pharm final

A patient who takes ciprofloxacin [Cipro] and runs 6 miles daily tells a nurse about heel and calf tenderness. The nurse anticipates the healthcare provider to take which action?1. No action is needed because this is a temporary but expected side effect.2. Continue the antibiotic with an anti-inflammatory medication.3.Slow the running pace and walk more.4. Discontinue the medication, because severe damage can result.

.4. Discontinue the medication, because severe damage can resul tendon rupture is serious adverse effect and medication should be stopped immediately at first sign

The client with erectile dysfunction is being evaluated for the use of sildenafil (Viagra). Which of the following questions should the nurse ask before initiating therapy with sildenafil?1) Are you currently taking medication for angina?2) Do you have a history of diabetes?3) Have you ever had an allergic reaction to dairy products?4) Have you ever been treated for migraine headaches?

1 (life threatening hypotension is an adverse effect in clients taking sildenafil and organic nitrates

A client tells the nurse that he used amphetamines to be productive at work. The nurse is aware that abrupt discontinuation of the drug will produce which symptom?1. Severe anxiety 2. Increased yawning 3. Altered perceptions 4. A motivational syndrome

1. Severe anxiety also nausea, depression, prolonged sleep, excessive eating, craving for more

A client with severe acne is seen in the clinic and the physician prescribes isotretinoin (Accutane). The nurse reviews the client's medication record and would contact the physician if the client is taking which medication? 1. Vitamin A 2. Digoxin (Lanoxin) 3. Furosemide (Lasix) 4. Phenytoin (Dilantin)

1. Vitamin A also tetracyclines!!

After completing a course of ciprofloxacin [Cipro] for a skin infection, the patient says, "I took the whole bottle of pills, but my infection hasn't gotten any better." Which additional information should the nurse recognize as most significant?1.The patient takes antacids on a daily basis.2.The medication was stored in a cool, dry area.3.The patient did not use sunscreen while taking the ciprofloxacin [Cipro].4.The patient took two doses of diphenhydramine [Benadryl] while on ciprofloxacin [Cipro] therapy.

1.The patient takes antacids on a daily basis antacids decrease affect!!!

A client has been started on cyclobenzaprine for the management of muscle spasms in the cervical spine. The client is experiencing drowsiness, dizziness, and dry mouth. The nurse interprets these signs/symptoms as which response? 1.These are the common side effects of this medication. 2.These effects represent an allergic reaction to the medication. 3.These effects are related to the problem with the cervical spine. 4.These effects are dose-related; the client should cut the medication dose in half.

1.These are the common side effects of this medication.

dantrolene sodium is prescribed for a client experiencing flexor spasms, and the client asks the nurse about the action of the medication. The nurse responds knowing that which is the therapeutic action of this medication? 1.Depresses spinal reflexes 2.Acts directly on the skeletal muscle to relieve spasticity 3.Acts within the spinal cord to suppress hyperactive reflexes 4.Acts on the central nervous system (CNS) to suppress spasms

2.Acts directly on the skeletal muscle to relieve spasticity acts directly on skeletal muscle to relieve muscle spasticity. The primary action is the suppression of calcium release from the sarcoplasmic reticulum. This in turn decreases the ability of the skeletal muscle to contract

The nurse is reviewing the laboratory studies on a client receiving dantrolene sodium. Which laboratory test(s) would identify an adverse effect associated with the administration of this medication? 1.Creatinine 2.Liver function tests 3.Blood urea nitrogen 4.Hematological function tests

2.Liver function tests

A home care nurse is visiting an 88-year-old man, who is taking acetaminophen for arthritic pain in his knees. Which of the following patient teaching statements is most appropriate to implement?A. "Acetaminophen will only relieve pain but not the inflammation from arthritis."B. "Acetaminophen is appropriate for the treatment of inflammation from arthritis."C. "Your primary health care provider should consider a prescription of Vicodin (acetaminophen/hydrocodone

A. "Acetaminophen will only relieve pain but not the inflammation from arthritis." it is an antipyretic and analgesic only!!

