Pharm Final Quizzes

The nurse is reviewing the history of a patient who will be taking the amylin mimetic drug pramlintide (Symlin). Which condition is a contraindication to the use of this drug?

gasteroparesis

Which of the following is NOT utilized by nurses in safe medication administration?

giving meds prepared by another nurse

The nurse is preparing an infusion for a patient who has a deficiency in clotting factors. Which type of infusion is most appropriate?

fresh frozen plasma

A dose of long-acting insulin has been ordered for bedtime for a patient with diabetes. The nurse expects to give which type of insulin?

garligine

Which information should the nurse include when teaching a patient about inhaled glucocorticoids?

use of a spacer can reduce side effects

A 17-year-old male patient asks about treatment options for Chlamydia trachomatis infection. Which response by the nurse is appropriate?

"Chlamydia is bacterial and is treated with azithromycin [Zithromax]."

A nurse is teaching a client about clindamycin. Which statement by the patient indicates correct understanding of possible adverse effects from this medication?

"Diarrhea may occur however I should call my provider if the diarrhea becomes excessive."

Isotonic solutions contain the same osmolarity as body fluids. Which of the following in an example of an isotonic solution?

0.9% NaCl

Which intravenous (IV) fluid would be most appropriate for treating isotonic volume contraction?

0.9% NaCl

A patient has been prescribed fentanyl 50 mcg IV PRN 1 hour for labor pain. Fentanyl is available on your unit 100 mcg/2 mL. How many mL will you administer to your patient per dose?

1 ml

A laboring adult patient is about to receive fentanyl 75 mcg IM to the left vastus lateralis per provider order. Which needle is the correct size for this administration?

1.5 inch 25 gauge

An IV antibiotic needs to be infused over 30 minutes. The IV bag contains 50 mL. Calculate the setting for the infusion pump in mL/hr.

100ml/hr

The order reads, "Infuse 1000 mL of normal saline over the next 8 hours." Calculate the mL/hour rate for the infusion pump.

125 ml/hr

The order for chemotherapy reads: "Give asparaginase (Elspar) IV 200 units/kg/day." The patient weighs 297 lb. The pharmacy department will prepare the medication for intravenous infusion. How much drug will be given per dose?

27000 units

The order reads, "Infuse 1000 mL of normal saline over the next 8 hours." The IV tubing has a drop factor of 15 gtt/mL. Calculate the drops/minute setting for the IV tubing with this gravity infusion.

31 gtt/min

The patient is ordered divided doses of vancomyocin (Q 12 hours). The patient is to receive the next dose at 4 pm. When should the nurse obtain the trough level?

3:59

The sliding-scale insulin order reads, "Do bedside glucose testing before meals. For glucose results over 150 mg/dL, give regular (Humulin R) insulin, 1 unit for every 20 mg/dL over 150 mg/dL." If the blood glucose level is 238 mg/dL, the patient will receive _____________ units of insulin.

4 units

A patient receives a bupivacaine [Marcaine] injection for infiltration anesthesia. When would the nurse expect the onset of local anesthesia to occur?

5 minutes

Calculate the amount of maintenance fluid replacement in mL/hr for a child weighing 55 lbs.

67 ml/hr

Which information should the nurse include when teaching a patient about isoniazid (INH) therapy?

An adverse effect of isoniazid therapy is peripheral neuropathy, which can be reversed with pyridoxine.

Which drugs are useful for preventing preterm labor? (Select all that apply.)

Antibiotics Hydroxyprogesterone

Which statement about the BCG vaccine does the nurse identify as true?

BCG vaccine can be used to treat carcinoma of the bladder.

Why is systemic toxicity rare with medications such as procaine?

Because plasma esterases rapidly convert the drug to inactive, non-toxic products.

The nurse knows that diuretics mostly affect which function of the kidneys?

Cleansing and maintenance of extracellular fluid volume

Which statement about alkylating agents does the nurse identify as true?

Development of resistance to alkylating agents is common.

Hydroxyzine is an example of which type of antihistamine?

H1 antagonist: first generation

Which serum levels increases risk for nephrotoxicity and ototoxicity from administration of gentamicin?

High total cumulative and trough levels

A patient who is a chronic alcoholic is admitted to the hospital. Admission laboratory work reveals a magnesium level of 1.2 mEq/L. The prescriber orders intravenous magnesium sulfate in a 10% solution at a rate of 10 mL/min. What will the nurse do?

Hold dose, clarify orders

A patient is receiving intravenous (IV) potassium supplements. What is the most important nursing implication when administering this drug?

IV pottasium must be dilutes before given by a infusion pump

The nurse is caring for a patient receiving IV therapy with a 3% sodium chloride infusion at 75 mL/hr. The nurse should closely monitor for which adverse effect of treatment?

JVD, pitting edema

Which medication is indicated for treatment of vancomycin-resistant enterococci and methicillin resistant Staphylococcus aureus?

Linzoild

On 10am rounds, your laboring patient's blood pressure was 140/70, HR 80 bpm, respirations 12/min and oxygen saturation of 99%. She has an epidural in place for pain control. Which of the following should the nurse recognize as maternal hypotension with decreased placental perfusion?

