Pharmacology Exam 2

a nurse is caring for a client who is about to begin taking aspirin. The nurse should instruct the client to report which of the following manifestations of salicylism? (select all that apply) A. fever B. tinnitus C. diaphoresis D. thrombophlebitis E. Dizziness

A. fever B. tinnitus C. diaphoresis D. Dizziness

a nurse is caring for a client who asks about taking acetaminophen. The nurse should identify that acetaminophen is indicated for which of the following conditions? (select all that apply) A. to reduce fever B. to decrease inflammation C. to relieve mild pain D. to promote sedation E. to alleviate anxiety

A. to reduce fever C. to relieve mild pain

a nurse is reviewing the drug list for a client who has a new prescription for allopurinol. The nurse should identify that which of the following drug reacts with allopurinol? A. Warfarin B. Ibuprofen C. Insulin D. Furosemide

A. warfarin

What are some complications of agonist antagonist for the patients that have been taking pure opioids for some time?

Abstinence syndrome

a nurse is teaching s client who has a new prescription for allopurinol. The nurse should instruct the client to report which of the following adverse drug reactions? (select all that apply) A. palpitations B. sore throat C. vertigo D. bruising E. vision changes

B. sore throat C.. vertigo D. bruising E. vision changes

a nurse is caring for a client who is receiving morphine to relieve severe pain. The nurse should monitor the client for which of the following adverse drug reactions? (select all the apply) A. diarrhea B. urinary retention C. respiratory depression D. sedation E. orthostatic hypotension

B. urinary retention C. respiratory depression D. sedation E. orthostatic hypotension

a nurse is caring for a client who is opioid dependent and has a new prescription for butorphanol. The nurse should monitor the client for which of the following manifestations of abstinence syndrome? (select all that apply) A. bronchospasm B. vomiting C. peripheral edema D. abdominal cramps E. hypertension

B. vomiting D. abdominal cramps E. hypertension

a client arrives in the emergency department with an ischemic stroke. what should the nurse do before the client receives tissue plasminogen activator (t-PA)? A. ask what medications the client is taking. B. complete a history and health assessment. C. identify the time of onset of the stroke. D. determine if the client is scheduled for any surgical procedures.

C. identify the time of onset of the stroke. UNLESS SATA, THEN ALL.

what information should the nurse provide to the client who is receiving warfarin? A. partial thromboplastin time values determine the dosage of warfarin sodium. B. protamine sulfate is used to reverse the effects of warfarin sodium. C. international normalized ratio (INR) is used to assess effectiveness. D. warfarin sodium will facilitate clotting of the blood.

C. international normalized ratio (INR) is used to assess effectiveness.

A pt asks you to compare pure opioids to agonist-antagonist opioids fo them. What is a good reply?

Compared to pure opioids Lower potential for abuse-can cause anxiety, restlessness, mental confusion when given in high doses Less respiratory depression Less analgesic effect

A provider prescribes Prednisone for a client who has type one diabetes mellitus. Recognizing the risk for an adverse drug reaction to the Prednisone, which of the following precautions should the primary care provider take for this client? A. reduced the insulin dose b. increase carbohydrate intake C. reduced the Prednisone dose D. increase serum glucose monitoring

D. increase serum glucose monitoring

A client is about to start taking aspirin to prevent cardiovascular events you should instruct the patient to watch for and report which adverse drug reaction of aspirin? A. dyspnea b .Constipation c. calf pain D. petechiae

D. petechiae

a client has chest pain rated at 8 on a 10-point visual analog scale. the 12-lead electrocardiogram reveals ST elevation in the inferior leads, and troponin levels are elevated. what should the nurse do FIRST? A. monitor daily weights and urine output. B. limit visitation by family snd friends. C. provide client education on medications and diet. D. reduce pain and myocardial oxygen demand.

D. reduce pain and myocardial oxygen demand.

A client with angina is prescribed atenolol. Following absorption of the drug, the nurse should monitor the client for what desired effect?

