Pharmacology Exam 3

A postoperative appendectomy patient has a nasogastric tube and wonders why the previous nurse told him that he was receiving an IV "ulcer-preventing" medication called ranitidine. The patient states that he has never had any stomach problems in his life. Which is the best response by the nurse?

"Because you are not eating after surgery, this medication will help reduce the hydrochloric acid your stomach is still secreting."

The nurse is instructing a patient recently diagnosed with GERD. Which statement by the patient indicates a need for further teaching?

"I will eat small frequent meals and have a snack at bedtime."

A friend reports using loperamide (Imodium) for continual diarrhea for a week since returning home from a vacation outside the country. Which is the nurse's best response?

"I'd stop taking the Imodium and go in to see a healthcare provider immediately. You may have an infection in your intestinal tract."

Which is a common adverse effect of magnesium-based antacid preparations?

Diarrhea

What occurs with mania associated with bipolar disorder?

Distinct episodes of elation

The outcome statement for a patient suffering from anxiety disorder reads, "After 1 week on alprazolam (Xanax) therapy, patient will exhibit a manageable level of anxiety." Which assessment finding validates that this outcome is met?

Patient reports sleeping better and increased interest in activities.

The nurse is performing a premedication assessment. For which patient would laxative use be contraindicated?

Patient with appendicitis

What is the purpose for the nurse administering metoclopramide (Reglan) IV postoperatively?

Prevent postoperative nausea and vomiting.

What will the nurse caution a patient about when providing information about the prescribing sedatives?

Risk of injury when using machinery

Why are beta blockers used cautiously in patients with respiratory conditions?

They may produce severe bronchoconstriction.

Which patient assessment would indicate to the nurse that salicylate/aspirin toxicity is occurring?

Tinnitus

Which medication is used to control seizures or prevent migraine headaches?

Topiramate (Topamax)

Which cholinergic symptoms of Parkinson's disease are reduced with anticholinergic drugs?

Tremors and drooling

For which condition may carbamazepine (Tegretol) be used?

Trigeminal neuralgia pain

The nurse is providing discharge teaching to a patient prescribed phenytoin (Dilantin) for management of a seizure disorder. Which patient statement indicates a need for further teaching?

"If I develop enlarged gums, I will stop taking the medication."

In addition to facilitating sleep, what is another benefit of sedatives?

Decreased patient anxiety

The nurse finds that a patient is extremely agitated, yells frequently, and is attempting to get out of bed without assistance. What is the nurse's initial action?

Administer zolpidem after taking the patient's vital signs.

Dystonic reactions, pseudoparkinsonism, akathisia, and tardive dyskinesia are types of which effect?

Extrapyramidal symptoms

The nurse is completing an assessment on a nonverbal adult patient. Which type of pain scale assessment tool is the most accurate to use?

FLACC

Which herb has been used in many cultures to provide relief of nausea associated with pregnancy?

Ginger

A patient who is taking NSAIDs to treat arthritis asks the nurse why misoprostol has also been prescribed. Which explanation by the nurse is accurate?

NSAIDs often cause GI irritation that can result in peptic ulcers.

Which adverse effects associated with levodopa therapy would support the nursing diagnosis risk for injury?

Orthostatic hypotension

When the nurse assesses bowel habits in a patient, which is the best example of normal bowel elimination?

Regular bowel elimination pattern of soft stool

When a patient taking a monoamine oxidase B inhibitor receives his dietary tray, the nurse knows to remove the:

cheese

A patient hospitalized in an acute care setting reports to the nurse that since starting on an adrenergic medication, he has been feeling "dizzy and weak." The most appropriate action for the nurse is to:

monitor the blood pressure in both the supine and standing positions.

A long-term care resident is taking an anticholinergic agent. The nurse observes the resident to be disoriented and hallucinating. The priority nursing action is to:

provide for resident's safety.

The nurse transcribes an order for lorazepam for a patient experiencing nausea and vomiting as a result of alcohol withdrawal. The most appropriate route of administration for lorazepam with this patient would be:

via an IV

The nurse is preparing to administer medications and notes that a patient has sucralfate ordered qid. When is the best time to administer this medication?

1 hour before meals

A patient with Parkinson's disease asks the nurse why anticholinergics are used in the treatment. Which response by the nurse is most accurate?

"These drugs inhibit the action of acetylcholine."

An 86-year-old patient who was admitted with GI bleeding as a result of salicylate therapy is being discharged. As the nurse reviews the discharge medication list, the patient states that she doesn't understand why Tylenol doesn't work as well as the aspirin she had been taking. What would be the nurse's best response?

"Tylenol does not help with inflammatory discomfort."

What instruction is most important for the nurse to teach the patient who has recently been prescribed alprazolam (Xanax)?

"You may feel dizzy or unsteady when rising to a standing position."

Which action will the nurse take when a patient receiving morphine sulfate via percutaneous coronary angioplasty (PCA) has a shallow, irregular respiratory rate of 6 breaths/min?

Notify the healthcare provider and prepare to administer naloxone (Narcan)

Lithium (Eskalith) is the drug of choice for which of the following disorders?

Bipolar disorders

Prior to the administration of metoprolol, a beta-adrenergic blocking agent, which is most important for the nurse to assess?

Blood pressure

Which is the laxative of choice for an older patient who is in the end stage of Alzheimer's disease and requires a daily laxative?

Bulk forming

Explain nonpharmacologic and pharmacologic management of GERD?

Nonpharmacologic management methods for GERD include avoiding acidic foods, excessive alcohol, and eating too quickly. Waiting about 2 hours before lying down after a meal also helps. Pharmacologic methods include antacids, H2 antagonists, and PPIs.

In your own words describe how cholinergic and anticholinergic drug work and what are side effects of each?

Cholinergic drugs mimic the effect of acetylcholine. They are parasympathetic drugs, so they promote the activities of the parasympathetic system such as increasing GI and urinary motility, decreasing heart rate, and miosis of the pupil. May cause diarrhea or hypotension. Anticholinergic drugs do the opposite because they block the effects of acetylcholine and increase heart rate and BP and may lead to constipation.

Explain nonpharmacologic and pharmacologic management of constipation?

Nonpharmacologic management methods for constipation: increasing fiber intake by eating high bulk foods such as fresh fruits and vegetables and whole grains. Increasing fluid intake and being active/mobile helps as well. Pharmacologic management of constipation includes taking laxatives and stool softeners.

Which condition is associated with hydantoin therapy?

Gingival hyperplasia

Before the initiation of anticholinergic medications, it is important for the nurse to screen patients for which condition?

Glaucoma

Which organism or disorder is responsible for many cases of PUD?

H. pylori

The nurse is assessing a patient who is complaining of hearing voices. What is this patient experiencing?

Hallucinations

The nurse is explaining the use of medications to a patient with insomnia. Which statement about sedatives is true?

Increased relaxation occurs with sedatives.