Reading Quizzes Pharm II Final Part 2

Match the following mechanism of action with the appropriate laxative: [This question is worth 4 points--one point will be given for each correct match] A. swells with water to form a gel to soften and increase fecal mass. B. stimulates peristalsis and increases water in the intestine C. lowers surface tension to promote penetration of water into the stool D. salts that draws water into the intestine to soften stool and stimulate peristalsis Matching Items 1. Psyllium [Metamucil] 2. Docusate sodium [Colace] 3. Biscodyl [Dulcolax] select 4. Milk of Magnesia (MOM)

1: A 2: C 3: B 4: D

Your patient complains of having recent episodes of insomnia and would like a prescription for a hypnotic drug such as zolpidem (Ambien). Which statement made by the patient would concern the nurse? A. "I work full-time and in the past, I've experienced some day-time drowsiness when taking zolpidem (Ambien)." B. "I have stopped drinking wine while taking this medication." C. "I'm on birth control and plan on notifying my provider if I plan on getting pregnant." D. "I was recently diagnosed with sleep apnea and just started using a CPAP machine at night."

A

A client with the diagnosis of schizophrenia is given one of the antipsychotic drugs. The nurse understands that antipsychotic drugs can cause extrapyramidal side effects. Which effect is cause for the greatest concern? A. Tardive dyskinesia B. Akathisia C. Acute dystonic reaction D. Parkinsonian syndrom

A

A patient in the emergency department is given intravenous diazepam [Valium] for seizures. When the seizures stop, the nurse notes that the patient is lethargic and confused and has a respiratory rate of 10 breaths per minute. The nurse will expect to administer which of the following? A. Respiratory support B. Toxicology testing C. Gastric lavage D. Flumazenil [Romazicon]

A

A patient who has gastroesophageal reflux disease (GERD) is taking magnesium hydroxide (milk of magnesia). Which outcome should a nurse expect if the medication is achieving the desired therapeutic effect? A. Neutralized gastric acid B. Increased barrier to pepsin C. Reduced duodenal pH D. Reduced stomach motility

A

A patient with Parkinson's disease is prescribed pramipexole [Mirapex] along with his levodopa/carbidopa [Sinemet]. Which symptom is most likely a manifestation of an adverse effect of these drugs when given together? A. Dyskinesia B. Diarrhea C. Wheezing D. Headache

A

A primary healthcare provider prescribes 0.25 mg of diazepam [Valium] by mouth three times a day for a client with anxiety and physical symptoms related to work pressures. For what most common side effect of this drug will the nurse monitor the client? A. Drowsiness B. Bradycardia C. Agranulocytosis D. Tardive dyskinesia

A

All patients with gastric or duodenal ulcers and confirmed infection with H. pylori should be treated with antibiotics in combination with an anti secretory agent. A. True B. False

A

An antidepressant is prescribed for a depressed older adult client. After 1 week, the client's son expresses concern that there does not seem to be much improvement. How should the nurse respond? A. "Antidepressants require several weeks of therapy before it becomes effective." B. "Antidepressant therapy will be more effective as the physical condition improves." C. "Additional medications may be required before behavioral changes will be observed." D. "Additional time is needed for the medication to become effective because of the prolonged depression."

A

Misoprostol is contraindicated for use during pregnancy as it is classified in FDA Pregnancy Risk Category X. A. True B. False

A

The student nurse is explaining the adverse effects of niacin including flushing of the face, neck, and ears. What advise can the student nurse give to reduce this adverse effect? A. Take 325 mg of aspirin 30 minutes prior to taking niacin B. Take the tablet with food C. Take 975mg of Tylenol prior to taking niacin D. Crush the tablet and dissolve in fruit juice

A

Which group of laxatives is the most widely "used and abused" laxatives? A. Stimulant laxatives B. Surfactant laxatives C. Bulk forming laxatives D. Osmotic laxatives

A

Neuroleptic Malignant Syndrome (NMS) is a rare, but potentially fatal condition associated with first generation antipsychotics. Fatalities from NMS have dramatically decreased from 30% to 4% due to early identification and treatment. Which of the following are signs/symptoms of NMS? [Select all that apply] A. High fever. B. "Lead pipe" rigidity. C. Fluctuating blood pressure. D. Opisthotonus.

