Pharmacology Final Exam

When taking a patient's drug history, the nurse asks about use of OTC drugs. The patient responds by saying, "Oh, I frequently take aspirin for my headaches, but I didn't mention it because aspirin is nonprescription." What is the nurse's best response?

"Although aspirin is over the counter, it's still important to know why you take it, how much you take, and how often."

A patient who is taking a xanthine derivative for COPD asks the nurse, "I miss my morning coffee. I can't wait to go home and have some." What is the nurse's best response?

"It's important not to take coffee or other caffeinated products with this medicine, as it may cause an increased heart rate as well as other problems."

A client who just picked up a prescription at the pharmacy asks the nurse why the client was prescribed a medication for mental health issues when the client sought treatment for allergies. What is the nurse's best response?

"Tell me the name of your prescription please."

A nurse is providing discharge teaching to a client who has pulmonary tuberculosis and a new prescription for rifampin. Which of the following information should the nurse provide?

"Urine and other secretions might turn orange."

How many mL in 1 tbs?

15mL= 1 tbs

A nurse is preparing to administer aspirin 650 mg PO every 12 hr. The amount available is aspirin 325 mg tablets. How many tablets should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

2 Tablets

How many pounds are in a kilogram?

2.2 pounds

A nurse is caring for an adolescent client who has pneumonia and a prescription for cefpodoxime 5 mg/kg PO every 12 hr for 5 days. The client weighs 88 lb. How many mg 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.)

200mg

How many mL in 1 cup?

240 mL = 1 cup

How many centimeters are in a foot?

30.48 cm = 1 foot

How many mL in 1 tsp?

5 mL = 1 tsp

A nurse is admitting a client who has active tuberculosis to a room on a medical-surgical unit. Which of the following room assignments should the nurse make for the client?

A room with air exhaust directly to the outdoor environment

What action should the nurse perform during the implementation step of the nursing process?

Administrations and documentation of medications.

A nurse is teaching a client who has a new diagnosis of asthma. Which of the following medications should the nurse instruct the client to use to abort an acute asthma attack?

Albuterol

After a nebulizer treatment with the beta agonist albuterol, the patient complains of feeling a little "shaky," with slight tremors of the hands. The patient's heart rate is 98 beats/min, increased from the pretreatment rate of 88 beats/min. The nurse knows that this reaction is which of these?

An expected adverse effect of the medication.

A nurse is preparing to perform hand hygiene. Which of the following actions should the nurse take?

Apply 4 to 5 mL of liquid soap to the hands.

The nurse has just administered a client's medication. What action should the nurse perform next?

Assess for drug effects.

What laboratory value is monitored closely with the use of oral glucocorticoids to manage COPD?

Blood glucose

The barrier system that restricts the passage of various chemicals and microscopic entities (e.g., bacteria, viruses) between the bloodstream and the central nervous system. It still allows for the passage of essential substances such as oxygen.

Blood-brain barrier

The nurse is preparing to administer a medication to an older adult. The nurse should consider what factor that could affect therapeutic dosing in an older adult?

Changes in the gastrointestinal (GI) system can reduce drug absorption.

The name that describes the chemical composition and molecular structure of a drug.

Chemical name

This is the patient being able to follow their physician's prescribed course of treatment or therapeutic plan. Their ability to do so is known as?

Compliance

A nurse is providing discharge instructions to a client who has asthma and a new prescription for montelukast. The nurse should instruct the client to report which of the following adverse effects to the provider?

Depression

Which is an example of a black box warning by the Food and Drug Administration (FDA)?

Difficulty breathing and maintaining an airway

A nurse is preparing to administer medications to a client who states, "I don't want to take those drugs." Which of the following actions should the nurse take?

Document that the client refuses the medications.

The processes involved in the interaction between a drug and body cells (e.g., the action of a drug on a receptor protein); also called mechanism of action (MOA).

Drug actions

The nurse is performing an intake assessment for a patient with a history of glaucoma, clotting disorder, diabetes, and hypercholesterolemia. The patient reports consuming 2-3 beers nightly and taking diphenhydramine to promote sleep. What is the priority nursing intervention?

