Exam 1

A mother calls the urgent care center and frantically tells the nurse that her toddler drank a bottle of cleaning fluid. Which of the following is the priority instruction the nurse should give the parent? a. Contact the poison control center. b. Watch the child closely and call back if there are signs of respiratory distress. c. Take the child immediately to the emergency department. d. Give the child syrup of ipecac.

a

A patient asks why all healthcare providers do not rely on complementary and alternative medicine. When talking to this patient, the nurse knows that many complementary and alternative therapies: a. Have not been subjected to rigorous clinical studies. b. Consist only of old wives' tales and fables. c. Only provide a placebo effect. d. Are costly and not worth the risk.

a

A patient takes a dose of albuterol (Ventolin) prior to bedtime. Which effect would the nurse consider normal for this drug? a. Insomnia b. Sleepiness c. Urticaria d. Tinnitus

a

A patient who is taking an adrenergic antagonist for hypertension reports being dizzy when first getting out of bed in the morning. The nurse should advise the patient to: a. Move slowly from the recumbent to the upright position. b. Drink a full glass of water before rising to increase vascular circulatory volume. c. Avoid sleeping in a prone position. d. Stop taking the medication.

a

A patient who uses over-the-counter phenylephrine (Neo-Synephrine) nasal spray asks the nurse how the medication works. The nurse's response would be: a. "It helps to shrink the swelling in your nose by tightening the blood vessels there." b. "It works to locally destroy invading organisms that cause colds and flu." c. "It coats the nasal passages to reduce swelling." d. "It is absorbed after you swallow it to act as a decongestant."

a

A pregnant patient asks the nurse what factors determine if a drug will cross the placenta. The nurse's response will be based on which of the following principles? a. Highly lipid-soluble drugs cross the placental membrane more easily than low lipids. b. The lower the lipid content of a drug, the easier it crosses the placental membrane. c. Drugs with large molecular weight pass rapidly through the placental membrane. d. Highly protein-bound drugs pass rapidly through the placental membrane.

a

Bethanechol is a: a. Cholinergic agonist b. Sympatholytic c. Beta blocker d. Anticholinergic

a

Muscarinic antagonists, such as benztropine (Cogentin), are most often contraindicated in glaucoma because these drugs can: a. Increase intraocular pressure b. Promote ocular infections c. Cause miosis, which leads to blindness d. Detach the retina

a

Nonselective beta blockers such as Inderal are contraindicated in clients with: a. Asthma and COPD b. Hypertension and Tachycardia c. Diabetes and Asthma d. Kidney Disease and Hypertension

a

Prior to the administration of an antibiotic, the patient informs the nurse that 4 years ago the patient experienced an allergic reaction. Based on this information what should the nurse do first? a. Ask the patient to describe the reaction further. b. Notify the HCP on call about the patient's statements. c. Administer the dose and observe the patient for a reaction. d. Check the medical administration record for documented allergies.

a

The experienced pediatric nurse is teaching a new nursing student about injections in the pediatric population. Which statement by the student would indicate that teaching was effective? a. "Intramuscular (IM) injections in infants are absorbed slowly." b. "Children experience rapid absorption of IM medications." c. "IM injections are encouraged due to their predictable absorption rate." d. "Strong muscle contractions result in delayed absorption of IM medication."

a

The healthcare provider knows that the pediatric patient and parents will most likely adhere to the medication regimen if the: a. Regimen is simple and inexpensive. b. Medications are costly but well known. c. Medications are prescribed for a long period. d. Medications are taken at different times each day.

a

The nurse administering succinylcholine knows that this drug causes: a. Muscle paralysis; it does not produce anesthesia or loss of consciousness. b. Loss of consciousness, along with muscle paralysis and anesthesia. c. Deep muscle relaxation and relief from pain. d. Increased mental alertness with muscle paralysis.

a

The nurse cannot read the number of milligrams (mg) to be administered in a drug order written by the healthcare provider. The nurse cannot determine whether 125 mg, 1.25 mg, or 12.5 mg should be administered. What action would be most appropriate to prevent a medication error? a. Telephone the HCP about the illegible medication order. b. Ask another nurse to read the questionable medication order. c. Contact the pharmacist about the medication order. d. Consult a drug handbook and administer the normal dose.

