Pharm Midterm Units # 1-5 NCLEX Based Study Questions

A nurse administers naloxone (Narcan) to a postoperative patient experiencing respiratory sedation. What undesirable effect would the nurse anticipate after giving this medication? A) Drowsiness B) Tics and tremors C) Increased pain D) Nausea and vomiting

C

A patient admitted to the ED is describing severe pain even after being given opioid pain medications. The patient admits to consuming alcohol on a daily basis, and sometimes borrows her friends pain medication to manage her symptoms. As the nurse, you believe what is causing her pain? A. enzyme induction causing tolerance of the medications B. enzyme inhibition causing tolerance of the medications C. Chronic opioid addiction D. Opioid toxicity making the patient increasingly ill

A

A patient who uses an inhaled glucocorticoid for chronic asthma calls the nurse to report hoarseness. What should the nurse do? a. Ask whether the patient is gargling after each dose of the glucocorticoid. b. Request an order for an antifungal medication. c. Suggest that the patient be tested for a bronchial infection. d. Tell the patient to discontinue use of the glucocorticoid.

A

A postoperative patient has an epidural infusion of morphine. The patient's respiratory rate declines to 8 breaths/min. Which medication would the nurse anticipate administering? A) Naloxone (Narcan) B) Acetylcysteine (Mucomyst) C) Methylprednisolone (Solu-Medrol) D) Protamine sulfate

A

After giving a patient their morning medications of Oxycodone, Tums, a benzodiazepine, and a transdermal fentanyl patch. you return to the room 40 minutes later to assess their pain value. Your patient describes no decrease in their pain. As their nurse you notice that one of their medications may have caused decreased effectiveness in other medications. Which drug would this be and why? A. Tums; b/c it is used to inhibit intestinal absorption which would diminish drug effects B. Fentanyl because it increases drug metabolism C. Benzo because it is the antidote for oxycodone D. Tums b/c it inhibits intestinal absorption and causes other drugs to be metabolized much faster

A

Naloxone (Narcan) is administered to a client with severe respiratory depression and suspected drug overdose. After 20 minutes, the client remains unresponsive. The most likely explanation for this is: a.) The client did not use an opioid drug. b.) The dose of naloxone was inadequate. c.) The client is resistant to this drug. d.) The drug overdose is irreversible.

A

The nurse watches for which electrocardiogram changes in the patient receiving methadone? A. Prolonged QT interval B. Ventricular Fibrillation C. Increased heart rate D. Elevated T waves

A

Which agent below is most likely to cause serious respiratory depression as a potential adverse reaction? A) Morphine B) Percocet C) Hydrocodone D) Tramadol

A

Which of the following is true regarding drug and food interactions? a. Calcium rich food can decrease drug absorption. b. Fiber can increase drug absorption. c. All meds are best taken with food. d. High calorie meals can decrease absorption of drugs.

A

Which type of drug is able to crossover the placental barrier? a. lipophilic drugs b. hydrophilic drugs c. polarized drugs d. ionized drug

A

While visiting their PCP, a patient brings along their list of home medications. As the nurse, you notice there are more than 15 medications, and several that each treat the same issue. When educating the patient how would you describe the issue with poly pharmacy? A. "The simultaneous use of multiple drugs can lead to complications and diminished mental status" B. "Using multiple drugs at once may put you at an increased risk for tolerance and addiction" C. "Polypharmacy is very expensive and probably is overtreating your conditions"

A

You're educating a group of new nurse graduates about loop diuretics. One topic you discuss is ototoxicity. You ask the new nurses to explain how to prevent this adverse side effect in a patient prescribed a loop diuretic. Which response by one of the new nurses is correct? A. "Always administer intravenous loop diuretics slowly." B. "Monitor for signs and symptoms of low potassium levels because this increases the risk of inner ear damage while taking loop diuretics." C. "Administer the medication with meals." D. "Avoid administering loop diuretics with a tetracycline."

A

Your patient is prescribed to take Lisinopril and Triamterene (a potassium sparing diuretic). As the nurse you know that these medications increase a patient's risk for developing? A. Hyperkalemia B. Hypertension C. Hypernatremia D. Renal failure

A

Which patients below may be prescribed a loop diuretic based on their diagnosis? Select all that apply: A. A 58-year-old male with congestive heart failure. B. A 69-year-old female with pulmonary edema. C. A 45-year-old male with hypercalcemia. D. A 50-year-old male experiencing a gout attack.

