Pharm Test week 5 wvjc CH 60-65,68-69
68-A nurse identifies therapeutic goals for androgen therapy for which patients? (Select all that apply.) -A male patient with prostate cancer -A female patient with breast cancer -A male patient with hypogonadism -A female patient with breast engorgement -A female patient with acquired immunodeficiency syndrome (AIDS)
A male patient with hypogonadism A female patient with breast engorgement A female patient with acquired immunodeficiency syndrome (AIDS)
69-A nurse is educating a patient about sildenafil [Viagra]. The nurse should instruct the patient that which adverse effect would be a priority for the patient to report to his prescriber? -Flushing -Diarrhea -Hearing loss -Dyspepsia
Hearing loss
61-A nurse is caring for a patient with decreased triiodothyronine (T3) and thyroxine (T4) and elevated thyroid-stimulating hormone (TSH) levels. The nurse knows the patient is likely suffering from what? -Thyrotoxicosis -Hypothyroidism -Hyperthyroidism -Graves' disease
Hypothyroidism
64-The nurse is providing teaching regarding Duavee (conjugated estrogens/bazedoxifene). Which statement by the patient indicates that the teaching was effective? -"I know I am at an additional risk for increased growth of my uterus lining." -"I understand that the combination product should help protect me from the side effects of the estrogen." -"I will have to set an alarm to take my medication four times per day." -"I am prepared to take this medication for the rest of my life."
"I understand that the combination product should help protect me from the side effects of the estrogen."
61-A patient has been given instructions about levothyroxine [Synthroid]. Which statement by the patient indicates understanding of these instructions? -"I'll take this medication in the morning so as not to interfere with sleep." -"I'll plan to double my dose if I gain more than 1 pound per day." -"It is best to take the medication with food so I don't have any nausea." -"I'll be glad when I don't have to take this medication in a few months."
"I'll take this medication in the morning so as not to interfere with sleep."
61-A patient with Graves' disease is treated with iodine-131 therapy. Which statement by the patient would indicate understanding of the treatment's effects? -"I'll have to isolate myself from my family so I don't expose them to radiation." -"I'm looking forward to feeling better immediately after this treatment." -"I'll tell my doctor if I have fatigue, hair loss, or cold intolerance." -"I'll need to take this drug on a daily basis for at least 1 year."
"I'll tell my doctor if I have fatigue, hair loss, or cold intolerance."
60-A teaching plan for a patient who is taking lispro [Humalog] should include which instruction by the nurse? -Inject this insulin with your first bite of food, because it is very fast acting." -"The duration of action for this insulin is about 8 to 10 hours, so you'll need a snack." -"This insulin needs to be mixed with regular insulin to enhance the effects." -"To achieve tight glycemic control, this is the only type of insulin you'll need."
"Inject this insulin with your first bite of food, because it is very fast acting."
62-A patient is receiving desmopressin [DDAVP] for the treatment of diabetes insipidus. Which instruction is the priority for a nurse to give the patient? -"Reduce your water intake to prevent water intoxication." -"Rotate the nostril you use daily to prevent irritation." -"Weigh yourself several times each week." -"You'll quickly see the results of a lower urine amount.
"Reduce your water intake to prevent water intoxication."
69-A patient taking sildenafil [Viagra] asks a nurse what action to take if priapism occurs. Which response should the nurse make? -''Take an additional half-strength dose of sildenafil." -"The condition usually resolves in 12 hours or less." -"Wait until the following day and notify the doctor." -"Seek emergency help, because permanent damage can occur."
"Seek emergency help, because permanent damage can occur."
65-The nurse is checking in a patient who is taking newly prescribed combined oral contraceptive pills. The blood pressure reading is 150/80. The patient has no prior history of hypertension. The patient is concerned. Which statements by the nurse are accurate? (Select all that apply.) -"This may be caused by the birth control pills." -"The provider may have you monitor your blood pressure at home." -"This is not likely caused by your pills. How has your diet been?" -"The provider may discuss blood pressure medications with you today." -"Have you started any other mediations or been sick lately?"
"This may be caused by the birth control pills." "The provider may have you monitor your blood pressure at home." "The provider may discuss blood pressure medications with you today." "Have you started any other mediations or been sick lately?"
