Pharmacology Exam 2 ~worksheets

A client complains of a nose bleed that won't stop. It would make most sense to stop the nose bleed with an agent that has which one of the following Adrenergic Receptor effets?

Alpha 1 agonist

Sympathetic System

Also called Adrenergic System

Parasympathetic System

Also called Cholinergic System

Atropine is a(n):

Anticholinergic Agent

Atropine produces its effect primarily by blocking the muscarinic receptors of the cholinergic system

Atropine produces its effect primarily by blocking the muscarinic receptors of the cholinergic system

Treatment for Muscle Spasms/Spasticity

Baclofen (Lioresal) Dantrolene (Dantrium)

A client has urinary retention caused from a tumor that is obstructing (blocking) the urinary sphincter. The drug of choice for this problem is Bethanechol (Urecholine).

False

Characteristic side effects of Selective Serotonin Reuptake Inhibitors (SSRI's)include drowsiness and weight loss

False

Doneprezil Hydrochloride (Aricept) is likely to have side effects of dry mouth and constipation.

False

Hydrochlorothiazide (HydroDiuril) has greater diuresis ability than Furosemide, and thus is used more commonly for the treatment of hypertension.

False

If a drug works because it "inhibits the reuptake of norepinephrine", it would produce sympatholytic effects.

False

It is safe to prescribe Beta Blockers to treat Glaucoma in patients with a history of sinus bradycardia. Because the medication is prescribed topically, the drug is not absorbed systemically, and thus will not produce pulmonary or cardiac effects.

False

Occlusive dressings applied over glucocorticoid ointment should be encouraged.

False

Otitis Externa is an inflammatory process of the ear canal, also called "swimmers ear". This most commonly is caused by a virus, and recommended treatement is to keep the ear as dry as possible. The inflammation will clear within one week with no pharmacological regimen.

False

Parkinson's Disease is treated with drugs that will decrease Dopamine level and/or increase acetylcholine levels

False

The nurse counsels a patient who has abused anabolic steroids (Nandrolene) for the enhancement of his athletic performance. When discussing adverse effects, the nurse should include

Hypertension

Which of the following statements made by the client, indicates understanding of discharge teaching regarding Alendronate (Fosamax)?

I will take the medication first thing in the morning on an empty stomach

Beta 1

Increase force of cardiac contraction

Beta 1

Increase in heart rate

Beta 1

Increase renin release from the kidneys

Latanoprost (Xalatan), a Prostaglandin Analog agent used in the treatment of Glaucoma, works to lower the intraocular pressure by:

Increasing the outflow of the aqueous humor

The pediatric patient is prescribed Methylphenidate (Ritalin) for Attention Deficit Hyperactivity Disorder. Side effects you might expect to see, include: Mark all that apply

Insomnia and restlessness Increase in heart rate and blood pressure

Levetiracetam (Keppra) is an antiepileptic agent. Which of the following are true statements regarding this drug? Mark all that apply

Levetiracetam (Keppra) is rapidly and completely absorbed in both the presence and absence of food. Warfarin and Oral Contraceptive doses do not have to be adjusted when a patient is taking Levetiracetam (Keppra)

Which one of the following pharmacological agents will be most likely have an "off" episode if the patient consumes a high protein meal?

Levodopa

Which one of the following diuretics would be preferred when treating increased intracranial pressure caused from cerebral edema?

Mannitol (Osmitrol)

Treatment for Rheumatoid Arthritis

Methotrexate Etanercept (Enbrel)

Which of the following are true statements regarding the treatment of acne. Mark all that apply

Mild acne can typically be treated with topical antimicrobial agents and topical retinoids. The choice of drug therapy for acne is determined by the severity of the symptoms. Adolescence with acne should be instructed to avoid the use of oil-based moisturizers.

What drugs dilate the pupils to allow for better observation of retinal structures during an eye examination.

