Pharm Exam 2 Practice Questions
A nurse is caring for a patient receiving intrathecal baclofen [Lioresal]. The patient is unresponsive. After asking a coworker to contact the provider, the nurse anticipates performing which intervention? A. Preparing to support respirations B. Administering an antidote to baclofen C. Administering diazepam to prevent seizures D. Obtaining an electrocardiogram
A. Preparing to support respirations
A nurse is admitting a patient to the hospital. The patient reports taking oral baclofen [Lioresal] but stopped taking the drug the day before admission. The nurse would be correct to anticipate which adverse effects? A. Seizures and hallucinations B. Weakness and dizziness C. Fatigue and drowsiness D. Respiratory depression and coma
A. Seizures and hallucinations
A patient is to begin taking phenytoin [Dilantin] for seizures. The patient tells the nurse that she is taking oral contraceptives. What will the nurse tell the patient? A. She should consider a different form of birth control while taking phenytoin. B. She may need to increase her dose of phenytoin while taking oral contraceptives. C. She should remain on oral contraceptives, because phenytoin causes birth defects. D. She should stop taking oral contraceptives, because they reduce the effectiveness of phenytoin.
A. She should consider a different form of birth control while taking phenytoin.
A patient is admitted with severe hypertensive crisis. The nurse will anticipate administering which medication? A. Sodium nitroprusside [Nitropress] IV B. Captopril PO C. Minoxidil 20 mg PO D. Hydralazine [Apresoline] 25 mg PO
A. Sodium nitroprusside [Nitropress] IV
A patient has 2+ pitting edema of the lower extremities bilaterally. Auscultation of the lungs reveals crackles bilaterally, and the serum potassium level is 6 mEq/L (elevated). Which diuretic agent ordered by the prescriber should the nurse question? A. Spironolactone [Aldactone] B. Furosemide [Lasix] C. Hydrochlorothiazide [HydroDIURIL] D. Bumetanide [Bumex]
A. Spironolactone [Aldactone]
A female patient taking an ACE inhibitor learns that she is pregnant. What will the nurse tell this patient? A. The patient should stop taking the medication and contact her provider immediately. B. The patient's prescriber probably will change her medication to an ARB. C. The fetus must be monitored closely while the patient is taking this drug. D. The fetus most likely will have serious congenital defects.
A. The patient should stop taking the medication and contact her provider immediately.
A patient shows loss of consciousness, jaw clenching, contraction and relaxation of muscle groups, and periods of cyanosis. The nurse correctly identifies this as which type of seizure? A. Tonic-clonic B. Absence C. Myoclonic D. Atonic
A. Tonic-clonic
A psychiatric nurse is teaching a patient about an antidepressant medication. The nurse tells the patient that therapeutic effects may not occur for several weeks. The nurse understands that this is likely the result of: A. changes in the brain as a result of prolonged drug exposure. B. direct actions of the drug on specific synaptic functions in the brain. C. slowed drug absorption across the blood-brain barrier. D. tolerance to exposure to the drug over time.
A. changes in the brain as a result of prolonged drug exposure.
A patient asks a nurse to explain what drug tolerance means. The nurse responds by telling the patient that when tolerance occurs, it means the patient: A. may need increased amounts of the drug over time. B. has developed a psychologic dependence on the drug. C. will cause an abstinence syndrome if the drug is discontinued abruptly. D. will have increased sensitivity to drug side effects
A. may need increased amounts of the drug over time.
A group of nursing students asks a nurse to explain the blood-brain barrier. The nurse would be correct to say that the blood-brain barrier: A. prevents some potentially toxic substances from crossing into the central nervous system. B. causes infants to be less sensitive to CNS drugs and thus require larger doses. C. allows only ionized or protein-bound drugs to cross into the central nervous system. D. prevents lipid-soluble drugs from entering the central nervous system
A. prevents some potentially toxic substances from crossing into the central nervous system.
A patient who was in a motor vehicle accident sustained a severe head injury and is brought into the emergency department. The provider orders intravenous mannitol [Osmitrol]. The nurse knows that this is given to: A. reduce intracranial pressure. B. reduce reduce renal perfusion. C. reduce peripheral edema. D. restore extracellular fluid.
A. reduce intracranial pressure.
A 42-year-old female client was injured at work and had a right surgical knee repair 2 weeks ago. The client was diagnosed and admitted to an acute care unit with a right calf deep vein thrombosis pulmonary embolus. After several days of continuous IV heparin infusion, the primary health care provider prescribed warfarin while the client continued with the heparin infusion. What health teaching related to drug therapy should the nurse provide for the client in preparation for the client's discharge to home on warfarin? Select All That Apply. "Be sure to get all laboratory testing done as prescribed to monitor your clotting values." "Inform any other health care professional, including your dentist, that you are taking warfarin." "Do not take other drugs that can cause bleeding, including NSAIDs like ibuprofen." "Use an electric razor to shave your legs rather than any other type." "Let your primary health care provider know if you plan to get pregnant before you try conceive." "Stop taking your warfarin if bleeding occurs until you contact your primary health provider." "Be sure to eat more foods high in vitamin K to prevent another blood clot." "Report any unusual bleeding to your pri
"Be sure to get all laboratory testing done as prescribed to monitor your clotting values." "Inform any other health care professional, including your dentist, that you are taking warfarin." "Do not take other drugs that can cause bleeding, including NSAIDs like ibuprofen." "Use an electric razor to shave your legs rather than any other type." "Let your primary health care provider know if you plan to get pregnant before you try conceive." "Stop taking your warfarin if bleeding occurs until you contact your primary health provider." "Report any unusual bleeding to your primary health care provider immediately." "Use a soft toothbrush and do not be too aggressive with brushing."
