Pharmacology Exam
A nurse is caring for a client who is receiving esomeprazole. Which of the following best indicates the desired therapeutic effect
"I don't have pain in my stomach"
Which of the following intervention should be included in the medical management of Crohn's Disease
using long-term steroid therapy
Which of the following medications is available in "sprinkles" (making it easier to administer to children)
valproic acid
A client has a history of CHF and takes digoxin and furosemide. The nurse evaluates a digoxin level of 3.96 ng/mL and potassium level of 3.0 and
Holds the medications and contact the HCP (normal digoxin 0.5-2)
While caring for a client with acute respiratory distress syndrome, the nurse will
elevate the HOB to 45-90 degrees, cluster clients ADLs together, and assess lung sounds
Side effects of loperamide include all of the following EXCEPT
diarrhea (it is an antidiarrheal)
You have given morphine sulfate 4mg IV to a client who has an acute MI. When you evaluate the client's response 5 minutes after giving the medication, which findings indicate a need for immediate action
Persisting pain at a level of 2 (on a scale from 0-10)
The nurse understands the purpose of administering dexamethasone to patient with ARDS is
The medication is given to decrease inflammation
A client with a history of TIA has an order for aspirin 160mg daily. When administering the medications, the client says, "I don't need the aspirin today. I don't have any aches or pains," the nurse
explains that aspirin is ordered to decrease stroke risk
Sucralfate (Carafate) achieves a therapeutic effect by
forming a protective barrier around gastric mucosa
Which of the following medications is used for partial seizures, restless leg syndrome, and neuralgia
gabapentin
What are predictors of poor HIV medication adherence
poor financial status, side effects of the drug, life-long compliance
Digoxin toxicity is most likely to develop in clients receiving digoxin in combination with:
potassium wasting diuretics (they intensify the toxicity)
Zidovudine, a nucleoside reverse transcriptase inhibitor can be safely given during pregnancy
true
Which adverse reaction is the nurse concerned with then administering Vancomycin
Flushing of the face, neck, and chest
As a home health nurse obtains an admission history on a client who has DVT and is taking warfarin 2mg daily, which statement indicates more education is needed
"I have started to eat more healthy foods like green salads and fruits"
Teaching has been effective on the use of atenolol for angina by which statement
"It is important not to suddenly stop taking atenolol"
A patient admitted to the medical surgical unit with a venous thromboembolism (VTE) is started on enoxparin and warfarin. The patient asks the nurse why 2 medications are needed. Which response by the nurse is accurate
"The Lovenox will work immediately, but the Coumadin takes several days to reach full effect"
A client with a duodenal ulcer is diagnosed with H. pylori infection. The physician prescribed Amoxicillin, Pantoprazolem and Clarithrymycin. Which statement made by the nurse correctly explains the purpose of these medications
"These medication will stop the acid production and will kill the bacteria"
The nurse needs to know that the therapeutic range for phenytoin is
10-20
Which of the following medications is considered thrombolytic
Alteplase
Which classification of medications play a pivotal role in the management of heart failure due to systolic dysfunction
Angiotensin converting enzyme inhibitors
A client who has been started on the beta-1 agonist dobutamine needs to be monitored for which adverse reaction
Arrhythmias
A nurse is teaching a client who takes furosemide and has a serum potassium level of 3.2 mEq/L. Which of the following foods should the nurse tell the patient to include in his/her diet
Bananas
The nurse teaches the client using transdermal nitroglycerine patches to