64-A patient has been prescribed Flibanserin [Addyi] for treatment of low libido. The nurse provides education for the patient. Teaching has been effective when the patient makes which statement? -"This medication should begin working within a couple of days". -"This medication should be taking a couple of hours before intercourse is desired". -"This medication can cause heart palpitations in patients with cardiac conditions". -"This medication should be discontinued if no improvements are seen after 8 weeks".
"This medication should be discontinued if no improvements are seen after 8 weeks".
65-A patient has been prescribed Flibanserin [Addyi] for treatment of low libido. The nurse provides education for the patient. Teaching has been effective when the patient makes which statement? -''This medication should begin working within a couple of days." -"This medication should be taking a couple of hours before intercourse is desired." -"This medication can cause heart palpitations in patients with cardiac conditions." -"This medication should be discontinued if no improvements are seen after 8 weeks."
"This medication should be discontinued if no improvements are seen after 8 weeks."
68-Which application instruction is the priority for a nurse to provide to a patient starting to use AndroGel testosterone gel? -"Apply the gel to clean, dry skin of the shoulders or upper arms." -"Squeeze the entire packet into your palms and then rub the gel into your skin." -"Wait about 5 or 6 hours before showering or swimming." -"Wash your hands after applying the gel to prevent transfer to others."
"Wash your hands after applying the gel to prevent transfer to others."
63-The nurse is teaching the patient about oral steroid therapy. Which statement by the patient indicates a need for further teaching? -"I can take my full dose in the morning." -"I can break up my dose and take some in the afternoon if I get tired." -"I understand that I shouldn't experience many adverse effects." -"When I am traveling for work, I will take lower doses''
"When I am traveling for work, I will take lower doses."
63-The patient states that when he takes hydrocortisone 24 mg in the morning, he is very tired by mid-afternoon. Which statement by the nurse is correct? -''You can take 12 mg in the morning and 12 mg at night." -"You can take 24 mg at night instead." -"You can take 16 mg in the morning and 8 mg in the afternoon." -"This is an adverse effect and you should stop taking the medication."
"You can take 16 mg in the morning and 8 mg in the afternoon." Correct
69-Which statement should a nurse include when providing teaching to a patient who is scheduled to start taking dutasteride [Avodart]? -"Protect yourself from sun exposure to avoid any skin sensitivity." -"You may notice immediate relief of your urinary symptoms." -"Dutasteride will increase both ejaculatory volume and libido over time." -"You cannot donate blood while on this medication or for 6 months after stopping it."
"You cannot donate blood while on this medication or for 6 months after stopping it."
61-Which statement is the most important for a nurse to make to a patient who is taking methimazole? -"You need to notify your doctor if you have a sore throat and fever." -"Another medication can be given if you experience any nausea." -"You may experience some muscle soreness with this medicine." -"Headache and dizziness may occur but not very frequently."
"You need to notify your doctor if you have a sore throat and fever."
