NSG367 Exam 1
Drug Half Life
the time required for the amount of drug in the body to decrease by 50%
What are the main neurotransmitters of the parasympathetic nervous system?
-acetylcholine Binds to muscarinic or nicotinic receptors
What are the main neurotransmitters of the sympathetic nervous system?
-catacholamines -norepinephrine -epinephrine Upon release, neurotransmitters bind to adrenergic receptors (alpha, beta)
The nurse is preparing to give an oral dose of acetaminophen (Tylenol) to a child who weighs 12 kg. The dose is 15 mg/kg. How many milligrams will the nurse administer for this dose?
180mg
An 86-yr-old patient is being discharged to home on digitalis therapy and has very little information regarding the medication. Which statement best reflects a realistic outcome of patient teaching activities? A- The patient and patient's daughter will state the proper way to take the drug B- The nurse will provide teaching about the drug's adverse effects C-The patient will state all the symptoms of digitalis toxicity D- The patient will call the prescriber if adverse effects occur
A- The patient and patient's daughter will state the proper way to take the drug
The nurse is reviewing factors that influence pharmacokinetics in the neonatal patient. Which factor puts the neonatal patient at risk with regard to drug therapy? A- immature renal system B- increased peristalsis in the GI tract C- irregular temperature regulation D- smaller circulatory capacity
A- immature renal system
The nurse is reviewing the various forms of topical medications. Which of these are considered topical medications? (Select all that apply) A- rectal ointment for hemorrhoids B- eye drops for inflammation C- sublingual tablet for chest pain D- inhaled medication for asthma E- intradermal injection for tuberculosis testing
A- rectal ointment for hemorrhoids B- eye drops for inflammation D- inhaled medication for asthma
Drug binding has affinity for receptor. Stimulates or activates (also has intrinsic activity) receptor to produce effect/response. A. Agonist B. Antagonist
A. Agonist If a drug is an agonist, it produces a chemical reaction after being attached to the receptors of the brain.
This adrenergic receptor has to do with blood vessels, the iris, and urinary bladder. Vasoconstriction, increase in BP, pupil dilation, increased closure of sphincter. A. Alpha-1 B. Alpha-2 C. Beta-1 D. Beta-2
A. Alpha-1
A nurse is teaching a client who has a new prescription for allopurinol. Which of the following instructions should the nurse include? A. Avoid driving or activities that require mental alertness B. Avoid crushing the tablets C. limit fluid intake during therapy D. Limit potassium while taking allopurinol
A. Avoid driving or activities that require mental alertness
A nurse is teaching a client who is taking allopurinol about minimizing adverse effects. Which of the following instructions should the nurse include? A. Eat a small meal before taking the drug B. Suck on hard candy or chew gum C. Take a stool softener daily D. Avoid the use of NSAIDS.
A. Eat a small meal before taking the drug
A nurse is caring for a client who is about to begin taking aspirin. The nurse should instruct the client to report which of the following manifestations of salicylism? (select all that apply) A. Fever B. Tinnitus C. Diaphoresis (sweating) D. Thrombophlebitis E. Dizziness
A. Fever B. Tinnitus C. Diaphoresis E. Dizziness
Drugs that produce unconsciousness and lack of responsiveness to all painful stimuli. A. General anesthetics B. Local anesthetics C. Monitored anesthesia care (mac)
A. General anesthetics Given only by licensed anesthesiology (physicians) and CRNAS (nurses). Used to facilitate certain procedures.
The name that a pharmaceutical company gives a drug after developing it. Not capitalized. Ex: acetaminophen A. Generic name B. Brand/Trade name
A. Generic name
The teaching for a patient who is taking tamsulosin (Flomax) to reduce urinary obstruction due to benign prostatic hyperplasia will include which of these? A. Get up slowly from a sitting or lying position. B. Fluids need to be restricted while on this medication C. Blood pressure must be monitored because the medication may cause hypertension D. Take the medication with breakfast to promote the maximum effects of the drug.
A. Get up slowly from a sitting or lying position. This medication is used to relieve impaired urinary flow in men with benign prostatic hyperplasia, but it also can cause orthostatic hypotension when changing positions from sitting or lying positions. Because of these effects, the blood pressure may become dramatically lowered, and lightheadedness may occur, increasing the risk of falling. Tamulosin is a Alpha-1 antagonist. Anything that ends in OSIN is an Alpha-1 antagonist which leads to vasodilation, reduced bp and reduced vascular restriction. A risk due to the decrease in blood pressure is orthostatic hypotension, which is when the blood pressure drops rapidly when standing up.
