Pharm E2 chap 76,77,78,79,80

Which instruction should be included in the teaching for a patient for whom fluticasone propionate [Flovent] MDI has been ordered? a. "Gargle after using your inhaler." b. "Take the medication immediately at the onset of an attack." c. "Take your albuterol first, followed by the Flovent 5 minutes later." d. "Make sure you monitor your fingerstick blood glucose level each morning."

a. "Gargle after using your inhaler."

A nurse instructs a female patient with peptic ulcer disease who is to start a treatment regimen that includes ranitidine [Zantac] and bismuth subsalicylate [Pepto-Bismol]. Which statement by the patient indicates that the teaching has been effective? a. "While I'm taking these medications, my bowel movements could look black." b. "I have a medicine at home to take when I start having some loose diarrhea stools." c. "I'm so glad that my allergies will be helped while I'm taking these medications." d. "I'll include more calcium and vitamin D in my diet to prevent osteoporosis."

a. "While I'm taking these medications, my bowel movements could look black."

The nurse expects laxatives to be ordered for which of the following patients? (Select all that apply.) a. A patient with chronic pain b. A patient recovering from cardiac surgery c. A patient who recently delivered a child d. A patient with acute food poisoning e. A patient with no bowel sounds

a. A patient with chronic pain b. A patient recovering from cardiac surgery c. A patient who recently delivered a child

The nurse is aware that laxatives are contraindicated in patients with which of the following? (Select all that apply.) a. Abdominal pain b. Diverticulitis c. Constipation d. Bowel obstruction e. Pregnancy

a. Abdominal pain b. Diverticulitis d. Bowel obstruction

A nurse should establish which outcomes on the care plan for a patient taking oral terbutaline? (Select all that apply.) a. Absence of tachycardia b. No reports of chest pain c. Less irritation of gum tissue d. Decrease in bronchospasm e. No jaundice or dark urine

a. Absence of tachycardia Correct b. No reports of chest pain Correct d. Decrease in bronchospasm

The parent of a pediatric patient with nasal stuffiness and congestion asks a nurse about cold remedies. Which additional information is the priority for the nurse to obtain? a. Age b. Developmental stage c. Body weight d. Swallowing ability

a. Age

Which medication is indicated for suppression of cough? a. Benzonate [Tessalon] b. Guaifenesin [Mucinex] c. Acetylcysteine [Mucomyst] d. Fluticasone furoate [Veramyst]

a. Benzonate [Tessalon]

A nurse administers metoclopramide [Reglan] to a patient who is having nausea and vomiting postoperatively. The nurse should expect which therapeutic action if the medication is having the desired result? a. Blocking of serotonin and dopamine receptors b. Inactivation of histaminergic (H1) receptors c. Activation of chloride channels in the intestine d. Reduced motility in the small intestine

a. Blocking of serotonin and dopamine receptors

An adult patient in a physician's office reports severe diarrhea after returning from a trip to Mexico. Which medication might be prescribed for this patient? a. Ciprofloxacin [Cipro] 500 mg twice daily b. Sulfasalazine [Azulfidine] 500 mg daily c. Metoclopramide [Reglan] 10 mg 3 times daily 30 minutes before meals and at bedtime d. Ondansetron [Zofran] 8 mg 3 times daily

a. Ciprofloxacin [Cipro] 500 mg twice daily

A postoperative patient is scheduled to start taking a daily oral dose of bisacodyl [Dulcolax]. When does the nurse administer the medication? a. Just before bedtime b. Before the morning bath c. At the evening meal d. After ambulating

a. Just before bedtime

A patient is having high-volume output from a new ileostomy. A nurse develops a plan that includes teaching the patient to take which antidiarrheal agent? a. Loperamide [Imodium] b. Alosetron [Lotronex] c. Bismuth subsalicylate [Pepto-Bismol] d. Paregoric (camphorated opium tincture)

a. Loperamide [Imodium]