a

The nurse is administering medication to a group of pregnant women. At which stage of fetal development are congenital malformations least likely to occur? a. 1 to 2 weeks b. 3 to 4 weeks c. 5 to 6 weeks d. 7 to 8 weeks

a

The nurse is caring for several patients. Which patient will the nurse anticipate is most likely to experience an alteration in drug metabolism? a. A 3-day-old premature infant b. A 22-year-old pregnant woman c. A 32-year-old man with kidney stones d. A 50-year-old executive with hypertension

a

The nurse is discussing the adverse effects associated with a muscarinic agonist. The nurse knows that reflex tachycardia may occur with this drug because: a. Baroreceptors acknowledge transient hypotension and signal the medulla to increase the heart rate. b. This drug stimulates the sinoatrial node in the right atrium. c. Aortic receptors identify episodes of systolic hypertension and stimulate heart rhythms. d. This drug stimulates bronchial muscle contraction and a narrowing of the airway.

a

The nurse is researching a new drug prior to administration. The drug handbook states that the adverse effects are "dose related," which means that: a. As the dose increases, the risk of adverse effects also increases. b. The adverse effects should be expected after the first dose. c. Oral preparations will produce the most adverse effects. d. The timing of each dose should be correlated with the presence of adverse effects.

a

The nurse is teaching at a community wellness seminar when one participant asks, "How can I be sure that my herbal supplement is pure?" Which of the following labeling marks indicates that the product meets acceptable standards of purity? a. USP verified dietary supplement mark b. DEA prescriber number c. FDA identification and regulation code d. U.S. Customs Service integers

a

The nurse knows that a drug with a high therapeutic index is: a. Probably safe b. Often dangerous c. Frequently risky d. Most likely effective

a

The nurse knows that drugs that are subject to stricter regulations are those: a. With a high potential for abuse or dependency. b. That are most costly and difficult to produce. c. With adverse effects and high occurrence of drug or food interactions. d. That have taken years to be proven effective in the laboratory.

a

The nurse knows that patients characterized as slow acetylators: a. Are more prone to drug toxicity b. Require more time to absorb enternal medications c. Must be given liquid medications only d. Should be advised to decrease protein intake

a

The patient is started on propranolol (Inderal). Which is the most important action to be included in the plan of care for this patient related to this medication? a. Monitor apical pulse and blood pressure b. Elevate the head of the bed during meals c. Take the medication after meals d. Consume foods high in potassium

a

The patient returned from major surgery 3 hours ago and requests medication for pain. In considering the best action for this patient, the nurse knows that: a. Prescription drugs rarely cause addiction when used according to accepted medical protocol. b. All drugs should be withheld until the patient's past substance abuse history is evaluated. c. It is best to wait until the patient can no longer tolerate the pain to avoid addiction problems. d. Patients often request analgesia when it is not really needed.

a

To avoid the first-dose phenomenon, the nurse knows that the initial dose of prazosin (Minipress) should be: a. Very low and given at bedtime. b. Doubled and given before breakfast. c. The usual dose and given before breakfast. d. Doubled and given immediately after breakfast.

a

When considering pharmacodynamic principles for a patient's drug therapy, the nurse is aware that affinity for a receptor is most closely associated with a drug's: a. Potency b. Efficacy c. Metabolism d. First-pass effect

a

Where does the disintegration of enteric-coated tablets occur? a. Small intestine b. Large intestine c. Stomach

a

Which medication would have fewer adverse and toxic effects? a. One that has a half life of four hours and is 50% protein bound b. One that is fat soluble and is 65% protein bound c. One that is fat-soluble and has a half-life of 50 hours d. One that is fat soluble and is 90% protein bound

a

Which patient is most likely to experience drug toxicity while taking dietary supplements? a. An 80-year-old woman with cirrhosis b. A 58-year-old man with cardiac irregularities c. A 30-year-old woman with pneumonia d. An 18-year-old man with chronic acne

a

Which statement by the patient would inform the nurse that more teaching is necessary prior to discharge? a. "It doesn't matter if the medication works as long as the doctor prescribed it." b. "This medication is fully covered by my health insurance." c. "I have been taking my medications by myself all my life." d. "I don't mind making changes to my lifestyle while I am on this drug."

