Pharm Exam 3 -11.19

36. A patient with type 1 diabetes takes 12 units of regular insulin and 34 units of NPH insulin in the morning. How would the nurse explain why two different types of insulin are required to control the patient's blood sugar? A. "Different onsets and peak effects extends blood glucose control." B. "The mixture makes each drug work more effectively." C. "The combination reduces the adverse effects experienced." D. "Patients are less likely to experience hypoglycemia."

A. "Different onsets and peak effects extends blood glucose control."

3. After the patient's anginal pain is relieved, he says to the nurse, "That nitroglycerin (Nitrostat) works great. How does it do that?" What is the nurse's best response? A. "Nitroglycerin (Nitrostat) decreases the amount of oxygen needed by the heart to function." B. "Nitroglycerin (Nitrostat) makes the coronary arteries narrower." C. "Nitroglycerin (Nitrostat) promotes growth of new, smaller arteries to supply oxygen to the heart." D. "Nitroglycerin (Nitrostat) increases afterload."

A. "Nitroglycerin (Nitrostat) decreases the amount of oxygen needed by the heart to function."

58. What would the nurse teach the patient about potency of nitroglycerin? (Select all that apply.) A. "The tablet should fizzle or burn when placed under the tongue." B. "Protect the drug from heat and light." C. "Always replace when past the expiration date." D. "Older tablets may require you to use two tablets at one time." E. "Nitroglycerin does not lose its potency easily."

A. "The tablet should fizzle or burn when placed under the tongue." B. "Protect the drug from heat and light." C. "Always replace when past the expiration date."

33. A patient receives aspart (NovoLog) insulin at 8:00 AM. Which time will it be most important for the nurse to monitor for symptoms of hypoglycemia? A. 9:00 AM B. 11:30 AM C. 4:00 PM D. 8:00 PM

A. 9:00 AM

57. The nurse is taking a health history on a 38-year-old man who is taking atorvastatin (Lipitor) for high cholesterol. What will the nurse question specifically related to the safe use of this drug? A. Alcohol B. Nicotine C, Caffeine D. Herbal therapy

A. Alcohol

27. The nurse teaches the client with type 1 diabetes that insulin needs vary depending upon certain conditions. The client's understanding is verified when he states that his insulin need may increase in the following condition(s)? (Select all that apply). A. Exercise B. Fever C. Anxiety D. Decreased food intake E. Stress

A. Exercise B. Fever C. Anxiety E. Stress

1. A patient is being started on niacin (vitamin B3) to reduce triglyceride levels. The nurse is providing patient education and should include which adverse effects? (Select all that apply.) A. Facial flushing B. Gastric upset C. Constipation D. Hypoglycemia E. Itching

A. Facial flushing B. Gastric upset E. Itching

43. The nurse is caring for a patient with a bladder infection. What symptoms are most common with this type of infection? (Select all that apply.) A. Frequency B. Urgency C. Dysuria D. Flank pain

A. Frequency B. Urgency C. Dysuria

14. A client who has recently started taking rosuvastatin (Crestor) and niacin (vitamin B3) reports all the following symptoms to the nurse. Which is most important to communicate to the health care provider? A. Generalized muscle aches and pains B. Nausea when taking the drugs before eating C. Skin flushing after taking the medications D. Dizziness when changing positions quickly

A. Generalized muscle aches and pains

19. A patient who has recently started taking pravastatin (Pravachol) and niacin reports several symptoms to the nurse. Which information is most important to communicate to the health care provider? A. Generalized muscle aches and pains B. Dizziness with rapid position changes C. Nausea when taking the drugs before meals D. Flushing and pruritus after taking the drugs

A. Generalized muscle aches and pains

37. The nurse is performing diabetes screening and recognizes what ethnic group is at higher risk for diabetes but is also predisposed to a higher normal range of blood glucose? A. Native Americans B. Japanese Americans C. African Americans D. Caucasian Americans