A 65-year-old male client has had a history of essential hypertension since he was 54 years of age. He has been on a variety of antihypertensive medications but does not have consistent blood pressure control, especially when he is stressed or visits his provider. His new primary health care provider prescribed losartan 100 mg orally once daily at night because his serum creatinine is slightly elevated and his diastolic blood pressure is ranging between 86 and 90 mm Hg. Which health teaching would the nurse provide for the client at this time? Select All That Apply. "This drug can cause wheezing or tightness in your chest, especially if you have asthma." "Buy a home blood pressure device and take your blood pressure at least daily at different times of the day." "Follow up with all appointments with your primary health care provider to monitor your blood pressure." "Don't take this drug with any other antihypertensive drug or diuretic." "Call 911 immediately if you experience swelling or tightness in your throat, mouth, or lips." "Be sure to change positions slowly, especially from sitting or lying to standing, to prevent dizziness or light-headedness:" "Check your pulse twice a day bec
"Buy a home blood pressure device and take your blood pressure at least daily at different times of the day." "Follow up with all appointments with your primary health care provider to monitor your blood pressure." "Call 911 immediately if you experience swelling or tightness in your throat, mouth, or lips." "Be sure to change positions slowly, especially from sitting or lying to standing, to prevent dizziness or light-headedness:" "This drug will help protect your kidneys because it is often used for hypertension caused by kidney disease:'"
A 71-year-old male client was diagnose with an ST-elevation myocardial infarction (STEMI) in the emergency department. The only drug he was taking before his MI was tamsulosin for recently diagnosed benign prostatic hyperplasia (BPH). During transport to the ED, the client's chest pain did not respond to three doses of sublingual nitroglycerin. After the client was stable, he was admitted to the coronary care unit with the following medication orders: Oxygen at 6 L/min Nitroglycerin 5 mcg/min IV infusion Unfractionated heparin IV bolus of 5000 units followed by a continuous hepain infusion of 1300 units/hr for 24 hours Propranolol 20 mg orally every 6 hours Tamsulosin 4 orally once a day The client's wife asks why he has to take so many drugs because he "hates to take medicine." What health teaching will the nurse include to help the client's wife understand the purpose for these medications? Select all that apply. "The IV heparin infusion will help prevent further clotting in your husband's blood vessels." "Your husband will likely continue to be on propranolol after discharge from the hospital." "The nitroglycerin drip will constrict the small vessels attached to his heart so that it
"The IV heparin infusion will help prevent further clotting in your husband's blood vessels." "Your husband will likely continue to be on propranolol after discharge from the hospital." "Your husband will likely continue to be on an oral anticlotting drug after discharge from the hospital." "Propranolol will help to decrease chest pain and prevent further heart damage."
A 72 year-old male client was diagnosed with beginning heart failure that has been controlled by hydrochlorothiazide (HCTZ) 25 mg orally each day for the past 11 months. Two days ago he was admitted to the telemetry unit for sinus bradycardia and increased peripheral edema. This morning his weight indicated that he gained 4 lb (1.82 kg) since admission. The client also reports new-onset shortness of breath. Use an X to indicate whether the nursing actions below are Anticipated (appropriate or necessary), Contraindicated (could be harmful), or Non-Essential (make no difference or are not necessary) for the client's care at this time. Use a zero ( 0 ) to indicate an incorrect nursing action. 1. Draw a comprehensive metabolic panel (CMP). 2. Carefully monitor the client's intake and output. 3. Initiate oxygen therapy. 4. Continue to carefully monitor daily weights. 5. Prepare to administer IV push furosemide stat. 6. Keep the client in a supine flat position. 7. Monitor the client's vital signs frequently.
1. non essential 2. anticipated 3. anticipated 4. anticipated 5. anticipated 6. contraindicated 7. anticipated
A nurse is teaching a group of nursing students how the CNS adapts to psychotherapeutic medications. Which statement by a nursing student indicates a need for further teaching? A. "Adaptation results in an increased sensitivity to side effects over time." B. "Adaptation can lead to tolerance of these drugs with prolonged use." C. "Adaptation helps explain how physical dependence occurs." D. "Adaptation often must occur before therapeutic effects develop."
A. "Adaptation results in an increased sensitivity to side effects over time."
A nurse counsels a patient who is to begin taking phenytoin [Dilantin] for epilepsy. Which statement by the patient indicates understanding of the teaching? A. "I should brush and floss my teeth regularly." B. "Once therapeutic blood levels are reached, they are easy to maintain." C. "I can consume alcohol in moderation while taking this drug." D. "Rashes are a common side effect but are not serious."