a

While administering medication to several patients, the nurse suddenly realizes that the wrong medication has been given to a patient. Which would be the first priority action taken by the nurse? a. Assess the patient in order to monitor for adverse effects. b. Call the HCP and report the error. c. Complete the hospital's drug error form. d. Report the medication error to the FDA.

a

While reviewing a drug manufacturer's package insert, the nurse reads about the dose-response curve. The purpose of the dose-response curve is to illustrate the relationship between: a. The amount of a drug administered and the degree of response it produces. b. The prevalence of toxic effects in a given population. c. The degree of response and the total duration of action of the drug. d. The peak serum drug level when half the dose is administered.

a

While teaching the patient about disulfiram (Antabuse), which of the following should the nurse instruct the patient to avoid? a. Mouthwash, alcoholic beverages, and over-the counter cold medications b. Dairy products such as milk, cream, and yogurt c. Foods high in iron such as green leafy vegetables d. Driving or operating machinery while taking this medication

a

In general, drug absorption in the older adult is somewhat slowed. What physiologic changes may account for this? (Select all that apply.) a. Increased gastric pH b. Decreased rate of blood flow to the GI tract c. Increased gastrointestinal motility d. Increased body surface area e. Decreased cardiac output

a, b

A nurse notes that multiple patients had a reaction to the same medication, a drug that has been available for several years. Which action should the nurse take? (Select all that apply.) a. File an Adverse Event Report with the FDA. b. Note the reaction in the patient's chart. c. Notify the healthcare provider who ordered the drug. d. Wait until the FDA sends a notification of the drug's recall before informing the patient. e. Compare each patient's reaction to determine if it is the same.

a, b, c

Older adults experience adverse effects more frequently than young adults due to which of the following? (Select all that apply.) a. Excessive prescribing b. Multiple-drug therapy c. Increased drug sensitivity d. Increased body mass e. Lack of consistent exercise

a, b, c

The nurse is aware that the therapeutic uses for cholinergic antagonists include (select all that apply): a. Ophthalmic procedures b. Cardiac rhythm abnormalities c. Asthma d. Poisonings e. Urinary retention

a, b, c, d

Which of the following is considered a gender factor that may influence effective pharmacotherapy? (Select all that apply.) a. Fat-to-muscle ratio b. Cerebral blood flow c. Limited drug research on females d. Health beliefs e. Dietary considerations

a, b, c, d

Which patient characteristics, if noted in the patient's medical record, would the nurse consider important information that may affect the physiologic response to various types of drug therapy? (Select all that apply.) a. 82-year-old and female b. Asian and obese c. Past medical history of kidney disease d. Mother and sister with diabetes e. Has no medical insurance

a, b, c, d

The nurse is monitoring the patient for which of the common adverse effects associated with bethanechol (Urecholine)? (Select all that apply.) a. Abdominal discomfort b. Sweating c. Flushed skin d. Constipation e. Blurred vision

a, b, c, e

The patient asks the nurse, "Why are dietary supplements so popular?" The nurse's answer is based on which factors? (Select all that apply.) Herbal supplements: a. Can now be purchased in virtually all supermarkets. b. Are aggressively marketed by the herbal and supplement industry. c. Cost less than prescription medicines. d. Are safer than synthetic pharmaceuticals. e. Appeal to the aging population.

a, b, c, e

What parameters would the nurse use to determine whether the average dose of a medication is effective for a patient? (Select all that apply.) a. Physical examination b. Vital signs c. Laboratory values d. Dosage time e. Efficacy

a, b, c, e

As a member of an interprofessional team, what key responsibilities does the nurse have to ensure effective pharmacotherapy? (Select all that apply.) a. Monitoring the patient's condition before and during pharmacotherapy b. Teaching the patient about self-administration and any required monitoring of drug effects c. Ensuring that all drug and treatment options have been considered before beginning pharmacotherapy d. Frequently conducting a medication reconciliation to verify current medications in use e. Determining the ideal drug to be prescribed to the patient to treat the current condition

a, b, d

The nurse is teaching the patient about the use of an adrenergic agonist nasal spray at home. What patient teaching is needed related to this medication? (Select all that apply.) a. Do not share the nasal spray with another individual. b. Use this drug only for 3 to 5 days unless directed otherwise by a healthcare provider. c. Symptoms of excessive use of this drug is lethargy and fatigue. d. Infants and children should not use this medication unless directed to do so by a healthcare provider. e. This drug can be safely used by individuals with diabetes.

