pharmacology
A nurse is teaching parents how to use an Epi-Pen for their child, who has a peanut allergy. Which statement by the parents indicates understanding of the teaching? a. "After using the Epi-Pen, we must go to the emergency department." b. "The Epi-Pen should be stored in the refrigerator, because epinephrine is sensitive to heat." c. "The teacher should call us when symptoms start so that we can bring the Epi-Pen to school." d. "We should jab the device into the thigh until it is empty of solution."
A
What is the target organ when a beta1 agonist is administered? a. heart b. kidney c. respiratory d. liver
A
A nurse is caring for a woman with breast cancer who is receiving tamoxifen. A review of this patient's chart reveals a deficiency of the CYP2D6 gene. The nurse will contact the provider to suggest: a. a different medication. b. an increased dose. c. a reduced dose. d. serum drug levels.
ANS: A Women with a deficiency of the CYP2D6 gene lack the ability to convert tamoxifen to its active form, endoxifen, and will not benefit from this drug. Another drug should be used to treat this patient's breast cancer. Increasing the dose, reducing the dose, or monitoring serum drug levels will not make this drug more effective in these women. DIF: Cognitive Level: Application REF: Genetic Variants That Alter Drug Metabolism
A nurse is preparing to give medications to four geriatric patients who are all taking multiple medications. Which patient is most likely to have an adverse drug reaction related to increased drug effects? a. Obese patient b. Patient with decreased serum creatinine c. Patient with chronic diarrhea d. Thin patient with a chronically low appetite
ANS: D The patient who is thin and has a poor appetite has an increased risk of malnutrition, with significant lowering of serum albumin. This can result in increased free drug levels of protein-bound drugs and can lead to drug toxicity. Obesity, which involves increased adipose tissue, would cause lipid-soluble drugs to deposit in adipose tissue, with a resulting reduction of drug effects. Decreased serum creatinine in an older adult patient may just be a function of a decrease in lean body mass and not of renal function. Chronic diarrhea would accelerate the passage of medications through the GI tract and reduce absorption.
A nursing student asks the nurse about receptor specificity of adrenergic agonist medications. What will the nurse say? a. As the dosage of these medications increases, drugs in this class are more selec-tive. b. Dopamine is selective for dopamine receptors and has no effects on alpha or beta receptors. c. Epinephrine is the most selective alpha-adrenergic agonist medication. d. Specificity is relative and is dose dependent.
D
A nurse is teaching a group of nursing students about neuropharmacology. Which statement by a student about peripheral nervous system (PNS) drugs indicates a need for further teaching? a. "Drugs affecting axonal conduction have a variety of uses." b. "Drugs that alter synaptic transmission can be highly selective." c. "Many PNS drugs act by altering synaptic transmission." d. "These drugs work by influencing receptor activity."
a
A patient has developed muscarinic antagonist toxicity from ingestion of an unknown chemical. The nurse should prepare to administer which medication? A Atropine (Sal-Tropine) IV B Physostigmine (Antilirium) C An acetylcholinesterase activator D Pseudoephedrine (Ephedrine
Physostigmine
A child with seasonal rhinitis has used budesonide (Rhinocort Aqua) for several years. The parents are concerned that the child's rate of growth has slowed. What will the nurse do?
Suggest that the parents discuss using fluticasone (Flonase) with the provider.
a patient with COPD is prescribed a bronchodilator medication. which type of bronchodilator is preferred for this patient? a. A long-acting inhaled beta2 agonist b. An oral beta2 agonist c. A short-acting beta2 agonist d. An intravenous methylxanthine
a
A nurse is teaching a group of nursing students about administering medications to older adult patients. Which statement by a student indicates a need for further teaching? a. "Alteration in hepatic function requires more frequent drug dosing." b. "Changes in GI function in older adult patients lead to lower serum drug levels." c. "Most adverse drug reactions in older adult patients are related to altered renal function d."Most nonadherence among older adult patients is intentional."
a
A nurse is preparing to give an antibiotic to a patient who reports being allergic to antibiotics. Before giving the medication, it is important for the nurse to do what? a. Ask whether the patient has taken this antibiotic for other infections. b. Question the patient about allergies to other medications. c. Obtain a history of other reactions to other drugs. d. Request an order for an antihistamine.