An automobile worker visits an occupational health nurse. He has pain in his right hand due to repetitive movements, for which he has been taking aspirin 650mg every 2 hours. Which of the following symptoms is indicative of salicylate toxicity?A. ringing in the earsB. halos around the lightsC. edemaD. dysthythmia

A. ringing in the ears

The nurse prepares to administer the antidote to a patient in cholinergic crisis. What medication does the nurse anticipate the healthcare provider to order? Neostigmine [Prostigmin] Atropine Pralidoxime [DuoDote] Dobutamine [Dobutrex]

Atropine

A 20-year-old client presents to the clinic with complaints of breast tenderness, nausea, vomiting, and absence of menses for 2 months. She has a history of a seizure disorder well controlled with carbamazepine (Tegretol). She tells the nurse that she has been taking her oral contraceptives as directed, but she wonders if she might be pregnant. The nurse's best response to her concern should be which of the following?A. "You can't be pregnant if you have been taking your oral contraceptives correctly."B. "Carbamazepine can decrease the effectiveness of oral contraceptive drugs, so we need to do a pregnancy test."C. "There is no need to worry. Oral contraceptives are very effective."D. "Taking antiseizure drugs with oral contraceptives significantly decreases your risk of getting pregnant.

B. "Carbamazepine can decrease the effectiveness of oral contraceptive drugs, so we need to do a pregnancy test.

A physician tells a patient to take aspirin for back pain. It is most important to instruct the patient toA. Take the medication on an empty stomach to enhance absorption.B. Take the medication after a meal to prevent gastric irritation.C. Crush the enteric-coated tablet for increased effectiveness.D. Take the medication 2 hours after a meal to enhance the absorption.

B. Take the medication after a meal to prevent gastric irritation with food or water!!

What information should the nurse provide to a patient who will self-administer an antiepileptic agent for the first time at home?A) Report any vision or hearing problems with levetiracetam (Keppra).B) Stir phenobarbital (Luminal) elixir into a cold carbonated beverage.C) Have a complete blood count monthly while taking carbamazepine (Tegretol).D) Administer pregabalin (Lyrica) every morning on an empty stomach.

C The nurse instructs the patient taking carbamazepine to have complete blood counts as directed, usually every month at first, because iminostilbenes can cause bone marrow suppression

To assess for the dose-limiting toxicity of ganciclovir (Cytovene), the nurse will monitor which laboratory test result?A. Blood urea nitrogenB. Liver function testsC. Complete blood count (CBC)D. Creatine phosphokinase

C. Complete blood count its stopped if plt is below 25,00 and if ANC below 500!

Which information should be given to the client taking phenytoin (Dilantin)?A. Taking the medication with meals will increase its effectiveness.B. The medication can cause sleep disturbancesC. More frequent dental appointments will be needed for special gum care.D. The medication decreases the effects of oral contra- ceptives.

C. More frequent dental appointments will be needed for special gum care. D. The medication decreases the effects of oral contra- ceptives.

amphetamine is a

CNS stimulant. it promotes release of norepinephrine and dopamine and inhibits re-uptake.

The nurse teaches the patient taking tacrolimus to avoid taking NSAIDs because they do what? Place additional stress on the liver Can exacerbate kidney injury Interfere with the action of tacrolimus Interfere with the absorption of tacrolimus

Can exacerbate kidney injury tacrolimus is toxic and often causes kidney toxicity

A nurse is teaching a child care class to prospective grandparents. Which of the following medications is contraindicated in children?A. ibuprofenB. acetaminophenC. amoxicillinD. aspirin

D. The nurse should instruct the grandparents that aspirin increases children's risk of developing Reye's syndrome, and they should not give the drug to children.

Which statement best describes the action of CNS stimulants?A.) CNS stimulants block or reduce the activity of inhibitory neurons.B.) CNS stimulants activate cyclic adenosine monophosphate.C.) CNS stimulants decrease the production of excitatory neurotransmitters.D.) CNS stimulants increase release of and block reuptake of neurotransmitters.

D.) CNS stimulants increase release of and block reuptake of neurotransmitters.

The patient is receiving IV antiepileptic therapy. Which parenteral antiepileptic drug is effective against generalized seizures?A) Phenytoin (Dilantin)B) Fosphenytoin (Cerebyx)C) Phenobarbital (Luminal)D) Valproic acid (Depakene)

DValproic acid is indicated in all its forms for generalized seizures, including tonic-clonic, absence, and myoclonic seizures. Phenytoin, fosphenytoin, and phenobarbital are parenteral antiepileptic medications, effective in the treatment of partial seizures and, secondarily, generalized tonic-clonic seizures.

