Pharm final 2
The patient has a low platelet count secondary to chemotherapy. Which nursing actions would be the most appropriate?
A) Apply pressure to injection site and assess for occult bleeding.
A patient with breast cancer is scheduled to receive anastrozole (Arimidex), an aromatase inhibitor. Which information should be included in the patient teaching?
A) Aromatase inhibitors block the peripheral conversion of androgens to estrogens.
The patient is to receive cyclophosphamide (Cytoxan) as part of her cancer treatment. Which nursing intervention should the nurse expect to complete?
A) Assess for signs of hematuria, urinary frequency or dysuria
A patient is scheduled to receive vincristine as part of her treatment for non-Hodgkin's lymphoma. She reports that she likes to "rely on nature" for complementary therapy. Which herbal/supplements should be avoided by this patient? (Select all that apply.)
A) Bromelain C) Periwinkle D) Shen-Mai-San
The patient, 61 years old is to receive doxorubicin (Adriamycin) as part of his chemotherapy protocol. Which assessment is the most important before administering the medication?
A) Cardiac status
The patient will be receiving chemotherapy that will lower her white blood cell count. Monitoring for which finding will be a nursing priority?
A) Change in temperature.
The nurse is preparing to administer chemotherapy which can cause severe nausea and vomiting, to a patient in the outpatient clinic. Which nursing action would be most appropriate?
A) Give an antiemetic before administering chemotherapy
The use is caring for a patient receiving combination chemotherapy. The patient asks why she has to take more than one agent. What is the nurse's best response?
A) It has better response rates than single-agent chemotherapy
The 65-year-old patient has metastatic cancer. He is scheduled to receive palliative chemotherapy. He states that he does not understand why he should receive palliative chemotherapy if it won't kill cancer cells. What is the best response?
A) It is done to help improve your quality of life.
The nurse is administering doxorubicin (Adriamycin) to a patient diagnosed with cancer. What should the nurse keep in mind with regard to tissue necrosis associated with this drug?
A) Tissue necrosis may occur 3-4 weeks after administration
The patient has exercise-induced bronchospasm and is being treated with a short-acting beta2 agonist. Which priority information will the nurse include in a review of inhaler administration for this patient? (Select all that apply.)
a) "Cleanse all washable parts of inhaler equipment daily." b) "Hold your breath for a few seconds, remove mouth piece, and exhale slowly." c) "Keep your lips secure around the mouthpiece and inhale while pushing the top of the canister once." d) "Monitor your HR while taking this medication."
What priority teaching should the nurse provide to a patient who has just started taking acebutolol (Sectral)?
a) "Do not abruptly stop this medication or you risk an adverse reaction."
The patient has been diagnosed with angina and has been prescribed verapamil (Calan). What priority teaching point(s) should the nurse include redarding this medication? (Select all that apply.)
a) "Eat lots of fiber to avoid constipation." c) "This medication is taken 3 times per day."
The 72 yo patient has a history of atrial fibrulation and has been discharged from the hospital on warfarin. He was taking heparin prior to being changed to warfarin for discharge. With regards to lab monitoring, what is a priority teaching intervention for the nurse?
a) "INR and aPTT will be monitored closely."
The patient is taking an inhaled beta agonist and a steroid for his asthma. He states, "I don't have time to wait between medications. I'm very busy. Why do I have to do this?" What is the nurse's best response?
a) "The inhaled medication will allow the bronchioles to dilate so the steroid works better."
What is the usual maintenance dose of digoxin?
a) 0.125-0.5 mg/day
The nurse has several patients receiving warfarin. Which INR(s) should concern the nurse? (Select all that apply.)
a) 1.2 b) 1.4 c) 1.8
The patient has environmental allergies and asks the student health nurse about the appropriate dose of diphenhydramine. What is the recommended dosage of diphenhydramine (Benadryl)?
a) 25-50 mg q6-8h
Which patient(s) would be candidate(s) for anticoagulant use? (Select all that apply.)
a) 28 year old with DVT b) 35 year old with an artificial heart valve d) 52 year old who has had a knee replacement
The patient weights 168 lbs and is going to receive abciximan (ReoPro) for unstable angina. What is the correct dosage for continuous infusion?
