Pharmacology Mid Term
The nurse is providing teaching to a patient taking an oral tetracycline antibiotic. Which statement by the nurse is correct?
"Avoid direct sunlight and tanning beds while on this medication."
A patient who is diagnosed with genital herpes is taking topical acyclovir. The nurse will provide which teaching for this patient?
"Be sure to wash your hands thoroughly before and after applying this medicine.", "Use a clean glove when applying this ointment.", "You will need to avoid touching the area around your eyes.", "You will have to practice abstinence when these lesions are active."
A young adult calls the clinic to ask for a prescription for "that new flu drug." He says he has had the flu for almost 4 days and just heard about a drug that can reduce the symptoms. What is the nurse's best response to his request?
"Drug therapy should be started within 2 days of symptom onset, not 4 days."
A nurse is discussing partial versus generalized seizures with a group of nursing students. Which statement by a student indicates understanding of the teaching?
"Febrile seizures are a type of generalized tonic-clonic seizure."
A nurse counsels a patient who is to begin taking phenytoin [Dilantin] for epilepsy. Which statement by the patient indicates understanding of the teaching?
"I should brush and floss my teeth regularly."
The nurse has given medication instructions to a patient receiving phenytoin (Dilantin). Which statement by the patient indicates that the patient has an adequate understanding of the instructions?
"I will need to take extra care of my teeth and gums while on this medication."
A nurse is discussing intravenous amphotericin B treatment with a nursing student who is about to care for a patient with a systemic fungal infection. Which statement by the student indicates a need for further teaching?
"Infusions of amphotericin B should be administered over 1 to 2 hours."
When given a scheduled morning medication, the patient states, "I haven't seen that pill before. Are you sure it's correct?" The nurse checks the medication administration record and verifies that it is listed. Which is the nurse's best response?
"Let me check on the order first before you take it."
A patient is taking nystatin (Mycostatin) oral lozenges to treat an oral candidiasis infection resulting from inhaled corticosteroid therapy for asthma. Which instruction by the nurse is appropriate?
"Let the lozenge dissolve slowly and completely in your mouth without chewing it."
The patient is to receive oral guaifenesin (Mucinex) twice a day. Today, the nurse was busy and gave the medication 2 hours after the scheduled dose was due. What type of problem does this represent?
"Right time"
A patient is being discharged home on antibacterial drug therapy. What instructions should you teach the patient about allergic reactions?
"Stop taking the drug if you develop hives or a rash.", "Call 911 if you experience any difficulty breathing."
When teaching a patient about taking a newly prescribed antiepileptic drug (AED) at home, the nurse will include which instruction?
"Take the drug at the same time every day."
A patient diagnosed with human immunodeficiency virus (HIV) infection taking antiretroviral therapy appears less depressed and more talkative. The patient tells you the drugs seem to be working, and she is certain she is now cured. What are your best responses?
"Taking the drug prevents more virus from being produced.", "HIV is not currently curable, but drug therapy slows the advance of the disease."
The mother of a 6-year-old child with a skin infection asks why her child is not being treated with tetracycline as she was for a similar infection. What is your best response?
"Tetracycline can impair the development of teeth and bones in young children."
When given an intravenous medication, the patient says to the nurse, "I usually take pills. Why does this medication have to be given in the arm?" What is the nurse's best answer?
"The action of the medication will begin sooner when given intravenously."
A patient with Parkinson's disease asks the nurse why anticholinergics are used in the treatment. Which response by the nurse is most accurate?
"These drugs inhibit the action of acetylcholine."
A nurse is giving a tablet medication. The patient asks why this method is preferable for this drug. How will the nurse reply?
"This route is safer, less expensive, and more convenient."
The nurse is preparing to administer medications and notes that a patient has sucralfate ordered qid. When is the best time to administer this medication?
1 hour before meals
The nurse is planning to administer an antacid to patient diagnosed with PUD who will receive an H2 antagonist at 8am. When is the most appropriate time for the nurse to provide the antacid to the pt?
2 hours after the H2 antagonist.
The nurse administers 50 mg of a drug at 6:00 AM that has a half life of 8 hours. What time will it be when 25 mg of the drug has been eliminated from the body?
