Pharmacology Quiz 4

A client newly diagnosed with type 2 diabetes has attended educational sessions to provide insight into the diagnosis. Which of the client's statements should prompt the nurse to provide further teaching?

"I'm disappointed, but I take some solace in the fact that I won't ever have to have insulin injections."

During a teaching session on the care of the client with diabetes, the nurse should make which statement to explain the differences in insulin?

"Insulins have different onsets and durations of action."

A client asks the nurse why two diuretics have been prescribed when a friend takes only a single combination medication. The client takes hydrochlorothiazide 75 mg every day with a potassium-sparing diuretic. What is the nurse's best response?

"It could be that you need a larger dose than is available in the combination medications."

A client is receiving low-molecular-weight heparin to prevent thromboembolic complications. The nursing student asks the instructor the reason why this treatment is given instead of heparin. What is the instructor's best explanation of the rationale for LMWH over heparin?

"LMWH is associated with less thrombocytopenia than standard heparin."

A client is being administered heparin IV and has been started on warfarin. The client asks the nurse why both medications have been prescribed. What is the nurse's most accurate response?

"Warfarin takes 3 to 5 days to develop anticoagulant effects, and you still need heparin."

A client asks the nurse, "Why is my prescription being switched from furosemide to spironolactone?" What is the nurse's best response?

"You will lose less potassium with spironolactone than with furosemide."

The goal of therapy for a client taking antihypertensive medication is to maintain: - Homeostasis - Fluid volume balance - Blood pressure within normal limits - Compliance

- Blood pressure within normal limits

A client with asthma is preparing to go home after being hospitalized with an acute asthma attack with a new prescription for fluticasone/salmeterol inhalant. Which point(s) should the nurse prioritize in the discharge teaching? Select all that apply.

- Check peak flow daily - Continue to carry a rescue inhaler - Rinse mouth after each use

Which statement demonstrates effective knowledge regarding the body's process of gas exchange? Select all that apply.

- Involves the exchange of carbon dioxide and oxygen - The gases are diffused into the capillary blood system - The gases diffuse through the respiratory membrane - It occurs at the alveolar level

The nurse is providing education to a client who has been prescribed monoamine oxidase inhibitor (MAOI) therapy following unsuccessful treatment with other agents. What foods should the nurse instruct the client to avoid? Select all that apply.

- aged cheeses - milk - chocolate - coffee

A nursing student reviews information about a drug and its action before preparing and administering the drug to a client. Which resources are the best choice for this student to consult? Select all that apply.

- clinical drug reference -clinical pharmacist

A nurse is preparing to administer medications. What information does the nurse need regarding the prescription? Select all that apply

- form -name -dosage

A nurse is assessing a client who comes to the emergency department with acute respiratory distress. The nurse suspects that the client is experiencing an asthma attack based on which of the following?

- generalized chest pain - cough with or without mucus

The nurse is assessing a client with a suspected diagnosis of acute benzodiazepine withdrawal. What assessment findings would support that diagnosis? Select all that apply.

- palpitations - agitation

Aerosols are often the drugs of choice to treat asthma because of what characteristics? Select all that apply

- they produce fewer adverse effects than oral or parenteral drugs. - they relieve symptoms quickly. - they act directly on the airways - they can usually be given in smaller doses

What must occur prior to initiating an effective therapeutic regimen? (Select all that apply.)

-Client complies with other tasks of daily living. -Client verbalizes desire to manage the medication regimen. -Nurse's assessment of the client's ability to understand medication regimen. -Assessment of client's educational level.

A nurse is preparing to administer ondansetron to a client with vomiting. A nurse should be aware of what drug-related information before administering ondansetron? Select all that apply.

-Constipation is a common adverse effect of the medication. -No dosage adjustment is necessary for older adult clients. -The medication may decrease mental alertness. -For pediatric clients, ondansetron can be used safely.

A nurse is preparing to administer hydroxyzine. Which important considerations are necessary for the nurse to know prior to administering hydroxyzine? Select all that apply.