a) 9.5 mcg/min
Which individual is the best candidate to take acetazolamide (Diamox)?
a) A 50 year old with open-angle glaucoma
Herb-drug interactions may occur if the patient is taking certain herbal supplements. An herb history should be obtained. What may occur in an individual who also uses ma-haung (ephedra) with an antihypertensive drug?
a) A decrease or counteraction of the effects of the antihypertensive drug
In which patient are loop diuretics contraindicated?
a) A patient with anuria
Captopril (Capoten) is from which group of antihypertensive?
a) ACE inhibitor
Which drug(s) may be used to treat heart failure? (Select all that apply.)
a) ACE inhibitors b) Beta blockers c) Calcium channel blockers d) Diuretics e) Vasodilators
The patient, 58 yo, has unstable angina and is having an emergency percutaneous transluminal coronary angioplasty (PTCA). The nurse is completing preprocedure teaching and explains that he will be receiving medication right before the surgery and then for the next 12 hrs by IV drip to prevent ischemia. What medication is the nurse teaching the patient about?
a) Abciximab (ReoPro)
The patient presents to the ER with complaints of GI bleeding. She is currently taking fondaparinux (Arixtra) at jome after having orthopedic surgery. She has been taking 2.5 mg for the past 5 days. What does the nurse anticipate is occurring?
a) Adverse reaction
Which herbal preparation(s) must be avoided when taking digitalis preparations? (Select all that apply.)
a) Aloe d) Ginseng e) Ma-haung
What dermatologic effects should the nurse assess for in a patient taking interferon alpha? (Select all that apply)
a) Alopecia c) Irritation at injection site d) Pruritus e) Rash
The 61 yo patient is in cardiac arrest. His ventricular fibrillation is refractory to other treatment. What medication is the drug of choice when other agents are ineffective?
a) Amiodarone (Cordarone)
The patient has a complicated medical history including heart failure, cardiac arrhythmias, arthritis, and depression. He is taking furosemide for his heart failure. Which of his other medications would be of major concern to the nurse?
a) Amiodarone (Cordarone)
A 64-year-old patient has hairy cell leukemia that is being treated with interferon alpha (Roferon-A). The patient reports all of the following gastrointestinal side effects. Which side effect is considered the dose-limiting toxicity for the gastrointestinal system?
a) Anorexia
What groups of drugs is/are used to treat cold symptoms? (Select all that apply.)
a) Antihistamines b) Antitussives c) Decongestants d) Expectorants
What is priority health teaching information for a 64 year old patient who has hairy cell leukemia that is being treated with interferon alpha (Roferon A) and her significant others? (Select all that apply.)
a) Any unusual weight loss should be reported b) Information on the effect of BRM-related fatigue on activities of daily living, including sexual activity c) She may return for another demonstration of drug administration techniques e) Somnolence, confusion, or problems w/ concentration should be reported to the health care provider
What action(s) will the nurse perfrom when caring for a patient who is receiving tenecteplase (TNKase)? (Select all that apply.)
a) Assess for repercussion arrhythmias c) Observe for signs and symptoms of bleeding e) Record vital signs and report changes
The patient is starting a course of a BRM while undergoing treatment for malignant melanoma. When is the best time to administer a BRM?
a) At bedtime
The patient presents to the ER and states he feels dizzy. He takes digitalis but he is unable to tell you why he is taking the medication. The nurse knows that this medication is usually prescribed for what abnormal rhythm?
a) Atrial fibrillation
Which medication(s) when prescribed with the theophylline will concern the nurse? (Select all that apply.)
a) Beta blockers b) Digitalis c) Lithium e) Phenytoin
What is/are the action(s) of antidysrythmics? (Select all that apply.)
a) Block adrenergic stimulation to the heart b) Decreased conduction velocity
Which is/are action(s) of angiotensin II receptor blockers (ARBs)? (Select all that apply.)
a) Block angiotensinogen II b) Cause vasodilation c) Decrease peripheral resistance
The patient is receive G-CSF therapy for treatment of severe chronic neutropenia. What is a priority assessment in this patient?
a) Bone pain
The patient is in the ER and has been diagnosed with an acute MI. The patient will be receiving streptokinase immediately while still in the ER. What might the nurse assess in a patient who is experiencing an allergic reaction to this drug? (Select all that apply.)
