Pharmacology Exam #2 Chapters 18-22

Which nutritional concept(s) is/are necessary to provide to patients receiving colestipol? (Select all that apply.)

Whole grains, raw fruits, and vegetables will minimize constipation. Report signs of vitamin K deficiency, including bleeding gums, dark tarry stools, and coffee-ground emesis. Supplemental fat-soluble vitamins may be necessary.

A patient has been started on lamotrigine (Lamictal). How does the nurse instruct this patient to take the medication to decrease the incidence of gastric irritation?

With milk or food

Which statement(s) about diuretics is/are true? (Select all that apply.)

A mechanism of action for the antihypertensive effects of diuretics includes volume depletion. They have been shown to reduce cardiovascular morbidity associated with hypertension. Electrolytes must be evaluated periodically for patients on loop diuretics.

Which drug categories are used as preferred antihypertensive treatments in patients with metabolic syndrome? (Select all that apply.)

ACE inhibitors, Beta blockers, Thiazide diuretics

Which is the correct focus of drug treatment for dyslipidemia?

Increase the level of HDLs and lower LDLs in the body.

Patients taking phenytoin (Dilantin) for control of seizures must be aware of the risk for which adverse effect(s)? (Select all that apply.)

Blood dyscrasias, Hyperglycemia, Gingival hyperplasia, Sedation.

Which criterion meets a general treatment goal for patients with metabolic syndrome?

Blood pressure reading of 128/72 mm Hg

An intravenous (IV) bolus of phenytoin (Dilantin) is administered with the patient under electrocardiographic (ECG) monitoring. Which risk factor should the nurse be prepared to assess?

Bradycardia

In addition to type 2 diabetes and heart disease, which condition(s) is/are associated with metabolic syndrome? (Select all that apply.)

Dementia, Renal disease, Obstructive sleep apnea, Polycystic ovary syndrome.

Drug therapy for initial treatment of metabolic syndrome is targeted at controlling which condition(s)? (Select all that apply.)

Diabetes mellitus, Hypertension, Dyslipidemia.

A patient has been prescribed amlodipine (Norvasc) for the treatment of hypertension. Which medication is contraindicated for this patient?

Digoxin (Lanoxin)

Which antihypertensive agents fall into the adjunctive category? (Select all that apply.)

Direct vasodilators, Central-acting alpha-2 agonists, Peripheral-acting adrenergic antagonists

A patient taking phenytoin (Dilantin) has started attending college and reports frequently drinking alcohol with friends. What does the nurse monitor for in this patient?

Increased seizure activity

A patient who is in hypertensive crisis is ordered nitroprusside sodium (Nitropress). Which route will the nurse use to administer this drug?

Intravenous

A patient is diagnosed with metabolic syndrome. Which patient data needs to be improved?

LDL level of 104 mg/dL

What is the most critical approach to the treatment of metabolic syndrome?

Lifestyle management

The nurse transcribes a new order for Lovaza on a patient in a long-term care facility. When providing education to the patient about this medication, the nurse will include which statement(s)? (Select all that apply.)

Liver function tests should be completed before initiating therapy. Lovaza should be used with caution if the patient has an allergy to fish. Lovaza does not cause myositis.

A patient taking phenytoin (Dilantin) and isoniazid reports feeling lethargic. Nystagmus is noted on physical examination. Which problem does this information suggest to the nurse?

Phenytoin toxicity

What will the nurse review when teaching a patient about therapy with statins? (Select all that apply.)

Statins are the most potent antilipemic agents available. Statins should be taken with food. Statins cause mild increases in HDL levels. Statins reduce inflammation, platelet aggregation, and plasma viscosity.

Which condition(s) may be managed by salicylates? (Select all that apply.)

Swollen joints, Fever, Muscle aches. Myocardial infarction.

A patient undergoing withdrawal from an opiate agonist asks the nurse how long the withdrawal symptoms will last. Which response by the nurse is best?

Symptoms peak in about 2 days and then disappear by the end of a week.

A patient is taking warfarin (Coumadin) and cholestyramine. Which instruction should the nurse provide?

Take warfarin 1 hour before or 4 hours after taking cholestyramine.

Which is the correct advantage of beta-adrenergic blocking agents over other antihypertensive medications?

They cause minimal orthostatic or exercise hypotension.

Which antiepileptic drug is effective for almost all forms of seizures?

Valproic acid (Depakene)

When teaching a patient who is starting therapy with NSAIDs, the nurse must be sure to mention drug interactions with which drug(s)? (Select all that apply.)

Warfarin (Coumadin), Lithium (Eskalith), Diuretics.

Which statement about metabolic syndrome is true?

Weight loss and increased physical activity are usually the first steps of treatment.

Which behavior modifications are appropriate for a patient to implement to help control hypertension? (Select all that apply.)

Weight reduction diet, Increased exercise, Smoking cessation, Stress reduction

Which statement(s) concerning the use of antihypertensive therapy for the treatment of hypertension would be considered true? (Select all that apply.)

