Pharm II terms

Nasal congestion

cholinergic stimulation causes vasodilation of the blood

Hypothyroidism

deficiency thyroid hormones( T3 and T4) S/S: Nonpitting edema of lower legs, weakness, fatigue, cold intolerance, wt gain.

Mucolytic

dissolves thick, sticky mucus

Glucocorticoid

hormone from the adrenal cortex that raises blood sugar and reduces inflammation Ex: Prednisone. Fluticasone proprionate

Hyperthyroidism (graves disease)

increase in thyroid hormones(T3 and T4) S/S: Anxiety, nervousness, wt loss, elevated HR with palpitations, elevated BP, bulging eyes.

Allergic rhinitis

inflammation of nasal mucosa from exposure to an allergen

Muscarinic Agonists

medication that activates the muscarinic receptors in the body. These receptors are found throughout the body, including heart, lungs, GI tract, Urinary tract Ex: Bethanechol

Decongestants

relieve nasal congestion Ex: Afrin-use of longer than 3-5 days can cause rebound symptoms

Which information should the nurse include in the teaching of a client with type 1 diabetes mellitus that would like to participate in sports?

"Eat a meal 1 hour before the game and consume a carbohydrate snack and fluids during the game."

A nurse is teaching parents how to use an EpiPen for their child, who has a peanut allergy. Which statement by the parents indicates understanding of the teaching

"After using the EpiPen, we must go to the emergency department."

A nurse is teaching a nursing student about the two classes of adrenergic agonist drugs. Which statement by the nursing student indicates understanding of the teaching?

"Catecholamines often require continuous infusion to be effective."

The nurse is preparing to provide education for a client prescribed Clopidogrel (Plavix) after a stent placement. Which statements should the nurse use to explain the action of Clopidogrel?

"Clopidogrel will make the platelets in your blood less sticky."

The nurse has provided a client education about enoxaparin (Lovenox). Which statement made by a client indicates an understanding of the information?

"Enoxaparin interferes with my body's ability to form a clot."

A nursing student asks the nurse why epinephrine, and not other adrenergic agonists, is used to treat anaphylactic shock. What will the nurse tell the student? "Other adrenergic agonists have more severe adverse effects and are not safe in the doses needed to treat anaphylaxis." "Other adrenergic agonists have little or no effects on beta2-adrenergic receptors." "Epinephrine has the ability to activate multiple types of adrenergic receptors." "Epinephrine is the only adrenergic agonist that may be given parenterally."

"Epinephrine has the ability to activate multiple types of adrenergic receptors."

The nursing instructor teaches student nurses about male reproductive function and the role of follicle-stimulating hormone (FSH). The instructor evaluates learning has occurred when the students make which statement? "Follicle-stimulating hormone (FSH) regulates male androgen production." "Follicle-stimulating hormone (FSH) regulates production of testosterone." "Follicle-stimulating hormone (FSH) regulates sperm production." "Follicle-stimulating hormone (FSH) regulates male progesterone."

"Follicle-stimulating hormone (FSH) regulates sperm production."

A client receiving insulin tells the nurse their blood glucose has been low the last few mornings. Which additional statement made by the client may be a contributing factor to the decrease in the blood glucose?

"I have been taking a garlic supplement to prevent colds."

The nurse has provided discharge education for a client prescribed an anticoagulant. Which statement made by the client indicates an understanding of the information?

"I should consult with my prescribing provider before having any surgery."

Which statement made by a client indicates an understanding of the education about insulin administration?

"I should only use an appropriate calibrated insulin syringe for the injections."

The nurse is teaching the patient about atenolol [Tenormin]. Which statement by the patient indicates a correct understanding of the nurse's instruction?

"I will not stop taking this drug without the approval of my healthcare provider."

Which information should the nurse include in the teaching for a client prescribed a progestin only oral contraceptive? "Progestin only contraception is more effective than combined contraception but has more systemic side effects." "Progestin only contraception puts you at increased risk of blood clots." "It is important to take the progestin only pill at the same time every day." "It is important to take progestin only contraception in the morning on empty stomach."

"It is important to take the progestin only pill at the same time every day."

