain has been gradually increasing, and the pain relievers taken at home are no longer effective. What type of pain is the patient experiencing?

Chronic pain

Place the phases of the nursing process in the correct order, with 1 as the first phase and 5 as the last phase. (Select all that apply.)

Assessment Diagnoses Planning Implementation Evaluation

A patient is undergoing major surgery and asks the nurse about a living will. He states, "I don't want anybody else making decisions for me. And I don't want to prolong my life." The patient is demonstrating which ethical term?

Autonomy

A patient has a new order for the adrenergic drug doxazosin (Cardura). When providing education about this drug, the nurse will include which instructions?

Be sure to lie down after taking the first dose, because first dose hypotension may make you feel dizzy

When monitoring a patient who is taking a low-dose cholinergic drug, the nurse will watch for which cardiovascular effect?

Bradycardia

During a period of time when the computerized medication order system was down, the prescriber wrote admission orders, and the nurse is transcribing them. The nurse is having difficulty transcribing one order because of the prescriber's handwriting. Which is the best action for the nurse to take at this time?

Contact the prescriber to clarify the order.

The nurse is reviewing a list of verbal medication orders. Which is the proper notation of the dose of the drug ordered?

Digoxin 0.125 mg

A patient with gout has been treated with allopurinol (Zyloprim) for 2 months. The nurse will monitor laboratory results for which therapeutic effect?

Decreased uric acid levels

The nurse is monitoring for therapeutic results of antibiotic therapy in a patient with an infection. Which laboratory value would indicate therapeutic effectiveness of this therapy?

Decreased white blood cell count

A patient is to receive acetylcysteine (Mucomyst) as part of the treatment for an acetaminophen (Tylenol) overdose. Which action by the nurse is appropriate when giving this medication?

Disguising the flavor with soda or flavored water

The nurse will monitor for which adverse effect when administering an anticholinergic drug?

Dry mouth

The nurse is administering medications to the patient who is in renal failure resulting from end-stage renal disease. The nurse is aware that patients with kidney failure would most likely have problems with which pharmacokinetic phase?

Excretion

When monitoring a patient's response to oral antidiabetic drugs, the nurse knows that which laboratory result would indicate a therapeutic response?

Fasting blood glucose level between 92 mg/dL

The teaching for a patient who is taking tamsulosin (Flomax) to reduce urinary obstruction due to benign prostatic hyperplasia will include which of these?

Get up slowly from a sitting or lying position

At 0900, the nurse is about to give morning medications, and the patient has asked for a dose of antacid for severe heartburn. Which schedule for the antacid and medications is correct?

Give the medications at 0900, and then the antacid at 1000.

The nurse notes in a patient's medication history that the patient is taking allopurinol (Zyloprim). Based on this finding, the nurse interprets that the patient has which disorder?

Gout

A patient who has been taking cimetidine (Tagamet) for hyperacidity calls the clinic to say that the medication has not been effective. The nurse reviews his history and notes that which factor may be influencing the effectiveness of this drug?

He smokes two packs of cigarettes a day.

A patient has been prescribed warfarin (Coumadin) in addition to a heparin infusion. The patient asks the nurse why he has to be on two medications. The nurse's response is based on which rationale?

Heparin is used to start anticoagulation so as to allow time for the blood levels of warfarin to reach adequate levels

The nurse checks the patient's laboratory work prior to administering a dose of vancomycin (Vancocin) and finds that the trough vancomycin level is 24 mcg/mL. What will the nurse do next?

Hold the drug, and notify the prescriber.

The nurse is reviewing infection-prevention measures with a patient who is receiving antineoplastic drug therapy. Which statement by the patient indicates the need for further teaching?

I will only eat fresh fruits and vegetables

When counseling a male patient about the possible adverse effects of antihypertensive drugs, the nurse will discuss which potential problem?

Impotence

When a patient is taking an adrenergic drug, the nurse expects to observe which effect?

Increased Heart rate

The nurse is administering a combination of three different antineoplastic drugs to a patient who has metastatic breast cancer. Which statement best describes the rationale for combination therapy?

Increased cancer-cell killing will occur.

During an assessment, the patient tells the nurse that he eats large amounts of garlic for its cardiovascular benefits. Which drug or drug class, if taken, would have a potential interaction with the garlic?

Insulin

A patient is receiving thrombolytic therapy, and the nurse monitors the patient for adverse effects. What is the most common undesirable effect of thrombolytic therapy?

Internal and superficial bleeding

During initial rounds, the nurse notes that a dobutamine infusion has extravasated into the forearm of a patient. After stopping the infusion, the nurse follows standing orders and immediately injects phentolamine (Regitine) subcutaneously in a circular fashion around the extravasation site. What is the mechanism of action of the phentolamine in this situation?

It increases blood flow to the ischemic site by vasodilation to prevent tissue damage

A patient calls the clinic to ask about taking cranberry dietary supplement capsules because a friend recommended them. The nurse will discuss which possible concern when a patient is taking cranberry supplements?

It may reduce elimination of drugs that are excreted by the kidneys.

