ATI MUSCULOSKELETAL PHARMACOLOGY
32. Prior to administering an oral dose of neostigmine (Prostigmin), a cholinesterase inhibitor, to a patient who has myasthenia gravis, you should check for which of the following?
a. Abdominal distention b. Ability to swallow c. Excessive oral secretions d. Presence of bowel sounds B) Ability to swallow
14. When treating a patient who has malignant hyperthermia, the health care professional should do which of the following? (Select all that apply)
a. Administer a depolarizing neuromuscular blocking agent b. Provide cooling measures c. Administer dantrolene (Dantrium) d. Discontinue anesthesiae. Reduce the IV fluid infusion rate B, C, D
10. A health care professional is preparing to administer neostigmine (Prostigmin) to a patient who has myasthenia gravis. Knowing the adverse effects of neostigmine, which of the following drugs should the health care professional have ready to administer?
a. Atropine (AtroPen) b. Lidocaine (Xylocaine) c. Epinephrine (Adrenalin) d. Naloxone A) Atropine (AtroPen)
6. A health care professional is caring for a patient who is about to begin methotrexate therapy for rheumatoid arthritis. The health care professional should include which of the following information? (Select all that apply)
a. Avoid people who are sick b. Periodic laboratory tests are essential c. The drug's effects are immediate d. Report bruising or petechiaee. Avoid drinking alcohol A, B, D, E
3. Which of the following is a therapeutic action of raloxifene (Evista)?
a. Blocks the effects of estrogen on endometrial tissue b. Mimics the effects of estrogen on bone tissue c. Stimulates secretion of parathyroid hormone d. Stimulates menstruation B) Mimics the effects of estrogen on bone tissue
37. The health care provider prescribes alendronate (Fosamax) to reduce bone resorption and instructs the patient to monitor for which of the following indications of a serious adverse effect of this drug?
a. Calf inflammation b. Chest pain c. Dizziness d. Dysphagia D) Dysphagia
1. Prior to administering calcitonin-salmon (Miacalcin) for the first time to a patient who is diagnosed with postmenopausal osteoporosis, the health care profession should perform which of the following tasks?
a. Check urine for sedimentation b. Assess liver function c. Check for allergies using skin testing d. Evaluate breath sounds C) Check for allergies using skin testing
15. A health care professional is caring for a patient who has myasthenia gravis and has been prescribed neostigmine (Prostigmin) to increase muscle strength. The health care professional should tell the patient to watch for which of the following as an indication of a serious adverse reaction to the drug?
a. Constipation b. Bradycardia c. Edema d. Fever B) Bradycardia
20. A health care professional is caring for a patient who is taking alendronate (Fosamax) to treat postmenopausal osteoporosis. The health care professional should explain to the patient that alendronate increases bone mass by which of the following actions?
a. Decreases activity of osteoclasts b. Increases calcium excretion c. Promotes intestinal absorption of calcium and phosphorus d. Reduces action of osteoblasts A) Decreases activity of osteoclastS
26. A patient is prescribed methotrexate for rheumatoid arthritis. Knowing the adverse effects of methotrexate, you should advise the patient to monitor for which of the following?
a. Dysphagia b. Sore throat c. Edema d. Paresthesia B) Sore throat
13. A health care professional is caring for a patient who is taking etanercept (Enbrel), a DMARD II that treats rheumatoid arthritis. The health care professional should monitor the patient for which of the following indications of a serious adverse reaction to the drug?
a. Excessive salivation b. Increased thirst c. Blood in the urine d. Shortness of breath D) Shortness of breath
33. A patient with rheumatoid arthritis is taking methotrexate. Toxicity from methrotrexate may be reduced with which of the following?
a. Folic acid b. Magnesium sulfate c. Ferrous sulfate d. Niacin A) Folic acid
16. A health care professional is preparing to administer neostigmine (Prostigmin) to a patient. Which of the following information in the patient's health history should alert her to use caution when administering neostigmine?
a. Glaucoma b. Thrombocytopenia c. Hepatitis d. Asthma D) Asthma
9. Alendronate (Fosamax) is contraindicated for patients who
a. Have heart failure b. Are allergic to fish protein c. Should remain flat on bed rest d. Have TB C) Should remain flat on bed rest
28. A patient is given raloxifene (Evista), a selective estrogen receptor modulator (SERM), to treat osteoporosis. Which of the following is an adverse effect of raloxifene (Evista)?
a. Hot flashes b. Breast cancer c. Blurred vision A) Hot flashes
5. A health care professional should recognize that depolarizing muscle relaxants, such as succinylcholine (Anectine), require cautious use with patients who have which of the following? (Select all that apply)
a. Hyperkalemia b. Myasthenia gravis c. Renal calculi d. Bowel obstructione. Respiratory depression A, B, E
31. The primary care provider prescribes calcitonin salmon (Miacalin) for a patient. Knowing the adverse effects of calcitonin, you should instruct the patient to do which of the following?
