pharmacy: assignment 9-12
A 46-year-old man is brought into the emergency department after having convulsions for approximately 10 minutes. What is the best choice for an initial medication for this patient? a. lorazepam b. phenytoin
a
A client is scheduled to take 4 mg of hydromorphone intravenously (IV). Prior to administering the drug, what should the nurse do? a. obtain a baseline respiratory assessment b. assist client to the bathroom
a
A client that just experienced head trauma asks the nurse why they cannot have an opioid analgesic. Which response should the nurse provide? a. opioids can mask changes in level of consciousness b. you may not be able to notice any changes you are experiencing
a
A nurse is planning to administer morphine IV to a client who is postoperative. Which of the following actions should the nurse take? a. withhold medication if respiratory rate is less than 12/min b. monitor for seizures and confusion with repeated doses
a
A nurse is preparing to administer butorphanol to a client who has a history of substance use disorder. The nurse should identify which of the following information as true regarding butorphanol? a. can cause abstinences syndrome in opioid dependent clients b. has a greater risk for abuse than morphine
a
A parent asks the nurse why his or her 8-year-old child cannot have cough syrup with codeine to help the child rest. Prior to responding to the parent, which should the nurse understand? a. contradicted in children b. will exacerbate the childs condition
a
The educator has discussed the types of opioid receptors with a nurse. Which statement made by the nurse indicates an understanding of the information? a. opioids agonists will activate mu and kappa receptors b. opioids exert their actions by interacting with 3 different receptors
a
The healthcare provider has prescribed furosemide for a client with chronic renal Failure. Which assessment finding associates the treatment is ineffective? a. wheezing b. hypotension
a
Which statement should the nurse include in education of a client prescribed a NSAIDs? a. take med with food b. constipation is common
a
The healthcare provider has prescribed intravenous phenytoin (Dilantin) IV piggyback. The client is currently receiving 5% dextrose in water (D5W) intravenously (IV). Which action should the nurse take? (Select all that apply) a. flush the IV line with saline b. use an IV line with a filter c. use a large vein for the infusion d. monitor pt for hypertension
a, b, c
Which statement correctly describes the proposed mechanism of action of cardioprotection from low dose aspirin? A. Aspirin potentially inhibits COX 1 to lead to a relative reduction in thromboxane A2 levels B. Aspirin potentially inhibits COX 1 to lead to a relative reduction in prostacyclin levels
A
Which of the following statement/s concerning phenytoin is/are correct? (Select ALL that apply) a. check albumin levels when checking phenytoin level b. phenytoin exhibits first order, then zero order kinetics c. steady state levels are achieved by 2nd day d. the therapeutic range is 10-20 mpg/mL
a, b, d
Which information in a health history should the nurse be concerned about for a client prescribed ibuprofen for a mild ankle sprain? a. alcohol abuse b. hypertension c. hx of injury d. recent hx of peptic ulcer e. allergy to aspirin
a, b, d, e
A nurse is preparing to provide education on the use of heroin. Which information should the nurse include? (Select all that apply) a. an opioid drug b. not as dangerous as oxycodone c. narcotic drug
a, c
The nurse is preparing to review the records of a client with cancer prescribed buccal fentanyl. Which findings should the nurse anticipate? (Select all that apply) a. the client is experiencing breath through pain b. the client is opioid naive c. the client is already receiving some form of fentanyl
a, c
What are possible complications with long-term phenytoin therapy? (Select ALL that apply) a. osteoporosis b. renal dysfunction c. hirsutism d. peripheral neuropathy e. gingival hyperplasia
a, c, d, e
Which condition should the nurse anticipate the healthcare provider to possibly prescribe a diuretic? Select all that apply A. Kidney infection B. Hypertension C. HF D. Cerebrovascular accident
A, b, c
Which information should the nurse include in teaching a client with a prescription with the nasal form of sumatriptan for migraines? Select all that apply A. Instill the spray into 1 nostril only B. Overusing med can lead to rebound headaches C. Use med at the first sign of a migraine D. Increase dietary in tyramine
A, b, c
Which is the most appropriate food for the nurse to recommend to a client to eat that is prescribed a loop diuretic? A. Cheese B. Yogurt C. Bananas
C
Which statement by the client prescribed acetylsalicylic acid indicates the client is experiencing an adverse effect? A. Bright lights give me a headache B. My nose is stuffed up C. My stools have been dark in color
C
Considerations for drug treatment of epilepsy in women may include: ?