2:00 PM
A 2-year-old patient with respiratory syncytial virus is prescribed aerosolized ribavirin (Virazole). Which visitor should you ensure is not in the patient's room during the aerosol treatments?
32-year-old pregnant mother
Which drug classification would you except a patient who was just diagnosed with a duodenal ulcer to be prescribed?
A PPI
The nurse is reviewing medication errors. Which situation is an example of a medication error?
A patient receives a double dose of a medication because the nurse did not cut the tablet in half.
A nurse is preparing to administer methylnaltrexone (Relistor). This drug is appropriate for which pt?
A terminally ill pt who has opioid-induced constipation
A pt is taking linaclotide (linzess) to treat ibs. the nurse will monitor this pt for which adverse effect?
Abd pain
A laxative has been ordered for a pt. The nurse checks the pt med hx and would be concerned if which condition is present?
Abd pain of unknown origin
The nurse is assessing a patient taking lactulose to treat chronic constipation. Which adverse effect should the nurse immediately report to the health care provider?
Abd tenderness
Which instruction will the nurse include in the discharge teaching of a patient taking psyllium?
Administer with a full glass of water.
The nurse is developing a care plan for a patient who is taking an anticholinergic drug. Which human needs statement would be appropriate for this patient?
Altered urinary elimination
A patient is diagnosed with peptic ulcer disease. The patient is otherwise healthy. The nurse learns that the patient does not smoke and that he drinks 1 or 2 glasses of wine with meals each week. The nurse anticipates that the provider will prescribe which drug's?
Amoxicillin (Amoxil), clarithromycin, and omeprazole (Prilosec)
The nurse in a long term care facility is preparing to pass medications to the residents. To which of the following residents should the nurse administer an antidiarrheal?
An 80-year- old with diarrhea of sudden onset that has lasted 3 days, A 92-year old man with diarrhea secondary to inflammatory bowel disease, A 70 year old woman with hx of chronic diarrhea from GI surgery.
An older adult is admitted through the er with complaints of nausea, abd tenderness, and continual stooling. On assessment, the nurse notes abd distention, smearing of stool on undergarments, and hypoactive bowel sounds LUQ and LLQ. The pt is unable to determine when the last bowel movement was. What is the nurse's priority assessment?
An impaction
A pt has been scheduled for a routine colonoscopy. Which of the following laxatives would be most appropriate to use for preparing the colon for this procedure?
An osmotic laxative
When assessing the medication history of a patient with a new diagnosis of Parkinson's disease, which conditions are contraindications for the patient who will be taking carbidopa-levodopa?
Angle-closure glaucoma, History of malignant melanoma, Concurrent use of monoamine oxidase inhibitors (MAOIs)
A patient with gastritis asks why the health care provider rx an antacid when she has already been eating well. Which would be the best response made by the nurse?
Antacids are used to neutralize the acidity in your stomach between meal. Antacids will help to neutralize stomach acid and reduced your discomfort.
you are giving discharge instruction to a patient who will be taking an antacid for gastric problems. Which instructions should be provided to this patient?
Antacids must be taken between meals, antacids should be taken at bedtime, antacids serve as a gastric buffer, antacids can cause diarrhea.
The nurse is reviewing the mechanism of action of antidiarrheal drugs. Which type of antidiarrheal medication works by decreasing the intestinal muscle tone and peristalsis of the intestines?
Anticholinergics such as belladonna alkaloids
What types of drugs prevent or control nausea and vomiting?
Antiemetic drugs
A nurse is taking a history on a clinic patient patient who reports being constipated. Upon further questioning, the nurse learns that the patient's last stool was 4 days ago, that it was of normal, soft consistency, and that the patient defecated without straining. The patient's abdomen is not distended, and bowel sounds are present. The patient reports usually having a stool every 1 to 2 days. What will the nurse do?
Ask about recent food and fluid intake.
The oral antiviral drug acyclovir (Zovirax) has been ordered for a patient with genital herpes. What is your best action before giving this drug?
Ask the patient if he/she is lactose intolerance.
You are teaching a patient who has been prescribed dronabinol for severe nausea. What information should be included in the patient teaching plan?
