Pharm Final Prep U

A nurse will use extreme caution when administering heparin to which of the following patients?

A 38-year-old male with peptic ulcer disease

Which client demonstrates the clearest indication for treatment with prednisone?

A 70-year-old man whose rheumatoid arthritis has not responded to OTC pain relievers

A 59-year-old patient is on warfarin therapy. On follow-up visits to the clinic, the nurse will assess the patient for which of the following?

Intake of vitamin K

Tetracycline is often a viable treatment option when a client has an allergy to what antibiotics?

penicillins

Albuterol is a

rescue drug that should be used first for all acute symptoms of shortness of breath or wheezing.

If the client develops priapism for longer than

4 hours, medical attention is needed to prevent permanent damage to the penis.

Conjugated estrogen therapy would be most appropriate for which one of these clients?

A 25-year-old female with primary ovarian failure

A nurse is teaching a client about omeprazole, which has been prescribed as part of a regimen to treat an H. pylori infection. What statement, made by the client, suggests that the client understands proper use of the drug?

"I need to swallow the drug whole."

After teaching a client who is prescribed sildenafil about using the drug, the nurse determines that the teaching was successful when the client states:

"I need to take the pill about an hour before any sexual stimulation."

After teaching a client who is receiving sucralfate about the drug, which statement indicates that the teaching has been successful?

"I should eat a high-fiber diet."

What indicates that a client understands how to use sublingual nitroglycerin?

"I should feel a fizzing or burning sensation."

The nurse is educating an adult male client diagnosed with erectile dysfunction about the prescribed sildenafil. Which statement made by the client establishes the need for further clarification?

"If I eat a fatty meal I will need to take two pills instead of one, so the drug will take effect faster."

A male clent has been diagnosed with impotence and is started on a regimen of androgens. Which statement by the client indicates that he has understood the teaching?

"If my skin appears yellow or my urine turns dark, I will contact my health care provider."

A nurse is caring for a client who is recceiving fluconazole. Which statement by the nurse should be used in the teaching plan for the medication?

"It decreases the localized yeast production."

A 50-year-old woman has begun taking baclofen to treat her recently diagnosed multiple sclerosis (MS). What teaching point should the nurse provide to the patient about her new drug regimen?

"Make sure that you don't stop taking baclofen suddenly because it might cause your symptoms to rebound quite sharply."

An older client has been prescribed omeprazole for the treatment of gastroesophageal reflux disease (GERD). What explanation should the nurse provide when asked by the client why they are not being treated with famotidine?

"Proton pump inhibitors, like omeprazole, produce fewer adverse effects among the older population."

The nurse is providing client teaching regarding the administration of levothyroxine (Synthroid). What is the nurse's priority teaching point?

"Take the medication with a full glass of water."

To minimize adrenal suppression, when should the nurse encourage a client to take his or her daily dose of prescribed prednisone?

"Take your medications in the morning."

A client has been prescribed baclofen and will be taking the drug on an outpatient basis. The client asks the nurse if it is still okay to drink wine with meals or end the day with a "nightcap." What is the nurse's best response?

"The combination of baclofen and alcohol could depress your nervous system to a dangerous level."

Which question would be most important for a nurse to ask a female client who is starting on an angiotensin II receptor blocker for hypertension?

"When was your last menstrual period?"

A client prescribed nitroglycerin reports to the nurse that he is having headaches. How should the nurse best respond?

"You may experience headaches as an adverse reaction to nitroglycerin."

A 59-year-old man with a recent history of erectile dysfunction has been assessed and prescribed sildenafil (Viagra). When providing patient education to this man, the nurse should tell him:

"You might find that your face becomes flushed or you get a headache after you take Viagra."

A client is to receive rifampin. Which would be most important for the nurse to include in the teaching plan for this client?

"Your urine or sweat may become orange in color."

When the nurse cares for a patient receiving an antibiotic, what instructions will the nurse provide no matter what medication is prescribed? (Select all that apply.)

- Drink plenty of fluids to avoid kidney damage. - Take all medications as prescribed until all of the medication is gone. - Report difficulty breathing, severe headache, or changes in urine output.

The client is scheduled to get a breakfast tray at 07:00. At what time should the client receive a prescribed dose of insulin lispro?

