Pharm- Exam 2 Review Questions

A client who is receiving intravenous lidocaine (Xylocaine) for ventricular dysrhythmias exhibits confusion and anxiety. The appropriate response by the nurse would be to: A.) Withhold the drug and notify the health care provider immediately. B.) Increase the infusion rate and calm the client. C.) Discontinue the infusion and administer the antidote. D.) Decrease the infusion rate and monitor for confusion.

A

A client with asthma asks which of the prescribed medications should be used in the event of an acute episode of bronchospasm. The nurse will instruct the client to use: A.) Albuterol, a beta agonist bronchodilator, by inhalation. B.) Beclomethasone, a glucocorticoid anti-inflammatory drug, by inhalation. C.) Ipratropium, an anticholinergic bronchodilator, by inhalation. D.) Zafirlukast, a leukotriene modifier, by mouth.

A

Methyldopa (Aldomet) is being initiated for a client with hypertension. Which of the following health teachings would be most appropriate for this drug? A.) Avoid hot baths and showers, and prolonged standing in one position. B.) This drug may discolor the urine to a pinkish-brown color. C.) You may experience bloating and weight gain. D.) The tablet should be taken only with food or milk.

A

The client asks how atenolol (Tenormin) helps angina. The response provided by the nurse is based on which of the following concepts? This medication: A.) Slows the heart rate and reduces contractility. B.) Increases the heart rate and diminishes contractility. C.) Blocks sodium channels and elevates depolarization. D.) Decreases blood pressure and blocks the alpha2 receptors.

A

The client taking atorvastatin (Lipitor) reports decreased urine output, edema, and weight gain. The nurse initially assesses the client for which of the following conditions? A.) Rhabdomyolysis B.) Rhabdomyoma C.) Rhabdomyosarcoma D.) Rhinorrhea

A

The client with deep vein thrombosis is being treated with a heparin infusion. The nurse would monitor for therapeutic effectiveness by noting which of the following? A.) Activated partial thromboplastin time (aPTT) B.) Prothrombin time (PT) C.) Platelet counts D.) International normalized ratio (INR)

A

The nurse determines that the client understands an important principle in self-administration of hydralazine (Apresoline) when the client makes which of the following statements? A.) "I should not drive until the response to drug therapy is determined." B.) "I can stop taking this medication once I begin to feel better." C.) "If I experience dizziness, I should take only half the dose." D.) "I should avoid air travel while taking this medication."

A

The nurse is monitoring a client receiving acetazolamide (Diamox). Which of the following acid-base imbalances is a potential risk for this client? A.) Metabolic acidosis B.) Metabolic alkalosis C.) Respiratory acidosis D.) Respiratory alkalosis

A

The nurse should inform the client who is prescribed a nebulizer treatment with a bronchodilator agent that a common adverse effect is: A.) An increased heart rate with palpitations. B.) Predisposition to infection. C.) Sedation. D.) Temporary dyspnea.

A

To avoid the first-dose phenomenon, the nurse knows that the initial dose of prazosin (Minipress) should be: A.) Very low and given at bedtime. B.) Doubled and given before breakfast. C.) The usual dose and given before breakfast. D.) Doubled and given immediately after breakfast.

A

The provider orders neostigmine for a client who has not urinated in the last 16 hours. The nurse collaborates with the prescriber about which of the following data related to this drug therapy? A.) Heart rate less than 60 beats per minute. B.) Change in pupillary size. C.) Increased salivation and thirst. D.) Respiratory rate of 16 per minute.

A REASON: -Neostigmine = Indirect collagenic agonist -Increase parasympathetic and decrease cardiovascular

A 4-year-old child with respiratory distress secondary to asthma has an order for a nebulizer treatment. The type of medication most likely to be given for asthma management is a: A.) Beta agonist. B.) Beta antagonist. C.) Corticosteroid. D.) Leukotriene modifier.