A B

A Patient with a medical history significant for CV disease & hyperthyroidism, is prescribed Bethanechol (Urecholine) to treat their current urinary retention. As a nurse you know which cardiac S/Sx would be important to assess for in this patient; Select all that apply A. Bradycardia & Hypotension B. Decreased Ejection Fraction C. Dysrhythmias D. Tachycardia & pulmonary Edema

A B C

What are the results of using glucocorticoid drugs to treat asthma? SELECT ALL THAT APPLY a. Reduced bronchial hyperreactivity b. Reduced edema of the airway c. Reduced number of bronchial beta2 receptors d. Increased responsiveness to beta2-adrenergic agonists d. Increased synthesis of inflammatory mediator

A B D

Which of the following pharmacokinetic changes in elderly patients cause issues with drug absorption? A. Decreased gastric acidity B. Decreased mobility C. Decreased GI blood flow D. Increased Urinary Incontinence E. Increased Bowel Surface Area F. Decreased surface area G.Decreased gastric emptying

A B F G

An elderly patient is visiting the his primary care office for a yearly well check. The patient ask you, the nurse, what types of illness he is most at risk for due to his advanced age. You respond that he may be at higher risk for which of the following- SELECT ALL THAT APPLY A. arthritis B. cancer C. heart disease D. decreased sensory perception E. bone disorders F. diabetes G. TIA

A C D E F

you're developing a plan of care for a patient with fluid volume overload related to heart failure exacerbation. The physician has prescribed an IV loop diuretic. What nursing interventions will you include in the patient's plan of care? Select all that apply A. Perform and assess daily weights. B. Educate the patient about consuming a low potassium diet. C. Strict measuring of the patient's daily intake and output. D. Encourage the patient to drink 2 L of fluids per day. E. Assess lung sounds every shift.

A C E

A pregnant mother describes frustration with her OB that she is unable to take ibuprofen to treat her headaches during pregnancy. When explaining why we are cautious with perscription/otc drug use in pregnancy, which is the best response from the nurse? A. "pregnant mother and fetus undergo changes that may change the affect of drugs, and we need to evaluate risk vs benefit with each drug" B. "Every drug will negatively affect your fetus, so we must be careful with the amounts of drugs you consume." C. "drugs that cross the placental barrier can be detrimental to fetal growth" D. "When evaluating risk vs benefit, headaches are not enough of a concern that you need treatment"

A.

you the nurse, suspect a patient may be experiencing a drug overdose. When does this become an emergency? A. Drug OD is always an emergency B. When the patient begins experiencing respiratory depression C. When the patient becomes unconscious D. Once the drug is given

A.

When teaching a new nurse about drug administration, they ask you why all patients respond to the same drug differently. the best response by you is what? A. "There are several underlying factors that affect a patients response to each drug" B. "Drugs always react with each other to change their affects" C. "A patients weight heavily influences their ability to metabolism drugs and their response" D. "All drugs have side effects, some patients just experience them differently"

A. Rationale: Answer D is incorrect because the nurse did not specifically ask about side effects

The nurse recognizes that the primary indication for the administration of morphine is to do what? A. Relieve pain B. Reduce anxiety C. Treat left ventricular failure D. Decrease level of consciousness

A. Relieve pain

A patient has a New Order for oxybutynin (Ditropan) due at 1700. When the nurse prepares to give this dose for the first time, which drug already prescribed to the patient would cause the nurse to hold the dose of Ditropan & notify the physician? A. IV Benadryl 300mg B. Acetaminophen 150 mg PO C. Theophylline 25 mg D. Morphine 3 mg PO

A; Antihystamines

what is the process that may involve manipulating deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) and recombining genes into hybrid molecules that can be inserted into living organisms (often Escherichia coli bacteria) and repeatedly reproduced? A. Biotechnology B. Bioavailability C. Enzyme Inhibitors D. DNA based pharmaceuticals

A; biotechnology

A patient is currently taking a potassium-sparing diuretic. The patient is experiencing EKG changes with tall-peaked T-waves, nausea, diarrhea, and paresthesia. The patient's morning lab results are back and the nurse makes it priority to check what lab result? A. Calcium B. Potassium C. Magnesium D. Sodium

