Pharm Midterm Quiz Q's

A nurse is caring for a child who is on a clear liquid diet. At lunch, the child consumed 1 cup of juice, 4 oz gelatin, a 6 oz bowl of chicken broth and 60 mL ginger ale. How many mL should the nurse record as the child's fluid intake?

600

Match the medication name with its therapeutic classification. 1. doxycycline 2. mycophenolate mofetil 3. diphenhydramine 4. diclofenac 5. dexamethasone A. immunosuppressant B. antihistamine C. nonopiod analgesic D. anti-inflammatory steroid E. anti-infective

1. E 2. A 3. B 4. C 5. D

A nurse is preparing to administer fentanyl 70 mcg IM to a client who reports postoperative pain. Available is fentanyl 50 mcg/mL. How many mL should the nurse administer? (Do not use a trailing zero.)

1.4

A patient who recently lost her husband to a fatal work-related accident is experiencing insomnia. The physician orders a one-week trail of 12.5 milligrams of diphenhydramine orally nightly at bedtime. The pharmacy supplies diphenhydramine 25 milligrams per 5 milliliter oral elixir in a multi-dose bottle along with a 3 mL syringe for dosing accuracy. How many milliliters will be drawn up for each dose?

2.5

A nurse is caring for a client who is to receive liquid medications via a gastrostomy tube. The client is prescribed phenytoin 250 mg. The amount available is phenytoin oral solution 25 mg/5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

50

A nurse caring for a patient experiencing ketoacidosis receives an order to infuse regular insulin drip at 9 units/hr. Available supply of the medication is regular insulin 100 units in 100 mL NS. What flow rate in milliliters per hour should the nurse set the IV pump?

9

Absorption, distribution, metabolism and excretion concern which of the following aspects of pharmacology? A. pharmacokinetics B. pharmaceutics C. pharmacotherapeutics D. pharmacodynamics

A

A patient receives a drug that has a narrow therapeutic range. What concerns should the nurse have regarding this drug? A. No specific concerns. The drug has a short half-life and will clear the body shortly. B. This drug can reach toxic levels more rapidly than drugs with wide therapeutic indices. C. Administer each dose over longer time intervals than the drug's known half-life. D. Teach the patient that maximum drug effects will occur within a short period.

B

A patient with moderate hypertension is taking lisinopril and hydrochlorothiazide. Which action by the nurse is correct? A. Administer the diuretic at bedtime. B. Administer the medications as ordered. C. Contact the health provider. D. Hold both medications if the blood pressure is normal.

B

Overdose of which agent can be treated with protamine sulfate? A. aspirin B. heparin. C. acetaminophen D. warfarin.

B

A patient taking an extended release nitroglycerin prescription for chronic chest pain relief. What statement should the nurse include in the medication teaching about nitroglycerin. A. "Nitroglycerin is selective for coronary artery smooth muscle cells, causing increased blood flow to the heart muscle." B. "Nitroglycerin increases aortic pressures and this results in more blood flowing back into the coronary arteries." C. "Nitroglycerin works by dilating veins and reducing the oxygen demand of the heart muscle." D. "Nitroglycerin dilates arteries and thereby reduces the force of contraction needed with each heart beat."

C

The nurse caring for a patient with heart failure notes a new order has been written in the patient's chart for a dopamine infusion. Which of the following effects should the nurse anticipate? A. A decrease in the patient's blood pressure. B. A decrease in the systemic vascular resistance. C. An increase in cardiac output. D. Worsening bradycardia.

C

The patient is to receive digoxin elixir 125 mcg orally once daily. The supply available has a concentration of 50 mcg/ml. How many milliliters should the nurse prepare to administer? Round answer to nearest tenth decimal place whenever applicable.

2.5

Match the correct mechanism of action to the generic drug name. 1. verapamil 2. metoprolol 3. bivalirudin 4. apixaban 5. labetalol A. factor Xa inhibitor B. decreased SA and AV node conduction C. beta 1 selective receptor antagonist D. alpha 1 and nonselective beta receptor antagonist E. thrombin inhibitor

1. B 2. C 3. E 4. A 5. D

Match the correct mechanism of action to the generic drug name. 1. valSARTAN 2. selegiline 3. pravaSTATIN 4. silodosin 5. pyridostigmine A. hmg coA reductase inhibitor B. angiotensin II receptor antagonist C. inhibits acetylcholine degradation enzyme D. type B monoamine oxidase inhibitor E. blocks alpha 1 adrenergic receptors

1. B 2. D 3. A 4. E 5. C

Match the generic drug name with its anticoagulant type. 1. warfarin 2. bivalirudin 3. clopridogrel 4. heparin 5. rivaroxaban A. irreversible antiplatelet agent B. factor Xa inhibitor C. vitamin K dependent factor inhibition in the liver D. thrombin inhibitor E. antithrombin potentiator

1. C 2. D 3. A 4. E 5. B

A nurse is preparing to administer 5% dextrose in 0.45% sodium chloride 1,000 mL IV to infuse over 18 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

56

What is the study of how drugs affect physiological processes called? A. pharmacodynamics B. pharmacognosy C. pharmacogenomics D. pharmacokinetics

A

A nurse is preparing to administer meperidine 50 mg IM to a client every 6 hr PRN for pain. Available is meperidine injection 125 mg/2 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

0.8

The nurse receives an order for atropine 0.75 mg intramuscular STAT. The available supply of the drug is 1 mg/mL. How many milliliters should the nurse prepare to give? Round answer to the nearest tenth decimal place.