a) Bronchospasm b) Dyspnea c) Hives d) Hypotension
Decongestants are contraindicated or to be used with extreme caution for patients with which condition's? (Select all that apply.)
a) Cardiac disease b) Diabetes mellitus c) Hypertension d) Hyperthyroidism
Which of the following is/are side effect(s) of theophylline? (Select all that apply.)
a) Cardiac dysrhythmias c) GI bleeding d) Headache e) Seizures
The nurse is reviewing the patient's medication on the MAR. Which medication(s) on the MAR would concern the nurse, given that the patient is taking digitalis? (Select all that apply.)
a) Cortisone b) Furosemide c) Hydrochlorothiazide
ARBs may be prescribed her HTN patients instead of ACE inhibitor. What is the most limiting factor in the use of ACE inhibitors?
a) Coughing
How often should the pulse be checked for a patient taking digoxin?
a) Daily before taking a dose
The nurse assesses the patient who is taking hydrochlorothiazide (HCTZ) for HTN. What might the nurse expect to see if the patient is experiencing undesirable side effects? (Select all that apply.)
a) Diarrhea b) Dizziness
What possible side effect(s) should be discussed with a patient who has begun taking acebutolol (Sectral)? (Select all the apply.)
a) Diarrhea b) Edema d) Impotence e) Vomiting
What special preparations and administration guidelines will the nurse follow with erythropoietin-stimulating agents? (Select all that apply.)
a) Discard unused portions from the single-dose vial b) Evaluate hemoglobin prior to administration and on a weekly basis c) Multidose vials must be disposed of after 21 days of initial access d) Prevent exposure to light when using Aranesp
The health teaching plan for a patient taking diphenhydramine (Benadryl) should include the side effects of the drug. What might the nurse assess in a patient experiencing a side effect? (Select all that apply.)
a) Disturbed coordination b) Drowsiness d) Nausea e) Urinary retention
The nurse is assessing the patient with essential HTN following the shift report. What might the nurse assess if the patient is experiencing side effects from his medications? (Select all that apply.)
a) Dizziness d) Nausea
What is one of the benefits of rivaroxaban (Xarelto)?
a) Does not require monitoring
Compare to first-generation antihistamines, second-generation antihistamines have a lower incidence of which side effect?
a) Drowsiness
What condition(s) can directly lead to cardiac dysrhythmias? (Select all that apply.)
a) Electrolyte imbalance b) Excess catecholamines e) Hypoxia
An oncology patient is to begin treatment for non-small cell lung cancer (NSCLC) with administration of gefitinib (Iressa). The nurse notes on his medical record that the patient is also taking warfarin daily for atrial fibrillation. What should concern the nurse about patient taking gefitinib and warfarin?
a) Gefitinib increases the effects of warfarin
Diphenhydramine blocks histamine receptors. Which histamine receptors does it block?
a) H1
What parameters should concern the nurse the most in a patient taking digitalis?
a) HR of 52 beats/min and irregular
What is the protein binding power of warfarin?
a) Highly protein-bound
What is the protein-binding power of amlodipine?
a) Highly protein-bound
What is the protein-binding power of valsartan (Diovan)?
a) Highly protein-bound
What is/are the side effect(s) of long-term use of glucocorticoids? (Select all that apply.)
a) Impaired immune response c) Hyperglycemia
The patient presents to the clinic with complaints of nasal congestion, sneezing, and fever for 4 days. She has been diagnosed with a cold. What priority teaching instructions should the nurse include for this patient? (Select all that apply.)
a) Instruct the patient to cover nose and mouth when sneezing b) Advise the patient to discuss use of any herbal remedies with her health care provider c) Encourage the patient to drink adequate fluids e) Promote good hand hygiene
ARBs have gained popularity for treating HTN. What is/are example(s) of ARB agents? (Select all that apply.)
a) Irbesartan (Avapro) b) Losartan potassium (Cozaar) c) Valsartan (Diovan)
What type of acid-base imbalance could occur if the patient is taking high doses of acetolamide (Diamox) or uses the drug constantly?
