Pharm exam 12 13 14 19 41 44
In addition to facilitating sleep, what is another benefit of sedatives?
Decreased patient anxiety
A patient is complaining of moderate bladder pain and spasms secondary to a UTI. Which drug would assist in relieving symptoms?
Phenazopyridine hydrochloride (Pyridium)
Why are beta blockers used cautiously in patients with respiratory conditions?
They may produce severe bronchoconstriction.
Which patient assessment would indicate to the nurse that salicylate toxicity is occurring?
Tinnitus
Fluoxetine, erythromycin, clarithromycin, ketoconazole, itraconazole, miconazole, vinblastine, ritonavir, and nefazodone may inhibit the metabolism of which drugs? (Select all that apply.)
Tolterodine Darifenacin Solifenacin
A patient experiencing chronic pain as a result of metastatic cancer has a new order for fentanyl (Duragesic) transdermal patch. The initial patch is applied at 8 AM on Monday. At 8 PM on Monday, the patient reports a pain level of 8. The nurse's best response is to:
provide a PRN analgesic medication as ordered.
The nurse receives a conscious patient from the postoperative unit after administration of a neuromuscular blocker. Once the patient's vital signs are stable, the best position for the nurse to assist the patient into is _____ position.
semi-Fowler's
Which vitamin will reduce the therapeutic effects of levodopa?
vitamin B6
The nurse is teaching a patient with Parkinson's disease about levodopa. Which statement by the nurse is accurate regarding drug administration?
"Take this medication with food or antacids to reduce GI upset."
How long after the administration of a parenteral pain medication will the nurse complete the next pain assessment to evaluate the effectiveness of the medication?
30 minutes
How often is fosfomycin (Monurol) usually administered when used in the treatment of UTIs?
In a one-time dose
What may become discolored by phenazopyridine (Pyridium) in addition to the urine?
Sclera
What is the primary response to alpha-1-receptor stimulation?
Vasoconstriction
The nurse is teaching a patient about the anticholinergic agent prescribed for urinary retention. Which statement by the patient indicates a need for further teaching?
"I will limit my fluid intake."
The nurse is providing education to a patient recently placed on selegiline disintegrating tablets. Which statement by the patient indicates a need for further teaching?
"I will place the tablet on my tongue before breakfast."
The nurse is assessing a patient who is being evaluated in an outpatient clinic for complaints of back pain. The patient reports taking diphenhydramine for insomnia related to job stress. Which statement by the nurse is accurate regarding this medication?
"This medication should only be taken for 1 week."
Which laboratory values will the nurse review prior to beginning medication therapy for skeletal and muscle disorders?
C-reactive protein (CRP), human leukocyte antigen (HLA), and liver function tests
An older adult patient received a hypnotic agent at 9:00 PM. At 2:00 AM, the nurse discovers that the patient has removed her gown and is attempting to get out of bed without assistance. What type of medication effect is the patient exhibiting?
Paradoxical
What is the pharmacologic action of entacapone, a potent catechol O methyl transferase (COMT) inhibitor?
Reduces the destruction of dopamine in peripheral tissues.
Why are neuromuscular-blocking agents used? (Select all that apply.)
Reducing the use and adverse effects of general anesthetics Easing endotracheal intubation and prevent laryngospasm Decreasing muscular activity in electroshock therapy
The nurse is assessing an older patient with Parkinson's disease who was started on entacapone 1 week ago. The patient has a history of coronary artery disease and takes an antihypertensive and aspirin. Which information would support the need for a reduction in medication dosage by the healthcare provider?
Dizziness
Which common adverse effect(s) is/are associated with opiate agonists? (Select all that apply.)
Dizziness Orthostatic hypotension Respiratory depression Urinary urgency
What is the rationale for administering levodopa instead of dopamine for treatment of Parkinson's disease?
Dopamine does not cross the blood-brain barrier when administered orally
The nurse is providing information to a patient recently prescribed entacapone. Which statement is correct?
