Pharm 2 exam 2
Which nutritional concept(s) is/are necessary to provide to patients receiving colestipol? (Select all that apply.)
Whole grains, raw fruits, and vegetables will minimize constipation. Report signs of vitamin K deficiency, including bleeding gums, dark tarry stools, and coffee-ground emesis. Supplemental fat-soluble vitamins may be necessary.
Which statement(s) about diuretics is/are true? (Select all that apply.)
A mechanism of action for the antihypertensive effects of diuretics includes volume depletion. They have been shown to reduce cardiovascular morbidity associated with hypertension. Electrolytes must be evaluated periodically for patients on loop diuretics.
The nurse is educating a patient about niacin prescribed to treat his hyperlipidemia. Which important teaching point(s) should be included in the educational plan? (Select all that apply.)
Effectiveness of niacin in lowering total cholesterol, Information on high cholesterol foods and food preparation using unsaturated fats, Adverse effects to report (e.g., fatigue, anorexia, nausea, malaise, jaundice, muscle aches)
The nurse is assessing a patient who is being evaluated for hyperlipidemia. which assessment will most increase the risk of coronary artery disease (CAD)?
Blood Pressure, 168/90 mmHg
Patients taking phenytoin (Dilantin) for control of seizures must be aware of the risk for which adverse effect(s)? (Select all that apply.)
Blood dyscrasias, Hyperglycemia, Gingival hyperplasia, Sedation
The nurse is teaching a patient about statin therapy. Which statement by the patient indicates a need for further teaching?
If i get a headache, i will notify my health care provider
Which nursing assessment confirms that the angiotensin II receptor blocker ARB that a patient is taking is effective?
Blood pressure is decreased
A nurse is reinforcing teaching with a client who has osteoarthritis and is taking acetaminophen for pain management. Which of the following statements should the nurse include in the teaching?
Increase your water intake to 2 liters per day."
In addition to type 2 diabetes and heart disease, which condition(s) is/are associated with metabolic syndrome? (Select all that apply.)
Dementia, Renal disease, Obstructive sleep apnea, Polycystic ovary syndrome,
Drug therapy for initial treatment of metabolic syndrome is targeted at controlling which condition(s)? (Select all that apply.)
Diabetes mellitus, Hypertension, Dyslipidemia
The nurse instructs the patient to avoid the sudden discontinuation of beta-adrenergic blockers so as to avoid which symptom?
Increased angina
Which sign or symptom displayed by a patient would be indicative of opiate withdrawal?
Diarrhea
A client is about to undergo a closed reduction of a fracture. In addition to analgesia, the nurse suggests that the client listen to an audiotape of music. Which of the following nonpharmacologic interventions for pain management is the nurse using?
Distraction
Which statement(s) concerning the use of antihypertensive therapy for the treatment of hypertension would be considered true? (Select all that apply.)
Diuretics are the most commonly prescribed antihypertensive agent. Diuretics are often prescribed in combination therapy with other antihypertensive agents.
A patient asks the nurse how amlodipine works to reduce the blood pressure. Which response will the nurse provide?
It causes blood vessel dilation
What is the most critical approach to the treatment of metabolic syndrome?
Lifestyle management
The nurse transcribes a new order for Lovaza on a patient in a long-term care facility. When providing education to the patient about this medication, the nurse will include which statement(s)? (Select all that apply.)
Liver function tests should be completed before initiating therapy. Lovaza should be used with caution if the patient has an allergy to fish. Lovaza does not cause myositis.
What will the nurse review when teaching a patient about therapy with statins? (Select all that apply.)
Statins are the most potent antilipemic agents available. Statins should be taken with food. Statins cause mild increases in HDL levels. Statins reduce inflammation, platelet aggregation, and plasma viscosity.
Which condition(s) may be managed by salicylates? (Select all that apply.)
Swollen joints, Fever, Muscle aches, Myocardial infarction
Which physiologic response will the nurse expect to assess in patients taking hydralazine (Apresoline)?
Tachycardia
What is mean arterial pressure(MAP)?
The average pressure throughout each cycle of the heartbeat
Which statement is true about neuropathic pain?
The pain is a result of nerve injury
What is the advantage of taking a NSAID that is a cox 2 inhibitor?
There are fewer GI adverse effects
The nurse is explaining to a patient how ACE inhibitors affect blood pressure. Which statement accurately describes the action of these medications?
They inhibit vasoconstriction
Which agents are preferred for the initial treatment of hypertension?