a) Metabolic acidosis
Which nursing outcomes would be most appropriate as part of the planning for a patient about to begin therapy with the oral multikinase inhibitor (MKI) sorafenib (Nexavar)? (Select all that apply.)
a) Patient will be free from symptoms of stomatitis b) Patient will maintain adequate fluid balance c) Patient will maintain skin integrity d) Patient will maintain weight
Which nursing outcomes would be most appropriate as part of the planning for a patient scheduled to begin treatment with imatinib (Gleevec)? (Select all that apply.)
a) Patient will maintain adequate nutrition and hydration status b) Patient will maintain blood counts in the desired range d) Patient will maintain renal function e) Patient will maintain weight
Which lab value(s) should a nurse monitor for a patient receiving chlorothiazide (Diuril)? (Select all that apply.)
a) Potassium b) Sodium d) Calcium
The patient has been prescribed furosemide 80 mg/day as a diuretic. Which food(s) should the nurse encourage the patient to include in his diet? (Select all that apply.)
a) Raisins c) Baked potatoes d) Tomatoes
A patient is admitted to the hospital 1 week after receiving imatinib (Gleevec). On physical assessment, the nurse notes the presence of petechiae, ecchymosis, and bleeding gums. Which nursing diagnosis would be most appropriate?
a) Risk for bleeding
What priority health teaching should be given to a patient taking nitroglycerine? (Select all that apply.)
a) Sips of water may be taken to aid in absorption b) Nitroglycerine should be stored in a cool, dark place
A patient taking diphenhydramine (Benadryl) breastfeeds her infant daughter. What advice will the nurse give her?
a) Small amounts of the drug pass into breast milk; breastfeeding is not recommended
When compared to oral medication for asthma, what information regarding a drug administered by metered-dose inhaler should the nurse be aware of? (Select all that apply.)
a) The inhaled does will be lower than the oral dose of medication b) There are fewer side effects with an inhaled medication d) Inhaled medication has a more rapid onset e) Some oral and inhaled medications can be taken together
A patient who has had a acute MI has been started on spironolactone (Aldactone) 50 mg/day. When evaluating routine laboratory work, the nurse discovers the patient has a potassium level of 5.8 mEq/L. What is the priority intervention to be implemented?
a) The spironolactone dose should be decreased and the patient instructed to decrease intake of foods rich in potassium
A 70-year-old patient has hairy cell leukemia that is being treated with interferon alpha (Roferon-A). The patient reports neurologic side effects. What will the nurse tell the patient about the side effects?
a) These side effects are reversible after the drug is stopped
What is/are primary functions of biologic response modifiers (BRMs)? (Select all that apply.)
a) To destroy tumor activities b) To enhance host immunologic function d) To promote differentiation of stem cells
A patient states that he wishes to stop taking captopril (Capoten) for his HTN. What is the nurse's best response?
b) "It is important to keep taking our medication as directed until you speak with your HCP."
The patient has asthma and takes cromolyn (Nasalcrom). What statements by the patient indicates the need for more education?
b) "It will stop an asthma attack before it has started."
The patient, 62 yo, is taking amlodipine (Norvasc) and complains of swelling in her ankles. What is the nurse's best response to her concern?
b) "Swelling may occur with Norvasc. I will contact your HCP to determine if the drug should be changed or it another drug should be added."
The patient present to her HCP's office for a follow-up visit. She has been taking digoxin for approximately 2 weeks. What does the nurse knows is a therapeutic digitalis level?
b) 0.5-2 ng/mL
The patient has been prescribed both ipratropium (Atrovent) and cromolyn (Nasalcrom). How many minutes should she wait between taking the two medications?
b) 5
Which patient would be most suited for treatment with a nonselective alpha-adrenergic blocker?
b) A 46 year old with sever hypertension caused by adrenal medulla tumor
What is the optimal time to administer diuretics?
b) After rising for the day
The patient has received alteplase (Activase) for treatment of a CVA. The patient begins to hemorrhage. What medication does the nurse anticipate will potentially be used as treatment for this hemorrhage?
b) Aminocaproic acid (Amicar)
Antihistamines are another group of drugs used for the relief of cold symptoms. What properties of these medications result in decreased secretions?