A. Native Americans

7. Your client has a history of severe liver failure, high lipid levels, pancreatitis and gallstones. Which medication would the nurse expect the health care provider to order for the client who cannot take fibrates or HMG-CoA reductase inhibitors? A. Niacin B. Nicotine C. Vitamin C D. Aspirin

A. Niacin

40. The nurse will question what medication order for a diabetic patient who takes insulin to control his blood sugar level? A. Propranolol (Inderal) 10 mg orally t.i.d. B. Furosemide (Lasix) 60 mg/d orally C. Cefaclor (Ceclor) 250 mg orally every 8 hours D. Metoclopramide (Reglan) 20 mg PO

A. Propranolol (Inderal) 10 mg orally t.i.d.

55. The patient receives a prescription for a lipid lowering medication from the health care provider and, before discharge, asks the nurse what else he or she can do to improve his or her lipid levels besides just taking medication. What recommendation will the nurse make? (Select all that apply.) A. Quitting smoking B. Exercising C. Following a low sodium diet D. Reducing stress E. Avoiding alcohol

A. Quitting smoking B. Exercising D. Reducing stress

54. When providing patient teaching to a patient beginning therapy with a beta-hydroxy-beta-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor, the nurse will explain the need for regular monitoring of what laboratory studies? (Select all that apply.) A. Renal function tests B. Liver function tests C. Lipid panel D. Hemoccult of stool E. Albumin level

A. Renal function tests B. Liver function tests C. Lipid panel

52. A patient is being treated for benign prostatic hyperplasia (BPH). The patient asks the nurse how the medicine used to treat BPH is supposed to work. The nurse explains that the drug therapy is designed to relieve the symptoms associated with this condition by doing what? A. Shrinking the gland and/or relaxing the sphincter of the bladder B. Increasing testosterone levels to improve sexual functioning C. Increasing blood pressure, which will increase blood flow to the area D. Activate nitric acid, which will dilate blood vessels in the area to relieve pressure

A. Shrinking the gland and/or relaxing the sphincter of the bladder

26. The nurse working on a high-acuity medical-surgical unit is prioritizing care for four patients who were just admitted. Which patient should the nurse assess first? A. The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30 Novolin insulin B. The patient with a pulse of 58 beats per minute who is about to receive digoxin (Lanoxin) C. The patient with a blood pressure of 136/92 mm Hg who complains of having a headache D. The patient with an allergy to penicillin who is receiving an infusion of vancomycin (Vancocin)

A. The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30 Novolin insulin

59. The nurse is teaching a 45-year-old patient about ways to lower cholesterol levels and explains that exercise has what effect? A.Increases high density lipoproteins (HDLs) and decreases low density lipoproteins (LDL) B. Increases LDL and decreases triglycerides C. Decreases HDL and increases LDL D. Decreases both HDL and LDL

A.Increases high density lipoproteins (HDLs) and decreases low density lipoproteins (LDL)

13. A client with a history of angina and hypertension is being started on niacin (vitamin B3). The nurse is providing client education. What statement made by the client demonstrates a need for further teaching? A. "This medication will lower my triglyceride levels." B, "I will take (acetaminophen) Tylenol with my medication to reduce the inflammatory effects." C. "I will be cautious taking this medication, because I have mild liver damage." D. "I will take an aspirin 30 minutes before my niacin to reduce flushing." d."This medication will lower my triglyceride levels."

B, "I will take (acetaminophen) Tylenol with my medication to reduce the inflammatory effects."

42. A diabetic patient is taking regular and NPH insulin to manage his diabetes. What is the best evaluation tool to measure the overall patient response to the insulin therapy? A. Blood pressure B. Bilirubin level C. Glycosylated hemoglobin (HbAlc) levels D. Fasting blood glucose levels

C. Glycosylated hemoglobin (HbAlc) levels

17. The nurse provides teaches the patient prescribed atorvastatin (Lipitor) about how the medication works. Which of the following indicates that the patient needs further teaching? A. "This medication is given as an adjuvant therapy with diet and exercise." B. "I can eat more red meat now that I am taking this medication to lower my cholesterol." C. "Since diet restrictions alone did not work, I now need medication to help lower my cholesterol." D. "I will need to follow up for tests on my liver periodically while taking this medication."

