Pharmacology (Test 2)

A nurse is providing teaching to a client who has type 2 diabtes mellitus and is starting repaglinide.Which of the following statements by the client indicates understanding of the administration of this medication?

"I'll take this medicine 30 minutes before I eat."

A nurse is teaching a client who has Grave's disease and a new prescription for propranolol. Which of the following clients statements indicates effective teaching?

"Propranolol will decrease my tremors and fast heart beat."

A nurse is teaching a client who will begin taking aluminim hydroxide. Which of the following information should the nurse include in the teaching?

"Take this medication two hours before or after other medications."

A nurse is educating the parents of a child who has a new diagnosis of Prader-Willi Syndrome (PWS) and has been prescribed somatotropin. Which of the following statements by a parent indicates understanding of the teaching?

"We will use a different spot for injection each time to give medication."

A nurse is planning teaching for a client who has been prescribed loperamide to treat diarrhea. Which of the following statements should the nurse plan to include?

"avoid driving or activities requiring alertness"

A nurse is teaching a client who has a new prescription for sulfasalazine. Which of the following statements should the nurse make?

"you sunscreen and protective clothing while taking sulfasalazine to prevent sunburn"

A nurse is providing teaching for a client who has a prescription for pramlintide for type 1 diabetes mellitus. Whihc of the following should the nurse inclide in the teaching? (Select all that apply.)

-"Inject pramlintide just before a meal." -"Disgard open vials after 28 days."

A nurse is teaching a client about probiotic supplements. Which of the following information should the nurse include? (Select all that apply_.

-"Probiotics are micro-organisms that are normally found in the GI tract." -"Probiotics are used to treat clostridium difficile." -"You can experience bloating while taking probiotic supplements."

A nurse is teaching a client about cimetidine. Which of the following are adverse effects of cimetidine?(Select all that apply.)

-Enlargment of breast tissue -Confusion -Decreased sperm count

Hyperthyroidism

-Grave disease, thyroid storm, Thyrotoxicosis. -Prototype: Methimazole, PTU MOA: Blocks the syntheis of thyroid hormones (blocks T3 convert to T4) -Contraindications: Preg Cat D.. also lactation is a prob...other iodine products. -Indications: Euthyroid state before/after surgery, B4 surgery PTU given & B Blockers. -A/E: BASICALLY CAN CAUSE HYPOTHYROIDISM-DROWSINESS, DEPRESSION, WEIGHT GAIN, EDEMA, BRADYCARDIA, COLD INTOLERANCE, LOW BP, PANCYTOPENIA/ **AGRANULOCYTES (fever-infection; Monitor CBC) PTU-Hepatotoxicity -Interaction: Anticoagulants -Admin: Take with meals at a consistent time each day. -RN/Teaching: monitor weight, VS..female RN handle with caution..what was the other medication we mentioned? Takes 3-12 weeks to work..avoid consumption of shellfish and iodine. -Monitor for BRADY, Sore Throat, Fever

A nurse is planning to administer ondansetron to a client. For which of the following adverse effects of ondansetron should the nurse monitor (Select all that apply.)

-Headache -Diarrhea -Prolonged QT interval

A nurse is planning care for a client who is receiving chemotherapy and has a new prescription for ondansetron. Which of the following actions should the nurse plan to take?(select all that apply)

-Infuse the drug 30 min prior to chemotherapy -Infuse the drug slowly over 15 min -Repeat the dose four hr after chemotherapy

A nurse is providing teaching to a client who is about to begin exentide therapy to treat type two diabetes mellitus. Which of the following instruction should the nurse include? (Select all that apply.)

-Inject the drug subcutaneously -Expect the peak effect in 2 hours -Use to drug as a supplement to an oral hypoglycemic

A nurse is providing teaching to a client about taking fludrocortisone to treat adrenocortical insufficiency. Which of the following instruction should the nurse include? (Select all that apply.)

-Obtain weight measurement daily. -Report weakness or palpitations. -Have blood pressure checked regularly.