a
A 7-year-old child with asthma uses a daily inhaled glucocorticoid and an albuterol MDI as needed. The provider has added montelukast (Singulair) to the child's regimen. Which state-ment by the child's parent indicates understanding of this medication? a. "I may notice mood changes in my child." b. "I should give this medication twice daily." c. "I will give my child one 4-mg chewable tablet daily." d. "This drug can alleviate symptoms during an acute attack.
a
A nurse educator is conducting a continuing education class on pharmacology. To evaluate the learning of the nurses in the class, the nurse educator asks, "Which drug name gives information about the drug's pharmacologic classiFcation?" Which is the correct response? a.Amoxicillin b.Tylenol c.Cipro d.Motrin
a
pregnant patient asks the nurse about the safe use of medications during the third trimester. What will the nurse tell her about drugs taken at this stage? a. They may need to be given in higher doses if they undergo renal clearance. b. They require lower doses if they are metabolized by the liver. c. They are less likely to cross the placenta and affect the fetus. d. They are more likely to cause anatomical defects if they are teratogenic.
a
The nurse is providing multiple medications to a patient whose spouse brings him grapefruit juice every morning. The nurse should be concerned about which classes of drugs? (Select all that apply.) a. Calcium channel blockers b. Selective serotonin reuptake inhibitors c. Aminoglycosides d. Beta blockers e. Penicillins
a b
A nurse is caring for a patient who is taking multiple medications. To help ensure that adverse drug reactions are prevented or minimized, the nurse will do which of the following? (Select all that apply.) a. Ask the patient about over-the-counter medications used. b. Contact the prescriber to request cytochrome P450 levels. c. Limit the patient's calcium intake. d. Obtain a thorough diet history. e. Request orders for PRN medications to treat any anticipated symptoms of drug interactions.
a b d
What are the results of using glucocorticoid drugs to treat asthma? (Select all that apply.) a.Reduced bronchial hyperreactivity b.Reduced edema of the airway c.Reduced number of bronchial beta2receptors d.Increased responsiveness to beta2-adrenergic agonists e.Increased synthesis of inflammatory mediators
a b d
Which claim may be made by manufacturers of dietary supplements? (Select all that apply.) a."Energizes and rejuvenates" b."Promotes pulmonary health" c."Reduces pain and stiffness from arthritis" d."Reduces stress" e."Relieves hot flashes associated with menopause
a b d
A child who has perennial allergic rhinitis has been using an intranasal glucocorticoid. The provider has ordered montelukast (Singulair) to replace the glucocorticoid, because the child has frequent nosebleeds. When teaching this child's parents about montelukast, the nurse will include which statement? a."Montelukast is also effective for treating infectious rhinitis." b."Montelukast may cause behavior changes in your child." c."Montelukast will treat both congestion and rhinitis." d."Montelukast works best when combined with a topical decongestant."
b
A nurse is caring for an infant after a surgical procedure. After ensuring that the ordered dose is appropriate for the infant's age and weight, the nurse administers a narcotic analgesic intravenously. When assessing the infant 15 minutes later, the nurse notes respirations of 22 breaths per minute and a heart rate of 110 beats per minute. The infant is asleep in the parent's arms and does not awaken when vital signs are assessed. The nurse understands that these findings are the result of: a. an allergic reaction to the medication. b. immaturity of the blood-brain barrier in the infant. c. toxic effects of the narcotic, requiring naloxone (Narcan) as an antidote. d. unexpected side effects of medications in infants
b
A patient is wheezing and short of breath. The nurse assesses a heart rate of 88 beats per minute, a respiratory rate of 24 breaths per minute, and a blood pressure of 124/78 mm Hg. The prescriber orders a nonspecific beta agonist medication. Besides evaluating the patient for a reduction in respiratory distress, the nurse will monitor for which side effect? a. Hypotension b. Tachycardia c. Tachypnea d. Urinary retention
b
A patient received atropine intravenously before surgery. The recovery room nurse notes that the patient is delirious upon awakening, has a heart rate of 96 beats per minute, a respiratory rate of 22 breaths per minute, and a blood pressure of 110/78 mm Hg. The nurse notiFes the anesthesiologist, who will order: A activated charcoal to minimize intestinal absorption of the antimuscarinic agent. B an acetylcholinesterase inhibitor to compete with the antimuscarinic agent at receptors. C an antipsychotic medication to treat the patient's central nervous system symptoms .D ipratropium bromide (Atrovent) to counter the respiratory e±ects of the antimuscarinic agent
b
A patient taking oral contraceptives thinks she may be pregnant. As part of this patient's history, what will the nurse ask the patient? a. "Do you drink grapefruit juice?" b. "Do you take seizure medication?" c. "Do you take your contraception with milk?" d. "Do you use laxatives regularly?"
