pharm final quiz questions
The nurse identifies which drug as a short-acting tetracycline? A. Tetracycline (generic) B. Declomycin C. Vibramycin D. Minocin
a
glucocorticoids are used clinically for all of the following conditions except a) conjunctivitis B) addisons dse c) lymphomas d) cushings dse
d
The nurse identifies which host factor as the most important when choosing an antimicrobial drug? A. Age B. Competent immune function C. Genetic heritage D. Previous medication reactions
b
The nurse is ready to begin a heparin infusion for a patient with evolving stroke. The baseline activated partial thromboplastin time (aPTT) is 40 seconds. Which aPTT value indicates that a therapeutic dose has been achieved? A. 50 B. 70 C. 90 D. 110
b
What does the nurse identify as an adverse effect of clindamycin [Cleocin] therapy? A. Cyanosis and gray discoloration of the skin B. Frequent loose, watery stools with mucus and blood C. Reduction in all blood cells produced in the bone marrow D. Elevated bilirubin, with dark urine and jaundice
b
Which cardiovascular finding does the nurse identify as a possible adverse effect of erythromycin [Ery-Tab] therapy? A. Heart rate of 52 beats per minute B. Prolonged QT interval C. Jugular vein distention D. Grade III diastolic murmur
b
Which instructions should a nurse provide to a patient who is to start taking amoxicillin/clavulanate [Augmentin]? A. "Take Augmentin once per day and only at bedtime." B. "Augmentin may be taken with food or meals." = C. "Avoid taking Augmentin with grapefruit juice." D. "Use a minimal amount of liquid to swallow the Augmentin."
b
a pt is being prescribed a cephalosporin for the tx of a respiratory infection. The health care provider plans to teach the pt to avoid which of the following ingredients in over the counter products while taking this antibiotic? a) aspirin b) alcohol c) anti-histamine d) pseudoephedrine
b
a pt reports neglecting to systematically rotate insulin injection sites. the provider reminds the pt that this could cause which of the following changes to the injection areas? a) a red, itchy dermatitis b) formation of hollows or depression in the skin c) soreness or induration d) increased risk of bleeding and severe bruising
b
a pt with constipation has been started on drug therapy with a stool softener, docusate sodium. if this drug is effective the pt should report + results to the health care provider within a) 6-12 days b) 1-3 days c) 5 days d) 2-6 hrs
b
a pt is receiving a sulfonamide drug for the first time as a part of therapy for a UTI. the provider would carefully assess this pt for which of the following during the first few doses of this drug? a) GI disturbances b) increased BP c) tinnitus and hearing loss d) hypersensitivity reactions
d
the oral contraceptive pill of choice in lactating women is: a) monophasic pill b) biphasic pill c) triphasic pill d) mini-pill
d
When performing a skin test for penicillin allergy, the nurse will do what? (Select all that apply.) A. Inject a tiny amount of the allergen subcutaneously. Incorrect B. Observe for a local allergic response. C. Have epinephrine readily available. D. Have respiratory support readily available. Administer diphenhydramine [Benadryl] as the first-line agent should anaphylaxis occur.
, b, d
phenothiazines such as chlorpromazine are most useful in treating NV d/t a) ingestion of poison b) motion sickness c) radiation therapy and chemo d) gastric stasis
c
which of the following statements best explains the term HAART to a newly diagnosed HIV pt? a) HAART is an antiviral therapy that is easy to follow for most pts b) HAART is an experimental therapy with few + results c) HAART refers to any of one of several combos of anti-HIV drugs that greatly reduce viral loads in pts d) HAART means therapy administration is directly observed by a health care professinal
c
A microbe acquires antibiotic resistance by which means? A. Development of medication resistance in the host B. Overriding of the minimum bactericidal concentration C. Incorrect dosing, which contributes to ribosome mutations d. Transfer of DNA coding to other bacteria
d
A nurse assessing a patient who is 12 years old should associate which complication with the patient's receiving tetracycline as a younger child? A. Delay in long bone growth B. Early onset of puberty C. Severe face and body acne d. Discoloration of the teeth
d
The nurse is caring for a patient who takes warfarin [Coumadin] for prevention of deep vein thrombosis. The patient has an international normalized ratio (INR) of 1.2. Which action by the nurse is most appropriate? A. Administer intravenous (IV) push protamine sulfate. B. Continue with the current prescription. C. Prepare to administer vitamin K. D. Call the healthcare provider to increase the dose.
