PHARMACOLOGY EXAM 3 (Questions)

A client reports having difficulty finding the over-the-counter (OTC) decongestant that the client used in the past. What assessment question should the nurse ask to help address the client's concern?

"Did the medication contain pseudoephedrine?"

An older client is taking an anticholinergic agent. After teaching the client about the drug, which client statement indicates the need for additional teaching?

"I need to exercise frequently outside in the warm weather."

An adolescent client is prescribed a leukotriene receptor antagonist as a part of a medication regime to manage his/her asthma. Which statement made by the client requires additional education on this classification of medications?

"I need to take the medication when I start to have problems breathing."

A nurse is preparing a teaching plan for a client and caregiver on the proper use of a dry powder inhaler. Which instructions will the nurse include in this teaching? (SATA question)

- Hold breath for 10 seconds. - Inhale quickly.

The nurse prepares to administer a selective alpha-adrenergic agonist medication to a client diagnosed with shock. What would the nurse consider to be therapeutic or desired effects based upon the characteristics of the prescribed medication? Select all that apply. Bronchodilation Glycogenolysis Tachycardia Increased blood pressure Increased cardiac output

- Increased blood pressure - Increased cardiac output

When evaluating the plan of care for a client receiving opioid analgesics for pain management, the nurse considers the plan successful when what occurs? (Select all that apply.) Client reports decreased urinary output. Therapeutic response is achieved and discomfort is reduced. An adequate breathing pattern is maintained. Client maintains adequate nutritional status. Client reports decreased bowel movements.

- Therapeutic response is achieved and discomfort is reduced. - An adequate breathing pattern is maintained. - Client maintains adequate nutritional status.

A health care provider prescribes 10 mg of donepezil hydrochloride per day to a client with dementia of Alzheimer's disease. Donepezil tablets are available as 10-mg tablets. How many tablets should the nurse have to administer to the client per day?

1 tablet

A patient is admitted to the emergency room after a car accident. Based on the experience of the emergency room nurse, what system will affect a response to the emergency? Central nervous system Autonomic nervous system Endocrine system Cardiovascular system

ANS

A client who has been taking medication for a seizure disorder is asking the nurse about getting pregnant. Why is pregnancy discouraged in women who are being treated for seizure disorders?

Antiepilepsy drugs are teratogenic

The nurse notes a client prescribed an extended-release opioid requests that all medications be crushed to facilitate the administration. What information about this form of opioid presents a problem respecting the client's request?

Crushing the medication may precipitate an overdose.

A nurse is assessing a client with Parkinson's disease. The nurse determines that the client's drug therapy is effective when the client exhibits what?

Decreased tremors

A 28-year-old client has been experiencing muscle spasms in the neck from a four-wheeler accident. The client is receiving 10 mg of cyclobenzaprine PO tid. The nurse's teaching plan should include which instruction?

Do not drive or operate heavy machinery for the first week.

The nurse is administering morphine to a trauma client for acute pain. What is a common side effect of morphine? Increased intracranial pressure Paresthesia in lower extremities Drowsiness Occipital headache

Drowsiness

A client presents at the clinic with a dry, nonproductive cough. The client is diagnosed with bronchitis, and it is determined that they will need help thinning sputum so that the cough can become productive. What does the nurse expect will be prescribed for the client?

Guaifenesin

A client receiving a dopaminergic agent has recently experienced nausea, vomiting, and dysphagia. Which nursing diagnosis would be most appropriate for this client?

Imbalanced nutrition: less than body requirements

An older adult client has been diagnosed with early-stage Alzheimer's disease and has begun treatment with donepezil. When providing health education to the client and the client's spouse, the nurse should identify what goal of treatment?

Improvement of cognition and function

A nurse is teaching a client about albuterol which has been prescribed. The nurse determines the session is successful when the client correctly chooses which adverse reaction to report immediately to the health care provider?

Insomnia

A patient is receiving albuterol as a bronchodilator. How does this agent work? it mimics the cardiotonic effects of digoxin (Lanoxin). It mimics the central nervous system. It mimics the parasympathetic nervous system. It mimics the sympathetic nervous system.

It mimics the sympathetic nervous system.

A client diagnosed with myasthenia gravis is administered a cholinergic drug named neostigmine. How does this drug produce its therapeutic effect?

It stimulates the parasympathetic nervous system

The nurse is educating an adult client diagnosed with rhinosinusitis with viscous clear mucous about the prescribed guaifenesin 400 mg PO every 4 hours. Which statement made by the client establishes the need for further clarification?

