Pharmacology CC

common suffix "phenytoin" Dilantin

Hydantoins

A nurse should observe a client who is taking a tricyclic antidepressant for which manifestations?

Hypotension and Sedation

How do antidepressants work?

by preventing the reuptake of neurotransmitters

common suffix: "pam/lam"

bzd

A client is known to be allergic to several medications. After a nurse administers a medication, an adult client's vital signs are 99.2 F 148-46, and BP 76/40. Which of these assessments should the nurse make? a. allergic reaction b. anaphylactic reaction c. side effect d. anticipated reaction

c (side effect) a drug reaction was expected

Client teaching about narcotics?

1. no alcohol or other CNS depressants 2. nothing that requires concentration 3. do not breastfeed 4. may cause constipation 5. high abuse potential

What are some common anticholinergic side effects (anti-parasympathetic NS)...similar to fight or flight.

dry mouth, difficulty urinating, constipation, tachycardia, confusion, memory impairment, may cause drowsiness

What are some common AEs of ibuprofen (Motrin)?

dyspepsia (GI distress), dizziness, headache, drowsiness, tinnitus, rash, puritis, increased liver enzymes, nausea, vomitting

How often should a fentanyl duragesic transdermal patch be changed?

every 72 hours

Detrol is an anticholinergic used to ______

relax bladder spasms; may cause dry mouth, urinary retention, constipation

Sedatives-________ Hypnotics-___________

relaxation, sleep (both CNS depressants, both contraindicated with alchohol)

Flomax is an alpha-adrenergic blocker that ________

relaxes smooth muscle to improve voiding urine in BPH. May cause hypotension.

NSAIDS can cause which AEs?

GI bleeding.(also,ulcer, MI, HF, renal impairment and rarely liver failure)

Patients taking Viagara should not take what class of drugs?

Nitrates (they are both vasodilators)

Should you give aspirin to treat a fever?

No-may cause Reyes syndrome, may cause allergic reaction in asthmatics

Drug of choice for superficial fungal infections?

Nystatin

Lasix assessments for HF, Edema, HTN:

HF-measure fluid loss via daily weight Edema-assess reduction in peripheral edema via measurements HTN-monitor for electrolyte balance, adequate urine output and lowered BP

A measure of time required for eliminating a drug from the body.

Half-life

How are anticholinergics used to control nausea and vomitting? ex. diphenhydramine (Benadryl) dimenhydrinate (Dramamine)

They block the transmission of impulses to the vomitting center of the brain

common prefix: cef

cephalosporins

What is the controlled substance in Tylenol #3?

codine

Humulin is a ____________ insulin

combination of both NPH and regular insulin

S/S of superinfections

fever, mouth ulcers, diarrhea, vaginal discharge

What drug is used to treat a benzodiazepine overdose?

flumazenil (Romazicon)

A client has been on long-term therapy with colestipol (Colestid). To prevent adverse effects related to the length of therapy and lack of nutrients, which of the following supplements may be required? (Select all that apply.) 1. Folicacid 2. Vitamins A,D,E,and K 3. Potassium,iodine, and chloride 4. Protein 5. B vitamins

1,2

Anticholinergics may be ordered for which of the following conditions? (Select all that apply.) 1. Peptic ulcer disease 2. Bradycardia 3. Decreased sexual function 4. Irritable bowel syndrome 5. Urine retention

1,2,4

Humalog has a _____min onset.

15 min

Normal glucose level is_______

70-140 mg/dl

Which is not an NSAID? a. acetominophen (Tylenol) b. ibuprofen (Motrin) c. naproxen (Aleve) d. indomethacin (Indocin)

A. Tylenol is NOT an NSAID

common suffix "April"

ACE inhibitors

common suffix "olol"

B blockers

What vital sign should be monitored during antipsychotic therapy?

BP

What drug is used to treat EPS?

Benzodiazepines

S/S of hypothyroid

CNS depression, decreased HR, decreased BP

A person receiving a xanthine bronchodilator should restrict __________ .

Caffeine

Drugs cause the specific activity of a cell to be _________ or ___________.

Enhanced or Inhibited

common suffix "kast"

Leukotriene inhibitors

Most drugs are metabolized by which organ?

Liver

common suffix: "prazole"

PPIs

The preferred site for injections in an infant is the ______________.

Vastus lateralis

When are superinfections likely to occur?

When using broad-spectrum antibiotics

A common anti-emetic that is a serotonin antagonist

Zofran (ondansetron)

The nurse teaches a patient who is taking prednisone to avoid eating? a. sodium b. calcium c. magnesium d. all of the above

a

What is Silvadine (sulfasiazine) used for?

a topical cream to prevent and treat infections in 2-3 degree burns

When a patient's platelet level drops, nursing measures include a. monitor weight b. monitor for bleeding c. limit calcium

b

Beta blockers are contraindicated with _______-___________ because they cause bronchoconstriction.

bad breathers

A client receiving an antipsychotic develops extrapyramidal symptoms. What medication does the nurse anticipate will be prescribed to treat this problem?

benzodiazapines

What is paradoxical?

contradictory- opposite of what you would expect; often in Benzodiazepines in elderly...instead of a CNS depressant it causes agitation and restlessness

What test is used to identify a microbial pathogen?

culture and sensitivity (C&S)

A nurse is assessing a client who is febrile. The nurse knows that the client needs an antipyretic medication. The nurse should check in which area of the MAR for this order? a. routine orders b. STAT orders c. HS orders d. PRN orders

d

Which of the following clients would most likely be receiving methylprednisone (Solu-Medrol)? a. arthritic b. immune system disorder c. allergic reaction d. all of the above

d

Who is most sensitive to drugs?

geriatric (wear and tear of the organs,polypharmacy) and pediatric population (immature and fragile organs)

common preffix: mycin

macrolide/aminoglycosides antibiotics/cytotoxic

Sandimmune is indicated to prevent ________.

organ rejection

What is Benign Prostatic Hypertrophy?

As the male ages, the prostate glad enlarges and can impair the bladder's ability to void urine

NPH insulin has a peak ____hours after administration?

4-12 hours

Common complaints of NSAID therapy?

GI upset

A noxious, unintended and undesired effect of a drug

adverse drug reaction

Sympathomimetics (beta adrenergic drugs/bronchodilators) : mimic sympathetic ns; used in tx of asthma

1. hypertension 2. cardiac arrhythmias 3. bronchial dilation-by relaxing smooth muscle AE's-palpitations,headaches, nervousness, tachycardia, dry mouth, insomnia

Important diet teaching for a patient taking Aldactone?

1. limit salt 2. limit potassium 4. limit salt substitutes

Sympathomimetics (bronchodilators) mimic the actions of the sns which results in the __________ of the airways.

dilation

3 classes of drugs to treat angina

1. nitrates 2. beta blockers 3. Ca channel blockers

The desired INR desired outcome of coumadin therapy is

2-3 times control

Regular insulin has a peak ____ hours after administration?

2-4 hrs

Which nitrate preparation has the longest duration of action?

transdermal patch

Following administration of phenylephrine (Neo-Synephrine), the nurse would assess for which of the following adverse drug effects? 1. Insomnia, nervousness ,and hypertension 2. Nausea, vomiting, and hypotension 3. Dry mouth, drowsiness, and dyspnea 4. Increased bronchial secretions, hypotension, and bradycardia

1

Simethicone (Gas-X, Mylicon) may be added to some medications or given plain for what therapeutic effect? 1. Decrease the amount of gas associated with GI disorders. 2. Increase the acid-fighting ability of some medications. 3. Prevent constipation associated with GI drugs. 4. Prevent diarrhea associated with GI drugs

1

A 15-year-old adolescent with a history of diabetes is treated in the emergency department for complications related to skipping her medication for diabetes. She confides in the nurse that she deliberately skipped some of her medication doses because she did not want to gain weight and she is afraid of needle marks. Before establishing a diagnosis of "Noncompliance," what should the nurse assess? 1. Whether the patient received adequate teaching related to her medication and expresses an understanding of that teaching 2. Whether the patient was encouraged to skip her medication by a family member or friend 3. Whether the patient is old enough to understand the consequences of her actions 4. Whether the provider will write another prescription because the patient refused to take the medication the first time

1

A 16-year-old client has taken an overdosage of citalopram (Celexa) and is brought to the emergency department. What symptoms would the nurse expect to be present? 1. Seizures, hypertension, tachycardia, extreme anxiety 2. Hypotension, bradycardia, hypothermia, sedation 3. Meiosis, respiratory depression ,absent bowel sounds, hypoactive reflexes 4. Manic behavior, paranoia, delusions,tremors

1

A 24-year-old client reports taking acetaminophen (Tylenol) fairly regularly for headaches. The nurse knows that a client who consumes excess acetaminophen per day or regularly consumes alcoholic beverages should be observed for what adverse effect? 1. Hepatic toxicity 2. Renal damage 3. Thrombotic effects 4. Pulmonary damage

1

A 63-year-old client with type 2 diabetes is admitted to the nursing unit with an infected foot ulcer. Despite previous good control on glyburide (Micronase), his blood glucose has been elevated the past several days and he requires sliding-scale insulin. What is the most likely reason for the elevated glucose levels? 1. It is a temporary condition related to the stress response with increased glucose release. 2. He is converting to a type 1 diabetic. 3. The oral anti diabetic drug is no longer working for him. 4. Clients with diabetes who are admitted to the hospital are switched to insulin for safety and tighter control.

