Unit 2 Pharm Test

Buspirone can take up to how long for the drug therapeutic effect?

2-4 weeks (on bingo card)

A nurse is teaching a client who received a prescription for interferon beta-1a for the treatment of multiple sclerosis. Which of the following information should the nurse include?

"Administer the drug in your thigh or upper arm." Interferon beta-1a is administered via subcutaneously

A nurse is teaching a client about adverse effects of etanercept. Which of the following statements by the client indicates understanding of the teaching?

"I will need to get my blood drawn periodically while on this medication" Etanercept places pt at risk for systemic fungal infections and other opportunistic infections, so the client should have their CBC monitoring periodically on this med

A nurse is teaching a client about methotrexate therapy for rheumatoid arthritis. Which of the following statements by the client indicates understanding of the teaching?

"I will take a birth control pill every day." Methotrexate is teratogenic to a fetus and is contraindicated during pregnancy. A client of childbearing age should use birth control while on this medication

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

"You should report signs of infection to your provider immediately." Symptoms of infection: - fever - cough - malaise (feeling of weakness) - weight loss - dyspnea (difficulty breathing)

Prior to starting alendronate, the nurse should assess which of the following for the client? Select all that apply

- ability to swallow - baseline vision

A nurse is teaching a client about methotrexate therapy for rheumatoid arthritis. Which of the following information should the nurse include? (Select all that apply)

- avoid being near people who are sick with a communicable illness; Methotrexate causes bone marrow suppression and increases the risk for infection. Clients taking the drug should avoid contact with large crowds or people who are sick or have a communicable illness - periodic lab tests are required; Periodic lab tests help the primary care provider monitor for kidney and liver damage. It is important to assess for jaundice and abdominal pain because they can indicate liver damage - report bruising or petechiae; Methotrexate can cause thrombocytopenia. Clients should report bruising or petechiae because that indicates a low platelet count. The nurse should monitor lab Calais for a decrease in platelets and red and white blood cells - avoid drinking alcohol; alcohol ingestion can increase the risk for liver damage

A nurse is teaching a client about methotrexate. The nurse should inform the client to monitor for which of the following as an adverse effect of this drug?

- black tarry stools Methotrexate can cause gastric intestinal ulceration, which can lead to perforation and bleeding. The client should watch for blood in stools or emesis and report either to the HCP stat

Contraindications of Alendronate:

- give the drug with 8 oz of water after taking the drug - have the pt remain in upright position for 30 min (both on card)

Serious Side Effects of Etanercept:

- heart failure - cough - elevated BP - SOB (on bingo card) monitor for abrasions, skin rashes or blisters because there is a great risk for infection patient is at a greater risk if they have Type 2 Diabetes

Alendronate Side Effects (problems)

- jaw pain - muscle pain - blurred vision

A nurse is preparing to administer alendronate (Fosamax) to a client who has osteoporosis. The nurse should recognize which adverse effect?

- joint pain treats joint and muscle pain with analgesics other adverse effects include: - nausea - visual disturbances - esophagitis

Which lab tests should you monitor for a client who is taking interferon beta-1b to treat multiple sclerosis? Select all that apply

- liver function - CBC - thyroid hormones Interferon beta-1b is an immunosuppressant, which cause hepatotoxicity and myelosuppression. Monitor liver studies and CBCs. The client should undergo thyroid function testing every 6 months. This drug can elevate serum creatinine and alter serum electrolytes

Early clinical manifestations of lithium toxicity include which of the following?

- nausea - muscle weakness Other early findings include thirst, vomiting, and fine muscle tremors. Clients should report these manifestations immediately.

A client is about to start taking hydrocortisone (Cortef) to treat adrenocortical insufficiency. You should instruct the client to do which of the following to help reduce the risk of adverse effects of this drug? (Select all that apply)

- report increased stress - record weight regularly - increase calcium and vitamin D intake - take drug with food

A nurse is caring for a client who is to begin taking calcitonin-salmon (Miacalcin) intranasal spray to treat osteoporosis. Which of the following information should the nurse include?

- report rash or itching; or if swelling develops - prime the pump before the first dose; to ensure proper dosage - report nasal irritation; or bleeding; client may need parenteral administration if there is several nasal irritations

When instructing the client about alendronate, which of the following information should the health care provider provide? Select all that apply

- take the drug on empty stomach - sit up right for 30 min following the dosage - take with a full glass of water (8 oz) take in the morning for optimal bioavailability

A nurse is caring for a client who is currently taking methotrexate for rheumatoid arthritis. The nurse should identify that which of the following is an adverse effect of this medication?

