QUESTION BANK TEST #2 PHARMACOLOGY

The client states, "I've never had such trouble breathing. What is a pulmonary embolus anyway?" What is the best nursing response?

"A pulmonary embolus is a portion of a blood clot that has moved from its original location to your lung."

The NP orders a thyroid panel for a patient on amiodarone. The patient tells the NP that he does not have thyroid disease and wants to know why the test is ordered. Which is a correct response?

"Amiodarone inhibits an enzyme that is important in making thyroid hormone and can cause hypothyroidism."

The nurse is providing teaching to a patient taking an oral tetracycline antibiotic. Which statement by the nurse is correct?

"Avoid direct sunlight and tanning beds while on this medication."

A patient who is diagnosed with genital herpes is taking topical acyclovir. The nurse will provide which teaching for this patient? (Select all that apply.)

"Be sure to wash your hands thoroughly before and after applying this medicine." "Use a clean glove when applying this ointment." "You will need to avoid touching the area around your eyes." "You will have to practice abstinence when these lesions are active."

During drug therapy with a tetracycline antibiotic, a patient complains of some nausea and decreased appetite. Which statement is the nurse's best advice to the patient?

"Drink a full glass of water with each dose."

Art is a 55-year-old smoker who has been diagnosed with angina and placed on nitrates. He complains of headaches after using his nitrate. An appropriate reply might be:

"Headaches are common side effects with these drugs. How severe are they?"

A clinic nurse is developing a teaching handout for clients who are prescribed warfarin (Coumadin) therapy. Which statement should be included in this information? Select all that apply.

"Tell your dentist you are taking warfarin prior to any procedures."

Breastfed infants should receive iron supplementation of:

1 mg/kg per day

The treatment of vitamin B12 deficiency is:

1,000 mcg daily of oral cobalamin

Whart is the peak onset age of Psoriasis

16-22 57-60

Premature infants require iron supplementation with:

2 mg/kg per day until age 12 months

patient will be receiving amoxicillin suspension 300 mg via a gastrostomy tube every 8 hours. The medication comes in a bottle that contains 400 mg/5 mL. How many milliliters will the nurse administer with each dose? (Record answer using one decimal place.)

3.8 mL 400 mg : 5 mL :: 300 mg : x mL Solve for x: (400 × x) = (5 × 300); 400x = 1500; x = 3.75, rounding to 3.8; administer 3.8 mL

Caffeine, exercise, and smoking should be avoided for at least how long before blood pressure measurement?

30 minutes

Valerie presents to clinic with menorrhagia. Her hemoglobin is 10.2 and her ferritin is 15 ng/mL. Initial treatment for her anemia would be:

325 mg ferrous sulfate TID

Chee is a 15-month-old male whose screening hemoglobin is 10.4 g/dL. Treatment for his anemia would be:

6 mg/kg/day of elemental iron

The length of treatment for sinusitis should be:

7 days beyond when symptoms cease

Allie has just had her pregnancy confirmed and is asking about how to ensure a healthy baby. What is the folic acid requirement during pregnancy?

800 mcg/day

Assessment for deep vein thrombosis (DVT) is a priority for which client?

A client recovering from a knee replacement

The nurse is addressing a group of clients who have experienced thromboembolic disorders. One of the clients states, "My dad had a problem with clotting too much and so does my brother." Before responding to this comment, the nurse considers which information?

A genetic deficiency of protein C can produce hypercoagulability.

When choosing a topical corticosteroid cream to treat diaper dermatitis, the ideal medication would be:

A low potency corticosteroid cream applied sparingly (hydrocortisone 1%)

Joanne is a 60 year old with an LDL of 132 and a family history of coronary artery disease. She has already tried diet changes (increased fiber and plant sterols) to lower her LDL and after 6 months her LDL is slightly higher. The next step in her treatment would be:

A statin

The nurse is planning a teaching session for a client newly diagnosed with hemophilia A. Which information should be included?

A substance that is part of the clotting process is missing.

Angina is produced by an imbalance between oxygen supply (MOS) and demand (MOD) in the myocardium. Which of the following drugs help to correct this imbalance by increasing MOS?

