Pharmacology Ch.3

The nurse is caring for a patient who experienced a severe headache. When the prescribed number of over-the-counter pain relievers did not work the patient said she took double the dosage an hour later. The nurse recognizes this patient is at greatest risk for what? A) An allergic reaction B) Anaphylactic reaction C) Poisoning D) Sedative effects

C) Poisoning

The nurse administers a loop diuretic to the patient. In addition to sodium and water, what other electrolyte would the nurse expect to be excreted in significant amounts? A) Calcium B) Magnesium C) Potassium D) Zinc

C) Potassium

The pharmacology instructor is talking to the nursing students about potassium-sparing diuretics and how they can lead to hyperkalemia, indicated by what assessment finding? A) Urine output of 1,500 mL/24 hours B) Blood pressure of 98/60 C) Potassium level of 5.9 mEq/L D) Calcium level of 11.4 mg/dL

C) Potassium level of 5.9 mEq/L

A patient is admitted to the intensive care unit with hyperkalemia. The nurse caring for the patient knows that the most severe adverse effect of hyperkalemia is what? A) Renal failure B) Cardiac emergency C) Liver failure D) Respiratory distress

B) Cardiac emergency

A nurse is providing teaching to a group of patients who are beginning drug therapy for acquired immunodeficiency syndrome (AIDS). What should be included in her instructions to the group? A) "Take your medications as directed. Poisoning occurs with overdosage causing damage to more than one body system." B) "Renal injury results from first-pass effect when the drug is excreted from the system." C) "A blood dyscrasia due to drug therapy can be serious. Call us if your skin looks yellowish or you experience itching." D) "Most drugs are metabolized in the liver and the first indication of damage is dark red papules, which should be reported immediately."

A) "Take your medications as directed. Poisoning occurs with overdosage causing damage to more than one body system."

What cardiac effect would the nurse be prepared to see in the patient with an extremely high potassium level? A) Arrhythmia B) Tachycardia C) Sudden death D) Bradycardia

A) Arrhythmia

The nurse is assessing a patient new to the clinic. The patient says she is allergic to penicillin. What would be the nurse's appropriate next action? A) Ascertain the exact nature of the patient's response to the drug. B) Document the patient is allergic to penicillin. C) Mark the patient's chart in red that she has a penicillin allergy. D) Continue to assess the patient for other allergies.

A) Ascertain the exact nature of the patient's response to the drug.

A 68-year-old patient who must take antihistamines for severe allergies is planning a vacation to Mexico. The nurse will encourage the patient to do what? A) Avoid sightseeing during the hottest part of the day. B) Discontinue the antihistamines if he becomes extremely restless. C) Decrease the dosage of the drugs if he experiences excessive thirst. D) Continue taking the antihistamines even if he begins to hallucinate.

A) Avoid sightseeing during the hottest part of the day. Feedback: Antihistamines can cause anticholinergic effects, which would result in decreased sweating and place the patient at high risk for heat stroke. Avoiding the hottest part of the day will help prevent dehydration and heat prostration. Extreme restlessness could indicate Parkinson-like syndrome not usually associated with antihistamines. Excessive thirst is characteristic of hyperglycemia. Hallucinations are associated with drugs that affect neurologic functioning. Further, nurses should never tell patients to decrease or discontinue a drug unless the prescriber has instructed them to do so.

A 42-year-old male patient is brought to the emergency department by ambulance. The patient is in distress. The nurse suspects an anaphylactic reaction resulting from taking oral penicillin. What assessment findings are important in making this diagnosis? A) Blood pressure (BP): 186/100, difficulty breathing B) Hematocrit (Hct): 32%, decreased urine output C) Temperature: 102º, swollen joints D) Profuse sweating, Blood Pressure: 92/58

A) Blood pressure (BP): 186/100, difficulty breathing

The nurse administers a medication to the patient that induces the secondary action of hypoglycemia. What organ will be most acutely impacted by inadequate circulating glucose? A) Brain B) Heart C) Lungs D) Skin