1

A 65-year-old client is prescribed ipratropium (Atrovent) for the treatment of asthma. Which of the following conditions should be reported to the health care provider before giving this client the ipratropium? 1. A reported allergy to peanuts 2. A history of intolerance to albuterol (Proventil, VoSpire) 3. A history of bronchospasms 4. A reported allergy to chocolate

1

A client is receiving cholestyramine (Questran) for elevated low-density lipoprotein (LDL) levels. As the nurse completes the nursing care plan, which of the following adverse effects will be included for continued monitoring? 1. Abdominal pain 2. Orange-red urine and saliva 3. Decreased capillary refill time 4. Sore throat and fever

1

A client is treated for psychosis with fluphenazine. What drug will the nurse anticipate may be given to prevent the development of acute dystonia? 1. Benztropine(Cogentin) 2. Diazepam(Valium) 3. Haloperidol(Haldol) 4. Lorazepam(Ativan)

1

A male, age 67, reports taking diphenhydramine (Benadryl) for "hay fever." Considering this client's age, the nurse assesses for which of the following findings? 1. A history of prostate or urinary conditions 2. Any recent weight gain 3. A history of allergic reactions 4. A history of peptic ulcer disease

1

A patient has an order for a tetracycline antibiotic and has been instructed to avoid taking the medication with foods, beverages, or drugs that contain calcium, iron, or magnesium. The patient takes the antibiotic along with a daily multivitamin, not realizing that the vitamin con- tains iron. What effect may this have on the tetracycline? 1. Impaired absorption 2. Increased distribution 3. Decreased metabolism 4. Impaired excretion

1

The client has been prescribed oxymetazoline (Afrin) nasal spray for seasonal rhinitis. The nurse will provide which of the following instructions? 1. Limit use of this spray to 5 days or less. 2. The drug may be sedating so be cautious with activities requiring alertness. 3. This drug should not be used in conjunction with antihistamines. 4. This is an OTC drug and may be used as needed for congestion.

1

The client is scheduled to receive 5 units of Humalog and 25 units of NPH (Isophane) insulin prior to breakfast. Which nursing intervention is most appropriate for this client? 1. Make sure the client's breakfast is available to eat before administering this insulin. 2. Offer the client a high-carbohydrate snack in 6 hours. 3. Hold the insulin if the blood glucose level is greater than 100 mg/dL. 4. Administer the medications in two separate syringes.

1

The client or family of a client taking tacrine (Cognex) should be taught to be observant for which of the following adverse effects that may signal that a possible overdose has occurred? 1. Excessive sweating, salivation, and drooling 2. Extreme constipation 3. Hypertension and tachycardia 4. Excessively dry eyes and reddened sclera

1

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 medications 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

The nurse is administering medications and the client states, "I've never seen that blue pill before." What would be the nurse's most appropriate action? 1. Verify the order and double-check the drug label. 2. Administer the medication in the existing form. 3. Instruct the client that different brands are frequently used and may account for the change of color. 4. Recommend that the client discuss the medication with the provider and give the medication.

1

The nurse is assisting the older adult diagnosed with a gastric ulcer to schedule her medication administration. What would be the most appropriate time for this client to take her lansoprazole (Prevacid)? 1. About 30 minutes before her morning meal 2. At night before bed 3. After fasting at least 2 hours 4. 30 minutes after each meal

1

The nurse is caring for a client with gastroesophageal reflux disease (GERD) and would question an order for which of the following? 1. Amoxicillin(Amoxil) 2. Ranitidine(Zantac) 3. Pantoprazole(Protonix) 4. Calciumcarbonate(Tums)

1

The nurse is providing education for a 12-year-old client with partial seizures currently prescribed valproic acid (Depakene). The nurse will teach the client and the parents to immediately report which symptom? 1. Increasing or severe abdominal pain 2. Decreased or foul taste in the mouth 3. Pruritus and dry skin 4. Bone and joint pain

1

The nurse should immediately report the development of which of the following symptoms in a client taking antipsychotic medication? 1. Fever, tachycardia, confusion, incontinence 2. Pacing, squirming, or difficulty with gait such as bradykinesia 3. Severe spasms of the muscles of the tongue, face, neck, or back 4. Sexual dysfunction or gynecomastia

1

The provider has ordered atropine, a drug that will prevent the patient's own chemical, acetylcholine, from causing parasympathetic effects. What type of drug would atropine be considered? 1. An antagonist 2. A partial agonist 3. An agonist 4. A protagonist

1

What is the term used to describe the magnitude of maxi- mal response that can be produced from a particular drug? 1. Efficacy 2. Toxicity 3. Potency 4. Comparability

1

When monitoring for therapeutic effect of any antidysrhythmic drug, the nurse would be sure to assess which essential parameter? 1. Pulse 2. Blood pressure 3. Drug level 4. Hourly urine output

1

Which of the following actions by the nurse is most important when caring for a client with renal disease who has an order for furosemide (Lasix)? 1. Assess urine output and renal laboratory values for signs of nephrotoxicity. 2. Check the specific gravity of the urine daily. 3. Eliminate potassium-rich foods from the diet. 4. Encourage the client to void every 4 hours.

1

Lisinopril (Prinivil) is part of the treatment regimen for a client with HF. The nurse monitors the client for the development of which of the following adverse effects of this drug? (Select all that apply.) 1. Hyperkalemia 2. Hypocalcemia 3. Cough 4. Dizziness 5. Heartburn

1,3,4

What client education should the nurse provide to the client with diabetes who is planning an exercise program? (Select all that apply.) 1. Monitor blood glucose levels before and after exercise. 2. Eat a complex carbohydrate prior to strenuous exercise. 3. Exercise may increase insulin needs. 4. Withhold insulin prior to engaging in strenuous exercise. 5. Take extra insulin prior to exercise.

1,2

A client has been diagnosed with tuberculosis and is prescribed Rifater (combination of pyrazinamide with isoniazid and rifampin). While the client is on this medication, what teaching is essential? (Select all that apply.) 1. "It is critical to continue therapy for at least 6 to 12 months." 2. "Two or more drugs are used to prevent tuberculosis bacterial resistance." 3. "These drugs may also be used to prevent tuberculosis." 4. "No special precautions are required." 5. "After 1 month of treatment, the medication will be discontinued."

1,2,3

What client education should be included for a client receiving enoxaparin (Lovenox)? (Select all that apply.) 1. Teach the client or family to give subcutaneous injections at home. 2. Teach the client or family not to take any OTC drugs without first consulting with the health care provider. 3. Teach the client to observe for unexplained bleeding such as pink, red, or dark brown urine or bloody gums. 4. Teach the client to monitor for the development of DVT. 5. Teach the client about the importance of drinking grapefruit juice daily.

1,2,3,4

Nursing implications of the administration of haloperidol (Haldol) to a client exhibiting psychotic behavior include which of the following? (Select all that apply.) 1. Take 1 hour before or 2 hours after antacids. 2. The incidence of EPS is high. 3. It is therapeutic if ordered on an as-needed (PRN) basis. 4. Haldol is contraindicated in Parkinson's disease, seizure disorders, alcoholism, and severe mental depression. 5. Crush the sustained-release form for easier swallowing.

1,2,4

The nurse is monitoring the client for early signs of lithium (Eskalith) toxicity. Which symptoms, if present, may indicate that toxicity is developing? (Select all that apply.) 1. Persistent GI upset (e.g.,nausea,vomiting) 2. Confusion 3. Increased urination 4. Convulsions 5. Ataxia

1,2,4

Which of the following medications may be used to treat partial seizures? (Select all that apply.) 1. Phenytoin(Dilantin) 2. Valproic acid(Depakene) 3. Diazepam(Valium) 4. Carbamazepine(Tegretol) 5. Ethosuximide(Zarontin)

1,2,4

A client has been diagnosed with genital herpes and has been started on oral acyclovir (Zovirax). What should be included in the teaching instructions for this client? (Select all that apply.) 1. Increase fluid intake up to 2L per day. 2. Report any dizziness,tremors,or confusion. 3. Decrease the amount of fluids taken so that the drug can be more concentrated. 4. Take the drug only when having the most itching or pain from the outbreak. 5. Use barrier methods such as condoms for sexual activity.

1,2,5

Metronidazole (Flagyl) is being used to treat a client's Giardia lamblia infection, a protozoal infection of the intestines. Which of the following are appropriate to teach this client? (Select all that apply.) 1. Metronidazole may leave a metallic taste in the mouth. 2. The urine may turn dark amber brown while on the medication. 3. The metronidazole may be discontinued once the diarrhea subsides to minimize adverse effects. 4. Taking the metronidazole with food reduces GI upset. 5. Current sexual partners do not require treatment for this infection.

1,2,5

Which of the following assessment findings in a client who is receiving atenolol (Tenormin) for angina would be cause for the nurse to hold the drug and contact the provider? (Select all that apply.) 1. Heart rate of 50beats/minute 2. Heart rate of 124beats/minute 3. Blood pressure 86/56 4. Blood pressure 156/88 5. Tinnitus and vertigo

1,3

A 2-year-old client is receiving vincristine (Oncovin) for nurse monitor to prevent or limit the main adverse effect (select all that apply) 1. Numbness of the hands or feet 2. Angina or dysrhythmias 3. Constipation 4. Diminished reflexes 5. Dyspnea and pleuritis

1,3,4

A client is given a prescription for finasteride (Proscar) for treatment of benign prostatic hyperplasia. Essential teaching for this client includes which of the following? (Select all that apply.) 1. Full therapeutic effects may take 3 to 6 months. 2. Hair loss or male-pattern baldness may be an adverse effect. 3. The drug should not be handled by pregnant women, especially if it is crushed. 4. Blood donation should not occur while taking this drug. 5. Report any weight gain of over 5lb (2kg) in 1 week's time.

1,3,4

Common adverse effects of antidysrhythmic medications include which of the following? (Select all that apply.) 1. Hypotension 2. Hypertension 3. Dizziness 4. Weakness 5. Panic attacks

1,3,4

AEs of oral contraceptives

1. fluid retention (HA, HTN) 2. blood clots 3. drug interactions: antibiotics decreases effectiveness of BCP 4. do not smoke

The nurse administers a medication to the wrong client. What are the appropriate nursing actions required? (Select all that apply.) 1. Monitor the client for adverse reactions. 2. Document the error if the client has an adverse reaction. 3. Report the error to the health care provider. 4. Notify the hospital legal department of the error. 5. Document the error in a critical incident/occurrence report.

1,3,5

A client who has not responded well to other drug therapy for Alzheimer's disease is placed on tacrine (Cognex). Which of the following are major disadvantages to the use of tacrine? (Select all that apply.) 1. It must be administered four times per day. 2. It causes weight gain. 3. It may cause vision difficulties. 4. It may cause serious hepatic damage. 5. It maybe purchased over the counter.