B. "I can eat more red meat now that I am taking this medication to lower my cholesterol."

15. The nurse is preparing a client for discharge who will receive a prescription for a HMG-Co-A inhibitor, atorvastatin(Lipitor). What statement by the patient demonstrates that they have a clear understanding of the teaching provided by the nurse? A. "I will not need to follow that low-fat diet anymore because this drug will take care of my lipids." B. "I should plan to take this drug before bedtime, because my body makes lipids mostly at night." C. "After I start taking this drug, I will not have to worry about the exercise routine the doctor prescribed." D. "I should take this drug first thing in the morning and make sure I drink a full glass of water."

B. "I should plan to take this drug before bedtime, because my body makes lipids mostly at night."

9. A client visits the clinic and receives a new prescription for a HMG-COA reductase inhibitor. Which statement about this class of drugs made by the nurse during patient education would be inappropriate? A. "Statins reduce the risk of stroke." B. "You should come into the clinic for liver enzymes in 1 month." C. "Statins reduce the risk of coronary events in people with normal LDL levels." D. "You should maintain a healthy lifestyle and avoid high-fat foods."

B. "You should come into the clinic for liver enzymes in 1 month."

5. When planning client care the nurse recognizes what client is at greatest risk of developing coronary artery disease? A. 32-year-old Asian American with total cholesterol of 120 mg/dL B. A 62-year-old white American with total cholesterol of 260 mg/dL C. A 48-year-old African American with total cholesterol of 198 mg/dL D. A 26-year-old Native American with total cholesterol of 150 mg/dL

B. A 62-year-old white American with total cholesterol of 260 mg/dL

21. When titrating IV nitroglycerin for a patient with a myocardial infarction (MI), which action will the nurse take to evaluate the effectiveness of the drug? A. Monitor heart rate. B. Ask about chest pain. C. Check blood pressure. D. Observe for dysrhythmias.

B. Ask about chest pain.

28. The nurse is caring for a diabetic client that is NPO for surgery. Which of these laboratory values, noted by the nurse when reviewing the chart of the client, indicates the need for administration of glucagon? A. Hb A1C of 5.8% B. Blood glucose of 52 mg/dL C. Hb A1Cof 6.9% D. Fasting blood glucose of 130 mg/dL

B. Blood glucose of 52 mg/dL

4. The nurse teaches the patient taking sublingual nitroglycerin (Nitrostat) to avoid what? A. Exercise B. Erectile dysfunction medications C. Milk products D. Synthetic fabrics

B. Erectile dysfunction medications

29. The diabetes nurse educator describes type 1 diabetes with what statement? A. Blood glucose level can be controlled with diet. B. Exogenous insulin is required for life. C. Oral agents can help to control blood glucose levels. D. It is always diagnosed in early childhood.

B. Exogenous insulin is required for life.

16. The nurse teaches the client that hydroxymethylglutaryl co-enzyme A (HMG-Co-A) reductase inhibitors work by: A. Inhibiting the process of bile secretion B. Inhibiting process of cholesterol formation in the cell C. Stimulating the intestinal wall to block fat absorption D. Stimulating the kidney to block fat excretion

B. Inhibiting process of cholesterol formation in the cell

48. The nurse is caring for a 79-year-old male patient who was admitted through the emergency room for mental status changes determined to be caused by a urinary tract infection. The patient is started on norfloxacin (Noroxin) before his discharge home. What adverse effect should the nurse observe this patient for? A. Liver toxicity B. Photosensitivity C. Excess saliva D. Congestive heart failure

B. Photosensitivity

56. A 54-year-old patient has a cholesterol level of 240 mg/dL. How would the nurse categorize this serum concentration of cholesterol? A. Optimal B. Desirable C. High D. Very high

C. High

61. An type 1 (insulin-dependent) diabetic reports recurrent hypoglycemia late in the morning. After collecting his health history what finding would the nurse suspect is causing the late morning hypoglycemia? A. The patient likes to nap after work before his evening meal. B. The patient jogs 2 miles in the morning before he goes to work. C. The patient likes to have an early lunch with his girlfriend. D. The patient eats oatmeal early in the morning for breakfast.

