Pharm Exam 1

A nurse teaches a nursing student about the differences between desmopressin (DDAVP) and vasopressin [Pitressin]. Which statement by the student indicates a need for further teaching? a. "Desmopressin has a shorter duration of action than vasopressin." b. "Desmopressin is easier to administer than vasopressin." c. "Vasopressin can be used in cardiac resuscitation." d. "Vasopressin can cause serious adverse cardiovascular effects."

a. "Desmopressin has a shorter duration of action than vasopressin." *key phrase: NEED for further teaching*

A pregnant adolescent patient asks the nurse whether she should continue to take her prescription for tetracycline [Sumycin] to clear up her acne. Which response by the nurse is correct? a. "Tetracycline can be harmful to the baby's teeth and should be avoided." b. "Tetracycline is safe to take during pregnancy." c. "Tetracycline may cause allergic reactions in pregnant women." d. "Tetracycline will prevent asymptomatic urinary tract infections."

a. "Tetracycline can be harmful to the baby's teeth and should be avoided."

A patient is hospitalized with head trauma after a motor vehicle accident. The nurse caring for the patient notes a marked increase in the output of pale, dilute urine. The nurse suspects which condition? a. Diabetes insipidus b. Diabetes mellitus c. Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

a. Diabetes insipidus

The nurse assesses a newly diagnosed patient for short-term complications of diabetes. What does this assessment include? a. Evaluation for hyperglycemia, hypoglycemia, and ketoacidosis b. Cranial nerve testing for peripheral neuropathy c. Pedal pulse palpation for arterial insufficiency d. Auscultation of the carotids for bruits associated with atherosclerosis

a. Evaluation for hyperglycemia, hypoglycemia, and ketoacidosis

A patient is to undergo orthopedic surgery, and the prescriber will order a cephalosporin to be given preoperatively as prophylaxis against infection. The nurse expects the provider to order which cephalosporin? a. First-generation cephalosporin b. Second-generation cephalosporin c. Third-generation cephalosporin d. Fourth-generation cephalosporin

a. First-generation cephalosporin

A nurse is educating the staff nurses about ketoacidosis. To evaluate the group's understanding, the nurse asks, "Which sign or symptom would not be consistent with ketoacidosis?" The group gives which correct answer? a. Blood glucose level of 600 mg/dL b. Blood glucose level of 60 mg/dL c. Acidosis d. Ketones in the urine

b. Blood glucose level of 60 mg/dL

2. A nurse counsels a patient with diabetes who is starting therapy with an alpha-glucosidase inhibitor. The patient should be educated about the potential for which adverse reactions? (Select all that apply.) a. Hypoglycemia b. Flatulence c. Elevated iron levels in the blood d. Fluid retention e. Diarrhea

b. Flatulence e. Diarrhea

A nurse caring for a patient notes that the patient has a temperature of 104°F and a heart rate of 110 beats per minute. The patient's skin is warm and moist, and the patient complains that the room is too warm. The patient appears nervous and has protuberant eyes. The nurse will contact the provider to discuss: a. cretinism. b. Graves' disease. c. myxedema. d. Plummer's disease.

b. Graves' disease. keywords: protuberant eyes

The nurse is caring for a pregnant patient recently diagnosed with hypothyroidism. The patient tells the nurse she does not want to take medications while she is pregnant. What will the nurse explain to this patient? a. Hypothyroidism is a normal effect of pregnancy and usually is of no consequence. b. Neuropsychologic deficits in the fetus can occur if the condition is not treated. c. No danger to the fetus exists until the third trimester. d. Treatment is required only if the patient is experiencing symptoms.

b. Neuropsychological deficits in the fetus can occur if the condition is not treated.

A nurse assisting a nursing student with medications asks the student to describe how penicillins (PCNs) work to treat bacterial infections. The student is correct in responding that penicillins: a. disinhibit transpeptidases. b. disrupt bacterial cell wall synthesis. c. inhibit autolysins. d. inhibit host cell wall function.

b. disrupt bacterial cell wall synthesis.

The nurse is caring for a patient who is receiving vancomycin [Vancocin]. The nurse notes that the patient is experiencing flushing, rash, pruritus, and urticaria. The patient's heart rate is 120 beats per minute, and the blood pressure is 92/57 mm Hg. The nurse understands that these findings are consistent with: a. allergic reaction. b. red man syndrome. c. rhabdomyolysis. d. Stevens-Johnson syndrome.

b. red man syndrome.