B

A patient is complaining of dry eyes & blurred vision. You as the nurse realize this could be caused by his Oxybutynin (Ditropan) because it affects both the bladder & eyes in what way? A. Tensing of the muscles to encourage bladder control B. Relaxation of the ciliary muscles, iris and bladder C. decreased blood pressure makes the patient dizzy and causes blurred vision D. rapid metabolism causes spastic control of muscles

B

A nurse and a nursing student are reviewing the care of a 30-kg patient who will receive intravenous theophylline. Which statement by the student indicates an understanding of the administration of this medication? a. "After the loading dose has been given, the patient will receive 6 mg/kg/hr." b. "Dosing is titrated based on the serum theophylline levels." c. "The patient will receive a loading dose of 180 mg over 5 minutes." d. "If the patient's serum theophylline level is less than 15 mcg/mL, the rate should be reduced.

B

A nurse is caring for a 50 year-old male with a history of ETOH and IV drug abuse. Which of the following is the nurse's biggest concern when preparing to give his morning medications? a. risk for narrow therapeutic index of drugs b. risk for extended half life of drugs c. his ability to absorb drugs d. his ability to distribute drugs

B

A nurse is caring for a cancer patient receiving subcutaneous morphine sulfate for pain. Which of the following nursing actions is most important in the care of this patient? A. Monitor urine output. B. Monitor respiratory rate. C. Monitor heart rate. D. Monitor temperature.

B

A nurse is planning care for a patient who takes fexofenadine (Allegra) for allergic rhinitis. Which outcome should the nurse anticipate? a. No complaints of dry mouth b. Relief of sneezing and itching c. Use limited to allergy season d. Absence of rebound congestion

B

A nurse is teaching a nursing student about the actions of agonist drugs. Which statement by the nursing student indicates the need for further teaching? a. "The drug binds with the receptor and increases the cell's normal action." b. "The drug binds with the receptor and blocks the cell's normal action." c. "The drug can have a high or low affinity to certain cells." d. "The drug activates receptors and mimics the body's own functions."

B

A patient admitted to the hospital with a diagnosis of pneumonia asks the nurse, "Why am I receiving codeine? I don't have any pain." The nurse's response is based on the knowledge that codeine also has which effect? A) Immunostimulant B) Antitussive C) Expectorant D) Immunosuppressant

B

A patient is scheduled to take a dose of Lithium at 1000. The patient is also prescribed a thiazide diuretic. What lab result below requires the nurse to hold the dose of Lithium and notify the physician for further orders? A. Potassium 3.2 mEq/L B. Sodium 115 mEq/L C. Calcium 10.5 mg/L D. Magnesium 2 mg/dL

B

A patient newly diagnosed with asthma receives prescriptions for an inhaled glucocorticoid and an inhaled beta2-adrenergic agonist. Which statement by the patient indicates understanding of this medication regimen? a. "I should use the glucocorticoid as needed when symptoms flare." b. "The glucocorticoid is used as prophylaxis to prevent exacerbations." c. "I will need to use the beta2 -adrenergic agonist drug daily." d. "The beta2 -adrenergic agonist suppresses the synthesis of inflammatory mediators."

B

A patient with heart failure is prescribed Digoxin and a loop diuretic. The nurse knows that what finding below would increase a patient's risk of developing Digoxin toxicity? A. Magnesium level 1.8 mg/dL B. Potassium 2 mEq/L C. BUN 15 D. Albumin 5 g/dL

B

As a nurse you know that drugs like Morphine are the first drug of a particular drug class to be developed; usually the standard against which newer, similar drugs are compared. You know this is an example of: A. Biotechnology advancement B. Prototype drugs C. Opioid Agonists D. Generic Drug names

B

In preparing an inservice about opioids, the nurse includes which problem as the most serious adverse effect? A. Suppressed cardiac automaticity B. Respiratory depression C. Profound sedation D. Hyperthermia

B

The main goal of this law is to Protect the Public, & ensuring drugs are safe and effective. Working as a nurse, you know this is an example of what? A. American act of drugs and cosmetics B. American Drug Laws and Amendments C. Controlled substance ACT D. DEA roles & responsibilities