A male client prescribed estrogen for prostate cancer asks the nurse why they are receiving a female hormone. Which response should the nurse provide? "It shrinks your cancer by causing the cells to die at a faster rate." "It keeps the cancer cells from receiving nutrients." "It eliminates the testosterone that encourages the growth of the cancer cells" "It suppresses secretion of the androgens that make your cancer grow."

"It suppresses secretion of the androgens that make your cancer grow."

A patient with newly diagnosed type 1 diabetes mellitus asks the nurse why they must take insulin and cannot take a pill like their friend does. Which answer would the nurse provide? "Insulin is more effective in controlling blood glucose levels." "Let me check with your healthcare provider to see if this is possible." "Calorie reduction along with insulin can prevent long term complications." "Oral hypoglycemics only work when the pancreas still produces insulin."

"Oral hypoglycemics only work when the pancreas still produces insulin."

Which information should the nurse include in the education for a client prescribed finasteride (Proscar)? "Do not do heavy exercise while taking this medication." "Take the medication on an empty stomach." "Reduce your sodium intake while taking this drug." "Use a condom during intercourse."

"Use a condom during intercourse."

Which statement is appropriate to include in the teaching plan for a patient with new prescription for phenytoin? Select all that apply. One, some, or all responses may be correct. "You may have some mild sedation. Do not drive until you know how this drug will affect you." "Be sure to call the clinic if you or your family notice thay you are experiencing increased anxiety or agitation." "It is very important to have good oral hygiene and visit your dentist regularly." "This drug may cause easy bruising. If you notice this, call the clinic immediately." "You may continue to have wine with evening meals but only in moderation."

"You may have some mild sedation. Do not drive until you know how this drug will affect you." "It is very important to have good oral hygiene and visit your dentist regularly."

The nurse educator is reviewing the process of hemostasis. Please put the steps of homeostasis in order.The nurse educator is reviewing the process of hemostasis. Please put the steps of homeostasis in order.

1. Vasoconstriction 2. Damage to the endothelium resulting in formation of platelet plug 3. Activation of the clotting cascade 4. formation of a blood clot 5. Activation of fibrinolysis for clot retraction

A client using Depo-Provera as a method of birth control asks the nurse how long the medication will be effective. Which response should the nurse provide the client? 4 months. 6 weeks. 12 weeks. 1 months.

12 weeks.

For which client experiencing muscle spasms is direct-acting antispasmodic medication dantrolene sodium (Dantrium) contraindicated? A 57-year-old with congestive heart failure A 40-year-old with multiple sclerosis A 65-year-old with a cerebral vascular accident A 20-year-old with a spinal cord injury

A 57-year-old with congestive heart failure

A patient presents to the emergency department with dilated pupils, a flushed face, a heart rate of 124 beats/min, a temperature of 102.6 °F, and urinary retention. The patient's partner reports the patient has been taking diphenhydramine for hay fever but is unaware of any other medications taken. Which condition does the nurse suspect the patient is experiencing?

Acute toxicity

The physician writes orders for the client with diabetes mellitus. Which order would the nurse question and validate with the physician before proceeding?

Administer Lantus insulin 20U BID.

Which intervention would the nurse perform for a patient suspected of anticholinergic toxicity?

Administer slow intravenous push physostigimine

A client with Addison's disease is experiencing nausea, vomiting, and confusion. Which priority intervention should the nurse anticipate to be included in the plan of care? Immediate endotracheal intubation Administration of intravenous hydrocortisone. Administration of intravenous diuretic. Placement of a nasogastric tube

Administration of intravenous hydrocortisone.

A patient who recently had a surgery was diagnosed with Deep Venous Thrombosis and is starting heparin therapy. Which medication order would the nurse expect to be changed now that the patient is on heparin. Advil 800mg p. o. every 8 hours for pain. Labetalol 200mg p. o. b. i. d. for hypertension. Norco 325/5 p. o. every 4 hours for pain. Cephalexin 500mg p. o. every 6 hours for wound infection.

Advil 800mg p. o. every 8 hours for pain.