Avoid drinking alcohol while taking this drug.
Which non-pharmaceutical intervention can be used to reduce symptoms of gerd?
Avoiding late-night meals, Stop smoking
Which vitamin will reduce the therapeutic effects of levodopa?
B6
You are caring for a hospitalized patient receiving gentamycin IV, an aminoglycoside, for the treatment of Pseudomonas pneumonia. Which laboratory values would be important to monitor to avoid adverse effects from drugs of this classification?
BUN and creatinine
What is the action of an antibiotic that is classified as bacteriostatic?
Bacteriostatic drugs slow the growth of bacteria.
A postoperative appendectomy pt has a nasogastric tube and wonders why the previous nurse told him that he was receiving an IV "ulcer preventing" medication called ranitidine. The pt sates that he has never had any stomach problems in his life. Which is the best response by the nurse?
Because you are not eating after surgery, this medication will help reduce the hydrochloric acid your stomach is still secreting.
The patient is receiving two different drugs. At current dosages and dosage forms, both drugs have the same concentration of the active ingredient. Which term is used to identify this principle?
Bioequivalent
Patients taking phenytoin (Dilantin) for control of seizures must be aware of the risk for which adverse effect(s)?
Blood dyscrasias, Hyperglycemia, Gingival hyperplasia, Sedation
A patient who is HIV-positive has been receiving medication therapy that includes zidovudine (Retrovir). However, the prescriber has decided to stop the zidovudine because of its dose-limiting adverse effect. Which of these conditions is the dose-limiting adverse effect of zidovudine therapy?
Bone marrow suppression
Which term refers to an antibiotic with a high degree of activity against many different organisms?
Broad-spectrum
Which is the laxative of choice for an older patient who is in the end stage of Alzheimer's disease and requires a daily laxative?
Bulk forming
Which treatment(s) would be considered safe for an infant?
Bulk forming laxatives, Malt soup extract
A patient who is diagnosed with genital herpes is taking topical acyclovir, and the nurse is providing instructions about adverse effects. The nurse will discuss which adverse effects of topical acyclovir therapy?
Burning when applied
A patient who developed vomiting has been given 10mg of prochlorperazine IM. What instructions should you provide to this patient?
Call for assistance when getting out of bed.
Which antiemetic drug class is reserved for patients with severe nausea and vomiting?
Cannabinoids
A patient has been given a prescription for levodopa-carbidopa (Sinemet) for a new diagnosis of Parkinson's disease. The patient asks the nurse, "Why are there two drugs in this pill?" The nurse's best response reflects which fact?
Carbidopa prevents the breakdown of levodopa in the periphery.
What specific problem can develop in a patient who has been rx both a 5-HT3 receptor antagonist and a phenothiazine?
Cardiac dysrhythimias
A patient allergic to penicillin is being evaluated for a gram-negative infection. Which antimicrobial drug class would the health care provider be cautious in prescribing because of a possible cross sensitivity and/or allergic reaction?
Cephalosporins
When reviewing the allergy history of a patient, the nurse notes that the patient is allergic to penicillin. Based on this finding, the nurse would question an order for which class of antibiotics?
Cephalosporins
A nurse receives an order to administer castor oil to pt. Which action by the nurse is correct?
Chill the medication and mix with fruit juice
Which factor(s) contribute(s) to the development of PUD?
Cigarette smoking, Genteics, H. pylori
During a period of time when the computerized medication order system was down, the prescriber wrote admission orders, and the nurse is transcribing them. The nurse is having difficulty transcribing one order because of the prescriber's handwriting. Which is the best action for the nurse to take at this time?
Contact the prescriber to clarify the order.
A patient is receiving digoxin (Inotropic positive effect and a Chronotropic negative effect) twice daily. When assessing the patient before giving a dose, the nurse counts a pulse of 55 beats per minute and learns that the patient is experiencing nausea. The nurse consults a drug manual and verifies that the ordered dose is correct. What should the nurse do?
Contact the prescriber to report the symptoms
A pt admitted to the hospital has a hx of peptic ulcer disease. The pt takes ranitidine (Zantac) and sucralfate (Carafate). The pt tells the nurse that discomfort is usually controlled but that sx occasionally flare up. What will the nurse do?