1,4

What is the role of the nurse in medication administra- tion? (Select all that apply.) 1. Ensure that medications are administered and delivered in a safe manner. 2. Be certain that health care provider orders are accurate. 3. Inform the patient that prescribed medications need to be taken only if the patient agrees with the treatment plan. 4. Ensure that the patient understands the use and administration technique for all prescribed medications. 5. Prevent adverse drug reactions by properly administering all medications.

1,4

A client is receiving treatment for asthma with albuterol (Proventil, VoSpire). The nurse teaches the client that while serious adverse effects are uncommon, the following may occur. (Select all that apply.) 1. Tachycardia 2. Sedation 3. Temporary dyspnea 4. Nervousness 5. Headache

1,4,5

A client with a congenital coagulation disorder is given aminocaproic acid (Amicar) to stop bleeding following surgery. The nurse will carefully monitor this client for development of which of the following adverse effects? (Select all that apply.) 1. Anaphylaxis 2. Hypertension 3. Hemorrhage 4. Headache 5. Hypotension

1,4,5

A patient with cirrhosis of the liver exhibits decreased metabolic activity. This will require what possible changes? (Select all that apply.) 1. A reduction in the dosage of the drugs 2. A change in the timing of medication administration 3. An increased dose of prescribed drugs 4. Giving all prescribed drugs by intramuscular injection 5. More frequent monitoring for adverse drug effects.

1,5

Proper use of an inhaler includes waiting ___ between puffs of the same medication and ___ between puffs of different medications.

1-2 5

Proper use of an inhaler includes waiting ____between puffs of the same medication and ____between puffs of different medication.

1-2 min, 5 min

2 groups in the sedative/hypnotic. Which is safer?

1. Barbiturates 2. Benzodiazepines-safer

Treatment for H. pylori (3 things)

1. PPI-prilosec, prevacid etc. 2. antibiotics 3. bismuth to lower stomach pH

3 properties of NSAIDS

1. analgesic-pain 2. anti-pyretic-fever 3. anti-inflamm-reduce inflam

Assessments for Digoxin, lanoxin for HF

1. apical pulse-1 full min <60 or > 120 do not give, digoxin can cause bradycardia 2. peripheral edema-measure to get baseline and after 3. lung sounds-dyspenea, rales may mean worsening edema 4, daily weight (no more than 2lbs/day) -to measure fluid statue 5. appetite-look for anorexia! n,v,a all adverse effects check therapeutic level is between 0.5-2.0

Pt teaching for Synthroid:

1. same time, daily, on empty stomach 2. don't change brands w/o MD 3. it is lifelong therapy 4. monitor pulse before taking 5. watch for drug interactions 6. report chest pain, palpitations, weight loss, insomnia, headache, nervousness, excessive perspiration or heat intolerance

Effects of corticosteroids on immune system?

1. slow wound healing 2. suppression of adrenal gland 3. hyperglycemia 4. may mask infections allowing them to grow rapidly

What lab results assess kidney damage?

1. urine protein (albumin) 2. GFR

2 signs of digoxin toxicity?

1. visual changes 2. anorexia (GI)

A client is taking a medication that has a half-life of six hours. The client has a plasma level of 5000 units of the drug when the medication is discontinued. How many units of the medication will remain in the client's plasma after 12 hours?

1250 units

When should you administer proton pump inhibitors?

15 min before meals and at bedtime

A 17-year-old client has been prescribed escitalopram (Lexapro) for increasing anxiety uncontrolled by other treatment measures. Because of this client's age, the nurse will ensure that the client and parents are taught what important information? 1. Cigarette smoking will counter act the effects of the drug. 2. Signs of increasing depression or thoughts of suicide should be reported immediately. 3. The drug causes dizziness and alternative schooling arrangements may be needed for the first two months of use. 4. Anxiety and excitability may increase during the first two weeks of use but then will have significant improvement.

2

A 20-year-old man is admitted to the psychiatric unit for treatment of acute schizophrenia and is started on risperidone (Risperdal). Which client effects should the nurse assess for to determine whether the drug is having therapeutic effects? 1. Restful sleep, elevated mood, and coping abilities 2. Decreased delusional thinking and lessened auditory/ visual hallucinations 3. Orthostatic hypotension,reflex tachycardia,and sedation 4. Relief of anxiety and improved sleep and dietary habits

2

A 32-year-old female has been started on amoxicillin (Amoxil, Trimox) for a severe UTI. Before sending her home with this prescription, the nurse will provide which instruction? 1. Teach her to wear sunscreens. 2. Ask her about oral contraceptive use and recommend an alternative method for the duration of the ampicillin course. 3. Assess for hearing loss. 4. Recommend taking the pill with some antacid to prevent GI upset.

2

A client has been prescribed fluticasone (Flonase) to use with oxymetazoline (Afrin). How should the client be taught to use these drugs? 1. Use the fluticasone first, then the oxymetazoline after waiting 5 minutes. 2. Use the oxymetazoline first, then the fluticasone after waiting 5 minutes. (antihistamine then steroid) 3. The drugs may be used in either order. 4. The fluticasone should be used only if the oxymetazoline fails to relieve the nasal congestion.

2

A client has been taking phenytoin (Dilantin) for control of generalized seizures, tonic-clonic type. The client is admitted to the medical unit with symptoms of nystagmus, confusion, and ataxia. What change in the phenytoin dosage does the nurse anticipate will be made based on these symptoms? 1. The dosage will be increased. 2. The dosage will be decreased. 3. The dosage will remain unchanged;these are symptoms unrelated to the phenytoin. 4. The dosage will remain unchanged but an additional antiseizure medication may be added.

2

A client has started clopidogrel (Plavix) after experiencing a transient ischemic attack (TIA). What is the desired therapeutic effect of this drug? 1. Anti-inflammatory and antipyretic effects 2. To reduce the risk of a stroke from a blood clot 3. Analgesic as well as clot -dissolving effects 4. To stop clots from becoming emboli

2

A client is given a prescription for propranolol (Inderal) 40 mg bid. What is the most important instruction the nurse should give to this client? 1. Take this medication on an empty stomach, as food interferes with its absorption. 2. Do not stop taking this medication abruptly; the dosage must be decreased gradually if it is discontinued. 3. If the client experiences any disturbances in hearing, the client should notify the health care provider immediately. 4. The client may become very sleepy while taking this medication; do not drive.

2

A client is started on efavirenz (Sustiva) for HIV. What should the nurse teach the client about this drug? 1. Efavirenz(Sustiva) will cure the disease overtime. 2. Efavirenz (Sustiva) will not cure the disease but may significantly extend the life expectancy. 3. Efavirenz (Sustiva) will be used prior to vaccines. 4. Efavirenz (Sustiva) will prevent the transmission of the disease.

2

A client who is undergoing cancer chemotherapy asks the nurse why she is taking three different chemotherapy 1. "Your cancer was very advanced and therefore requires more medications." 2. "Each drug attacks the cancer cells in a different way, increasing the effectiveness of the therapy." 3. "Several drugs are prescribed to find the right drug for your cancer." 4. "One drug will cancel out the side effects of the other."

2

A client will be discharged after surgery with a prescription for penicillin. When planning at-home instructions, what will the nurse include? 1. Penicillins can be taken while breast-feeding. 2. The entire prescription must be finished. 3. All penicillins can be taken without regard to eating. 4. Some possible side effects include abdominal pain and constipation.

2

A client with a severe systemic fungal infection is to be given amphotericin B (Fungizone). Before starting the amphotericin infusion, the nurse premedicates the client with acetaminophen (Tylenol), diphenhydramine (Benadryl), and prednisone (Deltasone). What is the purpose of premedicating the client prior to the amphotericin? 1. It delays the development of resistant fungal infections. 2. It decreases the risk of hypersensitivity reactions to the amphotericin. 3. It prevents hyperthermia reactions from the amphotericin. 4. It works synergistically with the amphotericin so a lower dose may be given.

2

A client with significant hypertension unresponsive to other medications is given a prescription for hydralazine (Apresoline). An additional prescription of propranolol (Inderal) is also given to the client. The client in- quires why two drugs are needed. What is the nurse's best response? 1. Giving the two drugs together will lower the blood pressure even more than just one alone. 2. The hydralazine may cause tachycardia and the propranolol will help keep the heart rate within normal limits. 3. The propranolol is to prevent lupus erythematosus from developing. 4. Direct-acting vasodilators such as hydralazine cause fluid retention and the propranolol will prevent excessive fluid buildup.

2

A client with type 2 diabetes treated with oral antidiabetic medication is receiving oral fluconazole (Diflucan) for treatment of chronic tinea cruris (jock itch). The nurse instructs the client to monitor blood glucose levels more frequently because of what potential drug effect? 1. Fluconazole(Diflucan) antagonizes the effects of many antidiabetic medications, causing hyperglycemia. 2. Fluconazole (Diflucan) interacts with certain antidiabetic drugs, causing hypoglycemia. 3. Fluconazole (Diflucan) causes hyperglycemia. 4. Fluconazole (Diflucan) causes hypoglycemia.

2

A patient experiences profound drowsiness when a stimulant drug is given. This is an unusual reaction for this drug, a reaction that has not been associated with that particular drug. What is the term for this type of drug reaction? 1. Allergic reaction 2. Idiosyncratic reaction 3. Enzyme-specific reaction 4. Unaltered reaction

2

A patient has a malignant brain tumor. What pharmacokinetic phase may be affected by the presence of the tumor? 1. Absorption 2. Distribution 3. Metabolism 4. Excretion

2

An 8-year-old boy is evaluated and diagnosed with absence seizures. He is started on ethosuximide (Zarontin). Which information should the nurse provide the parents? 1. After-school sports activities will need to be stopped because they will increase the risk of seizures. 2. Monitor height and weight to assess that growth is progressing normally. 3. Fractures may occur,so increase the amount of vitamin D and calcium-rich foods in the diet. 4. Avoid dehydration with activities and increase fluid intake.

