Pharmacology Final

The nurse is assessing a patient with chronic urinary incontinence. Which statement leads the nurse to believe the patient requires more education about this disorder?

"I'm reducing the amounts of fluids i drink in a day, so I don't leak as much urine"

Which is the most favorable lipid level?

Elevated high-density lipoprotein (HDL)

Which drug class should not be used when a patient is taking nitrates?

Erectile dysfunction drugs

What organism is most commonly responsible for bladder infections?

Escherichia coli

For blood clots to form in the body, something must trigger the intricate steps of the clotting cascade. For a person who receives a surgical incision, which pathway is triggered?

Extrinsic

Certain factors place us at risk for development of cardiovascular disease. Which one is non-modifiable risk factor?

Family history

A patient receiving furosemide (Lasix) for a month reports experiencing pain in the toes. The patient states it has been years since having that type of pain. What does the nurse suspect?

Gout

A nurse is attending a backyard picnic of an older neighbor when the nurse notices the neighbor is holding the chest and looking pale and diaphoretic. The neighbor is reaching for a second nitroglycerin tablet from the bottle and places it under the tongue. An ambulance has already been summoned, but the location is a rural area. What other measure does the nurse initiate?

Have the neighbor chew an aspirin tablet

When administering sublingual nitroglycerin for emergency treatment of angina or chest pain, the nurse monitors for which common adverse effect?

Headache

What aspect of selegiline (Eldepryl) therapy must patients be aware?

High-tyramine foods such as aged cheese and Chianti wine must be avoided

A patient is experiencing insomnia due to anxiety about an upcoming procedure in the morning. The patient is oriented and cooperative, but restless. The nurse has reassured the patient, explained what the patient can expect the next day, and provided a relaxing back rub. Which medication would be most effective for this patient?

Hypnotic

A patient with a history of heart failure is prescribed furosemide (Lasix). Several days after the aggressive diuretic therapy started, the patient began to exhibit confusion, tremores, muscle cramps, and nausea. What does the nurse suspect?

Hypokalemia

A patient is being started on a new drug that has been used safely by many people for years. The patient has no known allergies, and the nurse administers the drug correctly. Suddenly the patient experiences cardiac arrest. What is this type of reaction called?

Idiosyncratic

A low-dose sedative-hypnotic agent may be prescribed for a patient with which condition?

Inability to sleep

Which route of administration has the fastest rate of distribution?

Intravenous

Which drugs should not be taken by a pregnant woman?

Lithium & Losartan

Which assessment finding would the nurse suspect as being related to peripheral vascular disease?

No hair growth on shins

Administering lidocaine (Xylocaine) at too high a dose can produce which effect?

Seizures

The normal electrical conduction pathway in the heart starts with the firing of which component?

Sinoatrial (SA) node

It is important to maintain therapeutic levels of drugs to avoid the complications of being over or undermedicated. If a drug level of 0.5 to 2 ng/mL is considered therapeutic, a drug level of 0.45 ng/mL is considered to be what?

Subtherapeutic

Which administration strategy can a patient implement to reduce flushing, the most common adverse effect of niacin therapy?

Take with meals

Which is a common finding with combination diuretic products?

They increase the risk of hypokalemia

Why are the newer, nonbenzodiazepine medications for insomnia preferred over older medications?

They interfere less with natural sleep cycles

For which cardiac rhythm is the use of amiodarone (Cordarone, Pacerone), a potassium channel blocking agent, contraindicated?

Third-degree heart block

A patient undergoing chemotherapy for cancer has developed significant mucositis. Which technique may bring relief to the patient?

Use of viscous lidocaine

Which type of topical drug is more readily absorbed by infants?

Water-soluble

Patients taking which cholesterol-lowering agent may require supplements of fat-soluble vitamins?

bile acid-binding resins

Which range of systolic blood pressure is classified as prehypertension?

120-139

A patient has presented to the emergency department reporting feeling short of breath. What other symptom alerts the nurse that the patient may be in heart failure?

2+ ankle edema

How many hours of sleep per night are thought to be optimal for good health?

7 to 8

All the drugs are processed in the body through pharmacokinetics. What is the correct order that drugs pass through the body?

Absorption, distribution, metabolism, excretion

Which ethnic group tends to have the highest incidence of hypertension?

African american

What must be used with caution while taking anti-anxiety agents?

Alcohol

A nurse is reviewing core measures in charts of patients who have been discharged following an acute MI. the nurse should ensure patients are discharged home with which medication?

Beta-adrenergic blocker

A patient reports postoperative pain, and the nurse administers morphine (a narcotic analgesic) intravenously to ease the pain. 15 minutes later, the nurse notes that the patient is very drowsy, respirations are slow and shallow, and oxygen saturation is low. The nurse administers another drug that decreases the action of the morphine. What is this effect called?

Antagonistic

Up to ⅓ of patients who take ACE inhibitors for hypertension report which symptom after beginning therapy?

Chronic cough

To prevent future oral problems in children, when should regular oral care begin?