A nurse is preparing to teach a client how to take care of a newly created colostomy. The nurse should identify that which of the following factors can decrease the client's ability to learn? (select all) A. Impaired cognitive level B. Language barrier C. Discomfort D. Repetition of teaching E. Unreadiness to learn
A. Impaired cognitive level B. Language barrier C. Discomfort E. Unreadiness to learn
A nurse is caring for a client who is taking naloxone to treat acute morphine toxicity. The nurse should monitor the client for which of the following adverse drug reactions? (select all that apply) A. Increased respiratory rate B. Increased pain C. Thrombophlebitis D. Ventricular arrhythmias E. Hypertension
A. Increased respiratory rate B. Increased pain D. Ventricular arrhythmias E. Hypertension Naloxone is an opioid antagonist. Opioid agonists are used for analgesia, euphoria, and sedation so the adverse drug reactions should be the opposite of what opioid agonist cause (such as sedation, lower respiratory rate, lower bp, reduce pain)
A client who has a peanut allergy comes to the emergency department with suspected anaphylactic shock. Which of the following actions should you anticipate taking? (select all that apply) A. Initiate oxygen therapy to support respiratory function. B. Administer epinephrine to increase blood pressure. C. Give diphenhydramine to stop histamine release D. Establish and maintain an open airway to ensure oxygenation. E. Administer a drug agonist to neutralize the allergic reaction.
A. Initiate oxygen therapy to support respiratory function. B. Administer epinephrine to increase blood pressure. C. Give diphenhydramine to stop histamine release D. Establish and maintain an open airway to ensure oxygenation.
A nurse is planning care for a client who has stared taking prednisone. Which of the following interventions should the nurse include? A. Monitor the client's blood glucose B. Administer an antacid 30 min prior to prednisone C. Administer aspirin rather than NSAIDs if the client has pain D. Monitor the client for hyperkalemia
A. Monitor the client's blood glucose Prednisone can cause hyperglycemia. The nurse should monitor the client's blood glucose regularly.
The nurse is administering medications to the client and understands that which medication routes will be affected by first pass effect? A. Oral B. Intravenous C. SQ D. Trandermal
A. Oral Medications absorbed in the stomach and small intestine travel through the portal system and are metabolized by the liver before they reach the general circulation.
A nurse is caring for a client who was prescribed an antidepressant based on its ability to prevent the reuptake of neurotransmitters. The nurse should identify that which of the following terms describes why this drug was prescribed for the client? A. Pharmacologic action B. Chemical stability C. Route D. Adverse effects
A. Pharmacologic action The nurse should identify that the mechanism of action of a drug on the body to achieve the desired effect is referred to as pharmacologic action.
A nurse is reviewing the drug list for a client who has a new prescription for allopurinol. The nurse should identify that which of the following drug interacts with allopurinol? A. Warfarin B. Ibuprofen C. Insulin D. Furosemide
A. Warfarin Warfarin is an anticoagulant (blood thinner to reduce blood clots). Allopurinol is a uric acid reducer that treats gout and kidney stones. Using both together makes you bleed more easily.
A nurse is caring for a client who has a new prescription for a drug. After receiving the first dose of the drug, the client experiences anaphylaxis. The nurse should identify that anaphylaxis represents which of the following results of the drug? A. adverse effect B. paradoxical effect C. therapeutic effect D. toxicity
A. adverse effect Adverse effects are the unintended and unexpected effects of a drug.
An elderly woman took a prescription medicine to help her to sleep; however, she felt restless all night and did not sleep at all. The nurse recognized that this woman has experienced which type of reaction or effect? A- Allergic reaction B- Idiosyncratic reaction C-Mutagenic effect D- Synergistic effect
B- Idiosyncratic reaction An idiosyncratic reaction is an atypical response to a medication. In this case, the medication is giving the woman an atypical response because a medicine to help one sleep SHOULD NOT make you restless instead.
