Pharmacology Final Exam Fall 2022

5) When monitoring a patient who is on immunosuppressant therapy, the nurse knows that the drug may need to be discontinued if the leukocyte count drops below _____/mm3. A. 3000 B. 5000 C. 10,000 D. 15,000.

ANS: A: 3000 Laboratory studies should be performed monthly. If the leukocyte count should drop below 3000/mm3, the drug should be discontinued after the prescriber is notified

4) A 30-year-old woman is in the clinic for her yearly gynecologic exam and asks the nurse about the "new vaccine that prevents HPV." She wants to receive the papillomavirus vaccine (Gardasil). Which response by the nurse is most appropriate? (priority) A. "Unfortunately, this vaccine is recommended for women aged 13 to 26 years." B. "We will need to make sure you are not pregnant first." C. "There will be a total of three injections." D. "I will check with your doctor then get the first dose of the vaccine ready."

ANS: B We will need to make sure you are not pregnant first. It is important to make sure that a patient receiving Gardasil is not pregnant and that the patient knows that there are a total of three injections. The Gardasil 9 vaccine is approved for women and men up to age 45, though not recommended after age 26. The CDC guidelines recommend the vaccine for women aged 13 to 26 years and for girls aged 11 to 12 years. While the vaccine is safe, it is unlikely to provide much, if any, benefit as people get older.

A 72-year-old patient is to receive a pneumococcal vaccine, polyvalent (Pneumovax 23). The nurse recognizes that which of the following statements about this vaccine is true? A. It is given yearly to provide immunization against current strains of pneumococcal bacteria. B. It is given by deep intramuscular injection. C. It is given by subcutaneous injection. D. The patient will have to return for a total of three injections

ANS: B or C Administer PNEUMOVAX 23 intramuscularly or subcutaneously into the deltoid muscle or lateral mid-thigh. Do not inject intravascularly or intradermally, and administer only once.

6) Cyclosporine is prescribed for a patient who had an organ transplant. The nurse will monitor the patient for which common adverse effect? A. Nausea and vomiting B. Chills and tremors C. Chest pain D. Hypertension

ANS: D: Hypertension Moderate hypertension may occur in as much as 50% of patients taking cyclosporine. The other options are potential adverse effects of other immunosuppressant drugs.

A patient must be treated immediately for acute organ transplant rejection. The nurse anticipates that muromonab-CD3( Orthodone OKT3) will be ordered. What is the priority assessment before beginning drug therapy with muromonab- CD3? a) Serum potassium level b) Fluid volume status c) Electrocardiogram d) Blood glucose level

b) Fluid volume status

When administering eyedrops for glaucoma, the nurse understands the desired drug effect causes: a) Increased intraocular pressure b) decreased intraocular presssure c) reduced cytoplegia d) decreased inflammation

b) decreased intraocular pressure

The antidiarrheal drug Lomatil contains both diphenoxylate, a synthetic opiate agonist, and atropine, an anticholinergic. The purpose of the atropine in this combination is to: a) enhance the effects of the diphenoxylate b) discourage recreational use of the opiate diphenoxylate c) counteract the adverse effects of the diphenoxylate d) act as an absorbent for bacteria in the bowel

b) discourage recreational use of the opiate diphenoxylate

Which antiglaucoma drug works by increasing the outflow of aqueous humor between the uvea and sclera as well as the usual exit through the trabecular meshwork? a) Prostaglandins b) Osmotic diuretics c) Carbonic anhydrase inhibitors d) Opthalmic beta blockers

b) osmotic diuretics

Parents of a client tell the nurse that they want their child to receive scheduled vaccines, but that they are concerned because their friends say that children are always very irritable after they receive vaccines. The nurse teaches the patients to: a) Ensure that the child is adequately hydrated before the vaccines b) Provide acetaminophen( Tylenol) before and every 4 hours after vaccination is needed c) Use diphenhydramine( Benadryl) t relax the child before the vaccine d) Allow the child to be vaccinated only when fully without signs of infection

b) provide acetaminophen( Tylenol) before and every 4 hours after vaccination is needed

