pharm final
A patient who has been taking an antihypertensive medication for several years is recovering from a myocardial infarction. The prescriber changes the patient's medication to an ACE inhibitor. The patient asks the nurse why a new drug is necessary. What is the nurse's response? "ACE inhibitors can prevent or reverse pathologic changes in the heart's structure." "ACE inhibitors help lower LDL cholesterol and raise HDL cholesterol." "ACE inhibitors increase venous return to the heart, improving cardiac output." "ACE inhibitors regulate electrolytes that affect the cardiac rhythm."
"ACE inhibitors can prevent or reverse pathologic changes in the heart's structure."
A patient has a Pseudomonas aeruginosa infection that is sensitive to aminoglycosides, and the prescriber orders gentamicin. The patient tells the nurse that a friend received amikacin [Amikin] for a similar infection and wonders why amikacin was not ordered. What will the nurse tell the patient? "Amikacin is given when infectious agents are resistant to other aminoglycosides." "Amikacin is more vulnerable to inactivation by bacterial enzymes." "Amikacin is a narrow-spectrum drug and will probably not work for this infection." "Gentamicin is less toxic to the ears and the kidneys."
"Amikacin is given when infectious agents are resistant to other aminoglycosides."
A patient with variant angina wants to know why a beta blocker cannot be used to treat the angina. Which response by the nurse is correct? "A beta1-selective beta blocker could be used for variant angina." "Beta blockers do not help relax coronary artery spasm." "Beta blockers do not help to improve the cardiac oxygen supply." "Beta blockers promote constriction of arterial smooth muscle."
"Beta blockers do not help relax coronary artery spasm."
A nurse is explaining to nursing students why a cephalosporin is used in conjunction with an aminoglycoside for a patient with an infection. Which statement by a student indicates understanding of the teaching? "Cephalosporins enhance the actions of aminoglycosides by weakening bacterial cell walls." "Cephalosporins prevent neuromuscular blockade associated with aminoglycosides." "Cephalosporins prolong the postantibiotic effects of the aminoglycosides so doses can be decreased." "Cephalosporins reduce bacterial resistance to aminoglycosides."
"Cephalosporins enhance the actions of aminoglycosides by weakening bacterial cell walls."
A nursing student asks the nurse why more is not known about the teratogenic effects of maternal medication ingestion during pregnancy. Which response by the nurse is correct? "Clinical trials to assess this risk would put the fetus at risk." "It is safer to recommend that pregnant women avoid medications while pregnant." "Most women are reluctant to admit taking medications while they are pregnant." "The relatively new MEPREP study will allow testing of medications during pregnancy in the future."
"Clinical trials to assess this risk would put the fetus at risk."
A nurse is providing education about tetracycline [Sumycin]. Which statement by the patient best demonstrates understanding of the administration of this medication? "I should not take this medication with milk or other dairy products." "I should not worry if I experience an acnelike rash with this medication." "I should take an antacid, such as Tums, if I experience gastrointestinal distress." "I should take this antibiotic with a calcium supplement to improve absorption."
"I should not take this medication with milk or other dairy products."
The nurse is providing patient education to a patient who will begin taking fludrocortisone [Florinef] as adjunctive therapy to hydrocortisone. Which statement by the patient indicates understanding of the teaching? "I should move from sitting to standing slowly." "I should report any swelling of my hands and feet." "I should report weight loss to my provider." "I should report excessive urine output."
"I should report any swelling of my hands and feet."
A patient has begun taking phenobarbital after experiencing several seizures and is currently receiving 60 mg PO twice daily. After 2 weeks of therapy, the patient has a serum drug level of 30 mcg/mL and reports feeling drowsy much of the day. What will the nurse tell this patient? "I will contact your provider to discuss changing your dosing to once daily to minimize the drowsiness." "The drug level is low and you may need a higher dose, but taking it 3 times daily will reduce the drowsiness." "This side effect is expected and should decrease over time. You should avoid driving in the meantime." "Your laboratory work shows a higher than normal level of the drug and your provider will probably lower your dose."
"I will contact your provider to discuss changing your dosing to once daily to minimize the drowsiness."
A nurse is reviewing the phenomenon of reflex tachycardia with a group of nursing students. Which statement by a student indicates understanding of this phenomenon? "Baroreceptors in the aortic arch stimulate the heart to beat faster." "Reflex tachycardia can negate the desired effects of vasodilators." "Reflex tachycardia is more likely to occur when beta blockers are given." "Venous dilation must occur for reflex tachycardia to occur."
