PHARM FINAL PT 2

The nurse is reviewing instructions for vaginal antifungal drugs with a patient. Which statement by the nurse is an appropriate instruction regarding these drugs?

"Abstain from sexual intercourse until the treatment has been completed and the infection has resolved."

A 6-year-old child who has chickenpox also has a fever of 102.9° F (39.4° C). The child's mother asks the nurse if she should use aspirin to reduce the fever. What is the best response by the nurse?

"Acetaminophen (Tylenol) should be used to reduce his fever, not aspirin."

A patient is receiving her third course of 5-fluorouracil therapy and knows that stomatitis is a potential adverse effect of antineoplastic therapy. What will the nurse teach her about managing this problem?

"Be sure to examine your mouth daily for bleeding, painful areas, and ulcerations."

The nurse is teaching a patient who is taking colchicine for the treatment of gout. Which instruction will the nurse include during the teaching session?

"Call your doctor if you have increased pain or blood in the urine."

A patient has used enteric aspirin for several years as treatment for osteoarthritis. However, the symptoms are now worse and she is given a prescription for a nonsteroidal anti-inflammatory drug and misoprostol (Cytotec). The patient asks the nurse, "Why am I now taking two pills for arthritis?" What is the nurse's best response?

"Cytotec may help to prevent gastric ulcers that may occur in patients taking NSAIDs."

The nurse is reviewing infection-prevention measures with a patient who is receiving antineoplastic drug therapy. Which statement by the patient indicates the need for further teaching?

"I will eat only fresh fruits and vegetables."

A patient who has a history of coronary artery disease has been instructed to take one 81-mg aspirin tablet a day. The patient asks about the purpose of this aspirin. Which response by the nurse is correct?

"It will help prevent clot formation."

A patient is taking nystatin (Mycostatin) oral lozenges to treat an oral candidiasis infection resulting from inhaled corticosteroid therapy for asthma. Which instruction by the nurse is appropriate?

"Let the lozenge dissolve slowly and completely in your mouth without chewing it."

A patient has been advised to add a nasal spray (an adrenergic decongestant) to treat a cold. The nurse will include which instruction?

"Limit use of this spray to 3 to 5 days."

A patient has prescriptions for two inhalers. One inhaler is a bronchodilator, and the other is a corticosteroid. Which instruction regarding these inhalers will the nurse give to the patient?

"Take the bronchodilator inhaler first."

A patient who is being treated for malaria has started therapy with quinine and tetracycline. He asks the nurse why he is on an antibiotic when malaria is caused by a parasite. Which response by the nurse is correct?

"The two drugs are more effective against malaria when given together."

After receiving a nebulizer treatment with a beta agonist, the patient complains of feeling slightly nervous and wonders if her asthma is getting worse. What is the nurse's best response?

"This is an expected adverse effect. Let me take your pulse."

A patient newly diagnosed with tuberculosis (TB) has been taking antitubercular drugs for 1 week calls the clinic and is very upset. He says, "My urine is dark orange! What's wrong with me?" Which response by the nurse is correct?

"This is an expected side effect of the medicine. Let's review what to expect."

The nurse is providing instructions to a patient who has a new prescription for a corticosteroid metered-dose inhaler. Which statement by the patient indicates that further instruction is needed? (Select all that apply.)

(1) "I will gargle after using the inhaler and then swallow." (2) "I will use this inhaler for asthma attacks."

When teaching a patient who will be receiving antihistamines, the nurse will include which instructions? (Select all that apply.)

(1) "Take the medication with food to minimize GI distress." (2) "Drink extra fluids if possible." (3) "Avoid activities that require alertness until you know how adverse effects are tolerated."

The nurse is reviewing medications for the treatment of asthma. Which drugs are used for acute asthma attacks? (Select all that apply.)

(1) Albuterol (Proventil) nebulizer solution (2) Epinephrine

A 75-year-old woman has been given a nonsteroidal anti-inflammatory drug (an NSAID for the treatment of rheumatoid arthritis. The nurse is reviewing the patient's medication history and notes that which types of medications could have an interaction with the NSAID? (Select all that apply.)