Maternal blood pressure 110/60, HR 78 bpm with minimal fetal HR variability

Which medications are used to treat the rigors associated with administration of amphotericin B?

Meperidine or dantrolene

Which acid-base imbalance is caused by chronic renal failure, loss of bicarbonate during severe diarrhea, or metabolic disorders that result in overproduction of lactic acid?

Metabolic acidosis

Which acid-base imbalance is characterized by increases in both the pH and bicarbonate content of plasma?

Metabolic alkalosis

A patient is receiving chemotherapy. Which laboratory result will most likely require chemotherapy to be withheld?

Neutrophil count of 375/mm3

The nurse is caring for a patient about to receive nitrous oxide for labor analgesia. Which is the best response by the nurse in explaining why nitrous oxide is used during labor?

Nitrous oxide increases endorphin and dopamine levels which diminish pain and anxiety

Which statement regarding antihistamine administration to older adults does the nurse identify as true?

Older men with benign prostatic hypertrophy can experience worse symptoms when taking antihistamines.

When preparing an IV solution that contains potassium, the nurse knows that a contraindication to the potassium infusion would be

Potassium of 5.6

Which new assessment finding would be a priority to report to the obstetrician when the nurse is caring for a patient who is 35 weeks pregnant and receiving terbutaline to suppress preterm labor?

Pt. short of breath and sputum frothy

A patient is receiving 10 mEq of potassium chloride in 100 mL of normal saline intravenously over 1 hour via infusion pump. The patient has a 22 gauge peripheral IV in his right forearm and reports pain at the insertion site; the nurse notes that the site is reddened, warm, and tender to the touch. Which action would the nurse take?

Stop the infusion, and discontinue the IV immediately

A patient who takes over-the counter-diphenhydramine [Benadryl] for seasonal allergy symptoms complains of drowsiness. What should the nurse do?

Tell the patient to take fexofenadine [Allegra] instead of diphenhydramine.

A patient with mild symptoms of Alzheimer Disease is prescribed donepezil. Which statement is NOT correct regarding donepezil?

The drug will stop damage to the neurons in the brain.

A patient taking hydrocortisone for adrenal insufficiency is experiencing an increase in stress due to the death of a family member. The nurse has been instructed by the provider to explain to the patient the 3 by 3 rule regarding the dose of daily hydrocortisone. How many mg per day (if any) does the patient need to take following the 3 by 3 rule?

The patient needs to take hydrocortisone 75 mg/day for the next 3 days, then return to the original dose of 25 mg/day

A patient with which condition would most likely be prescribed a glucocorticoid in low doses for replacement therapy

addisons disease

When checking a patient's fingerstick blood glucose level, the nurse obtains a reading of 42 mg/dL. The patient is awake but states he feels a bit "cloudy-headed." After double-checking the patient's glucose level and getting the same reading, which action by the nurse is most appropriate?

administer oral glucose in the form of semisolid gel

Which medication is indicated for treatment of systemic fungal infections?

amphtercin B

The nurse teaches a patient with hypothalamic diabetes insipidus about desmopressin [DDAVP]. The nurse determines that the teaching was effective if the patient makes which statement?

can be taken by inhaling through the nose

A nurse is administering hydrocortisone to a newly admitted patient who is taking multiple drugs. Which of the following is NOT a drug interaction with prednisone?

cardiac and central nervous system actions are increased when drug is taken with an adrenergic agent

The nurse is caring for a patient receiving chemotherapy. The nurse knows certain antineoplastic medications are more toxic to the body as a whole based on the specificity of the medication. Which of the following medications would be part of the drug class which is more toxic to the body as a whole?

cyclophosphamide

Nursing considerations for all diuretics include

daily weights, monitoring for orthostatic hypotension, education regarding food and drug interactions, and taking the medication early in the day

When evaluating the effects of ergonovine [Ergotrate], the nurse expects which assessment finding?

decreased vaginal bleeding

A pediatric patient is prescribed somatropin [Humatrope] for growth hormone deficiency. It is most appropriate for the nurse to take which action?

draw up and give Sub Q

A patient is to receive 10 mg nalbuphine by slow intravenous push for pain relief during labor. When will the nurse plan to administer nalbuphine?

during uterine contraction

Adverse effects of diuretics includes

electrolyte imbalances

Which of the following methods of pain control during labor is considered most effective and used in the majority of women in the US during labor and delivery?

epiduarl administration

The nurse is reviewing the medication list of a patient with hypokalemia. Which product does NOT contribute to the cause of hypokalemia?

estrogen

The nurse monitors a patient who is experiencing thrombocytopenia from severe bone marrow suppression by looking for

excessive bleeding and brusing

Magnesium sulfate is the most effective drug available to suppress preterm labor.

false

Tocolytic drugs are used to induce and strengthen uterine contractions and to control postpartum bleeding.

false

A patient with hyperthyroidism is taking propylthiouracil (PTU). It is most important for the nurse to assess the patient for which adverse effects?

fever and sore throat

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

help delay birth while glucocorticoids are given

A patient is taking tamoxifen [Nolvadex] for treatment of breast cancer with metastatic bone cancer. It is most important for the nurse to assess the patient for the development of what?