The nurse is preparing to administer an injection to a preschool-age child. Which approaches are appropriate for this age group? (Select all that apply) A- Explain to the child in advance about the injection B- Provide a brief, concrete explanation about the injection C- Encourage participation in the procedure D- Make use of magical thinking E- Provide comfort measures after the injection
B- Provide a brief, concrete D- Make use of magical thinking E- Provide comfort measures after the injection
The nurse is reviewing new medication orders that have been written for a newly admitted patient. The nurse will need to clarify which orders? (Select all that apply) A- Metaformin (Glucophage) 1000 mg PO twice a day B- Sitagliptin (Januvia) 50 mg daily C- Simvastatin (Zocor) 20 mg PO every evening D- Irbesartan (Avapro) 300 mg PO once a day E- Docusate (Colace) as needed for constipation
B- Sitagliptin (Januvia) 50 mg daily E- Docusate (Colace) as needed for constipation
A nurse is caring for a client who takes low-dose aspirin to prevent cardiovascular events. The client asks the nurse about taking ibuprofen to treat rheumatoid arthritis. Which of the following responses should the nurse make? A. "Ibuprofen will increase your risk for developing salicylism." B. "Ibuprofen will reduce the cardioprotective effects of low-dose aspirin." C. "Low-dose aspirin will reduce the anti-inflammatory effects of ibuprofen." D. "Low-dose aspirin will reduce the analgesic effects of ibuprofen."
B. "Ibuprofen will reduce the cardioprotective effects of low-dose aspirin." Ibuprofen, an NSAID, reduces the cardioprotective effects of low-dose aspirin. Clients taking low-dose aspirin for its ability to decrease platelet aggregation should not take ibuprofen.
Occur when two drugs have similar actions when given together (ex. oxycodone and acetaminophen) A. Synergistic effects B. Additive effects C. Antagonistic effects
B. Additive effects
These receptors mediate responses to epinephrine (adrenaline) and norepinephrine. Has to do with the sympathetic immune system. A. Cholinergic receptors B. Adrenergic receptors
B. Adrenergic receptors
This adrenergic receptor has to do with nerve membranes and the pancreas. Decrease in NE release, moderates insulin release. A. Alpha-1 B. Alpha-2 C. Beta-1 D. Beta-2
B. Alpha-2
Drug binding prevents the action of an agonist but does not have any effect itself (think key fits lock but does not turn). A. Agonist B. Antagonist
B. Antagonist If a drug is an antagonist, it opposes a certain action. When an antagonist is given, it blocks the addictive drug from activating the receptors of the brain.
The nurse is screening a patient who will be taking a nonspecific/nonselective beta blocker. Which condition, if present, may cause serious problems if the patient takes this medication? A. Angina B. Asthma C. Hypertension D. Glaucome
B. Asthma (Nonspecific/nonselective beta-blocking drugs may precipitate bradycardia, hypotension, heart block, heart failure, bronchoconstriction, and/or increased airway resistance. Therefore, any preexisting respiratory condition such as asthma might be worsened by the concurrent use of any of these medications.)
A patient has had an overdose of an intravenous cholinergic drug. The nurse expects to administer which drug as an antidote? A. Bethanechol (Urecholine) B. Atropine sulfate C. Atenolol (Tenormin) D. Dobutamine
B. Atropine sulfate Atropine is a cholinergic antagonist and an emergency treatment for bradycardia.
The commercial or proprietary name of a drug. Capitalized and may vary according to the company producing and marketing it. Ex: Tylenol A. Generic name B. Brand/Trade name
B. Brand/Trade name
A nurse is teaching a client who has a new prescription for prednisone. Which of the following instructions should the nurse include? (select all that apply) A. Reduce the dose during periods of stress B. Discontinue the drug gradually C. Report illness or infection D. Increase intake of calcium and vitamin D E. Monitor for signs of gastric bleeding
B. Discontinue the drug gradually C. Report illness or infection D. Increase intake of calcium and vitamin D E. Monitor for signs of gastric bleeding
A nurse is caring for a client who is taking allopurinol to treat gout. The nurse should monitor the client for which of the following manifestations of hypersensitivity syndrome? A. Muscle pain B. Fever C. Anxiety D. Tremors
B. Fever
A client asks you about the difference between a generic drug and a trade or brand name drug. Which of the following are true regarding generic drugs? (select all that apply) A. Have the potential for abuse and dependence B. Have the same chemical composition as the brand-name drug C. May have several brand names D. May have several generic names E. Are usually less expensive than a brand-name drug
B. Have the same chemical composition as the brand-name drug C. May have several brand names E. Are usually less expensive than a brand-name drug
These anesthetics do not reduce consciousness, and they blunt pain only in a limited area. A. General anesthetics B. Local anesthetics C. Monitored anesthesia care (mac)
B. Local anesthetics Suppress pain by blocking sodium channels, thereby blocking impulse conduction along axons. Only in neurons located near the site of administration. Suppress pain without generalized depression of nervous system.