b
A young adult woman will begin using an inhaled glucocorticoid to treat asthma. The nurse will teach this patient about the importance of which action? a. Lowering her calcium intake and increasing her vitamin D intake b. Participating in weight-bearing exercises on a regular basis c. Taking oral glucocorticoids during times of acute stress d. Using two reliable forms of birth control to prevent pregnancy
b
A nurse is administering an agonist drug that acts on postganglionic neurons of the sympathetic nervous system. Which response will the nurse expect to see? a. Decreased sweating b. Bronchodilation c. Increased cardiac output d. Pinpoint pupils
c
A nurse is caring for an older adult patient during the immediate postoperative period after a total hip replacement. The surgeon has ordered meperidine (Demerol) for severe pain. What will the nurse do? a. Administer the medication as prescribed and initiate a fall risk protocol. b. Ask for a PRN order for diphenhydramine (Benadryl) for the expected side effect of itching. c. Request an order for morphine instead of meperidine (Demerol). d. Suggest to the surgeon that the patient receive diazepam (Valium) to reduce anxiety and the need for narcotics.
c In older adults, meperidine is not effective at usual doses and causes more confusion than in younger patients. Morphine is recommended for severe pain. A fall risk protocol is appropriate, but the drug ordered is not. Diphenhydramine is not recommended for older adult patients, because it causes blurred vision. Both diphenhydramine and diazepam have central nervous system (CNS) sedative effects, which will compound the CNS effects of the narcotic. Diazepam also produces prolonged sedation in older adults.
A patient reports becoming "immune" to a medication because it no longer works to alleviate symptoms. The nurse recognizes that this decreased eFectiveness is likely caused by: a. antagonists produced by the body that compete with the drug for receptor sites. b. decreased selectivity of receptor sites, resulting in a variety of eFects. c. desensitization of receptor sites by continual exposure to the drug. d. synthesis of more receptor sites in response to the medication.
c. desensitization of receptor sites by continual exposure to the drug.
A nurse is teaching a group of nursing students about the different formulations of beta2-adrenergic agonist medications. Which statement by a student indicates understanding of the teaching? a."Beta2-adrenergic agonists provide quick relief via any formulation." b."Long-acting beta2agonists may be used alone to prevent attacks." c."Short-acting beta2agonists are usually given by nebulizer." d."Oral beta2agonists are not useful for short-term treatment."
d
The nurse is caring for a child who has ingested a toxic amount of aspirin. The provider orders an intravenous drug that will increase pH in the blood and urine. The nurse understands that this effect is necessary to: a. decrease the gastric absorption of aspirin. b. decrease the lipid solubility of aspirin. c. increase the serum protein binding of aspirin. d. increase the urinary excretion of aspirin
d
The nurse is teaching a patient about home administration of insulin to treat diabetes mellitus. As part of the teaching, the patient and nurse identify goals to maintain specific blood glucose ranges. This represents which aspect of the nursing process? a. Assessment b. Evaluation c. Implementation d. Planning
d
Which medication should be used for asthma patients as part of step 1 management? a.Combination inhaled glucocorticoids/long-acting beta2agonists b.Inhaled low-dose glucocorticoids c.Long-acting beta2 agonists d.Short-acting beta2 agonists
d
Which medication used for asthma has off-label uses to treat allergic rhinitis? a.Diphenhydramine [Benadryl] b.Fexofenadine/pseudoephedrine [Allegra-D] c.Guaifenesin [Mucinex] d.Omalizumab [Xolair
d
Which statement about food and drug interactions is true? a. Foods alter drug absorption and metabolism but not drug action. b. Medications are best absorbed on an empty stomach. c. Patient discomfort is the food and drug interaction of most concern. d. Some foods can inhibit CYP isozymes and alter drug metabolism.
d
To which schedule does the nurse know that heroin belongs?
schedule 1
A child is receiving a combination albuterol/ipratropium (DuoNeb) inhalation treatment. The patient complains of a dry mouth and sore throat. What will the nurse do?