Mydriatic Drugs

Treatment for Gout

Probenecid Colchicine Allopurinol (Zyloprim)

Alpha 1

Prostate capsule contraction

Atropine will have which of the following effects on the body? Choose all that apply

Pupil dilation. Decreased tone and motility of the GI tract. Increases heart rate.

Which one of the following statements is true regarding Retinoids?

Retinoids are derivatives of Vitamin A and work by unplugging existing comedones and preventing development of new ones.

The patient is taking Quetiapine (Seroquel)for Schizophrenia. This patient exhibits involuntary twisting movements of the tongue and face as well as frequent lip smacking. These symptoms are indicative of which type of Extrapyramidal side effects?

Tardive Dyskinesia

In Parkinson's Disease, damage to the Extrapyramidal function causes the patient to manifest Dyskinesias. Dyskinesias that are characteristic of Parkinson's Disease include:

Tremors at rest, rigidity and bradykinesia

According to your text, "The increase in urine flow that a diuretic produces is directly related to the amount of sodium and chloride reabsorption that it blocks".

True

According to your text, diuretics work primarily by interfering with sodium and chloride reabsorption.

True

According to your text, greater than 99% of the water, electrolytes and nutrients that are filtered at the glomerulus of the kidneys, undergo reabsorption.

True

According to your textbook, the risk of acquiring acute otitis media is lower in infants who were breastfed for at least 6 months.

True

All of the antiglaucoma drugs are available for topical administration. This is the preferred route in the treatment of glaucoma.

True

Anticholinergic agents, if administered locally on the eye, will produce both a cycloplegic and mydriatic reaction of the eye. The patient should be informed that blurred vision, dry mouth and tachycardia are possible side effects.

True

Bumetanide (Bumex)and Torsemide (Demedex) are two other diuretics similar to Furosemide that works at the loop of henle.

True

Combination oral contraceptives and Spironolactone (Aldactone) have been effective in treating acne in young women.

True

Dexmedetomidine (Precedex) is a selective alpha 2 Adrenergic Agonist that is approved for short term sedation of critically ill patients. Considering that this is an Alpha 2 Agonist, hypotension is a common side effect.

True

Drugs that are protein bound and drugs that are highly ionized cannot cross the blood brain barrier.

True

During treatment with antidepressants, especially early on, the risk of suicide may actually increase. There is also a risk for suicide whenever the dose is changed.

True

Estrogen therapy will prevent bone loss in postmenopausal women with osteoporosis, however, prolonged estrogen replacement is not recommended due to an increase risk of uterine cancer and breast cancer.

True

Hydrochlorothiazide diuretics can cause retention of uric acid and may precipitate gouty arthritis in clients with a history of Gout.

True

Liver and kidney function assessments must be monitored in clients who are taking Methotrexate for Rheumatoid Arthritis.

True

Propionibacterium acnes is a microbe that converts sebum into irritant fatty acids, thus intensifying the symptoms of acne.

True

The most common side effect of topical anticholinergic eye drops are photophobia and blurred vision.

True

The nurse is caring for a client who takes Lithium for BiPolar disorder. If the client develops hyponatremia (low serum sodium level), he/she would be at greater risk for developing Lithium Toxicity.

True

Topical Clindamycin and erythromycin can be used to treat acne. They work by suppressing P. Acnes.

True

Topical glucocorticoids are used to relieve inflammation and itching associated with a variety of dermatologic disorders.

True

Treatment of Primary Open Angle Glaucoma is directed at reducing elevated intraocular pressure, and medication administration is the principal method in which this is accomplished.

True

When caring for a patient who has status epilepticus, the nurse will most likely initially administer Lorazepam (Ativan) or Diazepam (Valium) intravenously.

True

iPledge Program is designed to ensure that no woman starting isotretinoin (Accutane) is pregnant or becomes pregnant while on the medication.