A nurse is caring for a client who has a new prescription for butorphanol. The nurse should monitor the client for which of the following adverse drug reactions? A. Infection B. Nausea C. Tachycardia D. Dizziness E. Headache
B. Nausea D. Dizziness E. Headache Butorphanol is an opioid agonist.
Pain resulting from injury to peripheral nerves. Responds poorly to opioids- might use anti-epileptic meds instead, or things that block neuro pathways. A. Nociceptive pain B. Neuropathic pain
B. Neuropathic pain
A patient has a new prescription for a blood pressure medication that may cause him to feel dizzy during the first few days of therapy. Which is the best human needs statement for this situation? A. Physical activity B. Physical safety C. Freedom pain D. Interchange of gases
B. Physical safety Because he's dizzy and can fall and injure himself.
The nurse administers the preoperative medication midazolam (Versed). The nurse will monitor the patient for which intended effect of this medication? A. Decreased bronchial secretions B. Reduction in anxiety C. Respiratory depression D. Suppression of cough
B. Reduction in anxiety Anything with a lam or pam ending is a benzodiazepine (CNS depressant). They work to calm, induce sleep, relax, and provide anti anxiety in patients.
A nurse is reviewing the medical record of a client who has a new prescription for tramadol. The nurse should identify that which of the following conditions is a contraindication for tramadol? A. Hyperthyroidism B. Seizure disorder C. Rheumatoid arthritis D. Urinary incontinence
B. Seizure disorder
A nurse is teaching a client who has a new prescription for allopurinol. The nurse should instruct the client to report which of the following adverse drug reactions? (select all that apply) A. Palpitations B. Sore throat C. Vertigo D. Bruising E. Vision changes
B. Sore throat C. Vertigo D. Bruising E. Vision changes
A nurse is caring for a client who is receiving morphine to relieve severe pain. The nurse should monitor the client for which of the following adverse drug reactions? (Select all that apply) A. Diarrhea B. Urinary retention C. Respiratory depression D. Sedation E. Orthostatic hypotension
B. Urinary retention C. Respiratory depression D. Sedation E. Orthostatic hypotension
A nurse is caring for a client who is opioid dependant and has a new prescription for butorphanol. The nurse should monitor the client for which of the following manifestations of ab syndrome? A. Bronchospasm B. Vomiting C. Peripheral edema D. Abdominal cramps E. Hypertension
B. Vomiting D. Abdominal cramps E. Hypertension Butorphanol is an opioid agonist-antagonist.
A nurse is preparing to administer an IM dose of penicillin to a client who has a new prescription. The client states she took penicillin 3 years ago and developed a rash. Which of the following actions should the nurse take? A. Administer the prescribed dose. B. Withhold the medication and contact the healthcare provider. C. Ask the provider to change the prescription to an oral form. D. Administer an oral antihistamine at the same time.
B. Withhold the medication and contact the healthcare provider. The nurse should withhold the medication and notify the provider of the client's previous reaction to penicillin so that an alternative antibiotic can be prescribed. Allergic reactions to penicillin can range from mild to severe anaphylaxis, and prior sensitization should be reported to the provider.
The nurse is compiling a drug history for a patient. Which question from the nurse will obtain the most information from the patient? A- "Do you depend on sleeping pills to get sleep?" B- "Do you have a family history of heart disease?" C- "When you have pain, what do you do to relieve it?" D- "What childhood diseases did you have?"
C- "When you have pain, what do you do to relieve it?"
