Pharmacology Final Exam

A patient is prescribed an antibiotic to treat a urinary tract infection. What statement by the patient indicates a need for further teaching?

"I can stop the medication as soon as the symptoms have disappeared."

The nurse teaches a patient about bupropion [Wellbutrin]. Which statement by the patient indicates that more teaching is indicated?

"I had a serious head injury 3 years ago."

A nurse instructs a patient about signs and symptoms of digoxin toxicity. The nurse determines that teaching is successful if the patient makes which statement?

"I should report any muscle weakness or nausea."

The nurse provides teaching for a patient with obsessive-compulsive disorder who has been prescribed Sertraline [Zoloft]. Which statement by the patient indicates that more teaching is necessary?

"I will feel better in 3 weeks."

A patient with BPD is prescribed lithium. Which statement, if made by the patient, indicates the need for further teaching?

"I will reduce my salt intake while taking this medication."

A patient with depression has been prescribed fluoxetine [Prozac]. Which statement made by the patient indicates an understanding of the medication teaching?

"It may take 3 to 4 weeks before my mood is elevated."

The nurse is caring for a patient who is receiving pramipexole [Mirapex]. The nurse is most concerned if the patient makes which statement?

"Sometimes I just fall asleep without warning."

A patient with mild symptoms of AD is prescribed donepezil [Aricept]. Which statement made by the patient indicates the need for further teaching?

"The drug will stop damage to the neurons in my brain."

A patient has been taking a medication for 2 months. Which statement, if made by the patient, would indicate to the nurse that drug tolerance is occurring?

"The medication does not seem to be working as well."

The nurse teaches a patient about bethanechol [Urecholine]. Which statement by the patient requires an intervention by the nurse?

"The medication should be taken with meals."

The nurse receives a phone call from a patient who has been taking a CNS drug for 3 days. The patient tells the nurse that the medication causes nausea. Which response by the nurse is best?

"The nausea will most likely decrease over time."

The nurses receives a phone call from a patient who has been taking a CNS drug for 3 days. The patient tells the nurse that the medication causes nausea. Which response by the nurse is best?

"The nausea will most likely decrease over time."

The nurse instructs a patient about taking nifedipine [Procardia XL]. Which statement made by the patient indicates an understanding of medication teaching?

"The pill should be swallowed whole."

A patient is prescribed the dopamine agonist pramipexole [Mirapex]. Which statement made by the patient indicates a need for further teaching?

"This drug will stop the progression of Parkinson disease."

A patient is prescribed venlafaxine [Effexor XR] and requests information about the medication. Which response by the nurse is most appropriate?

"Venlafaxine [Effexor XR] is used to treat anxiety and depression."

The patient is ordered daily divided doses of gentamycin. The patient received an intravenous dose of gentamycin at 4:00 pm. When should the nurse obtain the peak level?

4:30 pm

A patient receives a bupivacaine [Marcaine] injection for infiltration anesthesia. When would the nurse expect the onset of local anesthesia to occur?

5 minutes

Which patient would be at highest risk for systemic toxicity from the topical administration of a local anesthetic?

A 58-year-old patient who receives a local anesthetic to a 10-cm×20-cm abrasion

A patient is diagnosed with type 2 diabetes mellitus and schizophrenia. The nurse will closely monitor the blood sugar if the patient receives which medication for the treatment of schizophrenia?

Clozapine [Clozaril]

Which patient would the nurse expect to have the highest risk for postural hypotension?

A patient who is prescribed a drug that promotes venous vasodilation

Which patient should receive prophylactic antibiotic therapy?

A patient who is scheduled for a hysterectomy

Which patient would most likely be prescribed sodium nitroprusside [Nitropress]?

A patient with a hypertensive crisis in the intensive care unit

A patient is prescribed verapamil [Calan]. The nurse should assess the patient for which common adverse effects?

Constipation, headache, and edema of the ankles and feet

Which of the following neurotransmitters are present in BOTH the CNS and PNS?

Acetylcholine

The nurse is administering efavirenz [Sustiva] to a patient with AIDS. What will the nurse do?

Administer the medication on an empty stomach at bedtime.

A patient who is taking spironolactone [Aldactone] is prescribed losartan [Cozaar]. The nurse should take which action?

Administer the medications as scheduled.

A patient is prescribed cefazolin. It is most important for the nurse to teach the patient to avoid which substance while taking cefazolin?

Alcohol

The nurse prepares to administer a cholinesterase inhibitor to a patient with AD. Which medication, if ordered by the healthcare provider, should the nurse question?

Amitriptyline [Elavil]

What suffix is -sartan?

Angiotensin- ii receptor blocker

What suffix is -pril?

Angiotensin-converting enzyme inhibitor (ACE)

What suffix is -cillin?

Antibiotic

A patient is scheduled for a dose of interferon beta [Betaseron]. Which nursing action would be most effective to decrease pain at the injection site?