a, b, d

The nurse is preparing to administer medication to the pediatric patient. Which factor(s) is/are true regarding the pharmacokinetics in the pediatric population? (Select all that apply.) a. Slower gastric motility in young children will keep the drug in the stomach longer. b. Before 6 months of age, there is greater plasma protein binding of drugs, and drug distribution will be lower in this age group. c. Before age 5, the liver may not metabolize drugs as readily as an adult's liver and doses must be adjusted accordingly. d. Drug excretion by the kidneys will not equal an adult's until the child is at least 2 years of age. e. Drugs with CNS effects have little to no effect in infants and very young children.

a, c

The community health nurse is visiting a postpartum mother who is breastfeeding her 3.2-kg (7-lb) infant daughter. Which of the following statements, if made by the mother, indicates that further teaching is necessary? (Select all that apply.) a. "When using over-the-counter medication, I should take only the lowest effective dose." b. "The higher the dose of medication, the more likely it will be secreted into breast milk." c. "I shouldn't take any drug during breastfeeding, even my prescriptions." d. "Medication in liquid form should be avoided since it more readily enters the breast milk." e. "Now that I'm no longer pregnant, I don't need to worry about the medicines affecting my baby."

a, c, d, e

A beta-adrenergic agonist is prescribed for each of the following conditions. A nurse would question the order for which condition? (Select all that apply.) a. Hyperthyroidism b. Asthma c. Shock d. Dysrhythmias e. Heart failure

a, d

The nurse is monitoring the therapeutic drug level for a patient on vancomycin (Vancocin) and notes that the level is within the accepted range. What does this indicate to the nurse? (Select all that apply.) a. The drug should cause no toxicities or adverse effects. b. The drug level is appropriate to exert therapeutic effects. c. The dose will not need to be changed for the duration of treatment. d. The nurse will need to continue monitoring because each patient response to a drug is unique. e. This drug will effectively treat the patient's condition.

a, d

A nurse is teaching a patient who will begin varenicline (Chantix) for smoking cessation. Which of the following instructions will the nurse give the patient? (Select all that apply.) a. Doses will be increased over a week's period and the drug used for up to 6 months. b. Smoking may continue because the drug blocks the harmful effects of nicotine. c. The drug is not known to cause any adverse effects and has an excellent safety profile. d. Any unusual rashes, skin reactions, or facial edema should be reported immediately. e. Any unusual changes in behavior including depression, hostility, or thoughts of suicide should be reported immediately.

a, d, e

A patient in her first trimester of pregnancy asks the nurse which medications should be avoided during pregnancy. The nurse's response is based on the knowledge that during pregnancy: a. Most over-the-counter medications are safe. b. When possible, drug therapy is postponed until after pregnancy and lactation c. It is wise to discontinue all drugs used in treating medical conditions. d. The decision whether or not to take medication is the responsibility of the woman.

b

A patient of Native American descent states, "I will only take medications that are approved by the Shaman." The nurse understands that this statement reflects the patient's: a. Ethnicity b. Cultural belief c. Genetic polymorphisms d. Health-related bias

b

A patient with myasthenia gravis has been receiving neostigmine, a cholinergic agonist, for the past 2 years. The nurse is ready to administer benztropine, a cholinergic antagonist. Which result will likely occur when these drugs are combined? a. Neostigmine will exhibit a greater effect. b. Neostigmine will exhibit a lesser effect. c. Neostigmine will not be affected by the administration of benztropine. d. Neostigmine will first exhibit a greater effect, followed by a lesser effect.

b

In initiating holistic care with a patient who has chronic headaches, which action would the nurse take? a. Tell the patient to take Tylenol as directed on the label. b. Ask the patient what he or she believes may be contributing to the problem. c. Monitor the patient's pupil response to light. d. Refer the patient to an ophthalmologist for an eye exam.

