PHARM FINAL

After teaching a patient about the action of spironolactone, the nurse determines that the teaching was successful when the patient states:

"I need to make sure I don't eat too many high potassium foods."

The nurse is caring for a 55-year-old client with Hashimoto's thyroiditis. During discharge teaching, which statement by the client tells the nurse the client understands the teaching?

"I should take this medication on an empty stomach in the morning."

A 66-year-old woman presents at the clinic with motion sickness. The health care provider orders a scopolamine patch. Which statement by the client leads the nurse to believe the client knows how to use the patch?

"I will change the patch every 3 days."

The nurse is preparing to administer a sulfonamide to a client when the client states, "I woke up this morning with a lot of sores in my mouth." What is the nurse's next best action?

"I'm going to contact your health care provider before I administer your medication."

The client has been prescribed norepinephrine. While the nurse is teaching the client about this medication, the client asks the nurse what is it for. What is the nurse's best response?

"It is a neurotransmitter that keeps the nerve message going from the brain to the organ."

A nurse is teaching an 82-year-old client about amphotericin B, an antifungal ordered by the health care provider. Which client statement would suggest that teaching has been effective?

"Taking this drug could damage my kidney functioning."

›Antiviral Action?

-Interfere with the virus's ability to reproduce in a cell by disabling the protein part of the virus

Fluoroquinolones uses?

-Lower respiratory infections -Bone and joint infections -Urinary tract infections and infections of the skin -Sexually transmitted diseases

The nurse is preparing to administer an intradermal injection. At which angle will the needle be inserted?

15 degrees

Penicillins may trigger an anaphylactic reaction in some clients. Within what period following injection of a penicillin is anaphylaxis most likely to occur?

30 minutes

The nurse assesses a client's blood glucose level after administering insulin. Which result would the nurse interpret as indicative of severe hypoglycemia?

34 mg/dL

The health care provider has ordered a daily dose of corticosteroid for a client. What should the nurse teach the client about the time to take a daily dose of a corticosteroid?

8:00 AM

Penicillin would NOT be indicated for which of the following clients?

A client with gram-negative bacteria allergic to penicillin

After teaching a group of nursing students about pharmacokinetics, the instructor determines that the teaching was successful when the students identify which actions as a phase? Select all that apply.

Absorption Distribution Metabolism Excretion

When preparing to administer a cholinergic drug, the nurse understands that which is responsible for activating the primary neurotransmitter in the parasympathetic nervous system?

Acetylcholinesterase

What Drug Class has these Actions? vProduce the following responses in varying degrees: oCNS: wakefulness; quick reaction to stimuli; quickened reflexes oMetabolism: increased use of glucose, liberation of fatty acids—adipose tissue oHeart: increase in heart rate oAutonomic nervous system: relaxation—smooth muscles of bronchi; constriction of blood vessels; sphincters—stomach; dilation—coronary blood vessels; decrease gastric motility

Adrenergic Drugs

After reviewing information about drugs used to treat lower respiratory system conditions, a group of nursing students demonstrate understanding of the information when they identify which as an example of a short-acting beta-2 agonist (SABA)?

Albuterol

The parents of a 7-year-old client who has been diagnosed with allergic asthma are being taught about their son's medication regimen. The nurse is teaching about the appropriate use of a "rescue drug" for acute exacerbations. What drug should the nurse suggests the parents to use in these situations?

Albuterol

The nursing instructor has completed teaching a group of students about the adrenergic nervous system. The instructor determines the class is successful when the students correctly choose which types of receptors are utilized by this system? Select all that apply.

Alpha receptors Beta receptors

After teaching a group of nursing students about sympatholytic drugs, the instructor determines that the teaching was successful when the students correctly choose which groups as an example? Select all that apply.

Alpha-adrenergic blockers Beta-adrenergic blockers

What are sulfonamides classified as?

Antibacterial

A health care provider orders a transdermal drug. When administering this drug, which action by the nurse would be most appropriate?

Apply next dose to a new site

A nurse is preparing to give a client an initial dose of a penicillin preparation. What should the first action be for the nurse?

Ask the client if there is a history allergy to a penicillin.

