Pharmacology Exam 2

A patient is admitted to the emergency room after a car accident. Based on the experience of the emergency room nurse, what system will affect a response to the emergency?

ANS

Which of the following is the substance responsible for transmission of nerve impulses across the parasympathetic nervous system?

ACh

Diabetic retinopathy is a disorder diabetics develop as a result of a thickening of the basement membrane. What is this caused by?

Inability of oxygen to diffuse across vessel membrane to tissues in the eye

A patient receives a dose of insulin lispro at 8 AM. The nurse would be alert for signs and symptoms of hypoglycemia at which time?

between 830 and 930 am

The nurse is aware that premixed insulins (those that contain both regular and NPH insulin) are least effective in what type of client?

client who has difficulty controlling diabetes

The nurse is assessing a patient with glaucoma. What therapeutic effect will the healthcare provider expect from the cholinergic agonist administered?

decreased intraocular pressure

As the nurse caring for a young child is diagnosed with type 1 diabetes (IDDM), you know that they become at high risk for what and you include assessment and management of this in their care plan?

delayed growth and development

When preparing to administer an insulin injection, the nurse would use which sized needle

25 gauge, 1/2 in

A patient is diagnosed with Alzheimer's disease. Which of the following medications are administered for the treatment of Alzheimer's disease?

Donepezil (Aricept)

A patient is diagnosed with type 1 diabetes. What distinguishing characteristic is associated with type 1 diabetes?

Exogenous insulin is required for life

After teaching a class about the various drugs used to control blood glucose, the instructor determines that the teaching was successful when the class identifies which of the following as a biguanide

metformin

A nurse is caring for a patient with diabetes mellitus who is receiving an oral antidiabetic drug. Which of following ongoing assessments should the nurse perform when caring for this patient?

observe for hypoglycemic episodes

A patient has received his evening meal and is recovering from surgery. What nervous system is stimulated?

parasympathetic nervous system

Your client is diagnosed with type 1 diabetes. She suddenly complains of feeling weak, shaky, and dizzy. Your first response is to:

perform a blood sugar analysis

A 58-year-old patient who has been diabetic since age 14 states he has pain in his feet and hands. What is this pain a result of?

peripheral neuropathy

After making an initial assessment of your patients you review their medications. What medication order should you question for a diabetic patient who takes insulin to control their diabetes?

propranolol 10 mg po tid

A nurse is providing patient education to a 13-year-old girl who was just diagnosed with type 1 diabetes mellitus. Which of the following statements by the patient will alert the nurse that special instructions regarding insulin are necessary?

"I am on the middle school track team."

You have provided patient teaching for a patient who has a new order for nadolol (Corgard) to treat their hypertension. What statement by the patient concerning nadolol (Corgard) would indicate that your teaching has been effective?

"I should never stop taking this drug abruptly, but will taper the doses gradually."

The nurse is discussing diabetes with a group of individuals who are at risk for the disease. Which statement by a participant indicates an understanding of the role of insulin in the disease?

"Insulin assists glucose molecules to enter the cells of muscle and fat tissues."

A 50-year-old female patient received atropine and meperidine (Demerol) preoperatively. After surgery, the patient complains of mouth dryness. What would the best response be to the patient?

"This is caused by your preoperative medication, which decreased your saliva. It is only temporary and will improve."

The anatomy and physiology instructor is discussing adrenergic receptors with the nursing class. What adrenergic receptor would the instructor tell the students is found in the heart and can stimulate increased myocardial activity and increase heart rate?

Beta1

Which assessment finding in a patient receiving cholinergic agonists warrants immediate action by the nurse?

Blood pressure decreased from 110/90 mm Hg to 80/50 mm Hg

Which of the following would be appropriate to include in teaching your client with type 2 diabetes?

It is possible with weight loss and exercise to discontinue the use of antidiabetic medication.

Jack Thomas is a 45-year-old automobile mechanic with a history of throat cancer. Jack has just undergone radical neck resection. As a result of the surgery, Jack suffers from xerostomia, a dry mouth condition. He is prescribed pilocarpine therapy. What advice should you give Jack regarding the drug therapy?

Jack should be cautioned about blurred vision and its hazards.

Your client is admitted to the intensive care unit with diabetic ketoacidosis. You know that your client will be placed on an intravenous insulin drip. The only type of insulin which can be administered intravenously is

Regular

A graduate of a nursing program is scheduled to take the NCLEX today. He wakes up and is noticing his heart is racing and his pupils are dilated. What can he attribute to this reaction?

SNS

A patient taking anticholinergic drugs should be taught to minimize the risks of heat exhaustion and heat stroke. What would be one way to meet this goal?

avoid extremes of temperature

A nurse is assigned to administer glargine to a patient at a health care facility. What precaution should the nurse take when administering glargine?

avoid mixing with other insulin

A 78-year-old female patient who is about to begin home care has been prescribed anticholinergic drugs. Which of the following should the home care nurse explain to the patient and her family

The effects of anticholinergic drugs include decreased gastrointestinal motility, decreased sweat production, and blurred vision. These effects put the older adult at increased risk of constipation, heat stroke, and falls. The risk of constipation can be reduced by increasing fiber and fluids in the diet. The risk of falls can be reduced by assisting the patient during ambulation.

Glycosylated hemoglobin levels provide reliable evidence of blood glucose control, T/F

True

You are caring for a client taking insulin. You realize the client is experiencing symptoms of hypoglycemia when he displays what symptoms

Weakness, sweating, decreased mentation

A patient has recently been prescribed a drug that treats his hypertension by blocking the sympathetic receptors in his sympathetic nervous system. This action is characteristic of

adrenergic antagonist

Prior to the administration of a sympatholytic drug, the nurse should check a patient's blood pressure and which of the following

apical pulse

A priority nursing assessment for a patient who is to receive an alpha- or beta-adrenergic antagonist would be to

assess HR

A 78-year-old man is admitted to the emergency department (ED) with bradycardia resulting from overdose of donepezil, a cholinergic drug prescribed for treatment of Alzheimer's disease. The nurse knows that the ED physician is likely to order

atropine

A patient is brought to the Emergency Department (ED) and is found to have cholinergic toxicity. What is the drug of choice to treat this condition?

atropine

A 72-year-old female patient is being discharged home from the hospital on newly prescribed anticholinergic drugs. A referral to the home health nurse has been made. What should the home health nurse make sure the patient and caregivers know?

do not drive or use machinery

A patient is brought to the Emergency Department (ED) with severe hypoglycemia. What drug would the nurse prepare to administer intravenously?

glucagon

During ongoing assessment of clients receiving insulin detemir (Levemir), the nurse assesses the client for symptoms of hypoglycemia that include which of the following

headache, confusion, diaphoresis

Rapid acting insulin?

humalog (lispro)

Adrenergic drugs produce which of the following effects

increased HR

The nurse admits a client who has been diagnosed with diabetic ketoacidosis, and will look for what assessment findings consistent with this diagnosis?

ketones in urine, flushed dry skin

A patient receives 25 units of NPH insulin at 7.AM. At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction?

late afternoon

another name for adrenergic drugs

sympathomimetic

The nurse is writing a plan of care for a patient receiving an adrenergic agonist. What should this plan of care include

take bp every 2-4 hours

Anticholinergics block acetylcholine at the muscarinic receptors. T/F

true

The nurse is providing discharge instructions to a client who has just been diagnosed with type 1 diabetes. What instructions are most important for the client to follow related to diet?

• Avoid drinking beer, wine, or liquor. • Use artificial sweeteners instead of sugar in tea and coffee. • Read food labels carefully to look for hidden sources of sugar.