A REASON: -Agonist = rescue/fast acting -Antagonist = inhibits/blocks

Which finding, if present, in a client who took a beta2-adrenergic agonist prior to bedtime would the nurse consider normal? A.) Insomnia B.) Sleepiness C.) Urticaria D.) Tinnitus

A REASON: **cant sleep**

A client who is taking an adrenergic agonist for hypertension complains of dizziness when first getting out of bed in the morning. The nurse should advise the client to: A.) Move slowly from the recumbent to the upright position. B.) Drink a full glass of water before rising to increase vascular circulatory volume. C.) Avoid sleeping in the prone position. D.) Stop taking the medication.

A REASON: Alpha 2 agonist is the only acception

A client is receiving a calcium channel antagonist for hypertension. The nurse included in the care plan to monitor the client for which of the following adverse effects? A.) Rash and chills B.) Increased urinary output C.) Weight loss D.) Changes in level of consciousness

D

The client is started on propranolol (Inderal). The most important action to be included in the plan of care for this client related to this medication includes which of the following? A.) Monitor apical pulse and blood pressure B.) Elevate the head of the bed during meals C.) Take the medication after meals D.) Consume foods high in potassium

A REASON: Beta blocker = Sympathetic down and parasympathetic up

The nurse knows that sympathomimetic decongestants should be avoided by people with which conditions or situations? A.) Hypertension and coronary artery disease B.) Wide-angle glaucoma C.) Breast-feeding women D.) Elderly clients

A REASON: effects CNS

A client who is receiving antituberculosis therapy is complaining of tingling and numbness of the fingers and toes. The nurse knows that these symptoms are most likely due to the drug's ability to: A.) Increase the sensitivity of nerve endings. B.) Decrease the activity of pyridoxine (vitamin B6). C.) Accelerate the excretion of neurotransmitters. D.) Enhance skin receptors to ascorbic acid (vitamin C).

B

In providing the heart failure client with information prior to discharge, the nurse will discuss digoxin (Lanoxin) therapy. Which of the following would the nurse include in the client's teaching? A.) Take the drug in the morning before rising. B.) Monitor the pulse daily prior to taking the drug. C.) Discontinue the drug if the pulse rate is 70 beats per minute. D.) Eat a diet high in bran fiber and calcium.

B

The client, who is receiving a daily dose of methyldopa (Aldomet) informs the nurse that the medication is causing severe drowsiness during the day. Which of the following responses would be best when addressing this complaint? A.) "You should drink at least 1 to 2 cups of caffeinated beverages such as coffee daily." B.) "You can minimize daytime sedation by changing medication dosages to nighttime." C.) "A midday nap each day will be most effective immediately after lunch." D.) "Daytime sleepiness is not an expected adverse effect. Stop taking the medication."

B

The community health nurse visits a client who has been prescribed atorvastatin (Lipitor). Which of the following statements, if made by the client, indicates that further teaching is necessary concerning this drug therapy? A.) "I should try to maintain my body weight at an optimal level." B.) "Most clients with lipid disorders have chest pain or shortness of breath." C.) "The best time for me to take this medication is before I go to bed." D.) "I will avoid beverages that contain grapefruit juice."

B

The nurse determines that the client understands an important principle in self-administration of nifedipine (Procardia) when the client makes which of the following statements? A.) "The use of antacids when taking the medication will enhance absorption." B.) "Grapefruit juice may enhance the absorption of nifedipine." C.) "If I miss a dose, I should take two nifedipine capsules when I remember." D.) "This drug will make my birth control pills ineffective."

B

The nurse is talking with a group of clients with cardiac conditions who are taking diuretic therapy. The nurse explains that individuals prescribed furosemide (Lasix) should: A.) Avoid consuming large amounts of cabbage, cauliflower, and kale. B.) Rise slowly from sitting or lying positions. C.) Count their pulse for 1 full minute before taking the medication. D.) Inject the medication subcutaneously around the umbilicus.

B

Which of the following health teaching concepts should the nurse review with a client receiving anticholinergic drug therapy? The client should be taught to: A.) Exercise daily to avoid muscle atrophy. B.) Increase dietary fiber and water intake to avoid constipation. C.) Consume foods high in iron to increase red blood cell production. D.) Monitor the heart rate for bradycardia.