An 82 year-old patient is admitted to the hospital after an episode of confusion at home. The nurse is assessing the current medications he is taking at hime. Which method is the best way to assess his home medications? A- Ask the patient what medications me takes at home B- Ask the patient's wife what medications he takes at home C- Ask the patient's wife to bring his medications to the hospital in their original containers D- Contact the patient's pharmacy for a list of the patient's current medications
C- Ask the patient's wife to bring his medications to the hospital in their original containers
While caring for a patient with cirrhosis or hepatitis, the nurse knows that abnormalities in which phase of pharmacokinetics may occur? A- Absorption B- Distribution C- Metabolism D- Excretion
C- Metabolism
While teaching a 76-year-old patient about the adverse effects of his medications, the nurse encourages him to keep a journal of the adverse effects he experiences. This intervention is important for the older adult patient because of which alterations in pharmacokinetics? A- increased renal excretion of protein-bound drugs B- more alkaline gastric pH, resulting in more adverse effects C- decreased blood flow to the liver, resulting in altered metabolism D- less adipose tissue to store fat-soluble drugs
C- decreased blood flow to the liver, resulting in altered metabolism
You note that a primary care provider prescribed morphine sulfate, an opioid agonist, to relieve a client's postoperative pain. Which of the following actions describes the action of an agonist on a receptor? A. Destroys the receptor B. Competes with the receptor C. Activates the receptor D. Blocks the receptor
C. Activates the receptor
When one drug reduces the effect of another drug, it is: A. An allergic reaction B. A synergistic effect. C. An antagonistic effect D. An adverse reaction
C. An antagonistic effect
Occur when two drugs are competing or have less effect when given together (ex. ciprofloxacin and iron) A. Synergistic effects B. Additive effects C. Antagonistic effects
C. Antagonistic effects
This adrenergic receptor has to do with the heart. It stimulates cardiac activity and increases heart rate. A. Alpha-1 B. Alpha-2 C. Beta-1 D. Beta-2
C. Beta-1
A nurse is caring for a client who has a new prescription for prednisone for long-term treatment of rheumatoid arthritis. The nurse should monitor the client for which of the following adverse drug reactions? A. Pulmonary embolism B. Hepatitis C. Bone loss D. Breast cancer
C. Bone loss Prednisone, a glucocorticoid, can cause osteoporosis, especially with long-term use. Clients who are taking the drug should increase weight-bearing activity and report back pain. The nurse should monitor the client's bone density.
A patient is going home with a new prescription for the beta-blocker atenolol (Tenormin). The nurse will include which content when teaching the patient about this drug? A. If adverse effects occur, stop taking the drug for 24 hours, and then resume. B. The medication will be stopped once symptoms subside. C. Never stop taking this medication abruptly. D. Be watchful for first-dose hypotension.
C. Never stop taking this medication abruptly. Stopping a beta blocker abruptly increases one's risk for heart attack, as beta blockers (aka beta antagonists) are known to reduce heart rate and contractility.
A nurse is reviewing the medical record of a client who has a new prescription for celecoxib. The nurse should identify that which of the following conditions is a contraindication to celecoxib? A. Rheumatoid arthritis B. Ankylosing spondylitis C. Sulfonamide allergy D. Adrenocortical insufficiency
C. Sulfonamide allergy Clients who are allergic to sulfonamides can have severe allergic reactions to celecoxib, a COX-2 inhibitor. Clients who are allergic to salicylates can also react adversely to celecoxib.
A nurse is caring for a client who has a prescription for aspirin to treat an ankle sprain. The nurse should instruct the client to report which of the following adverse drug reactions? A. Polyuria B. Bone pain C. Weight gain D. Infection
C. Weight gain
A patient has just received a prescription for an enteric-coated stool softener. When teaching the patient, the nurse should include which statement? A- "Take the tablet with 2 to 3 ounces of orange juice" B- "Avoid taking all other medications with any enteric-coated tablet" C- "Crush the tablet before swallowing if you have problems with swallowing." D- "Be sure to swallow the tablet whole without chewing it."
D- "Be sure to swallow the tablet whole without chewing it."
A pregnant patient who is at 32 weeks' gestation has a cold and calls the office to ask about taking an over-the-counter medication that is rated as pregnancy category A. Which answer by the nurse is correct? A- "This drug causes problems in the human fetus, so you should not take this medication." B- "This drug may cause problems in the human fetus, but nothing has been proven in clinical trials. It is best not to take this medication." C- "This drug has not caused problems in animals, but no testing has been done in humans. It is probably safe to take." D- "Studies indicate that there is no risk to the human fetus, so it is okay to take this medication as directed if you need it."
