pharmacology #1

A nurse is conducting an assessment of a client who has recently had several changes made to the drug regimen. What assessment question most directly addresses the safety implications of the client's drug regimen?

"Do you take any herbal supplements or alternative medications?"

The nurse is assessing a community-dwelling client with a history of rheumatoid arthritis. During the interview, the client states, "The last few months, I have this ringing in my ears that I just cannot seem to get away from." What assessment question should the nurse ask?

"Have you been taking aspirin on a regular basis?"

A client comes to the clinic reporting vaginal discharge with itching. Which statement would alert the nurse to the possibility that the client's reports are related to a superinfection?

"I just completed a course of antibiotics prescribed by my dentist to treat a tooth abscess."

If a client takes 40 mg of a drug with a half-life of 2 hours, how much of the drug will remain 2 hours after administration?

20 mg

The nurse administers amoxicillin 500 mg. The half-life of this drug is approximately 1 hour. At what point would the drug level in the body be 62.5 mg if the drug was not administered again?

3 hours after the original dose

The nurse is caring for a diverse group of clients. In which client should the nurse assess for an alteration in drug metabolism?

50-year-old male with cirrhosis of the liver

What client is experiencing an adverse effect that is a result of primary action?

A client taking anticoagulants who develops a gastrointestinal bleed

Which client is experiencing a secondary action of a medication?

A client who is drowsy after taking antihistamine

A nurse is caring for a client who is scheduled to receive three medications at the same time. What action should the nurse perform first?

Consult a drug guide to check for interactions.

When assessing a client who has developed an anaphylactic reaction, what would the nurse expect to find?

Difficulty breathing

A client comes to the clinic reporting tinnitus and difficulty hearing. What medication in the client's current regimen should the nurse suspect as causing the symptoms?

Erythromycin

Amphotericin B is given by which route?

IV

A client with a diagnosis of bipolar disorder has begun lithium therapy. What is the primary rationale for the nurse's instructions regarding the need for regular monitoring of the client's serum drug levels?

It is necessary to ensure that the client's drug levels are therapeutic but not toxic.

Which legislative act allowed the FDA to tighten control over the quality of drugs and required that safety and efficacy standards be established?

Kefauver-Harris Act of 1962

What type of drug therapy uses an individualized drug plan based upon a client's DNA?

Pharmacogenetics

What term is used to describe the process of absorption, distribution, and elimination of a drug in the body?

Pharmacokinetics

Mental dysfunction in an older adult may seem like a normal part of aging, but it can result from disease or another cause. What should the ER staff do first for a presenting older adult with a mental dysfunction such as extreme confusion?

Review the drugs being taken.

A 76-year-old client with congestive heart failure is being admitted to the hospital. The client states only taking medications that the health care provider prescribes, but when the nurse assesses the medications, three over-the-counter laxatives are in the client's bag of medications. What concerns does the nurse have about this omission?

The laxatives can interact with and complicate prescribed drug therapy.

Which client is most at risk for a cumulative drug effect?

a client with liver failure

The nurse is caring for a client receiving an aminoglycoside (antibiotic) that can be nephrotoxic. Which will alert the nurse that the client may be experiencing nephrotoxicity?

a decrease in urine output

A client with a serious Escherichia coli infection is being treated with gentamicin. When monitoring for potential adverse effects, the nurse should prioritize:

blood urea nitrogen and creatinine levels.

A student asks the study group how to define a drug allergy. What would be the peer group's bestresponse?

formation of antibodies to a drug protein causing an immune response when the person is next exposed to that drug

When administering a drug, the nurse understands that a drug administered by which route would be absorbed most rapidly?

intravenous

What plays the largest role in drug excretion?

kidneys

A nurse is caring for a client who has just been prescribed a loading dose of a drug. The nurse should explain what rationale to the client for administering a loading dose?

"We want to make sure you get the benefits of the drug as quickly as possible."

A recent nursing graduate is preparing to enter the workforce. What principle should guide the nurse's administration of medications?

Drugs can cause unexpected reactions even after thorough screening and testing.