Dosage is adjusted according to the patient's response.
Which organism causes most UTIs?
E. coli
Which drug interaction may occur when an aminoglycoside or tetracycline is given in conjunction with neuromuscular-blocking agents?
Increased neuromuscular-blocking activity
The nurse is explaining the use of medications to a patient with insomnia. Which statement about sedatives is true?
Increased relaxation occurs with sedatives.
The nurse is caring for an older patient recently admitted to an assisted living center who is experiencing insomnia associated with the recent relocation. At bedtime, which nursing action will assist the patient to sleep?
Performing back massage
Which condition will neostigmine be used to treat?
Postoperative or postdelivery urinary retention
For what conditions are benzodiazepines prescribed?
Preoperative sedation
Barbiturates have which common adverse effect(s)? (Select all that apply.)
Residual daytime sedation Headache Blurred vision Impaired coordination
Which symptoms will be most important for the nurse to assess for early signs of respiratory distress in the patient who has been given a neuromuscular-blocking agent?
Restlessness, anxiety, and lethargy
The nurse finds that a patient is extremely agitated, yells frequently, and is attempting to get out of bed without assistance. What is the nurse's initial action?
Spend uninterrupted time listening to the patient.
Which sleep pattern stage diminishes as an effect of aging?
Stage IV
Dopamine agonists have been linked with which adverse effects in patients with Parkinson's disease?
Sudden sleep events
Which condition(s) may be managed by salicylates? (Select all that apply.)
Swollen joints Fever Muscle aches Myocardial infarction
The nurse is administering Somnote to a patient. When providing medication education to the patient, the nurse will include that Somnote should be:
Taken with a full glass of water
Which statement is true about neuropathic pain?
The pain is a result of nerve injury.
What is the advantage of taking a nonsteroidal antiinflammatory drug (NSAID) that is a COX-2 inhibitor?
There are fewer GI adverse effects.
Why are benzodiazepines often preferred over barbiturates? (Select all that apply.)
They have selective action at specific receptor sites. There is a wide range of safety between therapeutic and lethal levels. REM sleep is decreased to a lesser extent. Accidental overdoses are well tolerated.
Which statement(s) is/are true about efferent nerves? (Select all that apply.)
They leave the CNS to carry impulses to other body parts. They are part of the peripheral nervous system. They transmit signals that control contractions of smooth and skeletal muscles. They transmit signals that control contractions of some glandular secretions.
Which cholinergic symptoms of Parkinson's disease are reduced with anticholinergic drugs?
Tremors and drooling
When a patient taking a monoamine oxidase B inhibitor receives his dietary tray, the nurse knows to remove the:
cheese
A long-term care resident is taking an anticholinergic agent. The nurse observes the resident to be disoriented and hallucinating. The priority nursing action is to:
provide for resident's safety.
Which instruction(s) given by the nurse will assist a patient to cope with the common adverse effects of anticholinergic medications? (Select all that apply.)
"Increase fluids daily." "Suck on candy or ice chips."
After undergoing prostate surgery, a patient is discharged on the medication phenazopyridine hydrochloride (Pyridium) to assist with urinary catheter discomfort. What information will the nurse include in the discharge teaching?
Urine will appear reddish orange.
What is the best way for the nurse to evaluate the effectiveness of the patient's opiate agonist?
Verbal report of 2 on a 1 to 10 scale
When reviewing a patient's history and physical information, the nurse notes that the patient has physician's orders for chloral hydrate and warfarin. During assessment of this patient, the nurse observes areas of petechiae and ecchymosis on the upper and lower extremities. The most appropriate lab work for the nurse to assess next is:
prothrombin time.
Which two phases make up normal sleep?
Rapid eye movement (REM) and non REM
The patient's family asks why neuromuscular-blocking agents are used before electroconvulsive therapy. Which explanation by the nurse is most accurate?
"They reduce the risk of injury during therapy."