Thiazide diuretics and beta adrenergic blockers
A nurse in an urgent care center is collecting data from a client who reports taking an excessive amount of aspirin. Which of the following findings should the nurse identify as an indication of salicylism?
Tinnitus
An 86 year old patient who was admitted with GI bleeding as a result of salicylate therapy is being discharged. As the nurse reviews the discharge medication list, the patient states she doesn't why Tylenol doesn't work as well as the aspirin she had been taking. What would be the nurse's best response?
Tylenol does not help with inflammatory
What is the best way for the nurse ti evaluate the effectiveness of the patient's opiate agonist?
Verbal report of 2 on a 1 to 10 scale
Which deficiency may develop in patients taking cholestyramine?
Vitamin K deficiency
A nurse in an urgent care center is collecting data from a client who reports taking an excessive amount of acetaminophen. Which of the following findings should the nurse identify as an indication of acute acetaminophen toxicity?
Vomiting
When teaching a patient who is starting therapy with NSAIDs, the nurse must be sure to mention drug interactions with which drug(s)? (Select all that apply.)
Warfarin (Coumadin), Lithium (Eskalith), Diuretics
Which common adverse effect(s) is/are associated with opiate agonists? (Select all that apply.)
Dizziness, Orthostatic hypotension, Respiratory depression, Confusion.
The nurse is preparing medications for patient. When is the best time for the nurse to administer lovastatin (Mevacor)?
During the patient's dinner
The seizure disorder that occurs primarily in children and usually disappears at puberty is called:
absence epilepsy
A patient is taking meperidine (demoral) as needed for moderate to severe pain level 2, temperature 99F , BP 130/76, respirations 10, lung sounds clear, abdomen soft and tender, bowel sounds present. Based on this assessment information, the priority nursing diagnosis is
altered breathing pattern
Medications used almost exclusively to treat epilepsy are referred to as:
anticonvulsants
Which class of anti-hypertension agents should be avoided by patients with asthma?
beta adrenergic blocking agents
The nurse is preparing to administer niacin for the first time to a patient being treated for dyslipidemia. Before administering this medication, the nurse will assess: (Select all that apply.)
blood glucose levels. blood pressure. heart rate.
A nurse at a pediatric hotline receives a call from a mother who plans to administer aspirin to a toddler for a fever and wants to know the dosage. Which of the following statements by the nurse is an appropriate response?
"Give her acetaminophen, not aspirin."
A nurse is caring for a client who reports daily use of acetaminophen to manage mild knee pain. Which of the following statements by the client should the nurse investigate further?
"I take over-the-counter cold medicine for my sinus congestion."
Which complication(s) is/are associated with uncontrolled hypertension? (Select all that apply.)
Angina, Stroke, Renal failure, Heart failure
What term is used to define an awareness of pain?
Perception
Which cardiovascular condition(s) is/are related to coronary artery diseases (CADs)? (Select all that apply.)
Angina pectoris, Acute myocardial infarction
A nurse is preparing to administer enteric-coated aspirin to an older adult client who had a cerebrovascular accident and has difficulty swallowing medications. The client asks the nurse if she will crush the medication to make it easier to swallow. Which of the following responses should the nurse make?
"If I crush it you might experience a stomach ache or indigestion."
A nurse is reinforcing teaching with a client who is to start taking enteric-coated naproxen for rheumatoid arthritis. Which of the following client statements by the client indicates a need for further teaching?
"It's okay to crush a tablet as long as I make sure it dissolves completely in water before swallowing it."
A nurse is caring for a client who is using a patient-controlled analgesia (PCA) pump for postoperative pain management. The nurse enters the room to find the client asleep and his partner pressing the button to dispense a dose of analgesia. Which of the following responses should the nurse make?
"Your husband should decide when more medication is needed."
The nurse is reviewing lab values for a patient taking gabapentin. She knows that the therapeutic blood levels are:
12 to 20 mg/L
According to the U.S. Food and Drug Administration, patients who were receiving antiepileptic drugs had approximately _______ times the risk of suicidal behavior or ideation as compared to other
2
A nurse is preparing to administer acetaminophen 10/mg/kg PO to a preschool child for fever. The child weighs 22 lb. Available is acetaminophen liquid 160 mg/5 mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
3.1 mL
How long after the administration of a parenteral pain medication will the nurse complete the next pain assessment to evaluate the effectiveness of the medication?
30 minutes
The nurse has an order to administer diazepam IV. The nurse knows that it should be administered at a rate of no more than:
5 mg/minute
A patient's blood pressure is 134/78 hg. The nurse records the pulse pressure as
56
If blood pressure is 120/70, what is the MAP?