Decrease heart rate and blood pressure

What adverse effect(s) should the nurse include in teaching the patient who is being started on a calcium channel blocker?

Dizziness and headache

About 3 hours later she puts on her call light to let you know she is feeling like she has to urinate but is not about to go when she tries. What might be happening?

Urinary retention

A client is being administered heparin IV and has been started on Warfarin. The client asks the nurse why she taking both medications. What is the nurse's most accurate response?

Warfarin takes 3-5 days to develop anticoagulant effects, so you will still need heparin

Patients being treated with warfarin need to maintain a consistent intake of food with vitamin K. Which of the following foods should the nurse inform the patient as having a high vitamin K content?

Green leafy vegetables

A patient with atrial fibrillation has a daily dose of warfarin ordered. This morning the patient's INR is 2.4. Which of the following nursing actions is most appropriate?

Hold today's dose and contact the provider

The patient received enoxaparin postoperatively. The nurse teaches the patient about this medication and evaluated the learning has occurred when the patient makes which statement?

It increases the time it takes for me to form a clot

A client is receiving low molecular weight heparin (LMWH) to prevent deep vein thrombosis. What is the best explanation of the rationale for the use of LMWH instead of the use of heparin?

LMWH is associated with stronger anticoagulant effects than standard heparin

a nurse is reviewing the medical record of a client who has a new prescription for tramadol. The nurse should identify that which of the following conditions is a contraindication for tramadol? hyperthyroidism seizure disorder

seizure disorder

A client diagnosed with erectile dysfunction. He asks what effects sildenafil has because he is taking nitroglycerin for chest pain. What is the best explanation for why nitrates are contraindicated with sildenafil?

"Nitroglycein and sildenafil cause a severe decrease in blood pressure."

Therapeutic use : Acetaminophen Morphine Prednisone Butorphanol

- fever reduction - sedation - Prevention of organ rejection - anesthesia adjunct

Classification: Morphine: Ibuprofen Naloxone Prednisone:

- opiod analgesic - nonsteroidal anti-inflammatory drug - opioid antagonist - glucocorticoid

A patient has been instructed to take one enteric-coated low dose aspirin a day for secondary prevention for cardiovascular events. The nurse will provide which instruction when teaching a patient about this medication?

-Do not crush, break, or open the enteric-coated tablet. -Swallow it whole with a glass of water. -Take it along with food if you experience stomach upset. -Avoid taking of herbal products along with aspirin. - Inform the doctor about aspirin before undergoing any procedure.

a nurse is teaching a client who has a new prescription for tramadol. Which of the following instructions should the nurse include? (select all that apply) A. increase fiber and fluid intake B. take the drug with food C. avoid driving after taking the drug D. change positions gradually E. reduce exercise level temporarily

A. increase fiber and fluid intake B. take the drug with food C. avoid driving after taking the drug D. change positions gradually

a nurse is caring for a client who is taking naloxone to treat acute morphine toxicity. The nurse should monitor the client for which of the following drug reactions? (select all the apply) A. increased respiratory rate B. increased pain thromboplebitis C. ventricular arrhythmias D. hypertension

A. increased respiratory rate B. increased pain thromboplebitis D. hypertension

a nurse is planing care for a client who has started taking prednisone. Which of the following interventions should the nurse include? A. monitor the clients blood glucose B. administer an antacid 30 min prior to prednisone C. administer aspirin rather than NSAIDs if the client has pain D. monitor the client for hyperkalemia

A. monitor the clients blood glucose

the nurse is teaching a client about taking prophylactic warfarin sodium. which statement indicates that the client understands how to take the drug. select all that apply. A. "the drugs action peaks in 2 hours." B. "Maximum dosage is not achieved until 3 to 4 days after starting the medication." C. "Effects of the drug continue for 4 to 5 days after discontinuing the medication." D. "Protamine sulfate is the antidote for warfarin." E. " I should have blood levels tested periodically."