A nurse is administering sulfasalazine to a client. Which of the following data should the nurse collect to help identify an adverse drug reaction? (select all that apply)

-Skin integrity -Temperature -CBC

What medications increase blood glucose? (SATA)

-Somatropin/Growth Hormone -Glucocorticoids/Steroids -Levothyroxine

A nurse is caring for a client who is about to begin taking propylthiouracil (PTU) to treat hyperthyroidism. The nurse should instruct the client to import which of the following adverse effects? (Select all that apply)

-Sore throat -Joint pain -Bradycardia -Rash

A nurse is providing teaching to a client who is about to start psyllium to treat Constipation. Which of the following instruction should the nurse include? (select all that apply)

-Take the truck with at least 8 oz (237 mL) of fluid. -Increase fluid and fiber intake

A nurse is caring for a client who is about to begin taking somatropin. The nurse should explain the need to monitor which of the following laboratory values? (Select all that apply.)

-Urine calcium -Blood glucose

A nurse administers pramlintide at 0800 to a client who had type 1 diabetes mellitus. At which of the following times should the nurse expect the drug to exert its peak action?

0820

When do you teach a aptient to take sucralfate?

1 hr before meals and at bedtime

Glargine (Lantus): Onset, Peak, and Duration

70+ min, None, 24 hrs

A nurse is caring for fou clients who have peptic ulcer disease. The nurse should identify misoprostol is contrainidacated for which of the following clients?

A client who is pregnant.

A nurse should recognize that misoprostol is contra indicated for a client who has which of the following conditions?

A positive pregnancy test

A nurse is caring for a client who has a new prescription for alosetron To treat irritable bowel syndrome. The nurse should instruct the client to report which of the following adverse effects of the drug?

Abdominal pain

A nurse is caring for a client who is taking metformin and is scheduled to undergo angiograpy using iodine containing contrast dye. The nurse should identify that in in direction between metformin and the IV contrast dye increases the clients risk for which of the following conditions?

Acute renal failure

A nurse is teaching a client who has a prescription for pranlintide therapy to treat type 1 diabetes mellitus. Which of the following instructions should the nurse include?

Administer pramlintide before meals

A nurse is admitting a client for a total hip arthroplasty. The client takes hydrocortisone for addision's disease. Whihch of the following actions if the nurses priority?

Administering a supplemental dose of hydrocortisone

A nurse is caring for a client who is about to begin taking pioglitazond to treat type two diabetes mellitus. The nurse should explain to the client about the need to monitor which of the following laboratory values? (Select all that apply.)

Alanine aminotransferase (ALT) LDL

A nurse is caring for a client who is taking allopurinol to treat gout and has a new prescription for azathioprine to treat ulcerative colitis. For which of the following reason should the nurse clarify these prescriptions with the provider?

Allopurinol delays the conversion of azathioprine and can lead to toxicity

A nurse is teaching a client who takes phenytoin and has a new prescription for sucrafae tablets. Which of the following instructions should the nurse include?

Allow a 2 hr interval between these medications.

Which of the following drugs has protocols that require clients to meet specific risk management criteria and sign a treatment agreement before the nurse can administer the drug?

Alosetron

A nurse is caring for a client who has peptic ulcer disease. The nurse should monitor the client phosphorus level when administering which of the following drugs?

Aluminum hydroxide

A nurse is caring for a client who has a new prescription for ranitidine to treat GERD. The nurse should instruct the client to wait at least one hour before taking ranitidine and which of the following over the counter drugs?

Antacids

What is the correctic order of reducing gastric acid

Antiacid, H2 antagonist, PPI

A nurse should recognize that sulfasalazine is contraindicated for clients who have which of the following conditions?

Aspirin sensitivity

A nurse is providing teaching to a client who has a new prescription for loperamide. Which of the following instruction should the nurse include?

Avoid activities that require alertness

A nurse is teaching a client who has a prescription for glipizide therapy to treat type two diabetes mellitus. Which of the following instructions should the nurse include?

Avoid drinking alcohol.

A nurse is caring for a client who is about to begin insulin glargine therapy. The nurse should identify the need for additional precautions because the client also takes which of the following types of drugs?

Beta Blockers

A nurse is caring for a client who is taking propythiouracil. Which of the following findings should the nurse monitor for as an adverse effect of this medication?

Bradycardia

A nurse is caring for a client who is taking for somatropin to stimulate growththe nurse should plan to monitor the clients urine for which of the following?

Calcium; risk for renal calculi

A nurse is caring for a client who received prochlorperazine 4 hr ago. The client reports spasms of the face. The nurse should expect a prescription for which of the following medications>

Diphenhydramine-suppress extrapyramidal effects of ____

A nurse is assessing a client who has administered ondansetron IV one hour ago. Which of the following findings should the nurse recognize as an adverse effect of the drug?