Reassure the patient that these are expected side effects.
A prescriber has ordered clonidine (Catapres) for a patient who has hypertension. The nurse teaches the patient about side effects of this drug. Which statement by the patient indicates understanding of the teaching? a. "I should chew sugar-free gum or drink water to reduce dry mouth." b. "I should not drive as long as I am taking this drug." c. "I should stand up slowly when taking this medication." d. "I should stop taking this drug if I feel anxious or depressed."
a
A prescriber has ordered medication for a newborn. The medication is eliminated primarily by hepatic metabolism. The nurse expects the prescriber to: a. order a dose that is lower than an adult dose. b. order a dose that is higher than an adult dose. c. increase the frequency of medication dosing. d. discontinue the drug after one or two doses.
a
A prescriber orders clonidine [Kapvay] ER tablets for a 12-year-old child. The nurse understands that this drug is being given to treat which condition? a.ADHD b.Hypertension c.Severe pain d.Tourette's syndrome
a
Because they cause vasoconstriction, alpha 1-adrenergic agonists are especially useful for: a. extending the duration of local anesthetics. b. producing mydriasis to facilitate ophthalmic examinations. c. slowing the heart rate in tachycardic patients. d. treating hypotension.
a
A nurse is teaching a patient about a medication that alters sympathetic nervous system functions. To evaluate understanding, the nurse asks the patient to describe which functions the sympathetic nervous system regulates. Which answer indicates the need for further teaching? a. The digestive functions of the body b. The cardiovascular system c. The fight-or-flight response d. Body temperature
a
A nurse is teaching a patient about a new prescription for reserpine (Serpasil) for hypertension. Which statement by the patient indicates the need for further teaching? a. "Depressive side effects are common and will improve over time." b. "I should report gastrointestinal side effects to the provider." c. "I should stand up slowly when getting up and lie down if I feel dizzy." d. "Therapeutic effects may not be optimal for a couple of weeks."
a
A parent asks a nurse about growth suppression resulting from the use of an inhaled glucocor-ticoid in children. What will the nurse tell the parent? a. Growth may be slowed, but eventual adult height will not be reduced. b. The growth rate is not impaired, but overall height will be reduced. c. The growth rate slows while the drug is used but resumes when the drug is stopped. d. Long-term use of the drug results in a decrease in adult height
a
A patient admitted to the emergency department with abdominal pain tells the nurse he has been taking kava. Which action is the nurse's priority at this time? a.Review liver function studies. b.Assess breath sounds and respiratory effort. c.Monitor cardiovascular status. d.Review complete blood count results.
a
A patient is given a new medication and reports nausea within an hour after taking the drug. The nurse consults the drug information manual and learns that nausea is not an expected adverse effect of this drug. When the next dose is due, what will the nurse do? a. Administer the drug and tell the patient to report further nausea. b. Hold the drug and notify the provider of the patient's symptoms. c. Report the symptoms of nausea to the MEDWATCH program. d. Request an order for an antiemetic to counter this drug's effects.
a
A patient receiving botulinum toxin injections to control muscle spasticity asks how the drug works. The nurse knows that this drug affects the transmitter acetylcholine by: a. inhibiting its release. b. interfering with its storage. c. preventing its reuptake. d. promoting its synthesis.
a
A patient will begin taking propranolol (Inderal) for hypertension. Which statement by the nurse is important when teaching this patient about the medication? a. "Check your hands and feet for swelling and report that to your provider." b. "It is safe to take this medication with a calcium channel blocker." c. "Stop taking the drug if you become short of breath." d. "Take your pulse and do not take the medication if your heart rate is fast."
a
A patient with asthma uses albuterol (Ventolin) for wheezing. The nurse assesses the patient and notes vital signs of HR, 96 beats per minute; RR, 18 breaths per minute; and BP, 116/78 mm Hg. The patient has clear breath sounds and hand tremors. What will the nurse do? a. Ask the patient how often the inhaler is used. b. Check the patient's blood glucose level. c. Request an order for isoproterenol (Isuprel) to reduce side effects. d. Stop the medication and report the tremors to the provider.
