Pharm exam 3 practice questions

Although mannitol is a diuretic, it is not prescribed for heart failure or hypertension. Which indications would be appropriate uses for mannitol? Select all that apply:

Glaucoma Severe Intracranial Pressure

Which of the following medications do we use to treat hypertension during pregnancy? select all that apply.

Methyldopa Labetalol Nifedipine

During the teaching of a patient who will be taking warfarin sodium at home, which statement by the nurse is correct regarding over-the-counter drug use?

"Aspirin products may result in increased bleeding."

Mr. D has a new diagnosis of asthma and was prescribed ipratropium (Atrovent) to take via an inhaler. When teaching the patient about the medication, which of the following questions is important to ask before he starts taking the medication? Select all that apply.

"Do you have any problems with your prostate" "Do you have any heart conditions?" "Have you ever been diagnosed with glaucoma?"

Which health education topic is most important to share with a client diagnosed with asthma?

"Exposure to cold temperatures can trigger asthma."

What are some potential goals of digoxin?

Decreased heart rate in patients atrial fibrillation Increased cardiac output in patients with Heart Failure

A nurse is providing discharge teaching to a client who has a new prescription for furosemide twice daily. The nurse should include which of the following instructions in the teaching? (Select all that apply.)

"Monitor for muscle weakness." "Increase intake of potassium-rich foods." "Dangle your legs from the side of the bed before standing."

A nurse is teaching a client who has a new prescription for beclomethasone. Which of the following instructions should the nurse include?

"Rinse your mouth after each use of this medication."

When applying transdermal nitroglycerin patches, which instruction by the nurse is correct?

"Rotate application sites with each dose."

A patient has prescriptions for two inhalers. One inhaler is a bronchodilator, and the other is a corticosteroid. Which instruction regarding these inhalers will the nurse give to the patient?

"Take the bronchodilator inhaler first."

A 46-year-old man started antihypertensive drug therapy 3 months earlier and is in the office for a follow-up visit. While the nurse is taking his blood pressure, he informs the nurse that he has had some problems with sexual intercourse. Which is the most appropriate response by the nurse?

"The physician can work with you on changing the dose and/or drugs."

A client, diagnosed with heart failure, asks the nurse for further details about heart failure. Which statement is most accurate?

"The use of digoxin will slow heart rate to make your heart more efficient."

When teaching a person how to use their inhalers, the nurse would know to include the following information in their plan... When using the same inhaler you should wait approximately ______ minutes between puffs.

1-2

Although unregulated by the FDA, patients may often choose to use herbal supplements like Fish Oil and Garlic to help control their cholesterol. Which patients below would be of concern when taking garlic or fish oil supplements?

A 78 year old patient who needs to have surgery A 62 year old patient with Atrial Fibrillation is taking fish oil and garlic and gets prescribed Warfarin

A patient is currently taking a statin. The nurse considers that the patient may have a higher risk for developing rhab-domyolysis when also taking which product?

A fibric acid derivative

This is PART 2: What are our Unintended Outcomes? (Meaning what are our adverse effects?)

A patient develops a sudden headache that is extremely painful A patient notes reddish pink urine A patient has become fatigued and gets tired easily

This is PART 1: What are our Intended Outcomes? (Meaning what are the goals of therapy?)

A patient with a DVT in their right leg reports decreased pain,swelling and redness in their leg A patient on IV heparin has a PTT of 68 seconds A patient with a hip replacement did not develop a DVT/PE post-operatively

"pril"

ACE inhibitor

"sin"

ALpha 1 blocker

A nurse administering niacin would implement which action to help to reduce adverse effects?

Administer a small dose of aspirin or an NSAID 30 minutes before the niacin dose.

During thrombolytic therapy, the nurse monitors for bleeding. Which symptoms may indicate a seri-ous bleeding problem? (Select all that apply.

Decreased level of consciousness Increased pulse rate Hypotension

A patient is starting warfarin (Coumadin) therapy as part of treatment for atrial fibrillation. The nurse will follow which principles of warfarin therapy? (Select all that apply.)

Administer the oral dose at the same time every day. Monitor laboratory results for a target INR of 2 to 3. Assess carefully for excessive bruising or unusual bleeding.

