ch 9,10,11,13 mini exam practice pharmacology

11. A client has been reading about the use of flax seed to lower cholesterol. What should the client be taught about the use of oat bran and cholestyramine? A) Cholestyramine absorption will be increased with oat bran. B) Cholestyramine absorption will be decreased with oat bran. C) Bleeding will be increased with oat bran and cholestyramine. D) Hypoglycemia will result from oat bran and cholestyramine.

A

12. A client is to be administered antithymocyte globulin (ATG) to treat renal transplant rejection. What skin test should be assessed prior to the administration of the first dose of medication? A) allergy to horse serum B) allergy to ragweed C) allergy to dust mites D) tuberculosis

A

16. A 71-year-old woman has experienced a sharp decline in her mobility and quality of life due to severe rheumatoid arthritis. As a result, her care provider has recently prescribed abatacept. This fusion protein inhibitor will achieve a therapeutic effect by what means? A) preventing the activation of T cells B) increasing antibody production by B cells C) antagonizing histamine receptors D) inhibiting the production of mast cells

A

16. A client who is recovering in hospital from a bilateral mastectomy has developed minor bleeding at one of the incision sites. During the process of clot formation, plasminogen will become part of a clot by which means? A) by binding with fibrin B) by binding with platelets C) by activating plasmin D) by activating factor VII

A

16. A client will begin taking atorvastatin, and the nurse is conducting relevant health education. The nurse should emphasize the need to report any new onset of: A) muscle pain. B) dry mouth. C) pruritus (itching). D) increased thirst.

A

18. An adult male client is experienced a kidney transplant 2 days ago, and his regimen of antirejection drugs began just prior to surgery. What nursing action should be integrated into this client's plan of care? A) Place the client in a single, protective isolation room. B) Arrange for the client to receive a raw-food, organic diet. C) Wash the client's skin with chlorhexidine twice daily. D) Have the client wear a gown and gloves when outside his room.

A

2. A client being 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? A) vitamin K B) vitamin E C) protamine sulfate D) acetylsalicylic acid (aspirin)

A

2. A client has received a bone marrow transplant. What will occur if the client receives inadequate immunosuppression after the transplant? A) graft versus host disease B) hepatotoxicity C) acute kidney injury D) sepsis

A

4. A client has been administered heparin to prevent thromboembolism development status postmyocardial infarction. The client develops heparin-induced thrombocytopenia. Which medication will be administered? A) argatroban 9 B) vitamin K C) calcium gluconate D) aminocaproic acid

A

4. A client is taking atorvastatin to reduce serum cholesterol. Which aspect of client teaching is most important? A) Call the health care provider if muscle pain develops. B) It is unacceptable to eat dietary fats. C) Decrease the dose if lethargy occurs. D) Eat two eggs per day to increase protein stores.

A

4. A client is to begin treatment for rheumatoid arthritis with infliximab. What potential risk should the nurse identify as being associated with this drug? A) risk for infection B) risk for decreased level of consciousness C) risk for nephrotoxicity D) risk for hepatotoxicity

A

5. A client has begun taking cholestyramine. Which are noted as the most common adverse effects? A) nausea, flatulence, and constipation B) increased appetite and blood pressure C) fatigue and mental disorientation D) hiccups, nasal congestion, and dizziness

A

5. A client is receiving low molecular weight heparin to prevent thromboembolic complications. The nursing student asks the nursing 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? A) "LMWH is associated with less thrombocytopenia than standard heparin." B) "LMWH is associated with stronger anticoagulant effects than standard heparin." C) "LMWH is given to clients who have a history of blood dyscrasia." D) "LMWH is more effective than standard heparin for clients with hypertension."