A. "I should brush and floss my teeth regularly."
A nurse is teaching the parent of a child with spastic quadriplegia about intrathecal baclofen [Lioresal]. Which statement by the parent indicates a need for further teaching? A. "If my child has a seizure, I should stop giving the medication immediately." B. "I can expect my child to be more drowsy when receiving this medication." C. "I should not notice any change in my child's muscle strength." D. "I will contact the provider if my child is constipated or cannot urinate."
A. "If my child has a seizure, I should stop giving the medication immediately."
Lovastatin [Mevacor] is prescribed for a patient for the first time. The nurse should provide the patient with which instruction? A. "Take lovastatin with your evening meal." B. "You may take lovastatin without regard to meals." C. "Take this medicine on an empty stomach." D. "Take this medicine before breakfast."
A. "Take lovastatin with your evening meal."
A patient has localized muscle spasms after an injury. The prescriber has ordered tizanidine [Zanaflex] to alleviate the spasms. When obtaining the patient's health history, the nurse should be concerned about which possible reason for considering another drug? A. A history of hepatitis B. Concomitant use of aspirin C. A history of malignant hyperthermia D. Occasional use of alcohol
A. A history of hepatitis
A patient with cerebral palsy has severe muscle spasticity and muscle weakness. The patient is unable to take anything by mouth. The nurse is correct to anticipate that which medication will be ordered for home therapy? A. Baclofen [Lioresal] B. Dantrolene [Dantrium] C. Diazepam [Valium] D. Metaxalone [Skelaxin]
A. Baclofen [Lioresal]
Which drugs are used to treat spasticity? (Select all that apply.) A. Baclofen [Lioresal] B. Dantrolene [Dantrium] C. Diazepam [Valium] D. Metaxalone [Skelaxin] E. Tizanidine [Flexeril]
A. Baclofen [Lioresal] B. Dantrolene [Dantrium] C. Diazepam [Valium]
A nurse is caring for a patient who has been taking an antiepileptic drug for several weeks. The nurse asks the patient if the therapy is effective. The patient reports little change in seizure frequency. What will the nurse do? A. Contact the provider to discuss an order for serum drug levels. B. Ask the patient to complete a seizure frequency chart for the past few weeks. C. Reinforce the need to take the medications as prescribed D. Request an order to increase the dose of the antiepileptic drug.
A. Contact the provider to discuss an order for serum drug levels.
A nurse is assessing a patient who becomes motionless and seems to stare at the wall and then experiences about 60 seconds of lip smacking and hand wringing. What should the nurse do? A. Contact the provider to report symptoms of a complex partial seizure B. Ask the patient about a history of absence seizures C. Notify the provider that the patient has had a grand mal seizure. D. Request an order for intravenous diazepam [Valium] to treat status epilepticus.
A. Contact the provider to report symptoms of a complex partial seizure
A patient has been taking fluoxetine [Prozac] for 2 years and reports feeling cured of depression. The nurse learns that the patient is sleeping well, participates in usual activities, and feels upbeat and energetic most of the time. The patient's weight has returned to normal. The patient reports last having symptoms of depression at least 9 months ago. What will the nurse tell this patient? A. Discuss gradual withdrawal of the medication with the provider B. Stop the drug while remaining alert for the return of symptoms. C. Indefinite drug therapy is necessary to maintain remission. D. Take a drug holiday to see whether symptoms recur. Ristad, John .
A. Discuss gradual withdrawal of the medication with the provider
A patient is brought to the emergency department with shortness of breath, a respiratory rate of 30 breaths per minute, intercostal retractions, and frothy, pink sputum. The nurse caring for this patient will expect to administer which drug? A. Furosemide [Lasix] B. Hydrochlorothiazide [HydroDIURIL] C. Mannitol [Osmitrol] D. Spironolactone [Aldactone]
A. Furosemide [Lasix]
A nurse is performing an admission assessment on a patient. The patient reports taking alprazolam [Xanax] for "nerves." The nurse knows that this patient is most likely being treated for which condition? A. Generalized Anxiety Disorder B. Post Traumatic Stress Disorder (PTSD) C. Obsessive Compulsive Disorder (OCD) D. Panic Disorder
A. Generalized Anxiety Disorder
A provider has ordered captopril [Capoten] for a patient who has hypertension. The patient reports a history of swelling of the tongue and lips after taking enalapril [Vasotec] in the past. Which action by the nurse is correct? A. Hold the dose and notify the provider. B. Request an order to administer fosinopril instead of captopril. C. Reassure the patient that this is not a serious side effect. D. Administer the captopril and monitor for adverse effects.
A. Hold the dose and notify the provider.
Which of the following is true of the drug Budesonide? A. It reduces chronic inflammation in the airways B. It is administered orally C. It causes bronchodilation D. It is a monoclonal antibody
A. It reduces chronic inflammation in the airways
The nurse in the medical department is preparing to administer insulin lispro [Humalog] to a client diagnosed with Type 1 diabetes. Which intervention should the nurse implement? A. Make sure the client easts the food on the meal tray that is at the bedside. B. Administer the dose according to the regular insulin sliding scale. C. Assess the client for signs of hyperosmolar, hyperglycemic, non-ketotic syndrome. D. Ensure the client is wearing a medical alert bracelet.