-Dosages for pediatric clients are based on age and weight. -Cautious use with older adult clients due to sedative effects. -Use with caution with clients with reduced renal and liver function. -Can be given in a variety of forms: parenterally, orally, or rectally.

A nursing professor teaching junior level students conducts a lecture regarding allergic contact dermatitis. which of the following statements made by the students verifies the lecture was effective? Select all that apply. -It usually occurs immediately after exposure to an antigen -Poison ivy is an example -Skin lesions are usually blistered -It is a type IV hypersensitivity from direct contact with antigens

-Poison ivy is an example -Skin lesions are usually blistered -It is a type IV hypersensitivity from direct contact with antigens

The health care provider has ordered intravenous pain medication for a client. Why are medications given intravenously? Select all that apply.

-There is less irritation to the tissues. -A smaller dose of the medication is needed to cause the desired effect. -It is effective when the client has impaired circulation.

What statement should the nurse rely upon to describe to a client the general characteristic associated with antidepressant therapy? Select all that apply.

-These drugs are metabolized by the body's cytochrome P450 enzymes. -It may take 10 days to 2 weeks before depressive symptoms improve. -While all of these drugs are effective in relieving depression, the drugs differ in adverse effects

The nurse knows that the lunch trays are usually distributed at approximately 12:15. The nurse should plan to administer the client's prescribed 4 units of regular insulin at what time?

11:45

A client with a fever was administered 650 mg acetaminophen orally at 0800. The nurse is aware that the half-life of acetaminophen is 2 hours. How much acetaminophen will be bioavailable at 1200? Record your answer as a whole number.

163 mg

A 9-year-old child with a traumatic family history has been diagnosed with depression and prescribed trazodone 1.5 mg/kg PO daily in three divided doses. The child weighs 88 lbs. How many 40-mg tablets should the nurse administer for each dose?

2 tablets

The healthcare provider orders acetaminophen 10 mg/kg q4 hours PRN (as needed) for an infant's pain. The drug is supplied with 160 mg/5 mL. The infant weighs 8 kg. How many milliliters of medication should the nurse administer? Round final answer to the nearest tenth of a milliliter.

2.5 mL

When administering an intradermal injection, a 1-mL syringe with what gauge needle should be used?

27 gauge

When a drug is given at a stable dose, how many half-life periods are required to achieve steady-state concentrations and develop equilibrium between tissue and serum concentrations?

4 to 5

A client has edema of the lower extremities and abdomen. What is the reason to administer a stronger diuretic than a thiazide diuretic to this client?

A thiazide diuretic will be ineffective when immediate diuresis is needed.

A client in her first trimester of pregnancy is anxious and has requested a benzodiazepine. The nurse states that this is not normally prescribed to pregnant clients due to the risks of what anomalies? Select all that apply.

A) Inguinal hernia C) Microcephaly D) Cleft lip or palate E) Cardiac defects

Which statement is true regarding antiemetic medications? Oral antiemetics are most preferred for therapeutic use. All antiemetics have the same mechanism of action. They are most effective as prophylaxis treatment. Pregnant women can take all antiemetics.

All antiemetics have the same mechanism of action.

An older adult client has been prescribed metformin for the treatment of type 2 diabetes for several years. Which change in the client's laboratory values may demonstrate a need to discontinue the medication?

An increase in serum lactate

A nurse monitoring a client taking lorazepam (Ativan) should be aware of which of the following as they are symptoms of benzodiazepine withdrawal? Select all that apply:

Anxiety Tremors Insomnia

A nurse monitoring a client taking lorazepam (Ativan) should be aware of which of the following as they are symptoms of benzodiazepine withdrawal? Select all that apply:

Anxiety • Tremor • Photophobia • Metallic taste

When considering controlled substances, what actions are considered nursing responsibilities? (Select all that apply.)