"Reflex tachycardia can negate the desired effects of vasodilators."
A patient who is an opioid addict has undergone detoxification with buprenorphine [Subutex] and has been given a prescription for buprenorphine with naloxone [Suboxone]. The patient asks the nurse why the drug was changed. Which response by the nurse is correct? "Suboxone has a lower risk of abuse." "Suboxone has a longer half-life." "Subutex causes more respiratory depression." "Subutex has more buprenorphine."
"Suboxone has a lower risk of abuse."
A nursing student who is preparing to care for a postoperative patient with deep vein thrombosis asks the nurse why the patient must take heparin rather than warfarin. Which response by the nurse is correct? "Heparin has a longer half-life." "Heparin has fewer adverse effects." "The onset of warfarin is delayed." "Warfarin prevents platelet aggregation."
"The onset of warfarin is delayed."
A nurse is giving an enteral medication. The patient asks why this method is preferable for this drug. How will the nurse reply? "This route allows more rapid absorption of the drug." "This route is safer, less expensive, and more convenient." "This route is the best way to control serum drug levels." "This route prevents inactivation of the drug by digestive enzymes."
"This route is safer, less expensive, and more convenient."
A patient with COPD is prescribed tiotropium [Spiriva]. After the initial dose, the patient reports only mild relief within 30 minutes. What will the nurse tell the patient? "You may have another dose in 4 hours." "You may need to take two inhalations instead of one." "You should have peak effects in about 6 hours." "You should see improved effects within the next week."
"You should see improved effects within the next week."
order- 1L of IV fluid Q6H. How many mL/hr will you set the pump to? Round to the nearest whole number.
167 mL/hr
Order- 170 mg Have- 10 mg/mL How many mL will you give?
17 mL
A patient is admitted to the unit for treatment for an infection. The patient receives IV amikacin [Amikin] twice a day. When planning for obtaining a peak aminoglycoside level, when should the nurse see that the blood is drawn? 30 minutes after the IV infusion is complete 1 hour after the IV infusion is complete 1 hour before administration of the IV infusion A peak level is not indicated with twice-daily dosing.
30 minutes after the IV infusion is complete
patient had 8 tsp of jello, 8 oz apple juice, and 12 tsp of chicken broth. How many mL of intake will document?
340 mL rationale: 1 tsp= 5 mL 8(5)= 40 mL 12(5)= 60 mL 8 oz= 240 mL Total =340 mL
your shift- 0700-1500 Your patient has IV fluid infusing at 50 mL/hr. What is the IV intake in mL for your patient during your shift?
400 mL
order- 1000 mL at 125 mL/hr Start it at 1100. Your shift is 0700-1500. How many mL of IV fluid will you record on your shift?
500 mL
A young, nonpregnant female patient with a history of a previous urinary tract infection is experiencing dysuria, urinary urgency and frequency, and suprapubic pain of 3 days' duration. She is afebrile. A urine culture is positive for more than 100,000/mL of urine. The nurse caring for this patient knows that which treatment is most effective? A 14-day course of amoxicillin with clavulanic acid [Augmentin] A 7-day course of ciprofloxacin [Cipro] A single dose of fosfomycin [Monurol] A 3-day course of trimethoprim/sulfamethoxazole [Bactrim]
A 3-day course of trimethoprim/sulfamethoxazole [Bactrim]
A nurse is caring for an older adult man who has Alzheimer's disease (AD). The patient's daughter wants to know if testing can be done to determine her risk for developing the disease. What will the nurse tell her? Female gender is known to increase the risk. Genetic testing can provide a definitive measure of the risk. Patients with the apolipoprotein E2 gene (apoE2) are more likely to develop the disease. Advancing age and family history are known risk factors.
Advancing age and family history are known risk factors.
A nurse is reviewing a patient's medical record before administering a medication. Which factors can alter the patient's physiologic response to the drug? (Select all that apply.) Ability to swallow pills Age Genetic factors Gender Height
Age Genetic factors Gender
Namenda is a cholinesterase used to treat what?