A. Make sure the client easts the food on the meal tray that is at the bedside.
What cells play a central role in the pathophysiology of Asthma? A. Mast Cells B. Capillary endothelial cells C. None of these D. Macrophages
A. Mast Cells
A patient with hypertension will begin taking an alpha1 blocker. What will the nurse teach this patient? A. Move slowly from sitting to standing when taking this drug. B. A persistent cough is a known side effect of this drug. C. Report shortness of breath while taking this drug. D. Eat foods rich in potassium while taking this drug.
A. Move slowly from sitting to standing when taking this drug.
A 16 year-old female client has had intrinsic asthma since she was 8 years old. Currently she is receiving drug therapy required for Step 5 chronic asthma. The nurse reviews her medications with the client and family: Fluticasone/vilanterol dry powder inhaler (DPI) 200 mcg/25 mcg per inhalation: 1 inhalation once daily Formoterol DPI 12 mcg per inhalation: 1 inhalation every 12 hours Albuterol metered-dose inhaler (MDI) 90 mcg/inhalation: 2 inhalations every 4 to 6 hours PRN Atomoxetine 80 mg orally once a day Choose the most likely options for the information missing from the statement below by selecting from the list of options provided. If the client feels that she is having problems breathing, she should use [A] for quick relief. Fluticasone/vilanterol DPI Nebulized levalbuterol Theophylline Terbutaline Nebulized ipratropium Systemic corticosteroids Albuterol MDI Nebulized formoterol
Albuterol MDI
A 72 year-old male client was diagnosed with beginning heart failure that has been controlled by hydrochlorothiazide (HCTZ) 25 mg orally each day for the past 11 months. Two days ago he was admitted to the telemetry unit for sinus bradycardia and increased peripheral edema. This morning his weight indicated that he gained 4 lb (1.82 kg) since admission and the primary health care provider prescribed furosemide 20 mg IV push. Complete the following statements by choosing the most likely option for the missing information from the drop down menu. For safe medication administration, the nurse will administer the IV push furosemide over 1 to 2 minutes. Within an hour of administration, the client would be expected to [ Select ] ["Have a bounding pulse", "Have an increased blood pressure", "Void a large amount", "Feel weak due to loss of blood", "Experience dizziness"] . If needed, IV push furosemide may be repeated in [ Select ] ["2 to 3 hours", "20 to 30 minutes", "1 to 2 hours", "3 to 4 hours", "15 to 20 minutes"] .
Answer 1:1 to 2 Answer 2:Void a large amount Answer 3:1 to 2 hours
A 42-year-old female client was injured at work and had a right surgical knee repair 2 weeks ago. The client was diagnosed and admitted to an acute care unit with a right calf deep vein thrombosis pulmonary embolus. The primary health care provider prescribed an unfractionated heparin IV bolus of 5000 units followed by a continuous infusion of 1300 units/hour. Choose the most likely option for the information missing from the statements below by selecting from the lists of options provided. During IV heparin administration, the nurse should monitor the client for possible adverse drug effects, especially bleeding or hemorrhage. To monitor for this complication, the nurse should assess for common signs of blood loss, including [ Select ] ["Decreased", "Increased", "Fluctuating", "Irregular", "Orthostatic", "Hyperreflexic"] blood pressure and [ Select ] ["Fluctuating", "Increased", "Decreased", "Orthostatic", "Hyperreflexic", "Irregular"] pulse.
Answer 1:Decreased Answer 2:Increased
A 75-year-old female client was recently started on low-dose digoxin and hydrochlorothiazide (HCTZ) for heart failure. The nurse is assessing the client during the visit to her primary health care provider. Complete the following statements by choosing the most likely option for the missing information from the drop down menu. The nurse performs a focused cardiovascular assessment because the client is at risk for [ Select ] ["Dehydration", "Hyperglycemia", "Hypermagnesemia", "Blurred vision", "Hyponatremia", "Peripheral neuropathy", "Dysrhythmias"] and Hypokalemia because she takes both digoxin and HCTZ. In addition, the client is at risk for drug toxicity, which can be prevented by monitoring the client's [ Select ] ["Glucose", "Triglyceride", "Hemoglobin", "Digoxin", "Sodium", "Platelet", "Creatinine"] and [ Select ] ["White blood cells", "Potassium", "BUN", "Calcium", "HCTZ", "A1C", "Magnesium"] levels.