Contact the provider to discuss serologic testing and an antibiotic.
The nurse is discussing the use of adsorbents such as bismuth subsalicylate (Pepto-Bismol) with a patient who has diarrhea. The nurse will warn the patient about which possible adverse effects?
Dark stools and blue gums
Which effect will the nurse expect when a patient is taking psyllium while on digoxin?
Decreased absorption of the digoxin
A 30-year old male patient will begin a three-drug regimen to treat peptic ulcer disease. The regimen will consist of bismuth subsalicylate, tetracycline, and cimetidine (Tagamet). The nurse will include witch information when teaching this patient abut this drug regimen?
Decreased libido, impotence, and gynecomastia are reversible side effects.
You are caring for a pt who is taking substance P/neurokinin1 (NK1) receptor antagonist. Which lab finding would suggest the pt is experiencing and adverse reaction to this class of drugs?
Decreased wbc
The nurse is monitoring for therapeutic results of antibiotic therapy in a patient with an infection. Which laboratory value would indicate therapeutic effectiveness of this therapy?
Decreased white blood cell count
Which common adverse effect of magnesium based antacid preparations?
Diarrhea
Which symptom is the patient with a lactase deficiency most likely to exhibit?
Diarrhea
A patient is experiencing status epilepticus. The nurse prepares to give which drug of choice for the treatment of this condition?
Diazepam (Valium)
The nurse is assessing a pt with constipation. Which situation(s) would cause constipation?
Diet low in fiber and/or residue, Iron supplements, use of morphine
Which drugs would be affected by the first-pass effect when administered?
Diphenhydramine (Benadryl) elixirs, Levothyroxine (Synthroid) tablets, Esomeprazole (Nexium) capsules
The nurse is administering an amphotericin B infusion. Which actions by the nurse are appropriate?
Discontinuing the drug immediately if the patient develops tingling and numbness in the extremities, Using an infusion pump for IV therapy, Monitoring the IV site for signs of phlebitis and infiltration, Administering premedication for fever and nausea
A pt taking metoclopramide (Reglan) for the last 6 months develops uncontrolled rhythmic movement of the face, lip-smacking, and rapid or wormlike movements of the tongue. What is your best action?
Document the finding and contact the prescriber
Which laxatives may be used safely in infants?
Docusate sodium (Colace), Glycerin suppositories, Lactulose
The nurse is caring for an older adult pt after a right hip open reduction internal fixation (ORIF). The pt is taking an opioid every 6hrs as needed for pain. The nurse discusses obtaining an order from the prescriber for which medication?
Docusate sodium (colace)
An elderly patient taking a loop diuretic comes in for a routine visit. During your interview with the pt, she informs you that she frequently uses a stimulant laxative. Which of the following problems may arise from frequent laxative use?
Electrolyte imbalance
The nurse is administering medications to the patient who is in renal failure resulting from end-stage renal disease. The nurse is aware that patients with kidney failure would most likely have problems with which pharmacokinetic phase?
Excretion
When administering mineral oil, the nurse recognizes that it can interfere with the absorption of which substance?
Fat-soluble vitamins
A 6-year-old has frequent constipation. The nurse provides teaching after the parent asks why the provider recommended using laxatives only when needed. Which statement by the parent indicates a need for further teaching?
Frequent use of laxatives can cause diverticulitis.
Which are routes of drug excretion?
GI tract; feces, Urinary tract; urine, Respiratory system; exhalation
Which neurotransmitter has an inhibitory action within the central nervous system?
Gamma-aminobutyric acid
Which organism or disorder is responsible for many cases of PUD?
H. pylori
Which drug therapy is aimed at reducing gastric acid secretions?
H2 antagonist, ppi
A patient indicates during the nursing assessment that he is currently taking zidovudine (Retrovir). For which condition is the patient being treated?
HIV infection
Carbidopa-levodopa (Sinemet) is prescribed for a patient with Parkinson's disease. The nurse informs the patient that which common adverse effects can occur with this medication?
Heart palpitations, hypotension, urinary retention
A patient is receiving lactulose (Enulose) tid. The nurse knows that the patient is not constipated and is receiving this drug for which reason?