- thrombocytopenia Methotrexate has many adverse effects that affect the central nervous, respiratory, dermatologic, and hematology systems, such as anemia, leukopenia, and thrombocytopenia

A nurse is caring for a client who has a prescription for alprazolam. For which of the following adverse effects should the nurse monitor? Select all that apply

- tolerance; also dependence can help with alprazolam; client should use these drugs only as needed and for short periods of time - anxiety; paradoxical reactions such as anxiety and insomnia can develop, especially in older adults - sedation; it is important to monitor for respiratory depression and recommend the lowest effective dose; clients should avoid alcohol whole taking a benzodiazepine such as Alprazolam - respiratory depression; also nausea, vomiting and diarrhea

A nurse is caring for a client who is about to start taking lithium carbonate to treat bipolar disorder. The nurse should instruct the client to monitor for which of the following findings as indications of lithium toxicity? Select all that apply

- tremors; a coarse tremor indicates advanced toxicity that can lead to seizure activity - confusion; also slurred speech and ataxia because of the drug's narrow therapeutic range - nausea; also vomiting and diarrhea - muscle weakness; the HCP should monitor lithium levels periodically

A nurse is teaching a client who has a prescription for calcitonin-salmon about manifestations of hypercalcemia. Which of the following manifestations should the nurse include in the teaching?

- vomiting Nurse should tell client that rebound hypercalcemia can occur when taking this drug. **Manifestations of hypercalcemia include nausea, vomiting, flank pain, lethargy, and deep bone pain

S/S of hypercalcemia

- vomiting (on bingo card) - nausea - flank pain - lethargy (tired) - deep bone pain

Which medication is used to treat Osteoporosis?

Alendronate (Fosamax) (on bingo card)

Which medication is used to treat hypercalcemia?

Calcitonin Salmon (Fortical)

Diazepam can increase risk for what and can contraindicate in clients that are pregnant?

Congenital malformations (on bingo card) Instruct pt to report to provider if they are or planning on being pregnant

This medication can cause nausea, vomiting and diarrhea. The patient needs to take this med with food to reduce these adverse effects.

Donepezil (on bingo card) encourage the pt to take this drug with food in order to reduce the adverse effects of nausea, vomiting and diarrhea

A nurse is teaching about self-administering methotrexate to a client who has rheumatoid arthritis. Which of the following statements should the nurse make?

Drink 2 to 3 L of water to promote the drug's excretion Methotrexate can cause kidney damage. Adequate hydration optimizes drug excretion and helps prevent kidney damage. Clients can take sodium bicarbonate tablet to increase urine alkalinity and reduce the drug precipitation that can lead to kidney damage

Which medication is used to treat Rheumatoid arthritis?

Etanercept (Enbrel)

A nurse is caring for a client who is taking interferon beta-1b. The nurse should identify that which of the following findings indicates a potential serious adverse effect of this drug?

Fatigue Because of the potential for bone marrow suppression and decreased platelet count, patients should report unexplained bruising, bleeding or fatigue

A client who has rheumatoid arthritis is taking methotrexate. Which of the following reduces toxicity from the drug?

Folic acid The client should take 5 milligrams or more of the folic acid supplement per week.

A nurse is reviewing the drug history of a client who is taking lithium carbonate for bipolar disorder. Which of the following findings should indicate to the nurse to monitor for lithium toxicity?

Furosemide (Lasix) for hypertension Furosemide increases sodium loss and can cause resorption. The nurse should evaluate the client for lithium toxicity

While obtaining a client's medical history, you find that the client is taking levodopa/carbidopa for Parkinson's disease. Which information in the client's health history alerts you to take further action?

Glaucoma Both dopamine-replacement drugs can cause changes intraocular pressure. Caution is required when using this drug with clients who have peptic ulcer disease. Can cause variety of vision disturbances

A nurse is caring for a client who has a prescription for methotrexate. Which of these following drugs would likely be prescribed in conjunction during the initial treatment for rheumatoid arthritis?

Ibuprofen

A nurse is providing teaching to a client about the adverse effects of drug therapy. The nurse should include that orthostatic hypotension is a common adverse reaction of which of the following drugs?

Imipramine (Tofranil) Clients taking this drug should change positions slowly from sitting or lying to standing

Which medication treats multiple sclerosis?

Interferon Beta 1a and 1b

Which medication is used to put people to sleep (sedation) and a short-acting barbiturate and causes (adverse effect of) respiratory depression?