A) Brain

The nurse administers an anticholinergic medication to the patient. When assessing this patient, what finding will the nurse consider a secondary effect of the drug? A) Nasal congestion B) Tachycardia C) Hyperthermia D) Profuse sweating

A) Nasal congestion

The pharmacology instructor explains to students that adverse effects can be extensions of what? A) Primary action of a drug B) Anaphylaxis C) Secondary action of a drug D) Anticholinergic responses to the drug

A) Primary action of a drug

A postsurgical client is being sent home on enoxaparin. The nurse should describe what benefit of this medication? A. Inhibiting the formation of clots B. Enhancing the flow of blood in peripheral vessels C. Dissolving any clots that form D. Stimulating production of certain clotting factors

A. Inhibiting the formation of clots

A client exhibits signs and symptoms of heparin overdose. The nurse would anticipate administering: A. Protamine sulfate B. Drotrecogin alfa C. Urokinase D. Vitamin K

A. Protamine sulfate

A patient with seasonal allergies is taking an antihistamine to relieve itchy, watery eyes, and a runny nose. When planning teaching for this patient, the nurse would include what teaching point? A) Advise the patient to limit fluid intake to dry out mucous membranes. B) Advise the patient to avoid driving or operating machinery. C) Advise the patient to report strange dreams or nightmares. D) Advise the patient to decrease dietary fat.

B) Advise the patient to avoid driving or operating machinery.

The nurse is caring for a patient receiving an antineoplastic medication who reports fever, chills, sore throat, weakness, and back pain. What type of adverse effect does the nurse suspect this patient is experiencing? A) Dermatologic reaction B) Blood dyscrasia C) Electrolyte imbalance D) Superinfection

B) Blood dyscrasia

The pharmacology instructor is discussing the adrenergic drug ephedrine with the nursing students and lists an adverse reaction of this drug as what? A) Bronchoconstriction B) Hyperglycemia C) Cardiac arrhythmias D) Severe constipation

B) Hyperglycemia Feedback: Ephedrine (generic), a drug used as a bronchodilator to treat asthma and relieve nasal congestion, can break down stored glycogen and cause an elevation of blood glucose by its effects on the sympathetic nervous system. Ephedrine does not cause bronchoconstriction, cardiac arrhythmias, or severe constipation.

A nurse is planning patient teaching about a newly prescribed drug. What is a priority teaching point included by the nurse to improve compliance and safety? A) List of pharmacies where the drug can be obtained B) Measures to alleviate any discomfort associated with adverse effects C) The cost of the brand name drug compared with the generic form D) Statistics related to Phase III testing for the prescribed drug

B) Measures to alleviate any discomfort associated with adverse effects

The nurse is acting as the triage nurse in the emergency department when a 16-year-old boy is brought in by his friends. The patient is in respiratory distress, he is vomiting, and blood is noted in the vomitus. He is somnolent and his electrocardiogram shows an arrhythmia. The boy's friends tell you he was taking a "bunch of little green pills" he got from the cupboard at his grandparent's house. The nurse suspects what? A) Overdose of sleeping pills B) Poisoning C) Anaphylactic shock D) Allergic reaction to Dyazide

B) Poisoning

What classification of drug allergy would be described as an immune system reaction to injected proteins used to treat immune conditions? A) A cytotoxic reaction B) Serum sickness C) A delayed reaction D) An anaphylactic reaction

B) Serum sickness

A student nurse asks her study group how to define a drug allergy. What would be the peer group's best response? A) A second effect of the body to a specific drug B) The formation of antibodies to a drug protein causing an immune response when the person is next exposed to that drug. C) A serum sickness caused by a reaction to a drug D) Immediate systemic reaction to the drug when exposed to the drug the first time.

B) The formation of antibodies to a drug protein causing an immune response when the person is next exposed to that drug.

The nurse is taking a health history on a 58-year-old client who is taking atorvastatin for high cholesterol. What assessment question should the nurse prioritize related to the safe use of this drug? A. "Do you use any over-the-counter medications for headache or colds?" B. "How many alcoholic drinks do you have in a typical day or week?" C. "Do you do any physical exercises on a regular basis?" D. "How would you describe your caffeine intake ?"

