Pharmacology Exam 2

A nurse caring for a client who is taking digoxin and develops changes on their ECG tracing and other manifestations that indicate the client has severe digoxin toxicity. Which of the following drugs should the nurse expect to administer to treat this complication? - Acetylcysteine - Flumazenil - Antigen-binding fragments - Deferoxamine

- Antigen-binding fragments

A nurse is caring for a client who will begin using transdermal nitroglycerin to treat angina pectoris. When speaking to the client about the drug, which of the following instructions should the nurse include? Select all that apply. - Apply a new patch at the onset of anginal pain - Apply the patch to dry skin and cover the area with plastic wrap - Apply the patch to a hairless area and rotate sites - Apply a new patch when you start your day - Remove patches for 10-12 hours each day

- Apply the patch to a hairless area and rotate sites - Apply a new patch when you start your day - Remove patches for 10-12 hours each day

A nurse is providing teaching to a client who is taking bethanechol for urinary retention. Which of the following instructions should the nurse include? Select all that apply - Avoid driving and activities that require alertness - Increase fluid intake - Take the drug with food - Stay close to a bathroom after taking the drug - Increase weight bearing activities

- Avoid driving and activities that require alertness - Increase fluid intake - Stay close to a bathroom after taking the drug

A nurse is caring for a male client who has hyperthyroidism and is not responding to treatment. The nurse should identify that hyperthyroidism is a contraindication for which of the following drugs? - Sildenafil - Bethanechol - Tamsulosin - Finasteride

- Bethanechol

A nurse is providing safety education to a client who is scheduled to begin treatment with tamsulosin for BPH. Which of the following instructions should the nurse include in the teaching? - Change positions slowly - Crush the medication - Take the medication on an empty stomach - Report increased urinary output immediately

- Change positions slowly

A nurse is teaching a client who is starting treatment with warfarin. The nurse should plan to include information on which of the following topics to promote the effectiveness of the drug? - Sleep modifications - Fluid modifications - Driving modifications - Dietary modifications

- Dietary modifications

A nurse is assessing a client who has a new rx of oxybutynin to treat neurogenic bladder. Which of the following assessment findings should the nurse identify as an adverse effect of the drug? Select all that apply - Diaphoresis - Dilated pupils - Dizziness - Distended Bladder - Fever

- Dilated pupils - Dizziness - Distended Bladder - Fever

A nurse is providing teaching to a client who has a new prescription for losartan to treat hypertension. The nurse should instruct the client that which of the following findings could indicate an adverse reaction to the drug and needs to be reported? - Facial edema - Sleepiness - Peripheral edema - Constipation

- Facial edema (can indicate angioedema)

A nurse is teaching a client who has a new prescription for nitroglycerin. The nurse should instruct the client that which of the following manifestations is a potential adverse effect of this drug? - Headache - Constipation - Hypertension - Hyperglycemia

- Headache- can be severe at the beginning of therapy but decrease in severity with continued exposure to nitrates.

A nurse is administering hydrochlorothiazide to a client who has gouty arthritis. The nurse should monitor the client for which of the following findings that indicates an adverse effect of this drug? - Hyperuricemia - Hypernatremia - Hyperkalemia - Hypoglycemia

- Hyperuricemia

A nurse is assessing a client who is taking a loop diuretic and is experiencing a thready, irregular pulse, orthostatic hypotension and confusion. The nurse should identify that these manifestations indicate which of the following adverse effects? - Hypokalemia - Hypoglycemia - Hypouricemia - Hyponatremia

- Hypokalemia

If combined, grapefruit juice and Verapamil can cause which of the following conditions? - Tachycardia - Dehydration - Diarrhea - Hypotension

- Hypotension. Grapefruit juice can inhibit the metabolism of verapamil

A nurse is caring for a client who is about to begin taking aspirin to reduce the risk of a cardiovascular event. The nurse should identify that the drug inhibits platelet aggregation by which of the following mechanisms? -Activating thromboxane A2 - Blocking adenosine diphosphate receptor agonists - Suppressing specific clotting factors - Inhibiting cyclooxygenase action in platelets

- Inhibiting cyclooxygenase action in platelets

A client is taking propranolol to treat tachydysrhythmia. The nurse should instruct the client to avoid taking which OTC drugs while taking propranolol? - Antihistamines - Potassium supplements - NSAIDS - Vitamin C

- NSAIDS

A nurse is caring for a client who is about to begin finasteride to treat BPH. The nurse should explain to the client the need to monitor which lab? - PSA - BUN - Creatinine Phosphokinase (CPK) - ALT