The nurse is administering cholestyramine (Questran), a bile acid sequestrant. Which nursing intervention(s) is(are) appropriate? (Select all that apply.)

Administering the drug with meals Not administering this drug at the same time as other drugs Instructing the patient to take a fiber supplement while taking this drug Increasing fluid intake

SABA (Short Acting Beta2 Agonist)

Albuterol

Everyone with a diagnosis of asthma should have a rescue inhaler. As an astute nurse, you know that the following inhalers can be used as rescue inhalers. select all that apply.

Albuterol Formoterol + ICS

Your patient is taking diphenhydramine. You know that this co-administration of this medication should be avoided with which of the following? select all that apply.

Alcohol Morphine Cyclobenzaprine Diazepam Phenobarbital

When giving antihypertensive drugs, the nurse will con-sider giving the first dose at bedtime for which class of drugs?

Alpha blockers such as doxazosin (Cardura)

Gentamicin

Aminoglycoside

What types of conditions can anticoagulants be used to treat?

An 18 year old patient with COVID-19 who developed a Pulmonary Embolism A 72 year old patient who just had their knee replaced A 55 year old patient with Atrial Fibrillation

A patient has a new prescription for an ACE inhibitor. During a review of the patient's list of current medications, which would cause concern for a possible interaction with this new prescription? (Select all that apply.)

An NSAID taken as needed for headaches A potassium supplement taken daily

What types of conditions can Epoetin Alfa be used to treat?

Anemia due to Chronic Kidney Disease Anemia due to Methotrexate

"sartan"

Angiotensin II Receptor Antagonist

Which of the following dyslipidemia medications are used to treat elevated LDL?

Atorvastatin Niacin Cholestyramine Ezetimibe

Which of the following medications is used to treat asymptomatic bradycardia?

Atropine

Following the administration of a scheduled dose of 50-mg atenolol PO, the nurse should prioritize what assessment?

BP

What should you assess prior to giving dopamine?

BP HR

Direct Acting Cholinergic Agent

Bethanechol

A nurse is assessing a client who has received atropine eye drops during an eye examination. Which of the following findings should the nurse expect as an effect of the medication?

Blurred vision

Which of the following are side effects of beta blockers? select all that apply.

Decreased libido Depression Bronchospasms Constipation

Meropenem

Carbapenem

Patients taking methylxanthines should be instructed to avoid which of the following?

Coffee

A nurse is caring for a client who is taking atorvastatin for hyperlipidemia. Which of the following client laboratory values should the nurse monitor?

Creatinine kinase

A nurse is planning to teach about inhalant medications to a client who has a new diagnosis of exercise-induced asthma. Which of the following medications should the nurse plan to instruct the client to use prior to physical activity?

Cromolyn

Mast Cell Stabilizer

Cromolyn

"dipine"

DHP CCB

Patients with hypertension should be instructed avoid which of the following drug classes?

Decongestants

A nurse is providing discharge instructions to a client who has asthma and a new prescription for montelukast. The nurse should instruct the client to report which of the following adverse effects to the provider?

Depression

Anti-Tussive

Dextromethorphan

Which of the following are TRUE concerning a patient taking dimenhydrinate?

Dimenhydrinate may cause urinary retention Patients taking Dimenhydrinate should not operate any machinery

When a patient is being taught about the potential adverse effects of an ACE inhibitor, which of these effects should the nurse mention as possibly occurring when this drug is taken to treat hypertension? (Select all that apply.)

Dry, nonproductive cough fatigue dizziness

True/False: It is unsafe to use both a MOAI and decongestant (such as pseudophedrine) because they can lower blood pressure to dangerously low levels

False

2nd Generation Antihistamine

Fexofenadine

Levofloxacin

Fluoroquinolone

LABA (Long Acting Beta2 Agonist)

Formoterol

In administering niacin, the nurse must monitor for which adverse effects? (Select all that apply.)

GI upset Pruritus flushing of the skin

Hydrochlorothiazide can cause the accumulation of which of the following lab values? SELECT ALL THAT APPLY:

GLUC: Glucose lipids uric acid calcium

A patient received a double dose of heparin during surgery and is bleeding through the incision site. While the surgeons are working to stop the bleeding at the incision site, the nurse will prepare to take what action?