(1) Anticoagulants (2) Diuretics (3) Corticosteroids

A patient is in the HIV clinic for a follow-up appointment. He has been on antiretroviral therapy for HIV for more than 3 years. The nurse will assess for which potential adverse effects of long-term antiretroviral therapy? (Select all that apply.)

(1) Lipodystrophy (2) Liver damage (3) Osteoporosis (4) Type 2 Diabetes

Methotrexate is ordered for a patient with a malignant tumor, and the nurse is providing education about self-care after the chemotherapy is given. Which statements by the nurse are appropriate for the patient receiving methotrexate? (Select all that apply.)

(1) Report unusual bleeding or bruising (2) Prepare for hair loss. (3) Avoid areas with large crowds or gatherings (4) Avoid foods that are too hot or too cold or rough in texture

When a patient is receiving cisplatin (Platinol-AQ) chemotherapy, the nurse will monitor for which adverse effects? (Select all that apply.)

(1) Tinnitus (2) Hearing loss (3) Elevated BUN and creatinine levels (4) Numbness or tingling in the extremities

The nurse is reviewing the history of a patient who has a new order for a nonsteroidal anti-inflammatory drug (NSAID) to treat tendonitis. Which conditions are contraindications to the use of NSAIDs? (Select all that apply.)

(1) Vitamin K deficiency (2) Peptic ulcer disease

A patient is in an urgent care center with an acute asthma attack. The nurse expects that which medication will be used for initial treatment?

A short-acting beta2 agonist such as albuterol (Proventil)

A patient has received a prescription for a 2-week course of antifungal suppositories for a vaginal yeast infection. She asks the nurse if there is an alternative to this medication, saying, "I don't want to do this for 2 weeks!" Which is a possibility in this situation?

A single dose of a fluconazole (Diflucan) oral tablet.

The nurse recognizes that use of estrogen drugs is contraindicated in which patient?

A woman with a history of thrombophlebitis

A patient is receiving heparin therapy as part of the treatment for a pulmonary embolism. The nurse monitors the results of which laboratory test to check the drug's effectiveness?

Activated partial thromboplastin time (aPTT)

A patient is receiving oxytocin (Pitocin) to induce labor. During administration of this medication, the nurse will also implement which action?

Administering the medication with an IV infusion pump

The nurse is reviewing the therapeutic effects of nonsteroidal anti-inflammatory drugs (NSAIDs), which include which effect?

Antipyretic

A patient who has been on methotrexate therapy is experiencing mild pain. The patient is asking for aspirin for the pain. The nurse recognizes that which of these is true in this situation?

Aspirin can lead to methotrexate toxicity

The nurse is providing teaching for a patient who is to receive estrogen replacement therapy. Which statement is correct to include in the teaching session?

Be sure to report any weight gain of 5 lbs or more per week

A patient who is HIV- positive has been receiving medication therapy that includes zidovudine (Retrovir). However, the prescriber has decided to stop the zidovudine because of its dose-limiting adverse effect. Which of these conditions is the dose-limiting adverse effect of zidovudine therapy?

Bone marrow suppression

Just before the second course of chemotherapy, the laboratory calls to report that the patient's neutrophil count is 450 cells/mm3. The nurse expects that the oncologist will follow which course of treatment?

Chemotherapy will be withheld until the neutrophil count returns toward normal levels.

An older adult patient had gastric surgery due to a gastrointestinal bleed 3 days ago, and he has been stable since the surgery. This evening, his daughter tells the nurse, "He seems to be more confused this afternoon. He's never been like this. What could be the problem?" The nurse reviews the patient's medication record and suspects that which drug could be the cause of the patient's confusion?

Cimetidine (Tagamet)

A patient is receiving cidofovir (Vistide) as part of treatment for a viral infection, and the nurse is preparing to administer probenecid, which is also ordered. Which is the rationale for administering probenecid along with the cidofovir treatment?