b

One third of older adult patients report that they are often nonadherent with drug therapy. Which response is given most frequently for nonadherence? a. "The drugs prevented me from doing other things I wanted to do." b. "I didn't have my medicine with me." c. "I wanted to save money." d. "I didn't believe the drugs were effective."

b

Patient Education for the client taking anticholinergic drugs would include which of the following? a. Increase intake of Vitamins A and C. b. Increase intake of high fiber foods. c. Decrease caffeine intake. d. Avoid meat products.

b

The dosage of the medication may need to be decreased for which of the following reasons? a. Decreased peripheral perfusion b. Liver failure c. Increased medication metabolizing enzymes d. Increased renal excretion

b

The drug research participant with a particular disease is taking part in an investigative study to examine the effects of a new drug. Previously, this drug was tested using healthy volunteers. The next phase of the clinical trial investigation in which the patient will be participating is: a. Phase 1 b. Phase 2 c. Phase 3 d. Phase 4

b

The nurse completes an initial home assessment of an independent 82-year-old woman recently diagnosed with type 2 diabetes mellitus managed with insulin injections. What is the most appropriate nursing action for insulin administration for this patient? a. Teach the daughter how to administer the insulin to her mother. b. Instruct the patient how to administer the insulin. c. Recommend daily visits by a home health aide to give the insulin. d. Ask the healthcare provider to change the order to an oral antidiabetic medication.

b

The nurse is counseling the patient on a medication taken daily. Which strategy should the nurse include in this teaching session that might prevent a medication error? a. Insist on trade-name drugs rather than generic drugs. b. Have all prescriptions filled at one pharmacy. c. Request all prescriptions be placed in easily opened containers. d. Consult the internet about possible adverse effects.

b

The nurse is looking up a drug that has been prescribed and wants to know the therapeutic classification for the drug. Which of the following would indicate a therapeutic classification? a. Beta-adrenergic antagonist b. Antihypertensive c. Diuretic d. Calcium channel blocker

b

The nurse is teaching the patient about a newly prescribed medication. Which statement made by the patient would indicate the need for further medication education? a. "The liquid form of the drug will be absorbed faster than the tablets." b. "If I take more, I'll have a better response." c. "Taking this drug with food will decrease how much drug gets into my system." d. "I can consult my HCP if I experience unexpected adverse effects."

b

The nurse knows that governmental drug legislation requires the drug manufacturer to prove that a drug is both safe and: a. Free of adverse effects and potential reactions. b. Effective for a specified purpose. c. Reasonable in cost and easily accessible. d. Beneficial to various population groups.

b

To evaluate the effectiveness of high-dose dopamine, the nurse would assess the: a. Pupillary response b. Blood pressure c. Level of consciousness d. Gag reflex

b

When considering various drug therapies, the nurse knows that most drug testing and approval occurs with which population? a. Multiple population types and is usually safe for all patients b. Caucasian men and may not be safe for other populations c. Older adults, and may be harmful to children and adolescents as well d. Animals, which verifies the drug's effectiveness in humans

b

When observing a patient for bone marrow toxicity, the nurse would monitor for: a. Increased reports of muscle and bone pain in the lower extremities. b. Decrease in red blood cells, white blood cells, and platelets. c. Decrease in the range of motion of the upper and lower extremities. d. Increase in hepatic enzymes.

b

Which age-related change in the older patient makes it necessary to reduce drug dosages? a. Decrease in total body fat b. Decrease in renal blood flow c. Increase in plasma protein levels d. Increase in total body water

b

Which factor in the patient's history would cause the nurse to question a medication order for atropine? a. A 42 year old woman with a history of drug abuse. b. An 85 year old man with benign prostatic hyperplasia. c. An 18 year old man with irritable bowel syndrome d. A 22 year old woman on the second day of her menstrual cycle

b

Which health teaching concept should the nurse review with a patient receiving tolterodine (Detrol) for urge incontinence? a. Exercise daily to avoid muscle atrophy. b. Increase dietary fiber and water intake to avoid constipation. c. Consume foods high in iron to increase red blood cell production. d. Monitor the heart rate for bradycardia.