When administering medications, the nurse finds a patient's eardrops in the medication refrigerator. If the nurse gives the eyedrops immediately, what response might the patient have? a) No unusual response b) Immediate relief of ear discomfort c) A Vestibular type reaction d) Increased ear pain

c) A vestibular type reaction

Which of the following is not a useful application of radionuclide imaging? a) Assessing thyroid disease or enlargement b) Screening for metastases in clients with diagnosed malignancies c) Evaluating gestational progress in complicated pregnancies d) Evaluating heart disease

c) Evaluating gestational progress in complicated pregnancies

A 48 year old pt has been admitted with abdominal pain, and states that she has not had a bowel movement in four days. Her abdomen is distended and slightly tender. Which laxative would be appropriate for the patient? a) Milk of magnesia b) A bulk forming laxative c) Mineral oil d) No laxative should be given at this time

c) Mineral oil- faster acting than milk of mag and bulk forming laxative

A foreign particle is removed from the patient's eye. He tells the nurse that he previously forgot to mention that he takes eyedrops for glaucoma. He can't remember the name o the drug, but he knows the eyedrop bottle has a purple lid. The nurse identifies a purple lid as most likely containing which type of antiglaucoma drug? a) Direct- acting cholinergic b) Sympathomimetics c) Prostaglandin agonist d) Carbonic anhydrase inhibitor

c) Prostaglandin agonist

Gentle massage of the tragus area of the ear after administering eardrops results in: a) decreased absorption of the medication b) softening of the cerumen in the ear canal c) Increased coverage of the medication in the ear canal d) reduced pain in the ear

c) increased coverage of the medication in the ear canal

When administering eyedrops to a patient, the nurse places the drop: a) directly onto the cornea b) in the lower canthus c) into the lower conjunctival sac d) onto the sclera

c) into the lower conjunctival sac

2 A patient receiving tetrahydrozoline asks how the drug works. The best response by the nurse will include that the drug works by: a) pulling fluid from the eye tissue to the blood stream. b) decreasing the amount of fluid produced by the eye. c) promoting vasoconstriction of blood vessels in and around the eye. d) causing the pupil to constrict.

c) promoting vasoconstriction of blood vessels in and around the eye

A patient receiving tetrahydrozoline asks how the drug works. The best response by the nurse will include that the drug works by: a) Pulling fluid from the eye tissue to the blood stream b) Decreasing the amount of fluid produced by the eye c) promoting vasoconstriction of blood vessels in and around the eye d) causing the pupil to constrict

c) promoting vasoconstriction of blood vessels in and around the eye

A patient is receiving lactulose four times a day but does not have a history of constipation. In fact, he has had several bowel movements every day. what is the reason for the lactulose? a) Cleansing the bowel before a procedure. b) Removal of helminths c) Reduction of high ammonia levels associated with liver failure d) Daily maintenance to prevent constipation

c) reduction of high ammonia levels associated with liver failure

The most commonly identified substances that are accidentally ingested by children who are younger than six years are: a) Pesticides b) Gasoline c) Paints d) Cosmetics

d) Cosmetics

When teaching an adult patient about eardrops, which statement will the nurse include? a) Hold your ear down and back to instill the drops. b) If you feel dizzy after instilling the ear drops, stand up and walk around the room. c) Warm the ear drops up for 30 seconds in the microwave before using them. d) Lie on the opposite side of that of your affected ear for about 5 minutes after instilling the drug.

d) Lie on the opposite side of that of your affected ear for about five minutes after instilling the drug

The ophthamologist tells the patient that she is going to place a dye onto the patient's eye to help identify the location of the foreign object. Which drug does the nurse anticipate the ophthamologist will use? a) olopatadine( Patadol) b) cromolyn sodium( Crolom c) tetrahydrozaline d) fluorescein(AK-Fluor)

d) fluorescein( AK-Fluor)

Some practitioners recommend that patients who take cyclosporine also drink grapefruit juice to increase blood levels of the cyclosporine. True or false

False; you do not want to take grapefruit juice for this

2. Which of the following is the currently preferred method of sterilization of items used during procedures requiring surgical asepsis? 1. Autoclaving 2. Ethylene oxide gas 3. Hot air ovens 4. Chemical sterilants

1. Autoclaving Several acceptable and practical sterilization methods now exist. Steam under pressure (autoclaving) is preferred as the most effective method. Ethylene oxide is a gas sterilant used for heat-labile materials, sharp-edged instruments that could be dulled by steam, electrical and anesthesia equipment, and bedding. Hot air ovens are used to sterilize glassware. Chemical sterilants are also used when necessary.

