Pharm Final Review

39. Order is cefaclor 300 mcg po TID (math)

12

14. A client is taking lispro insulin should be instructed to eat how soon after administering the injection?

5-15 minutes

9. Which patient has the highest risk for type 2 diabetes ?

A 55 year old woman who is 5 ft 3 in amd weighs 194 pounds

10. The nurse is educating the staff nurses about ketoacidosis which of the following signs and symptoms would not be consistent with ketoacidosis

A blood glucose of 60

35. A patient asks what generic drugs are and if he should be using them to treat his infection. Which of the following statements should be included in the nurse's explanation?

A generic drug is a drug that is sold by the names od the ingredient not by the brand name Usually cheaper and insurance probably won't pay for it Still have bad side effects and still need a prescription

7. A nurse is monitoring a client receiving chlorpropamide. The nurse understands that which of the following is not a therapeutic outcome for this client

A glycosylated hemoglobin A1C of 18%

26. Which patient would have the highest priority when providing nursing care to multiple patients?

A patient who received oral drugs 1 hour ago and has complained of tingling around his mouth to the nursing assistant

47. Clonidine is approved for the treatment of which conditions

ADHD, hypertension, severe pain

43. The physician orders lisinopril and furosemide to be administered together to the client with hypertension. The nurse should:

Administer the medications.

10. The patient with diabetes complains of low BS. The nurse questions the patient regarding compliance with meds. The platients states that she gets herself more insulin per dose so that she doesn't have to take it as often. Which factors should the nurse educate the patient about as affecting the patient's response to the med?

Administration

27. When considering various drug therapies, the nurse knows that most drug testing and approval occurs with which population?

Adult males and may not be safe for other populations

31. A nurse is teaching parents how to t use an Epi-pen for their child. Who has a peanut allergy. Which statement of the parents indicated understanding of the teaching

After using the Epi pen we must go to the ER

4. A client taking glipizide for control of type 2 diabetes should be cautioned against the use of

Alcohol

23. The symptoms of numbness and tingling around the mouth and respiratory distress with hives indicates:

Anaphylaxis

45. A patient is receiving dobutamine as a continuous infusion is the postoperative period. The patient also is receiving a diuretic. What adverse drug reactions are possible in this patient?

Angina Dysrhythmias Tachycardia

2. Previously prescribed an ACE inhibitor has now been prescribed an ARB. the nurse knows that research suggests this med change will decrease the patient's risk of developing

Angioedema

The nurse should review the six rights to med administration, because the events were distracting and therefore increased likelihood of a med error.

Antagonist

29. The nurse is researching a new drug prior to administration. The drug handbook states that the adverse effects are "dose related." Which means that:

As the dose increases the risk of adverse effects also increase

11. A nurse is providing education to a client preparing for discharge the nurse understand that the best way to promote compliance in the client going home on a new medication is to

Ask the patient to restate the instructions and verify understanding

4. An hour after taking a medication, a nurse notes that the client displays urticaria and pruritus. The nurse's priority action for the client would be to

Assess for changes in respiratory pattern and wheezing

5. A nurse has a busy morning and is rushed. While administering medications, the nurse realizes that he has made a medications error. What action should the nurse take first?

Assess the patient for any adverse reactions to the medications and notify the prescriber.

38. A patient is admitted to the ICU for treatment of shock. Iserpel of is ordered. Nurse expects the drug to increase tissue perfusion in the patient by activating:

Beta 1 receptors to cause a positive inotropic effect on the heart.

39. The prescriber order propranolol (Inderal), for a patient with a BP reading of 200/106. An electrocardiogram taken shortly afterward shows an av block. The nurse should immediately hold the propranolol and report this finding to the prescriber for which reason?

Beta blockers can intensify an AV block.

14. Most diuretics work by

Blocking Na and Cl reabsorption

22. Most diuretics work by

Blocking sodium and chloride reabsorption

22. when the therapeutic index of the drug is narrow, what should the nurse expect?

Blood levels of the drug would be monitored throughout therapy

18. What should the nurse assess to determine if a client is experiencing the therapeutic effect of valsartan (diovan), an angiotensin II receptor blocking agent?