It will suppress my cough so I can sleep easier

The nurse assesses that the client is having pain. The nurse asks the client to rate his pain on the pain scale. The client is unable to rate the pain, stating that it just hurts so bad he can't think. What is the most appropriate response of the nurse? Find a pain scale the client can use. Ask a family member if he or she can assist. Keep trying to have the client use the pain scale. Medicate the client for pain.

Medicate the client for pain

The nursing instructor is discussing cholinergic drugs with his clinical group. What system would the instructor tell the students is stimulated by cholinergic drugs?

Parasympathetic nervous system

The client newly diagnosed with epilepsy begins to show signs of seizure activity. What is the nurse's priority action? Obtain the client's vital signs as soon as possible. Attempt to calm the client. Protect the client's safety. Perform detailed documentation.

Protect the client's safety.

The nurse is teaching a group of clients with allergic rhinitis (hay fever) about medication use. What would be the most essential information to give these clients about preventing possible drug interactions?

Read drug labels before taking OTC medications.

An opioid-naïve client experiences acute pain after surgery and is prescribed opioid therapy. The nurse would be especially alert for the development of which reactions? Severe headache Urticaria Pruritus Respiratory depression

Respiratory depression

A 40-year-old client with a diagnosis of fibromyalgia has been prescribed cyclobenzaprine (Flexeril) as an adjunct to her existing drug regimen. What nursing diagnosis should the nurse prioritize for the nursing care plan for this client?

Risk for Injury related to CNS depressant effects

A client who is receiving an antiseizure agent reports feeling sleepy and tired and reports dizziness when standing up. Which intervention would the nurse most likely implement as the priority?

Safety precautions

Why are inhaled steroids used to treat asthma and COPD?

They act locally to decrease release of inflammatory mediators

The client is ordered bethanechol subcutaneously. After giving the client the injection of bethanechol, the nurse should make sure that what is available?

Urinal, bed pan, and call light

A client has been admitted to the emergency department with sudden nausea, diaphoresis, and shortness of breath. A thorough history has revealed that the client's signs and symptoms are attributable to an accidental overdose of neostigmine (Prostigmin). The nurse who is providing care should anticipate that the client is likely to require what drug?

atropine

Indications for use of anticholinergic drugs in the treatment for Parkinsonism include to:

decrease salivation, spasticity, and tremors.

A client having an acute asthma attack is prescribed epinephrine. The nurse should assess what therapeutic effect of this drug?

dilation of the bronchi with increased rate and depth of respiration

What medication should be prescribed to minimize the risk associated with a blood transfusion for a client with a history of a previous transfusion reaction?

diphenhydramine

A 70-year-old female patient has just been diagnosed with Alzheimer's disease. What cholinergic drug is used for the treatment of Alzheimer's disease?

donepezil (Aricept)

A client has been administered an opioid. For what effect should the nurse regularly assess?

level of consciousness

A client with cystic fibrosis may use which type of medication to reduce the viscosity of respiratory secretions?

mucolytics

A client has been diagnosed with partial seizures and has been prescribed carbamazepine. When providing health education about the safe and effective use of this medication, what should the nurse teach the client?

"It's safest if you avoid drinking alcohol while you're taking this drug."

The nurse is reviewing the discharge instructions with the client going home on an opioido for pain management. What would the nurse include in the instructions? Select all that apply. Limit fluid intake. Rise slowly from a sitting or lying position. Avoid driving Take a laxative/stool softener. Eat frequent small meals

- Rise slowly from a sitting or lying position - Avoid driving - Take a laxative/stool softener - Eat frequent small meals

A client asks the nurse about using dextromethorphan to relieve a cough. What type of cough would the nurse explain is best treated with the drug?

A dry, nonproductive cough

When considering possible side effects, which client should be considered for a prescription of cetirizine rather than diphenhydramine?

Any adult older than 56-years-of age.

What is the most common first-line therapy for relief of an acute asthma attack?

Beta2-adrenergic agonist

A nurse is providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The nurse will question the patient about her intake of which of the following?

Coffee

A client is receiving an opioid analgesic following abdominal surgery. On assessment the nurse notes the client has been in a chair, ambulating with assistance, fluids and food intake is good with active bowel sounds with minimal bowel movement. Which nursing diagnosis would be most appropriate? Malnutrition: Less Than Body Requirements Constipation Injury Risk Deficient Knowledge

Constipation

Which statement accurately describes an aspect of serum sickness?