Answer 1:Dysrhythmias Answer 2:Hypokalemia Answer 3:Glucose Answer 4:Potassium
A 65-year-old female client with a long history of acute coronary syndrome (ACS) had two cardiac stents placed via percutaneous coronary intervention. After this procedure, she was started on aspirin 325 mg orally once daily and clopidogrel 75 mg orally once daily. The nurse is preparing to provide education about each of these drugs. For each health teaching statement below, select yes from the drop down menu to indicate whether it is Essential (necessary or appropriate drug information) or Unrelated (not relevant or appropriate drug information) for the client. 1. "Report any unexpected bleeding to your primary health care provider." 2. "Continue taking your newly prescribed medications until your prescriber tells you not to do so." 3. "Drink a glass of water after each dose of your new drugs." 4. "Eat foods high in vitamin K and calcium to help prevent clotting." 5. "Avoid taking other medications that can cause bleeding, such as NSAIDs like ibuprofen." 6. "Follow up with the prescribed laboratory testing needed to monitor your clotting values."
Answer 1:Essential Answer 2:Essential Answer 3:Unrelated Answer 4:Unrelated Answer 5:Essential Answer 6:Unrelated
The nurse cares for a 22-yea-old client admitted to the Behavioral Health Unit with a diagnosis of schizophrenia. Day 1 1200 - Clint was brought to hospital when they were found to be walking downtown responding only to internal stimuli. Client previously nonadherent to medication regimen. Client appears unkempt and dehydrated from wandering away from home for 3 days. Client weight 96k (212 lb) and vitals are within defined parameters at this time. Client is confused on admission. Client is alert to self only. Client started on olanzapine PO with intent to transition to depot injection when stable. Day 2 0800 Client very drowsy today. Minimal responses to staff and other clients T 97.6F (36.4C), P 78, RR 18, BP 130/80, pulse oximeter 98% on RA 1000 Client becoming increasingly confused. Requested healthcare provider assess client. 1150 Client grossly diaphoretic, delirious and noted to have significant muscle rigidity . T 104F(40C), P 144, RR 26, BP 172/98, pulse oximeter 96% on RA What are the most significant assessments? Fill in each blank from the list below. Assessments Blood pressure Delirium Diaphoresis Heart rate Muscle rigidity Pulse oximeter Respiratory rate Temperature
Answer 1:Heart rate Answer 2:Blood pressure Answer 3:Temperature Answer 4:Diaphoresis
A 65-year-old male client has had a history of essential hypertension since he was 54 years of age. He has been on a variety of antihypertensive medications but does not have consistent blood pressure control, especially when he is stressed or visits his provider. Three months ago, his new primary health care provider prescribed losartan 100 mg orally once daily at night because his serum creatinine was slightly elevated and his diastolic blood pressure range between 86 and 90 mm Hg. A review of his blood pressure readings for the last month during his follow-up appointment showed the client's blood pressure usually stays within normal range until late afternoon, around 4pm (1600). The primary care provider added amlodipine 5 mg orally once daily to his drug regimen. Complete the following statements by choosing the most likely option for the missing information from the drop down menu. In view of the client's blood pressure pattern and the peak action of the amlodipine, the nurse would recommend that the client take his amlodipine [ Select ] ["In early morning", "Every other day", "During midafternoon", "At night with the losartan", "At around midnight"] . He should also avoid drinking
Answer 1:In early morning Answer 2:Grapefruit juice
A 20-year old female client was diagnosed with epilepsy at 13 years of age, which has been effectively controlled by valproic acid and lamotrigine. Today she is admitted to the emergency department with a diagnosis of generalized convulsive status epilepticus. Select from the drop down menu whether the nursing action is Indicated (appropriate or necessary), Contraindicated (could be harmful), or Non-essential (makes no difference or are not necessary) for client's care at this time. 1. Maintain the client's airway and ventilation 2. Place the client in a flat supine position 3. Establish an IV line immediately and administer a benzodiazepine such as lorazepam or diazepam 4. Document type and duration of each seizure 5. Monitor vital signs, especially temperature and heart rate, and cardiac rhythm 6. Draw labs to assess serum electrolyte values 7. Monitor the client's level of consciousness frequently Indicated
Answer 1:Indicated Answer 2:Contraindicated Answer 3:Indicated Answer 4:Indicated Answer 5:Indicated Answer 6:Non-essential Answer 7:Indicated
A 72 year-old male cclinet was recently diagnosed with beginning heart failure and has taken hydrochlorothiazide (HCTZ) 25 mg orally each day for the past 4 months. He also has a history of erectile dysfunction, for which he has been taking sildenafil 50 mg as needed. today the client is scheduled for his annual physical examination. For each assessment finding, Select from the drop down menu whether his treatment plan has been Effective (helped to meet expected outcomes), Ineffective (did not help to meet expected outcomes), or Unrelated (not related to the expected outcomes). 1. Sodium potassium = 3.2 mEq/L (3.2 mmol/L) 2. Serum sodium = 136 mEq/L (136 mmol/L) 3. Increased sexual desire and erection 4. No chest pain or dyspnea 5. Blood pressure = 118/66 mm HG 6. Frequent tearing eyes and sneezing when outdoors 7. 1+ to 2+ edema in both ankles
Answer 1:Ineffective Answer 2:Effective Answer 3:Effective Answer 4:Effective Answer 5:Effective Answer 6:Unrelated Answer 7:Ineffective