62-The healthcare provider orders octreotide [Sandostatin LAR] 250 mcg IM now. The available medication is octreotide [Sandostatin LAR] 1000 mcg/mL. The nurse plans to administer how much? -0.25 mL -0.5 mL -1.25 mL -4 mL
0.25
63-The healthcare provider orders hydrocortisone sodium succinate [Solu-Cortef] 500 mg IV now. The available medication is hydrocortisone sodium succinate [Solu-Cortef] 1000 mg/mL. How many mL will the nurse administer? -0.25 mL -0.5 mL -0.75 mL -2 mL
0.5L
61-The healthcare provider orders 150 mcg of levothyroxine [Synthroid] PO every morning. The medication available is levothyroxine [Synthroid] 75-mcg tablets. How many tablets will the nurse administer? -0.5 -1 -2 -4
2
64-Which patient may be given progestin therapy during pregnancy? -A woman who is 8 weeks pregnant and diagnosed with corpus luteum deficiency syndrome -A woman pregnant with triplets during her first pregnancy -A woman experiencing severe nausea and vomiting during pregnancy -A woman who is trying to achieve pregnancy through planned intercourse
A woman who is 8 weeks pregnant and diagnosed with corpus luteum deficiency syndrome
60-A nurse caring for a patient who has diabetic ketoacidosis recognizes which characteristics in the patient? (Select all that apply.) Type 2 diabetes -Altered fat metabolism leading to ketones -Arterial blood pH of 7.35 to 7.45 -Sudden onset, triggered by acute illness -Plasma osmolality of 300 to 320 mOsm/L
Altered fat metabolism leading to ketones Sudden onset, triggered by acute illness Plasma osmolality of 300 to 320 mOsm/L
69-A patient is scheduled to start taking sildenafil [Viagra]. A nurse should recognize that the patient is at risk for developing an adverse cardiac event if the patient's history reveals which of these conditions? -Angina -Hypertension -Varicose veins -Prosthetic mitral valve
Angina
62-Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are products of which structure? -Hypothalamus -Anterior pituitary gland -Posterior pituitary gland -Ovaries
Anterior pituitary gland
63-A nurse is developing a plan of care for a patient who has Addison's disease and is taking hydrocortisone [Cortef]. Which of these outcomes should receive priority in the plan? -At times of stress, the patient increases the glucocorticoid dose. -The patient wears a Medic Alert bracelet at all times. -The patient carries an injectable form and an oral form of glucocorticoid. -The patient divides the daily dose, taking two-thirds of it in the morning and one-third in the afternoon.
At times of stress, the patient increases the glucocorticoid dose.
61-A nurse should consider which diagnostic test a priority to obtain before a patient receives iodine-131? -White blood cell (WBC) count -Electrocardiogram (ECG) -Beta human chorionic gonadotropin (hCG) test -Creatinine level
Beta human chorionic gonadotropin (hCG) test
60-A patient is scheduled to start taking insulin glargine [Lantus]. On the care plan, a nurse should include which of these outcomes are related to the therapeutic effects of the medication. -Blood glucose control for 24 hours -Mealtime coverage of blood glucose -Less frequent blood glucose monitoring -Peak effect achieved in 2 to 4 hours
Blood glucose control for 24 hours
62-A patient in cardiac arrest receives vasopressin [Vasostrict] during cardiopulmonary resuscitation (CPR). An increase in which finding would indicate a desired effect of the medication? -Respiratory rate -Blood pH -Blood pressure -Body temperature
Blood pressure
69-Which assessment should a nurse monitor more frequently in a patient who takes both an alpha blocker for BPH and metoprolol [Lopressor]? -Blood glucose level -Hemoglobin level -Blood pressure -Urine output
Blood pressure
69-A patient in the emergency department reports taking sildenafil [Viagra] and nitroglycerin 1 hour before sexual activity. Which finding should the nurse immediately report to the physician? -White blood cell (WBC) count of 3200 units/L -Respiratory rate of 26 breaths per minute -Body temperature of 100.4°F (38°C) -Blood pressure (BP) of 70/50 mm Hg
Blood pressure (BP) of 70/50 mm Hg
69-A nurse should recognize that which therapies would be beneficial to a patient with BPH? (Select all that apply.) -Saw palmetto -Botulinum [Botox] -Tolterodine [Detrol] -Alfuzosin [Uroxatral] -Sildenafil [Viagra]
Botulinum [Botox] Tolterodine [Detrol] Alfuzosin [Uroxatral]
60-A patient who took NPH insulin at 0800 reports feeling weak and tremulous at 1700. Which action should the nurse take? -Take the patient's blood pressure. -Give the patient's PRN dose of insulin. -Check the patient's capillary blood sugar. -Advise the patient to lie down with the legs elevated.
Check the patient's capillary blood sugar.