Apply ice packs for 2 to 3 minutes.

An older patient with skin cancer and hypertension is prescribed levodopa/carbidopa [Sinemet] to treat Parkinson disease. Which action by the nurse is best?

Ask the patient about the type of skin cancer.

A patient is prescribed bethanechol [Urecholine] for urinary retention. If the patient exhibits signs of an overdose, such as increased salivation and sweating, bradycardia, or hypotension, which medication should the nurse administer?

Atropine [AtroPen]

A patient with schizophrenia is prescribed chlorpromazine oral concentrate. Which instruction should the nurse include in the teaching plan?

Avoid direct skin contact with this medication.

A patient is prescribed isocarboxazid [Marplan] for the treatment of depression. Which foods should the patient be taught to avoid?

Bananas, smoked fish, and cheese

What suffix is -olol?

Beta-adrenergic blocker

A patient with HIV is prescribed saquinavir [Invirase]. It is most important for the nurse to monitor which laboratory value?

Blood glucose levels

The nurse prepares to administer memantine [Namenda] to a patient with severe AD. The nurse should assess what before administering of the medication?

Blood urea nitrogen and serum creatinine

What suffix is -dipine?

Calcium Channel Blocker

When the nurse reviews a medication order, it is not clear what route should be used for administration. Which action by the nurse is best?

Call the prescriber to verify the route.

The nurse is caring for a patient with social anxiety disorder. The patient is currently experiencing intense anxiety. The nurse should prepare to administer which medication for the immediate relief of anxiety?

Clonazepam [Klonopin]

Which statement about alkylating agents does the nurse identify as true?

Development of resistance to alkylating agents is common.

A patient is prescribed doxepin [Sinequan] for the treatment of depression. Which over-the-counter medication should the nurse teach the patient to avoid?

Diphenhydramine [Benadryl]

A patient who takes oxybutynin [Ditropan] for an overactive bladder takes an over-the-counter antihistamine for hay fever symptoms. What symptoms should the nurse watch for that would indicate toxicity?

Dry mouth, increased temperature, and blurred vision

A patient with MS is prescribed interferon beta [Betaseron]. What is a priority for teaching at this time?

Educate about self-injection technique.

The nurse cares for a patient who is receiving mitoxantrone [Novantrone]. It is most important for the nurse to assess the patient for what?

Elevated temperature

Which statement about enfuvirtide does the nurse identify as true?

Enfuvirtide is reserved for treating HIV-1 infection that has become resistant to other antiretroviral agents.

A patient receiving chemotherapy is anemic. Which medication does the nurse anticipate administering to this patient?

Erythropoietin

The nurse cares for a patient who is receiving lithium. Which medication, if prescribed by the healthcare provider, should the nurse question?

Furosemide [Lasix]

A patient with severe hypertension is prescribed minoxidil. Which medications will the nurse expect to be administered to reduce adverse responses to minoxidil?

Furosemide [Lasix] and propranolol [Inderal]

A patient is prescribed doxycycline [Vibramycin]. If the patient complains of gastric irritation, what should the nurse do?

Give the patient food, such as crackers or toast, with the medication.

Which statement will the nurse include when teaching a patient with HIV about management of the disease?

HIV is considered a chronic disease.

What suffix is -Statin

HMG-CoA Reductase inhibitor

An adult patient receives lidocaine by injection before a procedure. Which finding indicates that the patient is experiencing a systemic reaction and toxicity?

Heart rate of 42 beats/min

What is an adverse effect of angiotensin-converting enzymes? (ACE inhibitors)?

Hyperkalemia

The nurse cares for a patient receiving digoxin [Lanoxin]. What indicates to the nurse that treatment with this medication is effective?

Improved cardiac output

The nurse cares for a patient with depression who has been prescribed an antidepressant. When would the nurse expect the medication to reach its full therapeutic effect?

In 2 to 3 weeks

A patient's cardiac output is 8 L/min. Which hemodynamic effect would the nurse expect?

Increased stroke volume

The major dose-limiting toxicity of bleomycin therapy is what?

Injury to the lungs

A patient taking levodopa/carbidopa [Sinemet] for Parkinson disease experiences frequent "on-off" episodes (ie, the abrupt loss of effect). Which action by the nurse is best?

Instruct the patient to avoid high-protein foods.

A patient who is hospitalized for an infection takes eplerenone [Inspra] for heart failure. Which medication, if ordered by the physician, should the nurse question?

Itraconazole [Sporanox]

A patient has an allergy to procaine [Novocain]. What local anesthetic would be safe to administer to this patient?

Lidocaine [Xylocaine]

Which are the characteristics of drugs that can cross the blood-brain barrier?

Lipid-soluble or move via transport systems

What should you take with Lithium?

Meals or milk

Which drug is NOT used to treat Parkinson Disease?

Memantine

Which tetracycline may be administered with meals?

