Pharmacology A

The nurse in the cardiac rehabilitation unit knows the maintenance dose of digoxin is in which range? 1. 1.0 to 3.0 mg 2. 0.5 to 1.0 mg 3. 3.5 to 5.0 mg 4. 0.125 to 0.5 mg

0.125 to 0.5 mg -Digoxin is a cardiac glycoside w/ a narrow therapeutic index or range. Its used in the treatment of HF, atrial fibrillation, flutter, or tachycardia. Adverse effects= anorexia, N&V, bradycardia, visual disturbances, confusion, & abdominal pain. The nurse will monitor pulse, serum blood levels, & s/s of toxicity.

The nurse provides medication education for a client receiving lovastatin. Which information is most important for the nurse to include? 1. "Notify the HCP if you experience muscle pain." 2. "This medication may damage your kidneys." 3. "Take the medication w/ a large glass of grapefruit juice." 4. "If you miss a dose, double the medication the following day."

1. Adverse effects w/ major consequences include muscle pain or injury & liver dysfunction. The client needs to avoid grapefruit juice. You shouldn't double the medication if you miss a dose.

A client diagnosed w/ depression is scheduled to begin electroconvulsive therapy (ECT) treatments. It is most important for the nurse to notify the HCP about which information? 1. the client is being treated for glaucoma 2. The client's parent had seizures w/ meningitis 3. The client has worn dentures for ten years 4. The client is allergic to shellfish

1. An anticholinergic such as atropine or glycopyrrolate is given before an ECT is administered, which causes pupil dilation (mydriatic effect)- which is contraindicated with glaucoma.

A client diagnosed w/ HTN & HF has been prescribed captopril. Which statement is most important for the nurse to include when providing medication education to the client? 1. "You should avoid salt substitutes while you're taking this medication." 2. "Notify the HCP immediately if you develop a slight, dry cough." 3. "You may experience some hair loss when first taking the medication." 4. "You should increase your intake or fiber to prevent constipation as long as you take this medication."

1. Captopril is an ACE inhibitor antihypertensive medication that spares potassium & causes one to excrete sodium & water. Most salt substitutes contain potassium chloride, which needs to be avoided. -A slight, dry cough is a minor side effect. -Hair loss & constipation aren't side effects. Side effects= N&V & diarrhea.

The nurse learns a client has been taking simvastatin for 7 months. Which statement by a colleague does the nurse correct? 1. "I should take the client's BP in supine, sitting, & standing positions." 2. "I will check the lab blood values for HDL & LDL, and their ratio." 3. "I will check the lab blood values for LFTs." 4. "I will ask the client if an eye exam has been completed since beginning the medication."

1. It is an antilipemic agent used to control cholesterol level when diet & exercise aren't effective in keeping the level in normal range. Adverse effects= eye lens opacities & liver dysfunction. Monitoring a supine, sitting, & standing BP isn't necessary

The nurse understands which are similarities between a Schedule I drug & a Schedule V drug? 1. Both Schedule I drugs & Schedule V drugs have some abuse potential. 2. Neither Schedule I drugs nor Schedule V drugs have a high risk of abuse potential. 3. Severe psychological or physical dependence can occur w/ Schedule I & Schedule V drugs. 4. Schedule I & Schedule V drugs have the same potential for abuse.

1. There is a high potential for abuse for Schedule I & II drugs (heroin or peyote) & a limited abuse potential for Schedule V (codeine). The abuse potential is not the same.

Which instruction by the nurse is best to include when teaching about amlodipine? 1. "Report any swelling of the face or extremities to the HCP." 2. "You need to refrigerate this medication." 3. "Report any weight loss to the HCP." 4. "Photophobia is a common adverse side effect that will diminish w/ repeated use."`

1. These are adverse effects that should be reported to the HCP. Amlodipine is a calcium channel blocker that inhibits Ca+ influx across cardiac & smooth muscle cells. It dilates coronary arteries & decreases BP & myocardial oxygen demand. Adverse effects= HA, fatigue, paresthesia, edema, & dyspnea. Nursing considerations= monitoring client for increased angina or symptoms of an acute MI. Client education= notify prescriber if s/s of HF occur- swelling or hands or feet or SOB. -You can store it at RT. Weight loss & photophobia aren't side effects.

The nurse counsels a client prescribed cromolyn to treat bilateral conjunctivitis. The nurse intervenes if the client makes which statement? 1. "I put the eye drops in the least affected eye first, & then the more infected eye." 2. "I put the drops in after I put in my contact lens in." 3. "I don't touch the tip of the dropper to anything." 4. "I wash my hands before & after instilling the drops."

2.