d
Thirty minutes after receiving an intramuscular (IM) injection of penicillin G [Pfizerpen], a patient reports itching and redness at the injection site. Which action should the nurse take first? A. Elevate the lower legs. B. Place an ice pack on the site. C. Make sure the patient stays calm. d. Administer subcutaneous epinephrine
d
Which laboratory result should a nurse monitor more frequently when a patient is receiving clarithromycin [Biaxin] and warfarin [Coumadin]? A. Activated partial thromboplastin time (aPTT) B. Platelet count C. Erythrocyte sedimentation rate (ESR) D. International normalized ratio (INR)
d
Which test is the most widely used method for assessing drug sensitivity? A. Minimum inhibitory concentration (MIC) B. Minimum bacterial concentration (MBC) C. Broth dilution Disk diffusion
d
The nurse identifies which statements about penicillins as true? (Select all that apply.) A. Penicillins are the safest antibiotics available. B. The principal adverse effect of penicillins is allergic reaction. Correct C. A patient who is allergic to penicillin always has a cross-allergy to cephalosporins. D. A patient who is allergic to penicillin is also allergic to vancomycin, erythromycin, and clindamycin. Penicillins are normally eliminated rapidly by the kidneys but can accumulate to harmful levels if renal function is severely impaired
a, b, e
The human immunodeficiency virus (HIV) uses which enzymes to replicate and infect a host cell? (Select all that apply.) A. Integrase B. Dihydrofolate reductase C. Reverse transcriptase D. Carbonic anhydrase Protease
a, c
The nurse knows that which statement is accurate for enoxaparin [Lovenox]? A. It equally reduces the activity of thrombin and factor Xa. Incorrect B. It has selective inhibition of factor Xa and no effect on thrombin. C. It reduces the activity of factor Xa more than the activity of thrombin. D. It has a lower bioavailability and shorter half-life than unfractionated heparin.
c
A child receives a vaccine for measles, mumps, and rubella (MMR). Six hours after the injection, the child's parent reports local soreness, erythema, lethargy, and a fever of 101°F to a nurse. Which action should the nurse take? A. Give instructions on relieving symptoms with acetaminophen (Tylenol). B. Seek emergency help, because these symptoms are signs of an anaphylactic reaction. C. Tell the parent that a live vaccine will cause a mild case of measles. D. Obtain and fill out a Vaccine Adverse Event Report form.
a
A nurse should teach a patient who has Pneumocystis pneumonia (PCP) about the dosing and therapeutic effects of which medication? A. Trimethoprim/sulfamethoxazole [Bactrim] B. Azithromycin [Zithromax] C. Acyclovir [Zovirax] D. Ganciclovir [Cytovene]
a
A patient is receiving penicillin G [Bicillin C-R]. Which assessment should the nurse monitor as an indicator of an undesired effect? A. Cardiac rhythm B. Serum sodium level C. Lung sounds Red blood cell (RBC) count
a
A patient on warfarin therapy is tested and the INR is in the range of 0.4-0.7. The health care provider decides which of the following actions with respect warfarin therapy: a) increase the dose b) decrease the dose c) leave the dose unchanged d) withdraw therapy immediately
a
A patient who has a vancomycin-resistant enterococci (VRE) infection is receiving linezolid [Zyvox]. Which laboratory result indicates that the patient is having an adverse effect? A. White blood cell (WBC) count of 1200 units/L B. Hemoglobin (Hgb) level of 18 g/dL C. Potassium level of 3.0 mEq/dL D. Glucose level of 200 mg/dL
a
A pt is being treated with aminoglycoside antibiotic, gentamicin. His therapy involves a 30 min iv infusion, 3x daily. He has an order to have plasma lvls measures with a 3rd dose of gentamicin. The health care provider tells him that: a) blood will be drawn prior to and 20-30 min after, the dose b) a urine sample will be collected before and after the antibiotic dose c) blood will be drawn the morning and the evening of the next scheduled dose d) only trough levels will be measured: the blood will be drawn 1 hr before the dose
a
The laboratory calls to report a drop in the platelet count to 90,000/mm3 for a patient receiving heparin for the treatment of postoperative deep vein thrombosis. Which action by the nurse is the most appropriate? A. Notify the healthcare provider to discuss the reduction or withdrawal of heparin. B. Call the healthcare provider to discuss increasing the heparin dose to achieve a therapeutic level. C. Obtain vitamin K and prepare to administer it by intramuscular (IM) injection. D. Observe the patient and monitor the activated partial thromboplastin time (aPTT) as indicated.