Diuretics are the most commonly prescribed antihypertensive agent. Diuretics are often prescribed in combination therapy with other antihypertensive agents.

Which drug categories are the preferred to treat hypertension? (Select all that apply.)

Diuretics, Beta-adrenergic blockers

Which common adverse effect(s) is/are associated with opiate agonists? (Select all that apply.)

Dizziness, Orthostatic hypotension, Respiratory depression, Confusion.

Which instruction does the nurse give to a patient beginning lovastatin (Mevacor) therapy?

Do not drink grapefruit juice.

The nurse is preparing to administer niacin for the first time to a patient being treated for dyslipidemia. Before administering this medication, the nurse will assess: (Select all that apply.)

blood glucose levels. blood pressure. heart rate.

Which question must be answered before a 40-year-old woman can begin statin therapy?

"Are you pregnant?"

The nurse is instructing a patient about the management of hyperlipidemia. Which statement by the patient indicates the need for further teaching?

"By taking my antilipemic medication, I will not need to modify my diet."

Which class of antidiabetic drugs inhibits alpha glucosidase and delays glucose absorption?

Alpha glycosidase inhibitors

Which complication(s) is/are associated with uncontrolled hypertension? (Select all that apply.)

Angina, Stroke, Renal failure, Heart failure

Which property of aspirin does acetaminophen (Tylenol) lack?

Antiinflammatory

Which potential effect of cholestyramine can cause bleeding gums, bruising, or dark tarry stools?

Deficiency of vitamin K

Which adult patient should the nurse hold an order for an opioid agonist?

Patient whose respiratory rate is 10

Which patient should not be prescribed carbamazepine (Tegretol)?

Patient with chronic hepatitis B

A patient taking a statin reports muscle aches and soreness. Which statement by the nurse correctly explains why this symptom is cause for concern?

"Muscle aches and soreness may be early signs of myopathy."

Which information does the nurse include for a patient taking tramadol (Ultram)?

"Tramadol may cause constipation, so be sure to include sufficient roughage in your diet."

Weight: 140 lb. Height: 5 feet 4 inches. What is the BMI?

24.03

Weight: 70 kg. Height: 164 cm (1.65 m). What is the BMI?

25.71

Which cardiovascular condition(s) is/are related to coronary artery diseases (CADs)? (Select all that apply.)

Angina pectoris, Acute myocardial infarction

A patient has been prescribed ezetimibe (Zetia) for the management of hyperlipidemia. Which adverse effect should be monitored?

Abdominal pain

The healthcare provider orders diazepam (Valium) 10 mg IV stat for a patient who was admitted with status epilepticus. What important nursing interventions(s) associated with administration of this medication IV should the nurse perform? (Select all that apply.)

Apply a cardiac monitor to the patient to assess for continuous heart rate, if not already done. Continuously assess the patient's airway. Obtain the correct dose (10 mg) and administer over slow IV push.

A patient who has received an initial dose of an opiate partial agonist reports feeling clammy, dizzy, and nauseated. Which action does the nurse implement next?

Assists the patient to rest in a supine position

A patient with hypertension has suffered a heart attack. Which agent does the nurse anticipate will be ordered by the healthcare provider?

Beta-adrenergic blocker

Which antihypertensive medication is more effective in African Americans and older adult patients?

Calcium channel blockers

Which drug used in the treatment of seizures requires careful monitoring of renal function?

Carbamazepine (Tegretol)

The nurse is preparing to assess blood pressure on a patient who has had two prior readings of 160/100. Physician's notes from a prior visit indicate that the patient is suspected to have hypertension. When reassessing this patient for hypertension, the nurse will do what? (Select all that apply.)

Choose a cuff encircling at least 80% of the arm. Support patient's arm at heart level. Encourage patient to sit quietly for 5 minutes before assessing blood pressure.

A patient is starting on an angiotensin-converting enzyme (ACE) inhibitor. Which assessment does the nurse include in the patient's care plan?

Close observation after the initial dose until blood pressure stabilizes in 2 to 3 hours

Which medication has received US Food and Drug Administration (FDA) approval for reducing blood glucose and glycosylated hemoglobin (A1c) in adult patients with type 2 diabetes?

Colesevelam

What does the nurse monitor in a patient taking zonisamide (Zonegran)?

Complete blood count (CBC)

Which assessment would be expected in a patient receiving high dosages of morphine?

Constricted pupils

A patient on anticonvulsant therapy confides to the nurse at an outpatient clinic that she suspects she may be pregnant. The nurse should encourage the patient to take which action(s)? (Select all that apply.)

Consult an obstetrician. Carry an identification card. Provide a list of seizure medications.

Which adverse effect of ACE inhibitors is more common in women than men?

Cough

A patient with hypertension for whom a diuretic is ordered asks the nurse how a "kidney pill" can help blood pressure. Which information about how diuretics lower blood pressure guides the nurse's response?