Give IV protamine sulfate as an antidote.

Which of the following conditions can be treated with Acetazolamide? Select all that apply:

Glaucoma Altitude sickness/illness

A 79-year-old patient is taking a diuretic for treatment of hypertension. This patient is very independent and wants to continue to live at home. The nurse will know that which teaching point is important for this patient?

He needs to take extra precautions when standing up because of possible orthostatic hypotension and resulting injury from falls.

What types of conditions can digoxin be used to treat?

Heart Failure Atrial Fibrillation

What should you assess prior to giving Epoetin alfa ?

Hematocrit Hemoglobin Blood Pressure

What should you assess prior to giving any anticoagulant?

Hemoglobin Platelets Hematocrit

A patient taking valsartan would be at risk for which of the following electrolyte disorders?

Hyperkalemia

Your patient is experiencing the common electrolyte side effect of lisinopril therapy. Which of the following electrolyte abnormalities would you suspect?

Hyperkalemia

What are some potential Unintended Outcomes of Epoetin alfa?

Hypertension Elevated Hematocrit Stroke DVT

The nurse is administering antihypertensive drugs to older adult patients. The nurse knows that which adverse effect is of most concern for these patients?

Hypotension

Are there any unique administration components with epoetin alfa?

IV doses are typically given during dialysis sessions Subcutaneous doses are typically given on the unit

What are some potential goals of dopamine?

Increased renal perfusion Increased Cardiac Output

When administering subcutaneous heparin, the nurse will remember to perform which action?

Inject the medication without aspirating for blood return.

What types of conditions can dopamine be used to treat?

Inotropic support for Heart Failure Shock/ Hemodynamic Support

SAMA (Short Acting Muscarinic Antagonist)

Ipratropium

Which point will the nurse emphasize to a patient who is taking an antilipemic medication in the statin class?

It is important to report muscle pain immediately.

A patient is being assessed before a newly ordered antilipemic medication is started. Which condition would be a potential contraindication?

Liver cirrhosis

Azithromycin

Macrolide

Which diuretic is used to treat increased ICP?

Mannitol

Acetylcysteine

Mucolytic

"ium"

Muscarinic Antagonist Inhalers

The nurse is reviewing the use of anticoagulants. Anticoagulant therapy is appropriate for which conditions? (Select all that apply.)

Myocardial infarction Atrial fibrillation Presence of mechanical heart valve

A patient is receiving instructions regarding warfarin therapy and asks the nurse about what medications she can take for headaches. The nurse will tell her to avoid which type of medication? Select all that apply.

NSAIDs aspirin The herbal product gingko

Clonidine, an alpha 2 agonist, has many clinical uses. What are some common uses of this medicaton? Select all that apply:

Opioid Withdrawal Hypertension

Anticholinergic for OAB

Oxybutynin

Nasal Decongestant Spray

Oxymetazoline

Which of the following are enzyme inducers? select all that apply.

PS PORCS Phenytoin Smoking Phenobarbital Oxcarbamazepine Rifampin carbamazepine St. John's Wart

A patient is taking a xanthine derivative as part of treatment for chronic obstructive pulmonary disease. The nurse will monitor for which adverse effects associated with the use of xanthine derivatives?

Palpitations

What are your planning goals? Do you need to educate the patient about anything with anticoagulants?

Patients should be instructed of signs and symptoms of bleeding The primary goal will be to prevent a blood clot or to help the body break down the blood clot Patients on heparin should have a target Partial Thromboplastin Time Patients on warfarin should have a goal INR

Jerry is at home cutting his grass when he develops sudden chest pain. What are the appropriate steps Jerry should follow when treating his chest pain? (Select all that apply)

Place 1 tablet of nitroglycerin under the tongue Stop activity and sit/lie down

Which of the following findings would the nurse expect to observe in the patient experiencing heparin-induced thrombocytopenia

Platelet count of 50,000/mL

Indirect Acting Cholinergic Agent

Pyridostigmine

A patient with heart failure will be starting the beta blocker metoprolol (Lopressor). The nurse will monitor for which expected cardiovascular effects? (Select all that apply.)

