Pharm Unit 1 Exam
The nurse is reviewing facts about pharmacology for a review course. The term legend drugs refers to which item?
Prescription drugs
A patient is about to undergo ocular surgery. The preoperative nurse anticipates that which drug will be used for local anesthesia?
Proparacaine (Alcaine)
The preoperative nurse is ready to perform a skin prep with povidone-iodine (Betadine) on a patient who is about to have abdominal surgery. Which allergies, if present, would be a contraindication to the Betadine prep?
Shellfish
Drug transfer to the fetus is more likely during the last trimester of pregnancy for which reason?
Enhanced blood flow to the fetus
A patient is considering taking oral aloe supplements and asks the nurse about potential problems with this therapy. Which statement by the nurse is correct?
"Aloe is used by some to treat constipation; it may cause diarrhea."
When teaching a patient about the proper application of eyedrops, the nurse will include which instruction?
"Apply the drops into the conjunctival sac instead of directly onto the eye."
A female patient has been taking isotretinoin (Amnesteem) for 3 months. During a follow-up appointment, which statement by the patient would be of highest concern to the nurse?
"I have been feeling rather down and lonely lately."
A 25 year old woman is visiting the prenatal clinic and shares with the nurse her desire to go "natural" with her pregnancy. She shows the nurse a list of herbal remedies that she wants to go buy so that she can "avoid taking any drugs." Which statement by the nurse is correct?
"It's important to remember that herbal remedies do not have proven safety ratings for pregnant women."
When given a scheduled morning medication, the patient states, "I haven't seen that pill before. Are you sure it's correct?" The nurse checks the medication administration record and verifies that it is listed. Which is the nurse's best response?
"Let me check on the order first before you take it."
The patient is to receive oral guaifenesin (Mucinex) twice a day. Today, the nurse was busy and gave the medication 2 hours after the scheduled dose was due. What type of problem does this represent?
"Right time"
The nurse is administering antibiotic eyedrops to a patient for the first time. After the first drop is given, the patient states, "That eyedrops is making my eye sting! Is that normal?" Which is the best response by the nurse?
"Sometimes these eyedrops may cause burning and stinging, but it should go away soon."
A patient is receiving ovular cyclosporine (Restasis) and also has an order for an artificial tears product. The nurse includes which instructions in the teaching plan for these medications?
"Take the Restasis first, and then wait 15 minutes before taking the artificial tears."
When given an intravenous medication, the patient says to the nurse, "I usually take pills, why does this medication have to be given to me in the arm?" What is the nurse's best answer?
"The action of the medication will begin sooner when given intravenously."
During the development of a new drug, which would be included in the study by the researcher to prevent any bias or unrealistic expectations of the new drug's usefulness?
A placebo
A teenage boy is taking tretinoin (Retin-A) for acne. Which statement will the nurse include in the teaching plan?
"This drug may cause increased redness of your skin."
The patient has even taking an over- the counter (OTC) acid-reducing drug because he has had "stomach problems" for several months. He tells the nurse that the medicine helps as long as he takes it, but once he stops it, the symptoms return. Which statement by the nurse is the best advice for this patient?
"Using this drug may relieve your symptoms, but it does not address the cause. Please make an appointment with your health care provider."
During a nursing assessment, which question by the nurse allows for greater clarification and additional discussion with the patient?
"What medications do you take?"
A female patient will be stating therapy with oral isotretinoin (Amnesteem) as part of treatment for severe acne, and the nurse is providing teaching. Which teaching point will the nurse include in her teaching plan about isotretinoin?
"You will have to use two contraceptive methods while on this drug."
The nurse is reviewing medication errors. Which situation is an example of a medication error?
A patient receives a double dose of medication because the nurse did not cut the pill in half
The patient is stating that he has a headache and asks the nurse which over the counter medication form would work the fastest to help reduce the pain. Which medication form will the nurse suggest?
A powder
During an admission assessment, the nurse discovers that the patient does not speak English. Which is considered the ideal resource for translation?
A translator who does not know the patient
The nurse recognizes that an elderly patient may experience a reduction in the stomach's ability to produce hydrochloric acid. This change may result in which effect?
Altered absorption of some drugs
When the nurse teaches a skill such as self-injection of insulin to the patient, what is the best way to set up the teaching/learning session?
After demonstrating the procedure, allow the patient to do several return demonstrations
A patient wants to take gingko to help his memory. The nurse reviews his current medication list and would be concerned about potential interactions if he is taking a medication from which class of drugs?