The prescriber has changed the patient's medication regimen to include the leukotriene receptor antagonist (LTRA) montelukast (Singulair) to treat asthma. The nurse will emphasize which point about this medication?

It needs to be taken every day on a continuous schedule, even if symptoms improve.

The nurse is providing teaching regarding drug therapy to the husband of a woman with Alzheimer's disease. She was diagnosed 3 months ago, has mild memory loss, and will be receiving donepezil (Aricept). What is the drug's expected action?

May help to improve the mood and decrease confusion

For which cultural group must the health care provider respect the value placed on preserving harmony with nature and the belief that disease is a result of ill spirits?

Native Americans

The nurse is discussing adverse effects of antitubercular drugs with a patient who has active tuberculosis. Which potential adverse effect of antitubercular drug therapy should the patient report to the prescriber?

Numbness and tingling of extremities

When evaluating a patient's use of a metered-dose inhaler (MDI), the nurse notes that the patient is unable to coordinate the activation of the inhaler with her breathing. What intervention is most appropriate at this time?

Obtain an order for a spacer device.

A patient has been treated for lung cancer for 3 years. Over the past few months, the patient has noticed that the opioid analgesic is not helping as much as it had previously and more medication is needed for the same pain relief. The nurse is aware that this patient is experiencing which of these?

Opioid tolerance

When educating a patient recently placed on inhaled corticosteroids, the nurse will discuss which potential adverse effects?

Oral candidiasis and dry mouth

The nurse is counseling a woman who will be starting rifampin (Rifadin) as part of antitubercular therapy. The patient is currently taking oral contraceptives. Which statement is true regarding rifampin therapy for this patient?

Oral contraceptives are less effective while the patient is taking rifampin.

A patient is receiving gabapentin (Neurontin), an anticonvulsant, but has no history of seizures. The nurse expects that the patient is receiving this drug for which condition?

Pain associated with peripheral neuropathy

The nurse is reviewing the use of anticholinergic drugs. Anticholinergic drugs block the effects of which nervous system?

Parasympathetic nervous system

The nurse notes in the patient's medication orders that the patient will be starting anticoagulant therapy. What is the primary goal of anticoagulant therapy?

Preventing thrombus formation

Which activity best reflects the implementation phase of the nursing process for the patient who is newly diagnosed with hypertension?

Providing education on keeping a journal of blood pressure readings

A patient is recovering from abdominal surgery, which he had this morning. He is groggy but complaining of severe pain around his incision. What is the most important assessment data to consider before the nurse administers a dose of morphine sulfate to the patient?

Respiratory rate

The patient is to receive oral guaifenesin (Mucinex) twice a day. Today, the nurse was busy and gave the medication 2 hours after the scheduled dose was due. What type of problem does this represent?

Right time

A patient is complaining of excessive and painful gas. The nurse checks the patient's medication orders and prepares to administer which drug for this problem?

Simethicone (Mylicon)

A patient is receiving his third intravenous dose of a penicillin drug. He calls the nurse to report that he is feeling "anxious" and is having trouble breathing. What will the nurse do first?

Stop the antibiotic infusion.

The nurse is aware that adrenergic drugs produce effects similar to which of these nervous systems?

Sympathetic nervous system

The patient is experiencing chest pain and needs to take a sublingual form of nitroglycerin. Where does the nurse instruct the patient to place the tablet?

Under the tongue

A patient has been instructed to take one enteric-coated low-dose aspirin a day as part of therapy to prevent strokes. The nurse will provide which instruction when providing patient teaching about this medication?

Take the medication with 6 to 8 ounces of water and with food.

The nurse is assessing an elderly Hispanic woman who is being treated for hypertension. During the assessment, what is important for the nurse to remember about cultural aspects?

The nurse's assessment needs to include gathering information regarding religious practices and beliefs regarding medication, treatment, and healing.

A patient has been selected as a potential recipient of an experimental drug for heart failure. The nurse knows that when informed consent has been obtained, it indicates which of these?

The patient has had the study's purpose, procedures, and the risks involved explained to him.

During therapy with a beta blocker, the patient notices that she has swollen feet, has gained 3 pounds within 2 days, feels short of breath even when walking around the house, and has been dizzy. The nurse suspects that which of these is occurring?

The patient may be developing heart failure

The nurse is performing an assessment of a newly admitted patient. Which is an example of subjective data?

The patient reports that he uses the herbal product ginkgo

The nurse is assigned to a patient who is newly diagnosed with type 1 diabetes mellitus. Which statement best illustrates an outcome criterion for this patient?

The patient will demonstrate correct blood glucose testing technique

The nurse is developing a plan of care for a patient who is experiencing gastrointestinal adverse effects, including anorexia and nausea, after the first course of antineoplastic therapy. What is an appropriate outcome for this patient when dealing with this problem?

The patient will maintain a diet of small, frequent feedings with nutrition supplements within 2 weeks.

When reviewing the medication orders for a patient who is taking penicillin, the nurse notes that the patient is also taking the oral anticoagulant warfarin (Coumadin). What possible effect may occur as the result of an interaction between these drugs?