Concurrent drug therapy with probenecid reduces thenephrotoxicity of the cidofovir.

A patient is receiving an aluminum-containing antacid. The nurse will inform the patient to watch for which possible adverse effect?

Constipation

The nurse is reviewing new medication orders for a patient who has an epidural catheter for pain relief. One of the orders is for enoxaparin (Lovenox), a low-molecular-weight heparin (LMWH). What is the nurse's priority action?

Contact the prescriber because the LMWH cannot be given if the patient has an epidural catheter.

A patient with gout has been treated with allopurinol (Zyloprim) for 2 months. The nurse will monitor laboratory results for which therapeutic effect?

Decrease uric acid levels

A patient is receiving doxorubicin (Adriamycin) as part of treatment for ovarian cancer. Which nursing diagnosis is related to this antineoplastic drug?

Decreased cardiac output r/t the adverse effect of cardiotoxicity

During a routine checkup, a patient states that she is unable to take the prescribed antihistamine because of one of its most common adverse effects. The nurse suspects that which adverse effect has been bothering this patient?

Drowsiness

When monitoring patients on antitubercular drug therapy, the nurse knows that which drug may cause a decrease in visual acuity?

Ethambutol (Myambutol)

The nurse is reviewing the sputum culture results of a patient with pneumonia and notes that the patient has a gram-positive infection. Which generation of cephalosporin is most appropriate for this type of infection?

First generation

A patient who has undergone a lung transplant has contracted cytomegalovirus (CMV) retinitis. The nurse expects which drug to be ordered for this patient?

Ganciclovir (Cytovene)

A patient is being discharged on anticoagulant therapy. The nurse will include in the patient-education conversation that it is important to avoid herbal products that contain which substance?

Ginkgo

The nurse notes in a patient's medication history that the patient is taking allopurinol (Zyloprim). Based on this finding, the nurse interprets that the patient has which disorder?

Gout

A patient who has been taking cimetidine (Tagamet) for hyperacidity calls the clinic to say that the medication has not been effective. The nurse reviews his history and notes that which factor may be influencing the effectiveness of this drug?

He smokes two packs of cigarettes a day.

A patient has been prescribed warfarin (Coumadin) in addition to a heparin infusion. The patient asks the nurse why he has to be on two medications. The nurse's response is based on which rationale?

Heparin is used to start anticoagulation so as to allow time for the blood levels of warfarin to reach adequate levels.

The nurse will assess the patient for which potential contraindication to antitubercular therapy?

Hepatic impairment

A female patient is receiving palliative therapy with androgen hormones as part of treatment for inoperable breast cancer. The nurse will discuss with the patient which potential body image changes that may occur as adverse effects?

Hirsutism and acne

A mother brings her toddler into the emergency department and tells the nurse that she thinks the toddler has eaten an entire bottle of chewable aspirin tablets. The nurse will assess for which most common signs of salicylate intoxication in children?

Hyperventilation and drowsiness

If a patient is taking fluconazole (Diflucan) with an oral anticoagulant, the nurse will monitor for which possible interaction?

Increased effects of oral anticoagulants

The nurse is providing instructions about the Advair inhaler (fluticasone propionate and salmeterol). Which statement about this inhaler is accurate?

It is used for the prevention of bronchospasms.

During the administration of finasteride (Proscar), the nurse must remember which important precaution?

It must not be handled by pregnant women.

The nurse is reviewing the medication orders for a patient who will be taking an H2 antagonist. Which drug may have an interaction if taken along with the H2 antagonist?

Ketoconazole (Nizoral) - AN ANTIFUNGAL MED.

When giving cisplatin (Platinol-AQ), the nurse is aware that the major dose-limiting effect of this drug is which condition?

Kidney damage

A gardener needs a decongestant because of seasonal allergy problems and asks the nurse whether he should take an oral form or a nasal spray. Which of these is a benefit of orally administered decongestants?