D- "Studies indicate that there is no risk to the human fetus, so it is okay to take this medication as directed if you need it."
Each statement describes a phase of pharmacokinetics. Put the statements in order with 1 indicating that the phase occurs first and 4 indicating that the phase occurs last. A- Enzymes in the liver transform the drug into an inactive metabolite B- Drug metabolites are secreted through passive glomerular filtration into the renal tubules. C- A drug binds to the plasma protein albumin and circulates through the body. D- A drug moves from the intestinal lumen into the mesenteric blood system
D- A drug moves from the intestinal lumen into the mesenteric blood system C- A drug binds to the plasma protein albumin and circulates through the body. A- Enzymes in the liver transform the drug into an inactive metabolite B- Drug metabolites are secreted through passive glomerular filtration into the renal tubules.
When the nurse is reviewing a list of medications taken by an 88-year-old patient, the patient says, "I get dizzy when I stand up." She also states that she has nearly fainted "a time or two" in the afternoons. Her systolic blood pressure drops 15 points when she stands up. Which type of medication may be responsible for these effects? A- Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) B- Cardiac glycosides C- Anticoagulants D- Antihypertensives
D- Antihypertensives
A patient's chart includes an order that reads as follows: "Atenolol 25 mg once daily at 0900." Which action by the nurse is correct? A- The nurse gives the drug via the transdermal route. B- The nurse gives the drug orally. C- The nurse gives the drug intravenously. D- The nurse contacts the prescriber to clarify the dosage route.
D- The nurse contacts the prescriber to clarify the dosage route.
The physiologic differences in the pediatric patient compared with the adult patient affect the amount of drug needed to produce a therapeutic effect. The nurse is aware that one of the main differences is that infants have A- increased protein in circulation B- fat composition lower than 0.001% C- more muscular body composition D- water composition of approximately 75%
D- water composition of approximately 75%
A nurse is caring for a group of postoperative clients. The nurse should identify that morphine is contraindicated for which of the following clients? A. A client who had a mastectomy B. A client who had a knee arthroplasty C. A client who had a colectomy D. A client who had a cholecystectomy
D. A client who had a cholecystectomy Morphine can cause biliary colic (pain in the abdomen usually bc of an obstruction). It should not be administered to a client who has just had biliary tract surgery, such as cholecystectomy.
A nurse is reviewing the medical record of a client who reports taking acetaminophen at home. The nurse should identify that which of the following client conditions is a contraindication for acetaminophen? A. Asthma B. Diabetes mellitus C. Heart failure D. Alcohol use disorder
D. Alcohol use disorder Acetaminophen can cause liver toxicity.
A nurse is caring for a child who has a viral infection. The nurse should identify that which of the following drugs can increase the risk of Reye syndrome in children who have viral infections? A. Butorphanol B. Acetaminophen C. Tramadol D. Aspirin
D. Aspirin
This adrenergic receptor has to do with smooth muscle in blood vessels, bronchi, and the periphery. It causes vasodilation of blood vessels and dilation of bronchi. A. Alpha-1 B. Alpha-2 C. Beta-1 D. Beta-2
D. Beta-2 Breathe better with beta 2!
A nurse is providing teaching to a pregnant client who is taking captopril, an ACE inhibitor, to treat hypertension. The nurse informs the client that captopril is a teratogenic drug. The nurse should explain that teratogenic drugs can cause which of the following? A. Maternal bleeding B. Maternal blood clots C. Gestational diabetes mellitus D. Fetal malformation
D. Fetal malformation
A nurse is reviewing a new prescription for ondansetron 4 mg po PRN for nausea and vomiting for a client. The nurse should clarify which of the following parts of the prescription with the provider? A. Name B. Dosage C. Route D. Frequency
D. Frequency Although it says PRN, there needs to be a limit as to how many times you can take it per day. Example 4 mg PO PRN BID
A nurse is caring for a client who currently takes furosemide and has a new prescription for prednisone. The nurse should monitor the client for which of the following manifestations during concurrent use of the two drugs? A. Hypercalcemia B. Hypoglycemia C. Hypothermia D. Hypokalemia
D. Hypokalemia Prednisone, a glucocorticoid, can cause hypokalemia. The risk for this electrolyte imbalance increases when the client is taking potassium-depleting diuretics, such as furosemide. The nurse should clarify the prescription with the provider and monitor the client's potassium levels.
