3118 Pharmacology Final - EXAM 2
A client is prescribed with Omeprazole (Prilosec). The nurse determines that the client is receiving its therapeutic effect if which of the following is stated by the client: A. Relief from GERD. B. Relief of nausea and vomiting. C. Decrease diarrheal episodes. D. The absence of constipation.
A
A daily dose of prednisone (same family as hydrocortisone) is prescribed for a client. The nurse provides instructions to the client regarding administration of the medication and should instruct the client that which time is best to take this medication? A. In the morning. B. At noon. C. At bedtime. D. At dinner time.
A
A patient who has duodenal ulcers is receiving long-term therapy with rantidine (Zantac). The nurse includes in the care plan that the patient should be monitored for which adverse effect? A. Neutropenia and thrombocytopenia. B. Urinary hesitation and fluid retention. C. Photophobia and skin irritations. D. Dyspnea and productive coughing.
A
Lomotil (diphenoxylate/atropine) has which mechanism of action? A. Slowing of intestinal movement B. Increasing water absorption in to the intestine C. Bulking of the stool D. Decreasing acid
A
Medications like AlternaGel (aluminum hydroxide) have an expected side effect of: A. Constipation B. Diarrhea C. Vomiting D. Flushing
A
The community health nurse visits a client at home. Hydrocortisone, 10 mg orally daily, has been prescribed for the client and the nurse teaches the client about the medication. Which statement, if made by the client, indicates that further teaching is necessary? A. "I can take ibuprofen and aspirin if I need it." B. "I need to take the medication every day at the same time." C. "If I gain more than 5 pounds a week, I will call my health care provider (HCP)." D. "I need to avoid coffee, tea, cola, and chocolate in my diet."
A
The most immediate initial concern the nurse has about a patient experiencing diarrhea is: A. Electrolyte imbalance B. The cause of the diarrhea C. Skin breakdown D. Fall risk
A
The nurse associates which effect with long-term glucocorticoid therapy? A. Decreased production of ACTH. B. Adrenal hypertrophy. C. Increased levels of endogenous cortisol. D. Pituitary atrophy.
A
The nurse is discussing levothyroxine (Synthroid) with a client diagnosed with hypothyroidism. Which intervention should be included in the client teaching? A. Instruct the client to take the medication in the morning. B. Explain the importance of not the taking medication with grape juice. C. Discuss the importance of not using iodized salt. D. Teach the client to monitor daily glucose levels.
A
The nurse should caution the client with Type 2 Diabetes Mellitus who is taking glyburide, a sulfonylurea, that alcoholic beverages should be avoided while taking these drugs because they can cause which of the following? A. Disulfiram (Antabuse)-like symptoms. B. Hypocalcemia. C. Hypokalemia. D. Hyperkalemia.
A
When administering a bulk laxative to a patient, the nurse will encourage the patient to: A. Take the laxative with a full glass of water B. Administer the laxative at night C. Hold fluids until mid-day D. Encourage the consumption of only fruit juices
A
In the administration of a drug such as levothyroxine (Synthroid), the nurse must teach the client. (Select all that apply). A. Report weight loss, anxiety, insomnia, and palpitations. B. Periodic lab test that includes T3-T4 are required. C. The medication can be stopped at any time if the patient feels better D. Report rhinorrhea.
A, B
A nurse is preparing to give medications to a patient with a peptic ulcer. The nurse would expect to give which of the following types of medication? Select all that apply: A. Antibiotic B. Proton Pump Inhibitor C. GI Protectant D. Stool softener
A, B, C
Before administering a morning lispro insulin (Humalog) injection, which activity should the nurse perform? (Select all that apply). A. Ensure that breakfast trays are present on the unit and the patient may eat. B. Check the patient's fingerstick glucose level. C. Obtain the patient's pulse and blood pressure. D. Obtain a morning urine sample for glucose and ketones. E. Assess for symptoms of hypoglycemia.
A, B, E
The nurse is monitoring a client who was diagnosed with type 1 diabetes mellitus and is being treated with NPH and regular insulin. Which client complaint(s) would alert the nurse to the presence of a possible hypoglycemic reaction? (Select all that apply). A. Irritability. B. Hot, dry skin. C. Tremors. D. Nervousness. E. Anorexia.
A, C, D
The nurse will the teach the patient which of the following strategies to prevent constipation: A. Increasing fluid intake B. Eating more protein C. Increasing dietary fiber D. Exercising
A, C, D
A client complains of feeling light headed and shaky. The patient's blood glucose reading is 60. The nurse should: A. Administer 1 unit of Lispro insulin B. Give the patient 6 oz of orange juice C. Obtain vital signs and call the provider D. Do nothing now, but recheck the blood glucose in 30 minutes
B
A patient has been taking hydrocotisone for long-term treatment of Addison's Disease and asks the nurse, "why are you checking my blood sugar when I don't have diabetes?" What is the nurse's best response: A. "Long-term corticosteroid therapy can cause a moon face." B. "Long-term corticosteroid therapy can cause hyperglycemia." C. "Long-term corticosteroid therapy causes weight gain." D. Long-term corticosteroid therapy can cause osteoporosis."