A 56-year-old female client with a 5-year history of diabetes mellitus type 2 visits her primary health care provider with report of an "itchy" skin rash that she has never had before. On inspection, the nurse notes that she has multiple raised reddened lesions of varying sizes located primarily on her legs and arms. The client reports that her diet has not changed and that she feels embarrassed about her skin problem. The nurse documents her current medications: Glipizide 5 mg orally once daily with breakfast for diabetes mellitus type 2 Furosemide 20 mg orally once every other day for hypertension Lovastatin 40 mg orally once daily for high cholesterol Duloxetine 60 mg orally once daily for clinical depression Trimethoprim/sulfamethoxazole DS 1 tablet every 12 hours for acute urinary tract infection Choose the most likely options for the information missing from the statements below by selecting from the dropdowns. The nurse should instruct the client that she should not continue taking Trimethoprim/sulfamethoxazole OS because the drug likely caused the [ Select ] ["Increased cholesterol", "Sulfonylurea", "Selective serotonin reuptake inhibitor", "Depression", "Skin reaction to sulfa"]
Answer 1:Trimethoprim/sulfamethoxazole OS Answer 2:Skin reaction to sulfa Answer 3:Glipizide Answer 4:Sulfonylurea
A patient with a history of elevated triglycerides and LDL cholesterol begins taking nicotinic acid [Niacin]. The patient reports uncomfortable flushing of the face, neck, and ears when taking the drug. What will the nurse advise the patient? A. "Ask your provider about assessing your serum uric acid levels which may be elevated." B. "You should take 325 mg of aspirin a half hour before each dose of Niacin to prevent this effect." C. "You should stop taking the Niacin immediately since this is a serious adverse effect." D. "You should stop taking the Niacin immediately since this is a serious adverse effect."
B. "You should take 325 mg of aspirin a half hour before each dose of Niacin to prevent this effect."
Which of the following anti-platelet drugs act by blocking the P2Y12 receptor? A. Abciximab B. Clopidogrel C. Dipyridamole D. Aspirin
B. Clopidogrel
A nurse preparing to administer morning medications notes that a patient with a history of hypertension has been prescribed spironolactone [Aldactone]. The nurse assesses the patient and notes dyspnea, bilateral crackles, and pitting edema in both feet. Which intervention is appropriate? A. Administer the medications as ordered. B. Contact provider to discuss an order for furosemide [Lasix]. C. Ask the patient about the use of salt substitutes. D. Contact the provider to request an order for serum electrolytes.
B. Contact provider to discuss an order for furosemide [Lasix].
A patient who has developed opioid tolerance will experience which effect? A. Increased respiratory depression B. Decreased analgesic effect C. Increased euphoria D. Decreased constipation
B. Decreased analgesic effect
A nurse administers an ACE inhibitor to a patient who is taking the drug for the first time. What will the nurse do? A. Request an order for a diuretic to counter the side effects of the ACE inhibitor. B. Instruct the patient not to get up without assistance. C. Make sure the patient takes a potassium supplement. D. Report the presence of a dry cough to the prescriber.
B. Instruct the patient not to get up without assistance.
Which of the following drugs are used in the treatment of asthma and has a during of 4-6 hours? A. formaterol B. Levalbuterol C. salmeterol D. vilanterol
B. Levalbuterol
A patient who has had abdominal surgery has been receiving morphine sulfate via a patient-controlled analgesia (PCA) pump. The nurse assesses the patient and notes that the patient's pupils are dilated and that the patient is drowsy and lethargic. The patient's heart rate is 84 beats per minute, the respiratory rate is 10 breaths per minute, and the blood pressure is 90/50 mm Hg. What will the nurse do? A. Encourage the patient to turn over and cough and take deep breaths. B. Prepare to administer naloxone and possibly ventilatory support. C. Note the effectiveness of the analgesia in the patient's chart. D. Discuss possible opiate dependence with the patient's provider.
B. Prepare to administer naloxone and possibly ventilatory support.
A patient on heparin is experiencing uncontrolled bleeding. Which of the following do you expect to be administered? A. Atropine B. Protamine Sulphate C. Vitamin K D. Epinephrine
B. Protamine Sulphate
The nurse is preparing to administer 30 units of NPH to client. He finds that the vial of insulin looks cloudy and uneven in appearance. Which of the following is the appropriate action? A. Give the client 10 units of regular insulin B. Shake the vial of NPH thoroughly then administer the dose C. Hold the dose and alert the prescriber D. Discard the vial of NPH and open a new one
B. Shake the vial of NPH thoroughly then administer the dose
A nurse is discussing how beta blockers work to decrease blood pressure with a nursing student. Which statement by the student indicates a need for further teaching? A. "Beta blockers decrease the release of renin." B. "Beta blockers decrease heart rate and contractility." C. "Beta blockers block the actions of angiotensin II." D. "Beta blockers decrease peripheral vascular resistance."
C. "Beta blockers block the actions of angiotensin II."
A patient with chronic congestive heart failure has repeated hospitalizations in spite of ongoing treatment with hydrochlorothiazide [HydroDIURIL] and digoxin. The prescriber has ordered spironolactone [Aldactone] to be added to this patient's drug regimen, and the nurse provides education about this medication. Which statement by the patient indicates understanding of the teaching? A. "I should use salt substitutes to prevent toxic side effects." B. "I should watch closely for dehydration." C. "I need to stop taking potassium supplements." D. "I can expect improvement within a few hours after taking this drug."