Alzheimers (moderate to severe)
A patient complains of painful urination. A physical examination reveals vesicles on her labia, vagina, and the foreskin of her clitoris. The nurse will expect to teach this patient about which medication? Acyclovir [Zovirax] Azithromycin [Zithromax] Metronidazole [Flagyl] Tinidazole [Tindamax]
Acyclovir [Zovirax]
A postoperative patient has orders for morphine sulfate 1 to 2 mg IV every 1 hour PRN for severe pain and acetaminophen-hydrocodone [Lortab] 7.5 mg PO every 4 to 6 hours PRN for moderate pain. The patient reports pain at a level of 8 on a scale of 1 to 10, with 10 being the worst pain. Which action by the nurse is appropriate? Administer acetaminophen-hydrocodone 7.5 mg PO every 4 hours. Administer acetaminophen-hydrocodone 7.5 mg PO every 6 hours and change to every 4 hours if not effective. Administer morphine sulfate 1 mg IV every 1 hour until pain subsides. Administer morphine sulfate 2 mg IV and evaluate the patient's pain in 15 to 30 minutes.
Administer morphine sulfate 2 mg IV and evaluate the patient's pain in 15 to 30 minutes.
A patient is diagnosed with peptic ulcer disease. The patient is otherwise healthy. The nurse learns that the patient does not smoke and that he drinks 1 or 2 glasses of wine with meals each week. The nurse anticipates that the provider will prescribe which drugs? A. Amoxicillin [Amoxil], clarithromycin, and omeprazole [Prilosec] B. Amoxicillin [Amoxil], metronidazole [Flagyl], and cimetidine [Tagamet] C. Clarithromycin, metronidazole [Flagyl], and omeprazole [Prilosec] D. Tetracycline, cimetidine [Tagamet], and lansoprazole [Prevacid]
Amoxicillin [Amoxil], clarithromycin, and omeprazole [Prilosec]
A nursing student asks the nurse what differentiates antiestrogen drugs from aromatase inhibitors in the treatment of breast cancer. What is the correct response by the nurse? Antiestrogen drugs decrease the risk for thromboembolic events. Antiestrogen drugs increase the risk for endometrial cancer. Aromatase inhibitors block the production of estrogen by the ovaries. Aromatase inhibitors can be used for tumor cells that lack estrogen receptors.
Antiestrogen drugs increase the risk for endometrial cancer.
What should you do if patient taking Piperacillin has serum BUN/creatinine levels that are elevated?
Ask the doctor to reduce the dose of Piperacillin
A patient who uses an inhaled glucocorticoid for chronic asthma calls the nurse to report hoarseness. What will the nurse do? Ask whether the patient is rinsing the mouth after each dose. Request an order for an antifungal medication. Suggest that the patient be tested for a bronchial infection. Tell the patient to discontinue use of the glucocorticoid.
Ask whether the patient is rinsing the mouth after each dose.
During a routine screening, an asymptomatic, pregnant patient at 37 weeks' gestation learns that she has an infection caused by Chlamydia trachomatis. The nurse will expect the provider to order which drug? Azithromycin Doxycycline Erythromycin ethylsuccinate Sulfisoxazole
Azithromycin
A patient who will begin taking colchicine for gout reports taking nonsteroidal anti-inflammatory drugs, simvastatin, amoxicillin, and digoxin. What will the nurse do? A. Contact the provider to discuss using a different antibiotic while this patient is taking colchicine. B. Notify the provider about the potential risk of muscle injury when simvastatin is taken with colchicine. C. Request an order for cardiorespiratory monitoring, because the patient is taking digoxin. D. Suggest that the nonsteroidal anti-inflammatory drugs (NSAIDs) be withdrawn during colchicine therapy.
B. Notify the provider about the potential risk of muscle injury when simvastatin is taken with colchicine.
Why should you not take Tetracycline with dairy products?
Because dairy products can make it harder for your body to absorb the medication therefore reducing its effects
An agitated, extremely anxious patient is brought to the emergency department. The prescriber orders a benzodiazepine. The nurse understands that benzodiazepines are used in this clinical situation based on which principle? Benzodiazepines have a very short half-life. Physical dependence is not a risk when taking benzodiazepines. Benzodiazepines are known to cure generalized anxiety. Benzodiazepines have a rapid onset of action.
Benzodiazepines have a rapid onset of action.