B

The physician prescribes the patient a thiazide diuretic. The patient is experiencing increased urination. As the nurse you know that this medication causes this type of affect by how it affects the nephron. It does this by?* A. inhibiting the sodium-potassium-chloride cotransporter in the distal convoluted tubule B. inhibiting the sodium-chloride cotransporter in the distal convoluted tubule C. inhibiting the water reabsorption in the distal convoluted tubule D. inhibiting the sodium-potassium transporter in the distal convoluted tubule

B

You're providing discharge teaching to a patient who will be taking a thiazide diuretic for the treatment of hypertension. You note that the patient has type I diabetes. What statement by the patient represents they misunderstood your teaching points about this medication and requires you reinforce some of the education pieces? A. "I must monitor my blood glucose closely while taking this medication." B." This medication can cause sudden and severe drops in my blood glucose." C. "I will try my best to eat a diet that includes foods rich in potassium." D. "I will report to my physician if I experience excessive thirst, little or no urination, and extreme fatigue."

B

In preparing to administer bethanechol (Urecholine), the nurse understands that: Select all that apply A. If taken without food can cause nausea & vomiting B. Has poor bioavailability & only small fractions of the dose will be absorbed C. Should be administered 1hr before or 2hr's after meals to avoid nausea/vomiting D. Is only given IV to avoid 1st pass effect

B C

You're developing a plan of care for a patient with heart failure that will be prescribed a thiazide diuretic. What nursing interventions will you include in this patient's plan of care? Select all that apply:* A. Encourage the patient to limit the consumption of bananas, avocadoes, spinach, strawberries, and potatoes. B. Measure the patient's intake and output daily. C. Weigh the patient daily using a bedside scale. D. Assess lab results for electrolyte imbalances like hypercalcemia and hyperkalemia.

B C

When taking shift report from the night shift nurse, you learn the patient was admitted for a very high serum drug level of theophylline. As a nurse you understand that A serum drug level reflects what? SELECT ALL THAT APPLY A. toxic concentrations B. the dosage of the drug vs its absorption C. the drugs half life D. bioavailability E. the level of hepatic enzymes F. anaphylactic reaction to the drug G. the rates of metabolism and excretion

B C D G

Which Factors affect the rate and extent of drug absorption? A. Activity levels B. dosage form C. route of administration D. temperature E. administration site blood flow F. GI function G. class of drug H. the presence of other food or drugs I. Bowel Surface Are

B C E F H I

A provider writes an order "MS 10mg IV push q 6 hr", what is the potential problem with this order? A. Drug dose is unsafe B. Patient name not specified in this order C. We never push MS through the IV route D. Uses an inappropriate abbreviation

D; could be Morphine Sulfate or Magnesium Sulfate, "Do Not Use" list

A nurse should teach a patient receiving oral pseudoephedrine (Sudafed) to observe for which adverse effects? SELECT ALL THAT APPLY a. Sedation b. Anxiety c. Hypotension d. Tachycardia

B D

In a patient who has overdosed on a drug what are our main goals as the nurse? SELECT ALL THAT APPLY A. Make sure the patient never takes that drug again B. decrease absorption of the drug C. prevent any side effects from occurring D. monitor lab values frequently for any changes E. increase the drugs elimination F. administer an antidote as soon as possible, if one is available G. Put in an order for naloxone ASAP

B E F

A provider puts in orders for Morphine, a barbiturate sedative, and a CNS stimulant like methylphenidate. As a nurse you are aware that these drugs need to be handled carefully because they are...... SELECT ALL THAT APPLY A. Always lead to addiction B. Schedule II Drugs C. Not normally used in a medical setting D. Have high potential for abuse

B D

The nurse would question the administration of morphine in the patient with a history of which condition? A. Diabetes B. Asthma C. Anorexia D. Cancer

B. Asthma

A 5-year-old child is brought to the emergency department after ingesting diphenhydramine (Benadryl). The child is uncoordinated and agitated. The nurse observes that the child's face is flushed, the temperature is 37.1C, and the heart rate is 110 beats per minute. The nurse will expect to: a. administer atropine to reverse the adverse effects. b. apply ice packs to stop the flushing. c. give activated charcoal to absorb the drug. d. prepare to provide mechanical ventilation.