- PSA

A nurse is caring for a client taking cisplatin for testicular cancer. What are the adverse effects? Select all that apply - Paresthesia - Sore throat - Flank pain - Tinnitus - Conjunctivitis

- Paresthesia - Sore throat - Flank pain - Tinnitus

A nurse should identify that clopidogrel is contraindicated for clients who have which of the following conditions? - MI - Peptic ulcer disease - Pancreatitis - Myasthenia Gravis

- Peptic Ulcer Disease

A nurse is teaching a client about receiving leuprolide to treat endometriosis. Which of the following should the nurse include? - Perform weight bearing activities - Wear sunscreen or protective clothing - Take the drug with food to increase absorption - Avoid drinking grapefruit juice

- Perform weight-bearing activities

A client is about to start taking clopidogrel to prevent TIA. You should instruct the client to watch for and report which of the following adverse effects of this drug? Select all that apply - Petechiae - Tinnitus - Diaphoresis - Weakness - Vision changes

- Petechiae - Weakness - Vision changes

A nurse is caring for a client who is taking spironolactone to treat HTN. The nurse should recognize that which of the following client lab values requires immediate intervention? - Sodium 140 mEq/L - Potassium 5.2 mEq/L - Chloride 100 mEq/L - Magnesium 1.9 mEq/L

- Potassium 5.2 mEq/L

A nurse is caring for a client who is taking a diuretic. The nurse should instruct the client to include which of the following foods in their diet to increase potassium intake? - Raisins - Cabbage - Cheese - Eggs

- Raisins

A nurse is monitoring a client who is undergoing anticoagulant therapy with heparin. Which of the following findings should the nurse identify as a possible indication of hemorrhage? - Rapid pulse - Yellowing of the sclera - Elevated blood pressure - Pale-colored stools

- Rapid pulse

A nurse is caring for a client who is about to begin captopril therapy. Which of the following adverse effects should the nurse instruct the client to report because it can indicate a need to discontinue drug therapy? Select all that apply - Rash - Distorted taste - Swelling of the tongue - Photosensitivity - Dry cough

- Rash - Distorted taste - Swelling of the tongue - Dry cough

A nurse is teaching a client who has a new prescription for gemfibrozil. Which of the following instructions should the nurse include? Select all that apply. - Take the drug with food - Report any new intolerance to fried foods. - Report muscle tenderness. - Expect periodic liver function testing. - Take the drug once each day.

- Report any new intolerance to fried foods. (drug can cause gallstones) - Report muscle tenderness. (drug can cause myopathy) - Expect periodic liver function testing. (drug can increase risk for liver toxicity)

A nurse is caring for a client who has a new prescription for verapamil. The nurse should clarify the rx with the provider if the client has a hx of which of the following conditions? - Migraine headaches - Pancreatitis - Second-degree AV block - Angina pectoris

- Second-degree AV block- calcium channel clockers can affect AV conduction

A nurse is reviewing new rxs with a client who has heart disease. The nurse should should instruct the client that which of the following drugs is prescribed to treat hypercholesterolemia? - Simvastatin - Furosemide - Losartan - Nitroglycerin

- Simvastatin

A nurse caring for a client who has a glomerular filtration rate of 10 mL/min and a reduced urine output. The nurse should clarify a prescription for hctz for this client because of which of the following characteristics of the drug? - The drug can cause hypoglycemia in clients who have a low urine output. - The drug does not reduce blood pressure for clients who have a low urine output - The drug can increase the risk of pulmonary edema for clients who have renal insufficiency - The drug does not promote diuresis for clients who have renal insufficiency

- The drug does not promote diuresis for clients who have renal insufficiency.

A nurse is caring for a client who is taking clopidogrel to prevent stent restenosis. The nurse should monitor the client for which of the following adverse reactions? - Hyperuricemia - Hyponatremia - Lymphocytopenia - Thrombocytopenia

- Thrombocytopenia Drug can cause thrombotic thrombocytopenia purpura. Monitor the clients platelet count and for bruising, bleeding gums, and petechiae

The nurse is considering drug therapy options for a client who has metastatic breast CA that is positive for human epidermal growth factor receptor 2 (HER2). Which drug should the nurse expect the provider to prescribe? - Trastuzumab - Imatinib - Leuprolide - Flutamide

- Trastuzumab

A patient is scheduled for an outpatient surgical procedure and reports taking 81 mg of Aspirin this morning. The patient is at risk for which complication? - Uncontrolled bleeding - Myocardial infarction - Respiratory depression - Decreased renal perfusion