The potassium-sparing diuretic spironolactone [Aldactone] prolongs survival and improves heart failure symptoms by which mechanism? Blocking aldosterone receptors Increasing diuresis Reducing venous pressure Reducing afterload
Blocking aldosterone receptors
A nurse is educating the staff nurses about ketoacidosis. To evaluate the group's understanding, the nurse asks, "Which sign or symptom would not be consistent with ketoacidosis?" The group gives which correct answer? Blood glucose level of 600 mg/dL Blood glucose level of 60 mg/dL Acidosis Ketones in the urine
Blood glucose level of 60 mg/dL
A patient claims to get better effects with a tablet of Brand X of a drug than with a tablet of Brand Y of the same drug. Both brands contain the same amount of the active ingredient. What does the nurse know to be most likely? A. Advertising by pharmaceutical companies can enhance patient expectations of one brand over another, leading to a placebo effect. B. Because the drug preparations are chemically equivalent, the effects of the two brands must be identical. C. Tablets can differ in composition and can have differing rates of disintegration and dissolution, which can alter the drug's effects in the body. D. The bioavailability of a drug is determined by the amount of the drug in each dose.
C. Tablets can differ in composition and can have differing rates of disintegration and dissolution, which can alter the drug's effects in the body.
A nurse is reviewing a patient's medications before administration. Which drug-to-drug interactions will most concern the nurse in a patient with a history of heart failure and a potassium level of 5.5 mEq/L? Furosemide [Lasix] and enalapril [Vasotec] Amlodipine [Norvasc] and spironolactone [Aldactone] Captopril [Capoten] and spironolactone [Aldactone] Metoprolol [Lopressor] and furosemide [Lasix]
Captopril [Capoten] and spironolactone [Aldactone]
What is Tiotropium method of action?
Its a long-acting anticholinergic used for COPD in which the effects begin after 30 minutes and, with subsequent doses, reach a plateau within 8 consecutive doses (8 days)
The parents of a child with asthma ask the nurse why their child cannot use oral corticosteroids more often, because they are so effective. The nurse will offer which information that is true for children? Chronic steroid use can inhibit growth. Frequent use of this drug may lead to a decreased response. A hypersensitivity reaction to this drug may occur. Systemic steroids are more toxic in children.
Chronic steroid use can inhibit growth.
What is acyclovir used to treat?
Cold sores, herpes simplex virus 2 outbreaks, vessels on vagina, labia, and clitoris
A patient with no known drug allergies is receiving amoxicillin [Amoxil] PO twice daily. Twenty minutes after being given a dose, the patient complains of shortness of breath. The patient's blood pressure is 100/58 mm Hg. What will the nurse do? Contact the provider and prepare to administer epinephrine. Notify the provider if the patient develops a rash. Request an order for a skin test to evaluate possible PCN allergy. Withhold the next dose until symptoms subside.
Contact the provider and prepare to administer epinephrine.
A patient with advanced cancer of the prostate begins treatment with leuprolide [Lupron Depot] injections and will receive 7.5 mg IM once per month. After the first injection, the patient experiences an increase in cancer symptoms. What will the nurse tell the patient? Desensitization to the drug over time will result in a decrease in these symptoms. The dose of leuprolide may have to be increased to 22.5 mg per month. These symptoms indicate a need for surgical castration to treat the cancer. This is a sign that the patient's cancer is getting worse.
Desensitization to the drug over time will result in a decrease in these symptoms.
A patient has been taking fluoxetine [Prozac] for 2 years and reports feeling cured of depression. The nurse learns that the patient is sleeping well, participates in usual activities, and feels upbeat and energetic most of the time. The patient's weight has returned to normal. The patient reports last having symptoms of depression at least 9 months ago. What will the nurse tell this patient? Indefinite drug therapy is necessary to maintain remission. Discuss gradual withdrawal of the medication with the provider. Stop the drug while remaining alert for the return of symptoms. Take a drug holiday to see whether symptoms recur.
Discuss gradual withdrawal of the medication with the provider.