a
A patient with severe, chronic COPD uses an inhaled LABA/glucocorticoid but continues to have frequent exacerbations of symptoms. The nurse will contact the provider to discuss: a.adding roflumilast [Daliresp] once daily. b.changing to oral theophylline twice daily. c.prescribing oral steroids once daily. d.Using an ipratropium/albuterol combination twice daily
a
A patient with stable COPD is prescribed a bronchodilator medication. Which type of bronchodilator is preferred for this patient? a.A long-acting inhaled beta2agonist b.An oral beta2agonist c.A short-acting beta2agonist d.An intravenous methylxanthine
a
A prescriber has ordered bethanechol (Urecholine) for a postoperative patient who has urinary retention. The nurse reviews the patient's chart before giving the drug. Which part of the patient's history would be a contraindication to using this drug? A Asthma as a child B Gastroesophageal reFux C Hypertension D Hypothyroidism
a
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? a.Chronic steroid use can inhibit growth. b.Frequent use of this drug may lead to a decreased response .c.A hypersensitivity reaction to this drug may occur. d.Systemic steroids can be toxic.
a
a patient asks a nurse how to know whether dietary supplements are safe. the nurse will tell the patient a. any standards addressing safety merely regulate labeling and manufacturing processes. b. manufacturers must provide the FDA with efficacy claims prior to marketing their supplements. c. the DSHEA requires labeling that prohi-bits claims of treatment of specific dis-eases or conditions. d. the FDA must approve dietary supple-ments prior to marketing them in the United States.
a
In administering an antihistamine to a patient, the nurse watches for drowsiness that is caused by this drug. This unintended finding is considered what?
a side effect
A nurse is explaining activation of beta 2 receptors to some student nurses during a clinical rotation at the hospital. Which statement by a student demonstrates a need for further teaching? a.Beta 2 activation results in bronchodilation. b.Beta 2 activation results in contraction of uterine muscle. c. Beta 2 activation results in glycogenolysis. d. Beta 2 activation results in vasodilation of skeletal muscles.
b
A nurse is making a home visit to an older adult woman who was recently discharged home from the hospital with a new prescription. The nurse notes that a serum drug level drawn the day before was subtherapeutic. What will the nurse do next? a. Ask the patient if she has difficulty swallowing pills. b. Count the pills in the prescription bottle. c. Notify the provider to request more frequent dosing. d. Request an order for renal function tests.
b
A nurse is performing a preoperative drug history on a patient who is admitted to the hospital for surgery. To evaluate the risk of hemorrhage, the nurse will ask the patient about antiplatelet and anticoagulant medications as well as which dietary supplement? a.Coenzyme Q-10 b.Ginkgo biloba c.Ma Huang (ephedra) d.St. John's wort
b
A nurse is preparing to administer a drug. Upon reading the medication guide, the nurse notes that the drug has been linked to symptoms of Parkinson's disease in some patients. What will the nurse do? a. Ask the patient to report these symptoms, which are known to be teratogenic effects. b. Observe the patient closely for such symptoms and prepare to treat them if needed. c. Request an order to evaluate the patient's genetic predisposition to this effect. d. Warn the patient about these effects and provide reassurance that this is expected.
b
A nurse is teaching a class to a group of pregnant patients. The nurse correctly teaches that the highest risk of teratogen-induced gross malformations exists during which time? a. Immediately before conception b. During the first trimester c. During the second trimester d. During the third trimester
b
A nurse is teaching a nursing student about the two classes of adrenergic agonist drugs. Which statement by the nursing student indicates understanding of the teaching? a. Catecholamines may be given orally. b. Catecholamines often require continuous infusion to be effective. c. Noncatecholamines do not cross the blood-brain barrier. d. Noncatecholamines undergo rapid degradation by monoamine oxidase.
b
A nurse is teaching a patient about a prescription for a monoamine oxidase (MAO) inhibitor for depression. What will the nurse teach the patient to avoid while taking this drug? a. Alcoholic beverages b. Aged cheeses c. Brussels sprouts and cabbage d. Grapefruit juice
b
A patient asks the nurse what type of medications would be most effective for treating seasonal and perennial rhinitis. Which response by the nurse is correct?a.Pseudoephedrine (Sudafed) b.Fluticasone propionate (Fluticasone) c.Loratadine (Claritin) d.Intranasal cromolyn sodium (Atrovent)
b
A patient has just given birth to a baby boy with a cleft palate. The nurse will review the patient's medication history with special emphasis on drugs taken during which period? a.Before she became pregnant b.During the first trimester c.During the second trimester d.During the third trimester
b
An infant has allergies and often develops a pruritic rash when exposed to allergens. The infant's parents ask the nurse about using a topical antihistamine. What does the nurse tell them? a. Antihistamines given by this route are not absorbed as well in children. b. Applying this medication to the skin can cause toxicity in this age group. c. The child will also need oral medication to achieve effective results. d. Topical medications have fewer side effects than those given by other routes.