The penicillin will cause an enhanced anticoagulant effect of the warfarin.

The nurse is reviewing pharmacology terms for a group of newly graduated nurses. Which sentence defines a drug's half-life?

The time it takes for one half of the original amount of a drug to be removed from the body

When administering drugs, the nurse remembers that the duration of action of a drug is defined as which of these?

The time period at which a drug's concentration is sufficient to cause a therapeutic response

A patient has been taking antitubercular therapy for 3 months. The nurse will assess for what findings that indicate a therapeutic response to the drug therapy?

There is a decrease in symptoms of tuberculosis along with improved chest x-rays and sputum cultures.

The nurse is teaching a class about the various chemotherapy drugs. Which of these statements explains why alkylating drugs are also called "cell cycle-nonspecific drugs"?

They are cytotoxic in any phase of the cell cycle.

After receiving a nebulizer treatment with a beta agonist, the patient complains of feeling slightly nervous and wonders if her asthma is getting worse. What is the nurse's best response?

This is an expected adverse effect. Let me take your pulse.

When a patient is on aminoglycoside therapy, the nurse will monitor the patient for which indicators of potential toxicity?

Tinnitus and dizziness

A patient who has been anticoagulated with warfarin (Coumadin) has been admitted for gastrointestinal bleeding. The history and physical examination indicates that the patient may have taken too much warfarin. The nurse anticipates that the patient will receive which antidote?

Vitamin K

The nurse is teaching a group of patients about self-administration of insulin. What content is important to include?

When mixing insulins, the clear (such as regular) insulin is drawn up into the syringe first.

When reviewing the allergy history of a patient, the nurse notes that the patient is allergic to penicillin. Based on this finding, the nurse would question an order for which class of antibiotics?

cephalosporins

A patient wants to take the herb gingko to help his memory. The nurse reviews his current medication list and would be concerned about potential interactions if he is taking a medication from which class of drugs?

anticoagulants

The nurse is reviewing the therapeutic effects of nonsteroidal anti-inflammatory drugs (NSAIDs), which include which effect?

antipyretic

A patient who has been on methotrexate therapy is experiencing mild pain. The patient is asking for aspirin for the pain. The nurse recognizes that which of these is true in this situation?

aspirin can lead to methotrexate toxicity

A patient has prescriptions for two inhalers. One inhaler is a bronchodilator, and the other is a corticosteroid. Which instruction regarding these inhalers will the nurse give to the patient?

bronchodilator first

A patient who has had abdominal surgery has been discharged on a cholinergic drug to assist in increasing gastrointestinal peristalsis. The nurse will teach this patient to look for which therapeutic effect?

passage of flatus

When teaching about hypoglycemia, the nurse will make sure that the patient is aware of the early signs of hypoglycemia, including:

confusion and sweating.

During drug therapy with a tetracycline antibiotic, a patient complains of some nausea and decreased appetite. Which statement is the nurse's best advice to the patient?

drink a full glass of water with each dose

Drug transfer to the fetus is more likely during the last trimester for which reason

enhanced blood flow to the fetus

A hospitalized patient is experiencing a severe anaphylactic reaction to a dose of intravenous penicillin. Which drug will the nurse expect to use to treat this condition?

epinephrine

A patient is taking intravenous aminophylline for a severe exacerbation of chronic obstructive pulmonary disease. The nurse will assess for which therapeutic response?

increased ease of breathing

A patient is receiving high doses of methotrexate and is experiencing severe bone marrow suppression. The nurse expects which intervention to be ordered with this drug to reduce this problem?

leucovorin rescue

when discussing dosage calculation for pediatric patients with a clinical pharmacist, the nurse notes that which type of dosage calculation is most commonly in pediatric calculation

mg/kg

the nurse is preparing to give an injection to a 4 year old child. which intervention is age appropriate

offer a brief, concrete explanation to the patient and with the parent or caregiver

When reviewing the health history of a patient who will be receiving antacids, the nurse recalls that antacids containing magnesium need to be used cautiously in patients with which condition?

renal failure

One patient has cancer of the bone; another has cancer in the connective tissues of the thigh muscles; a third patient has cancer in the vascular tissues. Which of these is the correct term for these tumors?

sarcoma

the nurse is aware that confusion, forgetfulness, and increased risk for falls are common responses in an elderly patient who is taking which type of drug?

sedatives

What is the nurse's priority action if extravasation of an antineoplastic drug occurs during intravenous (IV) administration?

stop the infusion immediately but leave the IV catheter in place

The nurse is about to administer a stat dose of intravenous atropine sulfate to a patient who is experiencing a symptomatic cardiac dysrhythmia. During administration of this drug, the nurse will monitor the patient closely for which adverse effect?

tachycardia

the nurse is administering drugs to neonates and will consider which factor may contribute the most to drug toxicity

the liver is not fully developed

A patient will be receiving a thrombolytic drug as part of the treatment for acute myocardial infarction. The nurse explains to the patient that this drug is used for which purpose?

to dissolve the clot in the coronary artery