ACE inhibitors

Heart failure is a leading cause of death and hospitalization in older adults (greater than 65 years old). The drug of choice for this population is:

ACE inhibitors

Patients who have angina, regardless of Class, who are also diabetic, should be on:

ACE inhibitors

Increased life expectancy for patients with heart failure has been associated with the use of:

ACE inhibitors, especially when started early in the disease process

Drug concentration is important for the eradication of bacterial infection. It is desired to keep the drug dose:

Above minimum effective concentration

The client has been ordered to be treated with amoxicillin. The highest priority instruction that the nurse should give the client related to diet while on the medication is to avoid:

Acidic fruits and juices

A client is receiving intermittent intravenous heparin therapy to treat deep vein thrombosis (DVT). Which laboratory value should the nurse review prior to administering this medication?

Activated partial thromboplastin time (APTT)

ACE inhibitors are a central part of the treatment of heart failure because they have more than one action to address the pathological changes in this disorder. Which of the following pathological changes in heart failure is NOT addressed by ACE inhibitors?

Activation of the sympathetic nervous system that increases heart rate and preload.

The client has been ordered treatment with Wycillin. The nurse notes that the solution is milky in color. What is the highest priority action on the part of the nurse?

Administer the medication as ordered by the physician

he baseline international normalized ratio (INR) of a client started on warfarin (Coumadin) for atrial fibrillation was A.B. The nurse notes that the INR value is B.5 prior to administration of the next dose of medication. What should the nurse do?

Administer the medication as ordered.

Lifestyle modifications for patients with prehypertension or hypertension include:

Adopt the DASH diet

All patients with hypertension benefit from diuretic therapy, but those who benefit the most are:

African Americans

Vanessa has been diagnosed with scabies. Her education would include:

All member of the household and close personal contacts should be treated

Jaheem is a 10 year old with sinusitis. Treatment for a child with sinusitis

Amoxicillin

Myles is a 2 year old who has been diagnosed with acute otitis media. He is afebrile and has not been treated with antibiotics recently. First-line treatment for his otitis media would include:

Amoxicillin

Jacob has been diagnosed with sinusitis. He is the parent of a child in daycare. Treatment for sinusitis in an adult who has a child in daycare is:

Amoxicillin 1 gram QID

Digoxin has a very limited role in treatment of heart failure. It is used mainly for patients with:

An audible S3

Which class of drugs would the nurse expect to be administered to a client who is bleeding excessively at a surgical site?

Antifibrinolytics

A child that may warrant "watchful waiting" instead of prescribing an antibiotic for acute otitis media includes patients who:

Are low risk with temperature less than 39oC or 102.2oF Have reliable parents with transportation Are older than age 2 years

Beta blockers are especially helpful for patients with exertional angina who also have:

Arrythmias

To reduce mortality, all patients with angina, regardless of Class, should be on:

Aspirin 81 to 325 mg/d

Patient teaching related to amlodipine includes:

Avoid grapefruit juice as it affects the metabolism of this drug.

The client has been ordered Cefazolin. The nurse anticipates an increase in the client's _____ from this medication?

BUN and serum creatinine

A topical corticosteroid may be used to treat facial eczema. What instruction must be given to a patient for whom a topical corticosteroid is prescribed for treatment of facial eczema?

Be careful not to get any of the medications in your eyes

Serum digoxin levels are monitored for potential toxicity. Monitoring should occur:

Because a reference point is needed in adjusting a dose

The nurse is preparing an infusion of amphotericin B for a patient who has a severe fungal infection. Which intervention is appropriate regarding the potential adverse effects of amphotericin B?

Before beginning the infusion, administering an antipyretic and an antiemetic drug

Catherine has head lice and her mother is asking about what products are available that are not neurotoxic. The only non-neurotoxin head lice treatment is:

Benzoyl alcohol (Ulesfia)

ACE inhibitors are contraindicated in pregnancy. While treatment of heart failure during pregnancy is best done by a specialist, which of the following drug classes are considered to be safe, at least in the later parts of pregnancy?

Beta Blockers

Kamie is a 34-year-old pregnant woman with familial hyperlipidemia and elevated LDL levels. What is the appropriate treatment for a pregnant woman?