86.66
Which medication lowers blood pressure by directly inhibiting renin?
Aliskiren
A nurse in an urgent care clinic is assisting with the care of a toddler who ingested 30 tablets of aspirin. Which of the following substances should the nurse administer to the toddler?
Activated charcoal
The healthcare provider orders diazepam (Valium) 10 mg IV stat for a patient who was admitted with status epilepticus. What important nursing interventions(s) associated with administration of this medication IV should the nurse perform? (Select all that apply.)
Apply a cardiac monitor to the patient to assess for continuous heart rate, if not already done. Continuously assess the patient's airway. Obtain the correct dose (10 mg) and administer over slow IV push.
Which medication is contraindicated when a patient is taking warfarin(Coumadin)?
Aspirin
Which vitamin has antilipemic actions?
B3
Which medication is often administered with hydralazine to reduce reflex physiologic responses to the drug?
Beta blockers
A nurse is reinforcing teaching for a client who has rheumatoid arthritis and a new prescription for aspirin 650 mg orally every 6 hr. The nurse should instruct the client to monitor for which of the following adverse effects of aspirin therapy?
Bleeding
Why are statins, or HMG CoA reductase inhibitors, administered at bedtime?
Cholesterol production is at its peak
The nurse is preparing to assess blood pressure on a patient who has had two prior readings of 160/100. Physician's notes from a prior visit indicate that the patient is suspected to have hypertension. When reassessing this patient for hypertension, the nurse will do what? (Select all that apply.)
Choose a cuff encircling at least 80% of the arm. Support patient's arm at heart level. Encourage patient to sit quietly for 5 minutes before assessing blood pressure.
The nurse is providing instruction to a patient who was recently prescribed an ACE inhibitor for hypertension. Which is an adverse effect of this medication?
Chronic cough
A patient is prescribed a bile acid resin. The nurse instructs the patient to report which adverse reaction related to vitamin K deficiency ?
Coffee ground emesis
A patient on anticonvulsant therapy confides to the nurse at an outpatient clinic that she suspects she may be pregnant. The nurse should encourage the patient to take which action(s)? (Select all that apply.)
Consult an obstetrician. Carry an identification card. Provide a list of seizure medications.
What information is most accurate regarding the nurse's understanding of pain management?
Encourage patients to report pain before the pain becomes too severe.
A patient recently prescribed felodipine (Plendidl) for treatment of hypertension is experiencing dizziness when rising to a standing position. Which action will the nurse take?
Encourage the patient to sit down if feeling faint
What lifestyle choice(s) may aggravate metabolic syndrome? (Select all that apply.)
Excessive tobacco smoking, Excessive consumption of alcohol
The nurse is completing an assessment on a non-verbal adult patient. Which type of pain scale assessment tool is the most accurate to use?
FLACC
The nurse is finished conducting nutritional education with a patient about the DASH (dietary approaches to stop hypertension) diet. The patient would like to complete the breakfast menu for tomorrow. Which foods offered for breakfast would be most appropriate for the patient to choose? (Select all that apply.)
Grapefruit, Orange juice, Oatmeal
A nurse is caring for a client who is postoperative following knee surgery. In addition to analgesia, the nurse suggests that the client imagine herself relaxing on a beach and enjoying the tropical breezes. Which of the following nonpharmacologic interventions for pain management is the nurse using?
Guided imagery
Which antilipemic agent is most potent?
HMG-CoA reductase inhibitor
A teaching plan for a patient with hyperlipidemia would instruct the patient to avoid which food(s)? (Select all that apply.)
Hard cheeses, Liver
Which common adverse effect of an angiotensin II receptor antagonist will the nurse expect to assess in a patient?
Headache
A nurse is collecting data from a female client who has osteoarthritis and reports she is thinking about taking aspirin for pain control. Which of the following data in the client's history should the nurse realize might be a contraindication to taking aspirin and should be reported to the provider?
History of vitamin K deficiency
Metabolic syndrome includes which key characteristic(s)? (Select all that apply.)
Hyperglycemia, Abdominal obesity, Low high-density lipoproteins, Hypertension
Which lipoprotein contributes to the development of atherosclerosis?
Low-density lipoprotein chylomicron (LDL C)
Which medication would the nurse administer to a patient who is rating the pain at 8 on a 0 to 10 scale?
Morphine
The nurse is providing education to a patient who has recently been prescribed niacin. Which information given by the nurse is accurate?