It is a delayed hypersensitivity reaction

A client has been prescribed an anticholinergic medication. What instructions should the nurse provide related to safety when outside in hot weather?

Keep well hydrated

A nurse is conducting a medication resolution of a new resident of a care facility and notes that the woman has been taking neostigmine. The nurse should recognize that the woman may have a history of what health problem?

Myasthenia gravis

A client taking levodopa-carbidopa for the treatment of Parkinson's disease reports blurred vision and the nurse observes that the client has worsening ataxia. Which nursing diagnosis should the nurse prioritize?

Risk of injury

What type of antihistamine is typically preferred for older adults?

Second - Generation antihistamine

A client prescribed phenytoin for a seizure disorder has recently run out of medication and has not obtained a refill. What is the client at risk for developing?

Status epilepticus

A client with Parkinson's disease began treatment with dopaminergics two weeks ago and has now presented for a follow-up assessment. What finding best suggests to the nurse that the treatment is having a therapeutic effect?

The client is able to walk more briskly and stably than two weeks ago

After teaching a group of students about inhaled steroids, the instructor determines that the teaching was successful when the students state...

The drugs are not for use during an acute attack.

Expectorants elicit their effect by which mechanism?

Thinning respiratory secretions

A nurse is caring for two clients who are status postoperative for abdominal surgery. What is the best way to evaluate pain response after administering analgesia? - If a family member is present, ask him or her if the medication worked. - The nurse should observe the client when the client is not aware the nurse is watching. - Use a pain assessment tool before and 30 minutes after medication administration. - Ask the non-licensed personnel (aide) to find out if the medication worked.

Use a pain assessment tool before and 30 minutes after medication administration.

Which receptor is responsible for increasing blood pressure? beta-1 receptors beta-2 receptors alpha-2 receptors alpha-1 receptors

alpha-1 receptors

A client is experiencing urinary retention after surgery. The nurse would anticipate administering:

bethanechol

An adolescent taking oral contraceptives has been prescribed an anticonvulsant medication. The nurse should tell the client to do what?

use another form of birth control

The nurse has been educating the client on the self-administration of phenytoin. Which statement by the client demonstrates an understanding of the medication? "I can purchase whichever brand is cheapest each month." "All brands of phenytoin are equal in strength and action." "I should not change brands without checking with my health care provider." "I will take aspirin for a headache."

"I should not change brands without checking with my health care provider."

A nurse is teaching a client about musculoskeletal medication that has been prescribed. The client needs further teaching about the medication when making which statement? "I made an appointment in two to three weeks to be reevaluated." "I take my medicine with three to four beers each evening." "I usually lie down for a few minutes after taking my medication." "I take my medication right after dinner."

"I take my medicine with three to four beers each evening."

A 56-year-old woman with a diagnosis of multiple sclerosis has begun taking dantrolene. What client teaching should the nurse provide? "You'll find that your muscles will get progressively stronger over the next several weeks." "Make sure to see your health care provider promptly if you develop yellowish skin or eyes." "Take an over-the-counter laxative so that you don't get constipated." "You'll have to come to the hospital daily to be administered this drug."

"Make sure to see your health care provider promptly if you develop yellowish skin or eyes."

The pharmacology instructor is discussing age-related susceptibility to adverse effects of cholinergic drugs. Which statement could the instructor make to accurately describe the influence of age?

"Physiologic changes resulting from the normal aging process place older adults at higher risk for adverse effects."

A client recently diagnosed with asthma anxiously reports that the symptoms of a recent episode were not relieved despite taking several puffs of the prescribed salmeterol. How should the nurse respond to the client's concern?

"Remember that your salmeterol isn't effective when you take it at the time of an asthma attack."

A female client is crying and states that everyone thinks she is a "drug addict," and that no one will listen to her. She states she has abdominal pain and must have something for the pain. What is the best response of the nurse? "Your behavior drives our perception." "You do not seem to be in pain right now." "Do you take a lot of pain medication." "Tell me more about your pain."

"Tell me more about your pain."

A patient has hypertension and wants to take a nasal decongestant for cold symptoms. Which statement by the nurse indicates the effect of nasal decongestant medications on hypertension?

"The administration of a nasal decongestant will increase blood pressure due to vasoconstriction of blood vessels."

A client, admitted to the surgical division after a mastectomy, has a PCA pump and states being fearful about being overdosed on morphine. Which response is most appropriate when addressing the client's concern of being overmedicated? - "If you follow the instructions, that won't happen to you." - "The pump will administer all of the doses, so you don't have to worry." - "The device will give you a placebo when you press it often." - "The device is preset, so you cannot receive more than you need."