High ammonia levels due to liver failure.
Cimetidine (Tagamet) is an example of which class of drugs?
Histamine (H2) receptor antagonisit
When obtaining a patient's health history, which assessment data would the nurse identify as having the most effect on drug metabolism?
History of liver disease
A patient has been taking selegiline (Eldepryl) for a few months, and recently the prescriber increased his dose to 20 mg/day. Today, during his office visit, he tells the nurse that he forgot and had a beer with dinner last evening, and "felt awful." What did the patient most likely experience?
Hypertension
A patient will be taking bismuth subsalicylate (Pepto-Bismol) to control diarrhea. When reviewing the patient's other ordered medications, the nurse recognized that which medication or medication class will interact significantly with the Pepto-Bismol?
Hypoglycemic drugs
A patient's provider has recommended a bulk-forming laxative for occasional constipation. Which statement by the patient indicates understanding of the teaching about this agent?
I should take each dose with a full glass of water.
The nurse is instructing a patient diagnosed with GERD. Which statement by the patient indicates a need for further teaching?
I will eat small frequent meals have a snack a bedtime.
A friend reports using loperamide (Imodium) for continual diarrhea for a week since returning home from a vacation outside the country. Which is the nurse's best response?
I'd stop taking Imodium and go in to see a health care provider immediately. you may have an infection in your intestinal tract.
A patient asks the nurse about the difference between diphenoxylate with atropine (Lomotil) and the over- the-counter drug loperamide (Imodium). Which response by the nurse is correct?
Imodium does not cause physical dependence.
A patient has been treated with antiparkinson medications for 3 months. What therapeutic responses should the nurse look for when assessing this patient?
Improved ability to perform activities of daily living
Which sign(s) and symptom(s) are consistent with dehydration?
Increased hemoglobin and hematocrit, mental confusion and excessive thirst, nonelastic skin turgor and delayed capillary filling.
The U.S. Food and Drug Administration has issued a warning for users of antiepileptic drugs. Based on this report, the nurse will monitor for which potential problems with this class of drugs?
Increased risk of suicidal thoughts and behaviors
You suspect an older patient of using excessive amounts of laxatives. Which would be an appropriate intervention for this patient to help reduce chronic laxative use and dependencey?
Instruct the patient to drink six to eight glasses of water each day.
A patient has been treated with alosetron (Lotronex) for severe IBS for 2 weeks. She calls the clinic and tells the nurse that she has been experiencing constipation for 3 days. the nurse will take which action?
Instruct the patient to stop taking the drug and to come to the clinic right away to be evaluated.
A patient with Parkinson's disease is taking levodopa/carbidopa [Sinemet] along with amantadine [Symmetrel] 400 mg/day to treat dyskinesias. The patient reports having increased dyskinesias several months after beginning the amantadine. The nurse will contact the provider to discuss which action?
Interrupting treatment with amantadine for several weeks
The nurse will be injecting a drug into the superficial skin layers immediately underneath the epidermal layer of skin. Which route does this describe?
Intradermal
What is the mechanism of action of a stimulant laxative?
Irritates the intestine directly, promoting peristalsis and evacuation
A patient with PUD asks nurse about the action of prokinetic medications. Which explanation by the nurse is accurate?
It increases the lower esophageal sphincter muscle pressure and peristalsis.
A patient has been taking senna {Senokot} for several days, and the nurse notes that the urine is yellowish-brown. What does the nurse know abut this symptom?
It is an expected harmless effect of senna.
A patient with a history of chronic alcohol abuse has been admitted to the unit with cirrhosis. Upon review of the pt's lab test results, the nurse notes that the pt's ammonia level is elevated at 218 mcg/dL. What medication should the nurse prepare to administer?
Lactulose
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?
Lipid pneumonia
A patient is in the HIV clinic for a follow-up appointment. He has been on antiretroviral therapy for HIV for more than 3 years. The nurse will assess for which potential adverse effects of long-term antiretroviral therapy?
Lipodystrophy, Liver damage, Osteoporosis, Type 2 diabetes
An older pt with severe GERD has had only minimal relief using a histamine2-receptor antagonist (H2RA). The pt is to begin taking omeprazole (Prilosec). What will the nurse teach the pt?