Which medications are used in the treatment plan for chemotherapy-induced nausea and vomiting? (Select all that apply.) a. Lorazepam [Ativan] b. Meclizine [Antivert] c. Dolasetron [Anzemet] d. Loperamide [Imodium] e. Dexamethasone [Decadron]

a. Lorazepam [Ativan] c. Dolasetron [Anzemet] e. Dexamethasone [Decadron]

A patient who has gastroesophageal reflux disease (GERD) is taking magnesium hydroxide (milk of magnesia). Which outcome should a nurse expect if the medication is achieving the desired therapeutic effect? a. Neutralized gastric acid b. Reduced stomach motility c. Increased barrier to pepsin d. Reduced duodenal pH

a. Neutralized gastric acid

A nurse administers which medication to inhibit an enzyme that makes gastric acid in a patient who has a duodenal ulcer? a. Omeprazole [Prilosec] b. Famotidine [Pepcid] c. Misoprostol [Cytotec] d. Ranitidine [Zantac]

a. Omeprazole [Prilosec]

A nurse should associate which factors with the pathophysiology of peptic ulcer disease? (Select all that apply.) a. Poor submucosal gastric blood flow b. Presence of Zollinger-Ellison syndrome c. Reduced stomach production of bicarbonate d. Increased synthesis of prostaglandins e. Gastrointestinal (GI) tract colonized with Haemophilus influenzae

a. Poor submucosal gastric blood flow b. Presence of Zollinger-Ellison syndrome c. Reduced stomach production of bicarbonate

The patient has an order for magnesium oxide/anhydrous citric acid/sodium picosulfate [Prepopik] to be given in two doses. The nurse knows that this medication is used for which indication? a. Preparation before a colonoscopy b. Preparation before an abdominal surgery c. Prevention of constipation d. Treatment of constipation

a. Preparation before a colonoscopy

A nurse should monitor more frequently the blood pressure of a patient with a history of hypertension who takes which medication for allergic rhinitis? a. Pseudoephedrine [Sudafed] b. Montelukast [Singulair] c. Mometasone [Nasonex spray] d. Oxymetazoline [Afrin spray]

a. Pseudoephedrine [Sudafed]

Which are advantages of a dry-powder inhaler (DPI) over a metered-dose inhaler (MDI)? (Select all that apply.) More of the drug is delivered to the lungs and less to the oropharynx. Correct a. Use of a spacer is not necessary. b. Less propellant is needed to deliver the medication. c. Less hand-lung coordination is required. d. DPIs pose no environmental risk.

a. Use of a spacer is not necessary. c. Less hand-lung coordination is required. d. DPIs pose no environmental risk.

Using a stepwise approach to managing asthma, a nurse teaches a patient who is at step 1 to use albuterol MDI [Proventil] at which of these times? a. Whenever needed (PRN) as a quick-relief agent b. Twice daily combined with an inhaled glucocorticoid c. Only with a long-acting beta2 agonist (LABA) d. If nighttime awakenings occur more than 2 days a week

a. Whenever needed (PRN) as a quick-relief agent

Which statement should the nurse include in the teaching for a patient who is to be started on zileuton [Zyflo]? a. "Use your zileuton [Zyflo] inhaler every 12 hours." b. "Have your blood drawn once a month for the next 3 months so that your liver function can be checked." c. "Take the zileuton [Zyflo] 2 hours before eating breakfast each day." d. "Take an extra dose of zileuton [Zyflo] if you have an asthmatic attack.

b. "Have your blood drawn once a month for the next 3 months so that your liver function can be checked."

A patient has been taking docusate sodium [Colace] daily for 1 year. Which statement by the patient would indicate a complication associated with use of this drug? a. "My doctor says that I've developed colon polyps." b. "I only have a bowel movement when I take the medicine." c. "The dental hygienist said I was losing the enamel on my teeth." d. "I've noticed that I'm having tremors now in my left hand."

b. "I only have a bowel movement when I take the medicine."

Which instruction should the nurse include in the teaching for a patient prescribed cetirizine [Zyrtec] for seasonal allergic rhinitis? a. "Clean the nasal applicator after use to prevent contamination." b. "Take the medication daily throughout the allergy season." c. "Expect a decrease in your nasal congestion in a day or two." d. "Take a stool softener daily to avoid the side effect of constipation."

b. "Take the medication daily throughout the allergy season."