B. "How many alcoholic drinks do you have in a typical day or week?"

A nurse is preparing to discharge a client who has been prescribed warfarin. While assessing the client's knowledge of the drug, what statement should the nurse address? A. "I drink a glass of wine with dinner some evenings." B. "I take aspirin to help with the pain of my arthritis." C. "I take vitamin C when I feel like I'm getting a cold." D. "I aim to walk 2 miles a day."

B. "I take aspirin to help with the pain of my arthritis."

A client taking an HMG-CoA reductase inhibitor presents to the clinic reporting acute muscle pain and not associated with exercise or injury. The nurse should complete a medication reconciliation to determine if this client has been taking which of the following medications? A. Over-the-counter (OTC) medications B. Gemfibrozil C. Saw palmetto D. Ginseng

B. Gemfibrozil

The nurse admits a 26-year-old client with sickle cell anemia. What drug should the nurse most likely administer? A. Leucovorin B. Hydroxyurea C. Hydroxocobalamin D. Methoxy polyethylene glycol-epoetin beta

B. Hydroxyurea

A client recently began taking lovastatin. The nurse should assess the client for what potential adverse effects? A. Hiccoughs, sinus congestion, and dizziness B. Nausea, flatulence, and constipation C. Confusion and mental disorientation D. Increased appetite and blood pressure

B. Nausea, flatulence, and constipation

The patient with diabetes is also taking ephedrine to treat asthma that causes her blood sugar to increase. The patient asks the nurse, "Why does this medication make my blood sugar go up?" What is the nurse's best response? A) "The active ingredient in ephedrine is mixed with sugar." B) "Ephedrine is a placebo containing only sugar." C) "Stored glycogen is broken down by ephedrine, which is causing higher blood sugar levels." D) "Insulin is inactivated by ephedrine so it cannot work to control sugar levels."

C) "Stored glycogen is broken down by ephedrine, which is causing higher blood sugar levels."

An 80-year-old patient presents at the clinic for a follow-up appointment. She is taking a macrolide antibiotic and is experiencing tinnitus. The nurse is talking with family members about home care for the patient. What should the nurse include in her instructions regarding home care? A) Keep the patient in a prone position when in bed. B) Eliminate salt from the patient's diet. C) Provide protective measures to prevent falling or injury. D) Monitor exposure to sunlight.

C) Provide protective measures to prevent falling or injury.

The Kardex record of a male patient who is prescribed antihistamines for treating an allergy reads as follows: Age: 32; Profession: Carpenter; Lifestyle & diet: Lives alone, average smoker, nonalcoholic, no food preferences, practices yoga; Medical history: Suffers from hay fever, recent urinary tract infection that has been treated successfully. What information from the Kardex is likely to have the greatest implication in educating the patient about antihistamine administration? A) The patient's age B) The patient's smoking habit C) The patient's profession D) The patient's medical history

C) The patient's profession

Why does the nurse need to be alert for any indication of an allergic reaction in patients? A) To obtain early warning of noncompliance in drug therapy B) To increase the effectiveness of a specific medication C) To maintain the patient's safety during drug therapy D) To reduce the risk of adverse effects during drug therapy

C) To maintain the patient's safety during drug therapy

The effects of warfarin are monitored by what laboratory test(s)? A. aPTT B. Platelet count C. PT and INR D. RBC

C. PT and INR

A male client is receiving heparin by continuous intravenous infusion. The nurse will instruct the client and family members to report what should it occur? A. Dizziness B. Sudden occurrence of sleepiness and drowsiness C. Presence of blood in urine or stools D. A skin rash

C. Presence of blood in urine or stools

Which patient should not receive epoetin alfa (Epogen) as ordered at 9 am? A. The patient with a heart rate of 100 beats per minute? B. The patient who is "too tired to get out of bed" C. The patient who has a blood pressure of 240/120 mm Hg D. The patient who has missed a round of chemotherapy

