Pharm ch3
A 42-year-old male patient is brought to the emergency department by ambulance. The patient is in distress. The nurse suspects an anaphylactic reaction resulting from taking oral penicillin. What assessment findings are important in making this diagnosis? A) Blood pressure (BP): 186/100, difficulty breathing B) Hematocrit (Hct): 32%, decreased urine output C) Temperature: 102º, swollen joints D) Profuse sweating, Blood Pressure: 92/58
A
A 68-year-old patient who must take antihistamines for severe allergies is planning a vacation to Mexico. The nurse will encourage the patient to do what? A) Avoid sightseeing during the hottest part of the day. B) Discontinue the antihistamines if he becomes extremely restless. C) Decrease the dosage of the drugs if he experiences excessive thirst. D) Continue taking the antihistamines even if he begins to hallucinate.
A
A nurse is providing teaching to a group of patients who are beginning drug therapy for acquired immunodeficiency syndrome (AIDS). What should be included in her instructions to the group? A) "Take your medications as directed. Poisoning occurs with overdosage causing damage to more than one body system." B) "Renal injury results from first-pass effect when the drug is excreted from the system." C) "A blood dyscrasia due to drug therapy can be serious. Call us if your skin looks yellowish or you experience itching." D) "Most drugs are metabolized in the liver and the first indication of damage is dark red papules, which should be reported immediately."
A
The nurse administers a medication to the patient that induces the secondary action of hypoglycemia. What organ will be most acutely impacted by inadequate circulating glucose? A) Brain B) Heart C) Lungs D) Skin
A
The nurse administers an anticholinergic medication to the patient. When assessing this patient, what finding will the nurse consider a secondary effect of the drug? A) Nasal congestion B) Tachycardia C) Hyperthermia D) Profuse sweating
A
The nurse is assessing a patient new to the clinic. The patient says she is allergic to penicillin. What would be the nurse's appropriate next action? A) Ascertain the exact nature of the patient's response to the drug. B) Document the patient is allergic to penicillin. C) Mark the patient's chart in red that she has a penicillin allergy. D) Continue to assess the patient for other allergies.
A
The pharmacology instructor explains to students that adverse effects can be extensions of what? A) Primary action of a drug B) Anaphylaxis C) Secondary action of a drug D) Anticholinergic responses to the drug
A
The post-anesthesia care unit nurse is serving a patient after a right knee arthroscopy. As the patient begins to wake up from anesthesia, the nurse assesses rigidity, involuntary movements, hyperthermia, and tachycardia. What would the nurse suspect is causing these effects? A) Neuroleptic malignant syndrome B) Parkinson-like syndrome C) Malignant tachycardia D) Anaphylactic shock
A
What cardiac effect would the nurse be prepared to see in the patient with an extremely high potassium level? A) Arrhythmia B) Tachycardia C) Sudden death D) Bradycardia
A
The nurse administers antipsychotic medications to the patient who has taken these same drugs for many years. What signs and symptoms would the nurse attribute to secondary actions of the drug? (Select all that apply.) A) Muscular tremors B) Drooling C) Changes in gait D) Yellow discoloration of skin and sclera E) Fine red rash on the trunk
A,B,D
A nurse is planning patient teaching about a newly prescribed drug. What is a priority teaching point included by the nurse to improve compliance and safety? A) List of pharmacies where the drug can be obtained B) Measures to alleviate any discomfort associated with adverse effects C) The cost of the brand name drug compared with the generic form D) Statistics related to Phase III testing for the prescribed drug
B
A patient is admitted to the intensive care unit with hyperkalemia. The nurse caring for the patient knows that the most severe adverse effect of hyperkalemia is what? A) Renal failure B) Cardiac emergency C) Liver failure D) Respiratory distress
B
A patient is taking chloroquine (Aralen) for rheumatoid arthritis. What problem reported by the patient would the nurse suspect may be an adverse reaction of the medication? A) "I have to urinate all the time." B) "Sometimes I have blurred vision." C) "I have tingling in my arms and legs." D) "Sometimes I feel like I am off balance."
B
A patient with seasonal allergies is taking an antihistamine to relieve itchy, watery eyes, and a runny nose. When planning teaching for this patient, the nurse would include what teaching point? A) Advise the patient to limit fluid intake to dry out mucous membranes. B) Advise the patient to avoid driving or operating machinery. C) Advise the patient to report strange dreams or nightmares. D) Advise the patient to decrease dietary fat.
B
A student nurse asks her study group how to define a drug allergy. What would be the peer group's best response? A) A second effect of the body to a specific drug B) The formation of antibodies to a drug protein causing an immune response when the person is next exposed to that drug. C) A serum sickness caused by a reaction to a drug D) Immediate systemic reaction to the drug when exposed to the drug the first time.
