Pharmacology Quiz

A nurse is caring for a client who has asthma and requires long term tx. The nurse should identify that which of the following medications used for long term tx places the client at an increased risk of asthma related death? A. Salmeterol B. Fluticasone C. Budesonide D. Theophylline

A. Salmeterol The nurse should identify that salmeterol is a long acting beta 2 agonist. When this med is used alone for long term tx of asthma, this class of med increases the clients risk of asthma related death. To decrease this risk the client should be prescribed both a long acting beta 2 agonist along w/ an inhaled corticosteroid.

A nurse is reinforcing discharge teaching with a client who has major depressive disorder and a new px for phenelzine. Which of the following foods should the nurse include in the plan as safe for the client to consume while taking phenelzine? A. broiled beef steak B. mac-&-cheese C. Pepperoni pizza D. Smoked salmon

A. broiled beef steak Phenelzine is an MAOI antidepressant. This medication interacts w/ a variety of foods to produce a hypertensive crisis. Beef steak and other meats that are fresh do not interact w/ phenelzine and are safe to consume.

A nurse is reinforcing teaching with a client who has tuberculosis and a prescription for rifampin. The nurse should identify which of the following findings as a harmless and expected adverse effect of rifampin? A. red-orange discoloration of urine B. increased ecchymosis C. yellow appearance of sclerae D. lack of energy

A. red-orange discoloration of urine The nurse should instruct the client that rifampin commonly causes a red orange discoloration of bodily fluids. This adverse effect is considered harmless and doesn't need to be reported to the provider.

A nurse is collecting data from a client who has AIDS and is taking zidovudine. Which of the following findings is the priority for the nurse to report to the provider? A. nausea & vomiting B. Decreased hemoglobin C. decreased appetite D. Anxiety

B. Decreased hemoglobin Zidovudine can cause severe anemia and neutropenia from bone marrow suppression, resulting in hematologic toxicity

A nurse is caring for a client who has diabetes insipidus. Which of the following laboratory values should the nurse identify as reflecting a contraindication to receiving vasopressin to treat this disorder? A. sodium 152 mEq/L B. Potassium 6.0 mEq/L C. Creatinine clearance 50 mL/min D. Aspartate aminotransferase (AST) 52 units/L

C. Creatinine clearance 50 mL/min Creatinine clearance should be above 87 mL/min for female clients and above 107 mL/min for male clients. A creatinine clearance of 50 mL/min indicated renal impairment and is a contraindication to receiving vasopressin. Renal impairment increases the likelihood of the life threatening adverse effect of water intoxication.

A nurse is preparing to administer medication to a client. Which of the following abbreviations indicates the greatest frequency of medication administration? A. BIG B. TID C. QID D. q8h

C. QID every 4 hours

A nurse is caring for a client who is experiencing cycloplegia following the administration of atropine eye drops during an eye exam. Which of the following findings should the nurse expect as a result of the cycloplegia? A. Inability to tolerate bright lights B. pinpoint pupils C. blurred vision D. inability to perform upward gaze

C. blurred vision Assessment findings of cycloplegia include blurred vision b/c focusing for near vision is impaired b/c paralysis of the ciliary muscle prevents near-vision focus. Accomodation is also temporarily impaired

A nurse working the in emergency department is admitting a client who has a gastric ulcer & gastrointestinal (GI) bleeding. Which of the following factors in the client's medical history should the nurse report to the provider? A. Arthritis tx with ibuprofen q8h PRN B. previous tobacco smoking with cessation 5 years ago C. negative H. pylori breath test 1 year prior D. prescribed bismuth subsalicylate as needed for GI upset

A. Arthritis tx with ibuprofen q8h PRN The nurse should identify that ibuprofen is an NSAID. NSAIDs can cause GI bleeding and are contraindicated for clients who have ulcer disease. NSAIDs inhibit prostaglandin secretion, which decreases blood flow in the GI tract and decreases bicarbonate & mucus secretions. This environment promotes the secretion of gastric acid and needs to be reported to the provider.

A nurse is caring for a client who has a new diagnosis of rheumatoid arthritis. The nurse should anticipate a prescription from the provider for which of the following medications for daily management of this condition? A. Celecoxib B. Prednisone C. Adalimumab D. Abatacept

A. Celecoxib The nurse should anticipate that the provider will prescribe celecoxib, which is an NSAID. This medication or another NSAID should be initiated for a client who has a new dx of rheumatoid arthritis.