The nurse is caring for an older adult patient after a right hip open reduction internal fixation (ORIF). The patient is taking an opioid every 6 hours as needed for pain. The nurse discusses obtaining an order from the prescriber for which medication? Docusate sodium [Colace] GoLYTELY Lactulose Polyethylene glycol [MiraLax]
Docusate sodium [Colace]
A provider has indicated that a serotonin/norepinephrine reuptake inhibitor (SNRI) will be prescribed for a patient who is experiencing major depression. When conducting a pretreatment health history, the nurse learns that the patient has a recent history of alcohol abuse. Which SNRI would be contraindicated for this patient? Desvenlafaxine [Pristiq] Duloxetine [Cymbalta] Escitalopram [Lexapro] Venlafaxine [Effexor SR]
Duloxetine [Cymbalta]
Which plasma lipoprotein level is most concerning when considering the risk of coronary atherosclerosis? Elevated cholesterol Elevated high-density lipoprotein Elevated low-density lipoprotein Elevated very-low-density lipoprotein
Elevated low-density lipoprotein
A patient who has urinary bladder cancer will begin receiving the chemotherapeutic agent valrubicin [Valstar]. What will the nurse do when administering this drug? Administer the drug intravenously using a large bore needle and tubing. Ensure that the tubing used to administer the drug does not contain polyvinyl chloride. Monitor the patient closely for a variety of systemic drug adverse effects. Use a normal saline or sterile water diluent to dilute the medication.
Ensure that the tubing used to administer the drug does not contain polyvinyl chloride.
The nurse assesses a newly diagnosed patient for short-term complications of diabetes. What does this assessment include? Evaluation for hyperglycemia, hypoglycemia, and ketoacidosis Cranial nerve testing for peripheral neuropathy Pedal pulse palpation for arterial insufficiency Auscultation of the carotids for bruits associated with atherosclerosis
Evaluation for hyperglycemia, hypoglycemia, and ketoacidosis
A patient with chronic hypertension is admitted to the hospital. During the admission assessment, the nurse notes a heart rate of 96 beats/min, a blood pressure of 150/90 mm Hg, bibasilar crackles, 2+ pitting edema of the ankles, and distension of the jugular veins. The nurse will contact the provider to request an order for which medication? ACE inhibitor Digoxin [Lanoxin] Furosemide [Lasix] Spironolactone [Aldactone]
Furosemide [Lasix]
Selective serotonin reuptake inhibitors are known to be effective for which disorders? (Select all that apply.) Generalized anxiety disorder (GAD) Obsessive-compulsive disorder Panic disorder Post-traumatic stress disorder Social anxiety disorder
Generalized anxiety disorder (GAD) Obsessive-compulsive disorder Panic disorder
A patient is receiving tobramycin three times daily. A tobramycin peak level is 4.5 and the trough is 1.2. What will the nurse do? Give the next dose as ordered. Hold the next dose and notify the provider. Monitor the patient for signs of nephrotoxicity. Tell the patient to report tinnitus.
Give the next dose as ordered.
What is the most reliable measure for assessing diabetes control over the preceding 3-month period? Self-monitoring blood glucose (SMBG) graph report Patient's report Fasting blood glucose level Glycosylated hemoglobin level
Glycosylated hemoglobin level
A nurse caring for a patient notes that the patient has a temperature of 104°F and a heart rate of 110 beats/min. The patient's skin is warm and moist, and the patient complains that the room is too warm. The patient appears nervous and has protuberant eyes. The nurse will contact the provider to discuss: cretinism. Graves' disease. myxedema. Plummer's disease.
Grave's Disease
A provider has ordered captopril [Capoten] for a patient who has hypertension. The patient reports a history of swelling of the tongue and lips after taking enalapril [Vasotec] in the past. Which action by the nurse is correct? Administer the captopril and monitor for adverse effects. Hold the dose and notify the provider. Request an order to administer fosinopril instead of captopril. Reassure the patient that this is not a serious side effect.
Hold the dose and notify the provider.
A patient has been receiving intravenous penicillin for pneumonia for several days and begins to complain of generalized itching. The nurse auscultates bilateral wheezing and notes a temperature of 38.5°C (101°F). Which is the correct action by the nurse? Administer the next dose and continue to evaluate the patient's symptoms. Ask the prescriber if an antihistamine can be given to relieve the itching. Contact the prescriber to request an order for a chest radiograph. Hold the next dose and notify the prescriber of the symptoms.
Hold the next dose and notify the prescriber of the symptoms.