Which statement by a patient indicates understanding of a nurse's teaching about fluticasone nasal spray [Flonase]? a. "I'll gradually stop taking this so I don't have any problems with withdrawal." b. "This drug will help prevent the inflammation and irritation from my allergies." c. "I'll have to be more careful about not falling, because my bones may break more easily." d. "I realize that I only need to take this when my symptoms are really bad."

b. "This drug will help prevent the inflammation and irritation from my allergies."

A nurse is teaching a patient about montelukast [Singulair]. Which statement by the patient would indicate that the nurse's teaching was effective? a. "I'll take a dose as soon as I feel short of breath and start to cough." b. "While taking this medicine, I may be able to reduce my steroid medication." c. "This is the priority of medication for preventing exercise-induced asthma symptoms." d. "If I have nosebleeds or excessive bruising, I'll stop the medication immediately."

b. "While taking this medicine, I may be able to reduce my steroid medication."

Which of the following administration techniques would be appropriate when giving a sucralfate [Carafate] tablet to a patient with a duodenal ulcer? (Select all that apply.) a. Crush the tablet into a fine powder before mixing it with water. b. Administer the tablet with sips of water 1 hour before meals. c. Allow the tablet to dissolve in water before administering it. d. Administer the tablet with an antacid for maximum benefit. e. Break the tablet in half so it is easier to swallow.

b. Administer the tablet with sips of water 1 hour before meals. c. Allow the tablet to dissolve in water before administering it. e. Break the tablet in half so it is easier to swallow.

A nurse should offer which fluid choice to a patient with acute diarrhea? a. Low-fat milk b. Apple juice c. Coffee with cream d. Prune juice

b. Apple juice

A nurse assesses a male patient who has developed gynecomastia while receiving treatment for peptic ulcers. Which medication from the patient's history should the nurse recognize as a contributing factor? a. Amoxicillin [Amoxil] b. Cimetidine [Tagamet] c. Metronidazole [Flagyl] d. Omeprazole [Prilosec]

b. Cimetidine [Tagamet]

The nurse is reviewing the prescriber's orders and notes that omeprazole [Prilosec] has been ordered for a patient admitted with acute coronary syndrome (ACS). The nurse should be concerned if this medication is combined with which medication noted on the patient's record? a. Aspirin 81 mg daily b. Clopidogrel [Plavix] 75 mg daily c. Heparin 5000 units subQ every 12 hours d. Metoprolol 50 mg every 8 hours

b. Clopidogrel [Plavix] 75 mg daily

A patient going on a vacation cruise is prescribed a scopolamine transdermal patch for motion sickness. The nurse teaches the patient to recognize which side effect? a. Increased heart rate b. Dry mouth c. Irritability d. Urinary frequency

b. Dry mouth

Why is intramuscular (IM) administration of promethazine [Phenergan] preferred over intravenous (IV) administration? a. The risk of respiratory depression is eliminated with IM injection. b. Extravasation of IV promethazine can lead to abscess formation or tissue necrosis. c. Extrapyramidal reactions do not occur when the drug is administered IM. d. IM injection has a more rapid onset of action.

b. Extravasation of IV promethazine can lead to abscess formation or tissue necrosis.

A nurse monitors a patient who has peptic ulcer disease and is taking antibacterial medications. If the treatment has been effective, the patient's breath test result should reveal the absence of what? a. Bicarbonate b. H. pylori c. Histamine2 d. Prostaglandins

b. H. pylori

The nurse prepares to administer a bisacodyl suppository to a patient who has not had a bowel movement in several days. When should the nurse administer the PRN medication? a. In the morning, before breakfast b. In the morning, after breakfast c. In the afternoon, before lunch d. In the evening, before bed

b. In the morning, after breakfast

A nurse should teach a patient receiving oral pseudoephedrine [Sudafed] to observe for which adverse effects? (Select all that apply.) a. Sedation b. Irritability c. Paranoia d. Anxiety e. Weight loss