Assuring that the controlled substances in safely stored in locked containers Keeping accurate recordings of the administration of prescribed controlled substances Assuring that the inventory of narcotics is accurate and sufficient for patient needs

A hospital client diagnosed with type 1 diabetes is prescribed regular insulin on a sliding scale. Based on the client's blood glucose reading, the nurse administered 8 units of insulin at 07:45. The nurse should consequently check the client's blood glucose level at what time to monitor peak effectiveness of the medication?

Between 09:45 and 10:45

A client taking warfarin after open heart surgery reports pain in both knees that began this week. The nurse notes bruises on both knees. Based on the effects of the medications and the report of pain, what should the nurse suspect is the cause of the pain?

Bleeding

The nurse knows that beta receptors are found in which areas of the body? (Select all that apply.)

Cardiac tissue Bronchi GI tract

An adult client with no known history of cardiovascular disease presents with atrial flutter. The client is prescribed propafenone PO 150 mg every 8 hours for 24 hours. What is the cardiac care nurse's priority assessment during this period? Continuous ECG monitoring Blood pressure monitoring every 10 minutes Monitoring of potassium levels every 1 hour Echocardiography

Continuous ECG monitoring

Which of the following are consequences of repeated exposure of dopamine receptors to dopamine? Select all that apply.

Decreased number of receptors Decreased sensitivity to dopamine

A 58-year-old man is admitted to the emergency department. A diagnosis of severe digoxin toxicity is made. Bradycardia is present, and an electrocardiogram (ECG) confirms toxicity. The nurse will administer which drug? Captopril Dopamine Furosamide Digoxin Immune Fab

Digoxin Immune Fab

An 8-month-old infant admitted with a new diagnosis of diabetes is to receive 1 unit of regular insulin. How will that 1 unit be administered?

Dilution strength of U-10

The nurse is visiting the home of a client who is prescribed antidysrhythmic medication. The nurse will teach the client to report which possible adverse effect? Decreased energy Improved functional status Dizziness Improved mentation

Dizziness

The nurse is providing education to a client who has been prescribed captopril. What common adverse effect would the nurse mention in the teaching? Dry cough Photosensitivity Rhinitis Rash to truck and extremities

Dry cough

An older adult client who resides in a care facility has been prescribed antihypertensives for the first time following many years of generally good health. When administering the first dose of the prescribed antihypertensive medication to an older adult, the nurse should recognize the related risk to which possible side effect? Infection Falls Impaired oxygenation Acute confusion

Falls

Adverse effects of inhaled corticosteroids include which of the following? Select all that apply.

Fungal Infection Pharyngeal irritation

Adverse effects of inhaled corticosteroids include which of the following? Select all that apply:

Fungal infection Pharyngeal irritation

A female client comes to the clinic with reports of burning pain in the stomach. She states that she thinks she had a virus 48 hours ago and she vomited many times. She hasn't vomited in 24 hours. She asks the health care provider to give her a prescription for omeprazole because she saw an ad on TV that said it would heal stomach pain. The nurse assists the client in understanding that PPIs are considered drugs of choice for treatment of what conditions? (Select all that apply.)

Gastric ulcers Zollinger-Ellison syndrome

Which are advantages of over-the-counter (OTC) medications? Select all that apply.

Greater autonomy to choose a medication Convenience to access the medications

The nurse is providing education regarding lifestyle changes to a client diagnosed with hypertension. When providing dietary instruction on a low-sodium diet, which dietary choice would the nurse identify as most appropriate?

Grilled chicken, green salad, and apple

A client presents to the emergency department with his 4 year old child. The child self-administered diphenhydramine of an unknown quantity. In overdosage of diphenhydramine, the nurse is aware that the child may experience what problems? (Select all that apply.) -Hallucinations -Hypotension -Convulsions -Headache -Dizziness

Hallucinations Convulsions

A client has developed clots and has bruising. It is determined that there is a depletion of the client's coagulation factors and widespread bleeding. Which medication will be administered?