Antiplatelet drugs
A woman suffered a second-degree burn of the skin on her arm and hand while cooking breakfast. After examination in the urgent care center, silver sulfadiazine cream (Silvadene) is ordered for the burned area. The nurse will apply the medication using which procedure?
Applying a thin layer with a sterile, gloved hand to clean and debride areas
A 60 year old patient is on several new medications and expresses worry that she will forget to take her pills. Which action by the nurse would be most helpful in this situation?
Assisting the patient with obtaining and learning to use a calendar or pill container
A patient is undergoing major surgery and asks the nurse about a living will. He states, "I don't want anybody else making decisions for me. And I don't want to prolong my life." This patient is demonstrating which ethical term?
Autonomy
The patient is receiving two different drugs. At current dosages and dosage forms, both drugs have the same concentration of the active ingredient. Which term is used to identify this principle?
Bioequivalent
The nurse is monitoring a patient who is in the 26th week of pregnancy and has developed gestational diabetes and pneumonia. She is given medications that pose a fetal risk, but the potential benefits may warrant the use of medications in her situation. The nurse recognizes that these medications are which US Food and Drug Administration pregnancy safety category?
Category D
The nurse is administering ophthalmic drops. Choose the action that should be performed first.
Clean debris from the eye as needed
A patient with a new prescription for a diuretic has just reviewed with the nurse how to include more potassium in her diet. This reflects learning in which domain?
Cognitive
A patient is admitted to the hospital for possible septicemia. He has a large pressure ulcer on his heel that is open and includes necrotic tissue. However, his prothrombin time/international normalized ratio (PT/INR) values are too high to permit surgical debridement at this time. The nurse expects that which wound care product will be used to treat the wound?
Collagenase (Santyl)
The nurse is developing a human needs statement for a patient who has a new diagnosis of heart failure. Identification of human needs statements occur with which of these activities?
Collection of patient data
The nurse is assessing a child with otitis medication. Which statement about otitis media is correct?
Common symptoms include pain, fever, malaise and a sensation of fullness in the ears
The medication order reads, "Give ondansetron (Zofran) 4mg, 30 minutes before beginning chemotherapy to prevent nausea." The nurse notes that the route is missing from the order. Which is the nurse's best action?
Contact the prescriber to clarify the route of the medication ordered
During a period of time when the computerized medication order system was down, the prescriber wrote admission orders, and the nurse is transcribing them. The nurse is having difficulty transcribing one order because of the prescriber's handwriting. Which is the best action for the nurse to take at this time?
Contact the prescriber to verify the order
The nurse is setting up a teaching session with an 85 five year old patient who will be going home on anticoagulant therapy. Which educational strategy would reflect consideration of the age-related changes that may exist with this patient?
Develop large print handouts that reflect the verbal information presented
When reviewing pediatric medication administration, the nurse recognizes that which type of medication error is most common with children?
Dosing errors
The nurse is preparing to give an earwax emulsifier to a patient and will assess the patient for which contraindication before administering the drops?
Drainage from the ear canal
When reviewing the various schedules of controlled drugs, the nurse knows that which description correctly describes Schedule II drugs?
Drugs with high potential for abuse that have accepted medical use
The nurse has been monitoring the patient's progress on a new drug regimen since the first dose and documenting the patient's therapeutic response to the medication. Which phase of the nursing process do these actions illustrate?
Evaluation
The nurse is administering medications to the patient who is in renal failure resulting from end stage renal disease. The nurse is aware that patients with kidney failure would most likely have problems with which pharmacokinetic phase?
Excretion
An 83 year old woman has been given a thiazide diuretic to treat heart failure. She and her daughter should be told to watch for which problem?
Fatigue, leg cramps and dehydration
A patient with an eye injury requires an ocular examination to detect the presence of a foreign body. The nurse anticipates that which drug will be used for this examination?
Fluorescein sodium (AK-Fluor)
A 55 year old obese patient was diagnosed with candidiasis in the skin folds under her breasts. When the nurse sees her at a follow-up visit 2 months later, she complains that it has returned. She said she applied the medicine for 1 week and stopped because the itching stopped and the cream was messy. Which statement is true regarding fungal infections of the skin?
Fungal infections often require prolonged therapy
The nurse is trying to give a liquid medication to a 2 1/2 year old child and notes that the medication has a strong taste. Which technique is the best way for the nurse to give the medication to the child?