True

Beta 2

Uterine relaxation

Alpha 1

Vasoconstriction of arterioles and veins

Which of the following are true statements regarding topical glucocorticoids. Mark all that apply

With prolonged use, topical glucocorticoids can cause atrophy of the dermis and epidermis. Absorption is greatly increased with the use of an occulsive dressing. Absorption of topical glucocorticoids would be higher from the axilla, face and perineum, compared to the palms of the hands and the soles of the feet. Adverse effects of topical glucocorticoids may be local or systemic.

Treatment for Osteoporosis

Alendronate (Fosamax) Calcitonin-Salmon (Fortical) Raloxifene (Evista)

A patient with rheumatoid arthritis is starting on methotrexate. The patient asks, "When can I expect to begin to see the effects of this medicine?" The nurse would give which response?

3 - 6 weeks

Which one of the following patients would be at highest risk for developing morphine-induced respiratory depression?

8 month old infant

A comedone is:

A common lesion in mild acne. The comedone appears as a blackhead if open, and a whitehead if the comedone is closed.

The definition of a "keratolytic agent" is:

A drug that promotes shedding of the horny layer of the skin. Effects range from peeling to extensive desquamation.

Sympathetic System

A drug that would cause an increase in heart rate, increase in blood pressure, pupil dilation, and bronchial dilation would mimic which system?

A patient with open-angle glaucoma begins a beta-blocker topical ophthalmic solution. After the first instillation, the patient telephones a nurse and complains of stinging. Select the nurse's best response.

"This is a normal effect and is generally transient".

A drug that "blocks" the effect of acetylcholine, would be called?

...

Which of the following are accurate statements/descriptions of Bethanechol (Urecholine):

...

Which of the following are true statements regarding Spironolactone (Aldactone)? Mark all that apply

...

Which of the following are true statements regarding antiepileptic agents? Mark all that apply

...

Parasympathetic System

A drug that would cause increase in salivation, bronchial constriction, increase in GI peristalsis and pupil constriction would mimic which system?

Which of the following statements are true regarding Benzoyl Peroxide. Mark all that apply.

Benzoyl peroxide is a first-line drug for mild to moderate acne. Benzoyl Peroxide works primarily by suppressing the growth of P. Acnes. Benzoyl peroxide may normally produce drying and peeling of the skin. If burning, blistering, scaling or swelling results, the frequency of application should be reduced. It is recommended that application of Benzoyl Peroxide should be once daily in the beginning, and over time the frequency of administration can be increased to a maximum of three times daily. Benzoyl Peroxide causes a keratolytic effect.

A client is in the Emergency Department with heart failure. It would make most sense to administer a _____ drug, which will increase the force of the cardiac contraction.

Beta 1 agonist

A client is in the Emergency Department with hypertension. It would make most sense to administer which one of the following agents to lower the blood pressure?

Beta 1 antagonist (blocker)

Propranolol (Inderal)is used to treat hypertension and angina pectoris. Propranolol works by:

Blocking beta 1 and beta 2 receptors.

Beta 2

Bronchodilation

The patients asks the nurse about the reason for switching from Levodopa to a combination Carbidopa/Levodopa drug (Sinemet). Which of the following are advantages to the combination drug? Select all that apply.

Carbidopa allows the dosage of Levodopa to be reduced by about 75%. Carbidopa reduces production of Dopamine in the periphery, decreasing cardiovascular responses to Levodopa.

A patient with Gout is given a prescription for Colchicine. The patient asks the nurse about the purpose of this drug. Which of the following would be the most accurate statement?

Colchicine decreases inflammation and pain associated with Gout".