Dizziness

A nurse is teaching a client about acarbose therapy to treat type two diabetes mellitus. Which of the following instruction should the nurse include?

Eat more iron-rich foods

A nurse is providing teaching to a client who is about to begin levothyroxine therapy to help hypothyroidism. Which of the following instruction should the nurse include?

Expect life-long therapy with the drug

Amoxicillin is an example of a probiotic

FALSE

Lugols Solution is a longterm treatment of hyperthyroidism

FALSE

Which of the following drugs should be a nurse have available for a client who is experiencing insulin toxicity?

Glucagon

Adrenal Hormone Replacement

Glucocorticoids (Steroid Hormone) -Hydrocortisone, Dexamethasone, Presdnisoone -MOA: replacement -CI active infection Indications: Addison's disease; tons of inflammatory disorders (RA, Lupus, etc..) allergic reaction A/E: Increase blood sugar, decrease immune system, wt gain, hypokalemia, osteoporosis, adrenal suppression, HTN, edema, infection, Cushings Syndrome Interactions: Vaccines, Diuretics, NSAIDS, APAP, ETOH--GI bleed Admin: Taper off, adjust insulin, keep away from sick people/report cough, monitor lites, take Ca supps w/ vitamin D, with weight bearing exercise, monitor for weakness and low BP watch for tarry stools.. We usually give them the med PO in the morning RN/Teaching: times of stress increase dose, plus the above.

A nurse is teaching a client who has a new prescription for methotrexate. The nurse should instruct the client to Monitor for manifestations of which of the following conditions?

Gout

Pharmacy just called and said your patients next TPN bag is delayed, what do you do when your current bag is empty?

Hang D10W

A nurse is reviewing the medical record of a client who takes desmopressin for diabetes insipidus.Which of the following findings is an adverse effect of desmopressin?

Headache

When considering replacement therapy options for a client who has chronic adrenocortical insufficiency, a nurse should recognize that the provider will choose which of the following drugs?

Hydrocortisone

Aluminim Hydroxide complications include

Hypophosphatemia and constipation

A nurse at a providers office is assessing a client who has been taking HydroCortisone for adrenal insufficiency. The client reports fatigue and feeling overwhelmed by personal responsibilities. Which of the following findings should the nurse identify as an indication the provider might need to increase the clients dosage?

Hypotension

A nurse is caring for a client who is taking propylthiouracil (PTU) and reports weight gain, drowsiness, and depression. The nurse should identify that the client is experiencing which of the following adverse reactions to the drug?

Hypothyroidism

A nurse should recognize that diphenoxylate/atropine should be used with caution for a client who has which of the following conditions?

Inflammatory bowel disease

Common A/E of levothyroxine 9synthroid) include:

Insomnia Palpitations Irritability

A nurse is reviewing the medical record of a client who has a new prescription for ranitidine. The nurse should recognize that which of the following drugs interact with ranitidine?

Ketoconazole

Pancytopenia

LOW LOW LOW RN blood transfusions Hang within 30 min -Prevent falls, bed alarm, clear path in room, siderails up, pad rails. -Give vitamin K -Blood type O- : Universal donor Reverse Isolation -No plants, fresh fruits & vegetables -No children < 18 yo -Close door w/ signage on door -Wash hands

A nurse is caring for a client who is taking metformin to treat type 2 diabetes mellitus and resorts muscle pain. Which of the following adverse reactions should the nurse suspect?

Lactic acidosis

A nurse is caring for an older adult client who has renal impairment and a new prescription for cimetidine. The nurse should instruct the client to report which of the following manifestations?

Lethargy

A nurse is teaching a client about self administering regular insulin. The nurse should instruct the client to rotate injection sites to prevent which of the following?

Lipohypertrophy

A nurse is caring for a client who has been taking acarbose for type 2 diabetes mellitus. Which of the following labratory tests should the nurse plan to monitor?

Liver function test-Acarbose can cause liver toxicity when taken long term. ENsure monitor lung function.