C. "I need to stop taking potassium supplements."
Which of the following drugs are thought to exert their actions by enhancing GABA receptor activation in the limbic system? A. Pentobarbital B. Lorazepam C. All of these drugs D. Temazepam
C. All of these drugs
A patient who has obsessive-compulsive disorder (OCD) has been undergoing behavioral therapy but continues to exhibit symptoms that interfere with daily life. Which intervention will the nurse expect the provider to order for this patient? A. Buspirone B. Deep Brain Stimulation C. Flouxetine D. Alprazolam
C. Flouxetine
Which of the following insulins can be given once daily to provide glucose control for 24 hours? A. Insulin aspart B. Regular Insulin C. Insulin glargine D. Insulin lispro
C. Insulin glargine
Which of the following anti-diabetic drugs is used to treat Polycyctic Ovarian Disease (PCOS)? A. Miglitol B. Rapaglinide C. Metformin D. Glyburide
C. Metformin
Which of the following insulins is available in both 100units/ml and 500units/ml concentrations? A. Insulin lispro B. NPH Insulin C. Regular insulin D. Insulin glargine
C. Regular insulin
A 42-year-old female client was injured at work and had a right surgical knee repair 2 weeks ago. Today she presents to the emergency department with reports of severe right calf pain and tingling, right leg swelling, and shortness of breath. After a complete work-up, the client is diagnosed and admitted to· an acute care unit with a right calf deep vein thrombosis and pulmonary embolus. The primary health care provider prescribes an unfractionated heparin IV bolus of 5000 units followed by a continuous heparin infusion of 1300 units/hr. Which laboratory test values would the nurse carefully monitor during the administration of this drug? Select all that apply. Complete blood cell count Activated partial thromboplastin time (aPTT) Prothrombin time (PT) Anti-factor Xa heparin assay Platelet count International normalized ratio (INR
Complete blood cell count Activated partial thromboplastin time (aPTT) Anti-factor Xa heparin assay Platelet count
A 16 year-old female client has had intrinsic asthma since she was 8 years old. Currently she is receiving drug therapy required for Step 5 chronic asthma. The nurse reviews her medications with the client and family: Fluticasone/vilanterol dry powder inhaler (DPI) 200 mcg/25 mcg per inhalation: 1 inhalation once daily Formoterol DPI 12 mcg per inhalation: 1 inhalation every 12 hours Albuterol metered-dose inhaler (MDI) 90 mcg/inhalation: 2 inhalations every 4 to 6 hours PRN Atomoxetine 80 mg orally once a day Choose the most likely options for the information missing from the statement below by selecting from the list of options provided. In addition to oxygen therapy, if she has a severe asthma attack, the drugs of choice most likely include B, C, and D. Nebulized ipratropium Nebulized formoterol Albuterol MDI Terbutaline Systemic corticosteroids Theophylline Fluticasone/vilanterol DPI Nebulized levalbuterol
Correct! Nebulized ipratropium Correct! Nebulized formoterol Correct! Systemic corticosteroids
A prescriber orders ramipril [Altace] for an obese patient with type 2 diabetes mellitus who has developed hypertension. The nurse provides teaching before dismissing the patient home. Which statement by the patient indicates understanding of the teaching? A. "I am less likely to develop diabetic nephropathy when taking this medication." B. "I should check my blood sugar more often, because hyperglycemia is a side effect of this drug." C. "This medication will probably prevent the development of diabetic retinopathy." D. "Taking this medication helps reduce my risk of stroke and heart attack."
D. "Taking this medication helps reduce my risk of stroke and heart attack."
Which of the following drugs acts in the small intestine to delay carbohydrate absorption? A. Sulfonylureas B. Rosiglitazone C. Rapaglinide D. Acarbose
D. Acarbose
Which statement about Regular insulin is correct? A. Is a cloudy solution B. It's rapid acting C. peaks at 6-12 hours D. Can be used IV
D. Can be used IV
Which plasma lipoprotein level is most concerning when considering the risk of coronary atherosclerosis? A. Elevated total cholesterol B. Elevated high density lipoprotein C. Elevated triglycerides D. Elevated low-density lipoprotein
D. Elevated low-density lipoprotein
A patient is taking enalapril [Vasotec]. The nurse understands that patients taking this type of drug for heart failure need to be monitored carefully for: A. Hypernatremia B. Hypokalemia C. Hypertension D. Hyperkalemia
D. Hyperkalemia
Which of the following is true of phenobarbital? A. Has a higher risk for physical dependence than alprazolam B. Is a good alternative to treat depression for those who cannot take sertraline C. It is more commonly used to treat anxiety than alprazolam D. It has a narrow therapeutic index
D. It has a narrow therapeutic index
A patient who is taking digoxin is admitted to the hospital for treatment of congestive heart failure. The prescriber has ordered furosemide [Lasix]. The nurse notes an irregular heart rate of 86 beats per minute, a respiratory rate of 22 breaths per minute, and a blood pressure of 130/82 mm Hg. The nurse auscultates crackles in both lungs. Which laboratory value causes the nurse the most concern? A. Sodium level of 140 mEq/L (normal) B. Oxygen saturation of 90% (low) C. Blood glucose level of 120 mg/dL (elevated) D. Potassium level of 3.5 mEq/L (low)
D. Potassium level of 3.5 mEq/L (low)
Which of the following is a thrombolytic drug that carries the greatest risk for hemorrhage? A. Enoxaparin B. Heparin C. Alteplase D. Streptokinase
D. Streptokinase
Which of the following is correct about the drug theophyline? A. Acts on Beta 2 receptors B. All of these C. Acts on M3 receptor D. Will cause bronchodilation
D. Will cause bronchodilation
A patient with heart failure who has been given digoxin [Lanoxin] daily for a week complains of nausea. Before giving the next dose, the nurse will: A. contact the provider to report digoxin toxicity. B. review the serum electrolyte values and withhold the dose if the potassium level is greater than 3.5 mEq/L. C. request an order for a decreased dose of digoxin. D. assess the heart rate (HR) and give the dose if the HR is greater than 60 beats per minute.
