Pharm Final Questions

a nurse and a nursing student are discussing the plan of care for a pt with schizophrenia. The pt, who has been taking a high-potency FGA for 2 months, has become restless and constantly needs to be in motion. Which statement by the student indicate a need for further education?

"Because this may be an exacerbation of psychosis, the provider may increase the dose of the FGA"

Pt brought to ER after taking 30 day supply of Alprazolam at once administer Flumazenil

(romazicom)

The nurse should consider teratogenic effects when caring for which clients? SELECT ALL

-A 29 year old client recovering prenatal care in her first trimester of pregnancy -A 37 year old female client who is taking fertility drugs

A nursing student is preparing to begin a pharmacology course. The student should anticipate what areas of study? SELECT ALL

-Impact of drugs on the body -The body's response to a drug -Adverse and anticipated drug effects

The nurse administers an intravenous medication with a half life of 24 half. The nurse should recognize what factors in this client that could extend the drug's half-life ? SELECT ALL

-Kidney -Liver -Cardiovascular disease

Discharge planning for clients leaving the hospital should include instructions on the use of over the counter (OTC) drugs. Which comments by the client should prompt the nurse to provide health education? SELECT ALL

-OTC drugs are safe and do not cause adverse effects if taken properly -OTC drugs have been around for years and have not been tested by the Food and Drug Administration (FDA)

The nurse administers typical antipsychotic medications to the client who has taken these same drugs for many years. What signs and symptoms should the nurse attribute to secondary actions of the drugs? SELECT ALL

1. Drooling 2. Changes in gait 3. Muscular tremors

What should the nurse identify as indications for the use of antacids? Select all that apply.

1. Gastric hyperacidity 2. Gastritis 3. Peptic Esophagitis 4. Hiatal Hernia

For which pt would a Laxative be appropriate for?

1. Pt recovering from MI 2. Client completed anthelmintic therapy (worms)

For which clients would it be appropriate for the nurse to administer a laxative? Select all that apply.

1. a pregnant client who is in early labor 2. a client who is recovering from a MI 3. a client who has completed anthelmintic therapy.

The nurse is caring for a 2-year-old child who has been having frequent diarrhea. What action are appropriate? Select all that apply.

1. administers loperamide as prescribed 2. monitor the client's electrolyte levels closely 3. monitor the client's fluid balance

You asses a pt who received humalin n insulin at 0730 for hypoglycemia at

1400 (bc of when it peaks) (6-8h)

When caring for a client diagnosed with a peptic ulcer, the administers omeprazole and amoxicillin. What diagnostic finding indicates therapeutic effects of this drug regimen?

Absence of helicobacter pylori

The nurse is caring for an older who needs to know that drugs, even when taken correctly, can produce negative unexpected effects. The nurse should address what topic during health education?

Adverse effects

The nurse cares for a pt on an antipsychotic drug Olanzepine (Zyprexa) who develops acute dystonia (severe spasms of the tongue, face neck and back). Which drug will mist likely be prescribed for this reaction

Anticholinergic (benztropine, Cogentin)

An agitated, extremely anxious patient is brought to the ed. Prescriber orders a benzodiazepine. The nurse understands that benzodiazepine are used in this clinical situation based on what principle?

Benzodiazepines have a rapid onset (bc they're lipid soluble)

What concept is prioritized when a provider is considering the substitution of brand name drug with generic?

Bioavailability

A client is admitted to the ICU with hyperkalemia due to the use of potassium-sparing diuretics. Whats assessment should the nurse prioritize?

Cardiac monitoring

The nurse administers metoclopramide to the client with what condition?

Chronic diabetic gastroparesis

Drugs for acute dystonia: Anticholigenic

Clozapine (Clozaril) {2nd generation: they gain weight, lipedema, and agranulocytosis}

The telephone triage nurse receives a call from a client asking for a prescription for an opioid (narcotic) to manage his surgical pain. The nurse explains that opioid prescriptions must be written and cannot be called in to the pharmacy. The client says, "Why are opioids so difficult get a prescription for?" What is the nurses best response?

Controlled substances like opioids are controlled by the FDA and DEA.

In response to the client's question about how to know whether drugs are safe , the nurse explains that all medication in the Untied States undergo rigorous scientific testing controlled by what organization/

FDA

A patient is brought to the ED with respiratory depression after taking a 30-day supply Alprazolam (Xanax) benzodiazepines at one time. Which drug should the nurse has available to administer?