Bile acid-binding resins

Most beta-lactam antibiotics are excreted through the kidneys. The nurse should assess the client's renal function by monitoring which levels?

Blood urea nitrogen and serum creatinine

Prescription of timolol maleate can result in several serious adverse reactions. Select the condition that is considered to be a common side effect of treatment with timolol maleate.

Blurred vision

Which of the following classes of drugs is contraindicated in heart failure?

CCB

When reviewing the allergy history of a patient, the nurse notes that the patient is allergic to penicillin. Based on this finding, the nurse would question an order for which class of antibiotics?

Cephalosporins

Alyssa is a 15 month old who has been on amoxicillin for 2 days for acute otitis media. She is still febrile and there is no change in her tympanic membrane examination. What would be the plan of care for her?

Change the antibiotic to amoxicillin/clavulanate.

First-line therapy for a patient with acute otitis externa (swimmer's ear) and an intact tympanic membrane includes:

Ciprofloxacin and hydrocortisone drops

The New York Heart Association and the Canadian Cardiovascular Society have described grading criteria for levels of angina. Angina that occurs with unusually strenuous activity or on walking or climbing stair after meals is:

Class II

Patients at high risk for developing significant coronary heart disease are those with:

Class II angina

Before starting therapy with a statin, the following baseline laboratory values should be evaluated:

Complete blood count Liver function (ALT/AST) and CK C-reactive protein

A patient is receiving cidofovir (Vistide) as part of treatment for a viral infection, and the nurse is preparing to administer probenecid, which is also ordered. Which is the rationale for administering probenecid along with the cidofovir treatment?

Concurrent drug therapy with probenecid reduces the nephrotoxicity of the cidofovir.

Drug choices to treat angina in older adults differ from those of younger adults only in:

Consideration of risk factors for diseases associated with and increased in aging

Phil is a 54-year-old male with multiple risk factors who has been on a high dose statin for 3 months to treat his high LDL level. His LDL is 135 mg/dL and his triglycerides are elevated. A reasonable change in therapy would be to:

Continue the statin and add in ezetimibe

When considering which cholesterol-lowering drug to prescribe which factor determines the type and intensity of treatment?

Coronary artery disease risk level

The client has been ordered treatment with Cefaclor as well as erythromycin. The nurse anticipates what effect from the interaction of the medications?

Decreased action of Cefaclor

The nurse is monitoring for therapeutic results of antibiotic therapy in a patient with an infection. Which laboratory value would indicate therapeutic effectiveness of this therapy?

Decreased white blood cell count

Jacob has hypertension for which a calcium channel blocker has been prescribed. This drug helps control blood pressure because it:

Decreases the amount of calcium inside the cell

Because primary hypertension has no identifiable cause, treatment is based on interfering with the physiological mechanisms that regulate blood pressure. Thiazide diuretics treat hypertension because they:

Deplete body sodium and reduce fluid volume

Sharlene is a 65 year old who has been on a lipid-lowering diet and using plant sterol margarine daily for the past 3 months. Her LDL is 135 mg/dL. An appropriate treatment for her would be:

Determined by her risk factors

The nurse is preparing to use an antiseptic. Which statement is correct regarding how antiseptics differ from disinfectants?

Disinfectants are used only on nonliving objects to destroy organisms.

If not chosen as the first drug in hypertension treatment, which drug class should be added as second step because it will enhance the effects of most other agents?

Diuretics

Stage C patients usually require a combination of three to four drugs to manage their heart failure. In addition to ACE inhibitors and beta blockers, diuretics may be added. Which of the following statements about diuretics is NOT true?

Diuretics from the potassium-sparing class should be used when using an ARB

Despite good blood pressure control, a NP might change a patient's drug from an ACEI to an angiotensin II receptor blocker (ARB) because the ARB:

Does not produce a dry, hacky cough

Which of the following is true about procainamide and its dosing schedule?

Doses of this drug should be taken evenly spaced around the clock to keep an even blood level.

A client's medication warrants peak and trough levels to be drawn. The nurse is aware that if the peak level of the drug is too high, what could occur?