hypercalcemia

Which of these findings, if identified in a patient receiving ergonovine [Ergotrate], should a nurse report to a physician immediately?

hypertension

When administering insulin, the nurse must keep in mind that which is the most immediate and serious adverse effect of insulin therapy?

hypoglycemia

A patient is taking hydrochlorothiazide 50mg/day and digoxin 0.25 mg/day. The nurse plans to monitor the patient for which potential electrolyte imbalance?

hypokalemia

The nurse is assessing a patient who has developed anemia after two rounds of chemotherapy. Which of these may be indications of anemia? (Select all that apply.)

hypoxia, fatigue

The male client with chronic hepatitis C is being prescribed ribavarin. Which medication should the nurse discuss with the client?

importance of 2 relaable forms of birth control

A patient with non-Hodgkin's lymphoma is prescribed cyclophosphamide [Cytoxan]. It is most important for the nurse to teach the patient what?

increase fluid intake to prevent kidney damage

A patient is receiving androgen deprivation therapy for treatment of prostate cancer. The nurse identifies all as adverse effects of androgen deprivation therapy except which?

increased muscle mass

The nurse is reviewing the use of obstetric drugs. Which situation is an indication for an oxytocin (Pitocin) infusion?

induction of labor at full term

While monitoring a patient who is receiving insulin therapy, the nurse observes for which signs of hypoglycemia?

irritability, sweating, confusion

A patient taking glipizide (Glucotrol) asks the nurse, "How does my insulin pill work?" Which information will the nurse provide to the patient regarding the mechanism of action of glipizide?

it increases insulin production

The nurse knows that which organ is primarily responsible for maintaining fluid volume and osmolality?

kidneys

The nurse is caring for a patient receiving oral magnesium gluconate. Which symptom indicates a common adverse effect of this medication?

loose stools

Which of the following is a contraindication to a laboring patient receiving an epidural anesthesia by continuous infusion?

maternal hypotension

A patient is receiving fluid replacement. The nurse's health teaching with this patient includes which suggestions?

measure weight daily

The nurse is administering vasopressin to a patient. Which of the following nursing interventions is indicated when administering vasopressin?

monitor the patient for increased blood pressure (hypertension)

Hypertonic solutions contain _________________________ amount of solutes than the cell which causes water to move ___________________ of the cell.

more, out

Levofloxacin is a second line agent used to treat TB disease which is caused by which organism?

multi-drug resistant organisms

The nurse is discussing therapy with clomiphene (Clomid) with a husband and wife who are considering trying this drug as part of treatment for infertility. It is important that they be informed of which possible effect of this drug?

multiple pregnancy (twins)

The nurse cares for a patient with primary hypoaldosteronism who took excessive doses of fludrocortisone [Florinef]. It is most important for the nurse to assess the patient for what?

muscle weakness and irregular heart beat

Which nursing action is the priority for a patient in preterm labor who is receiving magnesium sulfate?

obtaining deep tendon reflexes

____________________________ refers to the biochemical processes a medication undergoes as it travels through the body.

pharmokinetics

A patient who was in a motor vehicle accident sustained a severe head injury and is brought into the emergency department. The provider orders intravenous mannitol [Osmitrol]. The nurse knows that this is given to:

reduce intracranial pressure

A patient is to be given an insulin drip to control his high blood glucose levels. The nurse knows that the type of insulin that would be used for this intravenous infusion would be which of these?

regular

Which acid-base imbalance is caused by retention of CO2 secondary to hypoventilation?

respiratory acidosis

What acid-base imbalance is caused by hyperventilation?

respiratory alkalosis

A patient is prescribed codeine as an antitussive. Which symptom will the nurse observe for as an adverse effect of this medication?

respiratory depression

Local anesthetics effects are

selective and only affect the neurons located near the site of administration

A patient has a serum potassium level of 6.4 mEq/L and an arterial pH of 7.22. Which medication, if ordered by the physician, should the nurse question?

spironolactone (Aldactone) by mouth

A patient is receiving the drug somatropin. The nurse understands that the action of this drug is to do what?

stimulate growth in the long bones at epiphyseal plates

if extravasation of an antineoplastic drug occurs, what will the nurse do first?

stop infusion, dont remove IV

The nurse will monitor for significant interactions if sitagliptin (Januvia) is given with which of these?

sulfauraeas

A patient is taking levothyroxine. For which adverse effect would the nurse monitor?

tachycardia

The rise and fall of water levels in a water-seal chamber (chest tube drainage system) with respiratory effort is known as

tidling

he nurse is caring for a patient receiving intravenous gentamicin for a severe bacterial infection. Which assessment finding by the nurse indicates the patient is experiencing an adverse effect of gentamycin therapy?

tinitus

The amount of diuresis is directly related to the amount of sodium and chloride reabsorption blocked by the diuretic medication.

true

A nurse is obtaining a medication history from a client who is to receive imipenem-cilastatin IV to treat an infection. Which of the following medications the client also receives put him at risk for a medication interaction?

valproic acid

When will the nurse administer the drug acarbose (Precose)?

with first bite of meal