B
A patient is diagnosed with a peptic ulcer. The nurse would expect to look for lab work to evaluate A. Giardia B. H. Pylori C. TB D. Auto-antibodies
B
A patient who requires insulin injections is admitted to the hospital. During the patient's hospitalization, the nurse will: A. Ask which sites the patient usually uses for insulin injections and use those same sites for patient comfort B. Share with the patient the nurses will use injection sites that the patient usually does not use to prevent lipodystrophy C. Allow the patient to inject their own insulin during the hospitalization to help the patient maintain control D. Use IV insulin on a pump versus administering it subcutaneously while the patient is in the hospital
B
A patient with Type 1 diabetes will use a combination insulin which includes NPH and regular insulins. The nurse is teaching the patient about peak times. Why is this important for the patient to know? A. The patient will be able to estimate the time for the next injection based on these peaks. B. The risk for a hypoglycemic reaction is greatest around the peak insulin activity C. It is best to plan exercise and activities around the peak time to maximize glucose utilization D. Additional insulin may be required around peak times to prevent hyperglycemia
B
Constipation is defined as: A. Not having a daily bowel movement B. The passing of hard stool with decreased frequency C. Increased peristalsis D. Increased water in the intestine
B
Ondansetron (Zofran) has been ordered prior to chemotherapy for a patient receiving treatment for lymphoma. Prior to administering this drug, the nurse will review the patient's past medical history for what condition? A. History of chronic constipation. B. Cardiac dysrhythmias. C. Allergy to soy or soy products. D. Glaucoma.
B
Oral antidiabetic medications commonly cause which of the following undesired effect? A. Hypoglycemia B. GI upset C. Muscle pain D. Fatigue
B
The nurse is scheduling the patient's daily medication. When would the most appropriate time for the patient to receive proton pump inhibitors? A. At night. B. About 1/2 hour before a meal. C. After fasting at lease 2 hours. D. About 2 to 3 hours after eating.
B
The patient on replacement therapy with levothyroxine (Synthroid) reports feeling nervous and is having occasional palpitations and tremors. The nurse recognizes that these symptoms may indicate what effect is occurring? A. The patient now has normal thyroid function and the levothyroxine (Synthroid) is no longer needed. B. The patient is experiencing symptoms of hyperthyroidism and the drug dosage may need to be decreased. C. The patient is still experiencing hypothyroidism and the dose may need to be increased. D. The patient has developed diabetes and needs further evaluation.
B
When a nurse is assessing a patient experiencing constipation, which possible serious condition is a consideration? A. Inflammatory bowel disease B. Bowel obstruction C. Liver disease D. Renal failure
B
Omeprazole (Prilosec) is prescribed for a patient with gastroesophageal reflux disease (GERD). The nurse would monitor a reduction in which symptoms to determine if the drug therapy is effective? (Select all that apply). A. Appetite B. Dyspepsia C. Belching D. Dysphagia E. Nausea
B, C, D, E
A nurse caring for a patient who is receiving a proton pump inhibitor should teach the patient to: A. Take the drug after every meal B. Chew or crush the medication if the pill is too big to swallow C. Swallow the capsules whole D. Stop taking the drug after 3 weeks of therapy
C
A nurse caring for a patient who is receiving a proton pump inhibitors (PPIs) is aware of which of the following about this drug? A. PPI's neutralize stomach acid B. PPI's may increase the Ph of the stomach C. PPI's may decrease the Ph of the stomach D. PPI's may alter gastric motility
C
A nurse should question the order for pancrelipase (Creon) for which patient? A. The patient with coronary artery disease. B. The patient with hypertension. C. The patient with an allergy to pork products. D. The patient with hypersensitivity to iodine products.
C
A patient is scheduled for a colonoscopy. The patient would likely be prescribed which type of laxative for this procedure? A. Bulk laxative (metamucil) B. Colace (docusate) C. Stimulant laxative D. None of the above
C
Hydrocortisone is prescribed for a client with diabetes mellitus who is taking Humulin NPH insulin daily. Which prescription change does the nurse anticipate during therapy with the hydrocortisone? A. An additional dose of hydrocortisone daily B. A decreased amount of daily Humulin NPH insulin C. An increased amount of daily Humulin NPH insulin D. The addition of an oral hypoglycemic medication daily
C
Ondansetron is classified as a which type of drug? A. Histamine blocker B. Beta cell stimulator C. Serotonin receptor antagonist D. Enzyme inhibitor
C
The nurse is interviewing a client with type 2 diabetes mellitus. Which statement by the client indicates an understanding of the treatment for this disorder? A. "When I become ill, I need to increase the number of pills I take." B. "By taking these medications, I am able to eat more." C. "I take oral insulin instead of shots." D. "The medications I'm taking help release the insulin I already make."