63-A nurse administers dexamethasone [Decadron], 1 mg, at 11:00 PM to a patient who has suspected adrenal dysfunction. The nurse obtains blood for which of these laboratory tests at 8:00 AM the next morning? -Potassium -Cortisol -Glucose -Sodium
Cortisol
60-Before administering metformin [Glucophage], the nurse should notify the prescriber about which laboratory value? -Creatinine (Cr) level of 2.1 mg/dL -Hemoglobin (Hgb) level of 9.5 gm/dL -Sodium (Na) level of 131 mEq/dL -Platelet count of 120,000/mm3
Creatinine (Cr) level of 2.1 mg/dL
65-The nurse is providing education on birth control options for a woman who smokes and is not interested in quitting. Which options would be appropriate for the nurse to recommend if the patient wishes to become pregnant in the next year? -Intrauterine device -Combined oral contraceptives -Diaphragm -Sterilization
Diaphragm
60-Which instruction should the nurse provide when teaching a patient to mix regular insulin and NPH insulin in the same syringe? -"Draw up the clear regular insulin first, followed by the cloudy NPH insulin." -"It is not necessary to rotate the NPH insulin vial when it is mixed with regular insulin." -"The order of drawing up insulin does not matter as long as the insulin is refrigerated." -"Rotate subcutaneous injection sites each day among the arm, thigh, and abdomen."
Draw up the clear regular insulin first, followed by the cloudy NPH insulin
68-A nurse teaches a health education class to male adolescents. Which of these topics should be a priority for the nurse to include? -Adoption of healthy lifetime hygienic practices -Effects of performance-enhancing androgens -Pituitary gland regulation of sexual development -Self-esteem issues related to delayed onset of puberty
Effects of performance-enhancing androgens
69-When assessing a patient who takes finasteride [Proscar], a nurse should monitor for which adverse effect? -Hair loss -Increased libido -Ejaculatory dysfunction -Muscle weakness
Ejaculatory dysfunction
64-Progestins may be used to treat which conditions? (Select all that apply.) -Endometrial hyperplasia -Dysfunctional uterine bleeding -Endometriosis -Breast cancer -Amenorrhea
Endometrial hyperplasia Dysfunctional uterine bleeding Endometriosis Amenorrhea
63-A patient who has Cushing's syndrome is taking ketoconazole [Nizoral] as an adjunct treatment to brain radiation. A nurse should expect the patient to have which of these therapeutic responses? -Increased resistance to infection -Enhanced radiation effect to the brain -Suppressed cortisol synthesis -Increased ACTH production
Enhanced radiation effect to the brain
62-A pediatric patient has gigantism caused by excess growth hormone (GH). Which finding would indicate to the nurse that the patient has developed an additional complication related to this condition? -Blood glucose below 70 mg/dL -Elevation of liver function test results -Atrophy of sweat glands -Enlarged heart on chest x-ray
Enlarged heart on chest x-ray
65-Which is true regarding use of estrogens in women with migraines? -Estrogen increase the risk of cancer. -Estrogen increases the risk of stroke. -Estrogens increase the risk of fatigue. -Estrogens increase the risk of obesity.
Estrogen increases the risk of stroke.
61-Which finding in a patient taking levothyroxine [Synthroid] and warfarin [Coumadin] would require follow-up by a nurse? -Cardiac dysrhythmias -Excessive bruising -Weight loss of 5 kg -Shortness of breath
Excessive bruising
63-The nurse is planning care for a patient with signs of acute adrenal insufficiency. What is the priority nursing diagnosis? -Altered comfort -Altered nutrition -Fluid volume deficit -Activity intolerance
Fluid volume deficit Correct
62-Which nursing diagnosis should be the priority for a patient who is receiving desmopressin [DDAVP]? -Activity intolerance -Alteration in comfort -Fluid volume imbalance -Deficient knowledge
Fluid volume imbalance
64-Which beneficial metabolic effects does estrogen have in nonreproductive tissues? (Select all that apply.) -It promotes and suppresses coagulation. -It improves glomerular filtration rates. -It reduces low-density lipoproteins (LDLs). -It suppresses bone resorption. -It reduces fat deposits in the liver.
It promotes and suppresses coagulation. It reduces low-density lipoproteins (LDLs). It suppresses bone resorption.
60-A patient newly diagnosed with type 1 diabetes asks a nurse, "How does insulin normally work in my body?" The nurse explains that normal insulin has which action in the body? -It stimulates the pancreas to reabsorb glucose. -It promotes the synthesis of amino acids into glucose. -It stimulates the liver to convert glycogen to glucose. -It promotes the passage of glucose into cells for energy.
It promotes the passage of glucose into cells for energy.