Minocycline

The healthcare provider prescribes sustained-release verapamil [Calan SR] to an 82-year-old patient who takes digoxin [Lanoxin] daily. Which action is most appropriate for the nurse to take?

Monitor the patient's cardiac rhythm continuously.

What suffix is -mab?

Monoclonal antibody

Before administering gentamycin, it is most important for the nurse to assess the patient for a history of what?

Myasthenia gravis

A patient is receiving chemotherapy. Which laboratory result will most likely require chemotherapy to be withheld?

Neutrophil count of 375/mm3

A patient is concerned about developing AD. What should the nurse include in the teaching plan?

No solid evidence supports the use of drugs to prevent AD.

A patient is prescribed vancomycin orally for antibiotic-associated pseudomembranous colitis. The nurse will monitor the patient for what?

Ototoxicity

Vincristine [Oncovin] is prescribed for a patient with bladder cancer. The nurse will teach the patient that a common adverse effect of the medication is what?

Peripheral neuropathies

A patient is brought to the emergency department with hallucinations related to a tricyclic antidepressant overdose. The patient has hot, flushed skin and an oral temperature of 103.8°F (39.9°C). Which medication should the nurse prepare to administer as an antidote?

Physostigmine [Antilirium]

A patient who is diagnosed with BPD is prescribed lithium. To monitor for lithium toxicity, the nurse should observe the patient for which signs and symptoms?

Polydipsia, slurred speech, and fine hand tremors

A patient is prescribed a medication that causes venous dilation. It is most important for the nurse to teach the patient about what?

Postural hypotension

A patient is prescribed hydralazine. What is most important for the nurse to teach the patient?

Prevention of reflex tachycardia

What suffix is -prazole?

Proton pump inhibitor?

A patient who was prescribed an oral medication to be taken 4 times a day returns to the clinic for a follow-up visit. The patient tells the nurse that he forgets to take two or three doses of the medication each day. What is the most appropriate action that the nurse can take?

Re-educating the patient about the medication and how it should be taken

A patient is prescribed a medication that lowers the arterial blood pressure. The nurse should assess for which response by the body to restore the blood pressure?

Reflex tachycardia

A patient is prescribed digoxin [Lanoxin] and furosemide [Lasix]. It is most important for the nurse to assess which value before administering these medications?

Serum potassium

A patient is prescribed cefixime. The nurse should teach the patient to immediately report any signs of what?

Skin rash, hives, or itching

The nurse cares for a patient with a digoxin level of 1.9 ng/mL. Which action would be most appropriate for the nurse to take initially?

Start continuous heart monitoring.

The nurse knows that severe nausea and vomiting from chemotherapy are caused by what?

Stimulation of the chemoreceptor trigger zone

Which statement about superinfections does the nurse identify as true?

Superinfection is defined as a new infection that appears during the course of treatment for a primary infection.

A nurse is caring for a patient who has an infection. The healthcare provider has ordered an antimicrobial drug for the patient. The nurse understands that which of the following is the most important characteristic of this drug?

That the drug will kill the microorganism

The nurse prepares to administer the first dose of an antipsychotic agent to a patient. One hour after administration, it is most important for the nurse to assess what?

The orthostatic blood pressure measurements

A patient is to receive a scheduled dose of diltiazem [Cardizem]. The nurse should hold the medication and contact the prescriber if which of the following is noted?

The patient is in second-degree heart block.

The nurse is caring for a patient receiving intravenous gentamicin for a severe bacterial infection. Which assessment finding by the nurse indicates the patient is experiencing an adverse effect of gentamycin therapy?

Tinnitus

A patient with non-Hodgkin's lymphoma is prescribed cyclophosphamide [Cytoxan]. It is most important for the nurse to teach the patient what?

To increase fluid intake to prevent kidney damage

A patient who has been taking an opiate analgesic for chronic pain due to terminal cancer needs higher doses to produce the same pain relief as when originally prescribed. This may be an example of what?

Tolerance

The nurse is reviewing laboratory values from a patient who has been prescribed gentamicin. To prevent ototoxicity, it is most important for the nurse to monitor which value(s)?

Trough drug levels of gentamicin

Which manifestations does the nurse associate with tardive dyskinesia?

Twisting, worm-like movements of the tongue and face

The nurse prepares to administer lithium to a patient. Which laboratory result should first be assessed?

Urinary creatinine clearance

Before administering erythromycin to a patient for an upper respiratory tract infection, it is most important for the nurse to determine if the patient is also prescribed which drug?

Verapamil [Calan]

While preparing to administer medications to a patient, the nurse finds that he does not understand the rationale for the patient receiving one of the prescribed drugs. What should he do?

Verify with the prescribing healthcare provider the reason for the medication.

How should Lithium be taken?

Whole - no crushing

What is miosis?

constriction of the pupil

What is mydrasis?

pupil dilation