0.8

Match the medication name to its mechanism of action. 1. clindamycin 2. cephalexin 3. celecoxib 4. colchicine 5. cyclosporine A. interleukin-2 and T-cell inhibitor B. cell wall membrane destruction C. white blood cell suppression in gout D. protein synthesis inhibitor E. selective COX-2 inhibitor in osteoarthritis

1. D 2. B 3. E 4. C 5. A

Match the correct overdose antidote to each one of the generic medications. 1. atropine 2. heparin 3. diazepam 4. pancuronium 5. warfarin A. pyridostigmine B. flumazenil C. phytonadione D. physostigmine E. protamine sulfate

1. D 2. E 3. B 4. A 5. C

A nurse is preparing to administer lamivudine 150 mg orally twice daily. Available are lamivudine 100 mg scored tablets. How many tablets should the nurse administer per dose? (Use only numerical values without labeling in your answer.Round the answer to the nearest tenth if applicable. Use a leading zero if it applies. Do not use a trailing zero.)

1.5

Ampicillin 0.75 grams intramuscular injections are ordered every six hours for a patient who cannot safely take oral medications due to dysphagia. The pharmacy supplies ampicillin 500 milligrams per milliliter injectable solution. How many milliliters will be required for each dose? Enter a numeric value, no labels. Do not round your answer.

1.5

A nurse is reviewing a client's prescription for 1,000 mL of 5% dextrose in water IV to infuse over 8 hr. At 0900, the nurse observes that there is 500 mL of solution remaining in the client's current IV bag. At what time should the nurse administer the next bag of IV solution? The RN will prepare a new bag of D5W for

1300

A nurse is caring for a client who is prescribed tetracycline 2 grams daily PO in four divided doses every 6 hr. Available is tetracycline 250 mg capsules. How many capsules should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

2

The nurse would expect to administer which diuretic to treat a patient diagnosed with central diabetes insipidus? A. hydrochlorothiazide B. acetazolamide C. furosemide D. bumetanide

A

A patient is brought to the emergency department with shortness of breath, a respiratory rate of 30 breaths per minute, intercostal retractions and frothy, pink sputum. The nurse caring for this patient will expect to administer which drug? A. furosemide B. mannitol C. spironolactone D. hydrochlorothiazide

A

A patient with a ST segment elevation myocardial infarction is prescribed aspirin. Which teaching should the nurse include when administering the aspirin? A. "Chew the aspirin tablet thoroughly." B. "Take the enteric coated aspirin tablet whole." C. "Swallow the aspirin tablet with water." D. " The aspirin is to help you with the nitroglycerin headache."

A

A prescriber has ordered propanolol for a patient with recurrent ventricular tachycardia. The nurse preparing to administer this drug will be concerned about what in the patient's history? A. asthma B. hypertension C. exercise-induced tachyarrhythmias D. paroxysmal atraial tachycardia associated with emotion

A

The nurse caring for a patient with CHF notes a new order has been written in the patient's chart for a dobutamine infusion. Which of the following desired effects should the nurse anticipate? A. increased cardiac output B. increased heart rate C. increased preload D. increased systemic vascular resistance

A

A decreased lean body mass seen in the emaciated elderly person is likely to affect how some drugs impact physiologic processes. Therefore, drugs with which chemical property will reach higher distribution concentrations in older adults? A. drugs with significant polarity B. drugs with high water solubility (hydrophilicity) C. drugs with high fat solubility (lipophilicity) D. drugs with high ionic charges

B

A nurse notes that a patient reports he has been taking atenolol to prevent anginal chest pain. In addition, he states that his physician just informed him that he is developing heart failure. The nurse should base his next action on the understanding that: A. most patients with coronary artery disease develop heart failure. B. beta-blockers do not negatively impact heart failure symptoms. C. atenolol is an angiotensin-converting enzyme inhibitor. D. tapering off the medication is indicated to avoid worsening chest pain.

B

Albumin is responsible for much of which of the pharmacokinetic activities of the body? A. drug clearance B. drug distribution C. drug absorption D. drug metabolism

B

An African American patient has had blood pressures of 150/90 mm Hg and 148/90 mm Hg on two separate office visits. The patient reports a blood pressure of 145/92 mm Hg taken at the local drug store. The patient's diagnostic tests are all normal. The nurse will expect this patient's provider to order: A. a beta blocker. B. a thiazide diuretic. C. counseling on lifestyle changes. D. a loop diuretic and spironolactone.