D. assess the heart rate (HR) and give the dose if the HR is greater than 60 beats per minute.
A patient who is taking simvastatin [Zocor] develops an infection and the provider orders azithromycin [Zithromax] to treat the infection. The nurse should be concerned if the patient complains of: A. headache B. nausea C. tiredness D. muscle pain
D. muscle pain
A woman in labor receives meperidine [Demerol] for pain. The nurse caring for the infant will observe the infant closely for: A. excessive crying and sneezing B. congenital anomalies C. tremors and hyperreflexia D. respiratory depression
D. respiratory depression
The insulin produced endogenously by the pancreas has what length duration of action? A. up to 24 hours B. 3-5 hours C. 1-3 hours D. up to 10 hours
D. up to 10 hours
A 42-year-old female client was injured at work and had a right surgical knee repair 2 weeks ago. The client was diagnosed and admitted to an acute care unit with a right calf deep vein thrombosis pulmonary embolus. The primary health care provider prescribed an unfractionated heparin IV bolus of 5000 units followed by a continuous infusion of 1300 units/hour. Choose the most likely options for the information missing from the statements below by selecting from the lists of options provided. During IV heparin administration, the nurse should monitor the client for possible adverse drug effects, especially bleeding or hemorrhage. To monitor for this complication, the nurse should assess for common signs of blood loss. In addition to changes in blood pressure and pulse, the nurse should monitor for other indications of bleeding including __________, __________, and __________. Select All That Apply. Angioedema Constipation Ecchymosis Red or black stools Hematuria Decreased level of consciousness
Ecchymosis Red or black stools Hematuria Decreased level of consciousness
A 48-year-old obese male client was recently diagnosed with essential hypertension and a history of two "silent" myocardial infarctions diagnosed by electrocardiography. The client was placed on lisinopril 10 mg orally once a day, but the dose was increased to 20 mg 3 months ago. The client is visiting his primary health care provider for a follow up today, and the medical assistant takes his history and vital signs. The nurse reviews the following data in the client's electronic health record. Which data related to his drug therapy is of immediate concern to the nurse? Select All That Apply. Blood pressure = 128/78 mm Hg Pulse = 82 beat/min Respirations = 16 breaths/min No ankle or feet edema Blood pressure = 128/78 mm Hg Denies chest pain, palpitations, shortness of breath Has replaced sodium-based salt with potassium-based salt in his diet Reports new dry "hacking" cough that occurs almost every day Temperature = 98°F (36.7°C)
Has replaced sodium-based salt with potassium-based salt in his diet Reports new dry "hacking" cough that occurs almost every day
A major adverse effect of insulin that can be life-threatening is: Hypoglycemia Hyperglycemia Hypotension Hypertension
Hypoglycemia
A co-worker called 911 for a 52-year-old male client who was working at his construction job and who experienced sudden severe chest pain. After an evaluation at the local emergency department, the client was placed on verapamil ER 180 mg daily for angina pectoris and sent home for follow-up with his primary health care provider. What nursing actions are required related to this client's condition and his newly prescribed medication? Select all that apply Reminding the client to make a follow-up appointment with his primary care provider. Teaching the client the importance of checking his pulse daily, especially if he is taking other cardiac medications. Conducting medication reconciliation to ensure that the client is not currently taking a beta blocking agent or digoxin. Reminding the client to avoid grapefruit juice while on the medication. Reminding the client to call 911 if there are any other episodes of chest pain. Teaching the client about the need to take the drug on an empty stomach at night. Teaching the client to drink plenty of fluids and engaging in daily exercise to prevent constipation.
Reminding the client to make a follow-up appointment with his primary care provider. Teaching the client the importance of checking his pulse daily, especially if he is taking other cardiac medications. Conducting medication reconciliation to ensure that the client is not currently taking a beta blocking agent or digoxin. Reminding the client to avoid grapefruit juice while on the medication. Reminding the client to call 911 if there are any other episodes of chest pain.