2

Erectile dysfunction drugs such as sildenafil (Viagra) are contraindicated in clients taking nitrates for angina. What is the primary concern with concurrent administration of these drugs? 1. They contain nitrates, resulting in an overdose. 2. They decrease blood pressure and may result in prolonged and severe hypotension when combined with nitrates. 3. They will adequately treat the patient's angina as well as erectile dysfunction. 4. They will increase the possibility of nitrate tolerance developing and should be avoided unless other drugs can be used.

2

Nifedipine (Procardia) has been ordered for a client with hypertension. In the care plan, the nurse includes the need to monitor for which adverse effect? 1. Rash and chills 2. Reflex tachycardia 3. Increased urinary output 4. Weight loss

2

Planning teaching needs for a client who is to be discharged postoperatively with a prescription for oxycodone with acetaminophen (Percocet) should include which of the following? 1. Refer the client to a drug treatment center if addiction occurs. 2. Encourage increased fluids and fiber in the diet. 3. Monitor for GI bleeding. 4. Teach the client to self-assess blood pressure.

2

Prior to discharge, the nurse plans for client teaching related to side effects of phenothiazines to the client, family, or caregiver. Which of the following should be included? 1. The client may experience withdrawal and slowed activity. 2. Severe muscle spasms may occur early in therapy. 3. Tardive dyskinesia is likely early in therapy. 4. Medications should be taken as prescribed to prevent adverse effects.

2

The client asks what can be expected from the levodopa/ carbidopa (Sinemet) he is taking for treatment of parkinsonism. What is the best response by the nurse? 1. "A cure can be expected within 6 months." 2. "Symptoms can be reduced and the ability to perform ADLs can be improved." 3. "Disease progression will be stopped." 4. "EPS will be prevented."

2

The client is being discharged with nitroglycerin (Nitro- stat) for sublingual use. While planning client education, what instruction will the nurse include? 1. "Swallow three tablets immediately for pain and call 911." 2. "Put one tablet under your tongue for chest pain. If pain does not subside, you may repeat in 5 minutes, taking no more than three tablets." 3. "Call your health care provider when you have chest pain. He will tell you how many tablets to take." 4. "Place three tablets under your tongue and call 911."

2

The client is taking atenolol (Tenormin) and doxazosin (Cardura). What is the rationale for combining two anti- hypertensive drugs? 1. The blood pressure will decrease faster. 2. Lower doses of both drugs may be given with fewer adverse effects. 3. There is less daily medication dosing. 4. Combination therapy will treat the patient's other medical conditions.

2

The client is to begin taking atorvastatin (Lipitor) and the nurse is providing education about the drug. Which symptom related to this drug should be reported to the health care provider? 1. Constipation 2. Increasing muscle or joint pain 3. Hemorrhoids 4. Flushing or "hotflash"

2

The client receiving heparin therapy asks how the "blood thinner" works. What is the best response by the nurse? 1. "Heparin makes the blood less thick." 2. "Heparin does not thin the blood but prevents clots from forming as easily in the blood vessels." 3. "Heparin decreases the number of platelets so that blood clots more slowly." 4. "Heparin dissolves the clot."

2

The client taking benztropine (Cogentin) should be provided education on methods to manage which common adverse effect? 1. Heartburn 2. Constipation 3. Hypothermia 4. Increased gastric motility

2

The health care agency is implementing the use of root- cause analysis (RCA) to reduce the occurrence of medi- cation errors. What areas does RCA analyze in order to prevent errors from recurring? 1. Why the medication was ordered,whether it was the correct medication, and whether the client experienced therapeutic results 2. What happened, why it happened, and what can be done to prevent it from happening again 3. What the cost of the medication was, whether it was the most appropriate medication to order, or whether there is a better alternative 4. Whether the medication was documented in the provider's orders, medication administration record, and pharmacy

2

The nurse has administered prochlorperazine (Compazine) to a client for postoperative nausea. Before administering this medication, it is essential that the nurse check which of the following? 1. Pain level 2. Blood pressure 3. Breath sounds 4. Temperature

2

The nurse is preparing to administer chemotherapy to an oncology client who also has an order for ondansetron (Zofran). When should the nurse administer the odansetron? 1. Everytime the client complains of nausea 2. 30 to 60 minutes before starting the chemotherapy 3. Only if the client complains of nausea 4. When the client begins to experience vomiting during the chemotherapy

2

The nurse is providing teaching to a client who has been prescribed furosemide (Lasix). Which of the following should the nurse teach the client? 1. Avoid consuming large amounts of kale, cauliflower,or cabbage. 2. Rise slowly from a lying or sitting position to standing. 3. Count the pulse for one full minute before taking this medication. 4. Restrict fluid intake to no more than 1L per 24-hour period.

2

The nurse is teaching a community health class to a group of young adults who have recently immigrated to the United States about preventing hepatitis B (HBV). What is the most effective method of preventing an HBV infection? 1. Peginterferonalfa-2a(Pegasys) 2. HBV vaccine(Engerix-B) 3. Adefovir dipivoxil (Hepsera) 4. Entecavir(Baraclude)

2

The nurse notes that the client has reached his nadir. What does this finding signify? 1. The client is receiving the highest dose possible of the chemotherapy. 2. The client is experiencing bone marrow suppression and his blood counts are at their lowest point. 3. The client has peaked on his chemotherapy level and should be going home in a few days. 4. The client is experiencing extreme depression and will be having a psychiatric consult.

2

The nurse reads that the drug to be given to the patient, has a "narrow therapeutic index." The nurse knows that this means that the drug has what properties? 1. It has a narrow range of effectiveness and may not give this patient the desired therapeutic results. 2. It has a narrow safety margin and even a small increase in dose may produce adverse or toxic effects. 3. It has a narrow range of conditions or diseases that the drug will be expected to treat successfully. 4. It has a narrow segment of the population for whom the drug will work as desired.

2

The nurse reviews laboratory studies of a client receiving digoxin (Lanoxin). Intervention by the nurse is required if the results include which of the following laboratory values? 1. Serum digoxin level of 1.2 ng/dL 2. Serum potassium level of 3 mEq/L 3. Hemoglobin of 14.4g/dL 4. Serum sodium level of 140mEq/L

2

The nurse teaches the client relaxation techniques and guided imagery as an adjunct to medication for treatment of pain. What is the main rationale for the use of these techniques as an adjunct to analgesic medication? 1. They are less costly techniques. 2. They may allow lower doses of drugs with fewer adverse effects. 3. They can be used at home. 4. They do not require self-injection.

2

The order reads, "Lasix 40 mg IV STAT." Which of the following actions should the nurse take? 1. Administer themedicationwithin30minutesofthe order. 2. Administer the medication within 5 minutes of the order. 3. Administer the medication as required by the patient's condition. 4. Assess the patient's ability to tolerate the medication before giving.

2

Which of the following represents an appropriate out- come established during the planning phase? 1. The nurse will teach the patient to recognize and respond to adverse effects from the medication. 2. The patient will demonstrate self-administration of the medication, using a preloaded syringe into the subcutaneous tissue of the thigh, prior to discharge. 3. The nurse will teach the patient to accurately preparethe dose of medication. 4. The patient will be able to self-manage his disease andmedications.

2

The nurse is instructing a client on home use of niacin and will include important instructions on how to take the drug and about its possible adverse effects. Which of the following may be expected adverse effects of this drug? (Select all that apply.) 1. Fever and chills 2. Intense flushing and hot flashes 3. Tingling of the fingers and toes 4. Hypoglycemia 5. Dry mucous membranes

2,3

While taking the patient's admission history, the patient describes having a severe allergy to an antibiotic. What is the nurse's responsibility to prevent an allergic reaction? (Select all that apply.) 1. Instruct the patient to alert all providers about the allergy. 2. Document the allergy in the medical record. 3. Notify the provider and the pharmacy of the allergy and type of allergic reaction. 4. Place an allergy bracelet on the patient. 5. Instruct the patient not to allow anyone to give the antibiotic.

2,3,4

The nurse is preparing to administer the first dose of enalapril (Vasotec). Identify the potential adverse effects of this medication. (Select all that apply.) 1. Reflex hypertension 2. Hyperkalemia 3. Persistent cough 4. Angioedema 5. Hypotension

2,3,4,5

A client with HIV has been taking lopinavir with ritonavir (Kaletra) for the past 8 years and has noticed a redistribution of body fat in the arms, legs, and abdomen (lipodystrophy). The nurse will evaluate this client for what other additional adverse effects associated with this drug? (Select all that apply.) 1. Renalfailure 2. Hyperglycemia 3. Pancreatitis 4. Bone marrow suppression 5. Hepaticfailure

2,3,5

Which of the following medications would not be admin- istered through a nasogastric tube? (Select all that apply.) 1. Liquids 2. Enteric-coatedtablets 3. Sustained-releasetablets 4. Finelycrushedtablets 5. IVmedications

2,3,5

A 35-year-old male client has been prescribed omeprazole (Prilosec) for treatment of a GERD. Which of the following assessment findings would assist the nurse to determine whether drug therapy has been effective? (Select all that apply.) 1. Decreased "gnawing" upper abdominal pain on an empty stomach 2. Decreased belching 3. Decreased appetite 4. Decreased nausea 5. Decreased dysphagia (difficulty swallowing)

2,4,5

A client with a history of hypertension is to start drug therapy for rheumatoid arthritis. Which of the following drugs would be contraindicated, or used cautiously, for this client? (Select all that apply.) 1. Aspirin 2. Ibuprofen(Advil,Motrin) 3. Acetaminophen(Tylenol) 4. Naproxen(Aleve) 5. Methylprednisolone(Medrol)

2,4,5

The desired INR of coumadin therapy is?

2-3

A 16-year-old adolescent is 6 weeks pregnant. The pregnancy has exacerbated her acne. She asks the nurse if she can resume taking her isotretinoin (Accutane) prescrip- tion, a category X drug. What is the most appropriate response by the nurse? 1. "Since you have a prescription for Accutane,it is safe to resume using it." 2. "You should check with your health care provider at your next visit." 3. "Accutane is known to cause birth defects and should never be taken during pregnancy." 4. "You should reduce the Accutane dosage by half during pregnancy."