A nurse obtaining an admission history on an adult patient notes that the patient has a heart rate of 62 beats per minute, a blood pressure of 105/62 mm Hg, and a temperature of 96.2 F. The patient appears pale and complains of always feeling cold and tired. The nurse will contact the provider to discuss tests for which condition? a. Cretinism b. Graves' disease c. Hypothyroidism d. Plummer's disease

c. Hypothyroidism keywords: cold and tired

Insulin glargine is prescribed for a hospitalized patient who has diabetes. When will the nurse expect to administer this drug? a. Approximately 15 to 30 minutes before each meal b. In the morning and at 4:00 PM c. Once daily at bedtime d. After meals and at bedtime

c. Once daily at bedtime

To prevent yellow or brown discoloration of teeth in children, tetracyclines should not be given: a. to children once the permanent teeth have developed. b. to patients taking calcium supplements. c. to pregnant patients after the fourth month of gestation. d. with dairy products or antacids.

c. to pregnant patients after the fourth month of gestation.

A child with otitis media has had three ear infections in the past year. The child has just completed a 10-day course of amoxicillin [Amoxil] with no improvement. The parent asks the nurse why this drug is not working, because it has worked in the past. What will the nurse tell the patient? a. "Amoxicillin is too narrow in spectrum." b. "The bacteria have developed a three-layer cell envelope." c. "The bacteria have developed penicillin-binding proteins (PBPs) that have a low affinity for penicillins." d. "The bacteria have synthesized penicillinase."

d. "The bacteria have synthesized penicillinase."

Which cephalosporin may be used to treat meningitis? a. Cefaclor b. Cefazolin c. Cefoxitin d. Cefotaxime

d. Cefotaxime Note to self: 3rd generation antibiotic*

A patient is beginning treatment for active tuberculosis (TB) in a region with little drug-resistant TB. Which treatment regimen will be used initially? a. Isoniazid and pyrazinamide b. Isoniazid, pyrazinamide, and ethambutol c. Rifampin, pyrazinamide, and ethambutol d. Isoniazid, rifampin, pyrazinamide, and ethambutol

d. Isoniazid, rifampin, pyrazinamide, and ethambutol

A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on a sliding scale and are ordered before a meal and at bedtime. The patient's blood sugar level is 317 mg/dL. Which formulation of insulin should the nurse prepare to administer? a. No insulin should be administered. b. NPH c. 70/30 mix d. Lispro (Humalog)

d. Lispro (Humalog) FAST ACTING*

The nurse is caring for a patient on a medical-surgical unit who has a fever of unknown origin. The prescriber has ordered a broad-spectrum antibiotic. Which intervention is the priority? a. Administering the antibiotic immediately b. Administering antipyretics as soon as possible c. Delaying administration of the antibiotic until the culture results are available d. Obtaining all cultures before the antibiotic is administered

d. Obtaining all cultures before the antibiotic is administered

A nurse is performing a physical assessment on a patient with tuberculosis who takes rifampin [Rifadin]. What would be an expected finding? a. Crystalluria b. Myopathy c. Peripheral neuropathy d. Red-orange-tinged urine

d. Red-orange-tinged urine

The nurse has been caring for a patient who has been taking antibiotics for 3 weeks. Upon assessing the patient, the nurse notices the individual has developed oral thrush. What describes the etiology of the thrush? a. Antibiotic resistance b. Community-acquired infection c. Nosocomial infection d. Superinfection

d. Superinfection

A nurse preparing to administer intravenous gentamicin to a patient notes that the dose is half the usual dose for an adult. The nurse suspects that this is because this patient has a history of: a. antibiotic resistance. b. interpatient variation. c. liver disease. d. renal disease.

d. renal disease.

An adolescent patient recently attended a health fair and had a serum glucose test. The patient telephones the nurse and says, "My level was 125 mg/dL. Does that mean I have diabetes?" What is the nurse's most accurate response? a. "Unless you were fasting for longer than 8 hours, this does not necessarily mean you have diabetes." b. "At this level, you probably have diabetes. You will need an oral glucose tolerance test this week." c. "This level is conclusive evidence that you have diabetes." d. "This level is conclusive evidence that you do not have diabetes."

a. "Unless you were fasting for longer than 8 hours, this does not necessarily mean you have diabetes."

A male patient reports decreased libido and the nurse notes galactorrhea during a physical assessment. The nurse will report these findings to the provider and will anticipate an order for which medication? a. Cabergoline b. Conivaptan c. Dopamine d. Prolactin

a. Cabergoline

A patient with type 1 diabetes reports mixing NPH and regular insulin to allow for one injection. What should the nurse tell the patient? a. This is an acceptable practice. b. These two forms of insulin are not compatible and cannot be mixed. c. Mixing these two forms of insulin may increase the overall potency of the products. d. NPH insulin should only be mixed with insulin glargine.

a. This is an acceptable practice.

A nurse is teaching a nursing student what is meant by "generations" of cephalosporins. Which statement by the student indicates understanding of the teaching? a. "Cephalosporins are assigned to generations based on their relative costs to administer." b. "Cephalosporins have increased activity against gram-negative bacteria with each generation." c. "First-generation cephalosporins have better penetration of the cerebrospinal fluid." d. "Later generations of cephalosporins have lower resistance to destruction by beta-lactamases."

b. "Cephalosporins have increased activity against gram-negative bacteria with each generation."