Educate the patient about contraindications between drinking alcohol and taking diphenhydramine.

A patient with chronic COPD is prescribed prednisone after an acute exacerbation. What type of dosing does the nurse anticipate?

Give a higher dose for 3 days and then a tapered reduction.

A nurse in a public clinic is planning a health fair for older adult clients in the community. In teaching medication safety, which of the following foods should the nurse advise the clients to avoid when taking their prescriptions?

Grapefruit juice

Which of the following would be least important to include when teaching a client about drug therapy?

How to report a medication error

A nurse is reviewing the medical record of a client who reports taking pseudoephedrine for sinus congestion as needed. The nurse should identify that pseudoephedrine is contraindicated for which of the following client conditions?

Hypertension

The nurse is reviewing dietary supplements and US Food and Drug Administration (FDA) requirements. Which of these actions are required by the FDA for manufacturers of dietary supplements?

Identify the active ingredients on the label.

Any preventable adverse drug event involving inappropriate medication use by a patient or health care professional; it may or may not cause the patient harm.

Medication Errors

When educating patients about the safe use of herbal products, the nurse remembers to include which concept?

No adverse effects are associated with these products because they are natural and may be purchased without a prescription.

The nurse is working in a community outreach clinic. What should the nurse teach a client about over-the-counter medications?

OTC medications are not risk free.

These are achieved by the patient being able to change behaviors in order to demonstrate improved positive health behaviors.

Outcomes

The broadest term for the study or science of drugs.

Pharmacology

During a teaching session for a patient who will be receiving a new prescription for the LTRA montelukast (Singulair), the nurse will tell the patient that the drug has which therapeutic effect?

Reduces inflammation in the airway

The nurse is preparing a medication for a client and observes the date of expiration on the vial occurred 2 months ago. Which of the following actions should the nurse take?

Return the medication to the pharmacy.

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.

The health care provider has ordered an emergent theophylline injection in the hospital setting. How will the nurse plan to administer this medication?

Slow intravenous injection

A nurse is teaching a client about taking an expectorant to treat a cough. The nurse should explain that this type of medication has which of the following actions?

Stimulates secretions

A nurse is providing discharge instructions to a client who has asthma and is about to start taking theophylline (Theo-24). The nurse should tell the client that this medication might cause which of the following adverse effects?

Tachycardia

A nurse is caring for a client who requires a medication that is packaged in a single dose glass ampule. Which of the following techniques should the nurse use when opening the glass ampule?

Tap the top of the ampule, place a sterile gauze pad around the ampule neck, and break off the top by bending it toward the body.

A nurse is caring for a client who is taking montelukast. Which of the following outcomes indicates a therapeutic effect of the medication?

The client experiences an increased ease of breathing.

A nurse is caring for a client who asks how albuterol helps his breathing. Which of the following responses should the nurse make? (Select all that apply.)

The medication will open the airways. The medication will decrease coughing episodes. The medication will prevent wheezing.

The ratio between the toxic and therapeutic concentrations of a drug.

Therapeutic Index

The condition of producing adverse bodily effects due to poisonous qualities.

Toxicity

An older adult patient is being taught about inhaled beta2agonists. The patient has arthritis and has difficulty with hand-breath coordination. What should the patient be taught to do?

Use a spacer with a one-way valve

A client is administered an oral contraceptive. What is the process that occurs between the time the drug enters the body and the time it enters the bloodstream?

absorption

A nurse is caring for a client who is prescribed multiple medications. Which clients are MOST likely to have adverse drug reactions?

clients who are very young or very old

Clinical pharmacology is the study of?

drugs used to treat, prevent, or diagnose disease.

What drug administration route should be used to assure the best bioavailability as any particular drug?

intravenous

A nurse is preparing to administer a prescribed drug to a client who has liver disease. The nurse expects a reduction in dosage based on the understanding that what might be altered?

metabolism

How is pharmacodynamics best defined?

the action that the drug has on body cells

An older adult is taking theophylline for long-term treatment of asthma. The nurse monitors the laboratory values and notes that the theophylline level is 5 mcg/mL. When the nurse informs the health care provider, what is the anticipated order?