B REASON: Anticholinergic - asympathetic (fight or flight)

A client who is taking an anticoagulant states, "I wake up every morning with arthritis pain and I always take aspirin or ibuprofen." The nurse's response would be based on which of the following physiologic concepts? A.) Aspirin and ibuprofen (Motrin) will counteract the therapeutic effects of many anticoagulants. B.) Anticoagulants will reduce the half-life of drugs such as aspirin and ibuprofen. C.) Many substances such as aspirin and ibuprofen will increase the risk of bleeding. D.) The combination of aspirin products with anticoagulants will worsen arthritis pain.

C

A health care provider has ordered nifedipine (Procardia XL) for each of these clients. A nurse will most closely monitor which client for drug-related problems? A.) A client who is admitted for an appendectomy in the morning B.) A client who is receiving renal dialysis three times per week C.) A client who develops pulmonary edema in the intensive care unit D.) A client who receives psychotropic drugs for bipolar disease

C

A healthcare provider has ordered neostigmine for each of these clients. A nurse should question the order for which client? A client: A.) With postoperative abdominal distension. B.) Experiencing urinary retention. C.) Suffering from chronic obstructive pulmonary disease. D.)Who has received nondepolarizing muscle relaxants.

C

Nitroglycerin topical ointment is being initiated for a client with angina. Which of the following health teachings would be most appropriate? A.) Keep the medication in the refrigerator. B.) Only take this medication when chest pain is severe. C.) Remove the old paste before applying the next dose. D.) Apply the ointment on the chest wall only.

C

The nurse is preparing a plan of care for a client with myasthenia gravis. Which of the following is appropriate for a client receiving a cholinergic agonist for this condition? A.) Increase in HR, BP, RR B.) Enhanced urinary elimination C.) Decrease in muscle weakness, ptosis, diploplia D.) Prolonged muscle contractions and proprioception

C

Which of the following clients receiving isoniazid (INH) is most likely to experience hepatotoxicity? A.) A 42-year-old housewife B.) A 22-year-old postpartum female C.) An 82-year-old farmer D.) A 42-year-old marketing executive

C

A client is prescribed beclomethasone (Beclovent), a glucocorticoid inhaler. Education by the nurse will include: A.) "Check your heart rate because this may cause tachycardia." B.) "Limit your coffee intake while on this drug." C.) "Rinse your mouth out well after each use." D.) "You may feel shaky and nervous after using this drug."

C REASON: Could cause fungus infection in mouth if not rinsed.

A client's family asks the nurse to explain the most common cause for treatment failure in pulmonary tuberculosis. The nurse knows that treatment failure is most often caused by the client's: A.) Inability to pay for the medication. B.) Poor nutritional intake of complex proteins. C.) Inability or unwillingness to adhere to the therapeutic regimen. D.) Inability to restrict intake of calcium-enriched foods.

C REASON: Long-term = Compliance

The client with deep vein thrombosis is being treated with a heparin infusion. The nurse would monitor for therapeutic effectiveness by noting which of the following? A.) Inject medication in the deep fatty layer of the abdomen. B.) When assessing blood pressure, release cuff pressure as soon as possible. C.) Hold direct pressure on venipuncture sites for 10 minutes. D.) Instruct client on the importance of using dental floss daily.

D

The health care provider prescribes epinephrine (adrenalin) to a client who was stung by several wasps 30 minutes ago. The nurse knows that the primary purpose of this medication for this client is to: A.) Stop the systemic release of histamine produced by the mast cells. B.) Counteract the formation of antibodies in response to an invading antigen. C.) Increase the number of white blood cells produced to fight the primary invader. D.) Increase a declining blood pressure and dilate constricting bronchi associated with anaphylaxis.

D

Which of the following laboratory findings would cause the nurse to be concerned about digoxin (Lanoxin) toxicity? A.) Hypocalcemia B.) Hypermagnesemia C.) Hyperbilirubinemia D.) Hypokalemia

D

The nurse teaches the client that which type of over-the-counter cough preparations is not effective with coughs associated with the common cold and allergic rhinitis? A.) Dextromethorphan B.) Diphenhydramine C.) Mucolytics D.) Pseudoephedrine

D REASON: Sympathomimetic and used for nasal congestant. A.) Dextromethorphan - peripheral antitussive B.) Diphenhydramine - antihistamine 1st gen C.) Mucolytics - D.) Pseudoephedrine - decongestant