4 A 2-year-old is seen in the pediatrician's office with a bacterial middle ear infection. Which medication does the nurse anticipate being prescribed for the child? 1. amoxicillin 2. Cortic 3. carbamide peroxide (Debrox) 4. Acetasol HC

1. amoxicillin

At birth, the nurse prepares to administer which immunization to the neonate? a) Hep A b) Hep B c) Dtap d) IVP

2) Hep B

A patient is experiencing graft rejection. Which medication will he receive to reverse this problem? 1) Azathioprine( Imuran) 2) Mucomonab- CDE ( Orthoclone OKI3) 3) basiliximab( Simulect) 4) No medications can reverse graft rejection

2) Mucomonab- CDE ( Orthoclone OK13)

5. The nurse is aware that which of the following drugs is no longer currently used to minimize an adverse effect of a radiopaque agent containing iodine? 1. Prednisone 2. Ephedrine 3. Diphenhydramine 4. Ranitidine

2. Ephedrine For clients with a history of iodine hypersensitivity and those with a generally positive allergy history, pretreatment with prednisone, diphenhydramine (Benadryl), and an H2 blocker has minimized the incidence of a severe reaction (e.g., bronchospasm, shock) to less than 1%.

Which potential problem is of most concern for the patient receiving immunosuppressant drugs? 1) Orthostatic hypotension 2) Increased susceptibility to infection 3) Neurotoxicity 4) Peripheral edema

2. Increased susceptibility to infection

7. Nurses may be confronted with childhood poisonings in many ways. Clues to poisoning typically include which of the following? 1. Decreased sweating 2. Severe nausea and vomiting 3. Constipation 4. Polyuria

2. Severe nausea and vomiting Clues that typically point to poisoning include sudden, violent symptoms of severe nausea, vomiting, diarrhea, collapse, or seizures.

1. The nurse understands that which of the following nosocomial infections pose the highest risk for clients admitted to the hospital? 1. Urinary tract and respiratory infections 2. Wound and urinary tract infections 3. Respiratory and wound infections 4. Urinary tract and skin infections

2. Wound and urinary tract infections Urinary tract infections and postoperative wound infections account for the majority (approximately 70% or more) of the nosocomial infections detected in a hospital setting.

A patient who has had a kidney transplant is receiving cyclosporine PO in maintenance doses. What action would decrease the potency of this drug? 1. Taking it with orange juice 2. Taking it with milk 3. Using a Styrofoam container to administer the drug 4. Mixing it with chocolate milk

3) Using a Styrofoam container to administer the drug

6 While administering medications, the nurse finds a patient's eardrops in the medication refrigerator. If the nurse gives the eardrops immediately, what response might the patient have? 1. No unusual response 2. Immediate relief of ear discomfort 3. A vestibular-type reaction 4. Increased ear pain

3. A vestibular-type reaction

4. Which of the following is not a useful application of radionuclide imaging? 1. Assessing thyroid disease or enlargement 2. Screening for metastases in clients with diagnosed malignancies 3. Evaluating gestational progress in complicated pregnancies 4. Evaluating heart disease

3. Evaluating gestational progress in complicated pregnancies. Radionuclide images are used to make inferences about organ disorders and the body's ability to absorb, metabolize, or excrete substances. It is not used during pregnancy.5. The nurse is aware that which of the following drugs is no longer currently used to minimize an adverse effect of a radiopaque agent containing iodine?1. Prednisone2. Ephedrine3. Diphenhydramine4. Ranitidine

7 .Gentle massage of the tragus area of the ear after administering eardrops results in 1. decreased absorption of the medication 2. softening of the cerumen in the ear canal 3. increased coverage of the medication in the ear canal 4. reduced pain in the ear

3. increased coverage of the medication in the ear canal

3. When administering eyedrops to a patient, the nurse places the drop 1. directly onto the cornea. 2. in the inner canthus. 3. into the lower conjunctival sac. 4. onto the sclera.

3. into the lower conjunctival sac

6. The most commonly identified substances that are accidentally ingested by children who are younger than 6 years are 1. pesticides 2. gasoline 3. paints 4. cosmetics.