Flumazenil (romazicon)

When comparing effects and efficacy of Valproic and Lithium in pts with bipolar disorders nurse should understand Valproic Acid

Has a greater therapeutic index (25-100) (2nd generation psych cause weight gain)

A patient with bipolar disorder has frequent manic episodes alternating with depressive episodes. The prescriber orders an anti psychotic risperidone (Risperdal) in addition to the lithium (Lithobid) that the patient is already taking. The pt asks nurse why another drug is needed. The nurse will tell the patient that the risperidone is used

Help control symptoms during manic episodes

A pt with bipolar disorder has frequent manic episodes alternating with depressive episodes. The prescriber orders an antipsychotic risperidpne (Risperdal) in addition to lithium (Lithobid) that the pt is already taking. The pt asks the nurse why another drug is needed. The nurse will tell the patient that the risperidone is used to:

Help control symptoms during manic episodes

You are in your mental health rotation for nursing school. The instructor asks, "a patient is being treated for depression and is started on Prozac (fluxoetine). A week after the drug has started the patient reports that nothing has changed and she wants to try a different drug." How would you respond to this situation?

I would encourage the patient to keep taking the drug as prescribed because it usually takes up to 4 weeks to see the full antidepressant effect

Pt has cerebral edema following CVA you are giving Mannitol for what?

Increasing brain pressure

The home health nurse is caring for an 82-year-old man in his home. He reports almost daily diarrhea. The nurse should assess for what common cause of diarrhea in older adults?

Laxative overuse

Your observation of a pt taking an antipsychotic agent includes; drooling and displays tremors, rigidity and shuffling gait. It is correct that the pt is experiencing extrapyramidal symptoms that are consistent with assessment findings for which of the following disorders?

Parkinsonism

The care provider has prescribed intravenous hydromorphone, an opiod, for a client using a client controlled analegsia (PCA) pump. The nurse is aware the drug has a high abuse potential. Under which category would hydromorphone be classified?

Schedule II

What do you assess with pt being treated for psychosis before and after giving a drug for tx?

Suicidal thoughts

The nurse administers psyllium to client with constipation. What outcome best demonstrates therapeutic effects?

The bulk of the client's stools is increased.

The nurse is caring for a client who has recently been prescribed misoprostol. What change in the client's health status should the nurse communicate must promptly to the care provider?

The client believes that she may be pregnant.

The nurse is assessing a client whose asthma being treated with ephedrine. What assessment shows a possible ADR?

The client's blood glucose levels are 200 mg/dL.

A pt with schitzo has been taking an oral FGA for 1 week, Pt has been taking drug daily in two divided doses. Individual complains off daytime drowsiness, PTs fam reports decrease in persons hostility and anxiety but states pt remains antisocial with disordered thinking. What will the nurse tell the family?

The entire dose may be taken at bedtime

A nurse is instructing a pregnant client concerning the potential risk to her fetus from a pregnancy category D. What should the nurse inform the client?

There is evidence of of human fetal risk, but the potential benefits from use of the drug may be acceptable despite potential risks.

Secondary effect of anticholinergic

Urinary hesitancy

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

Urinary hesitancy

Dopamine is used to treat shock for which?

Vasoconstriction

Which of the following is essential that u include in the assessment of pt taking PTU?

WBC and differential (causes agranulocytosis)

The nurse caring for a client with cystic fibrosis, administers pancreatic enzymes in what schedule?

With meals and snacks.

The nursing is caring for a client who is receiving antacids to relieve GI discomfort. What nursing action is most appropriate?

administer the antacid 1 hour before or 2 hours after oral medications.

SE of Imodium

constipation so it inhibits peristalsis

Pt is sub therapeutic serum level of phenytoin (Dilantin) with seizure activity under control you should:

continue as ordered

You are providing patient education for a patient scheduled for an endoscopic procedure. The patient is anxious and says she is unclear about conscious sedation that will be used, which of the following drugs is used for this type of sedation?

midazolam (versed)

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

mineral oil

Your pt with Addison disease is sched for surgery. Which drug should u anticipate to be given

prednisone (NPO give IV, higher dose)

The nurse is providing education for a client with peptic ulcer disease resulting from chronic nonsteroidal anti-inflammatory drug (NSAID) use who will begin a prescription of misoprostol. The nurse evaluates the client understands the actions of this drug when he or she says it does what?

protects the stomach's lining