pharm exam 02/21

A client is discharged from the hospital with a prescription for warfarin. Which statement by the client indicates successful client teaching?

"I will avoid ginseng and St. John's wort."

Anticholinergics

... is a drying agent and causes dry mouth, urinary retention, avoid salt

PT

1.3-1.5

APPT/PTT clotting times

1.5-2.5

INR

2-3.5

withdrawal from stopping the medication

A 34-year-old executive for an insurance company has been taking lorazepam for the last 6 months for anxiety. The client abruptly stopped the medication. The client then calls the health care provider and reports feeling irritable, and increased heart rate, and restlessness. What would explain the client's current symptoms?

a history of current or past alcohol use.

A 64-year-old-client has been prescribed lorazepam because of increasing periods of anxiety. The nurse should be careful to assess for which?

Carbidopa

A client has been taking levodopa (L-dopa) for the treatment of Parkinson's disease. What additional medication may decrease the amount of levodopa needed to reach a therapeutic level in the brain, thereby reducing adverse effects of levodopa?

Pyridoxine (Vitamin B6)

A client is receiving levodopa as treatment for Parkinson disease. The nurse would instruct the client to avoid foods high in which vitamin to prevent a reduction in the effect of levodopa?

27mcg/mL

A client is receiving phenytoin. The nurse monitors the client's plasma drug level. Which level would alert the nurse to the possibility of toxicity? 27mcg/mL 10mcg/mL 18mcg/mL 15mcg/mL

narrow angle glaucoma

A client who diagnosed with Parkinson's disease is being treated with levodopa/carbidopa. Which disorder will result in the discontinuation of this drug based on a disease-related contraindication?

Lorazepam 2 mg PO

A client who has claustrophobia is scheduled for an magnetic resonance imaging (MRI) for the investigation of an abdominal mass. The nurse should anticipate what pre-medication order?

The client is able to walk more briskly and stably than two weeks ago

A client with Parkinson's disease began treatment with dopaminergics two weeks ago and has now presented for a follow-up assessment. What finding best suggests to the nurse that the treatment is having a therapeutic effect?

Melatonin

A male client tells the nurse that he has been taking an OTC supplement to aid with insomnia. What supplement is the client taking?

Decreased tremors

A nurse is assessing a client with Parkinson's disease. The nurse determines that the client's drug therapy is effective when the client exhibits what?

Observe respirations frequently.

A nurse is caring for a patient prescribed phenobarbital for status epilepticus. What intervention should the nurse perform when the patient has been administered the drug?

status epilepticus

A patient is prescribed daily doses of phenytoin for seizures. The nurse knows that a single dose should not be missed during the course of treatment. Which condition could result if a dose is missed?

Parkinson's disease

A progressive, chronic neurological disorder.

Bile Acid Sequestrants (lowers LDL) contraindications

Allergy Complete biliary obstruction Abnormal intestinal function Pregnancy/breastfeeding

use another form of birth control, such as condoms.

An adolescent taking oral contraceptives has been prescribed an anticonvulsant medication. The nurse should tell the client to do which?

The clinic nurse has been assigned to a 43-year-old man who is obese and loves to eat. He has been diagnosed with hyperlipidemia and has been prescribed lovastatin. Which of the following dietary instructions would be a priority for the nurse to discuss with the patient?

Avoid drinking grapefruit juice and decrease intake of fatty acids

A client is taking atorvastatin calcium to reduce serum cholesterol. Which aspect of client teaching is most important?

Call the health care provider if muscle pain develops.

Pharmacokinetics of nitrates

Comes in sublingual tablet, translingual spray, IV solution, a transdermal patch, a topical ointment, or a transmucosal agent. Rapidly absorbed Metabolized in the liver Excreted in the urine Crosses the placenta and enters breast milk

dry mouth, urinary retention, constipation, and increased pulse rate.

Common side effects of anticholinergics include:

action of ezetimibe

Decreases the absorption of dietary cholesterol from the small intestine

anticoagulants

Drugs that interfere with the normal coagulation process by interfering with the clotting cascade and thrombin formation

A client should be instructed to take sublingual NTG how often if he experiences chest pain?

Every 5 minutes times 3

How is heparin administered?

Heparin is injected IV or subcutaneously and has an almost immediate onset of action; excreted in the urine

The nurse is providing teaching to a client who is at risk for hyperlipidemia. The nurse tells the client that hyperlipidemia has many risk factors. The nurse knows that which of the following risk factors can be controlled or modified?

Obesity, inactivity, diet, and smoking

The effects of warfarin (Coumadin) are monitored by what laboratory test(s)?