06:45

A nurse obtains the serum digoxin level and immediately reports a level greater than which value?

2.0 ng/mL. Therapeutic drug levels are between 0.8 and 2 ng/mL.

A client's family asks why the nurse has placed suction equipment in the room immediately after administering a dose of naloxone (Narcan). Which explanation by the nurse is correct?

Abrupt reversal of opioid-induced respiratory depression may cause vomiting.

A parent has sought care from the nurse practitioner to treat a child's fever. The nurse practitioner is most likely to recommend what nonsalicylate drug?

Acetaminophen

A woman who is in the second trimester of her first pregnancy has been experiencing frequent headaches and has sought advice from her nurse practitioner about safe treatment options. What analgesic can the nurse most safely recommend?

Acetaminophen

A mother asks the nurse how acetaminophen works. What statement best describes the therapeutic action of acetaminophen?

Acetaminophen acts directly on the hypothalamus to cause vasodilation and sweating.

Androgenic effects

Acne, edema, hirsutism (increased hair distribution), deepening of the voice, oily skin and hair, weight gain, decrease in breast size, and testicular atrophy.

A primary health care provider has prescribed levothyroxine to a client with hypothyroidism. Which information would the nurse include in the teaching plan to promote an optimal response to the drug therapy?

Administer he drug early in the morning before breakfast

A male client presents with symptoms of bronchospasm that occurred during a birthday party for his grandson. What medication would the nurse expect the physician to give him?

Albuterol

Mr. Ashum is prescribed an albuterol inhaler as part of his treatment regimen for asthma. What is the mechanism of action for this medication?

Albuterol causes relaxation of the bronchial smooth muscles.

The nurse's assessment of a client who has presented to the emergency department reveals hyperglycemia. Which type of insulin will have the most rapid effect on the client's blood sugar levels?

Aspart

Which drug is used to decrease the risk of myocardial infarction in patients with unstable angina or previous myocardial infarction?

Aspirin

Which medication would the nurse expect to administer if prescribed to achieve skeletal muscle relaxation?

Baclofen

The health care provider has prescribed testosterone for a 77-year-old client with a low testosterone level. The nurse will evaluate this client for what condition that may develop in this client in response to this medication?

Benign prostatic hypertrophy

The nurse is teaching the patient about amoxicillin prior to discharge and includes what important teaching point?

Blackening of the tongue may occur but will subside when the drug is discontinued.

A client with atrial fibrillation who is receiving oral anticoagulant therapy is receiving atorvastatin. The nurse would monitor this client for:

Bleeding

When describing the action of chlorothiazide, what would a nurse include?

Blocking of the chloride pump

A young male patient, age 14, has been prescribed testosterone for delayed onset of puberty. Follow-up care includes a visit to the clinic at least every 6 months for ongoing assessment. It will be most important for the nurse to monitor:

Bone growth

When caring for a patient with angina, the nurse instructs the patient to place the nitroglycerin tablet between the cheek and the gums. Which route of administration is the nurse referring to?

Buccal

A 46-year-old client with a high body-mass index and a sedentary lifestyle has been diagnosed with hypertension after serial blood pressure readings. The clinician has opted to begin the client on captopril (Capoten). The nurse should recognize that the therapeutic effect of this drug is achieved in what way?

By inhibiting the transformation of angiotensin I to angiotensin II

Mark, age 42, is prescribed sildenafil for the treatment of pulmonary hypertension. The nurse caring for Mark would explain that sildenafil works by what mechanism?

Causing vasodilation in the pulmonary vascular bed

The 56-year-old client is diagnosed with osteoarthritis and reports joint pain and stiffness. Which medication would be identified as appropriate for the client to take?

Celecoxib

The client is concerned about taking NSAIDs for pain due to possible GI upset. The nurse identifies which medication causes the least gastrointestinal distress?

Celecoxib

A group of students are reviewing the various fertility drugs that are available. The students demonstrate understanding when they identify which drug as being administered orally?

Clomiphene

Which of the following is classified as an antiplatelet agent? (Choose one)

Clopidogrel (Plavix)

A client is taking androgens and warfarin (Coumadin). What effect will these two medications have on the client's coagulation?

Coagulation will be decreased.