C

Your patient is prescribed hydrochlorothiazide. The patient's potassium level is 2 mEq/L. What medication below should the nurse hold and notify the physician for further orders? A. Dilantin B. Digoxin C. Warfarin D. Lithium

B; Increased r/ of digoxin toxicity

1. The nurse is preparing to administer a drug that has a high therapeutic index. The nurse can expect this drug to be: a. more dangerous b. polarized c. safer d. have a longer half life

C

A nurse is teaching a patient who is to start taking an expectorant. The nurse provides the patient with which of the following instructions? a. "Restrict cold fluids to promote reduced mucus production." b. "Take the medication once a day only, usually at bedtime." c. "Increase your fluid intake to reduce the viscosity of secretions." d. "Increase your fiber and fluid intake to prevent constipation.

C

A young woman is admitted to your floor. She has a previous medical history significant for Chron's disease & bowel resection, which has left her with Poor GI Function and a smaller bowel surface area. In preparation to administer medications the nurse should be aware that which process will be diminished in this patient ? A. Metabolism B. Transportation C. Absorption D. Distribution

C

If a patient is a chronic cigarette smoker you know this will increase which aspect of pharmacokinetics? A. absorption B. excretion C. Metabolism D. Distribution

C

The nurse prepared to administer which drug to the patient with suspected opioid overdose? A. Glucose B. Caffeine C. Naloxone D. Tramadol

C

The physician prescribes the patient a potassium-sparing diuretic. Which statement below best describes how this medication works to cause diuresis? A. These medications work to inhibit the sodium-chloride cotransporter in the early part of the distal convoluted tubule. B. These medications work to inhibit the sodium-potassium-chloride cotransporter in the thick ascending limb of the loop of Henle. C. These medications work to inhibit the sodium and potassium exchange within the sodium channels in the distal tubule and collecting duct. D. These medications work to inhibit the sodium channels within the proximal convoluted tubule by decreasing sodium reabsorption.

C

Which of the following statements best describes partial agonists? a. Their effect is bigger than agonists b. They have a strong affinity for mu receptor sites c. They can act as antagonists as well as agonists d. They are irreversible and thus considered to be more dangerous.

C

Which patient is appropriate to receive Bethanechol (Urecholine)? A. a 72 y/o patient with incontinence due to a weakened bladder wall B. a 22 y/o patient with chronic urinary retention and a Hx of GI ulcers C. an 80 y/o patient who has urinary retention following a surgical procedure to treat hip fx D. A pediatric patient with a hx of asthma, who needs treatment fro neurogenic atony of the bladder

C

Which of the following statements is true regarding drug excretion? SELECT ALL THAT APPLY a. Lipophilic drugs excrete easily out of the kidneys through urine via glomerular filtration . b. Hydrophilic drugs move from the urine back into the blood via passive reabsorption. c. Albumin bound drugs cannot be excreted out the urine. d. Drugs must be changed to a water-soluble form to be excreted via glomerular filtration.

C D

Where are drug metabolizing enzymes located? A. BNP in the Heart B. Blood Brain Barrier C. Kidneys D. Liver E. Stomach F. RBC's & plasma G. Bowel H. Lungs I. GI Mucosa

C D F H I

The nurse correlates orthostatic hypotension resulting from opioid administration with which cause? A. Decreased heart rate B. Impaired contractility C. Dilation of peripheral veins D. Elevated circulating catecholamines

C. Dilation of peripheral veins

If the patient is scheduled for a dose of opioid, which of the vital sign parameters would require an immediate intervention? A. Pulse rate of 110 B. Temperature of 38 °C C. Respiratory rate of 10 D. Blood pressure of 160/86 mm Hg

C. RR

Which of the following patients is experiencing an adverse drug effect? A. A child with a viral stomach bug who was given acetaminophen, and has a temperature of 38.1 B. An elderly woman AxOx2, who is having hallucinations C. a patient taking morphine who has constricted pupils D. A patient who comes into the ED needing urgent mechanical ventilation for severe respiratory depression

C; Rational: in answer B & D. it is unknown if the patient has taken any drugs, in answer A. Acetaminophen does not have an adverse effect of fever, likely it has not effectively treated the fever

A nurse prepares medication for a patient prescribed Bethanechol (Urecholine). The nurse understands that this is a _____________ ______ drug, that acts on ___________ receptors.

Cholinergic Agonist; Muscarinic

A patient arrives at the emergency department complaining of back pain. He reports taking at least 3 acetaminophen tablets every three hours for the past week without relief. Which of the following symptoms suggests acetaminophen toxicity? A. Tinnitus. B. Diarrhea. C. Hypertension. D. Hepatic damage.