b

Which parameter is most critical when a nurse is assessing a patient with an overdose of sedatives? a. Cardiac stimulation b. Respiratory suppression c. Hepatic dysfunction d. Depression of consciousness

b

You are instructing your patient the proper way to use Sudafed. You know the patient understands your instructions if he states: a. The side effects of taking Sudafed are eye irritation, eye stinging, and watery eyes. b. When I take Sudafed I won't take it before bed because it can cause insomnia. c. The use of Sudafed is okay when I have hypertension. d. Using Sudafed will cause my nasal passages to dilate and allow for easier breathing.

b

The nurse is caring for a patient with chronic hypertension. The patient is receiving a beta-adrenergic blocker daily. Which patient manifestations would the nurse conclude are adverse effects of this medication? (Select all that apply.) a. Anorexia b. Increased serum triglycerides c. Hypoglycemia d. Decreased libido e. Thrombocytopenia

b, c, d

A healthcare provider has ordered neostigmine for each of these patients. A nurse should question the order for which patient? a. A patient with postoperative abdominal distension. b. A patient who is experiencing urinary retention. c. A patient who has COPD. d. A patient who has received nondepolarizing muscle relaxants.

c

A patient is being discharged from the hospital with a nebulizer for self-administration of inhalation medication. Which statement made by the patient indicates to the nurse that patient education has been successful? a. "Inhaled medications should only be taken in the morning." b. "Doses for inhaled medication are larger than those taken orally." c. "Medicines taken by inhalation produce a very rapid response." d. "Inhaled drugs are often rendered inactive by hepatic metabolic reactions."

c

A patient presents to the ED unresponsive, the patient's friend states the patient was "shooting heroin" and stopped breathing. The nurse is preparing naloxone (Narcan) to reverse the effects of the narcotic. This drug will be administered to reduce which type of drug effect? a. Combined b. Additive c. Antagonistic d. Synergistic

c

As the nurse enters the room to administer medication, the patient states, "I'm in the bathroom. Please leave the medication on my bedside table, and I will take it when I come out." Which would be the appropriate response by the nurse? a. "I will leave the medication and follow up with you in 30 minutes." b. "You must take the medication now or refuse the dose." c. "Let me know when you are ready, and I will then return with your medicine." d. "I've given the drug to your visitors. Take it when you come out of the bathroom."

c

Drugs that are most likely to create drug interactions in pediatric patients are those with: a. Low potency b. wide therapeutic index c. extensive protein binding d. effects on the skin

c

Food usually has what effect on the absorption of medication? a. Has no effect b. Accelerates c. Decelerates d. Prevents

c

It is time to give a 3-year-old oral medication. Which comment by the nurse is most therapeutic? a. "This is the medicine that makes you better." b. "If you don't take your medicine you can't go home." c. "Would you like to take your medicine with water or juice?" d. "See how easily your roommate has taken his medicine?"

c

On physical examination, the nurse observes raised hive-like welts covering the patient's trunk and arms. The patient also reports intense itching after receiving a new medication. The nurse will document which dermatologic adverse effect? a. Angioedema b. Stevens-Johnson syndrome c. Urticaria d. Photosensitvity

c

The nurse is administering medications to a patient who is 32 weeks pregnant. Which of the following normal physiologic principles associated with pregnancy will affect drug absorption? a. Medications are absorbed and distributed more quickly in pregnant women. b. There is greater hemoconcentration of drugs in pregnant patients. c. Drugs remain longer in the gastrointestinal tract, leading to extended time for absorption. d. Drug metabolism is highly affected by pregnancy.

c

The nurse is preparing a plan of care for a patient with myasthenia gravis. Which of the following outcome statements would be appropriate for a patient receiving a cholinergic agonist such as pyridostigmine (Mestinon) for this condition? The patient will exhibit: a. An increase in pulse rate, blood pressure, and respiratory rate. b. Enhanced urinary elimination. c. A decrease in muscle weakness, ptosis, and diplopia. d. Prolonged muscle contractions and proprioception.