The nursing instructor is teaching a session explaining the various drugs used to treat chronic obstructive pulmonary disease (COPD). The instructor determines the session is successful when the students correctly choose which conditions as being considered part of the COPD spectrum? Select all that apply.

Asthma Chronic bronchitis

A nurse suspects that a client receiving oral penicillin therapy is developing pseudomembranous colitis based on which assessment finding?

Bloody diarrhea

A health care provider has written an order for a new drug. As the nurse prepares to administer the drug, which factors will the nurse expect to find in the order? Select all that apply.

Client's name Drug name Dosage form Route of administration Frequency of administration

A client, diagnosed with a urinary tract infection, indicates the use of an herbal product to help prevent and relieve the symptoms. Which herb has the client most likely been using?

Cranberry

The nursing instructor is teaching a session explaining mast cell stabilizers. The instructor determines the session is successful when the students correctly choose which drug as an example?

Cromolyn

A nurse is caring for a 6-year old child with a severe case of typhoid fever. The client was mistakenly administered tetracycline, which can cause adverse reactions. What could be a permanent effect in the child?

Discoloration of the teeth

After teaching a group of nursing students about pharmacokinetics, the instructor determines that the teaching was successful when the students identify which phase as first?

Drug is made available for use in the body

A client with a history of allergies is prescribed an auto-injector for self-administration in case of an allergic reaction. The nurse understands that this device contains which drug?

Epinephrine

A client with motion sickness is prescribed transdermal scopolamine. The nurse would instruct the client to apply the patch at which frequency?

Every 72 hours

As part of a class discussion, a nursing instructor describes which agency as being responsible for the approval of new drugs in the United States?

Food and Drug Administration

Which organization is responsible for approving new drugs in the United States?

Food and Drug Administration (FDA)

A nursing instructor is teaching a class on the actions of the different classes of diuretics. Which drugs will the instructor point out as exerting action on the loop of Henle and distal and proximal tubules? Select all that apply.

Furosemide Bumetanide

A client with AIDS is treated with several drugs that work at different portions of the life cycle of the virus. This multiple drug therapy is called which?

HAART

A nursing instructor has finished teaching a group of nursing students the basic functions of the autonomic nervous system (ANS). The instructor determines the teaching is successful when the students correctly choose which functions as controlled by the ANS? Select all that apply.

Heart rate Blood pressure Glandular secretions GI activity

A nursing instructor determines a class on the various antiviral drugs is successful after the students correctly choose which viruses as being susceptible to antiviral medications? Select all that apply.

Human immunodeficiency virus (HIV) Herpes simplex virus (HSV) Cytomegalovirus (CMV)

A nurse is administering an IV infusion of amphotericin B. The nurse would be alert for which adverse reactions during the first hour of the infusion? Select all that apply.

Hypotension Nausea Chills

Amphotericin B is given by which route?

IV

A nursing instructor is teaching a group of students about cardiotonics. The instructor determines the session is successful when the students correctly relate which as actions of the cardiotonics? Select all that apply.

Improves myocardial contractility Increases myocardial efficiency Improves profusion to all body tissues

An elderly client is admitted to the medical floor with a fever, body aches and cough. What virus should the nurse suspect this client to have?

Influenza

The pharmacology instructor is discussing antimicrobials with the nursing class. What would the instructor tell the students is the mechanism of action of some antimicrobials?

Inhibiting cell wall synthesis

A nurse is preparing to administer insulin to the client. Which interventions should the nurse perform before administering each insulin dose?

Inspect the previous injection site for inflammation.

A nurse is caring for a client with crystalluria. When caring for the client, which intervention would the nurse include in the plan of care to prevent more stones from forming?

Instruct the client to increase fluid intake to 2000 mL.

During a teaching session on the care of the diabetic client, the nurse should make which statement to explain the differences in insulin?

Insulins have different onsets and durations of action

A client is entering the continuation phase of treatment for tuberculosis. Which drugs will the nurse prepare to teach the client about? Select all that apply.

