pharm

When administering two highly protein bound drugs, the higher bound drug will bind to the albumin, resulting in less binding sites for the lower bound drug, which can lead to toxicity of the lower bound drug. T or F?

True

When giving a subcutaneous injection, you should use an insertion angle of 45-90 degrees. T or F?

True

True or False: A client on insulin or oral antidiabetic medications should keep a form of glucose readily available in case of hypoglycemia.

True

True or False: Coughing and epigastric pain can be sign that acid-lowering medications are ineffective

True

True or False: Promethazine blocks dopamine, which means it can cause EPS.

True

When administering IV medications, it is imperative to use aseptic technique to avoid infection. T or F?

True

Match the patient teaching with the corresponding anticonvulsant medication. Carbamazepine Phenobarbital Phenytoin Topiramate Valproic Acid All the Anticonvulsants with Do not drink grapefruit juice. Do not take if you have liver disease. Do not drink alcohol within 6 hours of the dose. Brush your teeth a minimum of 2x per day. This medication causes severe drowsiness Take consistently to help keep the drug levels at steady state

- Carbamazepine - Do not drink grapefruit juice. - Phenobarbital - This medication causes severe drowsiness - Phenytoin - Brush your teeth a minimum of 2x per day. - Topiramate - Do not drink alcohol within 6 hours of the dose. - Valproic Acid - Do not take if you have liver disease. - All the Anticonvulsants - Take consistently to help keep the drug levels at steady state.

The nurse is caring for a client being treated for tuberculosis who is taking isoniazid (INH). Which statement made by the client indicates the need for further teaching? A) "I should limit my alcohol intake to 3 beers a day while I'm taking this medicine." B) "I need to call the doctor if I notice any yellow color to my skin or eyes." C) "I know I need to take this medication for at least 6 months." D) "I'll have to have regular checkups and eye exams to monitor for side effects."

A) "I should limit my alcohol intake to 3 beers a day while I'm taking this medicine."

What is the goal number of stools for a client with liver disease who is prescribed lactulose?

3-4

Sucralfate is given ______ minutes before meals and before bedtime in order to create a thick paste that will coat the ulcer, protecting it from gastric acid that is released during meals and rest.

30

Select all of the black box warning for the fluoroquinolone drug class. A) Achille's Tendon Rupture B) QT Prolongation C) Nephrotoxicity D) Exacerbation of Myasthenia Gravis E) Peripheral Neuropathy F) CNS Effects G) Crystalluria H) Tinnitus

A) Achille's Tendon Rupture D) Exacerbation of Myasthenia Gravis E) Peripheral Neuropathy F) CNS Effects

What foods should the nurse teach the client to avoid while prescribed phenelzine? A) Aged cheeses and meats B) Grapefruit juice C) High fiber foods D) Fried foods

A) Aged cheeses and meats

How should the nurse best identify the client? A) Ask the client to state their name and date of birth B) Ask the client to show you their driver's license or government issued ID C) Scan the armband and say "Good morning, Lisa Smith, I see you were born 3/6/1952" D) Look at the room number and medical record number on the armband

A) Ask the client to state their name and date of birth

What do you do first if you make medication error? A) Assess the client for any adverse effects B) Document using accurate, objective information C) Contact the healthcare provider D) Report the error to the Risk Management Department

A) Assess the client for any adverse effects

A client is prescribed alprazolam for anxiety. What is the most important information for the nurse to provide when providing education to the client? A) Avoid drinking alcohol when you take a dose of your medication B) Take this medication whenever you feel anxious C) You can quit attending your support group now that you have medication D) Take this medication every day on scheduled basis

A) Avoid drinking alcohol when you take a dose of your medication

A client is prescribed diphenhydramine. What information should the nurse include in the education? Select all that apply. A) Do not drive while on diphenhydramine B) Do not drink alcohol with diphenhydramine C) Be careful when standing and walking due to potential for dizziness D) Some clients experience paradoxical excitation E) You may experience drooling with diphenhydramine