3

A 32-year-old female client has been taking lorazepam (Ativan) for her anxiety and is brought into the emergency department after taking 30 days' worth at one time. What antagonist for benzodiazepines may be used in this case? 1. Epinephrine 2. Atropine 3. Flumazenil 4. Naloxone

3

A 77-year-old female client is diagnosed with depression with anxiety and is started on imipramine. Because of this client's age, the nurse will take precautions for care related to which adverse effects? 1. Dry mouth and photosensitivity 2. Anxiety,headaches,insomnia 3. Drowsiness and sedation 4. Urinary frequency

3

A client admitted with hepatitis B is prescribed hydrocodone with acetaminophen (Vicodin) 2 tablets for pain. What is the most appropriate action for the nurse to take? 1. Administer the drug as ordered. 2. Administer 1 tablet only. 3. Recheck the order with the health care provider. 4. Hold the drug until the health care provider arrives.

3

A client has been diagnosed with a fungal nail infection. The health care provider has prescribed griseofulvin (Fulvicin). The nurse will include which of the following in her teaching to the client? 1. Drug therapy will be for a very short time, probably 2 to 4 weeks. 2. Carefully inspect all intramuscular injection sites for bruising. 3. Notify the provider if symptoms of infection worsen. 4. Limit fluid intake to approximately 1,000 mL/day.

3

A client has been ordered gemfibrozil (Lopid) for hyper-lipidemia. The nurse will first validate the order with the health care provider if the client reports a history of which disorder? 1. Hypertension 2. Angina 3. Gallbladder disease 4. Tuberculosis

3

A client is receiving a thrombolytic drug, alteplase (Activase), following an acute myocardial infarction. Which of the following effects is most likely attributed to this drug? 1. Skin rash with urticaria 2. Wheezing with labored respirations 3. Bruising and epistaxis (bleeding from nose) 4. Temperature elevation of 100.8°F

3

A client who received a prescription for zafirlukast (Accolate) returns to his provider's office after three days, complaining that "the drug is not working." She reports mild but continued dyspnea and has had to maintain consistent use of her bronchodilator inhaler, pirbuterol (Maxair). What does the nurse suspect is the cause of the failure of the zafirlukast? 1. The client is not taking the drug correctly. 2. The client is not responding to the drug and will need to be switched to another formulation. 3. The drug has not had sufficient time of use to have full effects. 4. The pirbuterol inhaler is interacting with the zafirlukast.

3

A client with deep venous thrombosis (DVT) is receiving an infusion of heparin and will be started on warfarin (Coumadin) soon. While the client is receiving heparin, what laboratory test will provide the nurse with informa- tion about its therapeutic effects? 1. Prothrombin time(PT) 2. International NormalizedRatio(INR) 3. Activated partial thromboplastin time(aPTT) 4. Platelet count

3

A client with heart failure has an order for lisinopril (Prinivil, Zestril). Which of the following conditions in the client's history would lead the nurse to confirm the order with the provider? 1. A history of hypertension previously treated with diuretic therapy 2. A history of seasonal allergies currently treated with antihistamines 3. A history of angioedema after taking enalapril (Vasotec) 4. A history of alcoholism, currently abstaining

3

A client with severe diarrhea has an order for diphenoxylate with atropine (Lomotil). When assessing for therapeutic effects, which of the following will the nurse expect to find? 1. Increased bowel sounds 2. Decreased belching and flatus 3. Decrease in loose, watery stools 4. Decreased abdominal cramping

3

A female client reports using OTC aluminum hydroxide (AlternaGEL) for relief of gastric upset. She is on renal dialysis three times a week. What should the nurse teach this client? 1. Continue using the antacids but if she needs to continue beyond a few months, she should consult the health care provider about different therapies. 2. Take the antacid no longer than for two weeks;if it has not worked by then, it will not be effective. 3. Consult with the healthcare provider about the appropriate amount and type of antacid. 4. Continue to take the antacid; it is OTC and safe.

3

A patient who is in renal failure may have a diminished capacity to excrete medications. The nurse must assess the patient more frequently for what development? 1. Increased risk of allergy 2. Decreased therapeutic drug effects 3. Increased risk for drug toxicity 4. Increased absorption of the drug from the intestines

3

An early sign(s) of levodopa toxicity is (are) which of the following? 1. Orthostatic hypotension 2. Drooling 3. Spasmodic eye winking and muscle twitching 4. Nausea,vomiting, and diarrhea

3

An older adult patient has arthritis in her hands and takes several prescription drugs. Which statement by this patient requires further assessment by the nurse? 1. "My pharmacist puts my pills in screw-top bottles to make it easier for me to take them." 2. "I fill my prescriptions once per month." 3. "I care for my 2-year-old grandson twice a week." 4. "My arthritis medicine helps my stiff hands."

3

Before administering drugs by the enteral route, the nurse should evaluate which of the following? 1. Ability of the patient to lie supine 2. Compatibility of the drug with IV fluid 3. Ability of the patient to swallow 4. Patency of the injection port

3

During the evaluation phase of drug administration, the nurse completes which responsibilities? 1. Prepares and administers drugs correctly 2. Establishes goals and outcome criteria related to drug therapy 3. Monitors the patient for therapeutic and adverse effects 4. Gathers data in a drug and dietary history

3

Levodopa (Larodopa) is prescribed for a client with Parkinson's disease. At discharge, which of the following teaching points should the nurse include? 1. Monitor blood pressure every 2 hours for the first 2 weeks. 2. Report the development of diarrhea. 3. Take the pill on an empty stomach or 2 hours after a meal containing protein. 4. If tremors seem to worsen, take a double dose for two doses and call the provider.

3

Nitroglycerin patches have been ordered for a client with a history of angina. What teaching will the nurse give to this client? 1. Keep the patches in the refrigerator. 2. Use the patches only if the chest pain is severe. 3. Remove the old patch before applying a new one. 4. Apply the patch only to the upper arm or thigh areas.

3

Older adult clients taking bethanechol (Urecholine) need to be assessed more frequently because of which of the following adverse effects? 1. Tachycardia 2. Hypertension 3. Dizziness 4. Urinary retention

3

The client has been given a prescription of furosemide (Lasix) as an adjunct to treatment of hypertension and returns for a follow-up check. Which of the following is the most objective data for determining the therapeutic effectiveness of the furosemide? 1. Absence of edema in lower extremities 2. Weight loss of 6lb 3. Blood pressure log notes blood pressure 120/70mmHg to 134/88 mmHg since discharge 4. Frequency of voiding of at least six times per day

3

The client has been taking aspirin for several days for headache. During the assessment, the nurse discovers that the client is experiencing ringing in the ears and dizziness. What is the most appropriate action by the nurse? 1. Question the client about history of sinus infections. 2. Determine whether the client has mixed the aspirin with other medications. 3. Tell the client not to take any more aspirin. 4. Tell the client to take the aspirin with food or milk.

3

The client is prescribed digoxin (Lanoxin) for treatment of HF. Which of the following statements by the client indicates the need for further teaching? 1. "I may notice my heart rate decrease." 2. "I may feel tired during early treatment." 3. "This drug should cure my heart failure." 4. "My energy level should gradually improve."

3

The client who has not responded well to other therapies has been prescribed milrinone (Primacor) for treatment of his heart failure. What essential assessment must the nurse make before starting this drug? 1. Weight and presence of edema 2. Dietary intake of sodium 3. Electrolytes, especially potassium 4. History of sleep patterns and presence of sleep apnea

3

The nurse determines that the teaching plan for a client prescribed sertraline (Zoloft) has been effective when the client makes which statement? 1. "I should not decrease my sodium or water intake." 2. "The drug can be taken concurrently with the phenelzine (Nardil) that I'm taking." 3. "It may take up to a month for the drug to reach full therapeutic effects and I'm feeling better." 4. "There are no other drugs I need to worry about; Zoloft doesn't react with them."

3

The nurse is initiating discharge teaching with the newly diagnosed client with diabetes. Which of the following statements indicates that the client needs additional teaching? 1. "If I am experiencing hypoglycemia, I should drink 1/2 cup of apple juice." 2. "My insulin needs may increase when I have an infection." 3. "I must draw the NPH insulin first if I am mixing it with regular insulin." 4. "If my blood glucose levels are less than 60 mg/dL, I should notify my health care provider."

3

The nurse is preparing to give an oral medication to a 6-month-old infant. How should this drug be administered? 1. By placing the medication in the next bottle of formula 2. By mixing the medication with juice in a bottle 3. By placing the medicine dropper in the inner cheek, allowing time for the infant to swallow 4. By placing the medication toward the back of the mouth to avoid having the infant immediately spit out the medication

3

The nurse is teaching a client about the use of tadalafil (Cialis). What will the nurse teach him about the effects of tadalafil? 1. It should always result in a penile erection within 10 minutes. 2. It may heighten female sexual response. 3. It is not effective if sexual dysfunction is caused by psychological conditions. 4. It will result in less intense sensation with prolonged use.

3

The nurse is teaching a postoperative client about the medications ordered for use at home. Because this client also has a primary care provider in addition to the sur- geon, what strategy should the nurse include in this teach- ing session that might prevent a medication error in the home setting? 1. Encourage the client to consult the Internet about possible side effects. 2. Delay taking any new medications prescribed by the surgeon until the next health visit with the primary provider. 3. Have all prescriptions filled at one pharmacy. 4. Insist on using only brand-name drugs because they are easier to remember than generic names.

3

The nurse should assess a client who is taking lorazepam (Ativan) for the development of which of these adverse effects? 1. Tachypnea 2. Astigmatism 3. Ataxia 4. Euphoria

3

The parents of a young client receiving methylphenidate (Ritalin) express concern that the health care provider has suggested the child have a "holiday" from the drug. What is the purpose of a drug-free period? 1. To reduce or eliminate the risk of drug toxicity 2. To allow the child's "normal" behavior to return 3. To decrease drug dependence and assess the client's status 4. To prevent the occurrence of a hypertensive crisis

3

Verapamil (Calan, Covera-HS, Verelan) should be used with extra caution or is contraindicated in clients with which cardiovascular condition? 1. Hypertension 2. Tachycardia 3. Heart failure 4. Angina

3

What important information should be included in the client's education regarding taking ciprofloxacin (Cipro)? 1. The drug can cause discoloration of the teeth. 2. Fluid intake should be decreased to prevent urine retention. 3. Any heel or lower leg pain should be reported immediately. 4. The drug should be taken with an antacid to reduce gastric effects.