B. The patient jogs 2 miles in the morning before he goes to work.

46. Urinary anti-infectives are used only to treat urinary tract infections (UTIs). What causes urinary anti-infectives to be so effective in treating UTIs? A. They sterilize feces. B. They act specifically within the urinary tract. C. They reach high plasma levels in a short period of time. D. They are excreted through the liver.

B. They act specifically within the urinary tract.

6. The nurse is preparing to administer sublingual nitroglycerin (Nitrostat) to a client for the first time and warns that the client may experience what right after administration? A. Nervousness or paresthesia B. Throbbing headache or dizziness C. Drowsiness or blurred vision D. Tinnitus or diplopia

B. Throbbing headache or dizziness

18. A patient who is being admitted to the emergency department with intermittent chest pain gives the following list of daily medications to the nurse. Which medication has the most immediate implications for the patient's care? A. captopril B. sildenafil (Viagra) C. furosemide (Lasix) D. warfarin (Coumadin)

B. sildenafil (Viagra)

53. The nurse is assessing a patient who is taking oxybutynin (Ditropan). What would be the priority nursing assessment for this patient? A. Skin condition B. Cardiac arrhythmia C. Vision changes D. Mental status

C vision changes

20. In preparation for discharge, the nurse teaches a patient with chronic stable angina how to use the prescribed short-acting and long-acting nitrates. Which patient statement indicates that the teaching has been effective? A. "I will check my pulse rate before I take any nitroglycerin tablets." B. "I will put the nitroglycerin patch on as soon as I get any chest pain." C. "I will stop what I am doing and sit down before I put the nitroglycerin under my tongue." D. "I will be sure to remove the nitroglycerin patch before taking any sublingual nitroglycerin."

C. "I will stop what I am doing and sit down before I put the nitroglycerin under my tongue."

50. The nurse is providing health teaching to a 62-year-old female patient who has been started on norfloxacin (Noroxin). This patient should be taught to contact her physician if she experiences what adverse effect? A. Polydipsia B. Tachycardia C. Confusion D. Hypertension

C. Confusion

41. A patient is brought to the emergency department with severe hypoglycemia. What drug would the nurse prepare to administer intravenously? A. Diazole (Hyperstat) B. Glyburide (DiaBeta) C. Glucagon (GlucaGen) D. Insulin (Humulin R)

C. Glucagon (GlucaGen)

35. A diabetic client is taking regular and NPH insulin to manage his diabetes. What is the best evaluation tool to measure the overall client response to the insulin therapy? A. Blood pressure B. Bilirubin level C. Glycosylated hemoglobin (HbAlc) levels D. Fasting blood glucose levels

C. Glycosylated hemoglobin (HbAlc) levels

44. The clinic nurse is providing care for a patient with a urinary tract infection (UTI). Which drug would the nurse expect to administer to this patient? A. Solifenacin B. Pentosan polysulfate sodium C. Norfloxacin D. Alfuzosin E. Temperature elevation over 102°F

C. Norfloxacin

51. The pharmacology students are learning about medications used to treat urinary tract problems. What symptoms does phenazopyridine treat? A. Urinary retention B. Hematuria C. Pain and urgency D. Hesitancy

C. Pain and urgency

45. The nurse is caring for a patient who is taking a urinary anti-infective. What would the nurse need to assess this patient for? A. Discolored urine B. Jaundice C. Signs and symptoms of continuing urinary tract infection (UTI) D. Flank pain