Best be placed at the same time each day
A client is prescribed valproic acid for seizure control. The nurse must check other meds the client is taking because which adverse effect can occur
Bleeding
The nurse should assess the patient taking non-selective BB for which side effect
Bronchospasm
Following surgery for closure of ASD, the nurse expects which of the following medications to prevent clots from forming on the repaired area
Clopidogrel (Plavix)
Histamine-2 receptor antagonists:
Compete w/ histamine for binding sites on the parietal cells
Nifedipine is prescribed for a client with newly diagnosed Prinzmetal's (variant) angina. When teaching; the nurse includes information that Nifedipine will
Decrease spasm of the coronary arteries
A client with BPH taking 5-Alpha-reductase inhibitors may experience what severe psychosocial side effects
ED and gynecomastia
When administering furosemide to your patient who has CHF, the nurse would assess
Electrolyte levels, Blood Pressure, and lung Sounds
A nurse is caring for a client who is receiving the muscle relaxant vercuronium for ARDS. Which of the following medications should the nurse anticipate administering with this medication
Fentanyl (sublimate), and Midazolam (Versed)
The patient with a VSD may be prescribed which medication to alleviate pulmonary edema
Furosemide
A nurse is teaching medication safety to a group of healthy older adults at a community center. The nurse explains that due to the high frequency of food-drug interactions, the clients should avoid taking their medications with which of the following
Grapefruit juice
When taking Carbamazepine, what fluid places the client at risk for drug toxicity
Graprefruit juice
Disease modifying anti-rheumatoid drugs (DMARDS) suppress the immune system's response to RA that causes pain and inflammation. Methotrexate is a first line choice of drug for long-term use. List 2 serious adverse effects:
Hepatotoxicity, birth defects
Which of the following baseline laboratory data should be established before a client is started on tissue plasminogen activator or alteplase recombinant
Hgb, Hct, and platelet count
High dose prednisone is given to a child with Juvenile Idiopathic Arthritis. The nurse will monitor for the development of
Hyperglycemia
What is the only route of administration Mannitol can be given
IV
A child recently diagnosed with epilepsy is being evaluated for anticonvulsant medication therapy. The child will likely be placed on which type of regimen
One oral anticonvulsant medication to observe effectiveness and minimize side effects
To prevent shock and syncope in a client diagnosed with kidney stones, the nurse would administer what medication
Opioids
For a client receiving a continuous heparin infusion for DVT, the infusion rate will be adjusted according to the:
PTT
List various anti platelet aggregators. What do they do?
Plavix, Aspirin, Heparin, Lovenonx. They prevent clumping of platelets which creates clots
HIV medication enfuviritide, a fusion inhibitor, has what mechanism of action
Prevents the virus from attaching to the cell membrane
Whenever a nurse is caring for client who are receiving heparin, which of the following medications should the nurse have on hand in the event of an overdose
Protamine sulfate
A nurse is caring for a client who is recovering from surgical placement of an artificial heart valve and is to be started on warfarin prior to discharge. Which of the following diagnostic tests should the nurse use to monitor the effect of this therapy
Prothrombin time (PT)
It is important to teach the patient what assessment prior to taking their Digoxin
Radial pulse, and hold med for HR <60
Which laboratory value would alert the nurse caring for a client taking spironolactone to take further action
Serum potassium level of 5.2 mEq/L
A client realizes they forgot to take their anticonvulsant medication. What should they do?