The nurse instructs a client with a diagnosis of epilepsy who's prescribed phenytoin sodium. The nurse determines teaching is successful if the client makes which statement? 1. "If my urine changes color, I should go to the ED." 2. "I should avoid drinking alcohol while taking this medication." 3. "There are no restrictions on my activities when I begin this medication." 4. "I can stop taking the medication if I develop an upset stomach."

2. It is an anticonvulsant used to treat tonic-clonic & complex focal seizures. The client shouldn't drink alcohol or other CNS depressants. Adverse effects= drowsiness, ataxia, nystagmus, blurred vision, GI upset, & gingival hypertrophy. -A change in urine color (pink or brown shades) can occur & isn't a sign of toxicity. -Phenytoin can cause dizziness & drowsiness, so these need to be monitored. -Nausea & GI upset may occur when the client begins the medication but will likely subside.

The nurse provides care for a client w/ schizophrenia who's taking chlorpromazine. When providing medication education to the client, the nurse includes information about which common adverse effects? 1. Insomnia & restlessness 2. Abnormal motor movements & dry mouth 3. Weight loss & increased libido 4. HTN & dyspnea

2. It is an antipsychotic medication. Adverse effects= orthostatic hypotension, drowsiness, blurred vision, dry mouth, extrapyramidal symptoms, agranulocytosis, & neuromuscular difficulties.

A client asks the nurse, "How does lovastatin work?" Which is the nurse's best response? 1. "It prevents the reabsorption of bile acids into the small intestine." 2. "It prevents an enzyme in the liver from making more cholesterol." 3. "It is a vitamin that increases the activity of lipoprotein lipase." 4. "It is a fibric acid agent that activates lipoprotein lipase."

2. Lovastatin is an HMG-CoA reductase inhibitor that is effective in decreasing the LDL & triglyceride levels. It inhibits the enzyme that synthesizes cholesterol in the liver to lower sodium cholesterol levels. Adverse effects= abdominal cramps, constipation, diarrhea, flatus, heartburn, rashes, rhabdomyolysis, elevated liver enzymes, arthralgia, ED, nausea, chest pain, peripheral edema, bronchitis, blurred vision, rhinitis, altered taste, pancreatitis, drug-induced hepatitis, dizziness, insomnia, weakness, & HA. Nursing considerations= administer w/ food at evening meal, avoid large amounts of grapefruit juice. Client education= don't skip or double-up on doses, eat a low fat/low cholesterol diet, avoid OTC & prescription drugs, avoid herbal products, & avoid pregnancy & breastfeeding.

The home health care nurse visits an older adult client receiving quetiapine tablets 3x a day. The client's spouse states, "My spouse just seems so restless & moves constantly." Which action by the nurse is most appopriate? 1. Tell the spouse to decrease the medication to 2x a day 2. Notify the HCP 3. Remind the client not to drink alcohol while taking it 4. Tell the client's spouse that this is an expected adverse effect of the medication

2. The client is displaying symptoms of pseudoparkinsonism, a serious side effect. The HCP may prescribe another medication.

The nurse provides care for a client w/ RA who reports cramping & abdominal discomfort after taking prescribed hydrocortisone. Which instruction by the nurse is best? 1. "You need to take hydrocortisone w/ all of your medications." 2. "Restrict your fluid intake when you take hydrocortisone." 3. "Take hydrocortisone w/ food & not on an empty stomach." 4. "Hydrocortisone should be taken at bedtime."

3. -Mixing it w/ other meds can increase GI distress. -2 will not reduce GI distress. Taking meds w/ milk & food will decrease GI distress.

A client w/ a history of asthma & bronchitis is prescribed montelukast. The nurse determines the client understands teaching about the medication when the client makes which statement? 1. "I will use this medication as needed when I have an asthma attack." 2. "I need to take this medication first thing in the morning w/ breakfast." 3. "It will take several weeks for this medication to lessen the effects of chronic asthma." 4. "It prevents bacterial infections & is taken if I have an exacerbation of bronchitis."

3. -it should be taken w/ or w/out food in the evening.

Ten days after beginning to use beclomethasone nasal spray due to seasonal allergies, a client reports to the nurse that even though the medication is being used correctly, only slight relief has been experienced. Which action by the nurse is most important? 1. Review the correct procedure for administering the nasal spray 2. Contact the HCP to change the dose of medication 3. Remind the client that the peak effect can take up to 3 weeks or regular use 4. Educate the client about the strong effects of high allergen level on sinuses.

3. Beclomethasone is a corticosteroid nasal spray used to treat seasonal allergic rhinitis. Adverse effects= dizziness, HA, abdominal pain, nasal burning, & nasal irritation.

A client reports multiple watery bowel movements after taking a prescribed antibiotic for several days. The client is prescribed loperamide. It is most important for the nurse to follow up on which client statement? 1. "My mouth is do dry & I feel really dizzy." 2. "I am checking my bowel movements for blood." 3. "I will stop taking the antibiotic until this diarrhea stops." 4. "This medication makes me feel very drowsy & sleepy."