Increase the dose

A nurse in an emergency department is preparing to administer theophylline by continuous intravenous (IV) infusion to a client who is experiencing an asthma attack. Which of the following actions should the nurse take?

Infuse the medication with an IV pump.

The nurse is administering an antibiotic to her pediatric patient. She checks the patient's armband and verifies the correct medication by checking the physician's order, medication kardex, and vial. Which of the following is not considered one of the "rights" of drug administration?

Right frequency

After the patient takes a dose of an inhaled corticosteroid, such as fluticasone (Flovent), what is the most important action the patient needs to do next?

Rinse out the mouth with water

A patient presents to the Emergency Department with an acute asthma exacerbation. The patient states, "I tried to use my salmeterol inhaler when the symptoms started to worsen, but it didn't help." What does the nurse identify as the reason the patient's asthma exacerbation continued?

Salmeterolis a long-acting inhaler

What is the branch of pharmacology that uses drugs to treat, prevent, and diagnose disease?

pharmacotherapeutics

A patient who has a history of asthma is experiencing an acute episode of shortness of breath and needs to take a medication for immediate relief. The nurse will choose which medication that is appropriate for this situation?

A beta agonist, such as albuterol

What client is most likely to have impaired drug metabolism?

A client who has a diagnosis of hepatitis C

Which statement correctly defines a drug?

A drug is any chemical that can affect living processes.

An immunologic reaction resulting from an unusual sensitivity of a patient to a certain medication; a type of adverse drug event and a subtype of adverse drug reaction.

Allergic reaction

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.

The passive movement of a substance (e.g., a drug) between different tissues from areas of higher concentration to areas of lower concentration. (Compare with active transport)

Diffusion

An older adult client calls the health care provider's office and tells the nurse that prescriptions for three medications have run out and the pharmacy will not refill them this close together. A home health referral is made and the client is found to be taking the medication more often than prescribed. What is a priority nursing diagnosis for this client?

Nonadherence to therapeutic medication regimen

An organizational framework for the practice of nursing. It encompasses all steps taken by the nurse in caring for a patient: assessment, identification of human needs, planning (with goals and outcome criteria), implementation of the plan (with patient teaching), and evaluation.

Nursing Process

A nurse is beginning the apply the nursing process during a new client interaction. What activity should the nurse perform?

Obtain a medication history.

The study of the biochemical and physiologic interactions of drugs at their sites of activity. It examines the effect of the drug on the body.

Pharmacodynamics

The study of what happens to a drug from the time it is put into the body until the parent drug and all metabolites have left the body. Pharmacokinetics represent the drug absorption into, distribution and metabolism within, and excretion from the body.

Pharmacokinetics

The use of many different drugs concurrently in treating a patient, who often has multiple chronic health conditions.

Polypharmacy

A nurse is providing discharge teaching to a client who has asthma and a new prescription for fluticasone/salmeterol. For which of the following adverse effects should the nurse instruct the client to report to the provider?

White coating in the mouth

The client has been prescribed an oral medication. Prior to administration of this medication, what should the nurse do first?

evaluate the client's ability to swallow.

The nurse instructs the client that some drugs are no longer covered under patent and may be less expensive. What type of drug is the nurse describing?

generic

What is the nursing diagnosis the framework for?

nursing interventions

Drug evaluation studies are used to determine critical concentration. The nurse understands that the critical concentration is the amount of the drug needed to cause:

therapeutic effect.

What route does the nurse teach the patient to use for glucocorticoids in the management of chronic asthma?

Inhalation

A nurse is administering digoxin to a client. To administer medications so that the drug is as effective as possible, the nurse should prioritize what factor?

a. the process of pharmacokinetics

What represents a pharmacokinetic phase? (Select all that apply.)

absorption, distribution , metabolism, excretion

The nurse is caring for an older adult who needs to know that drugs, even when taken correctly, can produce negative or unexpected effects. The nurse should address what topic during health education?

adverse effects

What is the MOST frequently used drug administration route in clinical practice?

oral