Drug toxicity

Treatments for heart failure, including drug therapy, are based on the stages developed by the ACC/AHA. Stage A patients are treated with:

Drugs for hypertension and hyperlipidemia, if they exist

Which of the following adverse effects may occur due to a dihydropyridine-type calcium channel blocker?

Edema of the hands and feet

A patient with psoriasis needs to apply a lubricating lotion to a psoriatic plaque. The health provider recommends which of the following types of substances?

Emollient

Anemia due to chronic renal failure is treated with:

Epoetin alfa (epogen)

The Centers for Disease Control recommends all newborn infants receive prophylactic administration of ____ within 1 hour of birth.

Erythromycin ophthalmic ointment

Which of the following drugs has been associated with increased risk for myocardial infarction (MI) in women?

Estrogen replacement

Which situation shows appropriate use of an ophthalmic anesthetic for a patient with eye pain?

Facilitation of examination of the eye

Monitoring of a patient who is on a lipid-lowering drug includes:

Fasting total cholesterol every 6 months Lipid profile with attention to serum LDL 6 to 8 weeks after starting therapy then again in 6 weeks Complete blood count, CRP, and ESR after 6 weeks of therapy

Treatment costs are important for patients with hypertension. Which of the following statements about cost is NOT true?

Few antihypertensive drugs come in generic formulations.

Han is a 48-year-old diabetic with hyperlipidemia and high triglycerides. His LDL is 112 mg/dL and he has not tolerated statins. He warrants a trial of a:

Fibric acid derivative

The nurse is reviewing the sputum culture results of a patient with pneumonia and notes that the patient has a gram-positive infection. Which generation of cephalosporin is most appropriate for this type of infection?

First-generation

patient with an eye injury requires an ocular examination to detect the presence of a foreign body. Which drug would a health care provider expect to be of most use in this examination?

Fluorocaine

Cost of antianginal drug therapy should be considered in drug selection because of all of the following EXCEPT:

Generic formulations mat be cheaper but are rarely bioequivalent

Group I topical corticosteroids may cause adverse reactions. A patient who is being treated with a group I topical corticosteroid must be closely monitored for

HPA supression

Five questions should be asked during the follow up of any angina patient. They include:

Has the level of physical activity associated with the angina changed since the last visit?

Tobie presents to clinic with moderate acne. He has been using OTC benzoyl peroxide at home with minimal improvement. A topical antibiotic (clindamycin) and a topical retinoid adapalene (Differin) are prescribed. Education of Tobie would include:

He may see an initial worsening of his acne that will improve in 6 to 8 weeks

David presents to clinic with symptoms of allergic conjunctivitis. He is prescribed cromolyn sodium (Opticrom) eye drops. The education regarding using cromolyn eye drops includes:

He should not wear his soft contacts while using the cromolyn eye drops

Nitrates are especially helpful for patients with angina who also have:

Heart Failure Hypertension

Patients who are being treated for folate deficiency require monitoring of:

Hematocrit and hemoglobin at 1 week and then at 8 weeks

Monitoring for a patient taking iron to treat iron deficiency anemia is:

Hemoglobin, hematocrit, and ferritin 4 weeks after treatment is started

The topical antiviral drug acyclovir (Zovirax) is used to treat several different conditions. Which of the following conditions is an unlabeled use for acyclovir (Zovirax)?

Herpes labialis

Conjunctivitis in a child that is accompanied by acute otitis media is treated with:

High-dose oral amoxicillin

Patients who are treated with greater than 100 grams per week of topical calcipotriene for psoriasis need to be monitored for:

Hypercalcemia

When starting a patient on a statin, education would include:

If they stop the medication their lipid levels will return to pre-treatment levels Medication is a supplement to diet therapy and exercise If they have any muscle aches or pain, they should contact their provider

Valerie has been prescribed iron to treat her anemia. Education of patients prescribed iron would include:

Increase fluids and fiber to treat constipation

The patient is suffering from glaucoma and is scheduled to begin treatment with carbachol (Carboptic). The health care provider knows to monitor the patient closely for evidence of which effect of the drug?

Increased outflow of aqueous humor

Mike is a 47 year old who has been on standard dose atorvastatin for 3 months and his repeat LDL is 124 mg/dL. He is a smoker and has a strong family history of cardiovascular disease. His treatment plan would include reinforcing diet, exercise, plant sterol intake, and:

Increasing his dose of atorvastatin

The nurse is administering intravenous acyclovir (Zovirax) to a patient with a viral infection. Which administration technique is correct?