The client is taking cyclobenzaprine for muscle spasms secondary to an injury to the lumbar spine that occurred while lifting a motor at work. The client is being seen for a follow-up visit by the health care provider. The client reports dry mouth, blurred vision, and constipation. Why is the client having these side effects from cyclobenzaprine?

Cyclobenzaprine produces an anticholinergic response

What would danazol (Danocrine) be administered to women for?

Decrease symptoms of endometriosis

Which medication is classified as an antianxiety medication but is also used to treat muscle spasms?

Diazepam (Valium)

The nurse is reviewing the patient's medications and sees fluconazole has been ordered. The nurse will question this order when finding the patient is taking what other medication?

Digoxin

A male client is diagnosed with heart failure. The health care provider orders a loading dose of digoxin. Loading doses are necessary for what reason?

Digoxin's long half-life makes therapeutic serum levels difficult to obtain without loading.

The nurse is providing patient teaching before discharging a patient home. The patient is taking ciprofloxacin (Cipro). What would the nurse teach this patient is the best way to prevent crystalluria caused by ciprofloxacin (Cipro)?

Encourage at least 2 liters of fluid per day.

The nurse is instructing the parents of an 11-year-old male who has testosterone deficiency. Which symptom, if found in this child, would cause the discontinuation of this medication?

Enlarged penis

A client is menopausal and has been given a prescription for estrogen. She asks the nurse what some of the risks are in taking this medication. The nurse's best response is:

Estrogen increases the risk of certain cancers, myocardial infarctions, and blood clots.

The nurse admits a 1-year-old child to the pediatric intensive care unit (ICU) with cryptococcal meningitis. What drug will the nurse anticipate receiving an order for to treat this child?

Fluconazole (Diflucan)

What drug would the nurse administer orally without the need to question when treating infections caused by Candida albicans?

Fluconazole (Diflucan)

A client has a history of deep vein thrombosis, for which he is taking warfarin. When providing education for this client, who is now also taking fluconazole to treat a localized candidal infection, the nurse should instruct the client that:

Fluconazole increases the effects of warfarin. Have routine lab tests done.

An older adult male prescribed anabolic steroids for a deficiency condition has presented with blood pressure above the normal baseline. What might be the cause for an increase in blood pressure associated with anabolic steroid therapy?

Fluid and sodium retention

After teaching a group of students about loop diuretics, the instructor determines that the teaching has been successful when the students identify which agent as the safest for use in the home?

Furosemide

The nurse is teaching a female patient about newly prescribed digoxin. The patient tells the nurse that she occasionally uses herbal therapies. The nurse should caution the patient against using therapies that involve which herbs?

Ginseng

A 9-year-old boy is taking testosterone injections for treatment of hypogonadism. What should be measured every 6 months on this child?

Hand and wrist epiphyseal growth plates

The nurse is admitting a 12-year-old girl to the acute care facility and notices discolored secondary teeth. The mother says she doesn't know why the teeth are discolored because the child is very good about brushing and flossing and sees the dentist regularly. What question would the nurse ask?

Has she ever received tetracycline?

A client is receiving a diuretic as the first-line treatment of mild hypertension. The nurse monitors the client for signs and symptoms of hypokalemia with which agent?

Hydrochlorothiazide

A client who is allergic to sulfonamide would use what diuretic cautiously?

Hydrochlorothiazide

A client who has been taking hydrochlorothiazide arrives at the clinic for his 1-month follow-up appointment. The client tells the nurse that he feels weaker since he began taking the drug. What should the nurse consider as a possible cause of these symptoms?

Hypokalemia

A patient with dementia of Alzheimer's disease is administered donepezil HCL. Which of the following are the actions associated with cholinesterase inhibitors?

Increase in the level of acetylcholine in CNS

A patient has been administered donepezil HCL for dementia. The patient has informed the nurse that she has also been taking nonsteroidal anti-inflammatory drugs. Which of the following interactions should the nurse monitor for in this patient?

Increased risk of GI bleeding

A 26-year-old is prescribed clomiphene as part of treatment for infertility. What is the mechanism of action of clomiphene?

Increases the output of the pituitary gonadotropins

The client is taking NSAIDs for pain. The nurse explains to the client that NSAIDs act by which actions?

Inhibiting the synthesis of prostaglandins

A nurse is preparing to administer a rapid-acting insulin. Which medication would the nurse most likely administer?