A postoperative patient who has an intravenous infusion of morphine has a respiratory rate of 8 breaths per minute and is lethargic. Which as-needed (PRN) medication should the nurse administer to the patient? A. Methadone B. Nalbuphine C. Tramadol D. Naloxone
D. Naloxone
Chronic muscular disease caused by defect in neuromuscular transmission. Destruction of ACh receptors.
Myasthenia Gravis
The Peripheral Nervous System is composed of:
Somatic (skeletal muscle) and Autonomic (controls involuntary smooth muscle like the heart and gland activity)
A patient of Japanese descent describes a family trait that manifests frequently: She says that members of her family often have "strong reactions" after taking certain medications, but her white friends have no problems with the same dosages of the same drugs. The nurse recognizes that, because of this trait, which statement applies? a. She may need lower dosages of the medications prescribed. b. She may need higher dosages of the medications prescribed. c. She should not receive these medications because of potential problems with metabolism. d. These situations vary greatly, and her accounts may not indicate a valid cause for concern.
a. She may need lower dosages of the medications prescribed.
Before administering any medication, what is the nurse's priority action regarding patient safety? A. Counting medications in the medication cart drawers B. Documenting the medications given c. Checking the patient's identification using two identifiers D. Verifying orders with another nurse
c. Checking the patient's identification using two identifiers
The nurse is reviewing the four clinical phases of investigational drug studies. Place the four phases in the correct order of occurrence. a. Studies that are voluntarily conducted by pharmaceutical companies to obtain more information about the therapeutic and adverse effects of a drug. b. Studies that involve small numbers of volunteers who have the disease or ailment that the drug is designed to diagnose or treat. c. Studies that involve small numbers of healthy subjects who do not have the disease or ailment that the drug is intended to treat. d. Studies that involve large numbers of patients who have the disease that the drug is intended to treat; these studies establish the drug's clinical effectiveness, safety, and dosage range.
c. Studies that involve small numbers of healthy subjects who do not have the disease or ailment that the drug is intended to treat. b. Studies that involve small numbers of volunteers who have the disease or ailment that the drug is designed to diagnose or treat. d. Studies that involve large numbers of patients who have the disease that the drug is intended to treat; these studies establish the drug's clinical effectiveness, safety, and dosage range. a. Studies that are voluntarily conducted by pharmaceutical companies to obtain more information about the therapeutic and adverse effects of a drug.
A new drug has been approved for use, and the drug manufacturer has made it available for sale. During the first 6 months, the FDA receives reports of severe adverse effects that were not discovered during the testing and considers withdrawing the drug. This illustrates which phase of investigational drug studies? a. Phase I b. Phase II c. Phase III d. Phase IV
d. Phase IV Phase I: 20-30 health volunteers used to check for safety & dosage Phase II: 100-300 patient volunteers used to check for efficacy & side effects Phase III: 1000-3000 patient volunteers used to monitor reactions to long-term drug use Phase IV: FDA Review & Approval
a patient has been diagnosed with late-stage cancer. After consulting with his family, he tells the nurse, "I would like to try to live long enough to see my granddaughter graduate in 3 months, but after that I don't want any extra treatments." This patient is demonstrating which of these? a. veracity b. beneficence c. maleficence d. autonomy
d. autonomy
The Autonomic Nervous system is composed of:
sympathetic (fight or flight) and parasympathetic (rest and digest)
The nurse is reviewing data collected from a medication history. Which of these data are considered objective data? (Select all that apply) A- White blood cell count 22,000 mm^3 B- Blood pressure 150/94 mm Hg C- Patient rates pain as an "8" on a 10-point scale D- Patient's wife reports that the patient has been very sleepy during the day E- Patient's weight is 68 kg
A- White blood cell count 22,000 mm^3 B- Blood pressure 150/94 mm Hg E- Patient's weight is 68 kg
A nurse is teaching a client who has a prescription for a drug that has a receptor agonist effect. Which of the following information should the nurse include in the teaching? A. "This will increase the effects of normal cellular functions." B. "This prevents cells in your body from performing certain actions." C. "This prevents hormones in your body from attaching to cell receptor sites." D. "This minimizes the risk that the medications you take will become toxic."