"The device is preset, so you cannot receive more than you need."

The nurse educates a client diagnosed with asthma concerning the important aspects about the prescribed selective beta2-adrenergic agonist inhaler. Which client statement indicates the need for further clarification? "The medication will bind to beta2 receptors and activate the physiologic response." "The inhaler will cause my bronchi to dilate and make it easier for me to breathe." "The medication will cause my heart rate to increase and will cause palpitations." "Beta2 receptors are in the respiratory tract and the bronchi."

"The medication will cause my heart rate to increase and will cause palpitations."

A client who has been prescribed bethanechol asks a nurse to explain how the drug works. What would be a correct response?

"bethanechol is a direct-acting cholinergic drug that causes contraction of the smooth muscles of the bladder and passage of urine."

When developing the teaching plan for a client receiving an antihistamine, which would the nurse include? (SATA question)

- Advising the client to avoid alcohol consumption - Using sugarless candies or lozenges to combat dry mouth

Which statements are correct regarding the autonomic nervous system (ANS) receptors? Select all that apply. There are no drugs that affect the ANS or receptors. The nurse does not need to know about the receptors in the ANS. Drug effects depend on the branch of the ANS involved. Medications can either stimulate or inhibit the ANS. ANS drugs affect only specific organs and not the whole body.

- Drug effects depend on the branch of the ANS involved. - Medications can either stimulate or inhibit the ANS.

A 75-year-old client is diagnosed with COPD. The health care provider orders an adrenergic bronchodilator via inhaler and a spacer. What are the main risks associated with the drug for this client? (Select all that apply.)

- Excessive cardiac stimulation - CNS stimulation

The client is post-surgical and is receiving opioid analgesics for pain management. The nurse should encourage the client to do which? Select all that apply. - Get out of bed (e.g., ambulation) - Cough/deep breathing every two hours - Remaining supine in semi-Fowler's position - Keeping the lights dim to prevent eye strain - Limiting fluid intake

- Get out of bed (e.g., ambulation) - Cough/deep breathing every two hours

The nurse administers a medication that stimulates the parasympathetic nervous system (PNS). What manifestation(s) would indicate the medication is having the desired effect? Select all that apply. urinary incontinence constricted pupils hyperactive bowel sounds increased saliva production elevated heart rate

- constricted pupils - hyperactive bowel sounds - increased saliva production

Which of the following effects might occur following the administration of a cholinergic drug? Absorption of nitrous oxide by the endothelium of blood vessels Pupil dilation Decreased heart rate Constriction of blood vessels in the skin

- decreased heart rate

A client has been administered phenylephrine, a medication that affects alpha1-receptors. The nurse should anticipate what effects on the client? Select all that apply. decreased blood glucose pupil dilation drowsiness increased blood pressure flushed skin

- pupil dilation - increased blood pressure

The nurse is assessing a client who has urinary hesitation and occasional overflow incontinence. What adrenergic receptors may be overstimulated in this client? Alpha-2 Beta-2 Beta-1 Alpha-1

Alpha-1

A client with chronic bronchial asthma is prescribed montelukast. What will the nurse instruct the client to avoid taking?

Aspirin

A client with a diagnosis of asthma has been prescribed ipratropium 2 puffs QID. What is the most likely goal of this treatment?

Promoting long-term management of asthma symptoms

The nurse is caring for a client in the emergency department who is experiencing status epilepticus. The client's electronic medical record reveals a recent diagnosis of tonic-clonic seizures and prescription for phenytoin. What is the priority action? Obtain phenytoin level. Provide lorazepam IV push. Provide phenytoin IV. Assess length of seizure.

Provide lorazepam IV push.

When describing the parasympathetic nervous system to a group of students, which substance would the nursing instructor discuss as being responsible for transmission of nerve impulses across this system?

acetylcholine

Common side effects of anticholinergics include...

dry mouth, urinary retention, constipation, and increased pulse rate.

A client with allergies has expressed interest in taking pseudoephedrine for seasonal allergies. What client condition would most strongly lead the nurse to caution against taking the drug?

h/o severe hypertension

A client is admitted to the emergency department for an opioid overdose. What would the nurse expect to administer to this client?

naloxone/Narcan

The nurse has completed a teaching with a client prescribed phenytoin daily for seizure activity. The nurse determines the session is successful after the client correctly chooses which potential adverse reaction that can occur if the client misses a dose of medication?

reoccurrence of seizures