all the above
A 35-year-old woman is being started on lamotrigine for newly diagnosed epilepsy. She is otherwise healthy and is not taking any medications except for acetaminophen for an occasional headache. Which of the following will be most important to monitor as she starts lamotrigine? a. blood clot b. rash c. vision
b
A client asks the nurse how methadone (Dolophine) can help with a heroin dependence. Which response should the nurse provide? a. will cause illness if heroin is used b. does not cause extreme euphoria like heroin does
b
A client with epilepsy prescribed Phenobarbital (Luminal) tells the nurse she is planning a pregnancy. Which statement should the nurse provide the client? a. your med dose will need to be increased during pregnancy b. please talk to your doctor, this drug is contraindicated in pregnancy
b
A client with epilepsy who has been seizure free and prescribed phenytoin (Dilantin) asks the nurse why he or she needs to still have blood testing. Which response should the nurse provide the client? a. phenytoin can cause blood thinning in some patients b. phenytoin has a very narrow range between a therapeutic dose and a toxic dose
b
A nurse is preparing to administer an opioid agonist to a client who has acute pain. For which of the following manifestations should the nurse monitor as an adverse effect of this medication? a. irritating cough b. urinary retention
b
A patient had several seizures when she was a young child. She is now 13 years old and has been seizure-free for at least 5 years while taking carbamazepine. Choose the correct statement: a. should be discontinued immediately and substituted with topiramate b. should be tapered gradually to minimize the risk of seizures
b
An older adult is prescribed phenobarbital (Luminal) for seizure control. Which assessment should the nurse recognize is the most important? a. electrolyte imbalance b. respiratory function
b
Because phenytoin was prescribed STAT for a client who was just admitted to the nursing unit from the emergency department, which set of assessments is of highest priority for the nurse to perform? a. BUN, creatine, urinary output b. seizure activity, mental status, and respiratory status
b
For which finding should the nurse notify the healthcare provider for a client prescribed prednisone? a. asthma b. unexplained fever
b
In a case of an opioid overdose, naloxone can be given in repeated doses because of which property of naloxone? a. is only a partial opioid agonist b. may have a shorter half life
b
KM is a 64-year-old man who has been hospitalized following a car accident in which he sustained a broken leg and broken arm. He has been converted to oral morphine in anticipation of discharge from the hospital. Upon discharge, which medication should he receive along with the morphine? a. diphenhydramine b. senna
b
Most clinically used opioid analgesics are selective for which type of opioid receptor? a. delta b. mu
b
The educator has discussed with a nurse the protocol for the immediate availability of naloxone for a client with a patient-controlled analgesia PCA pump. Which statement made by the nurse indicates an understanding of the information? a. enhances the effect of the opioid in the patient controlled analgesia pump and increases analgesia b. will reverse the effects of the narcotic in the patient controlled analgesia pump if an overdose occurs
b
The nurse has administered intravenous (IV) diazepam (Valium) for the client in status epilepticus. Which initial assessment should the nurse perform? a. BP b. respirations c. HR
b
The nurse has administered naloxone (Narcan) intravenously to a client receiving morphine experiencing respiratory depression. Which should the nurse anticipate? a. an onset of action of 2 to 5 min b. an onset of action of 1 to 2 min
b
The nurse has provided a client education on the pharmacologic management of epilepsy. Which statement made by the client indicates an understanding of the treatment? a. I will avoid foods with tyramine b. I understand that I will take an anti seizure prescription indefinitely
b
The nurse is preparing to educate a client on prescribed antiepileptic drug (AED). Which information should the nurse include in the teaching? a. when experiencing side effects skip the next dose of the prescription b. the prescription should be taken at the same time every day
b
A 28-year-old woman is started on oxcarbazepine for partial seizures. Which of the following should she take in addition to the oxcarbazepine? a. vitamin A b. Vitamin C c. folic acid
c
A client with an oxycodone overdose has a respiratory rate of 8 and is difficult to arouse. Which prescribed treatment should the nurse anticipate administering? a. administering an opioid agonist b. administering activated charcoal c. administering opioid antagonist
c
All NSAIDs have a FDA black box warning regarding? A. Potential for causing GI bleeds B. Potential for changes in serum glucose
A