A

5. A client with chronic renal failure is prescribed filgrastim. What is the major effect of filgrastim? A) decreases neutropenia related to chemotherapy B) decreases white blood cells related to infection C) decreases growth of blood vessels due to ischemia D) decreases platelet count related to bleeding

A

6. A client has been diagnosed with chronic renal failure. Which agent will assist in raising the client's hemoglobin levels? A) epoetin alfa B) pentoxifylline C) estazolam D) dextromethorphan hydrobromide

A

7. A client is taking cholestyramine to reduce LDL cholesterol. Cholestyramine will cause a decrease in absorption of which medication? A) digoxin B) ibuprofen C) aspirin D) acetaminophen

A

8. A client is admitted with thrombophlebitis and sent home on enoxaparin therapy. Which statement indicates a good understanding of why enoxaparin is being administered? A) Enoxaparin inhibits the formation of additional clots. B) Enoxaparin eliminates certain clotting factors. C) Enoxaparin decreases the viscosity of blood. D) Enoxaparin will dissolve the existing clots.

A

9. A client has been placed on tacrolimus, and the route will be changed from IV to oral prior to discharge home from the hospital. How will this change in administration route affect the client's plan of care? A) The client's dose of tacrolimus will have to be increased. B) The client will receive the drug QID rather than BID. C) The client will have to be monitored more closely for adverse effects. D) The client will have to take tacrolimus concurrently with an antiemetic.

A

9. Which single drug class is known to be most effective in reducing the major types of dyslipidemia? A) statins B) bile acid sequestrants C) fibrates D) niacin

A

20. A client who is undergoing chemotherapy for the treatment of non-Hodgkin's lymphoma will soon begin treatment with epoetin alfa. The nurse should be aware that this drug may be administered by which route? Select all that apply. A) subcutaneous B) intramuscular C) oral D) buccal E) intravenous

A,E

1. An obese client who has an elevated triglyceride level and reduced high-density lipoprotein cholesterol is seen by the primary care provider. What do these data suggest in this client? A) the development of arthritic syndrome B) the development of metabolic syndrome C) the development of Reye's syndrome D) the development of Tay-Sachs disease

B

10. A client is discharged from the hospital with a prescription of warfarin. Which statement indicates successful client teaching? A) "If I miss a dose, I will take two doses." B) "I will avoid herbal remedies." C) "I will eat spinach or broccoli daily." D) "I will discontinue my other medications."

B

10. A client is ordered to receive cyclosporine intravenously, and the nurse has explained the need for frequent blood work. This blood work is required because cyclosporine: A) decreases erythropoiesis. B) has a narrow therapeutic range. C) has been linked to spontaneous hemolysis. D) can precipitate a thyroid storm.

B

12. A client asks the nurse what dose of acetylsalicylic acid is needed each day for antiplatelet effects to prevent heart attacks. What dose is most appropriate to reduce platelet aggregation? A) 10 mg B) 30 mg C) 625 mg D) 1000 mg

B

12. A client is administered a granulocyte colony-stimulating factor (G-CSF). What is the expected outcome of a G-CSF? A) red blood cell count of 3000 mm3 B) decreased number of infections C) decreased fatigue and increased energy D) white blood cell count of 20,000 mm3

B

13. An oncology nurse is providing care for an adult client who is currently immunocompromised. The nurse is aware of the physiology involved in hematopoiesis and immune function, including the salient role of cytokines. What is the primary role of cytokines in maintaining homeostasis? A) Cytokines perform phagocytosis in response to bacterial and protozoal infection. B) Cytokines perform a regulatory role in the development of diverse blood cells. C) Cytokines can be considered to be the basic "building blocks" of all blood cells. D) Cytokines are formed in response to the presence of antibodies.