C. Signs and symptoms of continuing urinary tract infection (UTI)

49. A 50-year-old man calls the clinic nurse and complains of gastrointestinal upset after taking nitrofurantoin (Furadantin) on an empty stomach. What recommendation should the nurse make? A. Stopping the medication B. Taking vitamin C along with the medication C. Taking the medicine with or after meals D. Continuing to take the medicine on an empty stomach

C. Taking the medicine with or after meals

31. A patient with type 2 diabetes is admitted for an outpatient coronary arteriogram using IV contrast. Which information obtained by the nurse is most important to report to the health care provider before the procedure? A. The patient's admission blood glucose is 128 mg/dL. B. The patient's most recent Hb A1C was 6.5%. C. The patient took the prescribed metformin today. D. The patient took the prescribed captopril this morning.

C. The patient took the prescribed metformin today.

39. A patient comes to the diabetes educator and asks about changing his insulin. The patient explains that his occupation takes him on long international flights and he does not want to administer insulin on the plane. What kind of insulin would the diabetic nurse educator seek an order for? A. Lispro (Humalog) B. Glulisine (Apidra) C. Ultralente (Humulin U Ultralente) D. Aspart (NovoLog)

C. Ultralente (Humulin U Ultralente)

10. A client presents to the clinic with complaints of muscle aches, muscle pain, and weakness. Upon review of the individual's medications, the nurse notes that the client is concurrently taking gemfibrozil (Lopid) and atorvastatin (Lipitor). The nurse should assess the client for the development of: A. migraines. B. hypothyroidism. C. myopathy. D. heart failure.

C. myopathy.

53. A patient is taking phenazopyridine (Azo-Standard) and ciprofloxacin (Cipro) for a urinary tract infection. What is the most important instruction the nurse needs to provide to the patient concerning this drug combination? A. "Do not be alarmed if your urine is a reddish-brown color." B. "Be sure to take your medication with food if you have GI irritation." C. "Increase your fluid intake. Drink lots of water." D. "If you notice yellowing of your eyes or skin, contact your health care provider immediately."

D. "If you notice yellowing of your eyes or skin, contact your health care provider immediately."

22. What outcome for a diabetic client would best indicate the nurse's teaching was effective and that medication therapy was appropriate? A. The client can explain how to take the medication. B. The client demonstrates the correct procedure for monitoring blood sugar. C. The client follows an appropriate diet. D. Blood glucose level is stable with no diabetic complications.

D. Blood glucose level is stable with no diabetic complications.

47. A small group of nursing students are giving an oral presentation to their classmates about urinary tract infections (UTIs). What is a measure that can be used to encourage patients to use to reduce the risk of recurrent urinary tract infections? A. Increase alkaline foods in your diet. B. Take tub baths, soaking 15 minutes daily. C. Use sterile gauze pads to cleanse after urinating. D. Drink 2,000 to 3,000 mL of fluid daily.

D. Drink 2,000 to 3,000 mL of fluid daily.

2. Which of the following would be a contraindication to taking a HMG-COA Reductase Inhibitor? A. Allergy to peanuts B. Smoke 1 pack of cigarettes per day C. Takes fish oil D. Hypersensitivity reaction to fungal byproducts

D. Hypersensitivity reaction to fungal byproducts

32. A patient with type 1 diabetes is eating breakfast at 7:30 AM. 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? A. No insulin should be administered. B. NPH C. 70/30 mix D. Lispro (Humalog)

D. Lispro (Humalog)

62. The nurse is caring for a patient with high serum cholesterol and triglyceride levels. In teaching the patient about therapeutic lifestyle changes such as diet and exercise, the nurse explains that the desired goal for cholesterol levels is what? A. High high-density lipoprotein (HDL) values and high triglyceride values B. Low soluble fiber C. Elevated blood lipids, fasting glucose less than 100 D. Low density lipoprotein (LDL) values and high HDL values