A patient has a viral sinus infection, and the provider tells the patient that antibiotics will not be prescribed. The patient wants to take an antibiotic and asks the nurse what possible harm could occur by taking an antibiotic. Which response by the nurse is correct? a. "Antibiotics are mutagenic and can produce changes that cause resistance." b. "Even normal flora can develop resistance and transfer this to pathogens." c. "Host cells become resistant to antibiotics with repeated use." d. "Patients who overuse antibiotics are more likely to have nosocomial infections."

b. "Even normal flora can develop resistance and transfer this to pathogens."

The nurse prepares a patient with Graves' disease for radioactive iodine (131I) therapy. Which statement made by the patient best demonstrates understanding of 131I therapy? a. "I will have to isolate myself from my family for 1 week so that I don't expose them to radiation." b. "This drug will be taken up by the thyroid gland and will destroy the cells to reduce my hyperthyroidism." c. "This drug will help reduce my cold intolerance and weight gain." d. "I will need to take this drug on a daily basis for at least 1 year."

b. "This drug will be taken up by the thyroid gland and will destroy the cells to reduce my hyperthyroidism."

What are the effects of prolactin secretion in males? (Select all that apply.) a. Breast development b. Decreased libido c. Delayed puberty d. Galactorrhea e. Infertility

b. Decreased libido c. Delayed puberty d. Galactorrhea

A patient who has been taking gentamicin for 5 days reports a headache and dizziness. What will the nurse do? a. Request an order for a gentamicin peak level. b. Suspect ototoxicity and notify the prescriber. c. Tell the patient to ask for help with ambulation. d. Tell the patient to report any tinnitus.

b. Suspect ototoxicity and notify the prescriber.

A patient is admitted to the hospital and will begin taking levothyroxine [Synthroid]. The nurse learns that the patient also takes warfarin [Coumadin]. The nurse will notify the provider to discuss ____ the ____ dose. a. reducing; levothyroxine b. reducing; warfarin c. increasing; levothyroxine d. increasing; warfarin

b. reducing; warfarin

A patient has a free T4 level of 0.6 ng/dL and a free T3 of 220 pg/dL. The patient asks the nurse what these laboratory values mean. How will the nurse respond? a. "These laboratory values indicate that you may have Graves' disease." b. "These results suggest you may have hyperthyroidism." c. "We will need to obtain a total T4 and a total T3 to tell for sure." d. "We will need to obtain a TSH level to better evaluate your diagnosis."

d. "We will need to obtain a TSH level to better evaluate your diagnosis."

What is the most reliable measure for assessing diabetes control over the preceding 3-month period? a. Self-monitoring blood glucose (SMBG) graph report b. Patient's report c. Fasting blood glucose level d. Glycosylated hemoglobin level

d. Glycosylated hemoglobin level

A patient with recurrent bacterial pneumonia is treated with an antibiotic that has worked previously but is not working to reduce symptoms in a current infection. The nurse caring for this patient understands that this is likely for which reason? a. The antibiotic altered the genetic makeup of the bacterial strain causing this infection. b. The antibiotic caused host cells to change and become more susceptible to bacterial effects. c. The antibiotic caused a mutation of the organism leading to reduced drug sensitivity. d. The antibiotic destroyed competing organisms that secrete substances toxic to the pathogen.

d. The antibiotic destroyed competing organisms that secrete substances toxic to the pathogen.

A patient with type 1 diabetes who takes insulin reports taking propranolol for hypertension. Why is the nurse concerned? a. The beta blocker can cause insulin resistance. b. Using the two agents together increases the risk of ketoacidosis. c. Propranolol increases insulin requirements because of receptor blocking. d. The beta blocker can mask the symptoms of hypoglycemia.

d. The beta blocker can mask the symptoms of hypoglycemia.

Which statement is accurate about the long-term complications of diabetes? a. Long-term complications are almost always the result of hypoglycemia and ketoacidosis. b. The complication rates for patients with optimally controlled type 2 diabetes are the same as for those whose disease is not optimally controlled. c. Tightly controlling of type 1 diabetes produces excessive episodes of life-threatening hypoglycemia. d. Tightly controlling of both types of diabetes reduces the risk of eye, kidney, and nerve damage.

d. Tightly controlling of both types of diabetes reduces the risk of eye, kidney, and nerve damage.

The nurse is caring for a patient receiving desmopressin [Stimate]. The nurse is performing a physical assessment and notes that the patient is drowsy and listless and complains of a recent onset of headache. Which finding would be most consistent with these symptoms? a. Hyperglycemia b. Hypernatremia c. Hypertension d. Water intoxication

d. Water intoxication *Note to self: patient should reduce fluid intake when on this drug*