3

What is the most appropriate method to ensure adequate pain relief in the immediate postoperative period from an opioid drug? 1. Give the drug only when the family members report that the client is complaining of pain. 2. Give the drug every time the client complains of acute pain. 3. Give the drug as consistently as possible for the first 24 to 48 hours. 4. Give the drug only when the nurse observes signs and symptoms of pain

3

What is the most effective treatment method for the nausea and vomitting that accompanies many forms of chemotherapy? 1. Administer an oral antiemetic when the client complains of nausea and vomiting. 2. Administer an antiemetic by IM injection when the client complains of nausea and vomiting. 3. Administer an antiemetic prior to the antineoplastic medication. 4. Encourage additional fluids prior to administering the antineoplastic medication.

3

Which of the following client statements indicates that the levodopa/carbidopa (Sinemet) is effective? 1. "I'm sleeping a lot more, especially during the day." 2. "My appetite has improved." 3. "I'm able to shower by myself." 4. "My skin doesn't itch anymore."

3

Which of the following clinical manifestations may indicate that the client taking metolazone (Zaroxolyn) is experiencing hypokalemia? 1. Hypertension 2. Polydipsia 3. Cardiac dysrhythmias 4. Skin rash

3

Which of the following drugs is most immediately helpful in treating a severe acute asthma attack? 1. Beclomethasone(Qvar) 2. Zileuton(ZyfloCR) 3. Albuterol(Proventil,Ventolin) 4. Salmeterol(Serevent)

3

Which of the following findings would suggest that myelosuppression is occurring in a client who is taking zidovudine (Retrovir)? 1. Increase in serum blood urea nitrogen(BUN) levels 2. Increase in white blood cell (WBC) count 3. Decrease in platelet count 4. Decrease in blood pressure

3

Which of the following is the best advice that the nurse can give a client with viral rhinitis who intends to purchase an OTC combination cold remedy? 1. "Dosages in these remedies provide precise dosing for each symptom that you are experiencing." 2. "These drugs are best used in conjunction with an antibiotic." 3. "It is safer to use a single-drug preparation if you are experiencing only one symptom." 4. "Since these drugs are available over the counter,it is safe to use any of them as long as needed."

3

Which of the following would be a priority component of the teaching plan for a client prescribed phenelzine (Nardil) for treatment of depression? 1. Headaches may occur. OTC medications will usually be effective. 2. Hyperglycemia may occur and any unusual thirst, hunger, or urination should be reported. 3. Read labels of food and over-the-counter drugs to avoid those with substances that should be avoided as directed. 4. Monitor blood pressure for hypotension and report any BP below 90/60.

3

While planning for a client's discharge from the hospital, which of the following teaching points would be included for a client going home with a prescription for chlorothiazide (Diuril)? 1. Increase fluid and salt intake to make up for the losses caused by the drug. 2. Increase intake of vitamin-C rich foods such as grapefruit and oranges. 3. Report muscle cramping or weakness to the healthcare provider. 4. Take the drug at night because it may cause drowsiness.

3

A client with asthma has a prescription for two inhalers, albuterol (Proventil, VoSpire) and beclomethasone (Qvar). How should the nurse instruct this client on the proper use of the inhalers? 1. Use the albuterol inhaler,and use the beclomethasone only if symptoms are not relieved. 2. Use the beclomethasone inhaler, and use the albuterol only if symptoms are not relieved. 3. Use the albuterol inhaler, wait 5-10 minutes, then use the beclomethasone inhaler. 4. Use the beclomethasone inhaler, wait 5-10 minutes, then use the albuterol inhaler.

3 (BD then steroid)

A client has a prescription for fluticasone (Flonase). Place the instructions that follow in the order in which the nurse will instruct the client to use the drug. 1. Instill one spray directed high into the nasal cavity. 2. Clear the nose by blowing. 3. Prime the inhaler prior to first use. 4. Spit out any excess liquid that drains into the mouth.

3,2,1,4

Place the following nursing interventions in order for a client who is experiencing chest pain. 1. Administer nitroglycerin sublingually. 2. Assess heart rate and blood pressure. 3. Assess the location, quality, and intensity of pain. 4. Document interventions and outcomes. 5. Evaluate the location, quality, and intensity of pain.

3,2,1,5,4

Which of the following are correct statements regarding nursing diagnoses? (Select all that apply.) 1. They identify the medical problem experienced by the patient. 2. They are identified for the patient by the nurse. 3. They identify the patient's response to actual or potential health and life processes. 4. They assist in determining nursing interventions. 5. They remain the same throughout the patient's health care encounter to ensure continuity of care.

3,4

The client admitted for heart failure (HF) has been receiving hydrochlorothiazide (Microzide). Which of the following laboratory levels should the nurse carefully 5. monitor? (Select all that apply.) 1. Platelet count 2. WBC count 3. Potassium 4. Sodium 5. Uric acid

3,4,5

The nurse administers morphine sulfate 4 mg IV to a client for treatment of severe pain. Which of the following assessments require immediate nursing interventions? (Select all that apply.) 1. The client's blood pressure is 110/70mmHg. 2. The client is drowsy. 3. The client's pain is unrelieved in 15 minutes. 4. The client's respiratory rate is 10 breaths per minute. 5. The client becomes unresponsive.

3,4,5

To reduce the chance of duplicate medication order for the older adult returning home after surgery, what actions should the nurse take? (Select all that apply.) 1. Call in all prescriptions to the patient's pharmacies rather than relying on paper copies of prescriptions. 2. Give all prescriptions to the patient's family member. 3. Take a medication history, including all OTC and prescription medications and a pharmacy history with each patient visit. 4. Work with the patient's health care provider to limit the number of prescriptions. 5. Perform a medication reconciliation before sending the patient home.

3,5

Zolpidem (Ambien) has been ordered for a client for the treatment of insomnia. What information will the nurse provide for this client? (Select all that apply.) 1. Be cautious when performing morning activities because it may cause a significant "hangover" effect with drowsiness and dizziness. 2. Take the drug with food; this enhances the absorption for quicker effects. 3. Take the drug immediately before going to bed; it has a quick onset of action. 4. If the insomnia is long-lasting,this drug may safely be used for up to one year. 5. Alcohol and other drugs that cause CNS depression (e.g., antihistamines) should be avoided while taking this drug.

3,5

A 32-year-old female client is started on metronidazole (Flagyl) for treatment of a trichomonas vaginal infection. What must the client eliminate from her diet for the dura- tion she is on this medication? 1. Caffeine 2. Acidic juices 3. Antacids 4. Alcohol

4

A client has been prescribed tetracycline. When providing information regarding this drug, the nurse should include what information about tetracycline? 1. It is classified as a narrow-spectrum antibiotic with minimal adverse effects. 2. It is used to treat a wide variety of disease processes. 3. It has been identified to be safe during pregnancy. 4. It is contraindicated in children younger than 8 years.

4

A client has been using a fluticasone (Flovent) inhaler as a component of his asthma therapy. He returns to his health care provider's office complaining of a sore mouth. On inspection, the nurse notices white patches in the client's mouth. What is a possible explanation for these findings? 1. The client has been consuming hot beverages after the use of the inhaler. 2. The client has limited his fluid intake, resulting in dry mouth. 3. The residue of the inhaler propellant is coating the inside of the mouth. 4. The client has developed thrush as a result of the fluticasone.

4

A client has received a prescription for zanamivir (Relenza) for flulike symptoms. The client states, "I think I'll hold off on starting this. I don't feel that bad yet." What is the nurse's best response? 1. "The drug has a stable shelf life so you can save it for later infections." 2. "It can be saved for later but you will also require an antibiotic to treat your symptoms if you wait." 3. "It can be started within two weeks after the onset of symptoms." 4. "To be effective,it must be started within 48 hours after the onset of symptoms."

4

A client is receiving temazepam (Restoril). Which of these responses should a nurse expect the client to have if the medication is achieving the desired effect? 1. The client sleeps in 3-hour intervals ,awakens for a short time,and then falls back to sleep. 2. The client reports feeling less anxiety during activities of daily living. 3. The client reports having fewer episodes of panic attacks when stressed. 4. The client reports sleeping 7 hours without awakening.

4

A client receives NPH and regular insulin every morning. The nurse is verifying that the client understands that there are two different peak times to be aware of for this insulin regimen. Why is this an important concept for the nurse to stress? 1. The client needs to plan the next insulin injection around the peak times. 2. Additional insulin may be needed at peak times to avoid hyperglycemia. 3. It is best to plan exercise or other activities around peak insulin activity. 4. The risk for hypoglycemia is greatest around the peak of insulin activity.

4

A client was admitted from the emergency department after receiving treatment for dysrhythmias and will be started on amiodarone (Cordarone, Pacerone) because of lack of therapeutic effects from his other antidysrhythmic therapy. When the nurse checks with him in the afternoon, he complains of feeling light-headed and dizzy. What will the nurse assess first? 1. Whether there is the possibility of sleep deprivation from the stress of admission to the hospital 2. Whether an allergic reaction is occurring with anticholinergic-like symptoms 3. Whether the amiodarone level is not yet therapeutic enough to treat the dysrhythmias 4. Whether the client's pulse and blood pressure are within normal limits

4

A client was prescribed chloroquine (Aralen) prior to a trip to an area where malaria is known to be endemic. The nurse will instruct the client to remain on the drug for up to 6 weeks after returning and the client asks why this is necessary. What is the nurse's best response? 1. "You may be carrying microscopic malaria parasites back with you on clothes or other personal articles." 2. "It helps prevent transmission to any of your family members." 3. "It will prevent any mosquito that bites you from picking up the malaria infection." 4. "It continues to kill any remaining malarial parasites that may have been acquired during the trip that are in your red blood cells."

4

A client with a history of BPH is complaining of feeling like he "cannot empty his bladder." He has been taking finasteride (Proscar) for the past 9 months. What should the nurse advise this client to do? 1. Continue to take the drug to achieve full therapeutic effects. 2. Discuss the use of a low-dose diuretic with the health care provider. 3. Decrease the intake of coffee, tea, and alcohol. 4. Return to the healthcare provider for PSA laboratory studies and a prostate exam.

