Exam 4 - Quiz Questions from Unit 10 & 11 Pharmacology

A patient newly diagnosed with diabetes expresses concern about losing her vision. Which interventions should be included in the plan of care to reduce this risk?

-Ways to reduce hyperglycemic episodes, -Smoking cessation, -Emphasis on the importance of taking antihypertensive drugs consistently Tighter glycemic control and fewer hyperglycemic episodes have been correlated with fewer complications. Smoking cessation and following strict compliance to any antihypertensive drugs prescribed for hypertension also help reduce the risk of complications. The use of contraception or a prokinetic drug is not related to a reduced risk of vision loss in patients with diabetes.

A patient with type 1 diabetes is eating breakfast at 7:30am. Blood sugars are on a sliding scale and are ordered before a meal and at bedtime. The patient's blood sugar level is 317 mg/dL. Which formulation of insulin should the nurse prepare to administer?

Lispro (Humalog) Regular insulin is indicated for sliding scale coverage. Insulin is definitely indicated for this high blood sugar level. NPH is used for scheduled insulin doses and is a longer-acting insulin. A 70/30 mix is also used for scheduled insulin coverage.

A healthy male patient who does not have erectile dysfunction asks about medications to improve sexual stamina. What will the nurse tell this patient?

Medications for ED have no effect on erections in healthy men.

A patient who has erectile dysfunction asks a nurse whether sildenafil {Viagra} would be a good medication for him to take. Which aspect of the patients history would most concern the nurse?

Occasional use of nitroglycerin. Patients taking nitroglycerin should not take sildenafil.

What is the priority nursing goal for 14-year-old with Graves disease?

Verbalizing the importance of adherence to the medication regimen

A nurse is discussing the use of immunosuppressants for the treatment of inflammatory bowel disease (IBS) with a group of nursing students. Which statement by a student indicates understanding of the teaching?

"Cyclosporine [Sandimmune] can be used to induce remission of IBD."

A nurse provides teaching to a patient who has had a hysterectomy and is about to begin hormone therapy to manage menopausal symptoms. Which statement by the patient indicates understanding of the teaching?

"I should take the lowest effective dose for the shortest time needed."

A nurse is teaching a patient who has been diagnosed with hypothyroidism about levothyroxine (Synthroid). Which statement by the patient indicates a need for further teaching?

"If I take calcium supplements, I may need to decrease my dose of Synthroid." Patients taking calcium supplements should take these either 4 hours before or after taking levothyroxine because they interfere with the medication absorption.

A nurse is teaching a patient about the use of sildenafil [Viagra] for erectile dysfunction. Which statement by the patient indicates understanding of the teaching?

"If my erection lasts longer than 4 hours, I should contact my provider."

A nurse provides dietary counseling for a patient newly diagnosed with type 1 diabetes. Which instruction should be included?

"Most of your calories should be in the form of carbohydrates and monounsaturated fats." "You should use a carbohydrate counting approach to maintain glycemic control." Patients with diabetes should be given intensive insulin therapy education using either a carbohydrate counting or experience-based estimation approach in achieving glycemic control. A patient with diabetes cannot eat any foods desired and then cover the glucose increase with a sliding scale of regular insulin. Evidence suggests that there is not an ideal percentage of calories that should be ingested from carbohydrate, fat, or protein. Every patient with diabetes must be assessed individually to determine the number of total calories the person should have daily. The total caloric intake should be spread evenly throughout the day, with meals spaced 4 to 5 hours apart.

An adult male patient will begin androgen therapy for testicular failure. Which statement by the patient indicates understanding of the treatment regimen?

"My libido may improve while I am taking this medication."

The nurse is caring for a pregnant patient recently diagnosed with hypothyroidism. The patient tells the nurse she does not want to take this medication while she is pregnant. What will the nurse explain to this patient?

"Neuropsychologic deficits in the fetus can occur if the condition is not treated." Maternal hypothyroidism can result in permanent neuropsychologic deficits in the child.