A nurse is reviewing the medical record of a client who has diabetes insipidus and has been taking oral desmopressin. Which of the following findings indicates the client is having a therapeutic response to the medication? A. decreased urine output B. weight gain C. serum glucose level w/in the expected reference range D. increase heart rate

A. decreased urine output DI causes a large output of dilute urine to be excreted due to a deficiency of antidiuretic hormone or its release by the hypothalamus. Urine output can range from 4-30L/day, and manifestations of dehydration are present (hypotension, tachycardia, dry mucous membranes, polydipsia, low urine specific gravity)

A nurse is caring for a client who has a prescription for an oral contraceptive to prevent pregnancy. The nurse should identify that which of the following actions is the purpose of this medication? A. inhibition of ovulation B. thinning of the endometrial lining C. inhibition of the luteinizing hormone D. thinning of the cervical mucus

A. inhibition of ovulation to prevent pregnency

A nurse is caring for a client who has multiple sclerosis & is receiving interferon bet-1a. The nurse should identify that which of the following client statements indicates a potential adverse effects of the medication? A. my body aches all over B. i have abdominal cramping C. my hair seems to be thinning D. it hurts when i urinate

A. my body aches all over The AE of interferon beta-1a can include flu-like symt. (gen. body & muscle aches)

A nurse is reviewing the medical record of a client. The medication administration record shows the client is taking clopidogrel. Which of the following events should the nurse expect to be reported in the client's medical history? A. recent myocardial infarction B. history of hemorrhagic stroke C. current outbreak of psoriasis D. history of hypertension

A. recent myocardial infarction the nurse should expect the client's medical record to indicate a hx of an atherosclerotic event such as MI, ischemic stroke, or peripheral vascular disease (PVD). Clopidogrel (Plavix) is an antiplatelet medication that inhibits aggregation of platelets to prevent such thrombotic events.

A nurse is caring for a client who is taking acarbose to treat type 2 diabetes mellitus. For which of the following adverse effects of this medication should the nurse monitor? A. Insomnia B. Diarrhea C. Joint pain D. Polycythemia

B. Diarrhea The. most common adverse effects of acarbose, an alpha glucosidase inhibitor, are gastrointestinal. They include diarrhea, abdominal distention, cramping, and flatulence

A nurse is reinforcing teaching about how to take donepezil with a client who has recently diagnosed with early Alzheimer's disease. Which of the following instructions should the nurse include? A. You should chew the medication thoroughly prior to swallowing B. You should take this medication late in the evening C. You should take this medication with food D. If you miss taking a dose for a day, take 2 doses the following day

B. You should take this medication late in the evening take this medication before going to bed

A nurse is reinforcing teaching about preventing systemic toxicity with a client who is using topical lidocaine. Which of the following pieces of information should the nurse include about the application of topical lidocaine? A. apply dressing after covering the affected areas with topical lidocaine B. apply topical lidocaine to affected areas that are intact C. apply topical lidocaine in a thick layer to the affect areas D. apply topical lidocaine frequently to large affected areas

B. apply topical lidocaine to affected areas that are intact The nurse should tell the client to apply topical lidocaine to skin that is intact rather than blistered, broken, or irritated to prevent a large amount of medication from being absorbed and to decrease the risk of systemic toxicity

A nurse is caring for a client who is receiving lidocaine for localized pain. THe nurse should recognize that which of the following actions will help prevent systemic toxicity of this medication? A. Applying a heating pad following administration to increase blood flow to the area B. applying the medication to intact skin C. Applying a large amount of the medication at once to avoid frequent reapplication D. applying the medication to large areas for maximum spread

B. applying the medication to intact skin

A nurse is caring for a client who has bronchitis and a prescription for a mucolytic agent. Which of the following findings should the nurse identify as an adverse effect of this type of medication? A. fluid overload B. bronchospasm C. electrolyte imbalance D. tachycardia

B. bronchospasm mucolytic agents can irritate the airways, resulting in bronchospasms which producing a cough and thinning mucus secretions.

A nurse is reinforcing teaching with the partner of a client who has moderate Alzheimer's disease about a new prescription for a rivastigmine transdermal patch. Which of the following information should the nurse provide? A. the patch should be changed q72hr (q3days) B. the patch provided higher drug levels than oral medications C. the old patch should be removed before a new patch is applied D. allowing the patch to get wet will deactivate it

B. the patch provided higher drug levels than oral medications remove to prevent toxicity

A nurse is collecting data on a client who is postop and receiving a dose of morphine 15 min ago. The client now has a respiratory rate of 8/min and is unresponsive. Which of the following medications should the nurse prepare to administer? A. Naproxen B. Nifedipine C. Naloxone D. Nebivolol

C. Naloxone the nurse should prepare to administer naloxone, an opioid antagonist.. Naloxone will reverse the over-sedation and respiratory depression the client is experiencing. However, with too large a dose the analgesia of the morphine will also be reversed, causing the client to experience postop pain again.