62-An adult patient who has GH deficiency is receiving somatropin [Norditropin]. An increase in which finding would indicate to the nurse that the patient is improving? -Height (by 3 inches) -Lean body mass -Physical strength -Joint range of motion
Lean body mass
61-Which statements about levothyroxine [Synthroid] are correct? (Select all that apply.) -Levothyroxine should be taken with food. -Levothyroxine can be given by IV but is usually taken orally. -Levothyroxine brands should not be changed if possible. -Levothyroxine should be taken at night to avoid adverse effects. -Levothyroxine can affect the metabolism of other medications.
Levothyroxine can be given by IV but is usually taken orally. Levothyroxine brands should not be changed if possible. Levothyroxine can affect the metabolism of other medications.
63-A patient is taking fludrocortisone [Florinef]. A nurse should recognize that the patient is at risk for developing an electrolyte imbalance if the patient reports which symptom? -Syncope -Weight loss -Muscle weakness -Numbness and tingling
Muscle weakness
65-The patient is inquiring about birth control methods and is specifically requesting information about the most reliable method. Which method does the nurse suggest? -Condoms -Spermicides -Patch -Nexplanon
Nexplanon
65-The nurse is caring for a patient with a history of thrombosis. Which order birth control should the nurse question? -Mirena -Oral combination -Nexplanon -Depo-Provera
Oral combination
65-Which statements are true regarding the effects of oral contraceptives on cancer? (Select all that apply.) -Oral contraceptives have been studied extensively regarding effects on cancer. -Oral contraceptives have a small risk of breast cancer. -Oral contraceptives protect against cancer. -Oral contraceptives have a greater risk of cervical cancer. -Oral contraceptive use does not have an impact on women with the BRCA2 mutation.
Oral contraceptives have been studied extensively regarding effects on cancer. Oral contraceptives have a small risk of breast cancer. Oral contraceptives protect against cancer. Oral contraceptive use does not have an impact on women with the BRCA2 mutation
63-When assessing a patient who has Cushing's syndrome, a nurse associates which clinical manifestations with this disorder? (Select all that apply.) -Osteoporosis -Moon face -Glycosuria -Ketonuria -Mood swings
Osteoporosis Moon face Glycosuria Mood swings
68-A nurse monitors for which adverse cardiovascular effects in a male patient taking testosterone [Androderm]? (Select all that apply.) -Postural hypotension -Atrial fibrillation -Pedal edema and weight gain -Prolonged QT interval -Decrease in high-density lipoprotein (HDL) levels
Pedal edema and weight gain Decrease in high-density lipoprotein (HDL) levels
68-Which measurements should a nurse obtain to evaluate the effects of androgen therapy on the epiphyses of a patient with hypogonadism? -Monthly height and weight -Periodic hand and wrist x-rays -Body mass/fat ratio indices -Blood testosterone levels
Periodic hand and wrist x-rays
64-During the follicular phase of the menstrual cycle, estrogen has which effects on the female reproductive organs? -Maturation of a corpus luteum -Ripening of an ovarian follicle -Proliferation of the endometrium -Monthly menstrual bleeding
Proliferation of the endometrium
68-Androgens are prescribed for a patient with anemia. The nurse is aware that the action of the androgen in this patient is what? -Iron replacement -Promoting synthesis of erythropoietin -Prevention of blood loss -Increase in bone formation
Promoting synthesis of erythropoietin
60-A patient who has type 2 diabetes is taking nateglinide [Starlix]. Which response should a nurse expect the patient to have if the medication is achieving the desired therapeutic effect? -Inhibition of carbohydrate digestion -Promotion of insulin secretion -Decreased insulin resistance -Inhibition of ketone formation
Promotion of insulin secretion
64-What is the primary difference between the selective estrogen receptor modulators tamoxifen and raloxifene? -Raloxifene does not protect against breast cancer. -Raloxifene does not produce hot flashes. -Raloxifene does not increase the risk for uterine cancer. -Raloxifene does not increase the risk for thromboembolism
Raloxifene does not increase the risk for uterine cancer.
60-A patient who has type 2 diabetes has a glycated hemoglobin A1c (HbA1c) of 10%. The nurse should make which change to the nursing care plan? -Refer the patient to a diabetes educator because the result reflects poor glycemic control. -Glycemic control is adequate; no changes are needed. -Hypoglycemia is a risk; teach the patient the symptoms. -Instruct the patient to limit activity and weekly exercise.