Insulin lispro

A male clent who uses a transdermal testosterone gel for treatment of his oligospermia applies the medication first thing in the morning and washes it off before bed. What client education is necessary?

Leave the gel on until the next application is due.

What medication would the nurse question if ordered for a pediatric patient?

Levofloxacin - Fluoroquinolones are contraindicated in patients who are younger than 18 years of age.

Which is the drug of choice in the treatment of status epilepticus, an emergency characterized continual seizure activity with no interruptions?

Lorazepam (Ativan)

A group of students are reviewing the various antihypertensive agents. The students demonstrate understanding of the information when they identify what as an example of an angiotensin II receptor blocker?

Losartan

The nurse is preparing to administer insulin lispro (Humalog) to a client at 7 AM. What is the nurse's priority intervention related to this medication?

Make sure the client's breakfast is available in the next 5-10 minutes.

Prior to administering morphine, the nurse checks the client's medication history. The nurse will contact the health care provider and hold the morphine if the nurse notes the client is currently taking which medication?

Monoamine oxidase (MAO) inhibitor

Which would a nurse have readily available should a client who is receiving morphine experience significant respiratory depression?

Naloxone

The nurse is preparing to administer a nonsteroidal anti-inflammatory drug (NSAID) to an older patient. What NSAID is associated with increased toxicity and should be avoided if possible?

Naproxen (Aleve)

A client is brought to the emergency department after taking an overdose of levothyroxine. When assessing this client, what adverse effects would the nurse expect to find?

Nervousness and tachycardia

After teaching a group of students about proton pump inhibitors, the instructor determines that the students have understood the information when they identify which agent as the prototype proton pump inhibitor?

Omeprazole

Which of the following would a nurse expect as most likely to be used in combination with antibiotics for treatment of Helicobacter pylori infection?

Omeprazole

A postmenopausal woman is receiving raloxifene as part of a treatment plan for osteoporosis. The nurse would instruct the patient that this drug is administered by which route?

Oral

A client is to receive clopidogrel. The nurse would expect to administer this agent by which route?

Oral Clopidogrel is administered orally.

Based on the metabolic action of glucocorticoids, a client who is on long-term glucocorticoid therapy is at risk of developing what disease?

Osteoporosis

Kalie, age 18, is prescribed progesterone for the treatment of primary amenorrhea. Which adverse effect would need to be reported immediately to the health care provider?

Pain in one leg

While reviewing a client's history, an allergy to which of the following would alert the nurse to a possible problem with the use of ipratropium?

Peanuts

A client, newly diagnosed with hypertension is started on captopril, an ACE inhibitor. The client should be informed of the possibility of what adverse effect?

Persistent cough

A client is scheduled for a colonoscopy in the morning. What laxative would the nurse expect to be prescribed the evening before the procedure?

Polyethylene glycol-electrolyte solution

The pharmacology instructor is discussing the differences among the various diuretic agents. Which would the instructor cite as a difference between spironolactone and hydrochlorothiazide?

Potassium losses are greater with hydrochlorothiazide than with spironolactone.

A teenage client who is using testosterone to treat a hormone deficiency calls the clinic to report acne-like skin eruptions on the face. How should the nurse counsel this client?

Practice frequent and thorough skin cleansing.

A male client is diagnosed with Addison's disease. What daily medication would the nurse expect to be administered?

Prednisone

Ms. Kern is treated with heparin therapy for a pulmonary embolism. As the nurse caring for Ms. Kern, you understand that heparin acts by which mechanism?

Prevents the extension of the clot that has formed in lungs

The nurse knows that for a client who still has her ovaries intact, estrogen must be paired with what other drug when used to treat menopausal symptoms?

Progestins

A client exhibits signs and symptoms of heparin overdose. The nurse would anticipate administering which of the following?

Protamine sulfate

A client who is taking estrogen therapy calls the clinic and tells the nurse that she is experiencing sudden, sharp chest pain. The nurse suspects the client is experiencing what adverse reaction related to estrogen therapy?

Pulmonary embolism

The nurse is caring for a client who is receiving IV vancomycin. The nurse infuses the medication at the prescribed rate to prevent what from occurring?