Reduced heart rate Decreased myocardial automaticity Delayed AV node conduction

A patient on your cardiac unit has a systolic blood pressure of 165 mmHg. The new resident orders Hydralazine 10 mg IV x 1 STAT. The nurse pushes the dose and the patients blood pressure drops rapidly. This puts the patient at risk for developing what condition?

Reflex Tachycardia

What action is often recommended to help reduce tolerance to transdermal nitroglycerin therapy?

Remove the patch at bedtime, and then apply a new one in the morning.

The nurse is assessing a patient who will be starting antihypertensive therapy with an ACE inhibitor. Which condition, if present in the patient, would be a reason for cautious use?

Renal insufficiency

A client who is undergoing chemotherapy for the treatment of non-Hodgkin's lymphoma will soon begin treatment with epoetin alfa. The nurse should be aware that this drug may be administered by which route? Select all that apply.

SC IV

Which of the following would be considerations when utilizing nitroglycerin patches? select all that apply.

Should rotate administration sites The skin should be cleaned with soap and water after patch removal. The patch should be applied to a hair free area of the skin. The patch should be removed for at least 10 hours/day.

Accumulation of which of the following drugs can result in "Cyanide toxicity"?

Sodium Nitroprusside

A male client has been diagnosed with moderately increased LDL, and his primary care provider wishes to begin him on a statin. What is a potential disadvantage of statins that the care provider should consider? Select all that apply.

Statins require regularly scheduled blood work. Statins should be taken in the evening.

Pseudephedrine

Sympathomimetic

Which of the following are known side effects of albuterol? select all that apply.

Tachycardia Angina Hypokalemia Tremors Hoarsness

Doxycycline

Tetracycline

A patient with chronic bronchitis calls the office for a refill of his albuterol inhaler. He just had the prescription filled 2 weeks ago, but he says it is empty. When asked, he tells the nurse, "I use it whenever I need it, but now when I use it, I feel so sick. I've been needing to use it more often." What is the most appropriate action by the nurse?

The nurse should ask the patient to come to the office for an evaluation of his respiratory status.

SW, has been admitted to the hospital for a heart failure exacerbation and is receiving a continuous furosemide drip at 10 mg/hr. The furosemide is rapidly depleting SW's potassium and so the attending orders a BMP every 8 hours to assess SW's potassium levels. The most recent BMP result shows that SW's potassium is 2.9 mEq/L. The provider orders 80 mEq IV KCl x 1 NOW (note: the patient only has a peripheral line). Which of the following are true about administration of KCl( potassium chloride) intravenously?

The potassium order should be split into two separate doses (40 mEq) for a each IV piggyback The potassium should be given no faster than 10 mEq per hour

Methylxanthine

Theophylline

Your patient has not been able to achieve a therapeutic INR with their warfarin. You are assessing their medication list and identify which of the following asthma drugs as likely causing issues with their warfarin levels...

Theophylline

LAMA (Long acting Muscarinic Antagonist)

Tiotropium

Which of the following are known side effects of SAMAs? select all that apply.

Urinary hesitancy Constipation Xerostomia Hoarsness Palpitations

The nurse is administering an intravenous infusion of a phosphodiesterase inhibitor to a patient who has heart failure. The nurse will evaluate the patient for which therapeutic effects? (Select all that apply.)

Vasodilation Positive inotropic effects

The nurse is assessing a patient who is receiving a milrinone infusion and checks the patient's cardiac rhythm on the heart monitor. What adverse cardiac effect is most likely to occur in a patient who is receiving intravenous milrinone?

Ventricular dysrhythmia

When teaching the patient about the signs and symptoms of cardiac glycoside toxicity, the nurse should alert the patient to watch for which of these? (Select all that apply.)

Visual changes such as halos around lights Headaches Dizziness

Cholestyramine is effective in binding up excessive bile acid to reduce LDL levels. What else might Cholestyramine bind ? (Select all that apply)

Vitamin D and K digoxin

A hospital client demonstrating peripheral edema has been prescribed furosemide. How should the nurse best determine the extent of the client's desired fluid loss?