4

A client with a history of HF will be started on spironolactone (Aldactone). Which of the following drug groups should not be used, or used with extreme caution in patients taking potassium-sparing diuretics? 1. NSAIDs 2. Corticosteroids 3. Loopdiuretics 4. ACE inhibitors or ARBs

4

A client with constipation is prescribed psyllium (Metamucil) by his health care provider. What essential teaching will the nurse provide to the client? 1.Take the drug with meals and at bedtime. 2. Take the drug with minimal water so that it will not be diluted in the GI tract. 3. Avoid caffeine and chocolate while taking this drug. 4. Mix the product in a full glass of water and drink another glassful after taking the drug.

4

A client with type 1 diabetes on insulin therapy reports that he takes propranolol (Inderal) for his hypertension. The nurse will teach the client to check glucose levels more frequently because of what concern? 1. The propranolol can produce insulin resistance. 2. The two drugs used together will increase the risk of ketoacidosis. 3. Propranolol will increase insulin requirements by antagonizing the effects at the receptors. 4. The propranolol may mask symptoms of hypoglycemia

4

A client with type 2 diabetes has been NPO since midnight for surgery in the morning. He has been on a combination of oral type 2 antidiabetic drugs. What would be the best action for the nurse to take concerning the administration of his medications? 1. Hold all medications as per the NPO order. 2. Give him the medications with a sip of water. 3. Give him half the original dose. 4. Contact the healthcare provider for further orders.

4

A health care provider has written an order for digoxin for the client but the nurse cannot read whether the order is for 0.25 mg, 0.125 mg, or 125 mg because there is no "zero" and the decimal point may be a "one." What action would be the best to prevent a medication error? 1. Check the dosage with a more experienced nurse. 2. Consult a drug handbook and administer the normal dose. 3. Contact the hospital pharmacist about the order. 4. Contact the healthcare provider to clarify the illegible order.

4

A patient with diabetes has been NPO since midnight for surgery in the morning. He usually takes an oral type 2 antidiabetic drug to control his diabetes. What would be the best action for the nurse to take concerning the administration of his medication? 1. Hold all medications as ordered. 2. Give him the medication with a sip of water. 3. Give him half the original dose. 4. Contact the provider for further orders.

4

As the nurse enters a room to administer medications, the client states, "I'm in the bathroom. Just leave my pills on the table and I'll take them when I come out." What is the nurse's best response? 1. Leave them on the table as requested and check back with the client later to verify they were taken. 2. Leave the medications with the client's visitors so they can verify that they were taken. 3. Inform the client that the medications must be taken now; otherwise they must be documented as "refused." 4. Inform the client that the nurse will return in a few minutes when the client is available to take the medications.

4

Education given to clients about the use of all drugs to treat insomnia should include an emphasis on what important issue? 1. They will be required long-term to achieve lasting effects. 2. They require frequent blood counts to avoid adverse effects. 3. They are among the safest drugs available and have few adverse effects. 4. Long-term use may increase the risk of adverse effects, create a "sleep debt," and cause rebound insomnia when stopped.

4

In taking a new client's history, the nurse notices that he has been taking omeprazole (Prilosec) consistently over the past 6 months for treatment of epigastric pain. Which recom- mendation would be the best for the nurse to give this client? 1. Try switching to a different form of the drug. 2. Try a drug like cimetidine(Tagamet) or famotidine (Pepcid). 3. Try taking the drug after meals instead of before meals. 4. Check with his healthcare provider about his continued discomfort.

4

Propranolol (Inderal) has been ordered for a client with hypertension. Because of adverse effects related to this drug, the nurse would carefully monitor for which adverse effect? 1. Bronchodilation 2. Tachycardia 3. Edema 4. Bradycardia

4

Superinfections are an adverse effect common to all antibiotic therapy. Which of the following best describes a superinfection? 1. An initial infection so overwhelming that it requires multiple antimicrobial drugs to treat successfully 2. Bacterial resistance that creates infections that are difficult to treat and that are often resistant to multiple drugs 3. Infections requiring high-dose antimicrobial therapy with increased chance of organ toxicity 4. The overgrowth of normal body flora or of opportunistic organisms such as viruses and yeast no longer held in check by normal, beneficial flora

4

Teaching for a client receiving carbamazepine (Tegretol) should include instructions that the client should immediately report which symptom? 1. Leg cramping 2. Blurred vision 3. Lethargy 4. Blister-like rash

4

The client states that he has not taken his antipsychotic drug for the past 2 weeks because it was causing sexual dysfunction. What is the nurse's primary concern at this time? 1. A hypertensive crisis may occur with such abrupt withdrawal of the drug. 2. Significant muscle twitching may occur, increasing fall risk. 3. EPS symptoms such as pseudoparkinsonism are likely to occur. 4. Symptoms of psychosis are likely to return.

4

The community health nurse is working with a client taking simvastatin (Zocor). Which client statement may indicate the need for further teaching about this drug? 1. "I'm trying to reach my ideal body weight by increasing my exercise." 2. "I didn't have any symptoms even though I had high lipid levels. I hear that's common." 3. "I've been taking my pill before my dinner." 4. "I take my pill with grapefruit juice. I've always taken my medications that way."

4

The emergency department nurse is caring for a client with a migraine headache. Which drug would the nurse anticipate administering to abort the client's migraine attack? 1. Morphine 2. Propranolol(Inderal) 3. Ibuprofen(Motrin) 4. Sumatriptan(Imitrex)

4

The nurse is admitting a client with rheumatoid arthritis. The client has been taking prednisone (Aristospan) for an extended time. During the assessment, the nurse observes that the client has a very round moon-shaped face, bruising, and an abnormal contour of the shoulders. What does the nurse conclude based on these findings? 1. These are normal reactions with the illness. 2. These are probably birth defects. 3. These are symptoms of myasthenia gravis. 4. These are symptoms of adverse drug effects from the prednisone.

4

The nurse is caring for a 72-year-old client taking gabapentin (Neurontin) for a seizure disorder. Because of this client's age, the nurse would establish which nursing diagnosis related to the drug's common adverse effects? 1. Risk for Deficient Fluid Volume 2. Risk for Impaired Verbal Communication 3. Risk for Constipation 4. Risk for Falls

4

The nurse is caring for a client with chronic stable angina who is receiving isosorbide dinitrate (Isordil). Which of the following are common adverse effects of isosorbide? 1. Flushing and headache 2. Tremors and anxiety 3. Sleepiness and lethargy 4. Light-headedness and dizziness

4

The nurse is counseling a mother regarding antipyretic choices for her 8-year-old daughter. When asked why aspirin is not a good drug to use, what should the nurse tell the mother? 1. It is not as good an antipyretic as is acetaminophen. 2. It may increase fever in children under age 10. 3. It may produce nausea and vomiting. 4. It increases the risk of Reye's syndrome in children under 18 with viral infections.

4

The nurse is teaching a client about the use of dextromethorphan with guaifenesin (Robitussin-DM) syrup for a cough accompanied by thick mucus. Which instruction should be included in the client's teaching? 1. "Lie supine for 30 minutes after taking the liquid." 2. "Drink minimal fluids to avoid stimulating the cough reflex." 3. "Take the drug with food for best results." 4. "Avoid drinking fluids immediately after the syrup but increase overall fluid intake throughout the day."

4

The nurse looks up butorphanol (Stadol) in a drug refer- ence guide prior to administering the drug and notes that it is a partial agonist. What does this term tell the nurse about the drug? 1. It is a drug that produces the same type of response as the endogenous substance. 2. It is a drug that will occupy a receptor and prevent the endogenous chemical from acting. 3. It is a drug that causes unpredictable and unexplained drug reactions. 4. It is a drug that produces a weaker,or less efficacious, response than an agonist drug.

4

The patient requires a drug that is known to be completely metabolized by the first-pass effect. What change will be needed when this drug is administered? 1. The drug must be given more frequently. 2. The drug must be given in higher doses. 3. The drug must be given in a lipid-soluble form. 4. The drug must be given by a nonoral route such as parenterally.

4

The teaching plan for a client receiving hydralazine (Apresoline) should include which of the following points? 1. Returning for monthly urinalysis testing 2. Including citrus fruits, melons, and vegetables in the diet 3. Decreasing potassium-rich food in the diet 4. Rising slowly to standing from a lying or sitting position

4

To reduce the effect of a prescribed medication on the infant of a breast-feeding mother, how should the nurse teach the mother to take the medication? 1. At night 2. Immediately before the next feeding 3. In divided doses at regular intervals around the clock 4. Immediately after breast-feeding

4

What health teaching should the nurse provide for the client receiving nadolol (Corgard)? 1. Increase fluids and fiber to prevent constipation. 2. Report a weight gain of 1kg per month or more. 3. Immediately stop taking the medication if sexual dysfunction occurs. 4. Rise slowly after prolonged periods of sitting or lying down.

4

What is the rationale for the administration of a loading dose of a drug? 1. It decreases the number of doses that must be given. 2. It results in lower dosages being required to achieve therapeutic effects. 3. It decreases the risk of drug toxicity. 4. It more rapidly builds plasma drug levels to a plateau level.

4

Which factor is most important for the nurse to assess when evaluating the effectiveness of a patient's drug therapy? 1. The patient's promise to comply with drug therapy 2. The patient's satisfaction with the drug 3. The cost of the medication 4. Evidence of therapeutic benefit from the medication

4

Which method may offer the best opportunity for patient teaching? 1. Providing detailed written information when the client is discharged 2. Providing the patient with Internet links to conduct research on drugs 3. Referring the patient to external health care groups that provide patient education, such as the American Heart Association 4. Providing education about the patient's medications each time the nurse administers the drugs

4

While educating the client about hydrocortisone (Cortef), the nurse would instruct the client to contact the health care provider immediately if which of the following occurs? 1. There is a decrease of 2lb in weight. 2. There is an increase in appetite. 3. There is tearing of the eyes. 4. There is any difficulty breathing.