Which drug class is prescribed as initial therapy for hypertension after myocardial infarction (MI)? Select all that apply. One, some, or all responses may be correct. Aldosterone antagonists Calcium Channel Blockers Diuretics Angiotensin- converting enzyme inhibitors Beta blockers

Aldosterone antagonists Angiotensin- converting enzyme inhibitors Beta blockers

Which lab result is a priority for the nurse to assess for a client who is prescribed dantrolene (Dantrium)?

Aspartate aminotransferase (AST) and alanine aminotransferase (ALT)

In which way would the nurse evaluate the therapeutic effectiveness of a class IV antidysrhythmic drug? Select all that apply. One, some, or all responses may be correct. Listen to breath sounds Assess for chest pain Check blood pressure Check pipil constriction Monitor cardiac function Count ventricular rate

Assess for chest pain Check blood pressure Monitor cardiac function Count ventricular rate

The nurse is preparing to administer diltiazem and atenolol. What is the priority nursing intervention before administering these two medications to the patient?

Assess the heart rate

Which condition in a postoperative patient is treated with bethanechol?

Atonic bladder

A patient who takes rivastigmine develops complete heart block. Which medication would the nurse administer to improve the patient's condition?

Atropine

Which medication would the nurse anticipate administering to a patient in cholinergic crisis? Atropine Dobutamine Neostigmine Pralidoxime

Atropine

Which ophthalmic solution is contraindicated for clients with glaucoma?

Atropine

Which drug increases the risk for unrecognized hypoglycemia in a patient receiving insulin? Codeine Thiazide diuretics Beta-adrenergic blockers Aspirin

Beta-adrenergic blockers

Anticholinergics

Block the activity of PNS by inhibiting effects of acetylcholine. Involved in bodily functions such as digestion, urination, and vision Ex: Atropine

Which medication would be used to treat hypertension and diabetic nephropathy? Quinapril Captoril Trandolapril Peridopril

Captoril

Antihistamines

Cause drowsiness Contraindications: prostatic hyperplasia, asthma, glaucoma

Which statement describes the primary difference between centrally acting muscle relaxants and direct-acting antispasmodics? Centrally acting agents inhibit neurons of the central nervous system, while direct-acting agents stimulate neurons of the central nervous system. Centrally acting agents stimulate the central nervous system, while direct-acting agents inhibit neuronal conduction of the central nervous system. Centrally acting agents stimulate neurons of the central nervous system, while direct-acting agents stimulate neurons of the peripheral nervous system. Centrally acting agents inhibit neurons of the central nervous system, while direct-acting agents work at the level of the neuromuscular junction and skeletal muscles.

Centrally acting agents inhibit neurons of the central nervous system, while direct-acting agents work at the level of the neuromuscular junction and skeletal muscles.

The nurse is reviewing the health record for a patient with type 2 diabetes mellitus. Which finding in the health record would cause the nurse to withhold the dose of metformin and contact the healthcare provider? Computed tomography scan with contrast scheduled for this morning Fasting blood glucose 100 mg/dL 2-lb weight gain in 1 week Blood pressure 142/90 mmHg

Computed tomography scan with contrast scheduled for this morning

Which is responsible for the secretion of progestins? Ovarian follicles. Anterior pituitary. Hypothalamus. Corpus luteum.

Corpus luteum.

A client with type 2 diabetes reports that he is allergic to sulfamethoxazole. A nurse knows that this patient might also be allergic to which diabetic medication.

Glipizide (Glucotrol).

Which medications are useful to relieve pain associated with muscle spasms? Select all that apply. One, some, or all responses may be correct. Cyclobenzaprine Fondaparinux Methocarbamol Carisoprodol Cefazolin

Cyclobenzaprine Methocarbamol Carisoprodol

Which describes the primary goal of pharmacotherapy for the treatment of hyperthyroidism (Graves' disease)? Increase synthesis of thyroid hormones. Suppress TSH. Decrease the metabolic processes. Decreasing the production of thyroid hormones

Decreasing the production of thyroid hormones

The nurse is caring for several patients prescribed propranolol [Inderal]. In which patient condition is propranolol [Inderal] contraindicated?