A nurse obtaining an admission history on an adult patient notes that the patient has a heart rate of 62 beats/min, a blood pressure of 105/62 mm Hg, and a temperature of 96.2°F. The patient appears pale and complains of always feeling cold and tired. The nurse will contact the provider to discuss tests for which condition? Cretinism Graves' disease Hypothyroidism Plummer's disease
Hypothyroidism
The parents of a boy with hemophilia A want to know why their son will receive factor replacement on an ongoing basis rather than when needed for bleeding episodes. They tell the nurse that the boy's grandfather, who had the same disease, received the drug only when he had bleeding. The nurse will give the parents which information about ongoing therapy? It can reverse progression of the disease. It is cheaper, because the amounts of the drug used are less. It is used to minimize long-term damage to the joints. It prevents the development of inhibitors.
It is used to minimize long-term damage to the joints.
A patient begins taking an ACE inhibitor and complains of a dry cough. What does the nurse correctly tell the patient about this symptom? It indicates that a serious side effect has occurred. It is a common side effect that occurs in almost all patients taking the drug. It may be uncomfortable enough that the drug will need to be discontinued. It occurs frequently in patients taking the drug but will subside over time.
It may be uncomfortable enough that the drug will need to be discontinued.
A patient with persistent, frequent asthma exacerbations asks a nurse about a long-acting beta2-agonist medication. What will the nurse tell this patient? LABAs are safer than short-acting beta2 agonists. LABAs can be used on an as-needed basis to treat symptoms. LABAs reduce the risk of asthma-related deaths. LABAs should be combined with an inhaled glucocorticoid.
LABAs should be combined with an inhaled glucocorticoid.
A patient receives a drug that has a narrow therapeutic range. The nurse administering this medication will expect to do what? Administer the drug at intervals longer than the drug half-life. Administer this medication intravenously. Monitor plasma drug levels. Teach the patient that maximum drug effects will occur within a short period.
Monitor plasma drug levels.
In a discussion of drug-drug interactions, which would be the best example of a beneficial inhibitory interaction? Naloxone [Narcan] blocking morphine sulfate's actions Antacids blocking the action of tetracycline [Sumycin] Propanolol [Inderal] blocking the effects of albuterol Cholestyramine blocking the actions of antihypertensive drugs
Naloxone [Narcan] blocking morphine sulfate's actions
Which organisms can be treated with penicillin G (Benzylpenicillin)? (Select all that apply.) Methicillin-resistant S. aureus Neisseria meningitidis P. aeruginosa S. pyogenes T. pallidum
Neisseria meningitidis S. pyogenes T. pallidum
Can drugs stop the progression of or prevent Alzheimers disease?
No (no solid evidence)
Insulin glargine is prescribed for a hospitalized patient who has diabetes. When will the nurse expect to administer this drug? Approximately 15 to 30 minutes before each meal In the morning and at 4:00 PM Once daily at bedtime After meals and at bedtime
Once daily at bedtime
Levodopa and Sinemet (Leovodopa and Carbidopa) are used to treat what?
Parkinson's
The nurse is teaching a patient how a medication works to treat an illness. To do this, the nurse will rely on knowledge of which topic? Clinical pharmacology Drug efficacy Pharmacokinetics Pharmacotherapeutics
Pharmacotherapeutics
A patient who takes nonsteroidal anti-inflammatory drugs (NSAIDs) for arthritis asks a nurse what can be done to prevent ulcers. The nurse will recommend asking the provider about using which medication? Antibiotics Histamine-2 receptor antagonists Proton pump inhibitors Mucosal protectants
Proton pump inhibitors
A patient will undergo a colonoscopy, and the provider has ordered sodium phosphate as a bowel cleanser before the procedure. The nurse reviews the patient's chart and notes that the patient's creatinine clearance and blood urea nitrogen are both elevated. What will the nurse do? Reduce the amount of fluid given with the laxative to prevent fluid retention. Request an order to give polyethylene glycol and electrolytes (PEG-ELS) instead. Suggest that the patient reduce the dietary sodium intake. Suggest using a suppository laxative instead.
Request an order to give polyethylene glycol and electrolytes (PEG-ELS) instead.
A patient is admitted with severe hypertensive crisis. The nurse will anticipate administering which medication? Captopril PO Hydralazine [Apresoline] 25 mg PO Minoxidil 20 mg PO Sodium nitroprusside [Nitropress] IV
Sodium nitroprusside [Nitropress] IV
A patient in her twenties with Graves' disease who takes methimazole [Tapazole] tells a nurse that she is trying to conceive and asks about disease management during pregnancy. What will the nurse tell her? A. Methimazole is safe to take throughout pregnancy. B. Propylthiouracil should be taken throughout her pregnancy. C. The patient should discuss changing to propylthiouracil from now until her second trimester with her provider. D. The patient should discuss therapy with iodine-131 instead of medications with her provider.