Weigh the client daily.

A nursing student is teaching a group of classmates about diuretics. What are some of the general monitoring parameters that the nursing student should teach?

Weigh the patient daily Assess a blood pressure prior to administration Check electrolytes prior to administration Measure the Urine Output of the patient

Are there any general or unique administration components? SELECT ALL THAT APPLY:

When educating a patient for home usage of enoxparin, it should be emphasized to not expel any air bubbles from the syringe When educating a patient for home usage of enoxparin, it should be emphasized to not aspirate the needle

Which cholesterol medication is recommended to be given nightly?

Which cholesterol medication is recommended to be given nightly?

JM recently had a Myocardial Infarction and has started taking simvastatin 80 mg PO nightly for elevated LDL levels. JM is also trying to lose weight and one of his friends recommended a Grapefruit Juice Cleanse. Are you concerned about JM?

Yes, the introduction of GrapeFruit Juice may increase the levels of his simvastatin, thus increasing his risk for rhabdomyolysis

One of the attendees expresses concern regarding her granddaughter's asthma. The attendee tells the nurse that she is afraid that she will not know which of her granddaughter's medications to give first in case of an asthma attack. Which medication should the nurse inform the attendee to administer first for an acute asthma attack?

albuterol

"stigmine"

anticholinesterase inhibitor

A client is prescribed sacubitril and valsartan for treatment of heart failure. What laboratory blood values should the nurse monitor to assure the treatment is successful? Select all that apply.

creatinine blood urea nitrogen Potassium

Inhaled Corticosteroid

beclomethasone

When evaluating treatment with a -statin, you would expect the medication to be taken at __________ to be most effective. fill in the blank.

bedtime

"terol"

beta 2 agonist

"lol"

beta blocker

What is the most common first-line therapy for relief of an acute asthma attack?

beta2-adrenergic agonist

What are some potential UNINTENDED outcomes of digoxin?

bradycardia yellowish visual changes anorexia confusion

An older adult client who resides in a care facility has been prescribed antihypertensives for the first time following many years of generally good health. When administering the first dose of the prescribed antihypertensive medication to an older adult, the nurse should recognize the related risk to which possible side effect?

falls

T/F: When giving furosemide, we also would plan to co-administer a sodium supplement.

false - give potassium

Which antihypertensive medications can be administered by transdermal patch?

clonidine

An adult client has developed renal failure secondary to an overdose of a nephrotoxic drug. Which assessment finding would the nurse recognize as being most suggestive of impaired erythropoiesis?

fatigue and increased heart rate

A client is diagnosed with hypertension and is being treated with captopril. A client with which diagnosis should be prescribed with captopril as the first-line treatment?

diabetes mellitus

An older adult client, who leads a sedentary lifestyle, has recently been diagnosed with dyslipidemia. The client is disappointed to learn about this condition, stating, "First it was the diabetes and then the arthritis, now this." The nurse has performed health education with the client and has described metabolic syndrome. In addition to the elevated cholesterol levels, what aspect of the client's health is congruent with a diagnosis of metabolic syndrome?

diabetes mellitus

Which medication will be administered to a client experiencing severe digitalis poisoning?

digoxin immune fab

1st Generation Antihistamine

diphenhydramine

A client has been diagnosed with chronic renal failure. Which agent will assist in raising the client's hemoglobin levels?

epoetin alfa

An older adult client is being treated in the hospital for a stroke and is undergoing an extended stay on a rehabilitation unit. The client's spouse has been participating actively in the client's care and performs much of the feeding and hygiene needs. This evening, the spouse has brought in a number of healthy snacks to keep at the client's bedside. Knowing that the client's medication regimen includes simvastatin, the nurse would remove which item?

grapefruit juice

The client has crackles in the lower lobes of the lungs, an audible S3, and pitting edema in the feet and ankles. What condition is the client most likely experiencing?

heart failure

"lukast"

leukotriene receptor Blocker

A patient is taking a beta blocker as part of the treatment plan for heart failure. The nurse knows that the purpose of the beta blocker for this patient is to

prevent stimulation of the heart by catecholamines.