PT and INR

A client has begun taking cholestyramine. Which action by the nurse best addresses likely adverse effects?

Promoting fiber and fluid intake

true

Respiratory distress is a contraindication for the use of barbiturates.

decreased anxiety

The client is scheduled for surgery. The nurse administers diazepam (Valium) preoperatively for what purpose?

"I may be a little drowsy at first when I start taking this medication."

The healthcare provider has prescribed alprazolam (Xanax) for a client. After the nurse has taught the client about this medication. The nurse confdiairms that the client understands the drug's action when the client makes which statement?

Levodopa

The most effective drug to treat major symptoms associated with Parkinson's is:

rash

The nurse has taught a client who is receiving lamotrigine about possible adverse effects. The nurse determines that the client has understood the teaching when the client identifies a need to promptly report what adverse effect?

Excessive sedation and interference with learning and social development

The nurse instructs the parent of a young school-age child with a seizure disorder who takes an AED to be alert for what signs and symptoms?

Informing the client and family that seizure control is not gained immediately

The nurse is formulating a care plan for a client with a seizure disorder. Which intervention would be an appropriate for the nurse to include?

Which patient should not receive epoetin alfa (Epogen) as ordered at 9 am?

The patient who has a blood pressure of 240/120 mm Hg

Strong evidence exists that atheroma development occurs more quickly in patients with elevated cholesterol and lipid levels.

True

antihyperlipidemic agents

Used to treat hyperlipidemia

Warfarin antidote

Vitamin K

Antiepilepsy drugs are teratogenic

What explanation should the nurse provide for why pregnancy is discouraged in women who are being treated for seizure disorders?

Diazepam

What medication may be administered intravenously (IV) to assist in reducing status epilepticus seizure activity?

liver toxicity

What should the nurse include as a possible adverse effect when teaching a client about phenytoin?

drug-drug interactions

When combination therapy is ineffective, what needs to be reassessed?

A client has been prescribed intravenous heparin. What laboratory value will the nurse prioritize when providing care for this client?

aPTT

Neurotransmitters

acetycholine (ach) dopamine - pleasure serotonin - mood glutamate - learning and memory

HMG-CoA Reductase Inhibitors contraindications

allergy active liver disease pregancy/ breastfeeding

Erythropoietin

anemia occurs when levels are low Kidneys produce erythropoietin

atenolol (drugs ending in olol)

beta adrenergic blockers used to prevent angina and lower blood pressure

An asthmatic client on a beta blocker should be observed for which adverse reaction?

bronchospasm

Anticoagulant drugs

coumadin (warfarin) heparin eliquis (apixaban)

The provider orders heparin for a 35-year-old female client. The nurse administers the drug only after confirming that the client:

does not have peptic ulcer disease.

Parkinson's disease medications

dopaminergic agents ex: levodopa(#1), cardopa

pathophysiology of hyperlipidemia

elevated concentrations of lipids or fats within the blood.

The client has been prescribed nicotinic acid for treatment of hyperlipidemia. The nurse should teach about which common side effects with this medication?

flushing of the skin

how does vitamin B3 affect cholesterol

generally reduces LDL and triglyceride levels and increases HDL levels

The nurse is teaching a client about dietary concerns related to the administration of warfarin. The nurse determines the teaching session is successful when the client correctly points out that a consistent intake of which foods is necessary when using warfarin?

green leafy vegetables

The nurse is caring for a client experiencing an acute angina attack. Sublingual nitroglycerin has been administered. The nurse assesses the client's vital signs for which reason?

identify hypotension

HMG-CoA reductase inhibitors

lipid lowering agent

antianxiety drugs

lorazepam (ativan) alprazolam (xanax) diazepam (valium)

HMG-CoA Reductase Inhibitors (medications)

medicztions ending in statin ex: atorvastatin

What happens when pt treated for seizures stops medication abruptly

more seizures

How are warfarin, eliquis, and drugs ending in aban administered?

orally

Heparin antidote

protamine sulfate

The client has been taking rosuvastatin for hyperlipidemia. The client now presents with severe weakness and states barely being able to move the extremities. The nurse suspects the client has which?

rhabdomylosis

The nurse would avoid administering nitrates to clients using which medication?

sildenafil (viagra) erectile dysfunction drugs

the nurse instructs the client that he can repeat the dose of nitroglycerin every 5 minutes up to a maximum total of how many doses

three

Parkinson's disease symptoms

tremors, lack of coordinations, weakness, bradykinesia, drooling, slowed/slurred speech, mask like expression, difficulty swallowing

nitrates

what drugs are these Isosorbide nitroglycerin