Which is a nursing intervention for a patient taking carbidopa-levodopa for parkinsonism?a. Encourage the patient to adhere to a high-protein diet.b. Inform the patient that perspiration may be dark and stain clothing.c. Advise the patient that glucose levels should be checked with urine testing.d. Warn the patient that it may take 4 to 5 days before symptoms are controlled.

Inform the patient that perspiration may be dark and stain clothing.

The nurse is preparing to give neostigmine [Prostigmin]. What best describes the action of this drug? It inhibits acetylcholine at all cholinergic synapses. It prevents inactivation of acetylcholine. It prevents activation of muscarinic receptors. It stimulates activation of adrenergic receptors.

It prevents inactivation of acetylcholine.

The nurse understands that immunosuppressants are indicated for treatment of what? Chemotherapy-induced thrombocytopenia Prevention of organ rejection Hemolytic anemia Leukopenia

Prevention of organ rejection

tacorlimus has

a narrow therapeutic index so lots of blood draws are done.

To evaluate the effectiveness of antiretroviral therapy (ART), which laboratory test result will the nurse review?a. Viral load testingb. Enzyme immunoassayc. Rapid HIV antibody testingd. Immunofluorescence assay

a. Viral load testing

principal adverse effect of penicillin

allergy!

Ganciclovir treats

herpes viruses and CMV!!!!!!

Trimethoprim-sulfamethoxazole is prescribed for a client. The nurse should instruct the client to report which symptom if it develops during the course of this medication therapy?

sore throat or rash. steven johnson syndrome!

the nurse should inform patient on metronidazole

to report symptoms of rash, pruritus and numbness throughout the regimen steven johnsons syndrome!!!!

The nurse identifies which medication as posing a significant risk of causing confusion, somnolence, psychosis, and visual disturbances in elderly patients?1.Metronidazole [Flagyl]2.Rifampin [Rifadin]3.Ciprofloxacin [Cipro]4.Daptomycin [Cubicin

3.Ciprofloxacin [Cipro] older than 60 is high risk!!!

Which of the following statements by a patient taking cyclosporine (Neoral, Sanimmune) would indicate the need for more teaching by the nurse?1. "I will report any reduction in urine output to my physician"2. "I will my wash my hands frequently"3. "I will take my blood pressure at home every day"4. "I will take my cyclosporine at breakfast with a glass of grapefruit juice"

4. "I will take my cyclosporine at breakfast with a glass of grapefruit juice" grapefruit juice should be avoided! (so should pregnancy) reduction in urine output and increased BP are adverse effects and should be monitored for!\

Carbidopa-levodopa (Sinemet) is prescribed for a client with Parkinson's disease, and the nurse monitors the client for adverse reactions to the medication. Which of the following indicates that the client is experiencing an adverse reaction?1. Pruritus2. Tachycardia3. Hypertension4. Impaired voluntary movements

4. Impaired voluntary movements Rationale:Dyskinesia and impaired voluntary movement may occur with high levodopa dosages. Nausea, anorexia, dizziness, orthostatic hypotension, bradycardia, and akinesia (the temporary muscle weakness that lasts 1 minute to 1 hour, also known as the "on-off phenomenon") are frequent side effects of the medication.

The nurse is conducting discharge teaching related to a new prescription for phenytoin (Dilantin). Which statements are appropriate to include in the teaching for this patient and his family? Select all that apply.A) "Be sure to call the clinic if you or your family notice increased anxiety or agitation."B) "You may have some mild sedation. Do not drive until you know how this drug will affect you."C) "This drug may cause easy bruising. If you notice this, call the clinic immediately."D) "It is very important to have good oral hygiene and visit your dentist regularly."