b
An older adult female client has been admitted to hospital for the treatment of exacerbation of chronic obstructive pulmonary disease. Which of the following statements constitutes a long-term outcome? a) The client will demonstrate the correct use of her metered dose inhaler. b) The client will return home able to conduct her activities of daily living without experiencing shortness of breath. c) The client will express an understanding of strategies for managing fatigue and shortness of breath. d) The client will ambulate 100 feet without supplementary oxygen or mobility aids.
b
Dopamine is administered to a patient who has been experiencing hypotensive episodes. Other than an increase in blood pressure, which indicator would the nurse use to evaluate a success-ful response? a. Decrease in pulse b. Increase in urine output c. Weight gain d. Improved gastric motility
b
What is ipratropium bromide (Atrovent)? a.A cholinergic agent used for perennial rhinitis b.An anticholinergic used for allergic rhinitis and colds c.A medication that is used only in patients with asthma d.A drug that is inappropriate for use in patients with allergic rhinitis
b
A patient will begin taking immunosuppressant drugs for rheumatoid arthritis. The nurse will caution this patient to avoid which dietary supplement? a.Black cohosh b.Echinacea c.Feverfew d.Glucosamine
b Echinacea stimulates the immune system so it should not be used in patients with autoimmunedisease such as RA; it also compromises the effectiveness of immunosuppressive drugs. Blackcohosh, feverfew, and glucosamine are not contraindicated in patients with RA
A nurse is reviewing a patient's medical record before administering a medication. Which factor(s) can alter the patient's physiologic response to the drug? (Select all that apply.) a. Ability to swallow pills b. Age c. Genetic factors d. Gender e. Height
b c d
Two nurses are discussing theories of drug-receptor interaction. Which statements are true regarding the affinity of a drug and its receptor? (Select all that apply.) a. Affinity and intrinsic activity are dependent properties. b. Affinity refers to the strength of the attraction between a drug and its receptor. c. Drugs with high affinity are strongly attracted to their receptors. d. Drugs with low affinity are strongly attracted to their receptors. e. The affinity of a drug for its receptors is reflected in its potency.
b c e
A nurse administers the same medication in the same preparation in the same dose to several patients and notes that some patients have a better response to the drug than others. What is the most likely explanation for this phenomenon? a. Altered bioavailability of the drug b. Patient compliance with the therapeutic regimen c. Pharmacogenomic differences among individuals d. Placebo effects enhancing expectations of drug efficacy
c
A nurse is discussing phentolamine (OraVerse) with a nursing student. Which statement by the student indicates the need for further teaching? a. "Phentolamine can be used to block both epinephrine- and norepinephrine-mediated vasoconstriction." b. "Phentolamine can be used to treat pheochromocytoma." c. "Phentolamine is a competitive adrenergic agonist that acts selectively on alpha 1 receptors." d. "Side effects of phentolamine may include tachycardia and hypotension."
c
A nurse is preparing to teach a forgetful older adult patient about a multiple drug regimen to follow after discharge from the hospital. To help promote adherence, what will the nurse do? a. Ask the patient to share the teaching with a neighbor or friend soon after discharge. b. Give the patient detailed written information about each drug. c. Cluster medication administration times as much as possible. d. Make sure the patient understands the actions and side effects of each drug
c
A nurse is teaching nursing students about the pharmacology of methyldopa. Which statement by a student indicates the need for further teaching? a. Methyldopa results in alpha 2 agonist activation, but it is not itself an alpha 2 ago-nist. b. Methyldopa is not effective until it is converted to an active compound. c. Methyldopa reduces blood pressure by reducing cardiac output. d. Methyldopas principal mechanism is vasodilation, not cardiosuppression.