Infuse intravenous acyclovir slowly, over at least 1 hour.

A client at an outpatient clinic is ordered to receive ampicillin (Omnipen) for an infection. Which nursing intervention related to penicillins would the nurse question?

Instruct client to discontinue penicillin when temperature is normal.

Appropriate initial treatment for psoriasis would be:

Intermittent therapy with intermediate potency topical corticosteroids

A nurse is caring for a patient who is on amphotericin B. On morning rounds the patient reports weakness, numbness, and a tingling sensation in his feet. What would be a priority action by the nurse?

Keep the bed in a low position and the side rails up at all times.

First-line therapy for hyperlipidemia is:

Lifestyle changes

Lack of adherence to blood pressure management is very common. Reasons for this lack of adherence include:

Lifestyle changes are difficult to achieve and maintain Adverse drug reactions are common and often fall into the categories more associated with nonadherence Costs of drugs and monitoring with labs can be expensive

Disease states in addition to hypertension in which beta blockade is a compelling indication for the use of beta blockers include:

MI

One of the three types of heart failure involves systolic dysfunction. Potential causes of this most common form of heart failure include:

Myocardial ischemia and injury secondary to myocardial infarction

Rose is a 3 year old with an upper respiratory infection (URI). Treatment for her URI would include:

Nasal saline spray

A client is ordered to receive a cephalosporin to treat a bacterial infection. Regarding monitoring of the client, the highest priority action on the part of the nurse includes assessing the client for which side effects?

Nausea, vomiting and diarrhea

Larry has heart failure which is being treated with digoxin because it exhibits:

Netiher Negative inotropism Positive chronotropism

Scott is presenting for follow up on his lipid panel. He had elevated total cholesterol, triglycerides, and an LDL of 122 mg/dL. He has already implemented diet changes and increased physical activity. He has mildly elevated liver studies. An appropriate next step for therapy would be:

Niacin (Niaspan)

Isosorbide dinitrate is a long-acting nitrate given BID. The schedule for administration is 7 AM and 2 PM because:

Nitrate tolerance can develop

Isosorbide dinitrate is prescribed for a patient with chronic stable angina. This drug is administered twice daily, but the schedule is 7 AM and 2 PM because:

Nitrate tolerance can develop

Combinations of a long-acting nitrate and a beta blocker are especially effective in treating angina because:

Nitrates increase MOS and beta blockers increase MOD Their additive affects permit lower doses of both drugs and their adverse reactions cancel each other out. They address the pathology of patients with exertional angina who have fixed atherosclerotic coronary heart disease

An ACE inhibitor and what other class of drug may reduce proteinuria in patients with diabetes better than either drug alone?

Nondihydropyridine calcium channel blockers

client with otitis media is ordered to receive amoxicillin (Amoxil). The client discloses to the nurse that she is allergic to penicillin. What is the highest priority action on the part of the nurse?

Notify healthcare

A client has been receiving a cephalosporin for 20 days to treat a severe bacterial infection. The client complains of mouth pain, and the nurse assesses white patches in the client's mouth. What is the highest priority action on the part of the nurse?

Notify the physician and describe symptoms

Kyle has Crohn's disease and has a documented folate deficiency. Drug therapy for folate deficiency anemia is:

Oral folic acid 1-2 mg per day

Which drug would a health care provider recommend to a patient who complains of dry eyes?

Polyvinyl alcohol (Hypotears)

Because of its action on various body systems, the patient taking a thiazide or loop diuretic may also need to receive:

Potassium supplements

Which of the following cardiac arrhythmias would not be amenable to treatment with digoxin (Lanoxin)?

Premature ventricular contractions

A patient will be having oral surgery and has received an antibiotic to take for 1 week before the surgery. The nurse knows that this is an example of which type of therapy?