B
Before administering a macrolide antibiotic the nurse would question the order for what patient? A) An 82-year-old woman with hypertension B) A 12-year-old boy with hearing loss C) A 30-year-old pregnant patient D) A 51-year-old man after myocardial infarction
B
The nurse is acting as the triage nurse in the emergency department when a 16-year-old boy is brought in by his friends. The patient is in respiratory distress, he is vomiting, and blood is noted in the vomitus. He is somnolent and his electrocardiogram shows an arrhythmia. The boy's friends tell you he was taking a "bunch of little green pills" he got from the cupboard at his grandparent's house. The nurse suspects what? A) Overdose of sleeping pills B) Poisoning C) Anaphylactic shock D) Allergic reaction to Dyazide
B
The nurse is caring for a patient receiving an antineoplastic medication who reports fever, chills, sore throat, weakness, and back pain. What type of adverse effect does the nurse suspect this patient is experiencing? A) Dermatologic reaction B) Blood dyscrasia C) Electrolyte imbalance D) Superinfection
B
The pharmacology instructor is discussing the adrenergic drug ephedrine with the nursing students and lists an adverse reaction of this drug as what? A) Bronchoconstriction B) Hyperglycemia C) Cardiac arrhythmias D) Severe constipation
B
What classification of drug allergy would be described as an immune system reaction to injected proteins used to treat immune conditions? A) A cytotoxic reaction B) Serum sickness C) A delayed reaction D) An anaphylactic reaction
B
An 80-year-old patient presents at the clinic for a follow-up appointment. She is taking a macrolide antibiotic and is experiencing tinnitus. The nurse is talking with family members about home care for the patient. What should the nurse include in her instructions regarding home care? A) Keep the patient in a prone position when in bed. B) Eliminate salt from the patient's diet. C) Provide protective measures to prevent falling or injury. D) Monitor exposure to sunlight.
C
The Kardex record of a male patient who is prescribed antihistamines for treating an allergy reads as follows: Age: 32; Profession: Carpenter; Lifestyle & diet: Lives alone, average smoker, nonalcoholic, no food preferences, practices yoga; Medical history: Suffers from hay fever, recent urinary tract infection that has been treated successfully. What information from the Kardex is likely to have the greatest implication in educating the patient about antihistamine administration? A) The patient's age B) The patient's smoking habit C) The patient's profession D) The patient's medical history
C
The nurse administers a loop diuretic to the patient. In addition to sodium and water, what other electrolyte would the nurse expect to be excreted in significant amounts? A) Calcium B) Magnesium C) Potassium D) Zinc
C
The nurse is caring for a patient who experienced a severe headache. When the prescribed number of over-the-counter pain relievers did not work the patient said she took double the dosage an hour later. The nurse recognizes this patient is at greatest risk for what? A) An allergic reaction B) Anaphylactic reaction C) Poisoning D) Sedative effects
C
The patient with diabetes is also taking ephedrine to treat asthma that causes her blood sugar to increase. The patient asks the nurse, "Why does this medication make my blood sugar go up?" What is the nurse's best response? A) "The active ingredient in ephedrine is mixed with sugar." B) "Ephedrine is a placebo containing only sugar." C) "Stored glycogen is broken down by ephedrine, which is causing higher blood sugar levels." D) "Insulin is inactivated by ephedrine so it cannot work to control sugar levels."
C
The pharmacology instructor is talking to the nursing students about potassium-sparing diuretics and how they can lead to hyperkalemia, indicated by what assessment finding? A) Urine output of 1,500 mL/24 hours B) Blood pressure of 98/60 C) Potassium level of 5.9 mEq/L D) Calcium level of 11.4 mg/dL
C
Why does the nurse need to be alert for any indication of an allergic reaction in patients? A) To obtain early warning of noncompliance in drug therapy B) To increase the effectiveness of a specific medication C) To maintain the patient's safety during drug therapy D) To reduce the risk of adverse effects during drug therapy
C
A 77-year-old man is brought to the clinic by his daughter for a routine follow-up appointment. The daughter tells the nurse that her father is only taking half the prescribed dosage of several of his medications. What effect would the nurse explain could result from this behavior? A) Increased risk of primary actions B) Dermatologic reaction C) Superinfection D) Reduced therapeutic effect
D
A patient presents at the clinic complaining of vaginal itching and a clear discharge. The patient reports to the nurse that she has been taking an oral antibiotic for 10 days. The nurse is aware that the patient is experiencing what? A) An adverse reaction from the antibiotic B) A drug toxicity effect of the antibiotic C) An overdose of the drug that is damaging to more than one body system D) A superinfection caused by the antibiotic, which has destroyed normal flora
D
A patient with Parkinson's disease is taking an anticholinergic drug to decrease the tremors and drooling caused by the disease process. The patient complains that he is having trouble voiding. The nurse would explain that this is what? A) A hypersensitive action of the drug B) A primary action of the drug C) An allergic action of the drug D) A secondary action of the drug
D
Oral antidiabetic drugs can cause alterations in glucose metabolism. Patients who are taking these drugs would need to be observed for what? A) Increased urination B) Deep Kussmaul's respirations C) Thirst and hot or flushed skin D) Confusion and lack of coordination
D
The home health nurse is caring for an elderly patient with benign prostatic hypertrophy. An anticholinergic drug has been prescribed. What would be the nurse's priority teaching point for this patient? A) Urinary incontinence may develop. B) Bladder hypertonia may develop. C) An increased dosage may be required. D) Empty the bladder before taking the drug.
D
The nurse administers erythromycin, a drug that is known to irritate mucosa in the stomach lining. When the patient reports abdominal discomfort after taking the medication, the nurse would classify this discomfort as what type of adverse effect? A) Primary action B) Secondary action C) Hypersensitivity reaction D) Allergic reaction
D
The nurse is writing a plan of care for a patient who is exhibiting Parkinson-like syndrome. What would be an appropriate intervention if, on assessing the patient, the nurse finds the patient is having difficulty swallowing? A) Thicken all liquids. B) Keep the patient NPO (not taking anything orally). C) Give only soft or pureed foods. D) Provide small, frequent meals.
D
The nurse needs to consider teratogenic effects of medications when caring for what population of patients? A) Older adults B) Patients with a history of cancer C) Children D) Young adult women
D