c
A nursing student is preparing to give a medication that has a black box warning. The student asks the nurse what this means. What will the nurse explain about black box warnings? a. They indicate that a drug should not be given except in life-threatening circumstances. b. They provide detailed information about the adverse effects of the drug. c. They alert prescribers to ways to mitigate potential harm from side effects. d. They provide information about antidotes in the event toxicity occurs.
c
A parent asks a nurse to recommend an intranasal decongestant for a 6-year-old child. Which response by the nurse is correct? a. "Decongestants are too sedating for children and should not be used." b. "Decongestants should not be given to children under 7 years old." c. "Decongestant drops are recommended instead of decongestant sprays." d. "Decongestant sprays should be used no longer than 5 to 10 days."
c
A patient asks a nurse why a friend who is taking the same drug responds differently to that drug. The nurse knows that the most common variation in drug response is due to differences in each patient's: a. drug receptor sites. b. hypersensitivity potential. c. metabolism of drugs. d. psychosocial response.
c
A patient in her twenties has frequent urinary tract infections, and her prescriber suggests drinking cranberry juice. She asks the nurse how drinking this can help. The nurse will tell herthat cranberry juice: a.acidifies the urine to slow the growth of the bacteria. b.helps treat established infections. c.prevents bacteria from adhering to the urinary tract wall. d.reduces the odor of the urine.
c
A patient is being discharged after surgery. During the admission history, the nurse had learned that the patient normally consumes two or three glasses of wine each day. The prescriber has ordered hydrocodone with acetaminophen (Lortab) for pain. What will the nurse do? a. Request an order for acetaminophen without hydrocodone for pain. b. Suggest that the patient use ibuprofen for pain. c. Tell the patient not to drink wine while taking the Lortab. d. Tell the patient to limit his wine intake to one or two glasses per day.
c
A pregnant patient in active labor is admitted to the emergency department. A toxicology screen and a physical assessment reveal that the patient is an active heroin addict. The nurse who cares for the neonate after delivery should anticipate which clinical manifestation(s)? a. Passivity and flat affect b. Diarrhea and salivation c. A shrill cry and irritability d. Continuous restless sleep
c
An adult male patient is 1 day postoperative from a total hip replacement. On a pain scale of 0 to 10, with 10 being the greatest pain, the patient reports a pain level of 10. Which medication would be most appropriate for the nurse to administer to this patient? a. 60 mg morphine sulfate PO b. 75 mg meperidine (Demerol) intramuscularly c. 6 mg morphine sulfate intravenously d. Fentanyl (Duragesic) patch 50 mcg transdermally
c
In a discussion of drug-drug interactions, which would be the best example of a beneficial inhibitory interaction? A. Antacids blocking the action of tetracycline [Sumycin] B. Propanolol [Inderal] blocking the effects of albuterol C. Naloxone [Narcan] blocking morphine sulfate's actions D. Cholestyramine blocking the actions of antihypertensive drugs
c
Parents ask the nurse why an over-the-counter cough suppressant with sedative side effects is not recommended for infants. Which response by the nurse is correct? a. "Babies have a more rapid gastric emptying time and don't absorb drugs well." b. "Cough medicine tastes bad, and infants usually won't take it." c. "Infants are more susceptible to central nervous system effects than are adults." d. "Infants metabolize drugs too rapidly, so drugs aren't as effective."
c
What is a desired outcome when a drug is described as easy to administer? a. It can be stored indefinitely without need for refrigeration. b. It does not interact significantly with other medications. c. It enhances patient adherence to the drug regimen. d. It is usually relatively inexpensive to produce.
c
Which type of drug taken by a pregnant patient is more likely to have effects on a fetus? a. Drug that is highly polar b. Ionized drug c. Lipid-soluble drug d. Protein-bound drug
c
A child ingests a parent's aspirin tablets, and the prescriber orders sodium bicarbonate to block the toxic effects of the aspirin. The nurse caring for this patient knows that sodium bicarbonate is effective against the aspirin because it: a.accelerates its passage through the intestine. b.alters urinary pH to enhance renal excretion. c.induces CYP isozymes to increase drug metabolism. d.raises the pH of the interstitial fluid to facilitate passage out of the cells
d
A nurse prepares to administer propranolol (Inderal) to a patient recovering from acute myocardial infarction. The patient's heart rate is 52 beats per minute, and the rhythm is regular. What action should thenurse take next?a.Administer the drug as prescribed. b.Request an order for atropine c.Withhold the dose and documentthe pulse rate. d.Withhold the dose and notify the prescriber
d
A nurse provides teaching to a patient who will begin taking a drug with a known risk of hepatotoxicity. Which statement by the patient indicates a need for further teaching? a. "I should avoid taking acetaminophen while taking this drug." b. "I will need periodic evaluation of aspartate aminotransferase and alanine aminotransferase levels." c. "If I experience nausea, vomiting, or abdominal pain, I should call my provider." d. "Routine testing and early detection of problems will prevent liver failure."
