Pharm Final

An adult resident of an assisted living facility has a history of migraines and has a prescription for sumatriptan, administered PRN. Before the client takes a dose, the nurse should ask what question to ensure the client's safety? "Have you recently taken any other medications to treat this migraine?" "When was your last bowel movement?" "When was the last time you took an antacid?" "Did this medication bring you relief the last time you had a migraine?"

"Have you recently taken any other medications to treat this migraine?"

During a teaching session on the care of the client with diabetes, the nurse should make which statement to explain the differences in insulin? "Insulin type is matched with the appropriate oral hypoglycemic agent." "Insulins have different onsets and durations of action." "Insulin is prescribed based on the client's age." "Insulin is prescribed based on the insurer's criteria for reimbursement."

"Insulins have different onsets and durations of action."

A 59-year-old man with type 2 diabetes is prescribed metformin. When the client returns to the clinic, he reports that he has lost 8 pounds in a month. How should the nurse respond? "We should really report this to your health care provider. The provider will likely change medications." "You should discontinue this medication immediately. I will contact your health care provider." "Please continue taking the medication and monitoring your weight. This is an expected outcome of this drug therapy." "We should really report this to your health care provider. The metformin dosage will need to be decreased."

"Please continue taking the medication and monitoring your weight. This is an expected outcome of this drug therapy."

The caregiver of client describes the client as having Alzheimer's disease (AD) for 10 years and is currently in the late stage of the disease. The caregiver asks the nurse if the client can go back on the medication donepezil. Which response by the nurse is appropriate? "The drugs are best used early as they slow the progression of AD." "A newer drug that has recently been developed is galantamine." "Donepezil has had research studies findings suggesting it cures AD." "Let me discuss your concerns with the prescriber."

"The drugs are best used early as they slow the progression of AD."

Insulin lispro, insulin aspart, and insulin glulisine are all what type of insulin? Regular insulin Rapid acting insulin Long acting insulin Intermediate acting insulin

Rapid acting insulin

A client has taken sumatriptan and does not feel it is working. The client wants to know when more medication can be administered. Which response should the nurse prioritize? "You can only take one dose safely." "You can take a second dose 2 hours after the first." "If it does not work with the first dose, we will add a different medication." "You can double the dose within a few minutes of administration."

"You can take a second dose 2 hours after the first."

I can give aspart insulin IV

.

Gave regular insulin at 0600 when should mean be there?

0630

The client is scheduled to get a breakfast tray at 07:00. At what time should the client receive a prescribed dose of insulin lispro? 06:45 07:00 06:20 06:00

06:45

Onset of rapid acting insulin (insulin analogs such as insulin lispro/ or Aspart) 30 minutes 1 hour 8 hours 15 minutes

15 minutes

Duration of action of long acting insulin - insulin detemir (Levemir) 23 hours 1 hour 8 hours 12 hours

23 hours

The nurse assesses a client's blood glucose level after administering insulin. Which result would the nurse interpret as indicative of severe hypoglycemia? 48 mg/dL 34 mg/dL 72 mg/dL 65 mg/dL

34 mg/dL

True/False Fever, flushing, and exhaustion are sign of anticholinergic toxicity?

True

How many triptans can be taken intranasally?

Two

What do we see in overdose of levothyroxine? Tachycardia tremors nervousness all

ALL

What should not be used with muscle relaxers?

Alcohol

When should naproxen not be taken?

Aspirin Allergy

A nurse is assigned to administer glargine to a patient at a health care facility. What precaution should the nurse take when administering glargine? Administer insulin that has been refrigerated. Avoid mixing glargine with other insulin. Administer glargine via IV route. Shake the vial vigorously before withdrawing insulin.

Avoid mixing glargine with other insulin.

When should i take Donepezil?

Bed time

A client receives a dose of insulin lispro at 8 AM. The nurse would be alert for signs and symptoms of hypoglycemia at which time? Between 12 noon and 8 PM Between 10 AM and 12 noon Between 2 PM and 4 PM Between 8:30 AM and 9:30 AM

Between 8:30 AM and 9:30 AM

A client has been receiving bethanechol for 1 week. One hour after the dose is administered, the client develops sweating, flushing, abdominal cramps, and nausea. The nurse prepares to intervene for what condition? Anaphylactic reaction Cholinergic overdose Pulmonary edema Myasthenic crisis

Cholinergic overdose

What should happen to TSH levels when taking Levothyroxine?

Decrease

Dizziness, Syncope are some side effects of?

Donepezil

Which agent would be most appropriate to administer to a client with Alzheimer's disease? Neostigmine Ambenonium Pyridostigmine Donepezil

Donepezil

I should stop dementia medication when memory improves ( true/false)

False

True/False Sumatriptan is given routinely to prevent the occurrence of long-term migraines.

False

True/False Take levothyroxine at night with a meal?

False

True/False Type II Diabetes is most often associated with children

False

True/False Weight gain is expected with Metformin

False

Clients with what disorder should not be given anticholinergic drugs? Attention deficit disorder Severe anxiety or hyperactivity Glaucoma Epilepsy

Glaucoma

What diabetic medication stimulates your pancreas to release insulin?