Methohexital Sodium (on bingo card) mechanical ventilation is usually required for people who receive this drug pt needs continuous observation

Which medication causes internal ulceration (cause an abdominal bleed) and should you monitor for black tarry stools?

Methotrexate (Trexall, Rheumatrexate) (on bingo card)

What should the pt do if the side effects for Alendronate occur?

Notify the physician immediately

People who take Imipramine should be careful when they are changing positions because it can cause?

Orthostatic (postural) hypotension this is from sitting to standing position or vice versa (don't do this too quickly) this decreases blood pressure

A nurse is teaching a client about interferon beta-1a. Which of the following instructions should the nurse give to help the client avoid the adverse effects of this drug?

Premeditate with acetaminophen (Tylenol)

Alprazolam (Xanax) is used to treat anxiety. The dosage should be decreased for clients who have?

Renal (kidney) and hepatic (liver) impairment (on bingo card)

A client is about to start therapy with methotrexone for rheumatoid arthritis. Knowing the adverse effects of methotrexone, you advise the client to watch for which of the following?

Sore throat Methotrexate may cause bone marrow suppression. The client should report any signs of infection, such as a sore throat or fever. Adverse effects of this drug include headache, mucositis (painful inflammation and ulceration of the mucous membranes, gastric ulcers, gingivitis (inflammation of the gums), and hepatotoxicity

At a visit to the provider's office, an older adult client's partner reports the client has nausea, diarrhea, and a loss of appetite. He has a history of Alzheimer's disease and is taking donepezil. Which information should be provided by the nurse?

Take the drug with food Donepezil commonly causes nausea, vomiting, anorexia, and other GI symptoms. The nurse should explain to the client and his caregiver that taking the drug with food and at bedtime will help minimize uncomfortable GI effects. The nurse should also instruct the partner to report vomiting, severe diarrhea, weight loss or sings of GI bleeding, such as dark stools or coffee-ground emesis.

What is lipohypertrophy?

a reaction at site of injection usually when taking an insulin injection and also deep injections

A nurse is caring for a client who has a new prescription for etanercept. Which of the following actions should the nurse take?

administer a tuberculin skin test prior to starting the medication the nurse should administer a tuberculin skin test prior to starting the medication

A nurse is teaching the family of a client who has a new diagnosis of Alzheimer's disease about donepezil. Which of the following information should the nurse include?

avoid the use of NSAIDS for pain Combining NSAIDS with donepezil can cause GI bleeding

A nurse is planning care for a client who has a new prescription for methotrexate. The nurse should monitor the client for which of the following adverse effects?

bone marrow depression The nurse should monitor the client for bone marrow depression, which is an adverse effect of folic acid analogs such as methotrexate

A nurse is teaching a client who is taking levodopa/carbidopa to treat Parkinson's disease. Which of the following instructions should the nurse include?

change position slowly to prevent orthostatic hypotension

Which medication do pts need to be careful taking when being exposed to sunlight and wear sunscreen?

chlorpromazine

A nurse is caring for a client who is taking alendronate to treat postmenopausal osteoporosis. The nurse should explain to the client that alendronate increases bone mass by which action?

decreases activity of osteoclasts

The health care provider prescribes alendronate (Fosamax) to reduce bone resorption and instructs the client to monitor for which indication of a serious adverse effect of this drug?

dysphagia (difficulty swallowing) (indicates esophagitis)

What does Alendronate prevent?

esophagitis

A patient has adrenal insufficiency and hypotension. The patient might need the dosage increased. Which medication is this patient taking?

hydrocortisone hypotension and fatigue are findings of adrenal insufficiency (problems) during times of stress; the client might need to increase the dosage to prevent adrenal insufficiency

You are caring for a client who is taking levothyroxine (Synthroid) to treat hypothyroidism. The client reports palpitations, weight loss, and diarrhea. You suspect which of the following adverse effects of this drug?

hyperthyroidism Levothyroxine can cause hyperthyroidism if the prescribed dose exceeds what the client requires to remain euthyroid. Monitor thyroid function via T4 and TSH levels. Instruct the client to watch for and report indications of hyperthyroidism, such as anxiety, insomnia, tachycardia, palpitations, diarrhea, and weight loss. Injectable hypoglycemic, such as insulin, can cause hypoglycemia

What does Levothyroxine treat?

hypothyroidism Levothyroxine is a life-long medication for pt's with hypothyroidism

What is the medication that is a tricyclic antidepressant?

imipramine

Alendronate (Fosamax) is contraindicated for administration to clients who have which condition?

inability to sit upright for 30 min

A nurse is caring for a client who has a prescription for etanercept. The nurse should identify that etanercept treats rheumatoid arthritis by which of the following actions?

inactivation of tumor necrosis factor prevents autoimmune response and subsequent inflammation of the joints

A primary care provider prescribes calcitonin salmon for a post-menopausal client. Knowing the adverse effects of calcitonin, you instruct the client to

increase calcium and vitamin D The client should increase calcium and vitamin D intake and watch for indications of hypocalcemia, such as muscle cramps and numbness in the fingers or toes. Calcitonin can cause weakness, SOB, and headaches.