b. Irritability d. Anxiety

Instruction by the nurse regarding alcohol abstinence is essential when a patient will be discharged taking which medication? a. Tetracycline b. Metronidazole c. Bismuth subsalicylate d. Clarithromycin

b. Metronidazole

To achieve therapeutic effectiveness, a nurse teaches a patient with chronic asthma to use an inhaled glucocorticoid medication according to which schedule? a. Only in an emergency b. On a continuing, daily basis c. To abort an asthma attack d. 2 weeks on, 2 weeks off

b. On a continuing, daily basis

A history of allergy to which substance is a contraindication to the use of ipratropium/albuterol [Combivent]? a. Mold b. Peanuts c. Penicillin d. Dairy products

b. Peanuts

A patient with renal impairment requires bowel cleansing before a diagnostic procedure. The nurse prepares to administer which laxative? a. Mineral oil b. Polyethylene glycol-electrolyte solution [GoLYTELY] c. Magnesium salts (magnesium citrate) d. Docusate sodium [Colace]

b. Polyethylene glycol-electrolyte solution [GoLYTELY]

A patient who has had a pancreatectomy is taking pancrelipase [Viokase]. Which finding would the nurse use to evaluate the effectiveness of this drug? a. Increase in flatulence b. Reduction in fatty stools c. Resolution of jaundice d. Decrease in abdominal distention

b. Reduction in fatty stools

A nurse is planning care for a patient who takes fexofenadine [Allegra] for allergic rhinitis. Which outcome should the nurse anticipate? a. No complaints of dry mouth b. Relief of sneezing and itching c. Use limited to allergy season d. Absence of rebound congestion

b. Relief of sneezing and itching

Which complaint indicates that a patient is experiencing an adverse effect of beclomethasone [Beconase AQ] nasal spray? a. Sneezing b. Sore throat c. Runny nose d. Rebound congestion

b. Sore throat

A nurse teaches a patient with chronic obstructive pulmonary disease (COPD) about the adverse effects of tiotropium [Spiriva]. Which behavior by the patient would indicate that the teaching has been effective? a. Combines tiotropium with an antacid. b. Sucks on hard candy as needed. c. Prevents constipation with a stool softener. d. Wears long sleeves and a wide-brim hat

b. Sucks on hard candy as needed.

The nurse reviews the patient's medication record and notes the following: sucralfate [Carafate] 1 gram orally 4 times daily before meals (7:30 AM, 11:30 AM, and 4:30 PM) and at bedtime (10:00 PM); phenytoin [Dilantin] 200 mg orally daily at 8 AM. Which modifications, if any, should be made to the medication regimen? a. The medications can be administered as ordered. b. The nurse should obtain a prescriber order to administer the phenytoin at 9:30 AM daily. c. The nurse should obtain a prescriber order for intravenous phenytoin to avoid a drug interaction. d. The nurse should administer the phenytoin with the 7:30 AM dose of sucralfate [Carafate], because this is more time efficient

b. The nurse should obtain a prescriber order to administer the phenytoin at 9:30 AM daily.

A nurse teaches a patient who has ulcerative colitis about the side effects of the treatment medication, sulfasalazine [Azulfidine]. Which statement by the patient would indicate understanding of the information? a. "My tongue may become discolored and my taste altered." b. "I may have constipation, so I'll increase my fluid intake." c. "I'll report any fatigue or sore throat and fever to my doctor." d. "I'll immediately report any chest pain or shortness of breath."

c. "I'll report any fatigue or sore throat and fever to my doctor."

A nurse is teaching a patient who is to start taking an expectorant. The nurse provides the patient with which of these instructions? a. "Restrict cold fluids to promote reduced mucus production." b. "Take the medication once a day only, usually at bedtime." c. "Increase your fluid intake to reduce the viscosity of secretions." d. "Increase your fiber and fluid intake to prevent constipation."

c. "Increase your fluid intake to reduce the viscosity of secretions."