Diabetes

Adrenergic Agonists

Drugs that stimulate and mimic the actions of the sympathetic nervous system. Also called sympathomimetics. Mimicks effect of norepinephrine and epinephrine. Ex: Albuterol. Dopamine. Epinephrine

A patient undergoing inhaled ipratropium therapy visits the clinic for a follow-up visit. Which report would the nurse anticipate from the patient?

Dry mouth

A middle-aged woman was just diagnosed with hypothyroidism due to Hashimoto's thyroiditis. What findings a nurse expects to see in her chart? Elevated TSH and decreased free T4. Decreased TSH and decreased TRH. Decreased TSH and elevated ACTH . Elevated TSH and elevated total T3.

Elevated TSH and decreased free T4.

The nurse would monitor for which adverse effect in a patient who takes amiodarone? Select all that apply. One, some, or all responses may be correct. Elevated liver enzymes Light sensitivity Dyspnea Hypertension Hyperthroidism

Elevated liver enzymes Light sensitivity Dyspnea Hyperthroidism

Which action is an appropriate nursing intervention for a patient who is taking hydrochlorothiazide? Schedule the dose to be taken in the evening Encourage the intake of foods rich in potassium Monitor serum calcium and sodium levels daily Take the radial pulse for 1 full minute before administering the drug.

Encourage the intake of foods rich in potassium

Which adverse effect would a nurse monitor for in a client taking clopidogrel?

Epistaxis

Rhinitis medicamentosa

Excessive blood from nasal passages causing swelling and more congestion

Which symptom is common for a client with untreated type 1 diabetes mellitus?

Fatigue.

Which insulin selection indicates patient understanding of teachings received from the nurse about the use of basal insulin for glucose stabilization?

Glargine

The nurse is teaching the patient why hypertension must be treated. Which complication would be included in the teaching plan? Select all that apply. One, some, or all responses may be correct. Heart Disease Heart failure Emphysema Stroke Kidney Disease Diabetes

Heart Disease Heart failure Stroke Kidney Disease

The patient has a deep vein thrombosis (DVT) and is admitted for initial heparin therapy. What complication the nurse needs to be aware of?

Heparin induced thrombocytopenia.

Which patient assessment finding contraindicates the use of bethanechol?

History of Asthma

The nurse is caring for a patient who sustained a myocardial infarction and is prescribed metoprolol before discharge. Which information would the nurse provide? Report continued dry coughing Notify the health care provider of bruising Monitor for decreased urination Hold the medication if the pulse is less than 55 beats/min

Hold the medication if the pulse is less than 55 beats/min

Which assessment findings should the nurse anticipate for the client with Cushing's syndrome? Hypertension. Shortness of breath. Thin, gaunt appearance of the face. Tachycardia.

Hypertension.

Which patient statement indicates understanding of the nurse's teachings related to a newly prescribed medication, insulin glargine (Lantus)? Select all that apply. One, some, or all responses may be correct.

I cannot mix this with other insulins I will administer subcutaneously The insulin will start working in one and a half hours

The nurse is taking the initial history of a patient admitted to the hospital for hypertension. The physician has ordered a beta-adrenergic blocker. Which statement by the patient does the nurse recognize as most significant? "I have always had problems with my asthma." "My father died of a heart attack when he was 48-years-old." "I don't handle stress well; I have a lot of diarrhea." "When I have a migraine headache, I need to have the room darkened."

I have always had problems with my asthma."

The healthcare provider has prescribed amiodarone for a patient with ventricular dysrhythmias. Upon reviewing the patient's medical history, which statement by the patient would lead the nurse to notify the healthcare provider? I take a blood thinner so I don't get clots I wear eyeglasses to read print up close I break out in a rash when I take antibiotics. I get faint when I see needles

I take a blood thinner so I don't get clots

Which finding for a patient on Coumadin (warfarin sodium) puts this patient at risk for severe bleeding?

INR of 6.

Cholinergic

Increase activity of PNS by mimicking effects of acetylcholine Involved in bodily functions such as digestion, urination, and vision Ex: Bethanechol. Rivastigmine

Which instruction would the nurse give a patient receiving verapamil to help prevent a common adverse effect of this drug? Increase calorie intake Increase fluid and fiber intake Use a skin barrier cream Use sunscreen

Increase fluid and fiber intake

Which is the action of the pharmacotherapy used to treat Parkinson's disease? Increase the amount of dopamine and acetylcholine. Reduce the amount of dopamine and acetylcholine. Reduce the amount of dopamine and increase the amount of acetylcholine. Increase the amount of dopamine and reduce the amount of acetylcholine.