Red man syndrome

A nurse is caring for a patient who is receiving cyclobenzaprine. Which of is the action of the drug on the patient?

Reduction of muscle spasm

The nurse is caring for a patient who is receiving an aminoglycoside. What would be a priority assessment on this patient?

Respiratory function

The client has had a myocardial infarction. The nurse is administering morphine sulfate for the pain. What vital sign would the nurse monitor that directly relates to the use of this narcotic?

Respiratory rate

An 11-year-old client is having a cavity filled in the left mandibular first molar. The health care provider has prescribed aspirin for pain relief after the procedure. The nurse discovers upon assessment that the child is suffering from a flulike illness. The nurse contacts the health care provider about the prescribed medication for pain. What is the risk if aspirin is administered to this client?

Reye syndrome

A group of students are reviewing the drugs available for treating penile erectile dysfunction. The students demonstrate understanding when they identify which drug as a PDE5 inhibitor?

Sildenafil

A male client has cirrhosis and is receiving diuretic therapy. The nurse knows that what drug will help prevent metabolic alkalosis or hypokalemia in this client?

Spironolactone

A nurse is preparing to administer a diuretic that antagonizes the action of aldosterone. Which drug would the nurse be most likely to administer?

Spironolactone

The clinic nurse is providing health teaching to a patient who has been prescribed

Stay out of the sun.

A patient is started on albuterol (Proventil). What reaction should the patient be instructed on?

Tachycardia will occur.

A client diagnosed with osteoarthritis has been prescribed meloxicam. Which instruction should the client be given to assure the medication's safe administration?

Take the medication with food

Ms. Main is sent home with subcutaneous heparin after a total hip replacement. What symptom would indicate a serious drug reaction?

Tarry stools

The nurse is caring for a 6-year-old child who has pyelonephritis. The use of what group of antibiotics would be contraindicated due to the client's age?

Tetracyclines

What is the priority reason for the nurse to consider questioning an order for tetracycline in a child younger than 8 years of age?

Tetracyclines can damage developing teeth and bone in children younger than 8 years of age

A male adolescent is prescribed testosterone. In order to help the client deal with the added social stress that the medication may cause, the nurse should discuss which possible adverse effect?

The development of acne

A triage nurse in the emergency department suspects that a 78-year-old patient is experiencing severe digoxin toxicity with significant cardiac dysrhythmia. If the nurse is correct, which action is likely to be taken?

The patient will be given digoxin immune fab.

A nurse obtains an allergy history from a client based on the understanding that which class is associated with a cross-sensitivity reaction with sulfonamides?

Thiazide diuretics

You are caring for a 73-year-old client receiving warfarin. When you perform your initial shift assessment, you observe blood in the client's urinary drainage bag. After reporting your observation to the physician, which of the following substances will you likely administer?

Vitamin K

A nurse assessing a client on digoxin suspects toxicity. Which visual disturbances would the nurse expect to assess?

Yellow or green vision with a white halo

When considering serious adverse effects, oral contraceptive use would most likely be contraindicated in which client?

a 38-year-old client who smokes 1 to 1½ packs of cigarettes per day

When teaching a patient who is receiving pseudoephedrine about possible adverse effects, what would the nurse include? (Select all that apply.)

a. Hypertension b. Anxiety c. Sweating

A nurse is aware that a client prescribed meloxicam is most likely being treated for what health problem?

arthritis

An older adult client's current medication regimen includes tamsulosin and sildenafil. The combination of these two medications should prompt what action by the nurse?

assessing the client regularly for signs of orthostatic hypotension

A 78-year-old man is admitted to the emergency department (ED) with bradycardia resulting from overdose of donepezil, a cholinergic drug prescribed for treatment of Alzheimer's disease. The nurse knows that the ED physician is likely to order

atropine

A client with muscle spasticity has been prescribed baclofen. In order to promote the safe use of this medication, the nurse should encourage the client to:

avoid drinking alcohol for the duration of treatment.