a
The pt has been told to begin taking abciximab as an antiplatelet drug to help prevent MI. The health care provider teaches the pt that the goal of the therapy is to prevent thrombi formation in which of the following types of blood vessels? a) arteries b) capillaries c) venules d) veins
a
Which administration instruction should the nurse give a patient scheduled to start receiving the HIV fusion inhibitor enfuvirtide [Fuzeon]? A. "Rotate injection sites in the arm, thigh, and abdomen." B. "Take only when you consume low-fat meals." C. "Dosing is optimal 30 minutes before meals." D. "Injection-site reactions are usually uncommon."
a
Which statement by an 18-year-old woman vaccinated with Gardasil indicates that more teaching is necessary? A. "This vaccination will cure the HPV infection I got when I was 16." B. "I will still need to have a routine Pap screen performed." C. "Gardasil can prevent genital warts in males and females." D. "This drug will not protect against all types of HPV."
a
insulin shock: a) severe hypoglycemia caused by an overdose of insulin b) severe hyperglycemia c) too little insulin in the bloodstream d) increased risk of bleeding and severe bruising
a
The nurse is aware that mother-to-child transmission of HIV occurs primarily during labor and delivery. Which of the following can reduce the risk of transmission? (Select all that apply.) A. ART during gestation to minimize maternal viral load B. IV zidovudine to the mother during labor and delivery C. Two forms of birth control, including barrier and hormonal D. Oral or IV zidovudine to the infant for 6 weeks following deliveryCorrect E. Planned induction of labor
a, b
A patient is being discharged from the hospital on warfarin [Coumadin] for deep vein thrombosis prevention. Which instructions should the nurse include in the patient's discharge teaching plan? (Select all that apply.) A. Wear a medical alert bracelet. B. Check all urine and stool for discoloration. C. Do not start any new medication without first talking to your healthcare provider. D. Enteric-coated aspirin and any aspirin products can be used unless they cause a gastrointestinal ulcer. E. No laboratory or home monitoring of international normalized ratio (INR) is required after the first 6 months.
a, b, c
The nurse identifies varicella vaccination as contraindicated in which patients? (Select all that apply.) A. A patient who is pregnant B. A 21-year-old patient with an allergy to neomycin C. A 12-year-old patient with an allergy to gelatin D. An 8-year-old patient with asthma E. A 10-year-old patient who receives chemotherapy for the treatment of leukemia
a, b, c, e
A patient is receiving the protease inhibitor (PI) amprenavir [Agenerase]. Which laboratory results would the nurse evaluate as indicators of adverse effects of this medication? (Select all that apply.) A. Plasma cholesterol level B. Serum transaminases C. Cardiac enzymes D. Blood glucose level E. Creatinine level
a, b, d
The nurse is caring for a group of patients taking warfarin [Coumadin]. Which patients are at moderate to high risk for harm as a result of warfarin therapy? (Select all that apply.) A. A patient with variant genes that code for VKORC1 and CYP2CP B. A patient with a current INR of 2.2 treated for deep vein thrombosis C. A woman with a new onset of symptoms of a pulmonary embolus D. A patient on day 4 after hip replacement with a new order for warfarin E. A patient with a prosthetic heart valve, for whom an interacting drug is being deleted from the regimen
a, c, e
A patient is receiving a continuous heparin infusion for venous thromboembolism treatment. Which laboratory results should the nurse monitor? (Select all that apply.) A. Platelets B. Vitamin K C. Prothrombin time (PT) D. International normalized ratio (INR) E. Activated partial thromboplastin time (aPTT)
a, e
1. A patient receives an immunization with an attenuated vaccine. Which response should a nurse expect if the vaccine produces active immunity? A. A mild form of the infectious illness B. Endogenous production of antibodies C. Immediate antibody protection D. A stronger immune system response
b
1. Which instruction should a nurse include in the discharge teaching for a patient who is to start taking tetracycline? A. "You may stop taking the pills when you begin to feel better." B. "Use sunscreen and protective clothing when outdoors." C. "You'll have to come back to the clinic for weekly blood work." D. "Take the medication with yogurt or milk so you won't have nausea."