4. Cosmetics Among children younger than 6 years, cosmetics and personal care products are the most frequent poison exposures.

5. When teaching an adult patient about eardrops, which statement will the nurse include?l 1. "Hold your ear down and back to instill the drops." 2. "If you feel dizzy after instilling the ear drops, stand up and walk around the room." 3. "Warm the ear drops up for 30 seconds in the microwave before using them." 4. "Lie on the opposite side of that of your affected ear for about 5 minutes after instilling the drug."

4. Lie on the opposite side of that of your affected ear for about five minutes after instilling the drug.

8. Which of the following conditions would contraindicate gastric lavage? 1. Central nervous system poison ingestion 2. Age older than 60 years 3. Sedative accidental poisoning 4. Presence of cardiac dysrhythmias

4. Presence of cardiac dysrhythmias Gastric lavage involves washing out the stomach with sterile water or a saline solution. It is generally reserved for large, potentially life-threatening ingestions and for substances not absorbed by charcoal. Lavage may be contraindicated in the presence of cardiac dysrhythmias

5. A patient is about to undergo a diagnostic bowel procedure. The nurse expects which drug to be used to induce total cleansing of the bowel? A. polyethylene glycol (GoLYTELY) B. docusate C. mineral oil D. milk of magnesia

A. polyethylene glycol( GoLYTELY)

The nurse is reviewing principles of immunity. What type of immunity occurs when the body is exposed to a relatively harmless form of an antigen, which imprints this information on the body's memory bank and stimulates the body's defenses to resist any subsequent exposures? A. Artificial active immunity B. Attenuating immunity C. Naturally acquired passive immunity D. Artificially acquired passive immunity

A. Artificial active immunity Artificial active immunity causes an antigen-antibody response and stimulates the body's defenses to resist any subsequent exposures. Passive immunity is conferred by bypassing the host's immune system and injecting the person with antiserum or concentrated antibodies obtained from other humans or animals; this gives the host direct means of fighting off an invading microorganism. The host's immune system therefore does not have to manufacture these antibodies. This process also occurs when antibodies pass from mother to infant during breast-feeding or through the placenta during pregnancy (natural passive immunization).

4. A patient will be taking bismuth subsalicylate (Pepto-Bismol) to control his diarrhea. When reviewing the patient's other ordered medications, the nurse recognizes that which medication will interact significantly with the Pepto-Bismol? A. digoxin (Lanoxin) B. Antacids C. acetaminophen (Tylenol) D. Tricyclic antidepressants

B. antacids

1. The nurse is providing teaching to a patient who will be taking the laxative docusate (Bisocodyl). Which statement by the nurse is appropriate during this teaching session? A. "The tablets may be crushed to improve action." B. "The tablets should be taken with water." C. "Do not take laxatives if you are experiencing vomiting or abdominal pain." D. "In a normal bowel pattern, a bowel movement occurs daily."

C. "Do not take laxatives if you are experiencing vomiting or abdominal pain.

3. When administering a bulk-forming laxative, the nurse instructs the patient to drink the medication mixed in a full 8-ounce glass of water. Which statement best explains the rationale for this instruction? A. There will be fewer systemic effects. B. The water will help to reduce the bulk of the intestinal contents. C. These laxatives may cause esophageal obstruction if taken with insufficient water. D. The water acts as a lubricant to produce bowel movements.

C. These laxatives may cause esophageal obstruction if taken with insufficient water.

A housekeeper has experienced a needlestick by a contaminated needle that was placed in a trash can. The nurse expects that which drug will be used to provide passive immunity to hepatitis B infection for this housekeeper? A. Hib vaccine B. Varicella virus vaccine (Varivax) C. Hepatitis B immunoglobulin D. Recombivax HB

C. Hepatitis B immunoglobulin Recombivax HB promotes active immunity to hepatitis B infection in people who are considered to be at high risk for potential exposure to the virus, whereas hepatitis B immunoglobulin provides passive immunity for the prophylaxis and postexposure treatment of people exposed to hepatitis B virus or HBs-Ag-positive materials, such as blood, plasma, or serum.