Which agent would the nurse identify as providing local anesthesia to the respiratory passages?

b. Benzonatate

What would a nurse identify as a first-generation antihistamine? (Select all that apply.)

b. Clemastine c. Meclizine f. Dimenhydrinate

What drug would the nurse expect to administer as a nasal spray?

b. Oxymetazoline

A trauma client has been receiving frequent doses of morphine in the 6 days since his accident. This pattern of analgesic administration should prompt the nurse to carefully monitor the client's what?

bowel patterns

Androgens may be prescribed to women to treat conditions related to the effects of the female sex hormones. Danazol is prescribed to prevent or treat fibrocystic breast disease and:

endometriosis

Which diuretic will most likely be the initial drug of choice when a client demonstrates dyspnea related to pulmonary edema?

furosemide

Anabolic steroid use causes an increase in muscular work capacity, which is what makes these agents popular as performance-enhancing drugs. They are dangerous specifically to teens because they:

can damage the heart, liver, and kidneys.

After 6 months of unsuccessfully trying to conceive, a 31-year-old woman and her husband have sought a referral to a fertility specialist in order to explore their options. A nurse at the clinic should recognize that the woman may benefit from:

clomiphene

After teaching a group of students about topical nasal steroid decongestants, the instructor determines the need for additional teaching when the students identify what as an example?

d. Tetrahydrozoline Tetrahydrozoline is a topical nasal decongestant, not a topical nasal steroid decongestant.

A patient is admitted to the unit with problems controlling their serum glucose levels. The patient has hypertension as a co-morbidity, and the physician has ordered hydralazine for this patient. The nurse caring for this patient knows that hydralazine is a(n):

direct vasodilator.

Which adverse effect should the nurse assess for when administering cyclobenzaprine?

drowsiness

A 49-year-old client reports frequent muscle cramps while on hydrochlorothiazide therapy. The nurse would advise the client to do which?

eat potassium-rich foods

An elderly client experiencing recurrent tension headaches reports taking an over-the-counter (OTC) combination of acetaminophen, aspirin, and caffeine several times a week. The nurse should recognize that this combination medication may be contraindicated if the client has a history of what medical condition?

gastrointestinal (GI) bleeding

Which would a nurse identify as an example of a sulfonylurea?

glyburide

Topical forms of testosterone

have a black box warning alerting the user to the risk of virilization in children who come in contact with the drug from touching the clothes and skin of the man using the drug. They are advised to cover all application areas if coming in contact with children and wash all clothing that has touched the area before children come in contact with it.

The most common adverse effects of lovastatin include:

headache and flatulence.

The nurse should be aware that the combination of omeprazole and warfarin creates a risk of what adverse reaction?

hemorrhage

A client is admitted to the emergency department with a suspected overdose of acetaminophen. What adverse effect is the most common in acute or chronic overdose of acetaminophen?

hepatotoxicity

Levothyroxine

increases T3 and T4 and decreases TSH

Ferrous sulfate is used in the treatment of

iron deficiency anemia

An adult client has begun treatment with fluconazole. The nurse should recognize the need to likely discontinue the drug if the client develops which sign or symptom?

jaundice

A nurse is teaching a class at the local high school on the abuse of anabolic steroids. Which potential adverse reaction should the nurse cite regarding the long-term use of these hormones?

liver tumors.

A client has been prescribed vardenafil. Which medication in the client's history would the nurse be <b>most</b> concerned about?

nitroglycerin

A client has been prescribed vardenafil. Which medication in the client's history would the nurse be most concerned about?

nitroglycerin

A patient enters the emergency room with reports of visual changes, drowsiness, and tinnitus. The patient is confused and hyperventilating. These symptoms may be attributable to:

salicylate intoxication.

A 49-year-old woman has been diagnosed with myalgia. The health care provider has recommended aspirin. The client is concerned that the aspirin will upset her stomach. The nurse will encourage the client to take this medication by:

swallowing the tablet with milk or food.

An adult client has been prescribed oral prednisone for the treatment of an acute dermatological condition. When teaching this client about this course of treatment, what teaching point should the nurse emphasize?

the importance of gradually reducing rather than abruptly stopping the drug

A nurse is instructing a 19-year-old female patient on the use of fluconazole for candida vaginitis. A teaching priority will be to:

use an alternative form of birth control, if taking an oral contraceptive

What effects are exerted by aspirin? (Select all that apply.)

• Analgesic • Antipyretic • Anti-inflammatory

What should a nurse recognize as a property of ibuprofen/Motrin? (Select all that apply.)

• Anti-inflammatory • Analgesic • Antipyretic