- Uncontrolled bleeding

A nurse is teaching a client about receiving leuprolide to treat endometriosis. The nurse should instruct the client to expect which of the following side effects? - Vaginal dryness - Hypertension - Blurred vision - Orthostatic hypotension

- Vaginal dryness

A nurse in an ED is assessing a client who has been taking warfarin and is experiencing rectal bleeding. Which of the following drugs should the nurse expect to administer to the client? - Filgrastim - Deferoxamine - Protamine - VItamin K

- Vitamin K

A nurse is preparing to administer finasteride to a client who has BPH. Which of the following precautions should the nurse plan to take when administering? - Administer med while client is sitting or reclining - Withhold med if client does not eat - Wear gloves when handling the tablet - Monitor heart rate prior to administration

- Wear gloves when handling the tablet

A nurse is assessing a client following a trastuzumab infusion to treat metastatic breast cancer. Which of the following findings should the nurse recognize as an indication that the client is experiencing an adverse reaction to the drug? - Wheezing - Dysrhythmias - Hypotension - Fever - Ascites

- Wheezing - Dysrhythmias - Hypotension - Fever

A nurse is administering digoxin, 0.125 mg, PO to a patient. Which nursing interventions will the nurse implement? (Select all that apply.) A. Checking the apical pulse rate before administration B. Monitoring the patient's serum digoxin level C. Instructing patient to report pulse rate less than 60 D. Advising patient to avoid foods high in potassium E. Always giving an antacid with digoxin to reduce GI distress

A. Checking the apical pulse rate before administration B. Monitoring the patient's serum digoxin level C. Instructing patient to report pulse rate less than 60

A nurse is monitoring a client who take aspirin 81mg po daily. The nurse should identify which of the following manifestations as adverse effects of daily aspirin therapy? CHOOSE ALL THAT APPLY A. Coffee-ground emesis B. Tinnitus C. Hypertension D. Discolored urine E. Hypokalemia

A. Coffee-ground emesis B. Tinnitus D. Discolored urine

Mr. B takes a diuretic for his hypertension. He complains of feeling lightheaded when walking, diarrhea x 3 days and family reports periods of confusion. What is your top concern for Mr. B? A. Dehydration B. Food poisoning causing diarrhea C. Possible dementia D. Nutritional status

A. Dehydration

A nurse is caring for a client who receives weekly Cisplatin IV for head and neck cancer. Which of the following adverse effects should the nurse monitor for? A. Diminished hearing B. Hot flashes C. Hyperpigmentation D. Changes in echocardiogram

A. Diminished hearing

A patient is ordered to receive digoxin (Lanoxin) to treat heart failure. The nurse is most concerned about which assessment finding? A. Heart rate 56 beats/min B. BP 138/90 mm Hg C. RR 18 breaths/min D. 1+ pitting edema of the lower extremities

A. Heart rate 56 beats/min

A nurse is teaching a client who has a new prescription for nitrofurantoin. What information should be included? CHOOSE ALL THAT APPLY A. Observe for bruising on the skin B. Take medication with milk or meals C. Crush medication if it is difficult to swallow D. Expect brown colored urine E. Expect a cough when taking

A. Observe for bruising on the skin B. Take medication with milk or meals D. Expect brown colored urine

A patient is receiving an angiotensin II receptor blocker (ARB). Which does the nurse recognize as an ARB? A. Valsartan (Diovan) B. Amlodipine (Norvasc) C. Captopril (Capoten) D. Metoprolol (Lopressor)

A. Valsartan

What responses occur with direct acting cholinergics? Select all that apply A. Decreased salivation B. Decreased heart rate C. Increased gastric motility D. Increased cardiac conduction

B. Decreased heart rate C. Increased gastric motility

You are talking with a client who is taking losartan for hypertension. She asks you about stopping contraception and starting a family. You inform the client that losartan is unsafe to take during pregnancy due to which risk? A. Macrosomia B. Fetal Injury C. Gestational Diabetes D. Thromboembolic Disease

B. Fetal injury

A client is about to start taking hydrochlorothiazide for hypertension. To assess for adverse effects of this drug, you monitor for which during drug therapy. Select all that apply. A. Ototoxicity B. Hyponatremia C. Hypokalemia D. Dehydration E. Hypoglycemia

B. Hyponatremia C. Hypokalemia D. Dehydration

A nurse is preparing to administer digoxin (Digitalis) to a patient. Which laboratory result is the nurse most concerned about? A. Sodium 138 mEq/L B. Potassium 3.0 mEq/L C. Digitalis level 1.8 ng/mL D. BNP 200 pg/mL

B. Potassium 3.0 mEq/L

Mr. B had a chemotherapy treatment for metastatic prostate cancer eight days ago. He is in the ER today with a 101.0 temp. Why did the physician ask you for his absolute neutrophil count (ANC)?A. To see if Mr. B is at risk for bleeding B. To confirm if his immune system is suppressed after chemotherapy C. To see if Mr. B needs a blood transfusion D. To see if he needs a prescription for nausea.