b
A nurse should recognize that which laboratory result is used as a major factor in deciding when antiretroviral therapy is indicated for a patient infected with HIV? A. Plasma HIV RNA assay B. CD4 T-lymphocyte count C. Western blot assay D. OralQuick Rapid HIV-1 Antibody Test
b
A patient has been prescribed efavirenz [Sustiva]. The nurse should instruct the patient to use which administration approach to minimize central nervous system (CNS) adverse effects? A. The drug should be taken in divided doses throughout the day. B. Bedtime dosing is most effective. C. The drug should be mixed only with an acidic beverage.Incorrect D. A steroid medication should be used concurrently.
b
Before administering intravenous (IV) penicillin, the nurse should do what? A. Flush the IV site with normal saline. B. Assess the patient for allergies. C. Review the patient's intake and output record. D. Determine the latest creatinine clearance result.
b
The development of a new infection as a result of the elimination of normal flora by an antibiotic is referred to as what? A. Resistant infection B. Superinfection C. Nosocomial infection D. Allergic reaction
b
ter 52: 1. A patient with a deep vein thrombosis receiving an intravenous (IV) heparin infusion asks the nurse how this medication works. What is the nurse's best response? A. Heparin prevents the activation of vitamin K and thus blocks synthesis of some clotting factors. B. Heparin suppresses coagulation by helping antithrombin perform its natural functions. C. Heparin works by converting plasminogen to plasmin, which in turn dissolves the clot matrix. D. Heparin inhibits the enzyme responsible for platelet activation and aggregation within vessels.
b
A patient diagnosed with a pulmonary embolism is receiving a continuous heparin infusion at 1000 units/hr. Of which findings should the nurse immediately notify the healthcare provider? (Select all that apply.) A. aPTT of 65 seconds B. aPTT of 40 seconds C. Nosebleeds D. aPTT of 100 seconds Correct E. Platelet count of 300,000/mcL
b, c, d
Which are examples of the improper use of antibiotic therapy? (Select all that apply.) A. Using surgical drainage as an adjunct to antibiotic therapy B. Treating a viral infection C. Basing treatment on sensitivity reports D. Treating fever in an immunodeficient patient e. Using dosing that results in a superinfection
b, e
1. An antimicrobial medication that has selective toxicity has which characteristic? A. Ability to transfer DNA coding B. Ability to suppress bacterial resistance C. Ability to avoid injuring host cells D. Ability to act against a specific microbe
c
A 3-year-old child is scheduled to receive pneumococcal vaccine (PCV). Which condition should the nurse recognize as a contraindication to the vaccine in this child? A. Autism B. Premature birth C. Temperature of 103°F D. The child's mother is pregnant
c
A nurse administers Gardasil, the human papillomavirus (HPV) vaccine, to an 11-year-old girl. The nurse informs the parent that routine screening with which diagnostic test is needed? A. Beta hCG B. Chlamydia test C. Pap test D. Mammogram
c
A patient has acquired an infection while in the hospital. The nurse identifies this type of infection as what? A. Superinfection B. Suprainfection C. Nosocomial infection D. Resistant infection
c
A patient presents to the emergency department with symptoms of acute myocardial infarction. After a diagnostic workup, the healthcare provider prescribes a 15-mg IV bolus of alteplase (tPA), followed by 50 mg infused over 30 minutes. In monitoring this patient, which finding by the nurse most likely indicates an adverse reaction to this drug? A. Urticaria, itching, and flushing B. Blood pressure of 90/50 mm Hg C. Decreasing level of consciousness D. Potassium level of 5.5 mEq/L
c
The antiretroviral medication raltegravir [Isentress] achieves therapeutic effectiveness through which action when administered to a patient infected with HIV? A. It blocks the entry of HIV into CD4 T cells. B. It increases protease enzyme activity. C. It inhibits the enzyme integrase. D. It destroys reverse transcriptase.
c
The nurse is monitoring a patient receiving a heparin infusion for the treatment of pulmonary embolism. Which assessment finding most likely relates to an adverse effect of heparin? A. Heart rate of 60 beats per minute B. Blood pressure of 160/88 mm C. Discolored urine D. Inspiratory wheezing
c
The nurse is working in an immunization clinic. Which patient will the nurse identify as not eligible to receive routine immunizations? A. An 8-year-old experiencing diarrhea B. A 2-year-old with a history of premature birth C. A 4-year-old with a fever and upper respiratory infection D. A 6-year-old who has recently been exposed to a classmate with chickenpox
c