Increase the amount of dopamine and reduce the amount of acetylcholine.

Which assessment finding indicates that a muscarinic agonist is having the anticipated effect? Urinary retention Increased gastrointestinal motility Mydriasis Vasconstriction

Increased gastrointestinal motility

Which statement is correct regarding the effect of Atropine on the heart?

Increases heart rate

The nurse makes a home visit to a client with diabetes mellitus. During the visit, the nurse notes that the client's 3-month supply of insulin vials that were delivered a week ago are not refrigerated. What is the best action by the nurse at this time?

Instruct the client that the insulin should be stored away from direct sunlight or excessive heat.

What is a rare but potentially fatal complication of metformin use in the management of type 2 diabetes?

Lactic acidosis

Which information should the nurse include in education for a client prescribed methimazole (Tapazole)? "Instruct the patient to notify their health care provider if they develop a fever and sore throat" "Occasionally you may feel your heart beating fast." "Call the clinic if you are having trouble sleeping." "You may experience a weight loss while taking this prescription."

Instruct the patient to notify their health care provider if they develop a fever and sore throat"

Match the peak times for different insulins: Insulin detemir (Levemir) Insulin isophane (NPH) Insulin lispro (Humalog) Insulin regular (Humulin R)

Insulin detemir (Levemir) No peak Correct!Insulin isophane (NPH) 4-12 hours Correct!Insulin lispro (Humalog) 0.5-1 hours Correct!Insulin regular (Humulin R). 2-4 hours

Which type of insulin should the nurse anticipate to administer intravenously to a client with a blood glucose of 563?

Insulin regular (Humulin R).

A patient on warfarin (Coumadin) is scheduled to have a test to check if the blood level of Coumadin is in therapeutic range. Which test will be ordered?

International normalized ratio (INR).

The administration of which anticoagulant is an error by the nurse? Intramuscular enoxaparin Oral dabigatran Subcutaneous heparin Oral warfarin

Intramuscular enoxaparin

The nurse is reviewing drugs on the emergency cart with regard to their therapeutic action. Which medications can help initiate heart contraction during a cardiac arrest?

Intravenous epinephrine

Neostigmine produces therapeutic effects by which mechanism of action?

It prevents inactivation of acetylcholine

The client receives metformin (Glucophage). What will the best plan by the nurse include with regard to patient education on the action of this drug?

It reduces insulin resistance.

The client receives metformin (Glucophage). What will the best plan by the nurse include with regard to patient education on the safety of this drug?

Kidney function needs to be monitored when a patient is taking Metformin.

Which of the following diabetic medications does not put a patient at risk for hypoglycemia?

Metformin (Glucophage).

Which drug does the nurse anticipate will be prescribed to a pregnant patient who developed hypertension at 28 weeks' gestational age? Propranolol Valsartan Captopril Methyldopa

Methyldopa

A patient who is taking a beta blocker for hypertension reports being dizzy when first getting out of bed in the morning. The nurse should advise the patient to:

Move slowly from the recumbent to the upright position.

Which assessment finding in an older adult prescribed levodopa-carbidopa (Sinemet) should the nurse be most concerned with?

Muscle twitching.

The nurse would suspect that a female patient is experiencing phenytoin toxicity if which manifestation is noted? Select all that apply. One, some, or all responses may be correct. Nystagmus Swollen, tender gums that bleed easily Excessive facial hair growth Double vision Staggering gait

Nystagmus Double vision Staggering gait

A nurse is caring for a patient prescribed doxazosin [Cardura] for hypertension. Safety is a priority because of which associated adverse effect?

Orthostatic hypotension

Which is responsible for the secretion of estrogen? Endometrium. Corpus luteum. Ovarian follicles. Anterior pituitary.

Ovarian follicles.

The nurse gives a medication that inhibits acetylcholinesterase. How would this drug affect autonomic activity?

Parasympathetic activity would increase

Which rationale differentiates type 1 diabetes from type 2 diabetes?