C
The nurse who is caring for a patient with gastroesophageal reflux disease (GERD) should question the order for which drug? A. Proton pump inhibitors. B. H2 receptor antagonists. C. Antibiotics. D. Antacids.
C
What is the mechanism of action of ondansetron (Zofran)? A. Ondansetron acts on the production of stomach acid to decrease nausea and vomiting B. Ondansetron acts on the smooth muscle in the mouth and esophagus to decrease vomiting C. Ondansetron acts in the central nervous system at the vomiting center to decrease vomiting D. Ondansetron acts directly on peristalsis in the small intestine
C
What should the nurse teach a patient who is newly diagnosed with hypothyroidism and will take levothyroxine (Synthyroid)? A. Take the pill in the afternoon with a high-fiber snack to prevent stomach upset. B. Eat plenty of fruits and vegetables such as strawberries, spinach and kale to replace vital nutrients. C. Check with a provider before accepting a generic form of this medication D. The drug may be taken every other day if diarrhea occurs.
C
A client is taking Humulin NPH insulin and regular insulin every morning. The nurse should provide which instructions to the client? (Select all that apply). A. The insulin vial needs to be shaken to break up the precipitates. B. The insulin dose should be decreased if illness occurs. C. The insulin should be administered at room temperature. D. Hypoglycemia may be experienced around dinner time. E. The NPH insulin should be drawn into the syringe first, then the regular insulin.
C, D
Which of the following assessment findings would the nurse expect to observe in an adult patient experiencing therapeutic effects from levothyroxine (Synthyroid)? Select all that apply A. Constipation and weight gain B. Decreased blinking and exophthalmos C. Decreased reports of fatigue D. Pulse rate between 60 and 100 beats/minute
C, D
A client who has been taking beclomethasone (medication in the hydrocortisone family), two inhalations a day, for treatment of asthma. The nurse knows that based on the generic name of this medication, that it is part of which class of medications? A. Antidiabetic Class B. Antihypoglycemic Class C. Anti-inflammatory class D. Corticosteroid class
D
A client with diabetes mellitus visits a health care clinic. The client's diabetes mellitus previously had been well controlled with metformin daily, but recently the fasting blood glucose level has been 180 to 200 mg/dL. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia? A. Atenolol (Tenormin). B. Phenelzine (Nardil). C. Allopurinol (Zyloprim). D. Hydrocortisone.
D
A nurse is preparing to give a patient diphenoxylate/atropine (Lomotil) for diarrhea. The nurse will teach the patient that they might experience which of the following: A. Black or tarry stool B. An increase in anxiety C. Stomach cramping D. A feeling of euphoria
D
A patient is scheduled for an imaging procedure that involves the use of IV radiographic contrast. The nurse would contact the provider to hold which medication? A. Regular insulin B. Glyberide (Micronase) C. Prandin (regaplinide) D. Metformin (glucophage)
D
A patient was started on metformin (Glucophage) for type 2 diabetes. He tells the nurse that he is not sure why he was prescribed this medication to help control his blood sugars. What is the nurse's best response? A. "You sometimes have to double your dose when your blood sugars remain high when taking this medication." B. "If this medication does not work, you will more likely need to take insulin." C. "This medication takes several weeks before it is fully effective." D. "This medication reduces fasting and postprandial glucose levels and does not cause hypoglycemia."
D
A patient will be treated with propylthiouracil (PTU) for hyperthyroidism. While the patient is taking this drug, which symptoms will the nurse teach the patient to report to the healthcare provider? A. Tinnitus, altered taste, and thickened saliva B. Insomnia, nightmares, and night sweats C. Increase in appetite and caloric intake D. Sore throat, low-grade fever, and chills
D
Exophthalmos, weight loss and nervousness are signs of: A. Hypothyroidism. B. Addison's Disease. C. Cushing's Syndrome. D. Hyperthyroidism.
D
H2 receptors are found where? A. Nasal passages, upper airway and stomach B. Central nervous system and stomach C. Respiratory system and heart D. Heart, CNS and stomach
D
The home health nurse visits a client with a diagnosis of type 1 diabetes mellitus. The client relates a history of vomiting and diarrhea and tells the nurse that no food has been consumed for the last 24 hours. Which additional statement by the client indicates a need for further teaching? A. "I need to call the health care provider (HCP) because of these symptoms." B. "I need to increase my fluid intake." C. "I need to monitor my blood glucose every 3 to 4 hours." D. "I need to stop my insulin."
D
The nurse explains the benefit of using the long-acting insulin glargine (Lantus) over other insulins. What will the nurse tell the patient about this insulin? A. It does not need to be administered by injection B. It can be given subcutaneously or intramuscularly C. It does not require blood glucose monitoring D. It has no definite peak but maintains a steady state of insulin in the body
D