B. "Maximum dosage is not achieved until 3 to 4 days after starting the medication." C. "Effects of the drug continue for 4 to 5 days after discontinuing the medication." E. " I should have blood levels tested periodically."

a client who has undergone a mitral valve replacement has had a mediastinal chest tube inserted. the client had persistent bleeding from the sternal incision during the early postoperative period. what actions should the nurse take? select all that apply. A. administer warfarin B. check the postoperative CBC, INR, PTT, and platelet levels. C. confirm availability of blood products. D. monitor the mediastinal chest tube drainage. E. start a dopamine drip for a systolic blood pressure <100 mm Hg.

B. check the postoperative CBC, INR, PTT, and platelet levels. C. confirm availability of blood products. D. monitor the mediastinal chest tube drainage.

a client with chronic heart failure has atrial fibrillation and is taking warfarin. what should the nurse tell the client about the expected outcome of this drug. A. "this medication will decrease the extra fluid your heart is circulating." B. "this medication will improve the work of your heart." C. "this medication will prevent a clot from forming." D. "this medication will regulate the rhythm of your heart."

C. "this medication will prevent a clot from forming."

a client arrives at the emergency room immediately following an incident acetaminophen (Tylenol) overdose which drug should you prepare to administer? A. Atropine B. Naloxone C. Acetylcysteine D. Flumazenil

C. Acetylcysteine

a client has received thrombolytic treatment for an ischemic stroke. the nurse should notify the health care provider (HCP) if there is a rapid increase in which vital sign? A. pulse B. respiration C. blood pressure D. temperatur

C. blood pressure

a nurse is caring for a group of postoperative clients. The nurse should identify that morphine is contraindicated for which of the following clients? A. a client who had a mastectomy B. a client who had a knee arthroplasty C. a client who had a colectomy D. a client who had a cholecystectomy

D. a client who had a cholecystectomy

a nurse is caring for a child who has a viral infection. The nurse should identify that which of the following drugs can increase the risk of Reye syndrome in children who have viral infections? A. butorphanol B. acetaminophen C. tramadol D. aspirin

D. aspirin

• A group of "friends" drop off a patient to the ED. They did not stay with her but said she took for morphine to get high. On your assessment you notice the patient is not responding and her respirations are only 6 BPM. What drug do you anticipate will be given to this patient?

Naloxone (Narcan) Might havd to give more than one dose.

What is the purpose of the PA pump? Who should control it? Who should not get a PCA pump?

Patient Controlled Analgesic Pump The PATIENT Patients that need scheduled/routine medication (cancer patients) Pts that are not able to push the button

A client is about to begin celecoxib therapy for osteoarthritis. You should instruct the client to watch for and report which of the following possible indications of a serious reaction to this drug. a. Black, tarry stools b. Polyuria c. Bone pain d. Dry mouth

a. Black, tarry stools

a client is about to start taking oral morphine to treat acute pain from an injury. Which of the following instructions should you include when talking with the client about taking morphine? Select all the apply. a. take it with food b. rise slowly from sitting or reclining C. take it on a fixed schedule D. increase fluid and fiber intake E. do not take it before driving.

a. take it with food b. rise slowly from sitting or reclining D. increase fluid and fiber intake E. do not take it before driving

A patient is receiving alteplase following an acute myocardial infarction. Which of the following adverse effects is mostly attributed to this drug?

skin rash

An older adult with fibrillation is started on a continuous heparin infusion. What enables the nurse to conclude that the anticoagulant therapy is within the therapeutic range?

the INR is 2.5

A patient has started taking clopidogrel after experiencing a transient ischemic attack (TIA). What is the desired therapeutic effect of this drug?

to reduce the risk of stroke from blood clot.

What does NSAIDs stand for and when should a patient take these?

