Pharmacology Exam 1 azi
Prednisone 10 mg orally daily has been prescribed for a client. The nurse provides instructions to the client regarding the medication. Which statement by the client indicates that further teaching is needed?
"I can take acetylsalicylic acid (aspirin) or my antihistamine if I need it."
The community health nurse visits a client at home who has been prescribed prednisone 5 mg orally daily. The nurse reinforces teaching for the client about the medication. Which statement made by the client indicates a need for further teaching?
"I can take aspirin or my antihistamine if I need it."
The nurse realizes that the client taking metformin (Glucophage) needs further teaching when the client makes which statement?
"I should treat hypoglycemic episodes due to metformin with glucose tablets only."
The nurse reinforces instructions to a client with myxedema about the dosage, method of administration, and side effects of levothyroxine sodium (Synthroid). Which statement by the client indicates an understanding of the nurse's instructions?
"I will report any episodes of palpitations, chest pain, or dyspnea."
Which instruction should the nurse reinforce to the client with diabetes mellitus receiving acarbose (Precose)? Select all that apply
"Take the medication with each meal." "Side effects include abdominal bloating and flatus." "Take some form of glucose if hypoglycemia occurs." "Report symptoms such as shortness of breath or tiredness."
An adult client with hypothyroidism is admitted to the hospital. When reviewing the client's health record, the nurse notes that the client is taking a maintenance dose of levothyroxine (Synthroid). Which is the range of the normal adult maintenance dose of this medication?
0.1 to 0.2 mg daily
The nurse is monitoring a clients receiving levothyroxine sodium (Synthroid) for hypothyroidism. Which findings indicate the presence of side effects associated with this medication? Select all that apply.p 1.insomnia 2.weight loss 3.bradycardia 4.constipation 5.mild heat intolerance
1, 2, 5
The nurse provide medication instructions to a client who is taking levothyroxine (Synthroid) and should tell the client to notify the HCP if which problem occurs? 1.fatigue 2.tremors 3.cold intolerance 4.excessively dry skin
2. Excessive doses of levothyroxine can produce signs and symptoms of hyperthyroidism. These include tachycardia, chest pain, tremors, nervousness, insomnia, hyperthermia, extreme heat intolerance, and sweating.
Admission assessment on a client who visit the healthcare clinic for the first time. The client tells the nurse that propylthiouracil (PTU) is taken daily. The nurse continues to collect data on the client suspecting that the client has a history of which condition? 1.myxedema 2.Graves' disease 3.Addison's disease 4.Cushing syndrome
2. Propylthiouracil inhibit thyroid hormone synthesis and is used to treat hyperthyroidism, or Graves' disease. Myxedema indicate hypothyroidism. Addison's disease and Cushing's syndrome are disorders related to adrenal function.
A daily dose of prednisone is prescribed for a client. The nurse provides instructions to the client regarding administration of the medication and should instruct the client that which time is best to take this medication? 1.at noon 2.at bed time 3.early morning 4.anytime, at the same time, each day
3. Corticosteroid (glucocorticoids) should be administered before 9 AM. Administration at this time helps minimize adrenal insufficiency and mimics the burst of glucocorticoids released naturally by the adrenal glands each morning.
Prednisone is prescribed for a client with DM who is taking Humulin NPH insulin daily. Which prescription change does the nurse anticipate during therapy with the prednisone? 1.an additional dose of prednisone daily 2.a decreased amount of daily humulin NPH insulin 3.an increased amount of daily humulin NPH insulin 4.the addition of an oral hypoglycemic medication
3. Glucocorticoids can elevate blood glucose levels. Clients with DM need their dosages of insulin or oral hypoglycemic medications increased during glucocorticoid therapy.
The nurse provides instructions to a client who is taking levothyroxine (Synthroid). The nurse should tell the client to take the medication at which time? 1.with food 2.at lunchtime 3.on an empty stomach 4.at bedtime with snack
3. This medication should be taken on an empty stomach to enhance absorption. Dosing should be done in the morning before breakfast.