3. Diarrhea can be a common adverse effect of taking antibiotics. The client should complete the course of antibiotic therapy. If possible. If necessary, the HCP may change to a different antibiotic that the client tolerates better.

A client diagnosed w/ gastroenteritis is instructed to take loperamide for episodes of diarrhea. Which information does the nurse include when teaching the client about this medication? 1. "Take two tablets after every loose bowel movement." 2. "You may be very wakeful & restlessness when taking the medication." 3. "This medication may cause you to have a dry mouth." 4. "It is safe to take this medication with other medications."

3. Loperamid is taken to reduce the motility of the GI tract & decrease the number of bowel movements which occur w/ diarrhea. Adverse effects= drowsiness & dry mouth. -2 tablets are taken after the first loose bowel movement & 1 tablet after each loose bowel movement after the 1st dose has been taken. -It may interact w/ narcotic analgesics & antihistamines & cause profound drowsiness & affect heart rhythym.

A client w/ a diagnosis of metastatic lung cancer is prescribed a transdermal fentanyl patch. Which information must the nurse understand to ensure the client achieves effective pain relief? 1. The transdermal patch is fully effective immediately after application 2. There's little risk of respiratory depression when using a transdermal fentanyl patch 3. The client will require administration of pain medication for several hours after application of the patch 4. Desired & adverse effects of the patch cease as soon as the patch is removed

3. To relieve the client's pain, we need to administer short-acting pain meds continually until the fentanyl from the patch is absorbed into the bloodstream & an effective blood level of the medication is achieved. -It takes 8-12 hrs for the patch to be effective -Fentanyl is an opioid narcotic. Adverse effects= somnolence, urinary retention, respiratory depression, nausea, itching, & respiratory arrest. -Respiratory depression can occur several hours after removal of the patch

A client is prescribed morphine sulfate 4 mg IV q4hrs PRN for pain after surgery. The nurse assesses the client 30 minutes after giving the medication for a report of pain of 8. The client's VS are: BP 172/88, pulse 92, RR 22. The client reports a pain level of 8. Which action by the nurse is most appropriate? 1. Notify the HCP to increase the dose 2. Tell the client to cough & deep breathe 3. Suggest the client listen to music 4. Assess the level of sedation

4.

The nurse recognizes which antipsychotic is used as a treatment for Tourette syndrome? 1. Risperidone 2. Quetiapine 3. Ziprasidone 4. Haloperidol

4. All the others are used for treatment of psychotic states. Risperidone adverse effects including drowsiness, dizziness, tardive dyskinesia, & constipation. Quetiapine side effects= drowsiness & dizziness. Ziprasidone side effects= drowsiness, dizziness, tardive dyskinesia, & constipation. Haloperidol side effects= drowsiness & dizziness.

A client is struggling w/ alcohol abuse & wants assistance to stop drinking. The nurse knows which medication will most likely be prescribed for the client? 1. Diazepam 2. Dexamethasone 3. Docusate 4. Disulfiram

4. It causes a severe hypersensitivity to alcohol, so it's used in the treatment of alcoholism in the motivated client. Adverse effects= flushing, sweating, throbbing HA, tachycardia, respiratory distress, & N&V in the presence of alcohol.

The nurse provides care for a client who's prescribed sertraline. Which statement is most important for the nurse to make? 1. "It will take a few days for you to achieve full therapeutic effect." 2. "One of the adverse effects of the medication is rapid weight gain." 3. "You need to avoid drinking beer when taking this medication, but you may drink wine in small amounts." 4. "This medication may make it more difficult for you to sleep at night."

4. It is an antidepressant used to treat depression, OCD, panic disorder, & PTSD. Adverse effects= GI upset, HA, dizziness, impotence, & insomnia. -The therapeutic effect may take up to 4 weeks. -It can cause loss of appetite, changes in taste sensation, & weight loss. -All forms of alcohol should be avoided during treatment & for one week after the end of therapy.

The nurse provides information to a client w/ a diagnosis of anemia about good dietary sources of folic acid & folate. Which food is included in the teaching plan? (SELECT ALL). 1. Dried beans 2. Bran 3. Citrus fruits 4. Fresh vegetables 5. Dairy products 6. Seafood

Dried beans, bran, citrus fruits, & fresh vegetables.

The nurse provides care for a client admitted w/ DKA. The nurse anticipates that which type of insulin will be prescribed?

Short-acting (regular) insulin. Via IV. Onset= 30-60 min. peak= 2-3 hrs. Duration= 4-6 hrs.

The nurse understands which occurrence is an adverse effect or toxic effect of aspirin? (SELECT ALL) 1. Rash 2. Tinnitus 3. Nausea 4. Vomiting 5. Hypoventilation

Tinnitus, nausea, & vomiting.