The patient should discuss changing to propylthiouracil from now until her second trimester with her provider.
A patient is using a metered-dose inhaler containing albuterol for asthma. The medication label instructs the patient to administer "2 puffs every 4 hours as needed for coughing or wheezing." The patient reports feeling jittery sometimes when taking the medication, and he or she doesn't feel that the medication is always effective. Which action is outside the nurse's scope of practice? Asking the patient to demonstrate the use of the inhaler Assessing the patient's exposure to tobacco smoke Auscultating lung sounds and obtaining vital signs Suggesting that the patient use 1 puff to reduce side effects
Suggesting that the patient use 1 puff to reduce side effects
A patient who has been taking gentamicin for 5 days reports a headache and dizziness. What will the nurse do? Request an order for a gentamicin peak level. Suspect ototoxicity and notify the prescriber. Tell the patient to ask for help with ambulation. Tell the patient to report any tinnitus.
Suspect ototoxicity and notify the prescriber.
A nurse caring for a 5-year-old child notes that the child has discoloration of several teeth. When taking a medication history, the nurse will ask about which group of medications? Glucocorticoids Salicylates Sulfonamides Tetracyclines
Tetracyclines
An older adult patient has confusion, memory loss, and disorientation in familiar surroundings. The patient has been taking donepezil [Aricept] 10 mg once daily for 6 months. The patient's symptoms have begun to worsen, and the patient's spouse asks if the medication dose can be increased. What will the nurse tell the spouse? The dose can be increased, because the patient has been taking the drug for longer than 3 months. The dose can be increased to twice daily dosing instead of once daily dosing. The increase in symptoms is the result of hepatotoxicity from the medication's side effects. The patient must take the drug for longer than 1 year before the dose can be increased.
The dose can be increased, because the patient has been taking the drug for longer than 3 months.
A female patient taking an ACE inhibitor learns that she is pregnant. What will the nurse tell this patient? The fetus most likely will have serious congenital defects. The fetus must be monitored closely while the patient is taking this drug. The patient's prescriber probably will change her medication to an ARB. The patient should stop taking the medication and contact her provider immediately.
The patient should stop taking the medication and contact her provider immediately.
A patient with type 1 diabetes reports mixing NPH and regular insulin to allow for 1 injection. What should the nurse tell the patient? This is an acceptable practice. These two forms of insulin are not compatible and cannot be mixed. Mixing these two forms of insulin may increase the overall potency of the products. NPH insulin should only be mixed with insulin glargine.
This is an acceptable practice.
What is Piperacillin?
Treats bacterial infections; it is a Penicillin antibiotic
A 20-year-old female patient has suprapubic discomfort, pyuria, dysuria, and bacteriuria greater than 100,000/mL of urine. Which are the most likely diagnosis and treatment? Uncomplicated lower urinary tract infection treatable with short-course therapy Complicated lower urinary tract infection treatable with single-dose therapy Uncomplicated upper urinary tract infection requiring 14 days of oral antibiotics Complicated upper urinary tract infection requiring parenteral antibiotics
Uncomplicated lower urinary tract infection treatable with short-course therapy
A premenopausal woman has ER-positive breast cancer, and her prescriber has ordered tamoxifen [Nolvadex]. She asks the nurse if anastrozole [Arimidex] would work better for her. What will the nurse tell her? Anastrozole is more likely to cause hot flushes than tamoxifen. Anastrozole is more likely to promote endometrial carcinoma. Cancer recurrence is higher with anastrozole. Until she is postmenopausal, anastrozole will not be effective.
Until she is postmenopausal, anastrozole will not be effective.
A patient who has chronic adrenal insufficiency is admitted to the hospital for an open cholecystectomy. The nurse obtaining the admission history learns that the patient takes hydrocortisone 25 mg PO daily in the morning. The patient's surgery is scheduled for the next morning. The nurse will expect an order to: administer the usual morning dose of hydrocortisone 25 mg PO. administer hydrocortisone 50 mg PO in the morning. administer hydrocortisone 50 mg IV before surgery. withhold the morning dose of hydrocortisone and give it after surgery.
administer hydrocortisone 50 mg IV before surgery.