b) Anticholinergic
For which conditions may GM-CSF be administered to patients? (Select all that apply.)
b) Autologous bone marrow transplant (BMT) recipient c) Allogenic BMT recipient
The patient has been prescribed atenolol (Tenormin) 50 mg/day. What type of drug is this?
b) Beta blocker
What classification of drug is bisoprolol (Zebeta)?
b) Beta blocker
What classification of drug is pindolol (Visken)?
b) Beta blocker
Which drug is not a LMWH?
b) Clopidogrel (Plavix)
Gefitinib (Iressa) most frequently causes which side/adverse effects?
b) Diarrhea
What is the antidote for digitalis toxicity?
b) Digoxin immune fab
The patient is given heparin for early treatment of DVT. Later, warfarin is prescribed. If the patient is also taking fluoxetine, which is highly protein-bound, what might occur?
b) Drug displacement of warfarin
A patient is being treated with interferon alpha (Roferon-A) for chronic myelogenous leukemia. What is the dose-limiting side effect?
b) Fatigue
The patient has been prescribed hydrochlorothiazide (HCTZ) for her HTN. When she comes to the office for a follow-up appointment, the nurse observes her drinking an energy drink. Which herb, commonly found in some energy drinks, can increase BP when taken with thiazide diuretics?
b) Gingko
What is the most commonly seen side effect a patient may experience when taking nitroglycerin (NTG)?
b) Headache
What are digitalis preparations effective for treating?
b) Heart failure
If a patient takes captopril (Capoten) with a potassium-sparing diuretic, what might occur?
b) Hyperkalemia
If a patient takes captopril (Capoten) with nitrates, diuretics, adrenergic blockers, what might the nurse assess in this patient?
b) Hypotensive reaction
Which statement best describes the direct renin inhibitor aliskiren (Tekturna)?
b) It can be combined with another antihypertensive drug such as an ARB
A patient in the outpatient oncology clinic is receiving sunitinib (Sutent) as part of his treatment for gastrointestinal stromal tumors (GIST). The HCP prescribes ketoconazole to treat a fungal infection. What should concern the nurse about taking these medications concurrently?
b) Ketaconazole may potentiate sunitinib toxicity
Enoxaparin sodium (Lovenox) is an anticoagulant used to prevent and treat DVT and pulmonary embolism. To which category does this drug belong?
b) LMWH
Which group(s) of diuretics is/are frequently prescribed to treat HTN and congestive heart failure? (Select all that apply.)
b) Loop diuretics d) Potassium sparing diuretics e) Thiazide diuretics
The patient presents to the HCP for his annual check-up. His vital signs are BP of 136/62mmHg, HR 72beats/min, respirations 16 breaths/min, and temperature 36.2 C. According to the JNC-7, to which hypertension category does this patient belong?
b) Prehypertension
What is the pharmacological action of spironolactone (Aldactone)?
b) Promote potassium retention and sodium excretion
An ARB can be combined with thiazide diuretic hydrochlorothiazide. What is the purpose of combining these two drugs?
b) To enhance the antihypertensives effect by promoting sodium and water loss
The 65 yo patient had an acute MI 6 months ago and has been prescribed spironolactone (Aldactone) 100 mg/day to treat an irregular heart rate. What statement by the patient indicates that he understands the medication teaching the nurse has provided?
c) "It helps keep potassium so my heart is not irregular."
The patient has had a DVT in her lower leg and has been started on warfarin (Coumadin). She asks the nurse how warfarin works. What is the nurse's best response?
c) "Warfarin prevents new clots from forming."
A patient presents to the HCP's office for a follow-up visit. The patient is taking theophylline, and the nurse is reviewing the lab results. What level of theophylline would fall in the therapeutic range?
c) 14 mcg/mL
What is the duration of action of a nitroglycerin patch?
c) 20-24 hours
The patient, a 48 yo African-American female, presents to her HCP. Her BP is 164/88 mmHg, and a decisision is made to start antihypertensive medication. What group of medications would be more effective than ACE inhibitors for this patient?
c) Calcium blockers
A patient's antihypertensive drug was changed from captopril (Capoten) to nifedipine (Procardia XL) 30mg q8h. What type of antihypertensive drug is nifedipine?