A, B, C

Which should the nurse assess to determine whether a patient has metabolic effects from their second generation antipsychotic medication? [Select all that apply]. A. Weight B. Lipid profile C. Fasting Blood Glucose D. Complete Blood count

A, B, C

Laxatives are contraindicated for individuals with which following conditions: [SELECT ALL THAT APPLY] A. Nausea. B. Abdominal cramps. C. Acute surgical abdomen. D. Fecal Impaction. E. Abdominal pain.

A, B, C, D, E

The following is a select all that apply question. Of the following drugs listed, which act to lower low density lipoprotein levels? A. Niacin B. Ezetimibe C. Bile-acid sequestrants D. Calcium channel blockers E. HMG-CoA reductase inhibitors (statins)

A, B, C, E

Which of the following are considered defensive factors that serve to protect the stomach and duodenum from self-digestion? [SELECT ALL THAT APPLY] A. Mucus B. Prostaglandins C. Blood flow D. H. pylori E. Bicarbonate F. NSAIDs

A, B, C, E

Which side effects are common in second-generation antipsychotic drugs? [Select all that apply]. A. Agranulocytosis B. Anticholinergic effects C. Extrapyramidal symptoms D. Postural hypotension E. weight gain

A, B, D, E

First generation antipsychotics have the ability to block which of the following receptor types? [Select all that apply] A. Dopamine. B. Serotonin. C. Acetylcholine. D. Histamine. E. Norepinephrine.

A, C, D, E

Which of the following contributes to chronic endothelial injury? [SELECT ALL THAT APPLY] A. Toxins B. Beta blocker usage C. Immune reactions D. Hypertension E. Hyperhomocystinemia F. Hyperlipidemia G. Smoking

A, C, D, E, F, G

A client who is feeling lonely and who is extremely depressed has been prescribed a tricyclic antidepressant. The client asks the nurse, "how will this medication help me feel better?" What is the nurse's best response: A. "This drug will help you forget why you're lonely and depressed." B. "The medication could increase your appetite and elevate your mood." C. "You'll start to feel much better after taking this medication for 2 or 3 days." D. "You will feel less depressed when you take this with a monoamine oxidase inhibitor."

B

Combining levodopa with a nonelective MAO inhibitor can result in severe hypotension. A. True B. False

B

Ki is a 43 year-old baker at Harris Teeter. She has been followed by her primary care provider for depression for the past 4 months and has been doing well on a selective serotonin reuptake inhibitor called fluoxetine. However, one issue arises during her visit that provides a clue that she's experiencing a common side effect of fluoxetine. Which side effect do you suspect: A. She has a resting tremor. B. She has gained about 7 pounds. C. She describes that she is uninterested in sex with her husband. D. She states that she has a pounding headache after she drinks red wine.

B

When used in combination with certain foods and drugs, monoamine oxidase inhibitors (MAOIs) can cause serious side effects. Which condition could occur in clients treated with MAOIs for depression when taken in combination with certain drugs or when eating certain foods high in tyramine? A. A significant increase in liver enzymes B. A serious increase in blood pressure C. A significant increase in cholesterol levels D. A serious drop in blood pressure

B

Which of the following is a major adverse effect of HMG-CoA reductase inhibitors (statins)? A. Wheezing and shortness of breath B. Myopathy and rhabdomyolysis C. Chest pain D. Renal failure

B

A client has become increasingly depressed and is prescribed an antidepressant. After a few months of therapy, the client returns to the clinic and appears relaxed and smiles at the nurse. The most significant conclusion that the nurse can draw from this behavior is that the client: A. Wants to please the staff. B. May be in denial of any problems. C. Is responding to the antidepressant therapy. D. Has resolved any conflicts.