• Non-Steroidal Anti-Inflammatory Drug Mild to moderate pain Those that might have pain related to inflammatory response

a nurse is caring for a client who is taking acetaminophen at regular intervals for mild discomfort. The nurse should tell the client to report which of the following early indications of acetaminophen toxicity? (Select all that apply.) A. diaphoresis B. palpitations C. shortness of breath D. nausea E. diarrhea

A. diaphoresis D. nausea E. diarrhea

a client is about to start taking tramadol to treat moderate pain. Which of the following instructions that should you include when take talking with the client about that taking this drug? A. allow one hour for it to take affect B. take on an empty stomach C. chew the extended-release tablets D. do not take it with grapefruit juice

A. allow one hour for it to take affect

a nurse is teaching a client who has a new prescription for allopurinol. Which of the following instructions should the nurse include? A. avoid driving or activities that require mental alertness B. avoid crushing the tablets C. limit fluid intake during therapy D. limit potassium while taking allipurinol

A. avoid driving or activities that require mental alertness

a client admitted to the telemetry unit with newly diagnosed atrial fibrillation has been started on warfarin. what should the nurse instruct the client to do when taking this medication. select all that apply. A. avoid injury to prevent bruising. B. be careful using a razor or fingernail clippers C. report any change in color of urine or stool. D. floss the teeth deep into the gums. E. not take the medication if the pulse is below 60.

A. avoid injury to prevent bruising. B. be careful using a razor or fingernail clippers C. report any change in color of urine or stool.

a client who is receiving chemotherapy allows allopurinol prior to the chemotherapy to reduce the risk for which condition? A. Agranulocytosis B. Hyperuricemia C. Aplastic anemia D. thrombocytopenia

B. Hyperuricemia

the nurse is assessing a client who has had a stent inserted in a coronary artery via the right femoral artery. the client is receiving intravenous heparin sodium at 1,000 units per hour. during the second post procedure check, the nurse notes that the puncture sit at the groin has begun to steadily ooze blood. what should the nurse do first? A. don gloves and apply direct pressure over the side. B. observe and document the bleeding. C. notify the health care provider. D.prepare protamine sulfate for intravenous administration.

A. don gloves and apply direct pressure over the side.

a nurse is teaching a client who is taking allopurinol about minimizing adverse effects. Which of the following instructions should the nurse include? A. eat a small meal before taking the drug B. suck on hard candy or chew gum C. take a stool softener daily D. avoid the use of NSAIDs

A. eat a small meal before taking the drug

a nurse is caring for a client who takes low-dose aspirin to prevent cardiovascular events. The client asks the nurse about taking ibuprofen to treat rheumatoid arthritis. Which of the following responses should the nurse make? A. "ibuprofen will increase your risk for developing salicylism" B. "ibuprofen will reduce the cardioprotective effects of low-dose aspirin" C. "low-dose aspirin will reduce the anti-inflammatory effects of ibuprofen" D. "low-dose aspirin will reduce the analgesic efforts of ibuprofen"

B. "ibuprofen will reduce the cardioprotective effects of low-dose aspirin"

Butorphanol is an unsafe analgesic choice for clients who? A. Take glucocorticoids for rheumatoid arthritis B. Use a fentanyl patch chronic pain C. Have type 1 diabetes mellitus and use an insulin pump D. Take warfarin for thrombophlebitis

B. Use a fentanyl patch chronic pain

a client with chest pain is prescribed intravenous nitroglycerin. which finding is of GREATEST concern for the nurse initiating the nitroglycerin drip. A. serum potassium is 3.5 mEg/L (3.5 moll/L) B. blood pressure is 88/46 mm Hg C. ST elevation is present on the electrocardiogram. D. heart rate is 61 bpm.