During assessment of a patient who is receiving digoxin, the nurse monitors for findings that would indicate an increased possibility of toxicity, such as

serum potassium level of 2.0 mEq/L.

A client is being assessed by the home care nurse on the appropriate use of her metered-dose inhalers. Instructions concerning which intervention will assist a client in the proper administration of a metered-dose inhaler?

use of a spacer

When teaching a person how to use their inhalers, the nurse would know to include the following information in their plan... When using different inhalers you should wait approximately ______ minutes between puffs.

2-5

The nurse is teaching a patient about the self-administration of enoxaparin (Lovenox). Which statement will be included in this teaching session?

"This drug is given in the folds of your abdomen, but at least 2 inches away from your navel."

The medication order reads, "niacin, 500 mg PO, every evening." The medication is available in 250-mg tablets. How many tablets will the patient receive per dose?

2

When starting an ACE-inhibitor, we should monitor the BP for the first _____ hours after initiation of treatment.

2

Fluconazole

Azole Antifungal

Patients on amlodipine therapy should be counselled to avoid taking which of the following?

Grapefruit Juice

When planning patient education on atorvastatin, which of the following juices would we included as needing to be avoided while taking the medication?

Grapefruit Juice

A patient with a tracheostomy has difficulty removing excessive, thick mucus from the respiratory tract. The nurse expects that which drug will be ordered to aid in the removal of mucus?

Guaifenesin

"statin"

HMG-CoA reductase inhibitor

The nurse is most concerned for the development of myopathy primarily in a patient taking which class of antilipemic drugs?

HMG-CoA reductase inhibitors

What should you assess prior to giving digoxin?

HR Potassium Digoxin level

Are there any important points of planning or education with Iron?

Patients should notice an improvement in Anemia symptoms over a period of several weeks Patients should expect stools to look black

Are there any unique administration components with iron?

Patients should remain upright after taking this medication Be sure to mix liquid iron with an acidic juice like tomato juice or orange juice

A patient presents with a blood pressure of 201/112 and the resident is trying to determine an appropriate anti-hypertensive for a Hypertensive Emergency. Which pharmacological agent would most likely be prescribed?

Sodium Nitroprusside

Which of the following diuretics are classified as "potassium sparing"? Select all that apply:

Spironolactone Eplerenone Triamterene

A patient has been taking simvastatin (Zocor) for 6 months. Today he received a call that he needs to come to the office for a "laboratory check." The nurse expects which laboratory studies to be ordered at this time? (Select all that apply.)

Total cholesterol HDL and LDL levels Liver function studies Triglycerides

What type of cough is best treated with dextromethorphan?

a dry, nonproductive cough

What are some potential UNINTENDED outcomes of dopamine?

hypertension angina tachycardia cardiac dysrythmias

A client is receiving epoetin alfa for anemia. Which adjunctive therapy is imperative with epoetin alfa?

iron supplement

Which medication classification is prescribed to decrease the nighttime episodes of bronchoconstriction and prevent asthma attacks?

leukotriene modifiers

Which of the following BP measurements would preclude giving the scheduled dose of lisinopril? select all that apply.

lower than 90 systolic lower than 50 systolic

A client has begun taking cholestyramine. Which are noted as the most common adverse effects?

nausea, flatulence, and constipation

A client is prescribed lisinopril. What adverse effect should the client be instructed on that can occur with angiotensin-converting enzyme (ACE) inhibitors?

persistent cough

A client with a history of heart failure is being treated with digoxin. The nurse knows that this medication increases the force of contractions of the heart. What effect improves the contractility of the heart?

positive inotropic effect

A client has been largely unsuccessful in achieving adequate control of dyslipidemia through lifestyle changes and the use of a statin. As a result, the client has been prescribed cholestyramine. What change in this client's lipid profile will the nurse identify as the most likely goal of therapy?

reduction in LDL cholesterol levels

Which single drug class is known to be most effective in reducing the major types of dyslipidemia?

statins

A client prescribed albuterol should be educated on identifying and managing which adverse reaction?

tachycardia

A patient on bumetanide therapy should report which of the following? Select all that apply:

tinnitus constipation irregular pulse