c

The nurse is reviewing the patient's medication record and does not recognize the medication, filgrastim-sndz (Zarxio). Consulting a drug guide, the nurse finds it is listed as a "biosimilar" to filgrastim (Neupogen). Which of the following best describes the definition of a biosimilar drug? a. It is another term for a "generic" drug when the two drugs exert similar biologic effects. b. It is a drug that has similar effects on the body, but belongs in a different chemical and therapeutic classification. c. It is a drug that is derived from living cells, such as yeast, and has comparable effectiveness and safety to the reference product drug. d. It is a drug that is identical to the reference product drug and thus, does not require FDA approval.

c

The nurse is using a drug handbook to determine the indications for the drug furosemide (Lasix). The term indications is defined as the: a. Way a drug works on the target organs. b. Amount of the drug to be administered. c. Conditions for which a drug is approved. d. Reason that the drug should not be given.

c

The patient is receiving a medication that causes hepatotoxicity. What symptoms would alert the nurse that this drug-related toxicity has occurred? a. Black furry tongue and vaginal yeast infection b. A sudden reduction in blood pressure on rising c. Right upper quadrant pain and anorexia d. Uncontrollable movements in the face, arms, and legs

c

The patient is receiving multiple medications, including one drug specifically used to stimulate gastric peristalsis. The nurse knows that this drug could have what influence on additional oral medications? a. Increased absorption b. Reduced excretion c. Decreased absorption d. Enhanced distribution

c

The patient will be taking cholinergic antagonists following discharge from the healthcare agency. Which statement, made by the patient, would indicate that additional teaching is needed? a. "To relieve dry mouth, I should drink plenty of water." b. "I will avoid activities requiring mental alertness until I know the effects of this drug." c. "The use of lubricating eyedrops should be avoided. I should see an eye doctor for dry eyes." d. "I will not breastfeed while taking this drug without consulting my HCP."

c

Various psychosocial variables may influence nonadherence to pharmacotherapy. An example of this would occur when the patient reports that the prescribed drug: a. Produces an unpleasant aftertaste. b. Is a very large tablet and difficult to swallow. c. is too expensive for the patient to afford. d. Potentially causes hepatotoxicity.

c

When given a medication, the patient tells the nurse, "I've never seen this pill before. It's not like the others I take." Which would be the most appropriate action for the nurse to take? a. Instruct the patient that different brands are frequently used. b. Administer the medication in the existing form. c. Verify the order and double-check the drug label. d. Advise the patient to talk with the HCP and give the drug.

c

Which health teaching concept should be included in the instructions for a patient taking echinacea? a. Dosage can be doubled if symptoms fail to resolve in 48 hours. b. Limit fluid intake while taking this supplement. c. Take the smallest amount possible when starting herbal therapy. d. Allergic reactions are not possible with natural supplements.

c

Which of the following statements made by the patient recovering from a substance use disorder would indicate high potential for relapse? a. "I need the help of a support system to stop using." b. "After I stop using, I will no longer have a desire to use drugs." c. "Whom I hang out with doesn't make any difference in whether or not I use drugs." d. "Talking with other recovering addicts will help me cope."

c

A 22-year-old heroin addict is exhibiting withdrawal symptoms. Which symptoms of withdrawal does the nurse expect? a. Somnolence, lethargy, and fatigue b. Dry skin, rash, and itching c. Paranoia, hallucinations, and delusions d. Chills, runny nose, and muscle spasms

d

A 55 year old female has been prescribed an anticholinergic for her complaints of urinary frequency and urgency. The nurse teaches the patient which of the following to address the primary side effect from this drug: a. Wear protective underwear b. Avoid activities that may cause injury or bleeding c. Carry an OTC antidiarrheal when traveling d. Rinse your mouth or use sugarless hard candy frequently

d

A healthcare provider has ordered an alpha1-adrenergic antagonist for each of these patients. A nurse should question the order for the patient with which disorder? a. Benign prostatic hyperplasia b. Pheochromocytoma c. Raynaud's disease d. Tachycardia

d

A patient has been treated with pyridostigmine (Mestinon) for myasthenia gravis and has been well managed until today. He is taken to the emergency department with symptoms of a cholinergic crisis. As the nurse caring for this patient, what symptom would be indicative of this complication? a. Nausea and vomiting b. Miosis c. Drooling d. Progressively severe muscle weakness

d

A research nurse is discussing the TD50 of a drug with the other members of the investigation team. On which of the following would the discussion focus? a. Effectiveness b. Dose response c. Receptor subtypes d. Toxicity

d

It is 2:45 a.m. and the nurse has telephoned the prescriber to report that the patient is experiencing an acute episode of postoperative pain. How can the nurse avoid medication errors when receiving a telephone order from a prescriber? a. Decline to accept the telephone order. b. Refuse to call the prescriber but attempt to comfort the patient. c. Instruct the patient's family to call the prescriber. d. Repeat the order verbally to ensure accuracy.