Glipizide

Hypoglycemia is adverse effect of?

Glyburide

Which would a nurse identify as an example of a sulfonylurea? Metformin Glyburide Miglitol Acarbose

Glyburide

Metformin (Glucophage) common side effects include all but which of those listed? Diarrhea Gas Abdominal Cramping Headache

Headache

Brand name for short acting insulin / regular insulin Lantus Humulin R Humalog Humulin N

Humulin R

If given too much insulin what action is closely monitored?

Hypoglycemia

If we are giving insulin or any oral medication to reduce blood glucose levels, what is our common adverse effect? Hyperglycemia Hypertension Hypotension Hypoglycemia

Hypoglycemia

Propylthiouracil does what? Inhibits production of thryroid hormone increase thyroid hormone nothing

Inhibits production of thryroid hormone

Another sign of levothyrozine overdose?

Insomnia

What has different onsets and duration of actions?

Insulin

Which insulin does not have a peak? Insulin detemir Insulin lispro Regular insulin Insulin glulisine

Insulin detemir

Which insulin does not have a peak? Insulin aspart Insulin isophane suspension Insuline glargine Insulin glulisine

Insuline glargine

What has onset of 1 to 1.5 hr, Peak 8 to 12 hr, Duration 18-24 hr?

Intermediate insulin

What is an intermediate insulin?

Isophane (NPH)

Which insulin is cloudy? Regular insulin Insulin aspart Insulin detemir Isophane insulin suspension

Isophane insulin suspension

Malaise, Tachypnea, ab pain, and muscle pain can be signs of?

Lactic acidosis

Nervousness, tachycardia and tremors are what signs in overdose of?

Levothyroxine

What blood pressure drug is given to protect the kidneys with diabetes?

Lisinopril

What is a rapid acting insulin?

Lispro & Aspart

What should be monitored when taking propylthiouracil?

Liver function

This type of insulin does NOT have a peak Rapid acting Intermediate acting Long acting Short acting

Long acting

What has onset 1 hr, does not peak, Duration 6-23 hr?

Long acting

What has onset 15 min, peak 1-3 hr, duration 3 to 5 hr

Rapid Acting

A client who has been prescribed metformin is scheduled to undergo diagnostic testing with the administration of parenteral radiographic contrast media containing iodine. What fact should direct the nurse's plan of care for this client? Metformin should be discontinued at least 48 hours before and after diagnostic tests that use contrast medias. The client needs to be encouraged to drink 1 to 2 L of water to flush the contrast media out of the kidneys. Insulin will be temporarily substituted for the metformin to address the risk of potential kidney failure. The client will be prescribed an extra dose of metformin to address the contrast media effect on the body.

Metformin should be discontinued at least 48 hours before and after diagnostic tests that use contrast medias.

A client has presented to the radiology department for a scheduled bronchoscopy. What drug will meet the client's needs for amnesia and sedation during this invasive procedure? Ketamine Midazolam Nitrous oxide Bupivacaine

Midazolam

When should levothyroxine be taken?

Morning

Besides alzheimer what can Donepezil be given for?

Multiple Sclerosis

A client is taking donepezil - which diagnosis is an appropriate indication for use? Select all that apply. Diabetes Mellitus Alzheimer's Status Epilepticus Multiple Sclerosis

Multiple Sclerosis Alzheimer's

What should be rolled not shaken?

NPH

A client is brought to the emergency department after taking an overdose of levothyroxine. When assessing this client, what adverse effects would the nurse expect to find? Skin rash and itching Slow speech and mental dullness Drowsiness and bradycardia Nervousness and tachycardia

Nervousness and tachycardia

Which of the following are symptoms of hyperthyroidism? Lethargy, constipation Hyperglycemia, edema Nervousness, tremors Bradycardia, parasthesias

Nervousness, tremors

A patient who is the administrator of a large healthcare agency reports constant stress on the job, causing "tension headaches." What therapy will the nurse teach the patient to use? Oxygen therapy Running hands under cold water Nonsteroidal anti-inflammatory agents IV medication

Nonsteroidal anti-inflammatory agents

What is used for neurogenic bladder?

Oxybutynin

Combination drug of levodopa, carbidopa and entacapone is used for?

Parkinsons

A client diagnosed with type 1 diabetes suddenly reports feeling weak, shaky, and dizzy. What should be the nurse's initial response? Administer 10 units of regular insulin subcutaneously. Have the client drink a 4-ounce (120-mL) glass of orange juice. Perform a blood sugar analysis. Administer 1 ampule of 50% dextrose intravenously.

Perform a blood sugar analysis.

What is the oldest antiepileptic?

Phenytoin

Which is not a S/S of hyperglycemia? Polyuria Polyphagia Polydipsia Polygamy

Polygamy

What Beta blocker can be used for migraines?

Propranolol

Which of the following meds can be given for migraines? Atropine Levothyroxine Metformin Propranolol

Propranolol

What insulin can be given IV?

Regular

What insulin is given IV for diabetic Ketoacidosis?

Regular

What is a short acting insulin?