Isoniazid Rifampin

The nurse is preparing a client for the initial treatment phase for tuberculosis. Which antitubercular drugs will the nurse anticipate teaching the client? Select all that apply

Isoniazid Rifampin Pyrazinamide Ethambutol

Your client is 32 weeks pregnant. She has just been diagnosed with a urinary tract infection. You know that tetracycline is contraindicated for her because:

It can cause a life-threatening toxicity for the fetus.

A client has been suffering from repeated sinus infections. The client is diagnosed with allergic rhinitis. The client is prescribed a daily antihistamine. What is the mechanism of action in the antihistamine medications?

It prevents histamine from acting on target tissues.

The nurse who has admited a client with diabetic ketoacidosis should look for what assessment findings that are consistent with this diagnosis? (Select all that apply.)

Ketones in the urine Flushed, dry skin

After teaching a group of nursing students about fluoroquinolones, the instructor determines that the teaching was successful when they choose which drug as an example? Select all that apply.

Levofloxacin Ciprofloxacin

A group of nursing students are comparing the actions of the various diuretic classes. Which drugs should the students choose when examining the ones that work on the glomerulus? Select all that apply.

Mannitol Urea

The nurse is teaching the client who has just been placed on sulfasalazine about its potential adverse reactions. One common reaction the nurse should definitely include in teaching is which?

May cause the skin and urine to turn orange-yellow

The nursing instructor is teaching a class on the various hormones in the body. The instructor determines the class is successful when the students correctly choose which hormones as products of the adrenal gland? Select all that apply.

Mineralocorticoids Glucocorticoids

The nurse is writing a plan of care for a client receiving an alpha-specific adrenergic agonist. What is the priority component of the client's plan of care?

Monitoring blood pressure and heart rate frequently

The nurse knows that tuberculosis (TB) is an infectious disease seen around the world and in many cases due to overcrowding. The nurse would be aware of this condition if the lab reports showed which bacteria?

Mycobacterium tuberculosis

A young adult has been receiving Keflex P.O. for the last 5 days to treat a respiratory infection. The nurse is concerned when the client reports urinating only once in the last 16 hours. What should the nurse consider as the cause?

Nephrotoxicity

A nurse is preparing to administer an aminoglycoside to a client. The nurse would be alert for the development of which toxicities? Select all that apply.

Nephrotoxicity Ototoxicity Neurotoxicity

When administering aminoglycosides, the nurse must be aware of which of the following adverse reactions?

Ototoxicity and nephrotoxicity

The nursing instructor is discussing cholinergic drugs with his clinical group. What system would the instructor tell the students is stimulated by cholinergic drugs?

Parasympathetic nervous system

Cephalosporins are structurally and chemically related to which classes of antibiotics?

Penicillins

The nurse is teaching a client about possible adverse reactions that can occur with tetracyclines. The nurse determines that the teaching was successful when the client identifies which reaction? Select all that apply.

Photosensitivity Diarrhea Stomatitis

A group of nursing students are comparing antineoplastic drugs. The instructor determines the class is successful when the students point out which type of drugs exerts a cell cycle-specific action? Select all that apply.

Plant alkaloids Antimetabolites

The nursing instructor is teaching a class about the actions of anticoagulants. The instructor determines the class is successful when the students correctly choose which as actions of anticoagulants? Select all that apply.

Prevent formation of a thrombus. Prevent extension of a thrombus.

The pharmacology instructor is discussing heparin with the students. How would the instructor explain the action of heparin?

Promotes the inactivation of clotting factors

A 36-year-old client with a history of rheumatic fever is scheduled for dental surgery. The primary care provider orders this client to take penicillin for 3 days before and for 3 days after surgery. This is a case of which type of therapy?

Prophylaxis

A client with hypertension is to begin treatment with a beta-adrenergic blocker. The nurse predicts the client will potentially begin with which medication? Select all that apply.

Propranolol Metoprolol Atenolol

What assessment should the nurse make before administering beta-adrenergic blocking agents?

Pulse and blood pressure

A nurse is preparing an inservice on the subject of preventing medication errors. Which actions will the nurse illustrate in the discussion? Select all that apply.