Hyperthyroidism

Lugol's solution ... SSKI - Saturated Solution of potassium iodine. Prototype: same MOA: Inhibits synthesis of T3 and T4, decreases vascularity of thyroid CI: active TB, Preg D, maybe shellfish allergy Indications: Hyperthyroidism, surgery A/E: Monitor for Iodinism (Brassy taste, burning mouth, sore teeth) dilute the juice Interactions: Don't use with ACE inhibitors Admin: Peaks in 1-2 weeks RN/Teaching: Can stain teeth, sip through straw, take after meals to decrease GI upset, assess oral mucosa.

Hyperthyroidism: (RADIOACTIVE IODINE 1-131 "IODOTOPE")

MOA: Is up taken by thyroid cells and kills them Contraindications: No young children/breastfeeding/ shellfish or sulfite allergy. Indications: Thyroid cancer, Med non-responders A/E: sore throat, bone marrow depression, hyperthyroidism, radiation sickness (hematemesis, epistaxis, N/V)... Hyperthyroidism; Dysgeusia Interactions: w/ Lugol's solution & other iodine solutions (d/C week prior) Admin: Homer Simpson style! Client secretions will be radioactive until the Iodine decays.. Time/Distance/Shielding RN/Teaching: Keep 6 feet away from others, DON'T prepare food or share utensils, limit contact to 30 minutes per day, increase fluid intake, careful disposing of secretions.. in hospital...take 3 months to work so given in conjunction with PTU DRINK LOTS OF WATER AFTER

Levothyroxine

Mechanism of action: Hormone replacement CI: Following an MI, Caution for angina, CAD, Tx of obesity. Indications: Lab values, Hypo w/ or w/out goiter A/E: basically s/s pf hyperthyroidism...Increase HR, HTN, seizures, dysrhythmias, tremors, nervousness, insomnia, weight loss, diaphoresis, headache, irritability Interactions: Increase anticoagulants effect, et al (warfarin), increase insulin req's Admin: PO pill 30-60 mins in morning before breakfast. CAN crush and mix with water but DONT take with soy isoflavones RN/Teaching: Dose gradually increases-full effect of med takes 4-8 weeks.. DON'T stop abruptly! Hold if HR >110

Your patient just came back from CT scan, what medication do you withhold and for how long?

Metformin; 48 hrs

A nurse is caring for a client who has diabetes and is experiencing nausea due to gastroparesis. The nurse should expect a prescription for which of the following medications?

Metoclopramide: a dopamine antagonist that is used to treat nausea and aldo increase gastric motility. It relieves bloating and nausea of diabetic gastroparesis.

A nurse is caring for a client who is taking lubiprostone. The nurse should tell the client that lubiprostone can cause which of the following adverse drug reactions?

Nausea

A nurse is caring for a client who has a prescription for alosetron. The nurse should recognize that alosetron therapy is effected when the client reports which of the following?

One formed stool per day

Loperamide is used for which type of patients?

Patients with ileostomy

A nurse is speaking with a client who is taking glipizide to treat Type two diabetes mellitus and has called to report feeling shaky, hungry, and fatigue. Which of the following actions should the nurse instruct the client to take?

Perform a fingerstick blood glucose check

A nurse is teaching a client who recently had a myocardial infarction and has a new prescription for docusate sodium. The nurse should inform the client that docusate sodium cause which of the following therapeutic effects?

Prevents straining

PT comes into the ER and states they take ondansetron at home. As the nurse what is the primary complication to monitor?

Prolonged QT interval

Prior to administering medication, which meds require a pregnancy beforehand? (SATA)

Radioactive Iodine Misoprostol

Hyper thyrodisim:

Radioactive iodine therapy Anti-thyroid PTU and Methimazole: Anti-thyroid drugs lower the T3 and T4 levels. Iodine-Lugol's Solution: Iodine in large doses rapidly inhibit synthesis of T3 and T4 and block their release into circulation, DECREASE vascularity of the thyroid gland NOT for long term therapy B-adrenergic blockers: Block the effects of the stress hormones catecholamines, block the effects of the sympathetic nervous system. Surgical Therapy: Unresponsive to drug therapy, Large Goiters/ Tumor causing Trachael compression, Malignancy Nutritional therapy

A nurse is assessing a client who has a new prescription for levothyroxine. The nurse should identify which of the following findings as a contraindication for this drug?

Recent myocardial infarction

A nurse is teaching clients about the use of insulin to treat type 1 diabetes mellitus. For which of the following type of insulin should the nurse tell the clients to expect a peak effect 1 to 5 hr after administration.