c) Calcium channel blocker
The patient has been prescribed acebutolol (Sectral) for treatment of ventricular dysrhythmia. What is the proper dose of this medication?
c) Cardio selective beta-blocker
Which priority information should be included in teaching a patient who is taking medications for a common cold and also has a history of atrial fibrillation and depression? (Select all that apply.)
c) Do not drive during initial use of a cold remedy containing an antihistamine d) Read labels of over the counter drugs for any interactions with current medications
The patient is taking furosemide 80 mg/day. She has a history of HTN and heart failure. She presents to the ER after sustaining a fall at a local sports bar. She has a laceration to her posterior scalp. Vital signs are temp 38 C, HR 98 beats/min, respirations 16 breaths/min, and BP 94/62 mmHg. Her electrolytes are within normal limits. Her blood alcohol is .06, and her toxicology screen is negative. What does the nurse know about possible drug interactions?
c) Furosemide can cause orthostatic hypotension when consumes with alcohol
Which expectorant is frequently an ingredient in cold remedies?
c) Guaifenesin
Abnormal atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) levels indicate which disease process?
c) Heart failure
The 62 yo patient has been taking ethacrynic acid (Edecrin) for severe edema. The family calls to report that the patient is very weak and unable to ambulate and is complaining of severe leg cramps. Knowing the mechanism of action of ethacrynic acid, the nurse is concerned the patient may experience which electrolyte imbalance?
c) Hypokalemia
What is the action of captopril (Capoten)?
c) Inhibition of formation of angiotensin II
A patient is beginning therapy with the epidermal growth factor/receptor inhibitor (EGFRI) erlotinib (Tarceva) for NSCLC. Which is the most important status for the nurse to assess before beginning therapy with this targeted agent?
c) Lung sounds
What is an example of phosphodiesterase inhibitor?
c) Milrinone
Phosphodiesterase inhibitors are used to treat HF by inhibiting phosphodiesterase enzyme. What do these agents promote?
c) Positive inotropic action
What is one of the primary reasons LMWHs are given?
c) Prevention of DVTs after hip or knew surgery
The patient is being treated for COPD. His medication is delivered via a metered-dose inhaler. Related health teaching would include which priority of information?
c) Shake the inhaler well before use
Drug selection and dosage in older adults with conditions of the lower respiratory tract need to be considered. The use of large, continuous doses of a beta-adrenergic agonist may cause which side effect(s) in the older adult? (Select all that apply.)
c) Tachycardia e) Urinary retention
What is the rationale for administering bevacizumab (Avastin) in a patient with metastic colon cancer?
c) To inhibit the formation of blood supply
The patient has been diagnosed with HTN and diabetes and has been started on hydrochlorothiazide. What statement made by the patient indicates understanding of the medication teaching the nurse has provided?
d) "I need to keep track of my weight and blood pressure at home."
The 70 yo patient has heart failure and has been prescribed hydrochlorothiazide (Esidrix). What statement by the patient indicates an understanding of the dosing regimen?
d) "I should only take it in the mornings so I don't have to go to the bathroom at night."
The 64 yo patient has a history of atrial flutter. His HCP has prescribed quinidine. The patient asks the nurse how this medication will help his heart. What is the nurse's best response?
d) "It will slow how fast the impulse travels through your heart."
The 76 yo patient has a history of heart failure and is taking digoxin 0.125 mg/day. He calls his HCP's office with complaints of nausea, dizziness, and headache, and a HR of 42 beats/min. He states, "I have an appointment in 2 weeks. Is it okay to wait until then?" What is the nurse's best response?
d) "You need to be seen either here or the ER today."