Rechecking all calculations Avoiding distractions and concentrating on only one task at a time Confirming any questionable orders Practicing the five + 1 rights of drug administration

A client is admitted to the intensive care unit with diabetic ketoacidosis. The nurse knows that the client will be placed on an intravenous insulin drip. The only type of insulin that can be administered intravenously is:

Regular.

The nursing instructor is teaching a group of students about the various medications used to treat hypertension. After the session the instructor determines the session is successful when the students correctly connect which actions with calcium channel blockers? Select all that apply.

Relaxation of blood vessels Increased oxygen supply to the heart Reduced workload on the heart Decreased blood pressure

A nursing mentor is monitoring a student as they prepare a prescribed drug for a client. The mentor determines the student is well prepared as they correctly verify which factors? Select all that apply.

Right client Right route Right drug

A client diagnosed with HIV infection is receiving HAART. On assessment, the nurse notes the client is alert and oriented, with reports of anorexia, nausea, and vomiting; 10-pound weight loss in past 6 weeks, pale, pin skin with irritation or breakdown, and without report of pain Which nursing diagnosis is a priority for this client?

Risk for Imbalanced Nutrition

Which anticholinergic agent is sometimes used to manage motion sickness when delivered by transdermal patch?

Scopolamine

A 25-year-old female client is diagnosed with hypothyroidism. The client is prescribed levothyroxine. Which instruction about the administration of this medication would be important?

She should take the medication in the morning before breakfast.

After administering sulfonamides to a client, the nurse observes the client has developed a fever, cough, and muscular aches, as well as lesions in the form of red wheals on the neck and the mouth. The nurse interprets these findings as indicating which possible adverse reaction?

Stevens-Johnson syndrome (SJS)

When describing the adrenergic branch of the autonomic nervous system to a group of nursing students, the instructor would also refer to it as which type of nervous system?

Sympathetic nervous system

The nurse working in the burn unit is preparing to change client's dressing for the first time. What should the nurse tell the client before changing the dressing and applying the ordered mafenide (sulfamylon) ointment?

That stinging or burning may be felt during and after application of the ointment

Your client was given tetracycline as a young child. You can tell this by changes in:

The color of her teeth.

After teaching a group of nursing students about amphotericin B, the instructor determines that the teaching was successful when the students identify which of the following as true? Select all that apply.

The drug is light sensitive. The drug can cause renal damage. The drug should be used within 8 hours.

A client is being treated with amphotericin B. Which statement indicates that the client has understood the client teaching?

The medication may cause kidney damage."

The nurse knows that pseudomembranous colitis is a superinfection of fluoroquinolones, especially when they are administered in high doses, because these medications have what effect in the body?

They disrupt the normal flora of the body.

A nurse is preparing to administer a sulfonamide to a client. The nurse is aware sulfonamides are commonly used to treat which types of infections? Select all that apply.

Ulcerative colitis Urinary tract infection Acute otitis media

A nurse is conducting an in-service about antibacterial drugs such as penicillins and cephalosporins. During the question-and-answer period, the audience asks for examples of conditions that can be treated by cephalosporins. Which examples would the nurse include in the response?

Urinary tract infections

The nursing student asks the instructor why it is more difficult to develop antiviral drugs than anti-infectives. The nursing instructor's best reply would be which?

Viruses are tiny and replicate inside cells.

A nurse is preparing to administer an adrenergic agent for shock. Which nursing assessment should be completed with priority?

Vital signs

The client has a severe infection in the leg from a boating accident. A diagnosis has been made of the presence of MRSA. MRSA can best be defined as which?

a bacteria resistant to antibiotics

›Nitrates actions??????

acts by relaxing the smooth muscle layer of blood vessels, increasing the lumen of the artery or arteriole, and increasing the amount of blood flowing through the vessels

A client experiencing a serious allergic reaction to a bee sting is brought to the emergency department. The client's right hand is swollen, red, and painful. She is extremely upset, short of breath, and the nurse detects wheezing and stridor. The nurse is ordered to administer epinephrine to relieve which of the clients symptoms?

acute bronchospasm.

A disulfiram-like reaction may occur if which substance is consumed within 72 hours after administration of certain cephalosporins?

alcohol

The route of medication administration can change dependent on client factors. Therefore, the route of medication administration is:

always included in the "five rights" of medication administration.