B

14. A client's current medical condition is suggestive of impaired erythropoiesis. Which laboratory study would be most clinically relevant in diagnosing this health problem? A) white blood cell count with differential B) RBC, hemoglobin, and hematocrit C) INR and aPTT D) D-dimer and C-reactive protein

B

14. An adult male client is being administered immunosuppressant agents on a long-term basis. Which assessments should be made routinely with the use of long-term immunosuppressant therapy? A) yearly bronchoscopy B) yearly skin assessment C) yearly bladder biopsy D) yearly prostate examination

B

15. An adult client has developed renal failure secondary to an overdose of a nephrotoxic drug. Which assessment finding would the nurse recognize as being most suggestive of impaired erythropoiesis? A) frequent infections and low neutrophil levels B) fatigue and increased heart rate C) agitation and changes in cognition D) increased blood pressure and peripheral edema

B

17. A 55-year-old man has been diagnosed with coronary artery disease and begun antiplatelet therapy. The man has asked the nurse why he is not taking a "blood thinner like warfarin." What is the most likely rationale for the clinician's use of an antiplatelet agent rather than an anticoagulant? A) Antiplatelet agents do not require the man to undergo frequent blood work; anticoagulants require constant blood work to ensure safety. B) Antiplatelet agents are more effective against arterial thrombosis; anticoagulants are more effective against venous thrombosis. C) Antiplatelet agents are most effective in large vessels; anticoagulants are most effective in the small vessels of the peripheral circulation. D) Antiplatelet agents have fewer adverse effects than anticoagulants.

B

17. The nurse's medication reconciliation performed on a client who is newly admitted to the hospital reveals that the client regularly takes infliximab, a humanized IgG monoclonal antibody. The nurse is justified in suspecting that this client may have a history of which of the following? A) osteoporosis B) Crohn's disease C) organ transplant D) severe seasonal allergies

B

19. A 66-year-old woman's most recent physical assessment and diagnostic workup reveal the presence of dyslipidemia. The woman is a candidate for monotherapy with a statin, and she will soon begin treatment with atorvastatin. The nurse should anticipate what order? A) "atorvastatin 150 mg PO BID" B) "atorvastatin 10 mg PO OD" C) "atorvastatin 50 mg PO TID with meals" D) "atorvastatin 75 mg PO BID"

B

19. Which nursing diagnoses would provide the most plausible indication for the use of epoetin alfa in a client with renal failure? A) risk for infection related to decreased erythropoiesis B) activity intolerance related to decreased oxygen-carrying capacity C) powerlessness-related sequelae of renal failure D) ineffective breathing pattern related to inadequate erythropoietin synthesis

B

20. An elderly client with dyslipidemia has had fenofibrate added to the existing medication regimen. In addition to having the lipid profile drawn on a regular basis, the nurse should educate the client about the need for what ongoing laboratory testing during therapy? A) complete blood count (CBC) B) liver panel C) INR and aPTT D) reticulocyte count

B

3. A client with a history of clot formation is scheduled for bowel resection due to colorectal cancer. What anticoagulant agent will be administered prophylactically? A) acetylsalicylic acid B) heparin C) warfarin D) streptokinase

B

4. A client is being administered chemotherapeutic agents for the treatment of cancer. Which blood cells will be stimulated by the colony-stimulating factors in response to the effects of the chemotherapy? A) white blood cells B) red blood cells C) phagocytes D) myocardial cells

B

6. A client is administered cyclosporine to prevent rejection of a kidney transplant. Which is a major adverse effect of cyclosporine? A) congestive heart failure B) nephrotoxicity C) anaphylaxis D) respiratory arrest

B

7. A client has experienced the formation of 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? A) aminocaproic acid B) heparin C) warfarin D) protamine sulfate

B

8. A client is prescribed fenofibrate. When providing client teaching, which accurately describes the action of fenofibrate? A) It binds to bile acids in the intestinal lumen. B) It increases oxidation of fatty acids in the liver. C) It inhibits an enzyme required for hepatic synthesis. D) It inhibits mobilization of free fatty acids from peripheral tissues.

B

8. A hospital client's complex medical history includes a recent diagnosis of kidney cancer. Which medication is used to treat metastatic kidney cancer? A) filgrastim B) aldesleukin C) interferon alfa-2b D) darbepoetin alfa

B

A 50-year-old man has undergone a bunionectomy and has been admitted to the postsurgical unit. What aspect of the man's medical history would contraindicate the use of heparin for deep vein thrombosis (DVT) prophylaxis? A) The man is morbidly obese. B) The man has a diagnosis of ulcerative colitis (UC). C) The man had a myocardial infarction (MI) 18 months ago. D) The man has a diagnosis of type 2 diabetes mellitus (DM).