D

A patient has a dose of Spironolactone due at 1000. Which finding below would require the nurse to hold the dose and notify the physician for further orders? A. Magnesium 1.5 mg/dL B. BUN 18 C. Sodium 140 mEq/L D. Potassium 7 mEq/L

D

A patient takes oxycodone (OxyContin), 40 mg PO twice daily, for the management of chronic pain. Which intervention should be added to the plan of care to minimize the gastrointestinal adverse effects? A) Take an antacid with each dose. B) Eat foods high in lactobacilli. C) Take the medication on an empty stomach. D) Increase fluid and fiber in the diet.

D

A patient who has overdosed on fentanyl is admitted to the ICU and is on an IV drip of Naloxone. When reviewing the providers order you believe the patient is not receiving enough of the naloxone. You are aware that this will be an issue because of what ? A. fentanyl OD is always fatal B. The patient will experience severe respiratory depression C. antidotes only work in very large amounts, the patient may die if the naloxone order is not increased D. Narcan has a short half life in comparison to opioids & if the appropriate amount is not administered the patient will begin to experience OD symptoms again.

D

After doing dosage calculations on an order for merperedine, you realize the order does not satisfy the MEC for your patient. Before approaching the doctor, you realize this order is unsafe for what reason? A. the plasma drug level is too high and will cause the patient to overdose B. its bioavailability is too low to cause therapeutic effects C. the plasma drug level is too low and will not reach receptors in the CNS D. the plasma drug level will not be high enough for therapeutic effects to occur

D

The client informs the nurse that he has experienced pain in the lower extremities for the past eight months. The nurse recognizes that this pain is classified as: a.) Moderate. b.) Severe. c.) Acute. d.) Chronic.

D

The nurse would recommend treatment with transdermal fentanyl for a patient with which issue? A. Postoperative pain after gastric bypass B. Initial treatment for migraine headaches C. Severe pain caused by cancer metastasis to bone D. Chronic lower back pain associated with lumbar strain

D

The physician prescribes the patient a loop diuretic. As the nurse you know that this type of diuretic causes diuresis by MAINLY affecting what structure in the nephron? A. Distal convoluted tubule B. Descending limb of the loop of Henle C. Proximal convoluted tubule D. Ascending limb of the loop of Henle

D

Which of the following definitions best describes an idiosyncratic event? a. An allergic reaction largely independent of dose. b. A response caused by the medical system. c. A condition capable of producing genetic defects. d. An uncommon drug response related to genetics.

D

Which patient would it be INNAPROPRIATE to administer Oxybutynin (Ditropan)? A. A young female patient with nocturia and urge incontinence B. An elderly man with overactive bladder due to old age, with a hx of bradycardia C. A woman with post partum incontinence who experiences incontinence at night, who is frequently constipated D. A man with overactive bladder who takes antipsychotics & drinks alcohol daily

D

You are giving 500mg of a drug that has a half life of 6 hours. This means that: a. All of the drug will be excreted in 6 hours. b. In 6 hours, the total amount remaining in the body will be 350 mg. c. In 3 hours, 250 mg of the drug will be metabolized. d. In 6 hours, the concentration of the drug in the body will be 250 mg.

D

You're providing discharge instructions to a patient who will be taking a loop diuretic at home. Which statement by the patient demonstrates they did NOT understand the teaching material and requires that you reinforce some of the teaching points? A. "I will eat a diet rich in potatoes, bananas, avocadoes, strawberries, and spinach." B. "I will weight myself daily and report to my physician if I gain more than 3 lbs in 1 day." C. "I will change position slowly because I can become dizzy easily while taking this medication." D. "This medication can cause dehydration, so I will stay hydrated by consuming at least 2 L or more of fluid per day."

D

The _______________ population is at the most risk for ____________ ________________ infections

Elderly; Antibiotic resistant

True or False: Thiazide diuretics are more potent than loop diuretics and provide immediate diuresis affects.* True False

False; Thiazide diuretics take approx 2 hours PO for diuresis to occur

When a drug is switched from prescription, to OTC Status, you as the nurse know that this may mean different _______________ & ____________ doses for use.

Indications; lower

distribution depends on the ________ of blood ______________

adequacy, circulation