When teeth first erupt

A patient with peripheral vascular disease has been on pentoxifylline (Trental) for 2 weeks. Which statement by the patient indicates a need for further patient teaching about the disease?

"I can't wait to go skiing this weekend now that my feet don't hurt so much"

A patient who was admitted with a deep vein thrombosis in the calf is being discharged on low-molecular-weight heparin enoxparin (Lovenox), which is administered by injection. The patient successfully demonstrates the injection technique, but which statement by the patient indicates a need for further instruction by the nurse?

"I'll be sure to massage the spot I inject so the drug will absorb"

A patient has been placed on a loop diuretic to reduce the fluid that has been accumulating in the lungs. Which statement made by the patient indicates a need for further teaching about the medication by the nurse?

"I'll be sure to take my medication with supper"

A patient has been recently diagnosed with heart failure due to systolic dysfunction. She asks the nurse to explain the disease process to family members. The best explanation is:

"The heart does not have adequate force to pump all the needed blood"

Which antilipemic drug acts by locking the absorption of cholesterol from the small intestine?

Ezetimibe (Zetia)

What oral disorder is contagious?

Fever blisters

A patient has been taking a beta blocker for several months to control hypertension and has no medications left. She calls the clinic friday to request a refill, but the healthcare provider has left the clinic for the weekend. The nurse should:

Contact the on call provider for a refill

Which is the most common drug class used to treat anxiety disorders?

Benzodiazepines

What is the meaning of the onset of action of a drug?

Concentration of a drug is sufficient to start a pharmacologic response

Class IV antidysrhythmic or calcium channel blockers have what action on the cardiovascular system?

Decrease flow of calcium

What is the therapeutic outcome of anti-Parkinson's disease?

Decrease the symptoms of the disease

What is the action of carbidopa/levodopa (Sinemet)?

Decreases the amount of levodopa to reach the brain

A patient is diagnosed with hypertension. What is the initial recommendation for this patient likely to be?

Diet and exercise

Which symptom is an adverse effect of anticholinergic agents used to treat overactive bladder syndrome (OAB)?

Dry mouth

What must the nurse do when obtaining lidocaine (Xylocaine), a class 1b antiarrhythmic, to administer to a patient with cardiac dysrhythmia

Ensure the dosage form to be administered is for dysrhythmias, not for local anesthesia

A patient admitted 4 days ago with a pulmonary embolism has been prescribed oral warfarin (Coumadin) and IV heparin. What is the reason for the patient receiving two anticoagulants?

Heparin is often used to initiate therapy, then oral anticoagulants are prescribed and adjusted until laboratory tests indicate an adequate therapeutic response

The use of diuretics in the treatment of heart failure may lead to what condition?

Hypotension

The non-rapid eye movement (NREM) phase of sleep is divided into 4 stages. Which stage accounts for the largest amount of normal sleep time for an adult?

II

What is the physiologic cause of tremors in patients with Parkinson's disease?

Increase in the amount of acetylcholine in the brain

To decrease the risk of cardiovascular disease in patients, which measure is recommended by healthcare professionals?

Increased HDL cholesterol levels

In which condition is leg pain produced upon increased activity and ischemia to tissues, but then the pain is reduced with rest?

Intermittent claudication

Which fact characterizes generalized anxiety disorder?

It often leads to other psychiatric disorders

Which form of medication is more easily administered for a toddler who requires a course of antibiotics?

Liquid

The nurse notes these assessment findings in a patient during a routine examination: obese with enlarged, fatty abdomen, hypertension, hyperglycemia, and hyperlipidemia. What does the nurse suspect the patient has developed?

Metabolic syndrome

Of all the anxiety disorders, which one is considered to be the most disabling to the patient?

Obsessive compulsive disorder (OCD)

Which laboratory test measures the effectiveness of heparin?

PTT

A nurse encounters a patient having a seizure. Which action is correct?

Placing a towel under the patients head

Digoxin (Lanoxin) is a cardiac glycoside that is among the oldest medications used for heart failure. What are its two primary actions?

Positive inotropy and negative chronotropy

Which nursing intervention is best for patients with Parkinson's disease?

Provide 6 small meals per day rather than 3 large ones

What is the major action of anticonvulsants?

Raising the seizure threshold

The nurse practitioner is caring for a patient who is experiencing xerostomia. Which type of treatment does the nurse prescribe for the patient?

Saliva substitute

Due to the decreased protein-binding capacity in preterm infants, what adjustment in dosage of protein-binding drugs would need to be made?

The dosage should be increased

A patient is undergoing milrinone (Primacor) therapy. Which severe adverse reaction does the nurse promptly report to the healthcare provider?

Thrombocytopenia

Which drug class is capable of dissolving blood clots?

Thrombolytic agents

Why is a patient who is using transdermal nitroglycerin patch instructed to remove the patch at bedtime and apply a new one in the morning

To prevent tolerance

A patient with peripheral vascular disease has been prescribed papaverine. Which symptom is considered a severe adverse effect that requires immediate reporting to the healthcare provider?

Hypotension