B

15. A male client has been diagnosed with moderately increased LDL, and his primary care provider wishes to begin him on a statin. What is a potential disadvantage of statins that the care provider should consider? Select all that apply. A) Statins are nephrotoxic. B) Statins are expensive. C) Statins are contraindicated in clients with a history of myocardial infarction. D) Statins require regularly scheduled blood work. E) Statins have an immunosuppressive effect.

B,D

15. A client is taking warfarin to prevent clot formation related to atrial fibrillation. How are the effects of the warfarin monitored? A) RBC B) aPTT C) PT and INR D) platelet count

C

17. An older adult client is being treated in the hospital for a stroke and is undergoing an extended stay on a rehabilitation unit. The client's spouse has been participating actively in the client's care and performs much of the feeding and hygiene needs. This evening, the spouse has brought in a number of healthy snacks to keep at the client's bedside. Knowing that the client's medication regimen includes simvastatin, the nurse would remove which item? A) purple grapes B) cranberry cocktail C) grapefruit juice D) trail mix (salted nuts and seeds)

C

18. A 69-year-old female client has been diagnosed with malignant melanoma. The care team has collaborated with the client and her family and agreed on a plan of care that includes administration of interferon alfa-2b. After administering interferon alfa-2b, the oncology nurse should anticipate that the client may develop which adverse effect? A) profound diaphoresis B) decreased level of consciousness C) flu-like symptoms D) cyanosis and pallor

C

20. A transplant nurse is aware of the need to closely monitor a client's serum levels of cyclosporine. In order to do this, the nurse should ensure that blood is drawn at what time? A) 30 minutes before a scheduled dose B) simultaneous to the administration of a dose C) 2 hours after a dose D) at the halfway point between two scheduled doses

C

3. A client has developed Kaposi's sarcoma. What defense mechanism is the most affected by this homeostatic change initially? A) The mucous membrane is affected. B) The respiratory tract is affected. C) The skin is affected. D) The gastrointestinal tract is affected.

C

5. A client is administered mycophenolate to prevent rejection of the transplanted heart. It is recommended that the client have a CBC drawn weekly. The client asks the nurse the reason for the weekly CBC. Which is the nurse's best response? A) "The weekly CBC is routine and ordered for all clients." B) "The weekly CBC assesses for the development of bleeding." C) "The weekly CBC assesses for the development of infection." D) "The weekly CBC assesses for changes in your blood's oxygen-carrying capacity."

C

6. A client who has been taking a statin has seen an improvement in cholesterol laboratory values; however, the low-density lipoprotein remains elevated. What medication will be added to the medication regimen? A) digoxin B) vitamin D C) cholestyramine D) calcium carbonate

C

9. A client is diagnosed with ischemic heart disease. The client is prescribed filgrastim. What effect will this medication provide in the treatment of ischemic heart disease? A) increase platelets B) decrease platelets C) promote angiogenesis D) prevent thrombus formation

C

13. A client is prescribed eptifibatide, which inhibits platelet aggregation by preventing activation of GP IIb/IIIa receptors on the platelet surface and the subsequent binding of fibrinogen and von Willebrand factor to platelets. Which syndrome is treated with eptifibatide? A) blocked carotid arteries B) intermittent claudication C) hypertension D) unstable anginaD

D

14. A client is receiving IV heparin every 6 hours. An activated partial thromboplastin time (aPTT) is drawn 1 hour before the 08:00 dose. The PTT is 92 seconds. What is the most appropriate action by the nurse? A) Give the next two doses at the same time. B) Give the dose and chart the client response. C) Check the client's vital signs and give the dose. D) Hold the dose and call the aPTT result to the health care provider's attention.