A nurse should give which nonmedication instruction to a patient who has peptic ulcers? a. "Reduce your intake of caffeine-containing beverages, such as coffee and colas." b. "Take a nonsteroidal anti-inflammatory drug once a day to help with pain." c. "It would be better to eat five or six small meals a day instead of three larger ones." d. "An ulcer diet of bland foods with milk and cream products will speed healing."

c. "It would be better to eat five or six small meals a day instead of three larger ones."

Which instruction by the nurse should be the priority for a patient scheduled to start intranasal cromolyn [NasalCrom]? a. "It is only moderately effective." b. "There are few adverse reactions." c. "Relief may take a week or two." d. "It suppresses histamine release."

c. "Relief may take a week or two."

Which instruction should the nurse give a patient who is to take bismuth subsalicylate for eradication of H. pylori? a. "Nausea and diarrhea are common side effects." b. "Do not drink alcohol while taking this medication." c. "The drug can cause your bowel movements to be black." d. "Take the medication through a straw to prevent staining of your teeth."

c. "The drug can cause your bowel movements to be black."

A patient with asthma is scheduled to start taking a glucocorticoid medication with a metered-dose inhaler (MDI). The nurse should give the patient which instruction about correct use of the inhaler? a. "After you inhale the medication once, repeat until you obtain symptomatic relief." b. "Wait no longer than 30 seconds after the first puff before taking the second one." c. "Use a spacer with the inhaler and rinse your mouth after each dose administration." d. "Breathe in through the nose and hold for 2 seconds just before activating the inhaler."

c. "Use a spacer with the inhaler and rinse your mouth after each dose administration."

Which instruction should be included in the teaching for a patient being started on the antihistamine azelastine [Astelin]? a. "Take the pill in the morning before breakfast." b. "Headache may be a side effect of the medication." c. "You may experience an unpleasant taste in your mouth when using azelastine." d. "You will experience a decrease in nasal congestion if the medication is working."

c. "You may experience an unpleasant taste in your mouth when using azelastine."

A patient who has peptic ulcer disease and is receiving magnesium hydroxide (milk of magnesia) is experiencing an increased number of bowel movements. Which is the nurse's priority action? a. Ask the healthcare provider for a reduction in dose. b. Encourage the patient to increase dietary fiber. c. Administer the drug with an aluminum hydroxide antacid. d. Instruct the patient to keep an accurate stool count.

c. Administer the drug with an aluminum hydroxide antacid.

Which finding in a patient taking oxymetazoline [Afrin] nasal spray every 2 hours would indicate that the patient has developed an adverse effect? a. Dry mouth and constipation b. Drowsiness and sedation c. Congestion and stuffiness d. Itching and skin rash

c. Congestion and stuffiness

Which medication is useful for stimulating the appetite in patients with acquired immunodeficiency syndrome (AIDS)? a. Aprepitant [Amend] b. Ondansetron [Zofran] c. Dronabinol [Marinol] d. Metoclopramide [Reglan]

c. Dronabinol [Marinol]

A nurse instructs a patient that which nonprescription medication requires patient identification and a signature for purchase? a. Chlorpheniramine [Chlor-Trimeton] b. Cetirizine [Zyrtec] c. Ephedrine d. Ipratropium bromide [Atrovent]

c. Ephedrine

A patient who takes cromolyn for exercise-induced bronchospasm should follow which approach for maximum therapeutic effectiveness? a. It should be used infrequently because of systemic adverse effects. b. One 10-mg tablet should be taken at least 2 hours before exercising. c. It should be administered by inhalation 15 minutes before anticipated exertion. d. It should be used as a quick-relief agent if exercise triggers asthma symptoms.

c. It should be administered by inhalation 15 minutes before anticipated exertion.