D. Low density lipoprotein (LDL) values and high HDL values

8. An Asian client comes to the clinic. Upon assessment, the nurse notes a slight yellow tint to the skin and sclera, edema, and hepatomegaly. The drug history reveals that the client has been taking rosuvastatin (Crestor) for 6 months. The nurse is concerned, because rosuvastatin has been shown to do what? A. Cause renal and pancreatic toxicity specifically in Asian clients B. Cause renal failure C. Create myoglobin in the urine D. Reach levels twice as high in Asians as in Caucasians, resulting in a greater chance of hepatotoxicity

D. Reach levels twice as high in Asians as in Caucasians, resulting in a greater chance of hepatotoxicity

34. A patient is admitted to the emergency department in diabetic ketoacidosis (DKA) with a blood glucose level of 485 mg/dL. The physician orders an initial dose of 25 units of insulin IV. Which type of insulin will be administered? A. NPH insulin B. Humulin L insulin C. Humulin N insulin D. Regular insulin

D. Regular insulin

12. A prescriber has ordered rosuvastatin (Crestor) for a client with non-alcoholic-related cirrhosis. Which intervention would be most appropriate for the nurse before administration of this drug? A. Question the order, because rosuvastatin (Crestor) is contraindicated in patients with liver disease. B. No intervention is necessary; just administer the drug as ordered. C. Assess the patient for liver disease. D. Review the baseline liver function test results.

D. Review the baseline liver function test results.

11. A client taking gemfibrozil (Lopid) and rosuvastatin (Crestor) concurrently begins to complain of muscle aches, fatigue, and weakness. What should the nurse monitor? A. For tendon tenderness B. For a lupus like syndrome C. The client's LFT results D. The client's creatinine kinase levels

D. The client's creatinine kinase levels

30. After the home health nurse has taught a patient and family about how to use glargine and regular insulin safely, which action by the patient indicates that the teaching has been successful? A. The patient administers the glargine 30 to 45 minutes before eating each meal. B. The patient's family fills the syringes weekly and stores them in the refrigerator. C. The patient draws up the regular insulin and then the glargine in the same syringe. D. The patient disposes of the open vials of glargine and regular insulin after 4 weeks.

D. The patient disposes of the open vials of glargine and regular insulin after 4 weeks.

25. The nurse, working in the emergency department, receives a client following a motor vehicle accident whose medical history is unknown with a blood glucose level of 325 mg/dL. What rationale does the nurse provide explaining this elevated blood glucose level? A. The client's accident was caused by diabetic ketoacidosis (DKA). B. The client has not been taking the antidiabetic agent as prescribed. C. The client most likely just finished a meal. D. The stress reaction caused an increase in blood sugar.

D. The stress reaction caused an increase in blood sugar.

24. Which statement is accurate about the long-term complications of diabetes? A. Long-term complications are almost always the result of hypoglycemia and ketoacidosis. B. The complication rates for patients with tightly controlled type 2 diabetes are the same as for those whose disease is not tightly controlled. C. Tightly controlling type 1 diabetes produces excessive episodes of life-threatening hypoglycemia. D. Tightly controlling both types of diabetes reduces the risk of eye, kidney, and nerve damage.

D. Tightly controlling both types of diabetes reduces the risk of eye, kidney, and nerve damage.

23. With what client would the nurse question the doctor regarding the order for administration of human insulin? A. Gestational diabetes B. Type 2 diabetes controlled on oral antidiabetic agents with systemic infection C. Type 1 diabetes of many years D. Type 2 diabetes controlled by diet

D. Type 2 diabetes controlled by diet

38. With what patient would the nurse question the administration of human insulin? A. Gestational diabetes B. Type 2 diabetes controlled on oral antidiabetic agents with systemic infection C. Type 1 diabetes of many years D. Type 2 diabetes controlled by diet

D. Type 2 diabetes controlled by diet

60. A nurse is to administer 150 mg of a drug intramuscularly. The label on the vial reads 100 mg/mL. How much would the nurse administer? A. 1.5 mL B. 1 mL C. 2 mL D. 2.5 mL

· A. 1.5 mL ·