Blood pressure

27. Spironolactone is prescribed for a patient. When teaching the patient about this medication, what does the nurse instruct the patient to avoid when making dietary choices?

Citrus juice

3. The nurse is teaching a group of clients with peripheral vascular disease to stop smoking. Which physiologic effect of nicotine should the nurse explain to the group?

Constriction of the peripheral vessels, increasing the force of flow.

7. A patient is admitted with essential hypertension. Which concurrent health problem would produce the greatest risk of a cardiovascular event?

Diabetes

20. Select the risk factors for hypertension

Diet (high sodium, low calcium, low magnesium, and low potassium) Substances abuse Sedentary lifestyle DM African American heritage Family history

13. Drugs that can be used to lower BP decrease venous resistance by

Dilating veins

36. While taking the patient admission history, the patient describe having a severe allergy to an antibiotic. What is the nurses responsibility to prevent an allergic reaction?

Document the allergy in the medical record Notify the provider and the pharmacy of the allergy and the type of reaction Place an allergy bracelet on the patient

20. When 2 or more drugs are combined, a positive or negative reaction may occur.

Drug to drug interaction

32. Clinical pharmacology is the study of

Drugs used to treat, prevent, or diagnose disease.

16. Angiotensin converting enzyme is chemically the same as the enzyme kinase II which stimulates the breakdown of bradykinin a patient may experience what

Dry cough

21. When a patient is being taught about the potential adverse rxns of ACEI you want to focus on:

Dry nonproductive cough

19. The dose at the middle of the frequency distribution curve, or the dose that is required to produce a defined therapeutic response in 50% of the population.

ED50

30. A nurse is administering IV dopamine to a patient in the ICU which assessment finding would cause the most concern?

Edema at the IV insertion site

25. A nurse is mentoring a student nurse. The student complains that it is unfair that the nursing program requires 100% proficiency in dose calculation on a dose calculation examination during the last semester. The student complains that students may be pleased by test taking shoud not....

Explain that students must be able to calculate drug dose under stress because emergency situations are stressful and dosing error in these situations can be fatal.

6. A prescriber orders a drug that is considered off label. A client asks what that means. The nurse explains that it means:

FDA approved for one use but is being prescribed for another purpose.

15. The nurse teaches the patient who is prescribed an ACE inhibitor that orthostatic blood pressure precautions are especially important when the

First dose or an increase in dosage is taken

9. After an oral medication has been absorbed, most of the medication is inactivated as the blood initially passes through the liver producing little therapeutic effect

First pass effect

34. The testing of new drugs is done by the following

Food and Drug Administration

32. A patient is brought to the ER with SOB, a RR of 30 BPM, intercostal retractions, and frothy pink sputum. The nurse caring for this patient will expect to administer which drug

Furosemide

11. An external insulin pump is prescribed for a client with diabetes mellitus. The client asks the nurse about the functioning of the pump, nurse plans to base the response on the information that the pump:

Gives a small continuous dose of insulin subcutaneously and can give a bolus before meals

15. The time required for the amount of drug in the body to decrease by 50%.

Half life

24. Teratogenic effect means that a drug can cause

Harm to the fetus if the patient takes the drug while she is pregnant

49. A provider has ordered captopril for a patient who has hypertension the patient reports a history of swelling of the tongue and the lips after taking enalapril in the past. Which action by the nurse is correct?

Hold the dose and notify the provider

23. Nurse prepares to administer hydrochlorothiazide to a patient with hypertension. The potassium level is 2.5 meq. What action should the nurse take next?

Hold the medication and notify the health care provider

35. The patient complains of muscle cramping in the calves, paresthesia of the toes, and the sensation of the heart skipping a beat. These symptoms can be symptoms of which of the following imbalances.

Hyperkalemia

17. When anticipating the possible health problems encountered in a health clinic in an african american community, the nurse particularly needs to focus on assessing for s/s of:

Hypertension

36. A patient with chronic congestive heart failure has repeated hospitalizations in spite of ongoing treatment with hydrochlorothiazide and digoxin, they have order spironolactone to be added. And the nurse provides education on this medication. Which statement from the patient states they understand the teaching?