Nausea can be decrease if you take this medication with food
Which action will the nurse take when a patient receiving morphine sulfate via percutaneous coronary angioplasty (PCA) has a shallow, irregular respiratory rate of 6 breaths/min?
Notify the health care provider and prepare to administer naloxone
When performing a baseline neurologic assessment prior to the administration of an NSAID medication, the nurse will assess which patient characteristic(s)? (Select all that apply.)
Orientation to date, time, and place, Mental alertness
What is included in the nursing management of the patient with generalized tonic-clonic seizure activity? (Select all that apply.)
Placing padding around or under the patient's head, Positioning the patient on the side once the relaxation stage is entered to allow oral secretions to drain, Requesting additional assistance and/or necessary equipment in case the patient does not begin breathing spontaneously when the seizure is over
The mother of a school-aged child asks the nurse how to help prevent her child from acquiring metabolic syndrome. The nurse informs the child's mother that education for children in primary grades should focus on which action(s)? (Select all that apply.)
Prevention of smoking, Importance of moderate activity, Discouraging use of alcohol
A patient experiencing chronic pain as a result of metastatic cancer has a new order for fentanyl (duragesic) transdermal patch. The initial patch is applied at 8am on Monday. At 8 PM on Monday, the patient reports a pain level of 8. The nurse's best response is to
Provide a PRN analgesic medication as ordered
Which additional nursing intervention(s) would be effective with pain management in the pediatric population? (Select all that apply.)
Provide diversional activities such as coloring, puzzles, and games. Allow uninterrupted sleep and rest. Perform hygiene measures. Encourage parental participation with caregiving to diminish the child's anxiety.
In addition to controlling hyperlipidemia, what are bile acid-binding resins prescribed to treat?
Pruritus secondary to biliary stasis
The nurse is assessing a patients pain. When the patient's pain. When the patient describes his pain as cramping and burning, which component of the pain history is being addressed?
Quality
What is the desired effect of any antilipemic therapy?
Reduced LDLs and total cholesterol levels
How does propranolol (inderal) control hypertension?
Reduces the sympathetic stimulation in cardiac muscle
Hydralazine, a direct vasodilator, is used to treat hypertension associated with which condition?
Renal disease
In which case would the nurse be correct in withholding an opiate agonist?
Respiratory rate of 10 breaths/min
A patient who has just began taking an ACE inhibitor calls the nurse and reports feeling very dizzy when standing up and asks if the medication should be discontinued. What is the nurse's best response?
Rise to a sitting or standing position slowly; symptoms will resolve
The nurse is preparing to administer zonisamide (Zonegran) to a newly admitted patient with the diagnosis of adult partial seizures. The nurse should hold this medication if the patient has which sign(s) or symptom(s)? (Select all that apply.)
Skin rash, Allergy to Bactrim, Pruritus
The nurse has provider information to a patient with diabetes who has been prescribed a beta-adrenergic blocker. Which statement by the patient indicates a need for further teaching?
if i get dizzy, i will stop taking the medication
The nurse has completed an admitting patient history and notes the patient's current medications to be simvastatin (Zocor) and warfarin (Coumadin). What is the result of the interaction of these drugs?
increased INR
Which is true about postural hypotension during therapy with direct vasodilators?
it gradually resolves with continued medication used
A back-and-forth movement of the eyeballs on the horizontal plane, particularly when looking laterally, is called:
nystagmus
A brief period of abnormal electrical activity in the nerve cells of the brain is called a:
seizure
A patient is taking a HMG CoA reductase inhibitor and reports muscle aches, soreness, and weakness. The nurse suspects these symptoms, the nurse will also be sure to report the results of the patient's
serum creatine phosphokinase levels
A rapidly recurring generalized seizure that does not allow the patient to regain normal function between seizures is called:
status epilepticus
Which drug class acts by elevating the seizure threshold by the depression of cortex nerve transmissions, which reduce the current in the T-type calcium channels found in primary afferent neurons?
succinimides
A nurse is caring for a client who asks why she is being prescribed aspirin 325 mg daily following a myocardial infarction. The nurse should instruct the client that aspirin is prescribed for clients who have coronary artery disease for which of the following effects?
to prevent blood clotting
The most common type of seizures are called:
tonic-clonic
when displayed by the patient, which symptom would be most indicative to the nurse to withhold a recently prescribed beta-adrenergic blocker?
wheezing
Prior to the administration of beta-adrenergic blocker, the nurse notes the patient to have a heart rate of 52 bpm, peripheral edema, crackles in the bases of the lungs, and mottled skin. Which is the priortiy nursing action?
withhold the medication and notify the health care provider