B. To confirm if his immune system is suppressed after chemotherapy

A patient has angina pectoris. The patient's BP is 100/60 mm Hg. The nurse administers nitroglycerin 0.4 mg sublingual (SL). It is most important for the nurse to assess the patient for the development of A. bradycardia. B. hypotension. C. bradypnea. D. hypokalemia.

B. hypotension

An 80-year-old male patient has been prescribed Finasteride for his BPH. What statement by the patient indicates a need for further teaching? A. "Since I have trouble swallowing pills, I can crush this medication." B. "I should not let me daughter handle this medication since she is trying to get pregnant." C. "I am so excited to get a full night sleep tonight after taking this new medication." D. "It will be hard to wait over 6 months to see if this medication is effective."

C. "I am so excited to get a full night sleep tonight after taking this new medication."

While talking with a client who is taking captopril to treat hypertension, which instructions do you include to her her manage the drug's adverse effects? A. Check your heart rate prior to taking the drug B. Wear sunscreen and protective clothing while outdoors C. Do not use salt substitutes to season your food D. Take the drug with a meal

C. Do not use salt substitutes to season your food

You are about to administer atropine as a preoperative medication. What side effect will you include in teaching prior to administration? A. Vomiting B. Urge to urinate C. Dry mouth D. Headaches

C. Dry mouth

When administering antianginal drugs, the nurse identifies which as the most common response? A. Tachycardia B. Bradypnea C. Hypotension D. Dry mouth

C. Hypotension

A nurse is caring for a client who has chronic stable angina. The nurse should identify that which of the following drugs inhibits the action of adenosine diphosphate receptors (ADP) on platelets and can be prescribed to reduce the client's risk for myocardial infarction? - Clopidogrel - Heparin - Warfarin - Alteplase

Clopidogrel (Plavix)

A nurse is caring for a client with breast cancer. The patient asks how chemotherapy works to treat her cancer. The response by the nurse should include which of the following? A. It stimulates the immune system. B. It is a protective agent C. You will have minimal side effects D. It halts cell growth and division in cancer cells that grow uncontrollably

D. It halts cell growth and division in cancer cells that grow uncontrollably

The nurse should teach the patient to report which of the following to the health care provider immediately if experienced after taking nitroglycerin? A. Dizziness B. Faintness C. Headache D. Persistent pain

D. Persistent pain

A nurse is teaching a client who has a new dx of breast CA about tamoxifen. The nurse should tell the client that which of the following conditions is a contraindication for taking tamoxifen? - DVT - COPD - DM - Alcohol use disorder

DVT

A patient is receiving an angiotensin II receptor blocker. It is most important for the nurse to assess the patient for Constipation tremors asthmatic attacks Dizziness

Dizziness

Patient has BPH and is taking tamsulosin. The nurse should question the use of the drug if the client also has which of the following? - A seizure disorder for which he takes carbamazepine - ED for which he take sildenafil - DM for which he takes glyburide - Angle-closure glaucoma for which he takes pilocarpine

ED for which he is taking sildenafil

A nurse is providing teaching to a client who is taking simvastatin. The nurse should instruct the client to report which of the following manifestations as an indication of a serious adverse reaction that could require discontinuing drug therapy? - Bronchoconstriction - Muscle Pain - Lip numbness - Somnolence

Muscle Pain- can progress to rhabdomyolysis

A nurse is caring for a client who is taking atorvastatin and has a new prescription for gemfibrozil. The nurse should recognize that this drug combo places the client at an increased risk for which of the following adverse effects? - Myopathy - Hypoglycemia - Irregular pulse - Kidney failure

Myopathy. Concurrent use of fibric acid derivatives, such as gemfibrozil, or other cholesterol lowering meds, can increase the risk of myopathy.

A patient with hypertension is ordered to receive an ACE inhibitor. The nurse identifies a common benign side effect of this class of medications as hiccups. flatulence. abdominal distention. a dry cough.

a dry cough.

The nurse should instruct a patient to not suddenly stop taking antihypertensives in order to avoid rebound bradycardia rebound tachycardia. rebound hypertension. rebound hypotension.

rebound hypertension.