D

14. An older adult client, who leads a sedentary lifestyle, has recently been diagnosed with dyslipidemia. The client is disappointed to learn about this condition, stating, "First it was the diabetes and then the arthritis, now this." The nurse has performed health education with the client and has described metabolic syndrome. In addition to the elevated cholesterol levels, what aspect of the client's health is congruent with a diagnosis of metabolic syndrome? A) sedentary lifestyle B) age over 65 C) arthritis D) diabetes mellitus

D

16. A client with a diagnosis of chronic renal failure will soon begin a regimen of epoetin that will be administered by the client at home. Which statement indicates that the nurse's initial health education has been successful? A) "I'll make sure to take my epoetin pill on a strict schedule and make sure I never miss a dose." B) "I'm glad that epoetin can help to protect me from getting an infection." C) "I'm excited that there's a medication that can help my kidneys work better." D) "I'm not all that comfortable with giving myself an injection, but I'm sure I'll be able to learn."

D

17. Which client would likely be the most appropriate candidate for treatment with filgrastim? A) a client who has undergone a mastectomy for the treatment of breast cancer B) a client with acquired immune deficiency syndrome (AIDS) who has been diagnosed with Kaposi's sarcoma C) a client who developed acute renal failure secondary to rhabdomyolysis D) a client whose acute myelogenous leukemia necessitated a bone marrow transplant

D

9. 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? A) eggs B) dairy products C) apples D) spinach

D

1. A client has a low erythrocyte count. How may a colony-stimulating factor affect the client's erythrocyte count? A) It stimulates growth of red blood cells. B) It suppresses T-cell production. C) It inhibits protein synthesis. D) It stimulates antibody production.

A

19. Following a successful kidney transplant in 2012, a 59-year-old woman has presented to the clinic for one of her regularly scheduled follow-up appointments. The nurse at the clinic should assess the client in the knowledge that long-term use of antirejection drugs has been associated with: A) early onset of dementia. B) increased risk of malignancy. C) atherosclerosis. D) increased risk of venous thromboembolism.

B

2. A client has an elevated total serum cholesterol of 260 mg/dL. Which aspect of client teaching of lifestyle changes is most important for the client? A) Eat organic foods. B) Stop smoking. C) Increase rest periods. D) Drink whole milk.

B

1. Which is the most likely indication for the use of immunosuppressant agents? A) intractable seizure disorders B) increased intracranial pressure C) organ transplantation D) HIV/AIDS with multiple drug resistance

C

10. A client with a diagnosis of renal failure is being treated with epoetin alfa. Frequent assessment of which laboratory values should be prioritized before and during treatment? A) AST B) C-reactive protein C) CBC D) ALT

C

11. A client is being administered heparin IV and has been started on warfarin. The client asks the nurse why she is taking both medications. What is the nurse's most accurate response? A) "After a certain period of time, you must start warfarin and heparin together." B) "You will need both warfarin and heparin for several days." C) "Warfarin takes 3 to 5 days to develop anticoagulant effects, and you still need heparin." D) "Warfarin cannot be given without heparin due to the amount of clotting you need."

C

11. A client is receiving epoetin alfa for anemia. Which adjunctive therapy is imperative with epoetin alfa? A) potassium supplements B) sodium restriction C) iron supplement D) renal dialysis

C

11. Sirolimus and cyclosporine are being used to prevent renal transplant rejection in an adult client. What principle should guide the nurse's administration of these two drugs? A) Sirolimus should be given orally; cyclosporine should be administered IV. B) The two drugs should be administered together to potentiate their effects. C) The two drugs should be given at least 4 hours apart. D) The drugs should be administered in a single intramuscular injection.

C

12. Which herbal and dietary supplement has shown proven success in lowering LDL and total cholesterol in research studies? A) soy B) flaxseed oil C) red yeast rice D) garlic

C

13. A client is receiving omalizumab to treat allergic asthma, which is not relieved by inhaled corticosteroids. Which nursing intervention is appropriate with each dose administration of omalizumab? A) Administer high-flow oxygen prior to administration. B) Avoid high-fat foods during the course of treatment. C) Have epinephrine available during administration. D) Administer a corticosteroid prior to administration.