Lack of rebound congestion

A patient is receiving high doses of methotrexate and is experiencing severe bone marrow suppression. The nurse expects which intervention to be ordered with this drug to reduce this problem?

Leucovorin rescue

A 75-year-old woman comes into the clinic with complaints of muscle twitching, nausea, and headache. She tells the nurse that she has been taking sodium bicarbonate five or six times a day for the past 3 weeks. The nurse will assess for which potential problem that may occur with overuse of sodium bicarbonate?

Metabolic alkalosis

A patient is taking the nonsteroidal anti-inflammatory drug indomethacin (Indocin) as treatment for pericarditis. The nurse will teach the patient to watch for which adverse effect?

Nausea and vomiting

The nurse is discussing adverse effects of antitubercular drugs with a patient who has active tuberculosis. Which potential adverse effect of antitubercular drug therapy should the patient report to the prescriber?

Numbness and tingling of extremities

When evaluating a patient's use of a metered-dose inhaler (MDI), the nurse notes that the patient is unable to coordinate the activation of the inhaler with her breathing. What intervention is most appropriate at this time?

Obtain an order for a spacer device.

When educating a patient recently placed on inhaled corticosteroids, the nurse will discuss which potential adverse effects?

Oral candidiasis and dry mouth

The nurse is counseling a woman who will be starting rifampin (Rifadin) as part of antitubercular therapy. The patient is currently taking oral contraceptives. Which statement is true regarding rifampin therapy for this patient?

Oral contraceptives are less effective while the patient is taking Rifampin.

The nurse will instruct patients about a possible systemic effect that may occur if excessive amounts of topically applied adrenergic nasal decongestants are used. Which systemic effect may occur?

Palpitations

A patient who has been taking isoniazid (INH) has a new prescription for pyridoxine. She is wondering why she needs this medication. The nurse explains that pyridoxine is often given concurrently with the isoniazid to prevent which condition?

Peripheral neuropathy

The nurse is reviewing the medication administration record of a patient who is taking isoniazid (INH). Which drug or drug class has a significant drug interaction with isoniazid?

Phenytoin (Dilantin)

The nurse notes in the patient's medication orders that the patient will be starting anticoagulant therapy. What is the primary goal of anticoagulant therapy?

Preventing thrombus formation

The nurse is reviewing the use of uterine tocolytics, such as indomethacin (Indocin). Which statement best describes the indication for these drugs?

Prevention of preterm labor in the 22nd week of pregnancy

A patient will be having oral surgery and has received an antibiotic to take for 1 week before the surgery. The nurse knows that this is an example of which type of therapy?

Prophylactic

A patient has received an overdose of intravenous heparin, and is showing signs of excessive bleeding. Which substance is the antidote for heparin overdose?

Protamine sulfate

During assessment of a patient with osteoarthritis pain, the nurse knows that which condition is a contraindication to the use of nonsteroidal anti-inflammatory drugs (NSAIDs)?

Renal disease

An infant has been hospitalized with a severe lung infection caused by the respiratory syncytial virus (RSV) and will be receiving medication via the inhalation route. The nurse expects which drug to be used?

Ribavirin (Virazole)

Which nursing diagnosis is appropriate for a patient who has started aminoglycoside therapy?

Risk for injury (renal damage)

A patient is complaining of excessive and painful gas. The nurse checks the patient's medication orders and prepares to administer which drug for this problem?

Simethicone (Mylicon)

The nurse is administering oxytocin (Pitocin). Which situation is an indication for the use of oxytocin?

Stimulation of contractions during labor

A patient is receiving his third intravenous dose of a penicillin drug. He calls the nurse to report that he is feeling "anxious" and is having trouble breathing. What will the nurse do first?

Stop the antibiotic infusion

A patient has a urinary tract infection. The nurse knows that which class of drugs is especially useful for such infections?

Sulfonamides

A patient has been instructed to take one enteric-coated low-dose aspirin a day as part of therapy to prevent strokes. The nurse will provide which instruction when providing patient teaching about this medication?