A) Do not drive while on diphenhydramine B) Do not drink alcohol with diphenhydramine C) Be careful when standing and walking due to potential for dizziness D) Some clients experience paradoxical excitation

When administering psyllium, when should the client drink the mixture? A) Immediately after stirring the mixture B) It is a dry powder and should not be mixed in fluid C) Wait for 15 minutes after mixing

A) Immediately after stirring the mixture

A client is prescribed buspirone for anxiety. What is the reason that buspirone is chosen over a benzodiazepine in the treatment for anxiety? A) It has less physical and psychological dependency issues B) It has no known interactions with herbal supplemants C) It does not have any severe adverse reactions D) It is not metabolized with the CYP 450 system

A) It has less physical and psychological dependency issues

A client is admitted with possible bowel obstruction. What prescribed medication will the nurse clarify with the healthcare provider? A) Metoclopramide B) Pantoprazole C) Ondansetron D) Promethazine

A) Metoclopramide

A client has been receiving subcutaneous heparin for venous thromboembolism prophylaxis. What lab is most concerning from this mornings lab results? A) Platelet count of 87,000 B) aPTT of 60 seconds C) PT of 12 seconds D) INR of 1.3

A) Platelet count of 87,000

Prior to administering hydromorphone for pain, what priority assessment should the nurse complete? A) Respiratory rate B) Blood pressure C) Pupil reaction D) Heart rate

A) Respiratory rate

The antilipemic "statin" drug classification are commonly prescribed. What are some potential side effects? Select all that apply A) Rhabdomyolysis B) Hepatotoxicity C) Respiratory depression D) Orthostatic hypotension E) Cataract formation

A) Rhabdomyolysis B) Hepatotoxicity E) Cataract formation

The client is prescribed 20 mg of furosemide PO daily. The nurse administered 20 mg of furosemide intravenously this morning. Which right of medication administration did the nurse NOT follow in this situation? A) Right Route B) Right Time C) Right Med D) Right Dose E) Right Pt F) Right Documentation

A) Right Route

A nurse is teaching the client about EPS and is specifically discussing pseudoparkinsonism. What signs and symptoms should the nurse include in the education? Select all that apply. A) Stooped posture B) Shuffling gate C) Flaccid muscles D) Tremors at rest E) Tachykinesia

A) Stooped posture B) Shuffling gate D) Tremors at rest

Select all of the abbreviations that are on the Joint Commission's "Do Not Use Abbreviation" List. A) U, u B) QD C) QOD D) QID E) PRN

A) U, u B) QD C) QOD

What required concentration of pantoprazole and how fast should it be administered by intravenous route? A) 40 mg/ 100 mL; 30 minutes B) 4 mg/mL; 2 minutes C) 4 mg/10mL; 5 minutes

B) 4 mg/mL; 2 minutes

A client with pneumonia is prescribed levofloxacin and ondansetron. The client has a history of cardiovascular disease. Based on this information, what action should the nurse take? A) Auscultate lung sounds B) Apply a heart monitor C) Check the blood pressure D) Count the apical pulse

B) Apply a heart monitor

What substance/drug is known to cause additive effects with methylphenidate? A) Dantrolene B) Caffeine C) Alcohol D) Lorazepam

B) Caffeine

A client is prescribed an NSAID for pain and inflammation associated with rheumatoid arthritis. What information in the past medical history is most concerning? A) Chronic liver disease B) Cardiovascular disease with previous myocardial infarction C) Seizure disorder D) Bone malformation of fingers with ulnar drift and severe pain

B) Cardiovascular disease with previous myocardial infarction

A client is prescribed an anti-thyroid medication. Which lab test should be monitored periodically during therapy related to potential adverse effects? A) Basic chemistry panel B) Complete blood count C) Hemoglobin A1C D) Thyroid panel

