pharm final (possible test questions)

a client, newly diagnosed with chronic obstructive pulmonary disease, calls the clinic and asks the nurse to explain what the newly prescribed inhaler steroids are for. What would be the most appropriate response by the nurse?

"The medications that have been ordered for you are to help relieve the inflammation and promote dilation of the bronchi."

The nurse is teaching a class about the autonomic nervous system for critical care nurses. What statements, if made by the nurse during the class, are accurate? Select all that apply

-adrenergic receptors respond you norepinephrine -adrenergic receptors are part of the sympathetic nervous system -cholinergic receptors are part of the parasympathetic nervous system

what physiologic processes contribute to the achievement of dynamic equilibrium when a nurse administers a drug? select all that apply

-excretion from the body -absorption from site where the drug enters the body -bio transformation -distribution to the site where the drug is active

A 76 year old man with COPD has been taking ipatropium an anticholirgenic. what change in the clients health status is most likely to require a change in the clients drug regimen?

...

A nurse teaches the patient potential side effects of spiriva (tiotropium), if absorbed systemically. The nurse teaches the following? Select all that apply

...

An elderly patient in thyroid crisis is admitted and requires a thyroidcetomy. Since surgery is not an option what would be the best choice of drug for this patient?

...

the nurse is providing teaching on somatropin to an 11 year old female and her parents. the nurse states that a workup is needed prior to beginning the medication because a contradiction to somatropin therapy is:

...

the nurse is reviewing the function of the renin angiotensin aldosterone system before assessing a client with hypertension. Place the events in the functioning of the raas system in order...

1. Decreased perfusion in the afferent arteriole stimulated secretion on renin 2. Liver produces angiotensin 3. Activation of angiotensin 1 and angiotensin 2 occur in the pulmonary capillary bed 4. Angiotensin 2, a powerful vasoconstrictor 5. Angiotensin 2 becomes angiotensin 3 which causes release of aldosterone 6. Aldosterone causes increased sodium and water reabsorption by kidneys (results in increased blood volume)

the nurse, is caring for a client taking a beta blocker and a nitrate to treat angina, recognizes the need for careful monitoring because of what comorbidity?

COPD...both vasodilators

A patient takes insulin for diabetes. The. nurse recognizes which of the following was symptom of hypoglycemia?

Cold sweat and tremor hunger fast heartbeat shaky and anxious

A 20 year old male has been admitted to the intensive care unite after a motorcycle accident. He was not wearing a helmet and has severe head trauma. The nurse notices abnormally large amounts of urine output in his Foley catheter. The nurse notifies the physician and the patient is diagnosed with having insufficient ADH secretion. Which medication should he nurse expect the physician to order?

DDAVP desmopressin

A patient is diagnosed with type 1 diabetes. What distinguishing characteristic is associated with type 1 diabetes?

Exogenous insulin is required for life.

A client has experienced a seizure. A deficiency in what neurotransmitter may have caused the client's seizure activity?

GABA

when describing the possible adverse effects associated with a mineralocorticoid, which of the following would be included? select all that apply

Hypernatremia Headache Edema

A client is taking a benzodiazepine. The nurse evaluates teaching as effective when the client makes which statement?

I should not stop taking this drug without talking to my health care provider first

lassie (furosemide) peak

IV admin Onset = 5 mins Peak = 30 mins Duration = 2 hrs PO admin Onset = 1 hr Peak = 1-2 hrs Duration = 6-8 hrs

the nurse prepares to administer a phosphodiesterase inhibitor by what route?

IV only

for what action would the nurse administer magnesium citrate?

Increase motility, increase fluid, and enlarge bulk of fecal matter

When compared with benzodiazepines, buspirone stands out as unique among anti anxiety drugs because of what therapeutic advantage?

Lacks muscle relaxant and sedative effects.

A client presents the the emergency department having an acute asthma attack and has been prescribed a sympathomimetic drug (albuterol). The nurse should assess what therapeutic effect of this drug?

MAYBE Cause dilation of the bronchi with increased rate and depth of respiration

the nurse is caring for a client whose unpredictable emotions are due to an infarct in the limbic system. The nurse should be aware that this part of the brain contains high levels of what neurotransmitter? select all that apply

Serotonin Epinephrine Norepinephrine

The pharmacology instructor is talking about the drug propylthiouracil(PTU). what would the instructor cite as the primary mode of action for PTU?

To inhibit production of thyroid hormone

A client with a history of migraines has been prescribed sumatriptan and is experiencing relief. What physiologic response is the client most likely experiencing?