Regular insulin

A nurse should recognize that a provider will prescribe a lower dose of sitagliptin for a client who has type two diabetes mellitus and who always has which of the following?

Renal impairment

When administering Misoprostol, primary nursing intervention is to

Run a pregnancy test

Pituitary Deficiency/Low Growth Hormone

SOMATROPIN Prototype: Same MOA: replacement CI: severly obese, sleep apnea Indications: Deficiency, AIDS wasting, Cachexia A/E: Hyperglycemia; renal calculi Interactions: concurrent corticosteroids can inactivate Ad: IM or SUB Q: NO SHAKE, Roll Solution RN/Teaching: Adjust insulin? Monitor for flank pain, fluid intake, rotate injection sites. **Decreased UOP but normal BUN/CR- Check for stones or BPH

A nurse is caring for a client who takes repaglinide 15 to 30 min before each meal to treat type two diabetes mellitus. The client asks, "If i skip a meal, what should i do?" Which of the following responses should the nurse make?

Skip the dose

A nurse is providing instructions should the use of laxatives to a client who has heart failure. The nurse should tell the client to avoid which of the following laxatives?

Sodium phosphate

A nurse is providing teaching for a client who has a new prescription for metformin. Which of the following findings should the nurse instruct the client to report as an adverse effect of metformin?

Somnolence: can indicate lactic acidosis, which is manifested by extreme drowsiness, hypoventilation, and muscle pain.

A nurse is caring for a client who takes phenytoin for a seizure disorder and has a new prescription for sucralfate to treat a duodenal ulcer. The nurse should instruct the client to take the drugs at least 2 hrs part for which of the following reasons?

Sucralfate interferes with the absorption of phenytoin

A nurse is providing teaching to a client who has a new prescription for omeprazole to treat a duodenal ulcer. Which of the following instructions should the nurse include?

Swallow the capsule whole

Diabetes Insipidus (DI)

TRAUMA IN BRAIN Vasopressin++/Desmopressin is synthetic ADH Prototype: Vasopressin MOA: replacement CI: CAD/MIAngina..monitor EKG Indications: DI, low bp, nocturnal enuresis (bed wet), CPR A/E: Constricts coronary arteries, water intoxication (s/s), decreased peripheral circulation Interactions: Lithium Admin: SQ, IM intranasal (bedtime dose) RN/Teaching: Monitor EKG, BP; Monitor serum NA; Monitor I & O closely; monitor urine SG

Glucocorticoids must bed tapered off

TRUE

A nurse is providing teaching to a client who has a new prescription for dimenhydrinate to prevent motion sickness. Which of the following instruction should the nurse include? (Select all that apply)

Take the drug 30 to 60 men before activities that trigger nausea Avoid activities that require alertness Increase fluid in fiber intake

A nurse is caring for an older adult client who has hypothyroidism and a new prescription for levothyroxine. Which of the following doage schedules should the nurse expect for this client?

The client will start on a low dosage, which can be gradually increase.

A nurse is caring for a male client who asked the nurse about taking alosetron for irritable bowel syndrome with diarrhea (IBS-D) lasting three months. Which of the following information should the nurse provide the client about alosetron?

The drug is prescribed to female clients who have IBS-D lasting more than six months

A nurse is teaching a client who has a new prescriptions for omeprazole. Which of the following information should the nurse include in the teaching?

This medication decreases the production of gastric acid.

RN teaching for Radioactive Iodine

Time: 30 minutes Shielding: Lead apron Do not share foods/utensil/laundry Distance: 6 feet away

Radioactive Iodine Therapy RAI

Treatment of choice in non-pregnant adults w/ hyperthyroidism -Also used to TX CA alone, and Post op -Preferred because is permanent I-131 damages or destroys thyroid tissue -usually on outpatient basis if high dose then hospital for few days Delayed Response 2-3 months -Post TX the pt is usually Hypo-need lifelong replacement Also treated with anti-thyroid drugs before and during first 3 months of RAI -PTU or methimazole

A nurse is caring for a client who is taking desmopressin. The nurse should make which of the following assessments to evaluate the drug's effectiveness?

Urine output

A nurse is caring for a client who is taking pioglitazone to treat type 2 diabetes mellitus. The nurse should monitor for which of the following findings?

Weight gain

Hypothyroidism

a "slow metabolism" low amount of T3,T4; Myxedema (coma), Hashimoto thyroiditis..