B) Complete blood count

While preparing to give amphotericin B to a client who is also receiving dexamethasone, which electrolyte imbalance is the client is at increased risk for due to this drug combination? A) Hypocalcemia B) Hypokalemia C) Hyponatremia D) Hypoglycemia

B) Hypokalemia

A client is suspected to have cholinergic crisis. Which signs and symptoms will the nurse expect to find upon assessment? (Select all that apply) A) Pupil dilation B) Pupil constriction C) Salivation D) Urination E) Dry Skin

B) Pupil constriction C) Salivation D) Urination

A client is prescribed captopril and is now reporting a dry cough that keeps them up all night. What is the most appropriate action by the nurse? A) Tell the patient this is a normal expected finding. B) Report the side effect to the provider. C) Discontinue the captopril and prescribe an ARB. D) Call 911, as this is a medical emergency.

B) Report the side effect to the provider.

A client is prescribed prednisone for bronchitis. What education should the nurse provide? A) "Prednisone increases calcium absorption into your bones and prevents osteoporosis." B) "Prednisone can cause excess fluid loss, be sure to increase your sodium and water intake." C) "Take the prednisone with food to help prevent gastric irritation and ulcer formation." D) "Avoid foods that contain potassium because prednisone can cause an elevated potassium."

C) "Take the prednisone with food to help prevent gastric irritation and ulcer formation."

What priority assessment should the nurse complete prior to administering a dose of carvedilol? A) Respiratory rate B) Daily weight C) Apical pulse D) Blood sugar

C) Apical pulse

A client is prescribed promethazine for nausea and vomiting. When administering the medication, what priority assessment should the nurse perform to prevent client injury? A) Assess the severity of the nausea and last time vomiting occured B) Auscultate the lungs and heart sounds prior to each dose C) Inspect the intravenous access site for signs of infiltration D) Monitor urine output to ensure client is hydrated

C) Inspect the intravenous access site for signs of infiltration

A client diagnosed with schizophrenia is prescribed clozapine. Which client symptoms would be most concerning to the nurse? A) Akathisia and hypersalivation B) Dry mouth and urinary retention C) Sore throat, fever, and malaise D) Insomnia and restlessness

C) Sore throat, fever, and malaise

A client diagnosed with schizophrenia is prescribed an antipsychotic medication daily. Which assessment finding should the nurse report immediately to the healthcare provider? A) Respirations of 22 breaths per minute B) Heart rate 95 beats per minute C) Temperature of 104 F D) Excessive salivation

C) Temperature of 104 F

The nurse is administering a viscous (thick) medication. What additional step must be added? A) Pull the skin taut B) Insert the needle at 90-degree angle using a dart-like motion C) Wait 10 seconds before removing the needle after the injection D) Don (put on) gloves

C) Wait 10 seconds before removing the needle after the injection

Upon assessment the nurse hears wheezing in all lung fields bilaterally. Which medication is most appropriate to administer? A) theophylline B) guaifenesin C) albuterol D) dextromethorphan

C) albuterol

You are to administer pantoprazole by intravenous route to your assigned client. What fluid should you use to reconstitute the powdered medication in the vial? A) Lactated Ringers (LR) B) Sterile water for injection (SWFI) C) Dextrose 5% in water (D5W) D) Normal saline (NS)

D) Normal saline (NS)

A client is finishing a course of azithromycin today. Upon assessment the client has an unsteady gait and appears off balance. What adverse effect does the nurse predict is resulting in these assessment findings? A) Hypokalemia B) Hypomagnesemia C) Hepatoxicity D) Ototoxicity

D) Ototoxicity

A client is prescribed methylphenidate. Which effect would be considered most dangerous and cause the nurse the greatest concern? A) Nervousness B) Decreased growth C) Weight loss D) Tachycardia

D) Tachycardia

A client has been recently diagnosed with angina and is prescribed nitroglycerin PRN for chest pain. What currently prescribed medication can cause a fatal drop in blood pressure? A) Lisinopril B) Verapamil C) Metoprolol D) Tadalafil