1) A nurse is monitoring a client receiving glipizide (Glucotrol). Which outcome indicates an ineffective response from the medication? 1. A decrease in polyuria 2. A decrease in polyphagia 3. A fasting plasma glucose of 100 mg/dL 4. A glycosylated hemoglobin level of 12%
Ans. 4 rationale Glipizide (Glucotrol) is an oral hypoglycemic agent administered to decrease the serum glucose level and the signs and symptoms of hyperglycemia. Therefore, a decrease in both polyuria and polyphagia would indicate a therapeutic response. Laboratory values are also used to monitor a client's response to treatment. A fasting blood glucose level of 100 mg/dL is within normal limits. However, glycosylated hemoglobin of 12% indicates poor glycemic control.
A client informs the nurse that she has been taking acarbose (Precose) as prescribed. The nurse determines that a therapeutic effect of the medication has occurred if which laboratory value is noted?
A 2-hour postprandial serum glucose of 120 mg/dL
A client has been prescribed acarbose (Precose) for treatment of diabetes mellitus. Client teaching regarding this medication should include which instructions? Select all that apply.
Abdominal cramping is common. Side effects include excessive flatulence. The medication should be taken with each meal.
When discussing the rationale for levothyroxine (Synthroid) with a client with hypothyroidism, the nurse should emphasize that the client can anticipate which primary expected outcome?
Achieving normal thyroid hormone levels
Prednisone is prescribed for a client with diabetes mellitus who is taking Humulin neutral protamine Hagedorn (NPH) insulin daily. Which prescription change does the nurse anticipate during therapy with the prednisone?
An increased amount of daily Humulin NPH insulin
Prednisone is prescribed for a client with diabetes mellitus who is taking NPH insulin daily. Which prescription should the nurse anticipate during therapy with the prednisone?
An increased amount of daily NPH insulin
A patient with type 2 diabetes is scheduled for an outpatient coronary arteriogram. Which information obtained by the nurse when admitting the patient indicates a need for a change in the patient's regimen? a. The patient's most recent hemoglobin A1C was 6%. b. The patient takes metformin (Glucophage) every morning. c. The patient uses captopril (Capoten) for hypertension. d. The patient's admission blood glucose is 128 mg/dl.
B Rationale: To avoid lactic acidosis, metformin should not be used for 48 hours after IV contrast media are administered. The other patient data indicate that the patient is managing the diabetes appropriately.
A patient has diabetes insipidus (DI). The LPN/LVN should plan to provide information on which medication? A. Insulin B. Cortisone C. Vasopressin D. Fludrocortisone acetate
C. Vasopressin
A client is admitted with chest pain related to atrial fibrillation. Based on her blood glucose reading, metformin (Glucophage) is prescribed for the client. As the nurse reviews the client's chart and prescriptions, which finding would require the nurse to verify the metformin prescription? Refer to chart.
Creatinine result
A client is diagnosed with hypothyroidism, and levothyroxine (Synthroid) is prescribed. The nurse notes that the client is presently taking warfarin sodium (Coumadin) and anticipates that the health care provider will alter which medication dosage?
Decrease the dosage of warfarin sodium.
The nurse is collecting data from a client seen in the health care clinic for the first time. When the nurse asks the client about current prescribed medications, the client tells the nurse that metformin (Glucophage) is taken daily. Based on this finding, the nurse elicits data from the client regarding the presence of which condition?
Diabetes Mellitus
A daily dose of prednisone is prescribed for a client. The nurse reinforces instructions to the client regarding administration of the medication and instructs the client to take this medication at which time?
Early morning
Levothyroxine sodium (Synthroid) is prescribed for a client with hypothyroidism. When should the nurse encourage the client to take the medication?
In the morning
The nurse reinforces instructions to a client who is taking levothyroxine (Synthroid). Which instruction should the nurse give the client?
Take the medication on an empty stomach.
The nurse reinforces medication instructions to a client who is taking levothyroxine (Synthroid). The nurse instructs the client to notify the health care provider (HCP) if which sign/symptom occurs?
Tremors
Which of the following diabetes drugs acts by decreasing the amount of glucose produced by the liver? a. Sulfonylureas b. Meglitinides c. Biguanides d. Alpha-glucosidase inhibitors
c. Biguanides Biguanides, such as metformin, lower blood glucose by reducing the amount of glucose produced by the liver. Sulfonylureas and Meglitinides stimulate the beta cells of the pancreas to produce more insulin. Alpha-glucosidase inhibitors block the breakdown of starches and some sugars, which helps to reduce blood glucose levels
The community health nurse visits the client at home. Prednisone, 10 mg orally daily, has been prescribed for the client and the nurse teaches the client about the medication. Which statement, if made by the client , indicates that further teaching is necessary? 1.I can take aspirin or my antihistamine if I need it. 2.I need to take the medication every day at the same time. 3.I need to avoid coffee, tea, cola, and chocolate in my diet. 4.if I gain more than 5 pounds a week I will call my HCP.