Long term therapy may be needed.
While recovering form surgery, and elderly woman started taking a stimulant laxative, senna (Senokot) to relieve constipation caused by the pain medications. Two weeks later, at her follow-up appointment, she tells the nurse the she likes how "regular" her bowel movements are now that she is taking the laxative. Which teaching principle is appropriate for this patient?
Long-term use of laxatives often results in decreased bowel tone and may lead to dependency.
A pt is severely constipated and needs immediate relief. The nurse knows that which type of laxative will provide rapid results?
Magnesium hydroxide (MOM)
Which are potentially worrisome adverse effects associated with ppi use in older patients?
Medication interactions, Osteoporosis, vitamin and mineral deficiencies
The nurse is caring for a patient receiving palliative care with opioid induced constipation. Laxative therapy has been unsuccessful in treating this patient. Which PRN medication should the nurse provide to best alleviate this type of constipation?
Methylnaltrexone
Which medication is used in the treatment of gastric reflux esophagitis and diabetic gastroparesis?
Metoclopramide
A patient receives a drug that has a narrow therapeutic range. The nurse administering this medication will expect to do what?
Monitor plasma drug levels.
A patient who is taking NSAIDS to treat arthritis asks the nurse why misoprostol has also been rx. Which explanation by the nurse is accurate?
NSAIDs often cause GI irritation that can result in peptic ulcers
Which common drug for nausea and vomiting is a 5-HT3 receptor antagonist?
Onadansetron
A pt reports constipation. Which high-fiber foods would the nurse instruct the pt to add to his diet?
Oranges, Bran cereals, Figs
A patient with gi upset has been prescribed an antacid. What information regarding this drug classification would be appropriate to provide to the patient?
Other drugs should be taken 1hr before or 2hrs after an antacid
A patient who takes nonsteroidal anti-inflammatory drugs (NSAIDs) for arthritis asks a nurse what can be done to prevent ulcers. The nurse will recommend asking the provider about using which medication?
PPI
A patient who has advanced cancer is receiving opioid medications around the clock to keep him comfortable as he nears the end of his life. Which term best describes this type of therapy?
Palliative therapy
A patient has been taking (Metamucil) two to three times daily for several days. The patient complains of stomach pain but has not had a stool. What will nurse do?
Palpate the patients' abd and auscultate for bowel sounds.
The nurse is administering parenteral drugs. Which statement is true regarding parenteral drugs?
Parenteral drugs bypass the first-pass effect.
The nurse is performing assessment. For which patient would laxative use be contraindicated?
Patient with appendicitis.
The nurse is reviewing the dosage schedule for several different antiepileptic drugs (AEDs). Which antiepileptic drug allows for once-a-day dosing?
Phenobarbital
The parent of a child with cerebral palsy reports that the child has pebble-like stools most of the time and seems uncomfortable if several days have passed between stools. The nurse will suggest that the parent discuss which medication with the provider?
Polyethylene glycol (MiraLax)
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?
Polyethylene glycol 3350 (GoLYTELY)
A patient who has been on antibiotic therapy for 2 weeks has developed persistent diarrhea. The nurse expects which med class to be ordered to treat this diarrhea?
Probiotics
Which factors prevent breakdown of the body's normal defense barriers that protect against ulcer formation?
Prostaglandins, Mucous cells
A pt is dx with Zollinger-Ellison syndrome. Which med does the expect the provider to order for this pt?
Ranitidine (Zantac)
When the nurse assesses bowel habits in pt, which is the best example of normal bowel elimination?
Regular bowel elimination pattern of soft stool.
Which problem may occur in a patient who has started aminoglycoside therapy?
Renal damage
When taking a telephone order for a medication, which action by the nurse is most appropriate?
Repeat the order to the prescriber before hanging up the telephone.
A pt will undergo a colonoscopy, and the provider has ordered sodium phosphate as a bowel cleanser before the procedure. The nurse reviews the pts chart and notes that the pts creatinine clearance and blood urea nitrogen are both elevated. What will then nurse do?