Vasoconstriction of cranial blood vessels

The nurse administers and adrenergic blocking agent to a client. When assessing a client after administration, the nurse should expect evidence of what physiologic affect on this neurotransmitter?

acetylcholine

which of the following is the neurotransmitter responsible for transmission of nerve impulses across the parasympathetic nervous system?

acetylcholine

The nurse is assessing a client who has developed shortness of breath, a rash, panic, and blood pressure of 189/106 mm HG after being administered a new medication. In addition to properly informing the care team, the nurse should perform what action?

administer epinephrine as prescribed

a female patient has been taking prednisone for her asthma for 1 month. The nurses priority teaching is that the patient should gradually decrease her dose of prednisone to avoid:

adrenal insufficiency

The clinic nurse is caring for a client who is taking a COX-2 inhibitor. The nurse should perform what related assessments? Select all that apply

bleeding time GI effects water retention

a client with a longstanding diagnosis of angina has been prescribed nitroglycerin and diltiazem. in addition to monitoring the clients heart rate, the nurse should prioritize what assessment?

blood pressure

the nurse is caring for a client who would like to start taking oral contraceptives. what aspect of this clients health history should the nurse prioritize for follow up?

blood pressure application

the 96 year old client is receiving digoxin and furosemide. in the morning, the client reports headache and nausea. what will the nurse do first?

check the client laboratory values and vitals

what drugs might the nurse administer that have been developed to stimulate the formation of red blood cells? select all that apply

darbepeoin alfa methoxy polyethylene glycol epoein beta epoetin alfa

when the nurse administers a beta-adrenergic blocker to the client with angina, the nurse expects the drug will help to control angina, but it also has what other effect?

decrease strength of heart muscle contraction

The nurse administers desmopressin to the client to treat diabetes insipidus. What assessment findings would indicate to the nurse that the desmopressin is producing a therapeutic effect?

decreased urine output

A nurse is caring for a client who has been receiving a drug by the intramuscular route add a dose of 0.25 mg. After discharge, the client will be prescribed the same medication orally add a dose of 2.5 mg. What phenomenon should the nurse describe when explaining the reason for the increase dosage for the oral dose?

first pass effect

The medics are called to the home of a known diabetic who has gone unresponsive. A check of the blood glucose level reveals a value of 32 mg/dl. Which of the following medications should the medics give?

glucagon?? idek

the nurse is preparing digoxin for an infant. What is the nurses priority interventions?

have another nurse check dosage calculations

A client is prescribed salmeterol, a beta specific agonist drug. What adverse effects should the nurse anticipate, based on the medications action?

headache and dizziness

the nurse suspects that the 16 year old client is taking anabolic steroids. The client Is complaining of right sided tenderness and fatigue. this suspects what potentially serious side effect may be occurring?

hepatitis

a client comes to the clinic for a 1 month follow up appointment. the client tells the nurse he or she has been taking a thiazide drug for a month and now has led cramps and "feels tired all the time." what will the nurse consider as the most likely cause of the clients symptoms?

hypokalemia

A nursing student is preparing to begin a pharmacology course. The student should anticipate what areas of study? Select all that apply

impact of drugs in the body the body's response to a drug adverse and anticipated drug effects

a clients blood pressure is 161/106. how will this blood pressure affect the clients cardiac workload?

increase after load created increased oxygen consumption

The nurse assesses that the patient is having a sympathetic response when noting what manifestations?

increase blood pressure, bronchodilation, and decrease vowel sounds

The nurse is assessing a client who is prescribed a cholinergic agonist. The nurse should recognize that the therapeutic effects of this medication are due to:

increased activity of acheltycholine receptor sites throughout the body

A client has been administered phenylephrine, A medication that affects alpha one receptors. The nurse should anticipate what affects on the client? Select all that apply

increased blood pressure pupil dilation

A nurse has administered a prescribed dose of an anticholinergic agent to a client. What assessment findings most clearly indicates a therapeutic response?

increased heart rate

When caring for a client receiving long-term therapy with corticosteroids, the nurse would plan care incorporating interventions aimed at preventing what?

infection

the nurse administers milrinone to a client with heart failure. what drug will result in forming an undesirable result if given via the same IV line without adequate flushing?

lasix (furosemide)

The nurse is caring for a client who has sedative hypnotic ordered. The nurse should consider this drug contradicted if the client has what disorder?