Prophylactic

Whether prescribing an antibiotic for a child with acute otitis media or not, the parents should be educated about:

Providing adequate pain relief for at least the first 24 hours

Not all chest pain is caused by myocardial ischemia. Non-cardiac causes of chest pain include:

Pulmonary embolism Pneumonia Gastroesophageal reflux

Beta blockers treat hypertension because they:

Reduce peripheral resistance

ACE inhibitors treat hypertension because they:

Reduce sodium and water retention Decrease vasoconstriction Increase vasodilation

Management of all types and grades of angina includes the use of lifestyle modification to reduce risk factors. Which of these modifications are appropriate for which reason? Both the modification and the reason for it must be true for the answer to be correct.

Reduce sodium intake to no more than 2,400 mg of sodium. Sodium increases blood volume and cardiac workload.

Joe has severe cystic acne and is requesting treatment with Accutane. The appropriate treatment for her would be:

Refer her to a dermatologist for treatment

When a patient has contact dermatitis, wet dressings with Domeboro solution are used for:

Relief inflammation

Compelling indications for an ACE inhibitor as treatment for hypertension based on clinical trials includes:

Renal parenchymal disease

Donald has been diagnosed with hyperlipidemia. Based on his lipid profile, atorvastatin is prescribed. Rhabdomyolysis is a rare but serious adverse response to this drug. Donald should be told to:

Report muscle weakness or tenderness and dark urine to his provider immediately

A client has relayed instructions from a physician regarding an allergy to a type of antibiotic therapy. The nurse would question which instruction

Restrict fluids when taking the antibiotic

Before beginning IM Vitamin B12 therapy, which laboratory values should be obtained?

Reticulocyte count, hemoglobin, and hematocrit Iron Vitamin B12

opical corticosteroids are used to treat several disorders. Topical corticosteroids are contraindicated for treatment of which of the following conditions?

Rosacea

should be monitored when Vitamin B12 therapy is started.

Serum potassium

Blood pressure checks in children:

Should be done during every health-care visit after age 3

ACE inhibitors are useful in a variety of disorders. Which of the following statements are true about both its usefulness in the disorder and the reason for its use?

Stable angina because it decreases the thickening of vascular walls to decreased MOD. Heart failure because it reduces remodeling of injured myocardial tissues.

At which stage/classification of hypertension should drug therapy be instituted according to the JNC-7 Report?

Stage 1

The American Heart Association and the American College of Cardiology have devised a classification system for heart failure that can be used to direct treatment. Patients with symptoms and underlying disease are classified as:

Stage C

Choose the type of ophthalmic medication that can result in glaucoma, cataracts, or secondary infection.

Steroids

James is a 45 year old with an LDL level of 120 and normal triglycerides. Appropriate first- line therapy for James may include diet counseling, increased physical activity, and:

Sterols

Jose is a 12-year-old overweight child with a total cholesterol of 180 mg/dL and LDL of 125 mg/dL. Along with diet education and recommending increased physical activity, a treatment plan for Jose would include ____ with a reevaluation in 6 months.

Sterols

A patient is receiving his third intravenous dose of a penicillin drug. He calls the nurse to report that he is feeling "anxious" and is having trouble breathing. What will the nurse do first?

Stop the antibiotic infusion

Heart failure is a chronic condition that can be adequately managed in primary care. However, consultation with or referral to a cardiologist is appropriate when:

Symptoms markedly worsen or the patient becomes hypotensive and has syncope There is evidence of progressive renal insufficiency or failure The patient remains symptomatic on optimal doses of an ACE inhibitor, a beta blocker, and a diuretic

Amiodarone has been prescribed in a patient with a supraventricular dysrhythmia. Patient teaching should include all of the following EXCEPT:

Take a hot shower or bath if you feel dizzy

Rapid-acting nitrates are important for all angina patients. Which of the following are true statements about their use?

Take one nitroglycerine tablet or spray at the first sign of angina; repeat every 5 minutes for no more than three doses. If chest pain is still not relieved, go to the hospital.

Jesse is prescribed tazarotene for his psoriasis. Patient education regarding topical tazarotene includes:

Tazarotene is applied in a thin film to the psoriasis plaque lesions

The nurse is monitoring a patient who has been on antibiotic therapy for 2 weeks. Today the patient tells the nurse that he has had watery diarrhea since the day before and is having abdominal cramps. His oral temperature is 101° F (38.3° C). Based on these findings, which conclusion will the nurse draw?

