Pharmacology Final Exam

A patient who is taking NSAIDs for arthritis complains of persistent heartburn. What further question(s) should the nurse ask the patient about heartburn? (Select all that apply)

"Do you take your medications with food?" "Have you noticed a change in the color of your bowel movements?" "What dosage of the NSAID are you taking?" "Where is your heartburn located?

The clinic nurse is reviewing medication instructions with a patient taking Nicorette gum 2 mg for smoking cessation. Which statement by the patient indicates a need for further teaching by the nurse?

"I can continue to smoke a cigarette once in a while when taking this drug."

A client newly diagnosed with bipolar disorder was prescribed with lithium meds. While giving the health teaching the client keeps asking about why there is a need for frequent blood works. Which of the following statement of the nurse addressing the client's question is true:

"It will help determine if the medication dosage is still within the therapeutic level"

The nurse is preparing to begin giving phenobarbital, which is known to induce CYP isozymes, to a patient on oral contraceptives. What patient teaching will the nurse expect to provide for this patient?

"Plan to use another form of birth control while taking phenobarbital."

The client diagnosed with a major depressive disorder asks the nurse, "Why did my psychiatrist prescribe an SSRI medication rather than one of the other types of anti-depressants?" Which statement by the nurse would be most appropriate?

"SSRIs have fewer side effects than the other classifications"

When comparing benzodiazepines to barbiturates, the nurse identifies which statements about benzodiazepines as true? (Select all that apply.)

A. Benzodiazepines have a high safety profile. D. Benzodiazepines have a low ability to cause tolerance. E. Benzodiazepines have a low abuse potential.

A nurse is caring for a patient who is taking digoxin. The nurse has to be careful when administering this drug due to the narrow therapeutic window. What is therapeutic window range?

0.5-2ng/ml

A nurse is preparing to administer 0.9% sodium chloride 1L IV to infuse over 8 hours. The nurse should set the IV infusion pump to deliver how many mL/hr?

125 mL/hr

A patient is taking an Anti-SARS-CoV-2 monoclonal antibody called Bebtelovimab. How should the IV injection be administered?

175 mg over at least 30 seconds

A nurse is preparing to administer famotidine 40 mg PO at bedtime. Available is famotitdine 20 mg tablet. How many tablets should the nurse administer?

2

__ symptoms must be present in children in order to be diagnosed with ADHD and __ symptoms in patients 18 years or older. These symptoms have to persist for __ months before being diagnosed.

6, 5, 6

When caring for a client for who is taking CYP3A4 inducers (like Rifampin) it is important to know that it may cause a roughly _____% reduction in serum concentrations of CYP3A4 substrates.

90%

Your patient is having a phacoemulsification for treatment of a cataract. You're providing education to the patient about the procedure. Which statement by the patient demonstrates he understood the educational material provided about this procedure?*

A. "The cloudy lens in my eye will be broken up with sound waves and removed. Then a new permanent lens, called an intraocular lens, will be placed in my eye."

What are the four types of biochemical processes that medications may go through?

Absorption Distribution Excretion Metabolize

Which of the following over-the-counter analgesics is one of the most common causes of liver failure in the United States?

Acetaminophen

Which of the following is not true about Heparin

Activates aggregation of platelets

A 65 year old male client is being discharged from a hospital on warfarin therapy for chronic atrial fibrillation. The nurse is aware that the discharge teaching needs to include which of the following instructions?

Alcohol should be limited to no more 1-2 servings on occasional basis

You are instructing a client who has multiple sclerosis about how dantrolene will help control spasticity. With which mechanism is this drug effective in treating this manifestation?

Alters intracellular calcium exchange at the muscles

A patient undergoing chemotherapy is taking cisplatin which can cause kidney damage especially with long-term use. The nurse remembers there is a drug that is used in combination with cisplatin to prevent kidney damage. What should the nurse administer to prevent kidney damage?

Amifostine

A patient who falls in the Advanced Cardiac Life Support category needs to go on antiarrhythmics. The nurse remembers there is a preferred drug for this patient's medical status. What drug should the nurse administer?

Amiodarone

The nursing student learns that not all drugs produce effects binding to a receptor. Which drugs do not act through receptors?

Antacids

The nurse is preparing to give a drug that will prevent receptor activation. Which term would describe this drug?

Antagonist

Which one of the following drugs or drug classes are not used in the acute treatment of migraine headaches?