Request an order to give polyethylene glycol and electrolytes (PEG-ELS) instead.
When assessing a patient for signs and symptoms of early respiratory depression immediately after leaving the postoperative area, the nurse will be alert for signs of what?
Restlessness, Anxiety, Lethargy
When giving medications, the nurse will follow the rights of medication administration. The rights include the right documentation, the right reason, the right response, and the patient's right to refuse. Which of these are additional rights?
Right drug, Right route, Right dose, Right time, Right patient
A patient is receiving a ribavirin (Virazole) aerosol treatment. Which precaution is important for the pregnant health care provider?
Staying out of the room during the aerosol treatment.
A patient who has had myocardial infarction is advised to avoid straining with defecation. Which medication would be prescribed to this pt?
Stool Softners
A patient is receiving morphine for pain control. What will the nurse emphasize about preventing constipation?
Stool softeners are taken on regular basis during opioid
A nursing student is caring for a pt who is taking sucralfate (Carafate) and ciprofloxacin (Cipro) to treat peptic ulcer disease. The student asks the nurse about the pharmacokinetics of sucralfate. Which statement by the student indicates a need for further teaching?
Sucralfate has a moderate-acid-neutralizing capacity
A patient who has been taking gentamicin for 5 days reports a headache and dizziness. What will the nurse do?
Suspect ototoxicity and notify the prescriber.
The nurse is providing education to a pt who has been rx both an antacid and cimetidine (Tagamet). Which instruction should the nurse give the pt about taking the meds?
Take the antacid 1 hr after the ranitidine
You are providing instruction to a pt about the use of a bulk-forming laxative for the treatment of constipation. Which statement should be included in the teaching plan for this pt.
Take this drug with a full glass of water
A patient with Parkinson's disease is taking levodopa/carbidopa [Sinemet] along with amantadine [Symmetrel] 400 mg/day to treat dyskinesias. The patient reports having increased dyskinesias several months after beginning the amantadine. The nurse will contact the provider to discuss which action?
The correct answer is: Interrupting treatment with amantadine for several weeks
During a routine appointment, a patient with a history of seizures is found to have a phenytoin (Dilantin) level of 23 mcg/mL. What concern will the nurse have, if any?
The drug level is at a toxic level, and the dosage needs to be reduced.
When administering a new medication to a patient, the nurse reads that it is highly protein bound. Assuming that the patient's albumin levels are normal, the nurse would expect which result, as compared to a medication, that is not highly protein bound?
The duration of action of the medication will be longer.
The nurse is administering one of the lipid formulations of amphotericin B. When giving this drug, which concept is important to remember?
The lipid formulations are associated with fewer adverse effects than the older drugs.
When treating patients with medications for Parkinson's disease, the nurse knows that the wearing-off phenomenon occurs for which reason?
The medications begin to lose effectiveness against Parkinson's disease.
The nurse planning patient teaching regarding drug names would include which statement(s)?
The official name is the name under which the drug is listed by the U.S. Food and Drug Administration (FDA)., Brand names are easier to pronounce, spell, and remember., The first letter of the generic name is not capitalized.
Phenytoin (Dilantin) has a narrow therapeutic index. The nurse recognizes that this characteristic indicates which of these?
The safe and the toxic plasma levels of the drug are very close to each other.
The nurse is reviewing pharmacology terms for a group of newly graduated nurses. Which sentence defines a drug's half-life?
The time it takes for one half of the original amount of a drug to be removed from the body
Which are important nursing considerations when administering prokinetic agents?
These agents are used to treat esophagitis's associated with gastric reflux, They are used to treat GERD when lifestyle changes and diet are ineffective, They may be useful in treating nausea associated with chemotherapy treatment, They may be administered intravenously.
What information about ppi is correct?
These drugs can cause dizziness, these drugs can increase the risk for osteoporosis. These drugs heal ulcer by reducing acid in the stomach.
When administering a bulk-forming laxative the nurse instructs the pt to drink the medication mixed in a full ounce glass of water. Which statement best explain the rationale for this instruciton?
These laxatives may cause esophageal obstruction if taken with insufficient water.
A patient with peptic ulcer who has been prescribed sucralfate asks you to explain how this drug works to heal the ulcer. What is the best response?