C

A female patient who takes a benzodiazepine, lorazepam [Ativan], for anxiety tells the nurse that she plans to become pregnant. What is the best instruction for the nurse to give the patient? A. "Eat a well-balanced diet that includes milk." B. "Discuss tapering the drug with the provider before conception." C. "Stop taking the drug and form another plan to manage anxiety." D. "Visit an obstetrician to determine the correct dose of lorazepam during pregnancy."

C

A patient has been taking high doses of clorazepate, a benzodiazepine, for several months for an anxiety disorder. The nurse assessing the patient observes that the patient is agitated, euphoric, and anxious. What will the nurse do? A. Withhold the next dose until a drug level can be drawn. B. Request an order for a longer-acting benzodiazepine. C. Suspect a possible paradoxical reaction to the clorazepate. D. Double-check the chart to make sure the last dose was given.

C

A patient is taking zolpidem [Ambien] for insomnia and tells the nurse that a recent telephone bill lists several calls to friends that the patient does not remember making. What is the nurse's next action? A. Contact the prescriber to request an order for a benzodiazepine with a shorter duration. B. Ask the patient about any alcohol consumption in conjunction with the benzodiazepine. C. Tell the patient that this is an example of anterograde amnesia that should be evaluated. D. Reassure the patient that this is most likely caused by a paradoxical reaction to the benzodiazepine.

C

A young adult patient has been taking an antidepressant medication for several weeks and reports having increased thoughts of suicide and a concrete plan for committing suicide. The nurse questions the client and learns that the patient has attempted suicide more than once in the past. The nurse contacts the provider to discuss: A. changing the medication to another drug class. B. requiring more frequent clinic visits for this patient. C. hospitalizing the patient for closer monitoring. D. discontinuing the medication immediately.

C

An 80-year-old patient with a history of renal insufficiency recently was started on cimetidine. Which assessment finding indicates that the patient may be experiencing an adverse effect of the medication? A. 3+ pitting edema to bilateral lower extremities B. Painful urination C. New onset altered mental status D. Tachypnea

C

What is the goal of pharmacologic therapy in the treatment of Parkinson's disease? A. To reduce the amount of dopamine available in the substantia nigra B. To increase the amount of acetylcholine at the presynaptic neurons C. To balance cholinergic and dopaminergic activity in the brain D. To block dopamine receptors in presynaptic and postsynaptic neurons

C

What is the preferred initial method to lowering LDL cholesterol? A. A low dose beta blocker B. A combonation of a beta blocker and a statin C. Diet modification and increasing exercise D. A high dose statin

C

A client is prescribed a monoamine oxidase inhibitor (MAOI). Which of the following should the nurse teach the client: A. It is necessary to avoid the sun. B. Drowsiness is an expected side effect of this medication. C. The therapeutic and toxic levels of the drug are very close. D. Many prescribed and over-the-counter drugs cannot be taken with this medication.

D

A client is prescribed doxepin, a tricyclic antidepressant, for severe depression. Which most dangerous side effect of tricyclic antidepressants will the nurse monitor the client for? A. Breast hypertrophy B. Dry mouth C. Constipation D. Dysrhythmias

D

A client is prescribed imipramine (Tofranil), a tricyclic antidepressant, for depression. The nurse assesses the client for adverse effects. Which adverse effect requires further assessment and possible medical intervention? A. Salivation. B. Weight gain. C. Diaphoresis. D. Urinary hesitancy.

D

An agitated, extremely anxious patient is brought to the emergency department. The prescriber orders a benzodiazepine. The nurse understands that benzodiazepines are used in this clinical situation based on which principle? A. Physical dependence is not a risk when taking benzodiazepines. B. Benzodiazepines have a very short half-life. C. Benzodiazepines are known to cure generalized anxiety. D. Benzodiazepines have a rapid onset of action.

D

Statin use is recommended for lowering LDL cholesterol in pregnancy. True or False

false

The lipid abnormality that contributes most to cardiovascular disease is high levels of high density lipoproteins. True or False

false

Atherosclerosis is plaque that can develop in any artery and thereby compromise circulation to any tissue. True or False

true

Therapy with cholesterol-lowering drugs must continue lifelong. If these drugs are withdrawn, cholesterol levels will return to pretreatment values. True or False

true