Which orders should the nurse question if the patient was prescribed an ACE inhibitor?
d) A 55 years old African American man
What is one of the effects of diphenhydramine (Benadryl)?
d) Antitussive
A cardioselective beta-adrenergic blocker is also known by which other term?
d) Beta blocker
Aliskiren is what type of drug?
d) Direct renin inhibitor
With use of direct-acting vasodilators, sodium, and water are retained, and peripheral edema occurs. Which category of drugs should be given to avoid fluid retention?
d) Diuretics
Which statement best describes clopidogrel (Plavix)?
d) It can be used together with aspirin after a MI or CVA to prevent platelet aggregation
An 80 yo patient is taking digoxin daily along with several other medications. Her BNP is 420 pg/mL. What concerns the nurse about this level?
d) It is markedly elevated
The nurse has received an order to administer 40 mg furosemide (Lasix) IV to the patient. What does the nurse know about how this medication should be administered?
d) It should be given over 1-2 mins
The patient has been prescribed digoxin for treatment of heart failure. The nurse is providing health teaching for this patient. With regards to diet, what food(s) should the patient avoid? (Select all that apply.)
d) Lettuce
The patient has been prescribed amlodipine (Norvasc) to help control his hypertension. What laboratory values must be monitored carefully?
d) Liver enzymes
The 68 yo patient has been diagnosed with COPD. When providing health teaching for this patient, the nurse discusses the side effects that may occur with the use bronchodilators. What possible clinical manifestation(s) should the patient be aware of? (Select all that apply.)
d) Nervousness e) Palpitations
What type of drug is propranolol (Inderal)?
d) Nonselective beta blocker
The U.S. food and drug administration has ordered removal of all cold remedies containing which drug?
d) Phenylpropanolamine
What is the advantage of systemic decongestants over nasal sprays and drops?
d) Provide longer relief
A patient is receiving GM-CSF therapy. Which system will the nurse focus attention on, both during and after these infusions?
d) Respiratory system
Where in the body do direct-acting vasodilators act to decrease BP?
d) Smooth muscles of the blood vessels
During the first dose of trastuzumab (Herceptin) the patient complains of shortness of breath and pruritus. What is the best action by the nurse?
d) Stop the infusion and manage the reaction
The 40 yo patient has been taking theophylline for long-term treatment of his asthma. He has also been taking ephedra to stay alert while finishing a project at work. The patient presents to the clinic complaining of feeling ill. Vital signs are temp 36.4 C, HR 124 beats/min, respirations 18 breaths/min, BP 170/90 mmHg, and SpO2 99% on room air. Fingerstick blood glucose is 210. His theophylline level is 26 mcg/mL. What does the nurse suspect may be the cause of the patient's symptoms?
d) Theophylline toxicity
The patient has essential hypertension. He is taking captopril (Capoten) 25 mg t.i.d. If the patient takes captopril with a highly protein-bound drug, what might occur?
d) There will be no drug displacement, because captopril is not highly protein-bound
When compared with thiazides, how do loop (high-ceiling) diuretics differ?
d) They are more potent as diuretics
What is/are the advantage(s) of using cardioselective beta-adrenergic blockers as an antihypertensive? (Select all that apply.)
d) They maintain renal blood flow e) They minimize hypoglycemic effect
What action does amlodipine (Norvasc) have in the body?
d) Vasodilation
What is lidocaine primarily used to treat?
d) Ventricular dysrhythmias
The 3 yo patient has gotten into a box of rat poison under the sink. The family brings the box to the ER and the main ingredient is warfarin. What priority medication will the nurse prepare to administer?
d) Vitamin K (Mephyton)
Which group(s) of individuals should absolutely not be prescribed valsartan (Diovan)? (Select all that apply.)
e) Pregnant women in the third trimester
A patient is being discharged after receiving IV chemotherapy. Which statement made by the patient indicates a need for additional teaching?
B) "I will not need to know how to check my temperature."
The 70-year-old patient is to receive cyclophosphamide (Cytoxan) for treatment of his lymphoma. His medical history is also positive for atrial fibrillation, arthritis, and cataracts. He takes digoxin 0.125 mg daily and naproxen 500 mg at bedtime. What should the nurse be aware of when giving these medications?
B) Cyclophosphamide decreases digoxin levels.
One week ago in the outpatient oncology clinic, a patient received his first cycle of chemotherapy consisting of cyclophosphamide (Cytoxan), doxorubicin (Adriamycin) and fluorouracil (5-FU, adrucil) (CAF). He returned to the clinic today for follow-up. Which nursing intervention would be most appropriate at this time?
B) Monitor blood counts and lab values
A patient in the outpatient oncology clinic has developed mucositis secondary to cancer therapy. Which statement made by the patient would indicate that she needs additional teaching about mucositis?