A patient with Stage C heart failure (HF) who has been taking an ACE inhibitor, a beta blocker, and a diuretic begins to have increased dyspnea, weight gain, and decreased urine output. The provider orders spironolactone [Aldactone]. The nurse will instruct the patient to: avoid potassium supplements. monitor for a decreased heart rate. take extra fluids. use a salt substitute instead of salt.
avoid potassium supplements.
A nurse is caring for a child who has hemophilia. While reviewing this child's immunization records, the nurse notes that the child needs the tetanus and reduced diphtheria toxoids and acellular pertussis (Tdap) vaccine and the hepatitis A vaccine. The nurse should notify the provider and obtain an order to give: both vaccines intramuscularly. both vaccines subcutaneously. the hepatitis A vaccine only subcutaneously. the Tdap vaccine only intramuscularly.
both vaccines intramuscularly.
A patient will begin taking tamoxifen [Nolvadex] to treat breast cancer. The nurse performs a medication history and learns that the patient is taking sertraline [Zoloft] for depression. The nurse will tell the patient to contact her provider to ask about: increasing her dose of sertraline. changing from sertraline to escitalopram [Lexapro]. switching from sertraline to fluoxetine [Prozac]. decreasing her dose of tamoxifen.
changing from sertraline to escitalopram [Lexapro].
A nurse is obtaining a medication history on a newly admitted patient, who reports taking minoxidil for hypertension. Admission vital signs reveal a heart rate of 78 beats/min and a blood pressure of 120/80 mm Hg. What is an important part of the initial assessment for this patient? Evaluating ankle edema Monitoring for nausea and vomiting Noting the presence of hypertrichosis Obtaining a blood glucose
evaluating ankle edema rationale: Ankle edema is a side effect of Minoxidil
What should you avoid when taking Sinemet and Levodopa?
high protein diet
A patient will begin taking etanercept [Enbrel] for severe rheumatoid arthritis. The patient has been taking methotrexate [Rheumatrex]. The patient asks if the etanercept is stronger than the methotrexate. The nurse will tell the patient that etanercept methotrexate. has synergistic effects with helps reduce adverse effects associated with is better at delaying progression of joint damage than has fewer adverse effects than
is better at delaying progression of joint damage than
Can you stop the progression of or cure Parkinson's Disease?
no
A patient who has a long-term addiction to opioids takes an overdose of barbiturates. The nurse preparing to care for this patient will anticipate: a severe abstinence syndrome when the effects of the barbiturates are reversed. minimal respiratory depression, because the patient has developed a tolerance to opioids. observing pinpoint pupils, respiratory depression, and possibly coma in this patient. using naloxone [Narcan] to reverse the effects of the barbiturates, because cross-tolerance is likely.
observing pinpoint pupils, respiratory depression, and possibly coma in this patient.
A prescriber has ordered medication for a newborn. The medication is eliminated primarily by hepatic metabolism. The nurse expects the prescriber to: order a dose that is lower than an adult dose. order a dose that is higher than an adult dose. increase the frequency of medication dosing. discontinue the drug after one or two doses.
order a dose that is lower than an adult dose.
A patient is receiving heparin postoperatively to prevent deep vein thrombosis. The nurse notes that the patient has a blood pressure of 90/50 mm Hg and a heart rate of 98 beats/min. The patient's most recent aPTT is greater than 90 seconds. The patient reports lumbar pain. The nurse will request an order for: a repeat aPTT to be drawn immediately. analgesic medication. changing heparin to aspirin. protamine sulfate.
protamine sulfate.
A patient with an infection caused by P. aeruginosa is being treated with piperacillin. The nurse providing care reviews the patient's laboratory reports and notes that the patient's blood urea nitrogen and serum creatinine levels are elevated. The nurse will contact the provider to discuss: adding an aminoglycoside. changing to penicillin G. reducing the dose of piperacillin. ordering nafcillin.
reducing the dose of piperacillin.
A patient who does not consume alcohol or nicotine products reports a strong family history of hypertension and cardiovascular disease. The patient has a blood pressure of 126/82 and a normal weight and body mass index for height and age. The nurse will expect to teach this patient about: ACE inhibitors and calcium channel blocker medications. the DASH diet, sodium restriction, and exercise. increased calcium and potassium supplements. thiazide diuretics and lifestyle changes.
the DASH diet, sodium restriction, and exercise.