Refer the patient to a diabetes educator because the result reflects poor glycemic control
65-A patient has been prescribed an oral contraceptive pill. Which symptoms should urge the client to seek immediate emergency medical treatment? -Fatigue -Failure to take the pill 2 days in a row -Shortness of breath -Dizziness
Shortness of breath
62-Which outcome should a nurse establish for a patient who has acromegaly and is receiving octreotide [Sandostatin]? -Normal urine volume -Softening of facial features -Increase in long-bone growth -Stimulation of the milk reflex
Softening of facial features
64-The nurse is teaching a group of women about increasing phytoestrogen consumption. What foods should they direct the women towards consuming? -Green leafy vegetables -Soybeans -Red meat -Oranges
Soybeans
65-The nurse is teaching a group of women about increasing phytoestrogen consumption. What foods should they direct the woman towards consuming? -Green leafy vegetables -Soybeans -Red meat -Oranges
Soybeans
65-Which method of birth control is most frequently utilized by patients? -IM injections -Oral contraceptives -Nexplanon implant -Sterilization
Sterilization
60-A nurse assesses a patient who is taking pramlintide [Symlin] with mealtime insulin. Which finding requires immediate follow-up by the nurse? -Skin rash -Sweating -Itching -Pedal edema
Sweating
60-A patient is taking glipizide [Glucotrol] and a beta-adrenergic medication. A nurse is teaching hypoglycemia awareness and should warn the patient about the presence of which symptom? -Vomiting -Muscle cramps -Tachycardia -Chills
Tachycardia
61-Which manifestations should a nurse investigate first when monitoring a patient who is taking levothyroxine [Synthroid]? -Tachycardia -Tremors -Insomnia -Irritability
Tachycardia
64-The Women's Health Initiative (WHI) landmark trial data led to which recommendations about hormone replacement therapy? (Select all that apply.) -There are benefits to using HRT short term to reduce vasomotor symptoms. C -Postmenopausal women should avoid smoking, exercise regularly, and control hypertension. -Estrogen/progestin therapy (EPT) is preferred as the primary treatment to prevent loss of bone mass. -Estrogen and progesterone should be used only to prevent cardiovascular events. -Treatment with HRT for longer than 5 years increases the risk for pulmonary embolus and stroke.
There are benefits to using HRT short term to reduce vasomotor symptoms. Postmenopausal women should avoid smoking, exercise regularly, and control hypertension Treatment with HRT for longer than 5 years increases the risk for pulmonary embolus and stroke.
61-The patient reports that she had to switch pharmacies to save money. She noticed that her "thyroid pill" looks different. The nurse anticipates that the healthcare provider will order what? -Thyroid stimulating hormone (TSH) -Electrocardiogram (ECG) -Beta human chorionic gonadotropin (hCG) test -Creatinine level
Thyroid stimulating hormone (TSH)
64-Which therapeutic effect is the purpose of a progestin medication in menopausal hormone therapy (HT)? -To reduce urogenital atrophy -To suppress endometrial proliferation -To relieve vasomotor symptoms -To prevent adverse cardiac events
To suppress endometrial proliferation Correct
62-Which manifestation would the nurse most clearly associate with a tumor of the hypothalamus? -Mood swings -Unstable body temperature -Irregular respirations -Increased heart rate
Unstable body temperature
62-A patient who has diabetes insipidus is receiving desmopressin [DDAVP]. Which laboratory test should a nurse obtain to evaluate the effectiveness of the medication? -Urine ketones -Blood urea nitrogen (BUN) -Creatinine -Urine specific gravity
Urine specific gravity
63-Which statements about hydrocortisone are correct? (Select all that apply.) -It is a synthetic steroid identical to cortisol. -It is a preferred drug for adrenocortical insufficiency. -It has glucocorticoid and mineralocorticoid actions. -It is given IV for chronic replacement therapy. -It should not be given during times of stress.
t is a synthetic steroid identical to cortisol. It is a preferred drug for adrenocortical insufficiency. It has glucocorticoid and mineralocorticoid actions