The primary way the kidney reabsorbs water is through the reabsorption of? A. Sodium B. Potassium
A
Which general adverse effect is associated with the use of diuretics? A. Ortho hypotension B. Weight gain
A
Which instructions should the nurse include in the teaching of a client prescribed aspirin? A. Take with food B. Take on empty stomach
A
Which is contradicted in a patient with hyperkalemia? A. Epiereone B. Ethacrynic acid
A
Which is the primary functional unit of the kidney? a. Nephron B. Loop of Henle
A
A 62 year old man has HF and has been taking a loop diuretic to reduce peripheral edema. His labs today show low potassium. Which diuretic could be of use added in this patient? A. Hydrochlorothiazide B. Triamterene
B
A client prescribed bumetanide asks the nurse how the drug works. Which response should the nurse provide? A. Prescription causes your kidneys to reabsorb potassium B. Prescription causes your kidneys to block the reabsorption of sodium
B
For which client is acetaminophen contradicted in? A. 65 year old with osteoarthritis B. 55 year old who drinks alcohol daily
B
The nurse is reviewing the medical history of a client prescribed hydrochlorothiazide. What should the nurse be concerned about? A. Asthma B. Gout
B
The nurse should include which precaution when teaching a client with liver disease about OTC? A. Have cholesterol level measured before using B. Consult your healthcare provider before taking meds
B
The nurse should indicate which instruction when teaching a client prescribed ergotamine for treatment of migraines? A. Take med every 4 hrs B. Lie down in darkened room after taking med
B
Which diuretic has the greater diuretic action than the Thiazides and is often prescribed for patients resistant to a Thiazide diuretic? A. Osmotic B. Loop
B
Which diuretic is most effective in reducing the mortality of a client with HF? A. Mannitol B. Spironolactone
B
Which finding is a common adverse effect of an anti inflammatory prescription? A. Diarrhea B. Heartburn
B
Which information should the nurse include when providing education for an older client prescribed hydrochlorothiazide? A. Take med before bedtime B. Take med in morning
B
Which is the client most likely at risk for when receiving spironolactone? A. Hyponatremia B. Hyperkalemia
B
Which should a client be monitored for when prescribed a glucocorticoid long term? A. Hypoglycemia B. Bruising
B
Which statement is correct regarding the difference between acetaminophen and naproxen? A. Acetaminophen has more GI bleeds B. Acetaminophen has less risk for CV events
B
The nurse suspects a client receiving chlorothiazide is experiencing side effects from the prescription. Which assessment finding supports the nurses suspicion? a. ataxia and diarrhea b. serum potassium level of 3.0 mEq/L and low BP
b
Which describes the mechanism of action for ibuprofen? a. blocks pain impulses sent to brain b. inhibition of prostaglandin synthesis
b
Which of the following neurotransmitters appears to be depleted in some patients with epilepsy? a. acetylcholine b. GABA
b
Which prescription should the nurse anticipate being included in the treatment of a client experiencing mild migraine headaches? a. amitriptyline b. ibuprofen
b
Which question should the nurse ask a postsurgical client prior to the administration of an opioid analgesic? a. have you ever been addicted to prescription pain medications b. would you pleasure rate your pain on a scale of 1 to 10
b
A postoperative client has a prescription for morphine 2 mg IV push every 2 hours and hydrocodone 5 mg every 6 hours. The client received the morphine 2 hours ago and is requesting hydrocodone. Which initial action should the nurse take? a. administer another dose of morphine b. encourage the use of distracted techniques c. using pain scale assess patients level of pain
c
Antonia is a 3-year-old child who has a history of status epilepticus. Along with her routine antiseizure medication, she should also have a home prescription for_________ to be used for an episode of status epilepticus. a. IV phenytoin b. IV phenobarbital c. rectal diazepam
c
JS, who has controlled partial seizures, has been experiencing at least 4 headaches per month for the past 4 months. Which of the following anticonvulsants is also indicated for migraine prophylaxis?a. clonazepam b. felbamate c. topiramate
c
The nurse is preparing to review the records for a client with absence seizures. Which prescription should the nurse anticipate the client has been prescribed? a. diazepam b. phenytoin c. ethosuximide
c
Which comment by the client receiving morphine should the nurse recognize as an adverse effect? a. my ears are constantly ringing b. my heart feels like it is skipping beats c. I feel like I am going to throw up
c
The nurse is preparing to administer phenytoin (Dilantin). Which route(s) of administration are used to administer the medication? (Select all that apply) a. IM b. Sub Q c. IV d. orally
c, d