d
A patient receives morphine and shows signs of toxicity. The prescriber orders naloxone (Narcan) to reverse the effects of the morphine. The nurse understands that the naloxone works at the same receptor sites as the morphine to: a. block transmitter reuptake. b. inhibit transmitter release. c. interfere with transmitter storage. d. prevent activation of receptors.
d
A patient who has esophageal cancer is experiencing dry mouth and the provider orders oral pilocarpine to treat this symptom. What will the nurse expect to teach this patient about this medication? a. "This medication may cause rapid heart rate and elevated blood pressure." b. "This medication may cause constipation and gastric discomfort in large doses." c. "You should experience sweating with this medication and should not have other side effects." d. "You will begin taking 5 mg three times daily and may increase the dose to 10 mg."
d
A patient who has seasonal allergies in the spring and fall asks the nurse about oral anti-histamines. Which response by the nurse is correct? a. "Anticholinergic effects are more common with second-generation antihistamines." b. "First-generation antihistamines, such as diphenhydramine (Benadryl), are more effective." c. "Make sure you take antihistamines only when you have symptoms to minimize side effects." d. "You should take oral antihistamines daily during each allergy season to get max-imum effects.
d
A patient will begin taking drugs for hyperlipidemia. The patient asks about using flaxseed supplements to increase fiber. What will the nurse tell this patient? a.Not to use defatted flaxseed b.That flaxseed helps with the absorption of medications c.That flaxseed is not recommended d.To take the flaxseed 1 hour before taking the drug
d
A patient will begin using a transdermal preparation of a muscarinic antagonist for overactive bladder (OAB). The nurse teaches the patient what to do if side effects occur. Which statement by the patient indicates the need for further teaching? a. "I can use sugar-free gum for dry mouth." b. "I may need laxatives for constipation." c. "I should keep the site covered to prevent other people from getting the medicine." d. "I will take Benadryl for any itching caused by a local reaction to the patch."
d
A prescriber orders transdermal clonidine (Catapres TTS) for a patient with hypertension. What will the nurse teach this patient? a. That medication given by transdermal patch has fewer systemic side effects b. That localized skin reactions are uncommon c. To apply the patch to intact skin on the forearm or leg d. To change the patch every week
d
A type I diabetic patient comes to the clinic for a follow-up appointment. The patient is taking NPH insulin, 30 units every day. A nurse notes that the patient is also taking metoprolol (Lopressor). What education should the nurse provide to the patient? A) "You need to increase your insulin to allow for the agonist effects of metoprolol." B) "Metoprolol may potentiate the effects of the insulin, so the dose should be reduced." C) "Metoprolol has no effects on diabetes mellitus or on your insulin requirements." D) "Metoprolol may mask signs of hypoglycemia, so you need to monitor your blood glucose closely."
d
The nurse assesses a patient who has been given phentolamine [OraVerse] to treat pheochromocytoma. The nurse notes a blood pressure of 76/52 mm Hg and a heart rate of 90 beats per minute. Which action by the nurse is correct? a.Contact the provider to request an order for epinephrine. b.Continue to monitor the patient's vital signs and notify the provider if the heart rate increases. c.Notify the provider and request an order for a beta blocker. d.Notify the provider and request an order for norepinephrine.
d
The nurse is assessing a newly admitted older patient who has recently lost 15 pounds. The nurse notes that the patient is taking warfarin (Coumadin). Which laboratory tests will the nurse discuss with this patient's provider? a. Blood glucose and C-reactive protein b. Complete blood count and hepatic function tests c. Renal function tests and serum electrolytes d. Serum albumin and coagulation studies
d
A patient brought to the emergency department requires sutures. The prescriber orders a local anesthetic with epinephrine. The nurse understands that epinephrine is ordered to:
prolong absorption of the anesthetic