B. blood pressure is 88/46 mm Hg

a nurse is caring for a client who has a new prescription for celecoxib. The nurse should tell the client to report which of the following adverse drug reactions? A. tinnitus B. chest pain C. constipation D. diaphoresis

B. chest pain

nurse is teaching a client who has a new prescription for prednisone. Which of the following instructions should the nurse include? (select all that apply) A. reduce the dose during periods of stress B. discontinue the drug gradually C. report illness or infection D. increase intake of calcium and vitamin D E. monitor for signs of gastric bleeding

B. discontinue the drug gradually C. report illness or infection D. increase intake of calcium and vitamin D E. monitor for signs of gastric bleeding

a nurse is caring for a client who is taking allopurinol to treat gout. The nurse should monitor the client for which of the following manifestations of hypersensitivity syndrome? A. muscle pain B. fever C. anxiety D. tremors

B. fever

a nurse is caring for a client who has a new prescription for butorphanol. The nurse should monitor the client for which of the following adverse drug reactions? (select all that apply) A. infection B. nausea C.tachycardia D. dizziness E. headache

B. nausea D. dizziness E. headache

a nurse is caring for a client who has a new prescription for prednisone for long-term treatment of rheumatoid arthritis. The nurse should monitor the client for which of the following adverse drug reactions? A. pulmonary embolism B. hepatitis C. bone loss D. breast cancer

C. bone loss

what is the expected outcome of thrombolytic drug therapy for stroke? A. increased vascular permeability B. vasoconstriction C. dissolved emboli D. prevention of hemorrhage

C. dissolved emboli

a nurse is caring for a client who has a prescription for aspirin to treat an ankle pain. The nurse should instruct the client to report which of the following adverse drug reactions? A. polyuria B. bone pain C. weight gain D. infection

C. weight gain

a nurse is caring for a client who currently takes furosemide and has a new prescription for prednisone. The nurse should monitor the client for which of the following manifestations during concurrent use of the drugs? A. hypercalcemia B. hypoglycemia C. hypothermia D. hypokalemia

D. hypokalemia

81 yo male comes to his yearly physical appt. The only complaint that he has is that his left great toe joint has been hutting him over the past few months. He says that he does not recall injury and states that is only on the left toe. When you inspect his feet, you notice there is swelling and redness as he reported. What do you suspect him to be diagnosed with?

Gout

A patient who is taking warfarin has just vomited blood. The nurse notifies the provider who orders, lab work revealing a PT of 42 seconds and an INR of 4.5. The nurse will expect to administer which of the following therapies?

Protamine Sulfate

What is the therapeutic effect of alteplase when administered during the first 6 hours after onset of MI?

Reestablish blood flow to the blocked coronary artery

A grandmother has been watching her 4 yo grandchild while the parents are away for the week on vacation. It was reported that grandma was giving the child aspirin since that is what she had laying around the house. What is the risk if a child is given aspirin? What of the signs of aspirin toxicity?

Reyes Syndrome • tinnitus, sweating, headache, dizziness, respiratory alkalosis

Your first pt at clinical is prescribed a dopamine antagonist for her CINV. After you administer her medication, you return in about 30 minutes to check on her. She said that her NV is not as severe, but she has cotton mouth even though she is drinking a lot more water. What are some nursing intervention you could offer her?

Suck on hard candy

The nurse is caring for a patient who just had a myocardial infarction. Which analgesic does the nurse expect to be prescribed?

TPA alteplase

a nurse is reviewing the medical record of a client who reports taking acetaminophen at home. The nurse should identify that which of the following client conditions is contraindicated for acetaminophen? A. asthma B. diabetes C. mellitus D. heart failure E. alcohol use disorder

alcohol use disorder

A client diagnosed with osteoarthritis has been prescribed meloxicam. The nurse observes a rash. Which one of the following reactions does the nurse suspect?

allergic reaction

a nurse is reviewing the medical record of a client who has a new prescription for celecoxib. The nurse should identify that which of the following conditions is a contraindication to celecoxib? a. rheumatoid arthritis b. ankylosing spondylitis c. sulfonamide allergy d. adrenocortical insufficiency

c. sulfonamide allergy