Antidepressants

After reviewing a patient's medical history, the nurse notices the patient has compromised renal function. Which paralytic should NOT be administered to the patient?

Atracurium

A nurse is educating her patient on their newly prescribed medication, Levodopa. Which statements should she include in the patient teaching: (select all that apply)

Avoid a high-protein diet Carbidopa is typically prescribed along with Levodopa Carbidopa increases the amount of levodopa in the CNS

A nurse has a patient who was newly prescribed with muscle relaxants. It is important to educate the client:

Avoid activities that require alertness, such as driving

You are taking care of a client who was taking Oseltamivir (a neuraminidase inhibitor) to prevent influenza from budding from the host cell to infect other cells. It is important to remind your patient of what clinical manifestation?

Can cause GI disturbance if the drug is not taken with food

Levodopa is not as effective in Parkinson Disease patients. What other drug in combined with it to create Sinemet?

Carbidopa

Stacy takes her baby into the pediatrician and is concerned that her baby has pneumonia. When talking with the doctor, it was confirmed that her baby does have pneumonia. Which of the following antibiotics should the doctor NOT prescribe due to the side effect of biliary sludging?

Ceftriaxone

Stacy takes her baby to the pediatrician and is concerned that her baby has pneumonia. When talking with the doctor, it was confirmed that her baby does have pneumonia. Which of the following antibiotics should the doctor NOT prescribe due to the side effect of biliary sludging?

Ceftriaxone

Katie is a 19 year old volleyball player. At her recent doctor's visit, MRSA was found. What type of antibiotic is specialized to treat MRSA?

Cephalosporins

Katie is a 19 year old volleyball player. At her recent doctors visit, MRSA was found. What type of antibiotic is specialized to treat MRSA?

Cephalosporins

A patient who is receiving ibuprofen asks the nurse, "What should I take the drug with?" Which of the following would the nurse suggest in the response? Select all that apply.

Milk Food Antacids

Which of the following birth control methods protect against STIs?

Condom

Which of the following is not a type of treatment the nurse would see on a patient's chart for the treatment of osteoporosis?

DMARDs

A nurse with a client taking alendronate should explain to the client that alendronate increases the bone mass by which of the following actions?

Decreases activity of osteoclasts

Combination oral contraceptives should be used with caution in clients with which of the following disorders?

Diabetes

After administering a paralytic, what is the first muscle you can expect to recover first?

Diaphragm

Which of the following drugs is used for alcohol use disorder (AUD)?

Disulfiram

You are about to administer ondansetron to a client to prevent anesthesia- induced nausea and vomiting. You prepare to monitor the client for which adverse effects?

Dizziness

You're treating a patient who has been diagnosed with eosinophilic asthma. What is the best medication used to treat this type of asthma

Dupilumab

A nurse checks the lithium level of a 28 year old patient that has been prescribed lithium citrate and sees the level is 1.5 mEq/L, and varies that the patient has not taken more than the prescribed medication. The nurse advises the client to?

Eat salty foods

You are a nurse who is giving a patient Magnesium Sulfate, while monitoring them you should do which of the following? (Select all that apply)

Monitor deep tendon reflexes Assure urine output <20 mL/hour c. Always administer by IV infusion via an infusion monitoring device Keep calcium gluconate readily available in case of overdose

A nurse has a patient come in with mental fog and nauseas, after a few tests she understands that it is opioids. What is the antidote that the nurse would give for opioids?

Naloxone (Narcan)

You are caring for a client who is taking Alprazolam (Xanax) to treat panic attacks. Since Alprazolam is a CYPSA4 substrate when combined with a CYP3A4 inhibitor what potentially serious toxicity could arise?

Excessive CNS depression

A client is about to start taking sulfasalazine to treat inflammatory bowel disease. You should instruct the client to watch for and report which of the following adverse reactions? (Select all that apply)

Fever

Which of the following symptoms would occur in a client with a detached retina?

Flashing lights and floaters

As a nurse you are caring for a patient who is going to be taking iron supplements. What should you warn the patient of before sending them home?

Harmless dark green or black color stool

A patient is diagnosed with Rheumatoid Arthritis, but the first line is Methotrexate. What are some tests that will need to be done before Methotrexate can be prescribed? (Select all that apply)

Hepatitis B Hepatitis C Renal Impairment

A nurse is prescribing their patient who is anemic to take an oral medicine called Ferrous sulfate. The nurse should inform the patient to consume what food products to better absorb the medicine?