Decreasing circulatory volume and dilating peripheral arterioles

The nurse is educating a patient about niacin prescribed to treat his hyperlipidemia. Which important teaching point(s) should be included in the educational plan? (Select all that apply.)

Effectiveness of niacin in lowering total cholesterol, Information on high cholesterol foods and food preparation using unsaturated fats, Adverse effects to report (e.g., fatigue, anorexia, nausea, malaise, jaundice, muscle aches).

What lifestyle choice(s) may aggravate metabolic syndrome? (Select all that apply.)

Excessive tobacco smoking, Excessive consumption of alcohol.

Which successful forms of treatment for metabolic syndrome are the most cost effective? (Select all that apply.)

Exercise, Smoking cessation, Dietary modification

Which supplemental vitamins may be required for patients taking bile acid-sequestering resins?

Fat-soluble vitamins

Which measurement is the best indicator of how well an antiseizure medication is working?

Frequency and duration of seizures

A patient is prescribed eplerenone (Inspra) for the treatment of hypertension. Which kind of juice should be avoided by this patient?

Grapefruit

The nurse is finished conducting nutritional education with a patient about the DASH (dietary approaches to stop hypertension) diet. The patient would like to complete the breakfast menu for tomorrow. Which foods offered for breakfast would be most appropriate for the patient to choose? (Select all that apply.)

Grapefruit, Orange juice, Oatmeal

A teaching plan for a patient with hyperlipidemia would instruct the patient to avoid which food(s)? (Select all that apply.)

Hard cheeses, Liver

A patient with diabetes is started on phenytoin (Dilantin) for partial seizures. What does the nurse closely monitor in this individual?

Hyperglycemia

Metabolic syndrome includes which key characteristic(s)? (Select all that apply.)

Hyperglycemia, Abdominal obesity, Low high-density lipoproteins, Hypertension.

A patient with a history of diabetes mellitus is prescribed aliskiren (Tekturna) for the treatment of hypertension. Which electrolyte imbalance may occur with this medication?

Hyperkalemia

Which key characteristics are found in individuals who have been diagnosed with metabolic syndrome? (Select all that apply.)

Hypertriglyceridemia, Type 2 diabetes mellitus, Abdominal obesity

Which activities are important to improve cardiovascular function? (Select all that apply.) CORRECT

Maintaining body weight in adults within a BMI range of 18 to 25 kg/m2, Reducing job-related stress, Increasing physical activity, Maintaining daily maximum caloric levels based on height, weight, and gender

Which instruction does the nurse include when teaching a patient with hyperlipidemia about how to take the powdered form of cholestyramine?

Mix the powder with 2 to 6 ounces of water or juice.

Which medication does the nurse hold if a patient's vital signs are blood pressure 144/90 mm Hg, pulse 60, and respirations 10?

Morphine

A patient has overdosed on morphine. Which medication does the nurse anticipate will be ordered by the physician to treat the patient's overdose?

Naloxone (Narcan)

Which medication has the greatest effect on increasing high-density lipoprotein (HDL) levels?

Niacin

A patient has a body mass index (BMI) of 23. Which BMI category does the nurse document?

Normal weight

Which factor should be considered during data collection when evaluating the effectiveness of succinimides?

Occurrence of petit mal seizures

When performing a baseline neurologic assessment prior to the administration of an NSAID medication, the nurse will assess which patient characteristic(s)? (Select all that apply.)

Orientation to date, time, and place. Mental alertness.

Which patient illustrates a physical dependence to an opioid agonist? CORRECT

Patient who experiences abstinence syndrome when the drug is abruptly discontinued.

Which patient best illustrates the ceiling effect?

Patient who receives an increasing dosage of medication and does not receive increased pain relief, but does experience an increased incidence of adverse effects

What is included in the nursing management of the patient with generalized tonic-clonic seizure activity? (Select all that apply.)

Placing padding around or under the patient's head, Positioning the patient on the side once the relaxation stage is entered to allow oral secretions to drain, Requesting additional assistance and/or necessary equipment in case the patient does not begin breathing spontaneously when the seizure is over.

The mother of a school-aged child asks the nurse how to help prevent her child from acquiring metabolic syndrome. The nurse informs the child's mother that education for children in primary grades should focus on which action(s)? (Select all that apply.)

Prevention of smoking, Importance of moderate activity, Discouraging use of alcohol.

Which additional nursing intervention(s) would be effective with pain management in the pediatric population? (Select all that apply.)

Provide diversional activities such as coloring, puzzles, and games. Allow uninterrupted sleep and rest. Perform hygiene measures. Encourage parental participation with caregiving to diminish the child's anxiety.

The nurse is reviewing dietary instructions with a patient diagnosed with metabolic syndrome. Which food does the nurse encourage the patient to eat more of?

Salmon

The nurse is preparing to administer zonisamide (Zonegran) to a newly admitted patient with the diagnosis of adult partial seizures. The nurse should hold this medication if the patient has which sign(s) or symptom(s)? (Select all that apply.)

Skin rash, Allergy to Bactrim, Pruritus.