Heparin

A client is receiving IV heparin every 6 hours. An activated partial thromboplastin time (aPTT) is drawn 1 hour before the 08:00 am dose. The PTT is 92 seconds. What is the most appropriate action by the nurse?

Hold the dose and the call the aPTT result to the health care provider's attention.

Naloxone is administered via which of the following? Select all that apply:

IM injection IV push Intrathecal injection SubQ

A client who regularly takes metformin has developed a severe infection. How will the infection change the established diabetic regimen?

Metformin is contraindicated in the presence of an infection.

The nurse is administering intravenous amiodarone to a patient in the emergency department. Which task would the nurse need to prioritize? Explaining the treatment to the family Monitoring blood pressure Giving the patient something to drink Checking urine output

Monitoring blood pressure

Hypersensitivity reactions are grouped into four types according to the mechanisms by which they are produced. Type I hypersensitivity reaction for allergic rhinitis follows a specific pattern. Which step is the last to occur in this cascade of events?

Nasal mucosa produces characteristic symptoms of allergic rhinitis

A nursing student is learning to apply the nursing process in the care of the clients. This student is prepared to become more proficient in this process by utilizing which steps? Select all that apply.

Observe the actions of the mentor Teach the concepts to new students Practice the concepts with each client Gain proficiency by continuing to use the process Update nursing skills at each opportunity

A client is taking warfarin to prevent clot formation related to atrial fibrillation. How are the effects of the warfarin monitored?

PT and INR

Medications are derived from which of the following sources? Select all that apply

Plants Laboratories Mold Minerals Animals

A 60-year-old man has scheduled a follow-up appointment with his primary care provider stating that the omeprazole (Prilosec) which he was recently prescribed is ineffective. The client states, "I take it as soon as I feel heartburn coming on, but it doesn't seem to help at all." How should the nurse best respond to this client's statement?

Prilosec will help your heartburn but it's not designed to provide immediate relief of specific episodes of heartburn

A patient, admitted to a health care facility with cardiac arrhythmia, is prescribed propranolol. Which factor should the nurse closely monitor as a part of the ongoing assessment during the therapy? Visual acuity Pulse rate Tendon reflexes Hydration

Pulse rate

When assessing a client, what finding would the nurse interpret as indicating stimulation of the parasympathetic nervous system? (Select all that apply.)

Pupil constriction Bronchoconstriction Decreased heart rate

A hospital nurse is vigilant in ensuring the safe use of medications and consistently applies the rights of medication administration. What are the rights of medication administration? Select all that apply.

Right to refuse prescribed medication. Right route for effective medication therapy. Right to effective medication education. Right evaluation of expected results.

The nurse is taking a history of a client who reports burning pain in the stomach. The nurse knows that which risk factors increase this client's chance of having a peptic ulcer?

Smoking Psychological stress Physiological stress

A client with arrhythmias is prescribed an antiarrhythmic. About which finding on the ongoing assessment should the nurse instruct the client to immediately notify the primary health care provider? A pulse rate of 90 Increased restlessness Sudden change in mental state Dry mouth and gums

Sudden change in mental state

The nurse is preparing to administer the first dose of hydrochlorothiazide to a client. What assessment should the nurse perform prior to administration?

Sulfonamide allergy

A patient has been prescribed zolpidem (Ambien) for short-term treatment of insomnia. Which of the following will the nurse include in a teaching plan for this patient? (Select all that apply.)

The drug does not cause sleepiness in the morning. One of the most common adverse effects of the drug is headache. It is available in both quick-onset and continuous-release oral forms

What is the initial step in the process that occurs in the absorption of an oral drug?

The drug moves from the small intestine directly into the portal venous system.

A nurse has administered a dose of a drug that is known to be highly protein bound. What are the implications of this characteristic?

The molecules of the drug that are bound to protein are inactive.

A client has been diagnosed with a duodenal ulcer caused by H. pylori infection. What medication regimen does the nurse expect the health care provider to prescribe?