Take the medication with 6 to 8 oz of water and with food

A 79-year-old patient is receiving a quinolone as treatment for a complicated incision infection. The nurse will monitor for which adverse effect that is associated with these drugs?

Tendonitis and tendon rupture

What is the benefit of administering one of the lipid formulations of amphotericin B? (42) The nurse is administering one of the lipid formulations of amphotericin B. When giving this drug, which concept is important to remember?

The lipid formulations are associated with fewer adverse effects than the older drugs.

The nurse is developing a plan of care for a patient who is experiencing gastrointestinal adverse effects, including anorexia and nausea, after the first course of antineoplastic therapy. What is an appropriate outcome for this patient when dealing with this problem?

The patient will maintain a diet of small, frequent feedings with nutrition supplements within 2 weeks.

When reviewing the medication orders for a patient who is taking penicillin, the nurse notes that the patient is also taking the oral anticoagulant warfarin (Coumadin). What possible effect may occur as the result of an interaction between these drugs?

The penicillin will cause an enhanced anticoagulant effect of the warfarin.

A patient is asking advice about which over-the-counter antacid is considered the most safe to use for heartburn. The nurse explains that the reason that calcium antacids are not used as frequently as other antacids is for which of these reasons?

Their use may result in kidney stones.

A patient has been taking antitubercular therapy for 3 months. The nurse will assess for what findings that indicate a therapeutic response to the drug therapy?

There is a decrease in symptoms of tuberculosis along with improved chest x-rays and sputum cultures

The nurse is teaching a class about the various chemotherapy drugs. Which of these statements explains why alkylating drugs are also called "cell cycle-nonspecific drugs"?

They are cytotoxic in any phase of the cell cycle.

A patient is taking a combination of antiviral drugs as treatment for early stages of a viral infection. While discussing the drug therapy, the patient asks the nurse if the drugs will kill the virus. When answering, the nurse keeps in mind which fact about antiviral drugs?

They may also kill healthy cells while killing viruses

When a patient is on aminoglycoside therapy, the nurse will monitor the patient for which indicators of potential toxicity?

Tinnitus and dizziness

A patient who has been hospitalized for 2 weeks has developed a pressure ulcer that contains multidrug-resistant Staphylococcus aureus (MRSA). Which drug would the nurse expect to be chosen for therapy?

Vancomycin (Vancocin)

A patient who has been anticoagulated with warfarin (Coumadin) has been admitted for gastrointestinal bleeding. The history and physical examination indicates that the patient may have taken too much warfarin. The nurse anticipates that the patient will receive which antidote?

Vitamin K

The nurse is providing counseling to a woman who is HIV positive and has just discovered that she is pregnant. Which anti-HIV drug is given to HIV-infected pregnant women to prevent transmission of the virus to the infant?

Zidovudine (Retrovir)

The nurse is monitoring a patient who has severe bone marrow suppression following antineoplastic drug therapy. Which is considered a principal early sign of infection?

fever

The nurse is administering a combination of three different antineoplastic drugs to a patient who has metastatic breast cancer. Which statement best describes the rationale for combination therapy?

increased cancer-cell killing will occur

A patient is receiving finasteride (Proscar) for treatment of benign prostatic hyperplasia. The nurse will tell him that a possible effect of this medication is:

increased hair growth

When reviewing the health history of a patient who will be receiving antacids, the nurse recalls that antacids containing magnesium need to be used cautiously in patients with which condition?

renal failure

A 73-year-old male patient is in the clinic for a yearly physical and is asking for a prescription for sildenafil (Viagra). He has listed on his health history that he is taking a nitrate for angina. The nurse is aware that which problem may occur if sildenafil is taken with a nitrate?

significant decrease in blood pressure

A patient has had recent mechanical heart valve surgery and is receiving anticoagulant therapy. While monitoring the patient's laboratory work, the nurse interprets that the patient's international normalized ratio (INR) level of 3 indicates that:

the patient's warfarin dose is at therapeutic levels