A nurse administers palifermin to reduce oral mucositis from chemotherapy in a patient with which type of malignancy? a. Brain b. Breast c. Leukemia d. Lung

c. Leukemia

An 80-year-old patient with a history of renal insufficiency recently was started on cimetidine. Which assessment finding indicates that the patient may be experiencing an adverse effect of the medication? a. +3 pitting edema b. Pain with urination c. New onset of disorientation to time and place d. Heart rate changes from a baseline of 70 to 80 beats/min (bpm) to 110 to 120 bpm

c. New onset of disorientation to time and place

A patient with hepatic encephalopathy receives lactulose. The nurse expects which therapeutic outcome if the medication is having the desired effect? a. Less ascitic fluid b. Normal serum sodium level c. Reduced ammonia level d. Release of glycogen stores

c. Reduced ammonia level

Which outcome would be most appropriate for a nurse to establish for a patient with a cough who takes an antitussive with codeine? a. Warm, dry, pink skin b. Oriented to time, place, and person c. Respiratory rate of 12 to 24 breaths per minute d. Effective productive cough

c. Respiratory rate of 12 to 24 breaths per minute

Which outcome should a nurse establish as a priority for a patient taking an oral glucocorticoid for long-term treatment of asthma? a. Increases the daily intake of vitamin D and calcium. b. Records daily peak expiratory flow rates. c. Supplements additional doses at times of stress d. Uses alternate-day therapy to reduce adverse effects.

c. Supplements additional doses at times of stress

A nurse is planning care for a patient undergoing chemotherapy. The care plan includes medications to reduce chemotherapy-induced nausea and vomiting (CINV). Which regimen should the nurse recognize as effective? a. Scopolamine [Transderm Scop] and lorazepam [Ativan] b. Prochlorperazine [Compazine] and diphenhydramine [Benadryl] c. Ondansetron [Zofran] and dimenhydrinate [Dramamine] d. Aprepitant [Emend] and ondansetron [Zofran]

d. Aprepitant [Emend] and ondansetron [Zofran]

A patient reports abdominal bloating and infrequent, small, hard stools after taking psyllium [Metamucil] for 2 weeks. Which is the nurse's priority action? a. Consult the physician about another laxative choice. b. Check the dose, because an increase may be indicated. c. Ask whether the patient is toileting at the same time every day. d. Ask whether the patient is using at least 8 ounces of fluid to prepare the psyllium.

d. Ask whether the patient is using at least 8 ounces of fluid to prepare the psyllium.

A patient is taking oral theophylline for maintenance therapy of stable asthma. A nurse instructs the patient to avoid using which substance to prevent a complication? a. Echinacea b. Cimetidine [Tagamet] c. Sunscreen products d. Caffeine

d. Caffeine

A nurse should teach a patient who takes alosetron [Lotronex] for diarrhea-prominent irritable bowel syndrome (IBS-D) to stop the medication immediately if the patient develops which condition? a. Blurred vision b. Heart palpitations c. Bruising d. Constipation

d. Constipation

A nurse is planning care for a patient who has peptic ulcer disease and is taking amoxicillin [Amoxil]. The nurse is aware that the action of this medication is which of the following? a. Inhibition of an enzyme to block acid secretion b. Coating of the ulcer crater as a barrier to acid c. Selective blockade of parietal cell histamine2 receptors d. Disruption of the bacterial cell wall, causing lysis and death

d. Disruption of the bacterial cell wall, causing lysis and death

A patient is admitted to the emergency department with acute severe exacerbation of asthma. Which drug should the nurse anticipate will be included in the treatment plan? a. Oral theophylline [Elixophyllin] b. Subcutaneous omalizumab [Xolair] c. Inhaled mometasone furoate [Asmanex] d. High-dose albuterol [Proventil] via nebulizer treatment

d. High-dose albuterol [Proventil] via nebulizer treatment

A nurse administering 30 mL of magnesium hydroxide (milk of magnesia) tells the patient to expect a bowel movement when? a. In 15 minutes to 1 hour b. In 2 to 4 hours c. In 1 to 3 days d. In 6 to 12 hours

d. In 6 to 12 hours

Which class of drugs is most effective in preventing and treating seasonal and allergic rhinitis? a. Antitussives b. Oral antihistamines c. Oral sympathomimetics d. Intranasal glucocorticoids

d. Intranasal glucocorticoids