A. "This will increase the effects of normal cellular functions."
Primary care providers prescribe drug dosages for children using which of the following information? (select all that apply) A. Body surface area B. Age C. Weight D. Developmental level E. Drug properties
A. Body surface area B. Age C. Weight E. Drug properties
When monitoring a patient who is taking a cholinergic drug, the nurse will watch for which cardiovascular effect? A. Bradycardia B. Tachycardia C. Palpitations D. Vasoconstriction
A. Bradycardia The cardiovascular effects of low doses of cholinergic drugs are decreased heart rate (not tachycardia) and vasodilation. Palpitations are not effects of cholinergic drugs.
These receptors mediate responses to acetylcholine. Has to do with parasympathetic immune system. A. Cholinergic receptors B. Adrenergic receptors
A. Cholinergic receptors
A nurse is caring for a client who is taking acetaminophen at regular intervals for mild discomfort. The nurse should tell the client to report which of the following early indications of acetaminophen toxicity? (select all that apply) A. Diaphoresis (sweating) B. Palpitation C. SOB D. N E. D
A. Diaphoresis (sweating) D. N E. D
A nurse is caring for a client who arrived at an emergency department following a bee sting. Which of the following indicates an anaphylactic reaction? (Select all that apply.) A. Low BP B. Wheezing C. Bradycardia D. Peripheral edema E. Difficulty swallowing
A. Low BP B. Wheezing E. Difficulty swallowing
Pain resulting from injury to tissues (somatic/skeletal pain, visceral/internal pain) A. Nociceptive pain B. Neuropathic pain
A. Nociceptive pain
An older client may be at risk for drug toxicity due to which of the following physiologic changes associated with aging? A. Reduced hepatic blood flow B. Increased glomerular filtration rate C. Reduced body fat D. Increased gastric motility
A. Reduced hepatic blood flow
A client with glaucoma asks you about taking oxybutynin, a muscarinic antagonist, to manage an overactive bladder. You explain that glaucoma is a contraindication for taking oxybutynin. Primary care providers should not prescribe contraindicated drugs because of their potential for which of the following? A. Serious adverse reactions B. Drug tolerance C. Drug dependence D. Interactions with other drugs
A. Serious adverse reactions
Occur when two drugs administered together interact in such a way that their combined effects are greater than the sum of the effects for each drug given alone. (ex. HCTZ and lisinopril) A. Synergistic effects B. Additive effects C. Antagonistic effects
A. Synergistic effects
Disease caused by progressive loss of ACh-producing neurons, resulting in loss of memory and function
Alzheimer's disease
A who had a thyroidectomy is now taking levothyroxine, a thyroid hormone, daily. Which term best describes this type of therapy? A- palliative therapy B- maintenance therapy C- supportive therapy D- supplemental therapy
B- maintenance therapy Maintenance therapy is for chronic type conditions such as asthma or diabetes. Maintenance therapy occurs when pts take drugs for years related to their disease process (does not eliminate disease, though).
A nurse is caring for a client who has a new prescription for celecoxib. The nurse should tell the client to report which of the following adverse drug reactions? A. Tinnitus B. Chest pain C. Constipation D. Diaphoresis
B. Chest pain
What are the three main groups of CNS depressants?
Barbiturates Benzodiazepines Miscellaneous Drugs
The Central Nervous System is composed of:
Brain and spinal cord
A 77-yr-old man who has been diagnosed with an upper respiratory tract infection tells the nurse that he is allergic to penicillin. What is the most appropriate response by the nurse? A- "Many people are allergic to penicillin" B- "This allergy is not of major concern because the drug is given so often." C- "What type of reaction did you have when you took penicillin?" D- "Drug allergies don't usually occur in older individuals due to built-up resistance to allergic reactions."
C- "What type of reaction did you have when you took penicillin?"
Local anesthesia along with sedation and analgesia A. General anesthetics B. Local anesthetics C. Monitored anesthesia care (mac)
C. Monitored anesthesia care (mac)
The nurse is giving medications to a patient in heart failure. The intravenous route is chosen instead of the intramuscular route. What patient function does the nurse recognize as the most influential when deciding to use the intravenous route of drug administration? A- altered biliary function B- increased glomerular filtration C- reduced liver metabolism D- diminished circulation
D- diminished circulation
