Pharm Final Alt.

34.Know what teaching point the nurse should covey to a patient who has been taking an OTC decongestant and the patient says that it hasn't really cured their cold.

"Drugs like this can often relieve some of the symptoms of a cold, but they won't cure it."

4. Know medication math for milliliters.

000ml = 1L; 1000ml = 1mcg

31.Know when a patient should expect to notice relief from chest pain when self-administered nitroglycerine is given sublingually.

1 - 3 minutes

51.Know what intervention the nurse in the OR should anticipate for a patient who has signs and symptoms of Malignant hyperthermia.

1.Discontinuation of anesthesia 2.100% oxygen given 3.Change to cooled fluids 4.Administration of dantrolene sodium (Dantrium) Notify the surgical team. Tachycardia and muscle rigidity are often the earliest signs of malignant hyperthermia.

. Know what size needle a nurse should use when administering a flu shot.

25 g 1 in

***44.Know what the potassium level should be for a patient receiving digoxin and potassium supplements.

3.5-5

15.Know how long to observe a patient for evidence of anaphylaxis after administration of immunizations.

30 mins

26.Know how long it will take for granulocytes to regenerate after ganciclovir therapy in a patient with HIV.

7 days

***22.Know what medication will diminish inflammation and assist in relieving bursitis.

Acetylsalicylic Acid

***47.Know what drug the nurse would expect to administer for suspected diagnosis of mushroom poisoning.

Activated charcoal, Amatoxin poisoning (silymarin), N-acetylcysteine (Acetadote)

***64.Know how the nurse should administer oral chlorpromazine.

Administer the day's last dose 1 to 2 hours before bedtime.

25.Know what the most likely intended effect of corticosteroid in a patient receiving chemotherapy.

Antiemetic; decrease nausea

35.Know what intervention should the nurse implement for a patient who asked the nurse to recommend an OTC cold remedy.

Assess the client for health problems that may contraindicate the use of a particular remedy.

32.Know what health problem would be prioritized for a patient with a diagnosis of asthma who is prescribed a beta-blocker.

Bronchospasm

Know where the medication is going to be administered if it states buccally.

Cheek

48.Know what diagnosis would be suspected after an edrophonium test and the patient reports muscle strength is weaker than before the test.

Cholinergic crisis

46.Know what type of medication would be administered to increase smooth muscle strength.

Cholinergic drugs

74.Know what disorders the nurse would suspect if a patient was prescribed ciprofloxacin eye drops.

Conjunctivitis

***12.Know the most common adverse effects of cholestyramine.

Constipation

***73.Know what the therapeutic effect of Phenylephrine drops are.

Constricting small blood vessels

9.Know what action should the nurse take to assure the patient's safety who has a diagnosis of neurogenic bladder secondary to a spinal tumor who is taking bethanechol.

Contact the health care provider as the client may be experiencing a cholinergic crisis.

***23.Know what medication can be prescribed to decrease sinus inflammation.

Corticosteroids

70.Know what medication would help facilitate an ophthalmic examination.

Cyclopentolate hydrochloride (Cyclogyl)

71.Know what the expected result of timolol therapy is.

Decrease IOP

63.Know what the nurse should suspect is triggering polyuria and polydipsia on a patient taking risperidone.

Diabetes mellitus

***59.Know what would be a suspected problem for a patient prior to starting Ramelteon.

Difficulty falling asleep at night

***54.Know what patient teaching the nurse would give to a patient newly diagnosed with migraines.

Eating cheese increases chance of migraines. Get regular sleep, eat healthy foods at regular times, avoid alcohol and drugs, and avoid foods that may trigger your headaches. Don't get too tired from hard physical activity. Don't take over-the-counter pain relievers more than 3 times a week, because you may get rebound headaches.

52.Know what opioid is most likely to be utilized in the OR to supplement anesthesia.

Fentanyl

***58.Know what condition is most likely to cause insomnia.

GORD, pregnancy, pruritic skin conditions, Parkinson's and osteoarthritis

28.Know what topic related to HTN is most important to include when educating a group of older adults.

HTN will increase the risk for heart disease

33.Know what preventive measure is most important to teach a community group about the common cold.

Hand washing

. Know what anticoagulant agent will be administered prophylactically to a patient with a history of clots undergoing bowel surgery.

Heparin

9. Know why a patient would be administered heparin IV and warfarin.

Heparin provides anticoagulation until therapeutic levels of warfarin are reached

19.Know what patient a live vaccine would be contraindicated.

Immunocompromised, corticosteroid treatment, radiation, cancer, HIV, pregnancy

***24.Know when you should tell the patient to take corticosteroids for adrenocortical insufficiency.

In the morning, before eating

13.Know how to describe what an immunization is for a baby to a parent.

Induces antibody formation because an infant's immune system is not fully developed

41.Know the most common first-line therapy for acute asthma attack.

Inhaled steroid

14.Know the most appropriate route to administer an immunization that contains aluminum phosphate.

Intramuscularly

. Know what route of administration is most likely appropriate for a patient with cardiovascular collapse who requires pharmacologic interventions.

Intravenous

8.Know what is most important regarding the schedule for administration for the MMR vaccine.