B

An inpatient on a cardiac care unit is taking an alpha 1 antagonist (vasodilator) that relaxes smooth muscles in veins and arteries. To help minimize drug side effects, the nurse caring for this patient will: A. tell the patient to report shortness of breath. B. caution the patient not to get up without assistance. C. warn the patient about the possibility of bradycardia. D. encourage the patient to increase fluid intake.

B

Certain medications have a narrow therapeutic index. This characteristic means that: A. The safe and the toxic plasma levels of the drug are very far apart. B. The safe and the toxic plasma levels of the drug are very close to each other. C. A very small dosage can result in the desired therapeutic effect. D. The medication requires high doses in order to be effective.

B

In stable angina the objective of drug therapy with calcium channel blockers is to relieve pain by: A. increasing heart rate and contractility. B. dilating arterioles and decreasing afterload. C. reducing platelet cohesiveness. D. constricting veins and increasing preload.

B

The nurse begins an intravenous infusion of diltiazem and places the patient on the cardiac monitoring telemetry device. The nurse should call the prescriber immediately if which complication of diltiazem occurs? A. a slower ventricular response in atrial fibrillation. B. a bradycardiac rhythm or heart block. C. a momentary drop in mean arterial blood pressures. D. increased pain and difficulty when passing stool.

B

The patient states that he thinks that he is taking a calcium-channel blocker to prevent anginal chest pain, but he is not sure which of his drugs is the calcium-channel blocker. The nurse reviews the list of medications and informs the patient that the calcium-channel blocker is: A. propranolol B. verapamil C. lisinopril D. isosorbide dinitrate

B

Two different medications are absorbed into the bloodstream at identical rates and achieve equal distribution concentrations. Also, the medications have identical therapeutic effects. What is the term that best describes all of these these properties? A. steady state B. bioequivalency C. compatability D. potency

B

Which of the following statements best sums up the goal of pharmacotherapeutics? A. Use the best drug at the lowest cost. B. Obtain the maximum benefit with the least amount of harm. C. Only use drugs that health insurance covers. D. Achieve a therapeutic drug response within 4 half-lives.

B

A patient with hypertension is prescribed lisinopril. The nurse reviewing the patient's medical record before administering the medication will be most concerned about which other disease process? A. coronary artery disease B. bronchial asthma C. bilateral renal artery stenosis D. diabetes mellitus

C

The parenteral route of medication is important because of which feature? A. The parenteral route uses the GI tract for absorption. B. The parenteral is the slowest route for absorption. C. The parenteral route avoids initial hepatic metabolism. D. The parenteral route results in a lower blood level of drug.

C

A drug that binds to and inhibits or decreases the activity of one or more receptors in the body is called a(n) ________________ drug. A. inducer B. agonist C. protolytic D. antagonist

D

A female patient who is diabetic sustained an ST-elevation myocardial infarction (STEMI). The nurse provides discharge teaching. Which statement, made by the patient, indicates that further teaching is required? A. "My blood pressure should be less than 130/80 mm Hg." B. "I will take aspirin, atenolol, and captopril indefinitely." C. "My new medications are needed to prevent heart failure." D. "I'm going to ask for estrogen therapy since I'm past menopause. I know estrogen has heart protective effects."

D

A nurse is preparing to give medications to 4 elderly patients, all of whom take multiple medications. Which patient should the nurse be concerned most about adverse drug reactions related to increased drug effects? A. An obese sedentary 40-year old male. B. A patient with a low-normal serum creatinine level. C. A patient with intermittent periods of constipation. D. An elderly emaciated female patient.

D

A patient is started on an extended release form of verapamil to manage chronic chest pain. Which statement by the patient indicates understanding of patient teaching provided for this medication? A. "I can continue to drink alcoholic beverages with dinner." B. "This medication will not impact my diabetes management outcomes." C. "I can continue to drink grapefruit juice at breakfast." D. "I must swallow the pill whole."

D

A physician prescribes a water-soluble drug for an obese chair-bound 85-year-old patient at the maximum range of normal dosage for a young adult. The RN should take what priority action regarding the amount of drug ordered. A. Encourage the patient to perform chair exercises to increase activity levels. B. Instruct the patient to increase daily water intake to increase renal drug clearance. C. Withhold the drug and report the physician's error to the pharmacist. D. Monitor for drug toxicity related to the patient's advanced age.

D

In caring for a patient with heart failure who is receiving furosemide and digoxin, the nurse notes that the patient's serum potassium is very low. The nurse recognizes that this laboratory data indicates that this patient is at high risk for: A. fluid volume deficit. B. cardiogenic shock. C. hypertension D. digoxin toxicity

D

Patients with inflammatory conditions who are taking both glucocorticoids and loop diuretics should be monitored for: A. increased calcium levels. B. decreased sodium levels. C. decreased glucose levels. D. decreased potassium levels.

D