4

A nurse is administering a liquid medication to a 15-month-old child. What is the most appropriate approach to medication administration by the nurse? (Select all that apply.) 1. Tell the child that the medication tastes just like candy. 2. Mix the medication in 8 oz of orange juice. 3. Ask the child if she would like to take her medication now. 4. Sit the child up,hold the medicine cup to her lips, and kindly instruct her to drink. 5. Offer the child a choice of cup in which to take the medicine.

4,5

Which of the following statements from a patient undergoing antineoplastic therapy would be of concern to the nurse (select all) 1. "I have attended a meeting of a cancer support group." 2. "My husband and I are planning a short trip next week." 3. "I am eating six small meals plus two protein shakes a day." 4. "I am taking my 15-month-old granddaughter to the pediatrician next week for her baby shots." 5. "I am going to go shopping at the mall next week."

4,5

Which of these is a long acting insulin? 1. Humalog 2. Novolog 3. NPH 4. Lantus

4. Lantus

What is a vesicant?

A drug (chemotheraputic) that can cause serious tissue injury if it leaks out of the vein and infiltrates into the tissue. This is called an extravasation

Sympathomimetics-(NE)"SNS" effects: for: shock, hypotension, asthma, COPD, nasal congestion, dysrhythmias, bronchodilators

ADRENERGICS! Alpha/Beta agonists

The prototype drug for herpes virus is? AE?

Acyclovir; Liver/kidney/neuro toxcitiy, may cause painful inflammation at site of infusion

Which drug is recommended for sleep for the elderly?

Ambien, zolpidem

Drug of choice for systemic fungal infections?

Amphotericin B

Why should you avoid alcohol on antifungals?

Antifungals are hepatotoxic

2 examples of anticholinergics that treat nausea/vomiting

Benadryl (diphenhydramine), Dramamine (dimendydrinate)

Antipsychotics may cause ___________; these can be treated with ___________. Benzodiazepines overdose can be treated with ___________.

Extrapyramidal symptoms; Benzodiazepines; flumazenil (Romazicon).

.A client receiving long term ____________ therapy should be taught to practice very good oral hygiene.

Dilantin

common suffix: "tiding"

H2 Receptor Antagonists (anti-ulcer)

Classes of anti-ulcer agents:

H2 Receptor antagonist (block HCl release), Prostaglandin (inhibit gastric acid secretion), PPIs (blocks final step in acid production), Antacids (neutralize), H Pylori combo (antibiotic, bismuth, PPI)

What describes a drug that has a higher max response given the same dose?

Higher Efficacy

What drug may be given to a diabetic in the hospital during an infection (that normally takes a pill for maintenance)?

Insulin R

What drug is used in iron deficiency anemia?

Iron; may cause black stools,-take with vitamin C to increase absorption

What is luminal used for?

It is a barbiturate used for sleep, anxiety and seizures

Important teaching about Potassium sparing diuretics (Aldactone)

May cause hyperkalemia-check potassium level. Avoid foods high in potassium. Monitor daily weight.

Important teaching about thiazide diuretics

May cause hypokalemia (eat foods high in K), but are weak diuretics. May increase blood glucose levels.

Important teaching about loop diuretics (Lasix)

May cause hypokalemia-check potassium level. Make sure to eat foods high in potassium. Monitor daily weight.

What describes a drug that has a higher intensity of response with less drug dosage?

More Potent

__________ is the prototype drug for severe pain and the drug against which all other opiates are compared.

Morphine

A client on coumadin therapy should be taught to NOT take which over the counter drugs?

NSAIDS/ASA

A patient on lithium should make sure they intake enough ____? Why?

Na+, Low sodium can lead to toxic levels of lithium. Take caution with diuretics (except K+ sparing)

common suffix: "azine"

Phenothiazines

Before administering digoxin, a nurse should first evaluate what laboratory results?

Potassium

A nursing student reads in a pharmacology textbook that 10 mg of morphine is considered to provide the same pain relief as 200 mg of codeine. This indicates that the morphine would be considered more ______________ than codeine. (Fill in the blank.)

Potent

Cromolyn is used as a _________ asthma medication.

Preventative; a mast cell stabilizer that inhibits the release of histamine. For minor asthma

Antidote for heparin?

Protamine sulfate

Which two laboratory values should be monitored to assess kidney damage?

Protein and GFR

Which should be drawn up 1st: regular insulin or NPH?

Regular insulin then NPH

What vital sign should be closely monitored with opioids?

Respirations; they can cause respiratory depression

Which schedule of controlled drugs have the highest abuse potential?

Schedule 1

What is plasma protein binding?

Some drugs bind to proteins. What is leftover or released is known as free drug (unbound) and is the active form. Need to know what drugs are protein bound to determine a possible drug interaction due to competing protein binding of different drugs.

A patient has a protein level below normal. How will this affect drug levels?

There will be an increase in free drug in the blood

Teaching for Fosamax (anti-osteoporosis) medication? Actions?

Take with 8oz of water 1st thing in the morning on empty stomach. Do not eat or lie down for 30 min after taking. Action: inhibits the osteoclasts from bone resorption

What is the action of Timoptic eye drops for glaucoma?

They are beta-adrenergic that relax smooth muscle; monitor pulse and BP

Why is vit K given to newborns?

Vitamin K is essential to clotting mechanisms; to prevent hemorrhagic disease of a newborn who may have a disorder that inhibits clotting

What is the action of the hematopoietic agents (Epogen, Aranesp)

To enhance the creation of RBC's in the bone marrow during chemo and renal failure

What is the action of colony-stimulating factors (Neupogen, Neulasta)?

To enhance the production of neutrophils (WBCs) during chemotherapy and post bone marrow transplant

This antibiotic drug is used for serious infections (MRSA), toxic to kidneys; Red Man Syndrome

Vancomycin; RMS-redding area of the trunk, head/neck, limbs or gluteal area; decreased BP or tachycardia-histamine release causes vasodilation and hypertension

Iron should be taken with what supplement to increase absorption?

Vit C

Antidote for Coumadin?

Vit K

The most common early sign of digitalis toxicity is

anorexia

Proton pump inhibitors

anti-ulcer agents, tx of GERD, Helicobacter pylori, upper GI bleeds; binds to enzyme of gastric parietal cells to prevent acid from being released; most effective long term

Anxiolytics are:

antianxiety, sedatives, not to be taken with alcohol

Aspirin (acetylsalicylic) works how?

antipyretic, antiinflamatory, prevents clots, analgesic

What is a toxic effect of Dilantin (phenytoin)?

ataxia (altered gait)

What is the difference between typical and atypical antipsychotics?

atypical has less side effects (EPS)

Which drug is used to treat gonorrhea?

azithromycin (macrolide)

A nurse asks a client to discuss the way medications will be taken at home. Which phase of the nursing process is the nurse using? a. assessment b. planning c. implementation d. evaluation

b

Drug used to treat thrombocytopenia after chemotherapy?

bone marrow stimulants-ex. Neumega (oprelvekin)

Lasix (furosemide), and hydrochlorothiazide (HCTZ) are a loop diuretic and a thiazide diuretic. What impact do they have on potassium levels?

decrease

Beta blockers and Ca channel blockers ______BP and ____pulse.

decrease, decrease

Which of these assessments, if made of a client who is taking isophane (NPH) insulin would require IMMEDIATE nursing intervention.

diaphoresis (sweating)

Nitrates may cause _______of the blood vessels and _________BP.

dilation, decrease/hypotension

Retaplase modifies coagulation by what action?

dissolving an existing clot

Subjective manifestations of hypoglycemia:

fatigue, anxiety, hunger, irritability, blurred vision

Objective manifestions of hypoglycemia:

heart palpitations, pale skin, shakiness, sweating, confusion, seizures, loss of consciousness

The nurse must monitor a client who is taking glucocorticoids for the development of ______________.

hypertension

Digoxin can become toxic with hypokalemia or hyperkalemia?

hypokalemia normal K+ is 3.5-5.0 mEq/L

Aldactone (spironolactone) and lupin (Lisinopril) are K+ sparing diuretics. What impact do they have on potassium levels?

increase

AE's of bronchodilators include ___pulse, ____BP, ____ Mentation

increase in pulse, increase in BP, decrease in Mentation

Name some benzodiazepines?

lorazepam (Ativan), alprazolam (Xanax), oxazepam (Serax), chlordiazepoxide (Librium), clonazepam (Klonopin), flurazepam (Dalmane) triazolam (Halcion), temazepam (Halcion), temazepam (Restoril), midazolm (Versed)

Teaching for antifungals?

many need several months of tx, complete entire course, increase fluid, report ringing (tinittis) of ears, may cause hyperglycemia, report chills, nausea, tremors, headache, weigh daily, take frequent BP, pulse, don't take with acidic foods or drinks

What drug is prescribed to prevent antibiotic-induced diarrhea or given for C. diff infection?

metronidazole (Flagyl)

What manifestations can occur with tricyclic antidepressants (anticholinergic)?

orthostatic hypotension and sedation; dry mouth, constipation, memory impairment

A nurse should observe a client who is taking a tricyclic antidepressant for which of these manifestations?

orthostatic hypotension, and sedation

What are two AEs of aminoglycoside therapy i.e. streptomycin, gentamicin?

ototoxicity and kidney damage

Which drug is used to treat syphilis?

penicillin

NSAIDS act by inhibiting the synthesis of ______.

prostaglandins

Diet teaching for patient on prednisone?

reduce sodium intake, increase vit C, increase K+, increase Ca2+

common suffix; "one"

steroids

Beta-adrenergics (albuterol) are bronchodilators known as___________________

sympathomemetics

Following the administration of a small nebulizer treatment with bronkosol, the nurse monitors for which possible side effect?

tachycardia/cardiac arrythmias

What is the expected outcome of a bronchodilator?

to relax smooth muscle, widening the airway and making breathing easier

What are Extrapyramidal symptoms?

tremor, slurred speech, restless (akathisia), dystonia, anxiety, distress

S/S of hyperthyroid

tremors/seizures, nervousness, increased HR (tachycardia), increased BP, insomnia and weight loss

Prilosec and amoxicillin are often used together to treat ___________.

ulcers/H. pylori infections