C. The patient who has a blood pressure of 240/120 mm Hg

A client is receiving epoetin alfa for anemia. Which adjunctive therapy is imperative with epoetin alfa? A. Potassium supplements B. Renal dialysis C. Sodium restriction D.Iron supplement

D .Iron supplement

A patient with Parkinson's disease is taking an anticholinergic drug to decrease the tremors and drooling caused by the disease process. The patient complains that he is having trouble voiding. The nurse would explain that this is what? A) A hypersensitive action of the drug B) A primary action of the drug C) An allergic action of the drug D) A secondary action of the drug

D) A secondary action of the drug Feedback: Sometimes the drug dosage can be adjusted so that the desired effect is achieved without producing undesired secondary reactions. But sometimes this is not possible, and the adverse effects are almost inevitable. In such cases, the patient needs to be informed that these effects may occur and counseled about ways to cope with the undesired effects. The situation described is not a hypersensitivity reaction that would indicate an allergic reaction, a primary reaction that would be excessive therapeutic response, or an allergic reaction to the drug.

A patient presents at the clinic complaining of vaginal itching and a clear discharge. The patient reports to the nurse that she has been taking an oral antibiotic for 10 days. The nurse is aware that the patient is experiencing what? A) An adverse reaction from the antibiotic B) A drug toxicity effect of the antibiotic C) An overdose of the drug that is damaging to more than one body system D) A superinfection caused by the antibiotic, which has destroyed normal flora

D) A superinfection caused by the antibiotic, which has destroyed normal flora

The nurse administers erythromycin, a drug that is known to irritate mucosa in the stomach lining. When the patient reports abdominal discomfort after taking the medication, the nurse would classify this discomfort as what type of adverse effect? A) Primary action B) Secondary action C) Hypersensitivity reaction D) Allergic reaction

D) Allergic reaction

Oral antidiabetic drugs can cause alterations in glucose metabolism. Patients who are taking these drugs would need to be observed for what? A) Increased urination B) Deep Kussmaul's respirations C) Thirst and hot or flushed skin D) Confusion and lack of coordination

D) Confusion and lack of coordination

The home health nurse is caring for an elderly patient with benign prostatic hypertrophy. An anticholinergic drug has been prescribed. What would be the nurse's priority teaching point for this patient? A) Urinary incontinence may develop. B) Bladder hypertonia may develop. C) An increased dosage may be required. D) Empty the bladder before taking the drug.

D) Empty the bladder before taking the drug.

The nurse needs to consider teratogenic effects of medications when caring for what population of patients? A) Older adults B) Patients with a history of cancer C) Children D) Young adult women

D) Young adult women Feedback: A teratogen is a drug that can harm the fetus or embryo so the nurse would consider the teratogenic properties of medications when caring for woman of child-bearing age including adolescents and young adult women. Teratogens have no impact on older adults or children. Carcinogens are chemicals that cause cancer.

A patient receives ferrous sulfate. The nurse would expect this drug to begin acting within time frame? A. 2 days B. 8 days C. 6 days D. 4 days

D. 4 days

The nurse instructs a client taking oral iron preparations about strategies for addressing which potential adverse effect? A. Frequent flatus B. Hypotension C. Clay-colored stools D. Constipation

D. Constipation

The client is admitted to the acute care facility with a diagnosis of acute renal failure. While collecting the client's history, the nurse discovers that the client was taking an HMG-CoA reductase inhibitor and enjoyed drinks of grapefruit juice every morning. The client reports muscle pain. What condition does the nurse suspect this client may have developed? A. Hypokalemia B. Gastric ulceration C. Congestive heart failure D. Rhabdomyolysis

D. Rhabdomyolysis

A client with hyperlipidemia has been taking atorvastatin for several months. How can the therapeutic effect of the medication be best determined? A. Performing a focused cardiac assessment B. Assessing the client's resting heart rate and postural blood pressure C. Assessing the client's exercise tolerance and activities of daily living D.Reviewing the client's laboratory blood work results

D.Reviewing the client's laboratory blood work results