The patient needs to be tested for Clostridium difficile infection.

When reviewing the medication orders for a patient who is taking penicillin, the nurse notes that the patient is also taking the oral anticoagulant warfarin (Coumadin). What possible effect may occur as the result of an interaction between these drugs?

The penicillin will cause an enhanced anticoagulant effect of the warfarin.

Stage B patients should have beta blockers added to their heart failure treatment regimen when:

They have an ejection fraction less than 40% They have had a recent MI

As the patient continues to undergo treatment with pilocarpine (Pilocar), he begins to experience itching of the eye. The most appropriate response of the health care provider is:

This is an expected adverse reaction to the medication, and treatment to relieve this symptom will be initiated.

The patient is being treated with the drug pilocarpine (Pilocar). He complains of eye irritation. The most appropriate response of the health care provider is:

This is an expected adverse reaction to the medication.

Education of women who are being treated with ophthalmic antibiotics for conjunctivitis includes:

Throwing away eye makeup and purchasing new

In teaching about the use of sublingual nitroglycerine, the patient should be instructed:

To place one tablet under the tongue if chest pain occurs and allow it to dissolve

The overall goal of treating hyperlipidemia is:

To reduce atherogenesis

Long-term treatment of moderate atopic dermatitis includes:

Topical corticosteroids and emollients

Caleb is an adult with an upper respiratory infection (URI). Treatment for his URI would include:

Topical oxymetazoline

A patient who is diagnosed with shingles is taking topical acyclovir, and the nurse is providing instructions about adverse effects. The nurse will discuss which adverse effects of topical acyclovir therapy?

Transient burning when applied

Class I recommendations for Stage A heart failure include:

Treatment of thyroid disorders, especially if they are associated with tachyarrhythmias

Diagnosis of heart failure cannot be made by symptoms alone since many disorders share the same symptoms. The most specific and sensitive diagnostic test for heart failure is:

Two-dimensional echocardiograms that identify structural anomalies and cardiac dysfunction

Patient education for a patient who is prescribed antibiotics for sinusitis includes:

Use of nasal saline washes

Pernicious anemia is treated with:

Vitamin B12

The dosage of Vitamin B12 to initially treat pernicious anemia is:

Vitamin B12 1,000 mcg IM daily x 1 week then 1,000 mg weekly for a month

Although they are often described as helpful in the lay media, which of the following therapies have not been shown to be helpful based on clinical evidence?

Vitamins C and E Co-enzyme Q10 Folic acid

Instructions for applying a topical antibiotic or antiviral ointment include:

Wash hands before and after application of topical antimicrobials

During antibiotic therapy, the nurse will monitor closely for signs and symptoms of a hypersensitivity reaction. Which of these assessment findings may be an indication of a hypersensitivity reaction? (Select all that apply.)

Wheezing Shortness of breath Swelling of the tongue itching

Situations that suggest referral to a specialist is appropriate include:

When chronic stable angina becomes unpredictable in its characteristics and precipitating factors When a post-MI patient develops new-onset angina When standard therapy is not successful in improving exercise tolerance or reducing the incidence of angina

A client who reports an allergy to penicillin is ordered to receive cephalexin (Keflex). The correct action for the nurse is to:

administer the medication and carefully observe for allergic reaction.

Which of the following disease processes could be made worse by taking a nonselective beta blocker?

both might worsen

When antibacterials are prescribed for the treatment of an infection and a culture is ordered, what should happen next?

culture should be taken before the initial dose of the antibiotic

During drug therapy for pneumonia, a female patient develops a vaginal superinfection. The nurse explains that this infection is caused by

large doses of antibiotics that kill normal flora.

With continuous use of antibiotics, antibiotic resistance result because:

mutant bacteria are surviving antibiotic use

A nurse is ordered to draw blood levels for a person receiving an antibiotic. The nurse is aware that peaks and troughs of serum antibiotic levels are monitored for drugs with a:

narrow therapeutic index.