›Antihistamines does what?

block most, but not all, of the effects of histamine

Prior to administration of adrenergic blocking drug for hypertension, which should the nurse assess first?

blood pressure

A client is taking rifampin (Rifadin) for active TB. The nurse should stress that what may be caused by the use of this drug?

body fluids such as urine, saliva, tears, and sputum may become discolored.

An elderly female client insists her asthma is exacerbated by her least favorite television show. While explaining that her dislike for the show's host may be a contributing factor, the nurse relates that an asthma attack is caused by substances released from mast cells, which cause:

bronchoconstriction and inflammation.

›The cholinergic blocking drug ipratropium bromide (Atrovent) is used for what?

bronchospasm associated with COPD; chronic bronchitis, and emphysema in emergent situations.

The nurse is caring for a client with a urinary tract infection (UTI) being treated with a sulfonamide. The client asks for something to drink. Which option should the nurse give to the client?

cranberry juice

A client is diagnosed with an infection. What would the nurse anticipate being used to determine the best drug to treat the infection?

culture and sensitivity (C&S)

What physical characteristic observed in an adult suggests that they were prescribed tetracycline as a child?

discoloration of the teeth

A client is showing signs of anaphylactic shock shortly after the administration of a drug. Which drug should the nurse administer to treat anaphylactic shock?

epinephrine

When describing the action of beta blockers to a client, the nurse would emphasize that the majority of drug action involve stimulation of the receptors in which organ?

heart

A nursing student is reading a journal article about highly active antiretroviral therapy (HAART). The nurse would expect to find which condition as being treated with this therapy?

human immunodeficiency virus (HIV)

›Expectorants (guaifenesin) action is?

increases the production of respiratory secretions, which in turn appears to decrease the viscosity of the mucus. This helps to raise secretions from the respiratory passages

Several medication errors occur with administration of a drug. Which two drugs have been associated with medication errors?

insulin and heparin

A client is being discharged home with a prescription for sublingual nitroglycerin. The nurse will instruct the client and family to do which?

keep the tablets in the original dark bottle.

A nurse is teaching a client about a prescribed thyroid supplement and describes a drug that is relatively inexpensive, requires once-a-day dosing, and has a more uniform potency than do other thyroid hormone replacement drugs. Which drug is the nurse describing?

levothyroxine

While studying thyroid replacement therapy in pharmacology class, the nursing students learn that hypothyroidism is treated with what drug?

levothyroxine

A client has been prescribed oral tetracycline. The nurse will instruct the client to take the drug how?

on an empty stomach

Bronchodilator Actions??

open the bronchi and allow more air to enter the lungs, by relaxing the smooth muscles and allows more air to enter the lungs, which in turn completely or partially relieves respiratory distress

A client has been admitted to the critical care unit with a diagnosis of peritonitis that has necessitated treatment with gentamicin. As a result, the care team should be cautious when concurrently administering other medications that may cause which?

ototoxicity or nephrotoxicity.

Which term is used to describe the study of drugs and their action on living organisms

pharmacology

After teaching a group of nursing students about sulfonamides, the instructor determines that the teaching was successful when the students choose which medication as an example of a sulfonamide antibiotic? Select all that apply.

sulfamethoxazole/trimethoprim silver sulfadiazine

Another name for adrenergic drugs is:

sympathomimetic drugs

A nurse is monitoring a client on sulfonamide therapy. Which finding would lead the nurse to suspect that the client is developing thrombocytopenia?

unusual bleeding

A client with a gram-negative infection is being treated with an aminoglycoside. What assessment should the nurse prioritize during treatment?

urine output and BUN and creatinine levels

What is the Action & Use of Insulin?

›Activates a process that helps glucose molecules enter the cells of striated muscle and adipose tissue ›Promotes protein synthesis ›Properties of insulin: onset, peak, duration ›Controls type 1 diabetes mellitus, type 2 diabetes

Can you list Beta-Adrenergic Blocking Drugs?

›Atenolol ›Esmolol ›Metoprolol ›Propranolol ›Sotalol ›timolol

Can you list Cholinergic Blocking Drugs?