Two antimicrobials and proton pump inhibitor

A client is diagnosed with allergic rhinitis. What type of hypersensitivity reaction is causing allergic rhinitis?

Type 1

A client who has been treated with warfarin after cardiac surgery is found to have an INR of 9.0. Which medication will be administered to assist in the development of clotting factors?

Vitamin K

A client who is receiving warfarin has blood in the urinary drainage bag. What medication will likely be prescribed by the health care provider?

Vitamin K

The nurse is caring for a group of clients in a long-term care facility. The nurse is aware that SSRIs are associated with what side effect that is especially undesirable in older adults?

Weight loss

The nurse has entered the room of a client who is being treated with regular doses of morphine. The client is unresponsive to voice but responsive to touch, with a respiratory rate of 6 breaths per minute. In addition to informing the care team, what is the priority action?

administer naloxone

A 79-year-old client has been brought to the emergency department by ambulance with signs and symptoms of ischemic stroke. The care team would consider the immediate (STAT) administration of what drug?

alteplase

The nurse is reviewing medications prescribed for a client. For which condition(s) will the nurse expect morphine to be prescribed? Select all that apply.

burns traumatic injuries acute myocardial infarction

The nurse is providing education to a client who has been prescribed furosemide 20 mg PO. The nurse should teach the client that a diet high in sodium will cause what effect?

decreased diuresis

The nurse is providing education to the parents of a child who has been newly diagnosed with type 1 diabetes. What distinguishing characteristic of the disorder does the nurse include in the teaching?

exogenous insulin is required for life

A client has edema of the lower extremities with crackles in the lung bases. What diuretic is most likely to be prescribed for a client assessed with lower extremity edema and bilateral lung crackles?

furosemide

The nurse is providing education to a client who has been prescribed therapy with an antidiabetic medication. During teaching, the nurse will caution the client against heavy intake of which herb?

garlic

A client takes aprepitant to control nausea and vomiting when receiving chemotherapy. Which assessment findings indicate to the nurse that the client is experiencing adverse effects of this medication? Select all that apply. headache weakness fatigue dizziness hiccups

headache weakness fatigue dizziness hiccups

A client has been prescribed a combination diuretic agent. The nurse knows that the major purpose of this combination is what?

it prevents potassium imbalance

A child is administered a benzodiazepine agent. How will the child's dose differ from an adult's dose?

it will be lower

Promethazine is commonly prescribed in the treatment of nausea and vomiting that is attributable to which triggers? Select all that apply.

migraines chemotherapy motion sickness anesthesia

The nurse is caring for a client who received naloxone to treat opioid toxicity. Which assessment findings will the nurse identify as adverse effects of this medication? Select all that apply.

nausea tremors sweating drowsiness

A group of students are reviewing the structure and function of the renal system. The students demonstrate understanding when they identify what as the functional unit?

nephron

A client is unconscious and experiencing increasing intracranial pressure. What type of diuretic will the client most likely be prescribed?

osmotic diuretic

The nurse is administering an H-2 receptor antagonist to a client with multiple burn trauma to prevent the development of stress ulcers based on the understanding that the drug:

provides protection of the stomach lining by blocking the release of hydrochloric acid.

A patient, admitted to a health care facility with cardiac arrhythmia, is prescribed propranolol. Which factor should the nurse closely monitor as a part of the ongoing assessment during the therapy?

pulse rate

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?

regular insulin

A client is being discharged from the hospital with warfarin to be taken at home. Which food should the client be instructed to avoid in the diet?

spinach

The nurse is caring for a client suspected of developing serotonin syndrome. What frequent assessments should the nurse include in the client's plan of care? Select all that apply.

temperature blood pressure level of consciousness

A client has been receiving regular doses of an agonist for 2 weeks. What finding should the nurse anticipate?

the drug will decrease in effectiveness

A hospital client demonstrating peripheral edema has been prescribed furosemide. How should the nurse best determine the extent of the client's desired fluid loss?

weigh client daily