High acidic food products (orange juice)

Your patient is put on phenelzine(Nardil). Which comment by your patient indicates the need for further teaching:

I can still eat my favorite food-pepperoni pizza.

Carbidopa-levodopa is prescribed for a pt with Parkinson's. The nurse monitors for which adverse/side effect?

Impaired voluntary movements

The nurse must teach clients and their families to monitor for an often-fatal side effect of antipsychotic medications characterized by muscular rigidity, high fever, leukocytosis, and increased production of muscle enzymes. This side effect is:

Neuroleptic malignant syndrome(NMS)

The client with a major depressive disorder taking the selective serotonin reuptake inhibitor (SSRI) fluoxetine (Prozac) calls the psychiatric clinic and reports feeling confused and restless and having an elevated temperature. Which action should the psychiatric nurse take?

Instruct the client to stop taking the SSRI

A 45 year old female asks the nurse what the fastest route of drug administration is for her. The nurse responds with:

Intravenous route of administration

The nurse is preparing to administer a drug with a high therapeutic index. What does this mean about the drug?

It is relatively safe

Which statement indicates the development of opioid tolerance?

Larger doses of opioids are needed to control pain, as compared to several weeks earlier.

A nursing instructor is teaching a class about the use of NSAIDs and interactions with other drugs. The instructor should emphasize that the effects of which of the following can increase with NSAID therapy? Select all that apply.

Lithium Cyclosporine Phenytoin

The doctor prescribed Phenobarbital as a sleep aid for your patient. You believe that they are showing signs of overdose. Overdose symptoms for barbiturates are: (select all that apply)

Loss of consciousness Tachycardia Low and shallow respirations

When taking a TNF, what is the best drug to take with it to add more beneficial effects to people with Rheumatoid Arthritis?

Methotrexate

A patient is taking taxanes, a class of anti-cancer drugs. The nurse remembers this class of drugs crosses the BBB, what adverse effect does the nurse need to keep in mind when administering this drug class?

Neurotoxicity

Which drug should a nurse use to treat coronary artery disease that is quick-acting and relaxes smooth muscle?

Nitrates

Which of the following drugs should the nurse recognize are centrally acting skeletal muscle relaxants? (select all that apply)

Orphenadrine Tizanidine

You are caring for a client who is taking exenatide (Byetta) to treat type 2 diabetes mellitus. The client reports severe abdominal pain. You suspect which of the following adverse reactions to this drug?

Pancreatitis

A client is prescribed clomiphene for infertility. The nurse should instruct the patient to monitor which of the following?

Pelvic Pain

The nurse working with a client who is started on Clozaril (clozapine) will include what in the teaching plan?

Plan for weekly CBCs to monitor for a drop in the white cell count.

The nurse should instruct a breast-feeding mother that the best way to prevent mastitis is to do which of the following?

Prevent nipple fissures by carefully positioning the infant during feedings. Remove the infant from the breast by inserting a finger in his mouth to break the suction.

The nurse is reviewing the medication history of a patient taking butabarbital (Butisol) for the treatment of insomnia. Which other medication prescribed for this patient would be cause for concern?

Propranolol (Inderal)

A nurse has a patient who is experiencing Respiratory Depression, the most serious adverse reaction of opioids, what are signs that the nurse would see to know to stop the medication? (select all that apply)

RR < 12 If the client is unarousable Falls asleep mid sentence

A patient is prescribed lamotrigine for control of their seizures. What symptom should cause an immediate discontinuation of the drug?

Rash

Serotonin receptor agonists (triptans) are available in all of the following dosage forms Except:

Rectal suppository

The drug the nurse is about to give induces P-glycoprotein (PGP). What outcome might the nurse expect when this drug is given with other drugs?

Reduced absorption of other drugs

A 9-year-old child has been prescribed with lithium as a mood stabilizer. His lab results shows his lithium level of 1.5 mmol/L. The priority nursing diagnosis for this child should be:

Risk for Aspiration

A patient comes in and is experiencing rigid tremors and are concerned it may be Parkinson Disease. What are some tests, as the medical professional, that you can do to determine physically that they may have Parkinson's? (Select all that apply)

Romberg Test Pull Test Push Test

In which situation would benzodiazepines be prescribed appropriately?