People with type 2 diabetes make insulin, but in inadequate amounts

The patient is taking a cholinergic agent. Indicate which medication is being used, what clinical effect the nurse can expect, and for what adverse effect the nurse should monitor. Choose the most likely option for the information missing from the statements below by selecting from the list of options provided. The nurse will discuss with the patient the use of Pilocarpine , which is used for glaucoma and will have the effect of [ Select ] ["reducing intraocular pressure", "relaxing the bronchioles", "reducing hear rate and blood pressure"] _. The predictable adverse effect for this medication is [ Select ] ["increased ocular pressure", "Diarrhea", "bradycardia", "hypertension", "tachycardia"] .

Pilocarpine reducing intraocular pressure Diarrhea

The nurse notices significant edema surrounding and proximal to the peripheral intravenous (IV) site where epinephrine is being infused. Which action would the nurse anticipate first?

Prepare to administer phentolamine [Regitine].

Which describes the primary action of anticoagulant therapy?

Prevent formation and growth of blood clots.

Which describes the mechanism of action of regular insulin?

Promote entry of glucose into the cells.

Why does the nurse anticipate administering metoprolol [Lopressor] rather than propranolol [Inderal] for diabetic patients who need a beta-blocking agent?

Propranolol causes both beta1 and beta2 blockade.

Which parameter will the nurse assess in a patient who is prescribed metformin for type 2 diabetes mellitus? Weight gain Renal Function Headache Cholesterol level

Renal Function

Which laboratory test should the nurse monitor the client for who is receiving insulin?

Serum Potassium.

Expectorants

Stimulates increase in bronchial gland secretions

Antitussive

Suppresses cough

Thyroxine has recently been added to the routine medications for a patient who also uses insulin, warfarin, cholestyramine, and antacids daily. Which statement by the nurse would be included in medication education? Your dose of warfarin will have to be increased while you are taking this medication Take your cholestyramine at least 4 hours apart from the levothyroxine You will need to avoid aluminum-containing antacids such as Maalox and Mylanta The dose of insulin that you take may need to be decreased

Take your cholestyramine at least 4 hours apart from the levothyroxine

The client injects his insulin as prescribed but then gets busy and forgets to eat. What is the nurse's most likely assessment finding?

The client will be sweating.

The nurse is managing care for a patient with a DVT (deep vein thrombosis) of the right calf. The patient receives heparin intravenously (IV). What is the priority outcome for this patient?

The patient will not experience bleeding.

The nurse is preparing to educate a client prescribed levothyroxine (Synthroid). Which information should the nurse include in the teaching? Serum blood levels of TSH needs to be checked weekly. This medication needs to be taken on empty stomach. Serum blood levels of levothyroxine needs to be checked monthly. This medication can cause decreased appetite.

This medication needs to be taken on empty stomach.

For which purpose would the nurse administer atropine solution sublingually to a dying patient with dyspnea?

To dry up respiratory secretions

A patient has started clopidogrel (Plavix) after experiencing a transient ischemic attack. What is the desired therapeutic effect of this drug?

To reduce the risk of a stroke from a blood clot

Which medication should the nurse prepare to administer for a client experiencing a warfarin sodium overdose?

Vitamin K.

A patient who is taking warfarin (Coumadin) has just vomited blood. The nurse notifies the provider, who orders laboratory work revealing a PT of 42 seconds and an INR of 3.5. The nurse will expect to administer

Vitamin k

A patient on heparin therapy is asking what laboratory test is used to adjust heparin dose. What is the nurse's best understanding that will help her to answer the question?

aPTT is used to make sure that heparin level is in therapeutic range

A patient with atrial fibrillation is receiving warfarin (Coumadin). The nurse notes that the patient's INR is 2.7. Before giving the next dose of warfarin, what should the nurse do: administer the dose as ordered. call the healthcare provider and request an order to give vitamin K (phytonadione). call the healthcare provider and request an order to increase the dose. call the healthcare provider and request an order to decrease the dose.

administer the dose as ordered.

Because they cause vasoconstriction, alpha1-adrenergic agonists are especially useful for:

causing hemostasis in skin and mucous membranes