Alpha 1

Contraction of the radial muscle of the iris causing pupil dilation (Mydriasis)

What agents paralyze the ciliary muscles and prevent the lens from moving during an eye examination

Cycloplegic Drugs

Beta Blockers decrease intraocular pressure in the treatment of glaucoma by:

Decreasing production of aqueous humor

Sympathetic System

Drugs that "block" the effect of this system, are called sympatholytic agents

Parasympathetic System

Drugs that activate the effect of this system, are called parasympathomimetics

Side effects that the nurse should anticipate when administering Anticholinergic Agents such as Atropine, include: Mark all that apply

Dry mouth. Blurred vision. Elevation of intraocular pressure.

Which of the following are true statements regarding the iPledge Program. Mark all that apply.

Each female patient must use two effective forms of birth control, even if one of them is tubal ligation or vasectomy of the male partner. For female patients, pregancy must be ruled out before the initial prescription and again before each monthly refill. Two pregnancy tests are required prior to the initial prescription. All transactions involving Isotretinoin must be processed through a central automated system. Rules will apply to the prescriber, patient, pharmacist and wholesale.

Isoproterenol is a sympathomimetic agent that stimulates both beta 1 and beta 2. Knowing this, what effects would Isoproterenol have? choose all that apply

Elevation of blood glucose level. Bronchodilation. Increased cardiac output by increasing heart rate and force of cardiac contraction.

Recommended treatment for all children with an acute otitis media infection includes a pain medication and a 10 day course of antibiotics. Without the antibiotic treatment, the ear infection will not resolve, and the ear drum will most likely rupture.

False

The patient who is taking Levodopa should avoid all foods containing protein.

False

When glucocorticoids are used in the treatment of rheumatoid arthiritis, they are always administered by intra-articular injection.

False

Which of the following are true statements regarding Isotretinoin (Accutane). Mark all that apply

For most patients, a single course of drug therapy is effective. A course of therapy is typically 15 - 20 weeks. Isotretinoin (Accutane) is used to treat severe nodulocystic acne. If a second course of drug therapy is necessary, the patient should wait 2 months after completing the first course.

Which of the following statements are true regarding Furosemide (Lasix). Mark all that apply

Furosemide would be the diuretic of choice in clients with pulmonary edema associated with heart failure. Possible side effects from Furosemide include hypotension and ototoxicity Furosemide acts in the thick segment of the ascending limb of Henle's loop to block reabsorption of sodium and chloride.

Beta 2

Glycogenolysis from the liver

The nurse is caring for a patient who is taking Carbamazepine (Tegretol) for a seizure disorder. Which of the following food items would cause a significant rise in peak and trough levels if consumed by this patient?

Grapefruit juice

The patient should be aware of potential side effects of prostaglandin analogs such as Latanoprost (Xalatan) used in the treatment of glaucoma. The nurse should include which of the following in the teaching plan?

Heightened pigmentation, usually a brown color of the iris, that is irreversible

A patient with rheumatoid arthritis begins therapy with Etanercept (Enbrel). Which of the following points should the nurse include in the teaching plan? Mark all that apply

The client should avoid any "live virus" vaccines while on this medication. Etanercept will increase the patient's risk of acquiring a serious infection. A Tuberculin skin test should be done on the patient before therapy begins.

Parasympathetic System

The main neurotransmitter for this system is acetylcholine

Sympathetic System

The main neurotransmitter for this system is norepinephrine.

A drug handbook states that a medication has a "possible side effect of miosis". Which assessment finding correlates with this resource?

The pupils are small and constricted

Which of the following are true statements regarding the adverse effects of Isotretinoin (Accutane)? Mark all that apply

There is some concern regarding a correlation between Accutane and depression. Clinicians should ask patients to report signs of depression or thoughts of suicide when taking Accutane. Isotretinoin (Accutane) can lead to elevated triglyceride levels, and thus triglyceride levels should be measured prior to treatment and periodically therafter. Nose bleeds are common in patients who are taking Isotretinoin (Accutane).

The nurse is educating a client, recently diagnosed with Gout, about their new prescription for Allopurinal (Zyloprim). Which one of the following is a true statement?

This agent is not beneficial in relieving pain during an acute Gout attack