The nurse is preparing to begin administration of apomorphine to a patient. Before administering, the nurse will perform a baseline assessment of the patient's: (Select all that apply.)
mobility. orientation. alertness. vital signs.
A 14-year-old male is taking tolterodine (Detrol). What is the action of this drug?
Decreases the urge to void.
Which adverse effects associated with levodopa therapy would support the nursing diagnosis risk for injury?
Orthostatic hypotension
In the intensive care unit, the nurse is taking care of a patient who is on a ventilator and is receiving succinylcholine (Anectine). Which is a priority nursing diagnosis for this patient?
Pain
Which condition would alert the nurse of the need to use beta-adrenergic blockers cautiously?
Emphysema
What information is most accurate regarding the nurse's understanding of pain management?
Encourage patients to report pain before the pain becomes too severe.
The nurse is completing an assessment on a nonverbal adult patient. Which type of pain scale assessment tool is the most accurate to use?
FLACC
The nurse is reviewing the urinalysis results of an older adult patient admitted with elevated temperature and incontinence. Which urinalysis properties are indicative of an infection? (Select all that apply.)
Foul odor pH of 8.2
What is the action of urinary antimicrobial agents?
Have an antiseptic effect on the urine and the urinary tract.
Patients with which conditions must be carefully assessed to determine whether they would tolerate treatment with a neuromuscular-blocking agent? (Select all that apply.)
Hepatic disease Pulmonary disease Renal disease Neurologic disorders
Which sign or symptom displayed by a patient would be indicative of opiate withdrawal?
Diarrhea
An 86-year-old patient who was admitted with GI bleeding as a result of salicylate therapy is being discharged. As the nurse reviews the discharge medication list, the patient states that she doesn't understand why Tylenol doesn't work as well as the aspirin she had been taking. What would be the nurse's best response?
"Tylenol does not help with inflammatory discomfort."
Which common adverse effects occur with neuromuscular-blocking agents?
Flushing
An older adult patient is to receive atenolol, a beta-adrenergic blocking agent. Prior to administration of the drug, the nurse assesses an apical pulse rate of 58 and notes ankle edema. Which action will the nurse take first?
Withhold the medication.
The nurse is caring for a patient taking Pyridium for the diagnosis of UTI. What should the nurse report to the healthcare provider? (Select all that apply.)
Yellow sclera Increased pain and burning
A patient taking rasagiline is assessed by the nurse to have a lasting significant increase in blood pressure. When reviewing the patient's current list of medications, the nurse decides to hold the next dose of:
ciprofloxacin
Which nerve endings liberate norepinephrine?
Adrenergic
What is the reason for a paraplegic patient to receive baclofen (Lioresal)?
It interrupts reflexes at the level of the spinal cord.
Which medication is contraindicated when a patient is taking warfarin (Coumadin)?
Aspirin
An employee at a factory has not been to work because of low back muscle spasms. His wife contacts the occupational health nurse to report that her spouse is on a centrally acting skeletal muscle relaxant and is having problems with sleepiness. Based on the medication action, what will the nurse tell her? (Select all that apply.)
"Your husband should avoid activities requiring alertness, such as driving or operating power equipment." "I need additional and specific information regarding the amount of your husband's sedation." "Sedation is an adverse effect of these medications and tends to resolve with continued therapy."
A patient taking a neuromuscular-blocking agent is assessed to have a heart rate of 120 and blood pressure of 80/50. The nurse will anticipate the physician writing an order for:
ABGs.
Which intervention(s) will help stimulate urination when a patient is experiencing postoperative urinary retention? (Select all that apply.)
Administration of bethanechol chloride (Urecholine) Pouring warm water over the perineum
The autonomic nervous system can be subdivided into which types of adrenergic receptors?
Alpha and beta
Which category of medications is used for peripheral vascular diseases characterized by excessive vasoconstriction, such as Raynaud's disease?