1. Aspirin and other OTC medications should not be taking unless the client consult with the HCP.
A client with DM visit the healthcare clinic. The clients DM previously had been well controlled with glyburide (DiaBeta) daily, but recently the fasting blood glucose level has been 180 to 200 mg/dL. Which medication, if added to the clients regimen, may have contributed to the hyperglycemia? 1.prednisone 2.phenelzine (Nardil) 3.atenolol (Tenormin) 4.allopurinol (Zyloprim)
1. Prednisone may decrease the effects of oral hypoglycemics, insulin, diuretics, and potassium supplements.
A client with diabetes mellitus visits a health care clinic. The client's diabetes mellitus previously had been well controlled with glyburide (DiaBeta) daily, but recently the fasting blood glucose level has been 180 to 200 mg/dL. Which medication, added to the client's regimen, may have contributed to the hyperglycemia?
Prednisone
A client diagnosed with hypothyroidism is taking levothyroxine (Synthroid). The client returns to the clinic 1 week after beginning the medication and tells the nurse that the medication has not helped. The appropriate nursing response to the client is based on which information?
Full therapeutic effect may take 1 to 3 weeks.
Metformin (Glucophage) is prescribed for a client with type 2 diabetes mellitus. Which should the nurse tell the client is a common side effect of the medication?
Gastrointestinal (GI) disturbances
The nurse preparing a client for surgery reviews the client's medication record. The client is to receive nothing by mouth (NPO) after midnight. Which medication noted on the client's record should the nurse question?
Prednisone
A client diagnosed with hyperthyroidism will be taking propylthiouracil (PTU). The nurse reinforces medication instructions and determines that the client understands the information if the client states that it is most important to report which symptoms to the health care provider?
Sore throat
The home healthcare nurse is visiting a client who was recently diagnosed with type 2 DM. The client is prescribed repaglinide (Prandin) and metformin (Glucophage) and asks the nurse to explain these medications. the nurse should provide which instructions to the client? Select all that apply. 1.diarrhea may occur secondary to the metformin. 2.the repaglinide is not taken if the meal is skipped. 3.the repaglinide is taken 30 minutes before eating. 4.A simple sugar food item is carried and used to treat mild hypoglycemia episodes. 5.metformin increases hepatic glucose production to prevent hypoglycemia associated with repaglinide. 6.muscle pain is an expected effect of metformin and maybe treated with acetaminophen (Tylenol).
1, 2, 3, 4 repaglinide, a rapid acting oral hypoglycemic agent that stimulates pancreatic insulin secretion, should be taken before meals (approximately 30 minutes before meals) and should be withheld if the client does not eat. Hypoglycemia is a side effect of repaglinide and the client should always be prepared by carrying a simple sugar with her or him at all times. Metformin is an oral hypoglycemic given in combination with repaglinide and works by decreasing hepatic glucose production. A common side effect of metformin is diarrhea. Muscle pain may occur as an adverse effect from metformin, but it might signify a more serious condition that warrants healthcare provider notification, not the use of acetaminophen.
A patient with type 2 diabetes that is controlled with diet and metformin (Glucophage) also has severe rheumatoid arthritis (RA). During an acute exacerbation of the patient's arthritis, the health care provider prescribes prednisone (Deltasone) to control inflammation. The nurse will anticipate that the patient may a. require administration of insulin while taking prednisone. b. develop acute hypoglycemia during the RA exacerbation. c. have rashes caused by metformin-prednisone interactions. d. need a diet higher in calories while receiving prednisone.
A Rationale: Glucose levels increase when patients are taking CORTICOsteroids, and insulin may be required to control blood glucose. Hypoglycemia is not a complication of RA exacerbation or prednisone use. Rashes are not an adverse effect caused by taking metformin and prednisone simultaneously. The patient is likely to have an increased appetite when taking prednisone, but it will be important to avoid weight gain for the patient with RA.