Take the med ASAP
NSAIDS used initially for RA can cause GI disturbances. Nursing education regarding NSAID should include:
Take w/ food, can cause N/V/D, take as directed, monitor for constipation, monitor for bleeding in stool and urine, and gums
A nurse is caring for a client who is hospitalized with DVT and has been on IV heparin for 5 days. The provider prescribes oral warfarin without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following is an appropriate nursing response
The coumadin takes several days to work, so the IV heparin will be used until the coumadin reaches a therapeutic level (2-3 INR)
Your patient with RA is taking prednisone and naproxen. What is the most important to report to the HCP
The patient has stools that are very dark
The nurse completes an assessment and health history for an HIV positive patient considering starting HAART therapy. Which patient information is of most concern
The patient states they are not consistent about taking medication
A patient is receiving enoxparin and warfarin therapy for a venous thromboembolism (VTE). Which lab value indicates that anticoagulation is adequate for enoxaparin can be discontinued
The patient's INR is 2.5
Digoxin improves cardiac output by increasing intracellular calcium in the heart, which improves the contractility of the ventricles
True
A nurse is providing information about probiotic supplements to a client with inflammatory bowel disease. Which of the following information should the nurse include? Probiotics
are microorganisms that are normally found in the GI tract, are used in clients with C diff., can cause bloating and increased flatulence
During a home visit to an 88 year old client who is taking digoxin 0.25mg daily to treat heart failure and atrial fibrillation, you obtain this assessment information. Which finding is most important to communicate to the HCP
Vision that is becoming "fuzzy"
A child is recently prescribed levetiracetam. The nurse understands which of the following medications would be prescribed to minimize the side effects of the drug
Vitamin B6
Which of the following drugs is the antidote to coumadin
Vitamin K
A client with CHF is being discharged on Digoxin, furosemide, spironolactone, and a low sodium diet. Which statement indicates the need for further teaching? "I should.."
Weigh myself daily and go on a diet if I gain a couple pounds
Why is it necessary for client to avoid alcohol intake when taking barbiturates
additive effect, CNS depression
Which medication should the nurse anticipate administering first to a child in status epileptics
administer rectal diazepam
You are working in the ED caring for a client who has just been admitted with left anterior chest pain, possible ACS. Which action will you take first
administer sublingual nitrogylcerin
The nurse is preparing to administer warfarin, an oral anticoagulant, to a patient with a mechanical valve replacement. The patient's INR is 2.7. Which action should the nurse take
administer the medication as ordered
A nurse is teaching a client who is taking sucralfate for PUD has a new prescription for phenytoin to control seizures. Which of the following instructions should the nurse include
allow a 2 hour interval between taking these medications
The nurse knows an expected outcome of beta adrenergic blocking agents is
decreased myocardial oxygen consumption
The nurse knows the therapeutic effect of metoprolol for a patient with MI is
decreased resting HR
What effect do NSAIDS have in treating kidney stones
decrease inflammation and pain
In evaluating the effectiveness of Nadolol, which is prescribed for a patient with coronary artery disease, the nurse would expect
decreased HR, decreased BP, and relief of chest pain
What major complications associated with immunosuppression therapy should a nurse monitor for
hepatotoxicity, renal dysfunction
The nurse is collecting a client's medication history who has GERD. Which medication below is not typically used to treat GERD
hydroxyzine
What would a client with Benign Prostatic Hyperplasia (BPH) taking Alpha-adrenergic receptor agonists expect to experience and why
increase in urine flow and decrease of symptoms
A nurse is caring for a client in liver failure with ascites who is receiving spironolactone. Which of the following outcomes should the nurse expect from this client's medication therapy
increased sodium excretion
During anticoagulant therapy, the nurse monitors the client for which common undesirable effect
internal and superficial bleeding
Which of the following is a proton pump inhibitor used in the treatment of gastroesophageal reflux disease
lansoprazole (Prevacid), rabeprazole (AcipHeX), esomeprazole (Nexium)
Patient diagnosed with hypo plastic left heart syndrome would be prescribed alprostadil for which reason
maintain potency of DA
The nurse recognizes the drug classifications used in the treatment of angina are
nitrates, calcium channel blockers, beta blockers
A client who has had an TIA has been placed on aspirin therapy every day. The nurse relates the expected outcome is prevention of
platelet aggregation
Medical management of cardiac failure, whether it is right sided or left sided, demonstrates similar methodology. Measures such as dietary modifications, lifestyle changes, medications to reduce dyspnea, and relieve anxiety, etc, are all used with one primary intention. What is the primary goal in the medical management of heart failure
reducing cardiac workload
After successful digitalization, a client is to begin oral maintenance of digoxin and furosemide for control of CHF. To prevent digitalis toxicity, the nurse understands that it is most important to monitor the clients
serum potassium