Alpha-adrenergic blocking agents
What can occur as a result of rapid withdrawal from long-term use of barbiturate therapy? (Select all that apply.)
Anxiety Delirium Weakness Grand mal seizures
What point(s) should be included when teaching a patient about the use of apomorphine for treatment of Parkinson's disease? (Select all that apply.)
Apomorphine does not have any opioid activity. A multidose injector pen is commonly used to administer apomorphine. You may experience nausea and vomiting, which can be treated with trimethobenzamide (Tigan). You may experience sleep attacks or episodes of daytime sleepiness.
Prior to the administration of metoprolol, a beta-adrenergic blocking agent, which is most important for the nurse to assess?
Blood pressure
Which body function(s) is/are controlled by the autonomic nervous system? (Select all that apply.)
Blood pressure GI secretion Body temperature Urination
Which disorder(s) would indicate the use of anticholinergic agents? (Select all that apply.)
Bradycardia Parkinson's disease Preparation for surgery
The nurse is assisting with postpartum care for a mother who has given birth to her fourth child. She reports a moderate amount of urinary incontinence since the birth of the third child and is concerned that this problem will worsen. Which instruction(s) may facilitate management of incontinence? (Select all that apply.)
Instruction of proper wiping techniques to prevent bacterial infection Education on bladder training and Kegel exercises Information on personal hygiene measures to prevent perianal breakdown Information of incontinence products and appliances Importance of establishing a regular toileting schedule
The nurse is assessing a patient prior to discharge from same day surgery following an incisional breast biopsy. When assessing the patient's central nervous system (CNS) function following sedative-hypnotic therapy, what will the nurse include? (Select all that apply.)
Level of alertness Orientation Ability to perform motor functions
A patient receiving diazepam (Valium) is complaining of nausea and vomiting and is becoming jaundiced. Which type of blood work will be performed?
Liver function tests
Which medication would the nurse administer to a patient who is rating the pain at 8 on a 0 to 10 scale?
Morphine (Roxanol)
Parkinson's disease has which characteristic symptom(s)? (Select all that apply.)
Muscle tremors Posture alterations Slow body movement
Which disease is associated with insufficient sleep?
Myocardial infarction
Which adverse effect(s) is/are common when a patient is receiving a cholinergic agent? (Select all that apply.)
Nausea Dizziness Bradycardia
A patient who has undergone a lengthy surgical procedure under general anesthesia is unable to breathe on his own following the procedure. Which drug will the nurse expect to be administered as an antidote to the neuromuscular-blocking agent?
Neostigmine methylsulfate (Prostigmin)
Which action will the nurse take when a patient receiving morphine sulfate via percutaneous coronary angioplasty (PCA) has a shallow, irregular respiratory rate of 6 breaths/min?
Notify the healthcare provider and prepare to administer naloxone (Narcan).
When performing a baseline neurologic assessment prior to the administration of an NSAID medication, the nurse will assess which patient characteristic(s)? (Select all that apply.)
Orientation to date, time, and place Mental alertness
Neurotransmitter(s) include: (Select all that apply.)
gamma aminobutyric acid. acetylcholine. serotonin. histamine. epinephrine.
A patient with chronic obstructive pulmonary disease (COPD) reports having insomnia and a racing heart after starting terbutaline therapy. Which explanation by the nurse is most accurate?
"The symptoms will tend to resolve with continued therapy."
A patient with Parkinson's disease asks the nurse why anticholinergics are used in the treatment. Which response by the nurse is most accurate?
"These drugs inhibit the action of acetylcholine."
A patient has been prescribed lorazepam (Ativan), a benzodiazepine used to treat insomnia. Which action will the nurse take?
Assess the patient's blood pressure in sitting and lying positions.
The nurse is examining a patient in the emergency department whose chief complaint is a dislocated shoulder. Which assessment data are needed to evaluate the patient? (Select all that apply.)