A, B, D Patients receiving an antiepileptic drug are at increased risk for suicidal thoughts and behavior beginning early in their treatment. The U.S. Food and Drug Administration (FDA) advises that patients, families, and caregivers be informed of the signs that may precede suicidal behavior and be encouraged to report these immediately. Mild sedation can occur in patients taking phenytoin even at therapeutic levels.Carbamazepine(Tegretol), not phenytoin, increases the risk for hematologic effects, such as easy bruising.Phenytoin causes gingival hyperplasia in about 20% of patients who take it. Dental hygiene is important.Patients receiving phenytoin should avoid alcohol and other central nervous system depressants because they have an additive depressant effect.

When the nurse is reviewing laboratory data for a patient who is taking methotrexate (Rheumatrex), which information is most important to communicate to the health care provider?a.The platelet count is 130,000/μl.b.The white blood cell count (WBC) is 1500/μl.c.The blood glucose is 130 mg/dl.d.The potassium is 5.2 mEq/L

Correct Answer: B Rationale: Bone marrow suppression is a possible side effect of methotrexate, and the patient's low WBC count places the patient at high risk for infection. The other laboratory values are also abnormal but are not far from normal values and would not have any immediate serious consequences.

3. A pt age 32 is started on metronidazole for treatment of trichomonas vaginal infections. While she is in this medication she should avoid

alcohol causes disulifram reaction

Krosakoff's Syndrome

amnesia, polyneuropathy, confabulation. Caused by excessive drinking: lack of thiamine in the brain (alcohol). not reversible.

ginkgo bilba interacts with

aspirin and anticoagulants bc it suppresses coagulation!

A patient has received neostigmine 50mg. Which of the following is a serious adverse effect of neostigmine (Prostigmin)?A. bronchospasmB. headacheC. nauseaD. sweating

bronchospasm

Most severe toxicity of Clindamycin?

c diff!!

A patient who has a positive test for human immunodeficiency virus (HIV) antibodies is admitted to the hospital with Pneumocystis jiroveci pneumonia (PCP) and a CD4+ T-cell count of less than 200 cells/uL. Based on diagnostic criteria established by the Centers for Disease Control and Prevention (CDC), which statement by the nurse is correct?a. "The patient meets the criteria for a diagnosis of an acute HIV infection."b. "The patient will be diagnosed with asymptomatic chronic HIV infection."c. "The patient has developed acquired immunodeficiency syndrome (AIDS)."d. "The patient will develop symptomatic chronic HIV infection in less than a year."

c. "The patient has developed acquired immunodeficiency syndrome (AIDS). considered aids when count reached <200!!!!

The nurse is teaching a client about a new eyedrop prescription for timolol (Timoptic) for treatment of open-angle glaucoma. The client has a history of seasonal allergies and hypertension. What is an important administration technique to stress for this client?a. Take any eyedrops for allergies 5 minutes before administering the timolol dropsb. Do not use the timolol drops while concurrently taking allergy medication.c. The timolol drops may temporarily worsen seasonal allergies.d. Gently put pressure on the inner canthus (tear duct) for 1 minute after instilling the timolol drop.

d. Gently put pressure on the inner canthus (tear duct) for 1 minute after instilling the timolol drop Timolol is a beta-adrenergic blocker. To prevent swallowing and systemic absorption, pressure should be applied to the inner canthus of the eye for 1 minute after instilling the drop.

important teaching of methylphenidate

do not take at bedtime because it can cause insomnia and interrupt periodically to assess need and minimize growth suppression

A patient asks the nurse for a supplement that can be used to prevent motion sickness during a vacation cruise. The nurse suggests which supplement?A Ginger root (Zingiber officinale)B Garlic (Allium sativum)C Coenzyme Q-10 (CoQ-10)D Feverfew (Tanacetum parthenium)

ginger root

important teaching point for ganciclovir

hazardous drug!! avoid pregnancy for 90 days.

health care personel should advise patient on sildenafil (viagra) to avoid which foods

high fat because it slows absorption!!

which drug for epilepsy poses the greatest risk for suicide?

lamotrigine (lamictal)

Wernicke's encephalopathy

most serious form of thiamine deficiency in alcoholic patients. manifested by confuion, nystagmus, abornmal ocular movements. give thiamine!!

can a female in first trimester take metronidazole to treat c-diff?

no! crosses placenta in BBB so should be avoided. caution in 2nd and 3rd.

patients on ciprofloxacin are at high risk for

photosensitivty