I need to stop taking potassium supplements

41 pt with migraines is started on beta blocker. Which statement indicates pt understanding of medication

I need to take it every day to reduce the frequency on migraines

37. A prescriber has ordered clonidine for a patient who has hypertension. The nurse teaches the patient about side effects of this drug which statement by the patient indicates they understand

I should chew sugar free gum or drink water to reduce dry mouth.

19. A client with chronic heart failure is taking furosemide. Which of the following statements made by the client indicates to the nurse the client understands the side effects of the med.

I should include more foods such as bananas, apricots, and legumes in my diet

5. A nurse reinforces instructions to a client newly diagnosed with DM type 1. The nurse evaluates the accurate understanding measures to prevent DKA when the client says

I will notify my physician if my blood glucose level is greater than 250 mg/dl

11. A patient who has been prescribed quinapril (Accupril) for hypertension has not had the expected reduction in BP. Regular use of which of the following OTC med may be contributing to lack of therapeutic effect of the ACE inhibitor?

Ibuprofen

28. The nurse is teaching the epatient about a newly prescribed medication. Which statement made by the patient would indicate a need for further teaching.

If i take more than ordered, I'll have a better response

29. Dopamine is administered to a patient who has been experiencing hypotensive episodes. Other than an increase in BP, which indicator would the nurse use to evaluate a successful response?

Increase in urine output

37. A patient who is in renal failure may have a diminished capacity to excrete meds. The nurse must assess the patient more frequently for what development?

Increased risk for drug toxicity

1. A patient has been diagnosed with CHF and DM2 has been prescribed lasix.

Increased thirst, confusion, and dry, hot skin

5. Drugs that block the renin-angiotensin-aldosterone system lower pressure by

Increasing excretion of water

7. The nurse is preparing to administer a medication via the parenteral route/ Which medication order best demonstrates this route of administration

Insulin NPH 30 Units subcutaneously

16. The dose of a drug that is lethal to 50% of the animals treated.

LD50

3. Clients taking metformin should be monitored for

Lactic acidosis

50. A prescriber has ordered methyldopa for a female patient with hypertension. The nurse understands that which laboratory tests are important before beginning therapy with this drug

Liver function test, hemoglobin and hematocrit, Coombs' test

38. If a drug is hepatotoxic the nurse knows to check the following lab values before giving the medication:

Liver profile

42. After a healthcare provider prescribed propranolol for a client with frequent PVCs, the nurse should include which of the following in the care plan?

Measure HR daily before taking doe and hold medication if heart rate is less than 60

48. A child who infested a handful of aspirin from a medicine cabinet at home is brought to the ER. The nurse caring notes a respiratory rate of 48 breaths per minute. The nurse understands that this child's respiratory rate is the result of the body's attempt to compensate for:

Metabolic acidosis

26. A nurse is caring for a post op patient who has a nasogastric tube with continuous suction. The nurse notes that the patient has shallow respirations and suspects that this patient has developed.

Metabolic alkalosis

8. A nurse is caring for a pregnant women who has developed high BP in her first trimester. What drug should the nurse expect to prepare for immediate administration?

Methyldopa (Aldomet)

31. A patient asks why all health care providers do not rely on complementary and alternative medicine. When talking to this patient the nurse knows that many complementary (herbals) and alternative therapies:

Not been subjected to rigorous clinical studies

17. Study of drug movement throughout the body, including absorption, distribution, metabolism, and excretion.

Pharmacokinetics

46 A nurse is discussing phentolamine (OraVerse) with a nursing student. Which statements by the student indicates understand of the drug?

Phentolamine can be used to block both epinephrine and norepinephrine mediated vasoconstriction Side effects of phentolamine may include tachycardia and hypotension. Can be used to prevent tissue necrosis after extravasation of drugs such as norepinephrine.