Short-term treatment of generalized anxiety disorder, alcohol withdrawal, and preoperative sedation.

You have a pregnant patient that is taking Terbutaline (also known as Brethine) due to the risk of preterm labor, your patient should be warned about which of the following side effects? (Select all that apply)

Tachycardia Angina

A client is about to start taking sustained release glipizide to treat type 2 diabetes mellitus. Which of the following instructions should you include when talking with the client about taking this drug?

Take it once a day, 30 min before breakfast

Varenicline (Chantix) is prescribed for a middle-aged client for smoking cessation. What is a priority nursing action for this client?

Tell the client that nausea and vomiting are likely with this drug.

A client diagnosed with generalized anxiety disorder is placed on clonazepam (Klonopin) and buspirone (BuSpar). Which client statement indicates teaching has been effective?

The client verbalizes that clonazepam (Klonopin) is to be used short-term until the buspirone (BuSpar) takes full effect.

Which assessment finding in a patient taking a sedative for insomnia concerns the nurse?

The patient has a decreased ability to perform activities of daily living.

The clinic nurse is preparing to test the visual acuity of a client using a Snellen chart. Which of the following identifies the accurate procedure for this visual acuity test?

The right eye is tested followed by the left eye, and then both eyes are tested.

Prolonged alcohol abuse can result in a severe deficiency in what vitamin?

Thiamine (B1)

Which laboratory tests should you monitor for a client who is taking interferon beta-1b to treat multiple sclerosis? (Select all that apply)

Thyroid hormones Liver function CBC

Your patient on lorazepam feels that their anxiety is getting worse, after being on the medication for over a year. This is probably due to:

Tolerance

You are caring for a client who takes acarbose (Precose) and a sulfonylurea to treat type 2 diabetes mellitus. Which of the following is an indication of an adverse reaction to this drug combination?

Tremors

The health care provider administers oxytocin for induction of labor. The nurse should monitor for which of the following in order to assess for an adverse reaction? (Select all apply)

Urine output Blood pressure Duration of contractions Fetal heart rate

A nurse needs to administer a prescribed injection to a toddler. Which of the following injection sites is most suitable for the client?

Vastus lateralis sits

A Nurse is caring for a client in need of treatment for their NSTEMI heart attack. Which of the following are the main calcium-channel blockers used?

Verapamil and diltiazem

A patient is prescribed valproate for focal seizures. What side effects should the nurse warn them about? (Select all that apply.)

Weight Gain Upset Stomach Hair Loss

A client is prescribed testosterone to treat testicular failure. The nurse tells the client to monitor and report which of the following?

Weight gain

You are instructing a 10 year old males guardians about the use of amphetamine-dextroamphetamine to manage the child's attention deficit/hyperactivity disorder. Which clinical manifestations should you instruct the parents to report? (Select all that apply.)

Weight loss Insomnia Hallucinations

A nurse is planning care for a client who has a new prescription for methotrexate. The nurse should plan to monitor the client for which of the following adverse effects?

a. bone marrow depression

After reviewing information about antihyperlipidemic drugs, a group of nursing students demonstrate understanding of the information when they identify which of the following as a fibrin acid derivative (vibrate)

b) gemfibrozil (Lopid)

A patient who recently started therapy with an HMG-COA reductase inhibitor asks the nurse, "How long will it take until I see an effect on my LDL cholesterol?" The nurse gives which correct answer?

b. "A reduction usually is seen within 2 weeks."

An adult pt has been taking drug A that is metabolized by the cytochrome P450 system. He has been on this med for 6 months. At this time he is started on a second med Drug B, that is an inducer of the cytochrome P450 system. You should monitor this pt for:

decreased therapeutic effects of Drug A

A nurse is teaching a client about calcitonin-salmon intra nasal spray to treat osteoporosis. Which of the following information should the nurse include? (select all that apply)

report rash or itching prime the pump before the first dose report nasal irritation

What are the symptoms of malignant hyperthermia?

tachypnea tachycardia muscular rigidity

During discharge instruction, a nurse wants to assess a patient's understanding of treatment with cholestyramine (Questran). Which statement made by the patient best demonstrates a need for additional teaching?

c. "I will weigh myself weekly."

Which body functions are affected last after administering an anesthetic drug? Select all that apply.

cardiac function pulmonary function