Give the medication with a spoonful of ice cream
A patient has been taking the corticosteroid dexamethasone (Decadron) but has developed bacterial conjunctivitis and has a prescription for gentamicin (Garamycin) ointment. The nurse notes that which interaction is possible if the two drugs are used together?
Immunosuppression may make it more difficult to eliminate the eye infection
A patient calls the clinic to ask about taking cranberry dietary supplement capsules because a friend recommended them. The nurse will discuss which possible concern when a patient is taking cranberry supplements?
It may reduce elimination of drugs that are excreted by the kidneys
During an assessment, the patient tells the nurse that he eats large amounts of garlic for its cardiovascular benefits. Which drug or drug class, if taken, would have a potential interaction with the garlic?
Insulin
The nurse will be injecting a drug into the superficial skin layers immediately underneath the epidermal layer of the skin. Which route does this describe?
Intradermal
A patient has a new prescription for an anti glaucoma eyedrop. The next day, she calls the clinic and states, "The package insert says this medication might make my blue eyes turn brown! Is this true?" The nurse realizes that the patient has a prescription for which eye medication?
Lantoprost (Xalatan), a prostaglandin agonist
The nurse is reviewing a list of verbal medication orders. Which is the proper notation of the dose of the drug ordered?
Levothyroxine 0.75 mg
The nurse will be giving ophthalmic drugs to a patient with glaucoma. Which drug is given intravenously to reduce intraocular pressure when other medications are not successful?
Mannitol (Osmitrol)
The nurse is giving a lecture about current US laws and regulations of herbal products. According to the Dietary Supplement and Health Education Act of 1994, which statement is true?
Medicinal herbs are viewed as dietary supplements
When discussing dosage calculation for pediatric patients with a clinical pharmacist, the nurse notes that which type of dosage calculation is used most commonly in pediatric calculations?
Milligram per kilogram of body weight formula
A child has been diagnosed with impetigo, a skin infection. The nurse anticipates that which drug will be used to treat this condition?
Mupirocin (Bactroban)
The nurse is reviewing laboratory results for a patient and notes that the patient has positive results for nasal colonization by MRSA. The nurse anticipates an order for which medication?
Mupirocin (Bactroban)
For which cultural group must the health care provider respect the value placed on preserving harmony with nature and the belief that disease is a result of ill spirits?
Native Americans
During a busy night shift, a new nurse administered an unfamiliar medication without checking it in a drug handbook. Later that day, the patient had a severe reaction because he has renal problems, which was a contraindication to that drug. The nurse may be liable for which of these?
Nursing negligence
The nurse is preparing to give an injection to a 4 year old child. Which intervention is age appropriate for this child?
Offer a brief, concrete explanation of the procedure at the patient's level and with the parent or caregiver present
The nurse is reviewing the use of ophthalmic preparations. Indications for the direct- and indirect acting miotics include which condition?
Open-angle glaucoma
For accurate medication administration to pediatric patients, the nurse must take into account which criteria?
Organ maturity
A patient who has advanced cancer is receiving opioid medications around the clock to keep him comfortable as he nears the end of his life. Which term best describes this type of therapy?
Palliative therapy
The nurse is administering parenteral drugs. Which statement is true regarding parenteral drugs?
Parenteral drugs bypass the first-pass effect
The nurse is preparing to administer a new order for eardrops. Which is a potential contraindication to the use of many otic preparations?
Perforated eardrum
When monitoring the patient receiving an intravenous infusion to reduce blood pressure, the nurse notes that the patient's blood pressure is extremely low, and the patient is lethargic and difficult to awaken. This would be classified as which type of adverse reaction?
Pharmacologic reaction
A member of an investigational drug study team is working with healthy volunteers whose participation will help to determine the optimal dosage range and pharmacokinetics of the drug. The team member is participating in what type of study?
Phase I
Which activity best reflects the implementation phase of the nursing process for the patient who is newly diagnosed with hypertension?
Providing education on keeping a journal of blood pressure readings
The nurse is teaching a patient's wife about administering ear drops to her husband. The nurse will use which technique when demonstrating the skill?
Pull the pinna of the ear up and back
What teaching by the nurse is important for the safety of the patient who has just received ear drops?
Remain supine or sitting for a few minutes after receiving the drops
When taking a telephone order for a medication, which action by the nurse is most appropriate?
Repeat the order to the prescriber before hanging up the telephone
During morning medication administration, the nurse discovered an error on the electronic MAR before the medication was given. Which action by the nurse is appropriate for this "near-miss?"