Treatment with gentamicin (Garamycin) may present disadvantages for the patient. A renal patient's use of the drug may lead to

ototoxicity

A patient with a long-term intravenous catheter is going home. The nurse knows that if he is allergic to seafood, which antiseptic agent is contraindicated?

povidone-iodine (Betadine)

Initial drug therapy choices should include a

topical agent

A patient will be receiving penicillin G potassium, 12 million units daily in divided doses every 4 hours IVPB. How many units will the patient receive for each dose?

2 million units If a medication is given every 4 hours, then there will be 6 doses in 24 hours (24 ÷ 4 = 6). 12 million units ÷ 6 doses = 2 million units/dose

Patient education when prescribing the Vitamin D3 derivative calcipotriene for psoriasis includes

A maximum of 100 grams per week may be applied

A patient has received a prescription for a 2-week course of antifungal suppositories for a vaginal yeast infection. She asks the nurse if there is an alternative to this medication, saying, "I don't want to do this for 2 weeks!" Which is a possibility in this situation?

A single dose of a fluconazole (Diflucan) oral tablet

The client has been ordered treatment with Amoxil. The client reports to the nurse that she has developed symptoms of vaginitis. The highest priority action on the part of the nurse is to recognize this as:

Evidence of development of a superinfection

Twenty-year-old Annie comes to clinic complaining of copious yellow-green eye discharge. Gram stain indicates she most likely has gonococcal conjunctivitis. While awaiting the culture results, the plan of care should be:

IM ceftriaxone

The nurse is assessing a patient who is about to receive antifungal drug therapy. Which condition, if found in the patient, would be of most concern?

Liver diseases

Rodesa usually starts in this part of a person's lifespan

Midlife

The most cost-effective treatment for two or three impetigo lesions on the face is:

Mupirocin ointment

Mild acne may be initially treated with:

OTC benzoyl peroxide

Nicolas is a football player who presents to clinic with athlete's foot. Patients with tinea pedis may be treated with:

OTC miconazole cream for 4 weeks

The nurse is reviewing the medication history of a patient who will be taking a sulfonamide antibiotic. During sulfonamide therapy, a significant drug interaction may occur with which of these drugs or drug classes? (Select all that apply.)

Oral contraceptives Sulfonylureas phenytoin (dilantin) Warfarin (coumadin)

Severe contact dermatitis caused by poison ivy or poison oak exposure often requires treatment with:

Oral corticosteroids for 2 -3 weeks

Jim presents with fungal infection of two of his toenails (onychomycosis). Treatment for fungal infections of the nail includes:

Oral griseofulvin

Dwayne has classic tinea capitis. Treatment for tinea on the scalp is:

Oral griseofulvin for a 6-8 weeks

Patients who should be cautious about using decongestants for an upper respiratory infection include:

Patients with cardiac disease

When prescribing topical penciclovir (Denavir) for the treatment of herpes labialis (cold sores) patient education would include:

Penciclovir therapy is started at the first sign of cold sore outbreak

Scabies treatment for a 4-year-old child includes a prescription for:

Permethrin 5% applied from the neck down

indane (Kwell, Scabene) is used to treat several different disorders. For which disorder is the use of lindane (Kwell, Scabene) contraindicated?

Seizures

A nurse is monitoring the fluid input and output of a 26-year-old woman who is on amphotericin B. Which of the following would the nurse report immediately to the physician?

Serum creatinine level of 3.5 mg/dL

During therapy with amphotericin B, the nurse will monitor the patient for known adverse effects that would be reflected by which laboratory result?

Serum potassium level of 2.7 mEq/L

Topical immunomodulators such as pimecrolimus (Elidel) or tacrolimus (Protopic) are used for:

Short term or intermittent treatment of atopic dermatitis

Sadie was prescribed betaxolol ophthalmic drops by her ophthalmologist to treat her glaucoma. Oral beta blockers should be avoided in patients who use ophthalmic beta blockers due to:

The additive effects may include bradycardia

The nurse is administering one of the lipid formulations of amphotericin B. When giving this drug, which concept is important to remember?

The lipid formulations are associated with fewer adverse effects than the older drugs.

A patient is infected by invasive aspergillosis, and the medical history reveals that the patient has not been able to tolerate several antifungal drugs. The nurse anticipates an order for which medication to treat this infection?

caspofungin (Cancidas)