D) Tadalafil

An older-adult client who has renal failure asks you if they can take milk of magnesia for constipation once a day. What is your best response? A) You can do this, but milk of magnesia is more hash than many other laxatives B) It is not necessary for you to have a bowel movement every day C) Why are you dependent on a laxative? Drink more fluids, eat more fiber, and walk more. D) Taking milk of magnesia frequently can cause high levels of magnesium

D) Taking milk of magnesia frequently can cause high levels of magnesium

The nurse is caring for an infant with oral thrush whose medications include nystatin suspension 5 mL PO QID. Which action should the nurse take when administering this medication? A) Use a needleless syringe to gently squirt small amounts into the infant's mouth B) Dilute the medication in 30 mL of water and provide it to the infant in a bottle C) Dip a pacifier into the medication and allow the infant to suck on the pacifier D) Use a cotton swab to coat the inside of the infant's cheeks, gums, and tongue

D) Use a cotton swab to coat the inside of the infant's cheeks, gums, and tongue

The client asks the nurse if they can crush all of their medications. Which medication will the nurse inform the client CANNOT be crushed? A) simvastatin B) diphenhydramine hcl C) acetaminophen rapid release D) aspirin EC

D) aspirin EC

A client currently prescribed gentamicin for endocarditis. After performing a physical assessment the nurse is most concerned about which of the following? A) Temperature 102F B) Blood Pressure 102/64 C) Heart Rate 103 D) 1 Bowel Movement in 6 hours E) Urine Output 200ml in 12 hours

E) Urine Output 200ml in 12 hours

A client has been administered heparin 5000 units, subcutaneously every 8 hours for two days. The nurse expects the client's aPTT to decrease in comparison to yesterday's aPTT. T or F?

False

A client's vancomycin trough results at 6 mcg/mL. The nurse assesses the level and determines it to be therapeutic. T or F?

False

SSRI's and SNRI's are the newer antidepressants and do not share the black box warning of suicide that the FDA provided for the older antidepressants. T or F?

False

True or False: Phenelzine can be taken concurrently with TCA's, SSRI's, and SNRI's. *be sure to know some names of the different antidepressants in each classification.

False

All NSAIDS can increase the chance of causing gastric ulceration bleeding and should be taken with food to help prevent gastric ulceration and bleeding. T or F?

True

Clients on ACE inhibitors, angiotensin-II receptor-blockers, and potassium sparing diuretics need to avoid salt substitute and avoid food that are high in potassium. These medications can raise the potassium level. T or F?

True

If the anticonvulsant drug level is below the therapeutic levels, the client is at risk for having seizures. T or F?

True

A client is on a medication that is metabolized through the CYP 450 system. Grapefruit juice will ________ the metabolism of the medication, leading to ________ half-life; whereas, nicotine will_________ metabolism of the medication, leading to _________ half-life.

decrease prolonged increase shortened

Calcium carbonate can cause increased calcium, which means that it will cause the phosphorous level to be ________.

decreased

For clients younger than 2, the correct technique for administering otic drops is to pull the ear outward and _______, however, for clients older than 2 years old, the ear should be pulled outward and _________ instead.

downward upward

I am a synthetic hormone. I should be taken on an empty stomach first thing in the morning. I am dosed in micrograms. My most dangerous adverse effects are cardiovascular. My half life is VERY LONG. What drug am I?

levothyroxine

I am used to treat type II diabetes. I must be held 48 hours before and after surgery. I can cause lactic acidosis and a lot of gastrointestinal symptoms. Client's creatinine clearance must be greater than 30mL/min in order to receive me.

metformin

Typical anti-psychotics are ________ likely to cause EPS when compared to atypical anti-psychotics.

more

I am used to treat the flu, you must take me within 48 hours of when you started to feel like poo. I do not replace the flu shot I am only used if it's is the flu you got. What drug am I?

oseltamivir