d

Polyherbacy may be of concern in the older adult population. A pharmacokinetic factor for this concern is that the older adult: a. Is more likely to have difficulty using herbal products correctly. b. May spend too much on herbal products rather than prescriptions. c. May hold unrealistic expectations for the outcomes of herbal therapy. d. May have age-related changes in liver or kidney function.

d

The healthcare provider prescribes epinephrine (Adrenalin) to a patient who was stung by several wasps 30 minutes ago. The nurse knows that the primary purpose of this medication for this patient is to: a. Stop the systemic release of histamine produced by the mast cells. b. Counteract the formation of antibodies in response to an invading antigen. c. Increase the number of white blood cells produced to fight the primary invader. d. Increase a declining blood pressure and dilate constricting bronchi associated with anaphylaxis.

d

The nurse is asked by a family member: "They're giving mom Motrin and she takes Advil. Hasn't the wrong drug been ordered?" The nurse will respond, knowing that: a. There has been an error in the order and the nurse will contact the healthcare provider. b. There may be a reason for the healthcare provider to order a different drug. c. Not all healthcare agencies buy the same generic drugs and that may account for the difference. d. Motrin and Advil are trade names for the same generic drug, ibuprofen.

d

The nurse is caring for a patient with hepatitis and resulting hepatic impairment. The nurse would expect the duration of action for most medications to: a. Decrease b. Improve c. Be unaffected d. Increase

d

The nurse is discussing the therapeutic effects of bethanechol (Urecholine) with a patient who is receiving this drug for urinary retention. The nurse understands that bethanechol: a. Changes the diameter of the urethral opening. b. Increases the amount of urine made in the kidneys. c. Improves blood flow to the kidney. d. Increases the contractions of the bladder and structures that promote urination.

d

The nurse is preparing to discuss drug use during pregnancy with a group of nursing students. The main topic is the FDA drug classifications. Which of the following drugs should the nurse inform the students are the most detrimental to the fetus? a. Category A b. Category B c. Category C d. Category X

d

The patient is receiving a medication that may cause nephrotoxicity. To decrease the risk of this adverse reaction, the nurse should encourage the patient to: a. Avoid sunbathing and exposure to direct sunlight. b. Increase the intake of potassium-enriched foods. c. Abstain from alcoholic beverages. d. Increase fluid intake to promote adequate hydration.

d

The patient requests that a refill prescription of a Schedule II controlled substance be telephoned to the drug store. When responding to the patient, the nurse would consider which factor? Refills of Schedule II drugs: a. Are less costly then the original prescription. b. Must be listened to by at least two people. c. Are verified through the local DEA office. d. Are not permitted under federal law.

d

Which is the most effective method for a nurse to recognize patient-specific genetic influences? a. Ask the patient if there have been drug-dose-related problems in the past. b. Consult reference books and the internet for information. c. Observe the effects with other patients of similar racial-ethnic background. d. Be cautious with all drugs and observe for individual patient responses.

d

Which of the following defines "mechanism of action"? a. A serious adverse effect usually caused by excessive dosing b. Indications for why a medication should not be given c. Primary action for which the medication is prescribed d. How the medication produces the desired therapeutic effect

d

Which of the following should the nurse instruct a patient with diabetes who is prescribed a beta-adrenergic blocker for the treatment of hypertension to do? a. Increase insulin intake by 2 to 3 units daily each morning. b. Decrease the intake of carbohydrates while on the antihypertensive medications. c. Elevate the lower extremities to promote venous drainage. d. Monitor blood glucose levels frequently and report hypoglycemia.

d