A nurse is teaching a client who has a new diagnosis of Parkinson's disease about how levodopa/carbidopa can help control symptoms. The nurse should identify that the drug has which of the following pharmacologic effects?

increases available dopamine in the brain This combination of the drug can act by increasing dopamine in the extrapyramidal center of the brain, reducing involuntary motion

A nurse should identify that a client who has diabetes mellitus and is taking etanercept is at an increased risk for which of the following adverse effects?

infection

A nurse is caring for a client taking etanercept. Which of the following adverse effects is most important to mention when educating this client?

injection site reaction can occur teach the client to look for localized signs such as - itching - erythema (redness) - swelling - pain

Which medication is a Parkinson's med and treats Parkinson's disease?

levodopa/carbidopa (Selegiline)

Lithium carbonate treats bipolar. Patients who have the following symptoms; tremors, nausea, confusion and muscle weakness, need to evaluated for?

lithium toxicity (on bingo card)

A nurse is caring for a client who has been taking Selegiline to treat Parkinson's disease. The provider is considering the use of analgesics for the client but should be aware that a drug interaction between Selegiline and Meperidine can result in which of the following?

muscle rigidity A drug interaction between Selegiline and opioids, especially Meperidine, can result in a serious resulting in rigidity, stupor agitation, hypertension, and fever

if Selegiline is mixed with an opioid analgesic to treat Parkinson's disease, it can create which negative effect?

muscle rigidity (on bingo card)

A nurse is caring for a client who is taking donepezil to treat Alzheimer's disease. For which of the following adverse effects should the nurse monitor?

nausea The most common adverse effects of donepezil, a cholinesterase inhibitor, are nausea, vomiting, and diarrhea. Taking the drug with food can help reduce adverse effects

A nurse is reviewing the medical history of a client who has a new prescription for a reduced dosage of alprazolam for anxiety. Which of the following findings should indicate to the nurse the reason for the prescription modification?

renal function impairment Alprazolam dosage should be decreased for clients who have renal or hepatic impairment

A nurse is caring for a client who is receiving methohexital sodium. The nurse should monitor the client for which of the following adverse effects?

respiratory depression Thiopental, a short-acting barbiturate, causes respiratory depression. Mechanical ventilation and continuous monitoring are essential for patients receiving the drug

A nurse is caring for a client who is taking etanercept for rheumatoid arthritis. The nurse should monitor the client for which of the following indications of a serious adverse reaction to the drug?

shortness of breath (on the bingo card) Etanercept can cause heart failure, manifesting as SOB, cough, elevated blood pressure and heart rate, and pink-tinged sputum

A nurse is teaching a client who is taking etanercept for rheumatoid arthritis. The nurse should instruct the client to monitor for which of the following indications of an adverse reaction to this drug?

skin rash serious reactions such as: - Stevens-Johnson syndrome - toxic epidermal necrolysis report any skin rashes or blisters immediately

How do you give the medication Interferon Beta 1a?

subcutaneously (on bingo card) in the upper arm and thigh

A nurse is caring for a client who is taking lithium carbonate to treat bipolar disorder. Which of the following diagnostic tests should the nurse recommend that the client would undergo periodically?

thyroid function tests Hypothyroidism is an adverse effect of lithium carbonate. Clients should report neck enlargement, weight gain, lethargy, and constipation. They should also have their thyroid function checked before they begin taking lithium and annually after.

A primary care provider prescribes etanercept to treat a client's rheumatoid arthritis. Prior to beginning treatment, the client requires testing for which of the following?

tuberculosis also monitor clients for development of TB during etanercept therapy

A nurse is caring for a client who has been taking alprazolam for an extended period of time to treat anxiety. The nurse should identify that abruptly stopping alprazolam therapy can result in which of the following adverse effects?

withdrawal symptoms Physical dependence can develop with extended use of alprazolam, a benzodiazepine. To prevent withdrawal symptoms, clients should taper the dose slowly over several weeks