›Atropine ›Dicyclomine ›Glycopyrrolate ›Scopolamine ›Trimethobenzamide ›Oxybutynin ›ipratropium

›Actions: Potassium-sparing diuretics?

›BLOCK THE REABSORPTION OF SODIUM IN THE KIDNEY TUBULES, THEREBY IN CREASING NA+ & H2O IN THE URINE-THIS REDUCES THE EXCRETION OF K+

Thrombolytic action???

›Break down fibrin clots by converting plasminogen to plasmin

What is the Action of Cholinergic Blocking Drugs?

›Cholinergic blocking drugs inhibit the activity of acetylcholine at the parasympathetic nerve synapse - meaning they inhibit the parasympathetic response, which means they decrease skeletal muscle contractions and smooth muscle contractions ›Some of these drugs inhibit nerve impulses at both muscarinic receptors (smooth muscle receptors) and nicotinic receptors (skeletal muscle receptors); affect many organs and structures of the body, including the eyes, respiratory and gastrointestinal (GI) tracts, heart, bladder

What is the action of Beta-Adrenergic Blocking Drugs?

›Decreased stimulation of sympathetic nervous system on certain tissues ›Decreased excitability of heart; decreased cardiac workload and oxygen consumption; provides membrane-stabilizing effects

Can you list Adrenergic Drugs?

›Dobutamine ›Dopamine ›Epinephrine ›Isoproterenol ›Midodrine ›norepinephrine

What are uses of adrenergic drugs?

›Hypovolemic, septic shock; allergic reactions; ventricular arrhythmias; respiratory distress ›Cardiac decompensation and arrest; hypotension ›Temporary treatment of heart block ›Plus more

›Actions: Loop Diuretics:

›INHIBIT REABSORPTION OF SODIUM & CHLORIDE IN THE DISTAL & PROXIMAL TUBULES OF THE KIDNEY & IN THE LOOP OF HENLE

Sulfonamides action?

›Inhibit the activity of folic acid in bacterial cell metabolism ›Slow the rate of bacterial multiplication ›The sulfonamides are well absorbed by the gastrointestinal (GI) system and excreted by the kidneys ›Control urinary tract infections caused by both gram-negative and gram-positive bacteria ›Treat infections caused by second- and third-degree burns

What are the Uses of Cholinergic Blocking Drugs?

›Primary uses of cholinergic blocking drugs: ›Pylorospasm and peptic ulcer ›Ureteral or biliary colic, bladder overactivity ›Vagal nerve-induced bradycardia ›Parkinsonism ›Preoperative reduction of oral secretions

Think about Vasopression, can you remember what it is good for?

›Regulates reabsorption of water by the kidneys ›Secreted by pituitary when body fluids must be conserved ›Used in treating diabetes insipidus ›Adverse reactions: tremor, sweating, vertigo, nasal congestion, nausea, abdominal cramping, water intoxication

What is the Drug Class & Generic Drug name that is widely used as an oral antidiabetic?

›The Biguanide -metformin!!!

Antiarrhythmic action??

›The goal of antiarrhythmic drug therapy is to restore normal cardiac function (NSR) and prevent life-threatening conduction problems

What are Beta-Adrenergic Blocking Drugs used for?

›Used in treatment of: ›Hypertension; cardiac arrhythmias, such as ventricular or supraventricular tachycardia; migraine headaches; heart failure; angina pectoris; glaucoma

What are the two Corticosteroids used to treat Addison's Disease?

›Used to treat Addison's disease ›Hydrocortisone/Glucocorticoid ›Fludrocortisone/Mineralocorticoid

Calcium channel blockers:??

›act by inhibiting the movement of calcium ions across cell membranes of cardiac and arterial muscle cells; effects on the heart: slowing the conduction velocity of the cardiac impulse; depression of myocardial contractility; dilating coronary arteries and arterioles

Antitussives (codeine & benzonatate) actions?

›are used to relieve a non-productive cough

Mucolytics (acetylcysteine) does what?

›break down thick, tenacious mucus in the lower portions of the lungs for better elimination thru the respiratory system

Expectorants?????

›used to help bring up respiratory secretions