It is administered at 12 - 15 months

42.Know what medication class will be prescribed to decrease nighttime episodes of bronchoconstriction and prevent asthma attacks.

Leukotriene modifiers

0.Know what medication should be considered the first choice when administering a benzodiazepine.

Lorazepam (Ativan)

***66.Know how the nurse should implement administration of Clozapine.

Monitor WBC

***11.Know what medication would be added to a patient who already is on statin therapy whose LDL remains elevated.

Niacin/ Fenofibrate/ Ezetimibe

6. Know what the development of syncope maybe related to which physiologic process after an antihypertensive agent is added to a patient's medication list.

Orthostatic Hypotension

57.Know what intervention would be added to a patient's care plan who has a diagnosis of generalized anxiety disorder and prescribed a benzodiazepine.

Patient has a risk for falls, risk for dependence

***21.Know the action of acetylsalicylic acid.

Produce analgesia & exert its anti-Inflammatory effect by inhibiting prostaglandin and other substances that sensitize pain receptors. Inhibits prostaglandin synthesis, acts on the hypothalamus heat-regulating center, interferes with production of thromboxane A, a substance that stimulates platelet aggregation.

75.Know what microorganism is most likely the cause of necrotizing otitis externa on a patient who was prescribed ciprofloxacin.

Pseudomonas aeruginosa

1. Know what aspect of administering scheduled II drugs falls under the auspices of the U.S. Drug Enforcement Administration.

Recording each dose administration on an agency narcotic sheet

56.Know what medication would contraindicate treatment of Frovatriptan for cluster headaches.

SSRI (serotonin syndrome)

38.Know what reaction is responsible for myalgia and fever after taking cephalexin.

Serum Sickness

16.Know what kind of reaction arthralgia four days after a tetanus shot is.

Serum sickness

36.Know what condition would most strongly lead the nurse to use pseudoephedrine for allergies cautiously.

Severe HTN

61.Know what assessment the nurse would prioritize for a teenager who was recently prescribed a SSRI.

Suicidal ideation

10.Know what medication would be consider for STAT administration for a patient with ischemic stroke.

TPA; Tissue-type plasmin activator

39.Know what recommendation the nurse should include in patient teaching for asthma that has been prescribed albuterol inhaler.

Take 15 minutes before exercising, use a spacer, quit smoking

67.Know what patient teaching the nurse would include for a patient diagnosed with narcolepsy.

Take brief, 20-minute naps during the day, Establish a regular exercise program, Teach the patient about the side effects of modafinil (Provigil).

55.Know what assessment finding would cause the nurse to suspect adverse effects of long-term therapy of naproxen.

The patient's stool tests positive for occult blood.

30.Know what type of diuretic would you expect to be prescribed to a patient of African descent who is about to begin multidrug treatment for HTN.

Thiazide diuretic

62.Know what diagnosis would the nurse suspect a school-age patient to have if he was prescribed haloperidol.

Tourette's syndrome

. Know what the greatest risk for medication-related effect for an older adult patient who has an elevated serum creatinine level.

Toxicity; Nephrotoxicity

29.Know which diagnosis Captopril would be prescribed as a first-line treatment.

Treating HTN in diabetic clients, particularly type 1

72.Know what ocular condition the patient with elevated intraocular pressure is at risk for.

Vision loss

50.Know by what means is the phase of induction is achieved.

When medications are administered to initiate general anesthesia and concludes adequate dept of anesthesia is reached and the patients airway is secured.

65.Know how the nurse should respond to a patient who asks if it is ok to have a few drinks from time to time while taking clozapine.

When you're taking clozapine, it's best to avoid drinking alcohol altogether.

45.Know why a patient's prescription would be switched from furosemide to spironolactone.

You will lose less potassium with spironolactone than with furosemide.

17.Know what vaccine should be administered to a 70-year-old patient to prevent herpes zoster.

Zoster vaccine; Zostavax

***37.Know the mechanism of action of antihistamine medication.

blocking the (H1) histamine receptors on the surfaces of basophils and mast cells

68.Know what physiologic process result in normal intraocular pressure.

consistent production and resorption of tears

***43.Know why a patient would be prescribed two diuretics.

i. "It could be that you nee a larger dose than is available in the combination medications." Know what the potassium level should

***69.Know what kind of drug the patient is receiving to get a fungal eye infection as an adverse reaction.

i. Ophthalmic corticosteroid

***20.Know what type of wound infection a patient has who burns when they develop an infection.

i. Opportunistic infection

27.Know the mechanism of Zidovudine for the treatment of HIV.

inhibiting the enzyme reverse transcriptase that HIV uses to make DNA and therefore decreases replication of the virus

53.Know the action of sumatriptan.

stimulating serotonin receptors in the brain that cause the muscles surrounding the blood vessels in the brain to contract and narrow the blood vessels. At the same time, it also reduces transmission of pain signals by nerves to the brain. Vasoconstriction of cranial arteries and basilar arteries

***40.Know the mechanism of action for inhaled corticosteroid agents.

suppress the release of inflammatory mediators, block the generations of cytokines, and decrease the recruitment of airway eosinophils.