C

13. A client is scheduled to have serum triglyceride level assessed. How long should the client be without food or fluids prior to the serum triglyceride test? A) 6 hours B) 8 to 10 hours C) 12 hours D) 24 hours

C

15. A client is administered methotrexate for the treatment of severe rheumatoid arthritis. Administration of this drug should be performed with particular care because of the associated high risk of: A) intracapsular bleeding. B) thrombophlebitis. C) hepatotoxicity. D) myocardial infarction or CVA.

C

1. A client, taking warfarin after open heart surgery, tells the home care nurse she has pain in both knees that began this week. The nurse notes bruises on both knees. Based on the effects of her medications and the report of pain, what should the nurse suspect is the cause of the pain? A) joint thrombosis B) torn medial meniscus C) degenerative joint disease caused by her medication D) bleeding

D

10. A client is taking cholestyramine and ezetimibe. What administration guideline is most important to teach this client? A) The two medications should be taken together. B) The ezetimibe inhibits cholesterol in the liver. C) The cholestyramine is administered 1 hour after ezetimibe. D) The administration of ezetimibe is 1 hour before cholestyramine.

D

18. A client has been largely unsuccessful in achieving adequate control of dyslipidemia through lifestyle changes and the use of a statin. As a result, the client has been prescribed cholestyramine. What change in this client's lipid profile will the nurse identify as the most likely goal of therapy? A) reduction in triglycerides B) reduction in total serum cholesterol levels C) increase in HDL levels D) reduction in LDL cholesterol levels

D

18. A nurse at a long-term care facility is conducting a medication reconciliation for a man who has just moved into the facility. The man is currently taking clopidogrel. The nurse is most justified suspecting that this man has a history of: A) hemorrhagic cerebrovascular accident. B) hemophilia A. C) idiopathic thrombocytopenic purpura (ITP). D) myocardial infarction.

D

19. A 79-year-old woman 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? A) low molecular weight heparin B) vitamin K C) clopidogrel D) alteplase

D

2. A client is exposed to a viral infection. What role will interferon most likely play during this exposure? A) It will stimulate B-lymphocyte activity. B) It will interfere with stem cell multiplication. C) It will stimulate growth of lymphoid cells. D) It will interfere with virus replication.

D

3. A client diagnosed with Crohn's disease is given a corticosteroid to decrease inflammation. Which effect will occur with the use of corticosteroids? A) increased joint pain B) increased C-reactive protein levels C) increased T-cell counts D) decreased antibody production

D

3. A client with a diagnosis of cardiovascular disease is taking atorvastatin to reduce serum cholesterol. What is the goal of therapy for LDL cholesterol for a client taking atorvastatin calcium? A) 100 to 115 mg/dL B) 75 to 85 mg/dL C) less than 60 mg/dL D) less than 130 mg/dL

D

6. A client who is receiving warfarin has blood in his urinary catheter drainage bag. What medication will likely be ordered by the health care provider? A) aminocaproic acid B) platelets C) protamine sulfate D) vitamin K

D

7. A client is receiving immunosuppressant therapy and is preparing for discharge. For which should the client be educated? A) the importance of a high-protein diet B) the need to maximize fluid intake C) the need for regular physical activity D) the importance of keeping the home clean

D

7. A client is undergoing a bone marrow transplant. Which medication is most effective in stimulating the production of granulocytes and macrophages? A) bacillus Calmette-Guérin B) epoetin alfa C) aldesleukin D) sargramostim

D

8. A client has been discharged from the hospital after a kidney transplant. Which nursing interventions is the first line of defense against the immunosuppressed client developing an infection? A) Ensure visitors do not come to the home. B) Teach the client to wear a mask consistently. C) Administer prophylactic antibiotics. D) Teach the client the importance of personal hygiene.

D