liver failure

onset peak duration diuretics

loop po: on-60m , p-1-2h , d-6-8h loop iv: on-5m , p-30m , d-2h thiazodes: on-1-3h , p-4-6h , d-6-12h

A patient is describing her medications to the nurse. The patient states she can't remember the name of her diabetes medication, however, she states, "it's the one I can't take for two days after having IV dye injected". Which medication should the nurse identify?

metformin

the nurse is caring for a patient who has had impacted stools twice in the past month. What is the most appropriate laxative for this client?

mineral oil

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

monitoring blood pressure and heart rate every 2-4 hours

The client is diagnosed with myasthenia gravis, a condition in which antibodies block, alter, or destroy the receptors for acetylcholine. What symptom would the nurse expect this client to display?

muscle dysfunction

A client has pheochromocytoma, which causes hypertension due to excessive hormone release from the adrenal medulla. This client's symptoms are due to disruptions in the level of what hormone?

norepinephrine

A nurse working in radiology administers iodine to a client who is having a computed tomography scan. The nurse working on the oncology unit administer his chemotherapy to clients who have cancer. At the public health department, a nurse administers a measles mumps rubella vaccine to a 14-month-old child as a routine immunization. Which branch of pharmacology best describes the actions of all three nurses?

pharmacotheraputics

the nurse reviews the laboratory results of a client taking digoxin. What findings creates a risk of digoxin toxicity?

potassium 3.3

the clients blood pressure is low due to shock and vasodilation of the blood vessels. the nurse recognizes this will have what impact on preload?

preload decreases (I think)

a 50 year old male is taking viagra for erectile dysfunction. the nurse alerts the patient to which of the following as a possible adverse effect?

priapism

A client with a history of glaucoma is prescribed pilocarpine, a muscarinic receptor agonist. For what potential local and systemic affect the nurse assess? Select all that apply

pupil constrictions increased secretions increased bladder contraction

A client is admitted to the emergency department in diabetic ketoacidosis (DKA) with a blood glucose level of 485 mg/dL. The client is prescribed an initial dose of 25 units insulin IV. Which type of insulin will be most likely be administered

regular insulin

the nurse is caring for a client whose potassium level is 5.9. the clients kidneys will respond to this potassium level by:

removing more potassium in the distal convoluted tubule

the nurse is preparing to administer a digitalizing dosage of digoxin to a geriatric client. what factors will the nurse assess first to avoid digging toxicity? select all that apply

renal function low body mass hydration

the nurse is caring for a client whose blood pressure is 75/49. the clients kidneys will compensate by secreting:

renin

when assessing a client before starting a drug regimen, how should the nurse best assess the clients ability to excrete medications?

review the laboratory values indicative of kidney function

The patient has arrived in the emergency department with a suspected heroin overdose. The nurse recognizes that heron belongs in the following narcotic schedule category?

schedule 1

The nursing students are studying sympathomimetic drugs. How do these drugs act on the body?

stimulate both alpha and beta receptors

the nurse is caring for a client with severe coronary artery disease who is experiencing chest pain because the oxygen demand exceeds supply. What forces could potentially be lowered to reduce oxygen consumption? select all that apply

stretch on ventricles preload afterload heart rate

the nurse develops a teaching plan for a 77 year old client who has been prescribed loperamide PRN. the nurses priority teaching point is what?

take drug after loose stool

The nurse is caring for a client with a brain infection of bacterial etiology. When administering medications to this client, the nurse should prioritize what variable related to the clients diagnosis?

the client will require lipid soluble antibiotics

a client taking a calcium channel blocker is seen in the clinic and diagnosed with drug toxicity. When collecting the nursing history, what finding would indicate the likely cause of this drug toxicity?

the ingestion of grapefruit juice

The nurse is caring for a client whose emotions often swing from one extreme to the other. The client spouse tells the nurse his mood swing started when the client awoke from a coma following a serious head trauma. What area of the brain does the nurse suspect was damaged?

the limbic system

biotransformation is affected by many factors. What happens to the clients drug metabolism and liver function is decreased?

the patient can develop toxicity

the client asks the nurse, "why shouldn't I smoke when taking estrogen?" I mean, are the risks really that high?" whats the nurses best response?

there is a high risk because estrogen combined with nicotine created a significant risk for blood clots

The nurse administers an anticholinergic medication to the client. When assessing this client, what findings should the nurse interpret as a secondary effect of a drug?

urinary hesitancy

The nurse is conducting the evaluation phase of the nursing process. The nurse should perform evaluation primarily based on what data?

whether the client is achieving health outcomes