A nurse is caring for a client who was recently diagnosed with Addison's disease and placed on long term mineralocorticoid therapy with fludrocortisone. Which of the following pieces of information should the nurse provide when explaining the purpose of this therapy? A. mineralocorticoids help the body metabolize carbs, fats, and proteins B. mineralocorticoids support secondary sexual development C. mineralocorticoids maintain electrolyte and fluid balance D. mineralocorticoids reduce the risk of cardiac dysrhythmias

C. mineralocorticoids maintain electrolyte and fluid balance mineralocorticoids, specifically aldosterone, are necessary for the regulation of fluid & electrolyte balance, particularly of sodium, potassium, and water. Addison's disease results in a deficiency of cortisol and aldosterone production and requires supplementation with glucocorticoids and mineralocorticoids. Fludrocortisone is the only mineralocorticoid available.

A nurse is teaching a client who is experiencing age related vaginal atrophy and has a prescription for estradiol cream. Which of the following statements should the nurse include in the teaching? A. this medication should be used daily B. this medication should be applied externally C. this medication has fewer systemic effects than oral estrogen D. this medication can increase your risk of bone loss

C. this medication has fewer systemic effects than oral estrogen The nurse should instruct the client that intravaginal estradiol cream has few systemic side effects b/c its applied topically. However, oral estrogen can cause serious systemic effects.

A nurse is reinforcing teaching with a client who has severe chronic gout and a new prescription for pegloticase. The client has been taking allopurinol for 1 month. Which of the following instructions should the nurse include about pegloticase? A. You will take this medication along with allopurinol. B. You will take this medication by mouth C. There are very few adverse effects of this medication. D. If you experience a flare-up, you can take an NSAID while receiving this medication.

D. If you experience a flare-up, you can take an NSAID while receiving this medication. The nurse should instruct this client who has chronic gout that during the first few months of tx, an increase in gout manifestations is expected. To reduce the intensity of these manifestations, clients are instructed to take an NAID such as Naproxen.

A nurse is planning care for a client who took an overdose of acetaminophen. Which of the following laboratory values should the nurse plan to monitor for adverse effects of the overdose? A. hematocrit B. high-density lipoproteins (HDL) C. pancreatic enzymes D. liver enzymes

D. Liver enzymes The nurse should monitor the liver enzymes alanine transaminase (ALT) & aspartate transaminase (AST) for indication of liver injury. Acetaminophen overdose can cause severe liver injury as high doses of the medication produce a toxic metabolite. It takes 48-72 hours (2-3days) after ingestion of liver failure to appear.

A nurse is caring for a client who is taking diphenhydramine for allergies. The client reports, "I feel sleepy during the day." Which of the following responses should the nurse make? A. You will find that all antihistamines cause sedation. B. You should avoid taking the antihistamine with food. C. The effects of sedation will occur with each dose. D. You should try antihistamines with non-sedative effects.

D. You should try antihistamines with non-sedative effects. The nurse should tell the client to try 2nd generation antihistamines that have no sedative effects, as these are large molecules w/ low lipid solubility that can't cross the blood brain barrier. Diphenhydramine is a 1st generation antihistamine and has a common AE of sedation.

A nurse is collecting data from a client who has tuberculosis and a prescription for ethambutol. The nurse should inform the client that he is likely to develop which of the following alterations as an adverse effect of this medication? A. mottling of the extremities B. orange-red urine and bodily secretions C. yellowing of the sclera D. loss of red/green color discrimination

D. loss of red/green color discrimination Ethambutol is an antitubercular med that impairs ribonucleic acid synthesis. A common adverse reaction is the loss of red/green visual discoloration due to optic neuritis. The nurse should notify the provider of this finding and expect a prescription to discontinue the meds.

A nurse is caring for a client who is taking a prescription for glucocorticoid adrenal replacement medication for the long term treatment of Addison's disease. Which of the following findings indicates that the client is experiencing an adverse effect of the medication? A. weight loss B. hypotension C. lethargy D. osteoporosis

D. osteoporosis long term use of steroid medications can inhibit bone growth and result in AE of osteoporosis