All drugs have adverse reactions when taken. Organ and tissue damage is one such adverse reaction. Which is an example of organ and tissue damage caused by a drug?

Stevens-Johnson syndrome

A client is on antibiotic therapy for an axillary abscess. The client has been outside working in the yard and observes a rash everywhere that is not covered by clothing. What should the client be told about this finding?

The client is having photosensitivity and this can occur even with brief exposure to the sun or UV rays.

Which phrase accurately describes the concept of a medication's serum half-life?

The time needed for the serum level to fall by 50%

The nurse received an order for furosemide (Lasix). Why should the nurse write the generic name on the order sent to the pharmacy?

There is less chance of the wrong drug being given, because trade names can be similar.

The nurse is caring for a client who has been prescribed a sulfonamide but does not have an infection. The nurse is aware that the medication has been prescribed to treat what condition?

Ulcerative Colitis

The nurse is assessing a client who has developed shortness of breath, a rash, panic, and a blood pressure of 189/106 mm Hg after being administered a new medication. In addition to promptly informing the care team, the nurse should:

administer epinephrine as prescribed.

The nurse is assessing a client who has developed shortness of breath, a rash, panic and a blood pressure of 189/106 mm Hg after being administered a new medication. In addition to promptly informing the care team, the nurse should perform what action?

administering epinephrine as prescribed

The nurse is called to a client's room 15 minutes after the client has received a new medication. The client reports pruritus as well as nausea. The nurse notes that the client appears pale, is sweating, and has begun to cough and wheeze. The nurse determines that the client is experiencing what type of reaction related to the new medication?

anaphylactic shock

The nurse is assessing a new client who states being allergic to nonsteroidal anti-inflammatories (NSAIDs. What subsequent assessment should the nurse prioritize?

asking the client what the client's response is to taking NSAIDs

The nurse's assessment of a client reveals that the client has been greatly exceeding recommended safe doses of acetaminophen for the past week. When reviewing the client's laboratory results for indications of toxicity, what finding should the nurse prioritize?

aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels

What would the nurse expect to assess in a client experiencing an anaphylactic reaction?

dilated pupils feeling of panic difficulty breathing

A post-surgical client rates the pain at 10/10. The nurse confirms that there are standing orders for the administration of opioid analgesics as needed. What route of administration should the nurse choose to achieve the fastest effect?

intravenous

A nurse notes new drug orders for a client who is already getting several medications. Which is the most important consideration when preparing to administer the new drugs?

possible drug-drug interactions that might occur

The nurse is reviewing the laboratory test results of a client receiving drug therapy. What would the nurse suspect if the results reveal an elevation in the blood urea nitrogen level and creatinine concentration?

renal injury

A nurse is teaching a client about the pharmacotherapeutics of the hormone replacement therapy that the client has been prescribed. What topic should the nurse address?

the effect of the drug on the client's body

The client expresses relief to the nurse after being prescribed a new medication, stating that they expect to experience great benefits. The nurse suspects this drug will be more effective than usual for this client because of what effect?

placebo effect

A newly admitting client has signs and symptoms of an infection and the nurse anticipates that the client will be prescribed antibiotics. What assessment should the nurse prioritize when determining the client's risk for an excessive drug response due to impaired excretion?

The client's blood urea nitrogen level and creatinine clearance rate

A nurse is administering gentamicin, an antibiotic that is ototoxic. Which report or sign would indicate that the client is suffering from ototoxicity?

buzzing or ringing sound in the ears (tinnitus)

A nurse is planning client teaching about a newly prescribed drug. What teaching point should the nurse provide to best improve adherence and safety?

measures to alleviate any discomfort associated with adverse effects

The increasing incidence of severe fungal infections may be attributed in part to:

the increasing number of immunocompromised individuals.

The nurse is providing for a client who is being treated for a Pseudomonas infection in the intensive care unit. The client's medication regimen includes gentamicin 75 mg IV t.i.d. When monitoring the client for adverse effects, what assessment should the nurse prioritize?

urine output and creatinine clearance