Details related to the mechanism of injury Degree of impairment Pain level Inspection of the affected part for swelling, capillary refill, bruising, redness, localized tenderness, deformities, and paresthesia
Which additional nursing intervention(s) would be effective with pain management in the pediatric population? (Select all that apply.)
Provide diversional activities such as coloring, puzzles, and games Allow uninterrupted sleep and rest. Perform hygiene measures. Encourage parental participation with caregiving to diminish the child's anxiety.
The nurse is assessing a patient's pain. When the patient describes his pain as cramping and burning, which component of the pain history is being addressed?
Quality
A patient is taking meperidine (Demerol) as needed for moderate to severe pain following an open appendectomy. The nurse assesses the following: current pain level 2, temperature 99°F, BP 130/76, respirations 10, lung sounds clear, abdomen soft and tender, bowel sounds present. Based on this assessment information, the priority nursing diagnosis is:
altered breathing pattern.
Which medication will be prescribed for a patient complaining of muscle spasms resulting from a back injury?
Cyclobenzaprine (Flexeril)
Which assessment is most important for the nurse to obtain when a patient is being treated with a neuromuscular-blocking agent?
Respiratory assessment for patent airway
When assessing a patient for signs and symptoms of early respiratory depression immediately after leaving the postoperative area, the nurse will be alert for signs of what? (Select all that apply.)
Restlessness Anxiety Lethargy
A patient is being discharged on an adrenergic bronchodilator. Which common adverse effect(s) will the nurse include in discharge teaching? (Select all that apply.)
Palpitations Dizziness Orthostatic hypotension Tremors
The nurse is caring for a patient taking a cholinergic agent. When auscultating lung sounds, the nurse notes inspiratory and expiratory wheezing bilaterally. The best action for the nurse to take would be to:
withhold the next dose and notify the physician.
A patient with a history of type 1 diabetes after myocardial infarction has been placed on a beta-adrenergic blocking agent. Which statement by the patient indicates a need for further teaching?
"This medication lowers my blood pressure by helping me get rid of fluid."
In which case would the nurse be correct in withholding an opiate agonist?
Respiratory rate of 10 breaths/min
What term is used to define an awareness of pain?
Perception
When teaching a patient who is starting therapy with NSAIDs, the nurse must be sure to mention drug interactions with which drug(s)? (Select all that apply.)
Warfarin (Coumadin) Lithium (Eskalith) Diuretics
The nurse is preparing to administer a single-dose packet of fosfomycin to a patient diagnosed with a UTI. When preparing this medication, the nurse will:
mix contents with 120 mL of water and administer by mouth.
A patient hospitalized in an acute care setting reports to the nurse that since starting on an adrenergic medication, he has been feeling "dizzy and weak." The most appropriate action for the nurse is to:
monitor the blood pressure in both the supine and standing positions.
A patient taking antipsychotic medication for schizophrenia is admitted with a temperature of 106°F. The admitting diagnosis is neuroleptic malignant syndrome resulting from antipsychotic medication. Which drug is indicated in treatment of this condition?
Dantrolene (Dantrium)
A patient has been taking an antimicrobial agent prescribed to treat a UTI for 2 days. She contacts the healthcare provider's office to report persistence of symptoms. In evaluating the medication effectiveness, which assessment(s) would be important? (Select all that apply.)
Complete emptying of the bladder Amount of pain with urination as well as frequency Amount of daily fluid intake and output GI symptom complaints Bleeding with urination
When obtaining urine for analysis on a patient in the labor and birth unit, the nurse assesses the urine to appear frothy. The nurse interprets this as a sign of possible:
preeclampsia (toxemia).
A 42-year-old woman is admitted with complaints of dysuria, frequency, and lower back pain. The urinalysis report is positive for red blood cells, and the blood work shows an elevated white blood cell count. Which medication will the nurse anticipate that the healthcare provider will order?
Ciprofloxacin (Cipro)
Before the initiation of anticholinergic medications, it is important for the nurse to screen patients for which condition?
Closed-angle glaucoma