A nursing student is caring for a patient who is taking sucralfate [Carafate] and ciprofloxacin [Cipro] to treat peptic ulcer disease. The student asks the nurse about the pharmacokinetics of sucralfate. Which statement by the student indicates a need for further teaching?

"Sucralfate has a moderate acid-neutralizing capacity."

A patient has been taking levothyroxine for several years and reports that "for the past 2 weeks, the drug doesn't seem to work as well as before". What will the nurse do?

Ask the patient when the prescription was last refilled. Not all levothyroxine preparations have the same drug bioavailability; therefore, if a patient is experiencing differing effects, the pharmacist may have switched brands. Asking a patient about a recent refill may help to explain why the drug has different effects. An elevated temperature and tachycardia would be signs of toxicity, not of a decrease in effectiveness. Calcium supplements and food would only interfere with absorption and further reduce the drug's effectiveness.

The nurse assesses a newly diagnosed patient for short-term complications of diabetes. What does this assessment include?

Evaluation for hyperglycemia, hypoglycemia, and ketoacidosis High blood sugar, low blood sugar, and ketoacidosis are short-term complications of diabetes. Microvascular and macrovascular complications, such as peripheral neuropathy, are long-term complications of diabetes. Arterial insufficiency and atherosclerosis also are long-term complications of diabetes.

A nurse caring for a patient notes that the patient has a temperature of 104 degrees F and a heart rate of 110 beats per minute. The patients skin is warm and moist and the patient complains that the room is too warm. The patient appears nervous and has protuberant eyes. The nurse will contact the provider to discuss:

Graves' disease. The signs and symptoms in this patient are consistent with hyperthyroidism, and because the patient's eyes are protuberant, they also are consistent with Graves' disease. Cretinism is hypothyroidism in children. Myxedema is severe hypothyroidism. Plummer's disease is a hyperthyroidism condition without exophthalmos.

The nurse is providing patient education about glucocorticoid therapy to a patient preparing to be discharged home. Which statement made by the patient best demonstrates understanding of the glucocorticoid therapy?

I may take two-thirds of the dose in the morning and one-third in the evening.

A nurse provides teaching to a group of nursing students about the risks and benefits of hormone therapy (HT), including estrogen therapy (ET) and combination estrogen/progestin (EPT) therapy. Which statement by a student indicates understanding of the teaching?

Principle benefits of ET are suppression of menopausal symptoms and prevention of bone loss.

A patient asks how to know whether dietary supplements are safe. The nurse will tell this patient that:

any standards addressing safety merely regulate labeling and manufacturing processes.

A patient is admitted to the obstetric unit in preterm labor at 36 weeks' gestation. The prescriber orders a tocolytic agent. When teaching he patient about this medication, the nurse will tell her tocolytics:

help delay delivery when glucocorticoids are given. Tocolytic agents are used to postpone premature labor and, on average, for only 48 hours. During this time glucocorticoids are given to help the fetal lungs mature.

A nursing student asks a nurse what the NMBER system that rates our dietary supplements means. The nurse responds the NMBER system:

helps consumers evaluate the safety and efficacy of products.

Which are contraindications for taking sildenafil [Viagra]?

patients who are taking nitroglycerin for angina pectoris, patients with nonarteritic ischemic optic nuropathy (NAION) in one eye, Patients with BPH who are taking alpha1-adrenergic antatgonists

A patient with type 1 diabetes who takes insulin reports taking propranolol for hypertension. Why is the nurse concerned?

the beta blocker can mask the symptoms of hypoglycemia.

A patient with type 1 diabetes reports mixing NPH and regular insulin to allow for one injection. What should the nurse tell the patient?

this is an acceptable practice. NPH insulin is the only insulin suitable for mixing with short-acting insulins, such as insulin aspart {NovoLog}. These insulins are compatible and are mixed frequently for management of diabetes. Insulin glargine canNOT be mixed with any other insulin for administration.