C) "I will use a mouthwash that has an alcohol base."
A patient is to receive fluorouracil (5-FU, Adrucil) as part of a treatment protocol for colon cancer. When teaching he patient about the drug, what should the nurse say concerning when the nadir usually occurs in the blood counts?
C) 10-14 days after administration
The nurse is administering IV fluorouracil (5-FU, Adrucil) to a patient in the outpatient oncology clinic. Which nursing intervention would be most appropriate?
C) Assess for hyper pigmentation along the vein in which the drug is given
The patient, 69 years old, is receiving cyclophosphamide (Cytoxan), doxorubicin (Adriamycin) and methotrexate (Trexall)(CAM) for the treatment of prostate cancer. During monitoring rounds, the patient complains of feeling short of breath. Physical assessment reveals crackles in both lungs. What is the most likely cause of this clinical manifestation?
C) Doxorubicin
Which nursing outcome would be most appropriate as part of the planning for a patient scheduled to receive cyclophosphamide (Cytoxan)?
C) Patient will show no signs of hemorrhagic cystitis
The nurse is administering doxorubicin (Adriamycin) to a patient in the outpatient oncology clinic. What the priority information to include in the patient teaching?
C) Report any shortness of breath, palpitations, or edema to your HCP
A patient receiving cyclophosphamide (Cytoxan), epirubicin (ellence), and fluorouracil (5-FU, Adrucil) (CEF) has experienced severe nausea, vomiting and diarrhea over the past week. He has lost 5.5 pounds. Which nursing diagnosis would be most appropriate?
C) Risk for altered nutrition
A patient is admitted to the hospital 1 week after receiving teniposide (VP-26) in the outpatient oncology clinic. On physical assessment, the nurse notes the presence of petechiae, ecchymoses, and bleeding on the toothbrush when the patient brushes his teeth. Which nursing diagnosis would be most appropriate?
C) Risk for bleeding
A patient has reached the nadir of his blood stream secondary to chemotherapy. Which nursing diagnosis is the most appropriate?
C) Risk for infection
A patient presents with neutropenia secondary to cancer therapy. Which nursing diagnosis would be the most appropriate?
C) Risk for infection
A patient is receiving chemotherapy and asks the nurse about side effects. What should the nurse know concerning the side effects of chemotherapy?
C) Side effects are caused by toxicities to normal cells.
The nurse is teaching a patient about doxorubicin (Adriamycin), which she will receive as part of her treatment for breast cancer. Which statement made by the patient indicates that she needs additional teaching?
D) "This drug may make my urine turn blue."
The nurse is teaching a community group about factors that influence the developer of cancer in humans. Which information will the nurse include in this teaching?
D) Human papillomavirus is associated with cancer of the cervix.
The patient has diarrhea secondary to chemotherapy. What important information should be included in patient teaching about chemotherapy-related diarrhea?
D) Limit caffeine intake
The patient is in the outpatient oncology clinic for treatment of her colon cancer. She is receiving fluorouracil (5-FU, Adrucil) as part of her treatment and has recently been started on metronidazole (Flagyl) for treatment of trichomoniasis. What should concern the nurse about this order?
D) Metronidazole may increase 5-FU toxicity
The nurse is teaching a 29 year old patient about cyclophosphamide (Cytoxan), which will be given as part of her treatment protocol for cancer. Which priority information should be included in the teaching?
D) Pregnancy should be prevented during treatment with cyclophosphamide
A patient is scheduled to receive vincristine (oncovin) as part of treatment for cancer. The medication record for the patient indicates that he is receiving phenytoin (Dilantin) to control a seizure disorder. What should the nurse monitor for in this patient?
D) Seizures
The nurse is preparing IV vinblastine (Velban), bleomycin (Blenoxane) and cisplatin (platinol) (VBP) for administration to a patient on the nursing unit. Which precaution should the nurse take when hanging IV chemotherapy?
D) Wear powder-free gloves
Which drug-lab value interaction is caused by thiazide diuretics?
Elevated lithium level
What anticholinergic drug has few systemic side effects and is administered by aerosol?
Ipratropium (Atrovent)
Which is the most potent calcium channel blocker?
Nifedipine (Procardia)