Regular (Novolin-R)

The nurse is preparing to administer insulin intravenously to a client with a blood glucose level over 600 mg/dL (33.33 mmol/L). What type of insulin will the nurse most likely give? NPH insulin Ultralente insulin Lente insulin Regular insulin

Regular insulin

What needs to be monitored closely when administering a benzodiazepine?

Respiratory Rate

Which triptan can be taken as an orally disintegrating pill? Rizatriptan Zolmitripan Sumatripan Frovatriptan

Rizatriptan

Should shake or roll insulin?

Roll

The nurse is providing client education prior to administering propylthiouracil. During teaching, the nurse should inform the client about the need for what form of follow-up? Routine liver function testing Daily nonfasting blood glucose testing Chest radiographs every 3 months Serial complete blood counts

Routine liver function testing

What has a onset of 30 min to 1 hr, Peak 2 to 3 hr, Duration 5 to 7 hr?

Short acting

Which triptan can be administered intranasally? Select all that apply Ruvatriptan Sumatriptan Zolmitriptan Frovatriptan

Sumatriptan Zolmitriptan

A client diagnosed with hypothyroidism is to start thyroid hormone replacement therapy. Which lab value should the nurse review to assist the health care provider in determining the dosage? Platelets Glucose TSH CBC

TSH

A female client has been taking Aricept for several months. The family feels that she is better and wants to stop the medication. What would be an important teaching point? This medication can be very expensive, but there are financial programs to help with the cost. This medication is a placebo, so instead of giving her that pill just give her an aspirin instead. Nausea and vomiting are common side effects. This medication is a treatment, not a cure. If you stop it, she will lose any benefits that she has gained.

This medication is a treatment, not a cure. If you stop it, she will lose any benefits that she has gained.

A client is taking levothyroxine, which lab are we going to expect a decreased level in when evaluting effectiveness? Creatinine clearance Thyroid stimulating hormone Complete blood count Thyroxine

Thyroid stimulating hormone

Intermediate insulin should not be mixed

True

True or false A common cause of hypoglycemia is Diabetic medication mismanagement?

True

True or false Glyburide is a sulfonylurea?

True

True or false Humulin R and Novolin R are short acting insulins?

True

True or false Sitagliptin can cause URI's?

True

True or false decrease of TSH is a therapeutic response of levothyroxine?

True

What is a nerve blocking agent and ventilation after the drug is given?

Vecuronium

What is one of several side effects of anesthesia?

Vomiting

Knowing that thyroid hormones are principally concerned with the increase in metabolic rate of tissues, which symptoms would a nurse observe in a client with uncontrolled hypothyroidism? (Select all that apply.) Sleepiness Elevated body temperature Weight gain Hypertension Bradycardia

Weight gain Bradycardia Sleepiness

Which are risk factors for type-2 diabetes that a nurse should recognize in a client? Select all that apply: younger age Caucasian race impaired glucose tolerance history of gestational diabetes obesity

impaired glucose tolerance obesity history of gestational diabetes

A client prescribed levothyroxine asks the nurse to explain when the medication should be taken. Which would the nurse include in the response? in the morning on an empty stomach in the morning on a full stomach in the evening on a full stomach in the evening on an empty stomach

in the morning on an empty stomach

The health care provider prescribes glyburide for a client who is a newly diagnosed type 2 diabetic. The nurse knows that this medication produces hypoglycemia by: preventing glucose absorption from the stomach. increasing the use of insulin by the muscles. increasing insulin secretion from the pancreas. stopping the production of insulin in the liver.

increasing insulin secretion from the pancreas.

After reviewing information about different insulin preparations, a nursing student demonstrates understanding of the information when the student identifies which medication as an example of a long-acting insulin? isophane insulin suspension insulin glargine insulin aspart insulin lispro

insulin glargine

A nurse is preparing to administer a rapid-acting insulin. Which medication would the nurse most likely administer? insulin lispro insulin glargine isophane insulin suspension insulin detemir

insulin lispro

Which of the following insulins is cloudy? isophane insulin suspension insulin insulin lispro insulin glargine

isophane insulin suspension

A patient will be undergoing surgery, during which the anesthesiologist plans to administer vecuronium. The nurse will recognize that the administration of this drug creates a need for: electroencephalographic monitoring. hemodynamic support. active body core warming. mechanical ventilation.

mechanical ventilation.

zQuiz A client's in diabetic ketoacidosis. What insulin are we giving? regular insulin insulin aspart isophane insulin suspension 10% dextrose

regular insulin

What should a diabetic carry at all times?

snack

The school nurse identifies more children with type 2 diabetes each year and recognizes that this trend is mainly attributed to what issue? Working parents Lack of after-school programs due to budget constraints Economics Obesity and inadequate exercise

Obesity and inadequate exercise

True/False Depakote is a drug that we need to monitor drug levels on

True

True/False Insulin isophane suspension has a peak of 8-12 hours.

True

True/False Insulins differ in their onset and duration of action?

True

True/False Understanding the onset peak and duration of insulin is vitally important to me as a nurse.

True

True or False Regular insulin (Humulin R) is the only insulin available for IV administration

True