2. The nurse is giving oral mineral oil as an ordered laxative dose. The nurse will take measures to prevent which potential problem that may occur with mineral oil? A. Fecal impaction B. Constipation C. Lipid pneumonia D. Esophageal blockage

C. Lipid pneumonia

Newborns receive immuniites during breastfeeding. This is known as: a) Natural, passive immunity b) Acquired, passive immunity c) Natural, active immunity d) Acquired, active immunity

Can be both 1 and 2. Either or is ok. Natural passive immunity and/ or acquired passive immunity

A physically and medically neglected 15-month-old child has been placed in foster care. The foster parents bring the child to the clinic for immunization updates. They have no idea what, if any, vaccines the child has previously received. The nurse anticipates administering which vaccines? a) No vaccines; assume the child is up to date b) DTaP #4, Hib #4, and MMR #1 c)MMR, IPV, PCV, hepatitis B, and varicella d)DTaP, Hib, hepatitis B, MMR, IPV, PCV, and varicella

If unsure, give : d) DTAP, Hib, hepatitis B, MMR, IPV, PCV, and varicella

M, age 68, has renal insufficiency and tells you that he often uses milk of magnesia for quick relief of constipation. Is there a concern? Explain your answer.

Magnesium- can build up, and he will not be able to get rid of it. He should avoid magnesium based products.

T has been on warfarin therapy for 2 years and is having severe diarrhea while on a visit to another country. She has a bottle of Pepto- Bismol and a packageof loperamide( Imodiumm). Which should she choose, if any?

Loperamide is better b/c Pepto runs the risk of causing bleeding in people on anticoagulants.

C., age 19, is experiencing severe abdominal pain and nausea, and has vomited twice. Her mother wants to give her a laxative to "clean her out." Should she do this?

We need to figure out what is causing the N/V. This will only lead to more dehydration, electrolyte problems in the future.

A 2 year old is seen in the pediatrician's office with a bacterial middle ear infection. Which medication does the nurse anticipate being prescribed by the child? a) Amoxicillin b) Cortic c) Carbamide peroxide( Debrox) D) Acetasol HC

a) Amoxicillin

Considering appropriate technology, the hospital nurse would use an antiseptic to clean which of the following: a) A patient's skin b) An overhead bead c) An intravenous pole d) A medication infusion pump

a) Patient's skin

After administering an ophthalmic anesthetic drug, which adverse effect does the nurse anticipate as possibly developing in the patient( select all that apply): a) Stinging b) Burning c) Redness d) Lacrimination e) Blurred vision

a) Stinging, b) Burning, and c) Redness

A 60 year old male with a history of benign prostatic hypertrophy and hypertension is seen in the ED because he was trimming his shrubs and got something in his right eye. He complains of a pain rating of 8 on a scale of 1 to 10 n the right eye. Which medication does the nurse anticipate administering via eyedrop to help control the patient's pain? a) Tetracaine b) Atropine c) Morphine d) Lidocaine

a) Tetracaine

1 Which statement about use of corticosteroids for ocular inflammation does the nurse identify as being true? a) They are used during the acute phase of the injury process to prevent fibrosis and scarring, which result in visual impairment. b) Corticosteroids produce a lesser immunosuppressant effect than the NSAIDs. c) They are used for the treatment of minor abrasions and wounds of the eye. d)Use of corticosteroids for ocular inflammation results in discoloration of the iris.

a) They are used during the acute phase of the injury process to prevent fibrosis and scarring, which result in visual impairment.

Which statement about use of corticosteroids for ocular inflammation does the nurse identify as being true? a) They are used during the acute phase of the injury process to prevent fibrosis and scarring, which results in visual impairment. b) Corticosteroids produce a lesser immunosuppressant affect than the NSAIDS c) They are used for the treatment of minor abrasions and wounds of the eye d) Use of corticosteroids for ocular inflammation results in discoloration of the iris

a) They are used during the acute phase of the injury process to prevent fibrosis and scarring, which results in visual impairment

3. Considering appropriate terminology, the hospital nurse would use an antiseptic to clean which of the following? 1. A client's skin 2. An overbed table 3. An intravenous pole 4. A medication infusion pump

a. A client's skin Disinfectants differ from antiseptics in the matter on which they are used and in their ability to destroy organisms. Disinfectants are used only on nonliving objects; they are toxic to living tissue. Antiseptics are typically applied only to living tissue; they must be less potent or made more dilute to prevent cell damage.

A person can be addicted to laxatives.

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