Report the near-miss using the facility's recommended protocol, and correct the error on the MAR
The nurse is aware that confusion, forgetfulness, and increased risk of falls are common responses in an elderly patient who is taking which type of drug?
Sedatives
The patient wants to take the herbal product kava to help him rest at night. The nurse would be concerned about potential interactions if he is taking a medication from which class of drugs?
Sedatives
A patient asks about using minoxidil (Rogaine) for hair thinning. Which statement about minoxidil is accurate?
Systemic absorption may cause tachycardia, fluid retention and weight gain
The nurse is administering ear drops that have been refrigerated. Which action by the nurse is correct before administering the drops?
Take the drops out of the refrigerator 1 hour before the dose is due
The nurse is administering eardrops that contain a combination of an antibiotic and a corticosteroid. What is the rationale for combining these two drugs in ear drops?
The corticosteroid reduces the inflammation and itching associated with ear infections
When reviewing the mechanism of action of a specific drug, the nurse reads that the drug works by selective enzyme interaction. Which of these processes describes selective enzyme interaction?
The drug binds to an enzyme molecule and inhibits or enhances the enzyme's action with the normal target cell
When administering a new medication to a patient, the nurse reads that it is highly protein bound. Assuming that the patient's albumin levels are normal, the nurse would expect which result, as compared to a medication, that is not highly protein bound?
The duration of action of medication will be longer
The nurse is administering drugs to neonates and will consider which factor may contribute the most to drug toxicity?
The liver is not fully developed
The nurse is assessing an elderly Hispanic woman who is being treated for hypertension. During the assessment, what is important for the nurse to remember about cultural aspects?
The nurse's assessment needs to include gathering information regarding religious practices and beliefs regarding medication, treatment and healing
A patient has even selected as a potential recipient of an experimental drug for heart failure. The nurse knows that when informed consent has been obtained, it indicates which of these?
The patient has had the study's purpose, procedures, and possible benefits as well as risks involved explained to him
The nurse is reviewing the medical record of a patient who is to receive wound care with topical silver sulfadiazine (Silvadene). Which finding, if noted, would be a potential contraindication?
The patient is allergic to sulfonamide drugs
During discharge patient teaching, the nurse reviews prescriptions with a patient. Which statement is correct about refills for an analgesic that is classified as Schedule C-III?
The patient nay have no more than five refills in a 6 month period
The nurse is performing an assessment of a newly admitted patient. Which is an example of subjective data?
The patient reports that he uses the herbal product ginkgo
The nurse is assessing a newly admitted 83 year old patient and determines that the patient is experiencing polypharmacy. Which statement accurately illustrates polypharmacy?
The patient uses multiple medications simultaneously
The nurse is assigned to a patient who is newly diagnosed with type 1 diabetes mellitus. Which statement best illustrates an outcome criterion for this patient?
The patient will demonstrate correct blood glucose testing technique
The nurse is developing a care plan for a patient who will be self administering a metered dose inhaler. Which statement reflects a measurable outcome?
The patient will demonstrate the proper technique of self-administering a metered dose inhaler
An elderly patient with a new diagnosis of hypertension will be receiving a new prescription for an antihypertensive drug. The nurse expects which type of dosing to occur with this drug therapy?
The patient will receive the lowest possible dose at first, and then the dose will be increased as needed
The nurse is reviewing the teaching plan for a clinic patient who was seen for a sinus infection. Which of these outcomes reflect the affective domain of learning?
The patient will take the prescribed antibiotic for the full 14 days of the prescription
When the nurse considers the timing of a drug dose, which factor is appropriate to consider when deciding when to give a drug?
The patient's last meal
When reviewing a patient's medical record, the nurse notes an order for carbamide peroxide ear drops. Based on this information, the nurse interprets that these ear drops are being used for which purpose?
To loosen cerumen for easier removal
The nurse is reviewing pharmacology terms for a group of newly graduated nurses. Which sentence defines a drug's half-life?
The time it takes for one half of the original amount of a drug to be removed from the body
When administering drugs, the nurse remembers that the duration of action of a drug is defined as which of these?
The tine period at which a drug's concentration is sufficient enough to cause a therapeutic response
The nurse is reviewing a list of scheduled drugs and notes that Schedule C-1 drugs are not on the list. Which is a characteristic of Schedule C-1 drugs?
They are used only with approved protocols
The patient is experiencing chest pain and needs to take a sublingual form of nitroglycerin. Where does the nurse intrust the patient to place the tablet?
Under the tongue
Nurses have the ethical responsibility to tell the truth to their patients. What is this principle known as?
Veracity