18. The name of a drug that can only be purchased legally with a written/telephone order from a health care provider.

Prescription

9. ACE inhibitors have the following action

Prevent conversion of angiotensin I to angiotensin II

25. When giving mannitol (Osmitrol), the nurse is aware that the therapeutic goal of this drug is to:

Reduce intracranial pressure

13. A patient in the ICU requires IV insulin. Nurse is aware of the facts that:

Regular insulin can be administered IV

8. A nurse notes that a client with type 1 diabetes mellitus has lipodystrophy on both upper thighs. The nurse would most appropriate for the client

Rotates sites for injection

4. The baroreceptors are the most important factor in minute to minute control of BP the baroreceptors

Sense pressure and immediately send that info to the medulla in the brain

6. What should the nurse teach a client to do to minimize orthostatic hypotension when starting an antihypertensive medication

Sit on the edge of the bed a short time before arising

34. The patient's arterial blood gases reveal metabolic acidosis. What med would the nurse anticipate being ordered?

Sodium bicarb

33. When teaching a patient about over the counter drugs, which points should the nurse include

Some of these drugs were once prescription drugs, but are now thought to be safe when used as directed Reading the level of these drugs is very important; the active ingredient is labed and you should always check the ingredients names. It is important to read the label to see what the recommended dose of the drug is; some of theses drugs can cause serious problems if too much of the drug is taken It is important to report the use of any OTC drug to your physician, because many of them can interact with drugs that might be prescribed for you.

10. When a patient is prescribed enalapril which of the following assessment findings would warrant an immediate response by the nurse.

Swelling around the mouth

6. A client newly diagnosed with diabetes mellitus has been stabilized with daily insulin injections. The nurse assists in preparing a discharge teaching plan regarding the insulin and includes which of the following concept?

Systemically rotate insulin injection sites

33. Which ECG finding suggests that the patient is experiencing hyperkalemia?

Tall, tented t-wave

30. The nurse cannot read the number of milligrams to be administered in a drug order written by the HCP. It is questionable whether 125 mg, 1.25 mg, or 12.5 mg should be administered. What action would be most appropriate to prevent a med error?

Telephone the health care provider about the illegible medication order

2. A patient with type I diabetes who takes insulin reports taking propranolol for hypertension. The nurse is concerned because

The beta blocker can mask the symptoms of hypoglycemia

40. A patient with type 1 diabetes who takes insulin reports taking propranolol for hypertension. The nurse is concerned because?

The beta blocker can mask the symptoms of hypoglycemia

21. The nurse is reading research about a drug. The literature states that the drug is potent. What does this mean?

The drug produces its effects at low doses.

8. The patient questions the nurse and asks why the dose is so large. The nurse would be correct to explain that:

The initial dose is sometimes higher to reach a therapeutic level more quickly

12. A nurse is collecting data from a client with type 2 diabetes mellitus. Which statement by the client indicates an understanding of the medication regimen?

The medication that i am taking helps release the insulin i already make

12. While preparing a drug for administration, a nurse is asked a question by the nursing assistant, is greeted by visitors coming to see another patient, and receives a telephone call. To promote safety, which action should the nurse take in this situation?

The nurse should review the six rights to med administration, because the events were distracting and therefore increased likelihood of a med error.

1. A patient recently diagnosed with type 2 diabetes asks a nurse, "Why did I get this condition?" Select the nurse's correct response.

There is a strong family association, so it may be hereditary The condition is strongly related to obesity The definitive cause of type 2 diabetes is unknown

12. The recommended diuretic for initial therapy of essential hypertension is a

Thiazide

24. Diuretics that produce the most significant diuresis affect reabsorption in the

Thick segment of the ascending Loop of Henle

14. The nurse is administering medications and the client state, "I've never seen that blue pill before." What would be the nurse's most appropriate action?

Verify the order and double check the drug label

28. The nurse is preparing to administer mannitol to a patient. The nurse notes crystals in a clear solution. What should the nurse do?

Warm the solution to dissolve the crystals, cool to body temperature, and use an inline filter

44. The best way to evaluate the effectiveness of the patient diuretic to remove fluids is to

Weight the pt daily