This drug works by providing a protective layer over the ulcer.
A patient taking entacapone (Comtan) for the first time calls the clinic to report a dark discoloration of his urine. After listening to the patient, the nurse realizes that what is happening in this situation?
This is a harmless effect of the drug.
Which instruction by the nurse will assist in the patient's understanding of lactulose, an osmotic laxative?
This medication draws water into the intestine and stimulates defacation.
The health care provider has prescribed penicillin and probenecid for a patient with a sexually transmitted disease. What is the purpose of combining these medications?
To inhibit the excretion of the penicillin
The nurse is administering an antibiotic intravenously. Which blood level determines the lowest amount of medication present in the patient?
Trough
A pt stops taking PPI after 6 weeks of therapy for treatment of peptic ulcer disease. The pt reports symptoms of dyspepsia to the nurse. The nurse will tell this pt to:
Try an antacid to see whether it relives these symptoms.
The patient is experiencing chest pain and needs to take a sublingual form of nitroglycerin. Where does the nurse instruct the patient to place the tablet?
Under the tongue
The nurse is reviewing the uses of oral laxatives. Which conditions are general contraindications to or cautions about the use of oral laxatives?
Undiagnosed abd pain, nausea and vomiting, Fecal impaction, Acute surgical abd
The nurse can prevent medication errors by following which principles?
Use two patient identifiers before giving medications., Always following the rights of medication administration., Minimize the use of verbal and telephone orders.
What is the drug of choice when treating a generalized tonic clonic seizure?
Valproic acid (Depakene)
A patient has an invasive aspergillosis infection. Which antifungal agent is the drug of choice for this infection?
Voriconazole [Vfend]
A patient will be taking bismuth subsalicylate (Pepto-Bismol) to control diarrhea. When reviewing the patient's other ordered medications, the nurse recognizes that which medication will interact significantly with the Pepto-Bismol?
Warfarin (coumadin), an anticoagulant
A patient who has gerd receives a rx for a ppi medication. What will the nurse include when teaching the patient about this drug?
You should report any fever and cough to your provider
The nurse is providing counseling to a woman who is HIV positive and has just discovered that she is pregnant. Which anti-HIV drug is given to HIV-infected pregnant women to prevent transmission of the virus to the infant?
Zidovudine (Retrovir)
A patient newly diagnosed with PUD reports taking low-dose aspirin (ASA) for prevention for cardiovascular disease. The nurse learns that the pt drinks 2 to 3 cups of coffee each day and has a glass of wine with dinner 3 or 4 nights per week. The pt eats three meals a day. The nurse will counsel this pt to:
change the meal pattern to five or six smaller meals per day.
A pt rx metoclopramide (Reglan) reports having difficulty sleeping, difficulty concentrating, tiredness, and feeling hopeless. What is your best action?
hold the drug and notify the prescriber
A recent campaign, initiated by the Centers for Disease Control (CDC), to delay the emergence of antibiotic resistance in hospitals, has what as one of its objectives?
ncreased adherence to prescribed antibiotics
A pt is admitted with lower abd pain and nausea. The nurse performing the initial assessment notes that the pt abd is distended and firm, and hypoactive bowel sounds are present. The pt has not had a stool for 3 days. The nurse will contact the provider, who will:
perform a diagnostic test.
A pt with renal disease is scheduled for a colonoscopy. Before the procedure, the nurse will anticipate administering:
polyethylene glycol and electrolytes
The nurse is discussing dietary and lifestyle changes with a pt diagnosed with GERD. When reviewing necessary modifications, the nurse will include information regarding?
smoking cessation, avoiding NSAIDs, using nonfat milk
A pt reports taking an oral bisacodyl laxative (Dulcolax) for several years. The provider has suggested d/c the laxative, but the pt is unsure how to do this. The nurse will tell the pt to:
stop taking the laxative immediately and expect no stool for several days.
A patient taking misoprostol (Cytotec) to treat a gastric ulcer reports recurrent diarrhea. The nurse should encourage this patient to:
take medication with meals
What problems may a pt with nausea and vomiting be at risk for?
weight loss, dehydration, electrolyte imbalance