a. Increase fluid intake b. Rise slowly from a reclining position c. Increase calcium intake d. Wear sunscreen and protective clothing C) Increase calcium intake
2. A health care professional is caring for a patient who is taking raloxifene (Evista). Which of the following information should the heath care professional include? (select all that apply)
a. Increase self-breast examinations to two times per month b. Increase activity, such as walking c. Use a contraceptive if there is any risk of pregnancy d. Take the drug on an empty stomach. Increase intake of calcium and vitamin D *B: walking reduces the risk of DVT and may increase bone density C: Preggers, E: Calcium and Vit D increase bone mass
23. A health care professional should tell a patient who is taking alendronate (Fosamax) to monitor for which of the following adverse effects? (Select all that apply)
a. Jaw pain b. Drowsiness c. Blurred vision d. Tinnituse. Muscle pain A Jaw Pain (osteonecrosis), C Blurred Vision (occular inflammation), E Muscle Pain (muscoloskeletal pain)
19. A health care professional should question the use of etanercept (Enbrel) for a patient who has a history of diabetes mellitus because which of the following risks?
a. Kidney toxicity b. Infection c. Gout d. DVT B) Infection
8. A health care professional is caring for a patient who is beginning raloxifene (Evista) therapy to prevent osteoporosis. The health care professional should tell the patient to monitor for which of the following as an indication of a serious adverse reaction to the drug?
a. Loss of hair b. Numbness of the fingertips c. Calf pain d. Blisters on mucous membranes C) Calf pain
21. A health care professional is caring for a patient who has given succinylcholine (Ancectine), a depolarizing neuromuscular blocker, during a surgical procedure. The patient develops rigid muscles, tachycardia, and a sudden spike in temperature. The health care professional should immediately suspect which of the following?
a. Malignant hyperthermia b. Neuroleptic malignant syndrome c. Toxic epidermal necrolysis d. Stevens-Johnson Syndrome A) Malignant hyperthermia
34. Which of the following information in the patient's history causes the health care provider to suspect the patient has osteoporosis? (select all that apply)
a. Menopause b. Calcium supplements c. Long-term corticosteroid use e. Weight Loss of height A, C, E
17. A health care professional should tell a patient who is taking methotrexate to monitor for which of the following?
a. Muscle pain b. Peripheral edema c. Black, tarry stools d. Redness in the calf C) Black, tarry stools
29. You are admitting a patient who is awake postoperatively but shows signs of muscle weakness. The patient was given pancuronium in the surgical suite. You should prepare to administer which of the following drugs to reverse the effects of pancuronium?
a. Naloxone b. Neostigmine (Prostigmin) c. Succinylcholine (Anectine) d. Dantrolene (Dantrium) B) Neostigmine (Prostigmin)
7. A health care professional is caring for a patient who is postoperative and who demonstrates weakness and needs mechanical ventilation. The patient received pancuronium during the surgery. The health care professional should suspect prolonged paralysis from a drug interaction with which of the following?
a. Neostigmine (Prostigmin) b. Atropine (AtroPen) c. Dantrolene (Dantrium) d. Gentamicin D) Gentamicin
27. A patient is prescribed etanercept (Enbrel) to treat rheumatoid arthritis. Prior to beginning the treatment, the patient should be tested for which of the following?
a. Pancreatitis b. Hepatitis c. Tuberculosis d. Gastritis C) Tuberculosis
30. When administering succinylcholine (Anectine) for relaxation during a surgical procedure, you should remember that succinylcholine
a. Provides analgesia b. Causes sedation c. Blocks respiratory muscles d. Reduces anxiety C) Blocks respiratory muscles
11. A health care professional is caring for a patient who is taking calcium supplement and reports flank pain. The health care professional should suspect the patient has which of the following?
a. Renal calculi b. Pancreatitis c. Liver disease d. Hip fracture *A) Renal calculi (Flank Pain is the area of the kidneys)
22. A health care professional is caring for a patient who is to begin taking calcitonin-salmon (Miacalcin) intranasal spray to treat osteoporosis. Which of the following information should the health care professional include? (Select all that apply)
a. Report rash or itching b. Deliver two sprays to each nostril c. Prime the pump d. Report nasal irritatione. Hold the pump horizontally A, C, D
12. A health care professional is administering succinylcholine (Anectine) to a patient. Which of the following information is correct regarding depolarizing neuromuscular blocking agents?
a. Reverses with a cholinesterase inhibitor, such as neostigmine (Prostigmin) b. Causes muscle paralysis by binding with cholinergic receptors at the neuromuscular junction c. Prevents the nerve from depolarizing and the skeletal muscle from contracting d. Blocks acetylcholine from binding with cholinergic receptors at the motor endplate B) Causes muscle paralysis by binding with cholinergic receptors at the neuromuscular junction
36. The health care provider instructs the patient about the importance of taking the prescribed 1500 mg/day dosage of calcium carbonate (Tums). Which of the following instructions should the health care provider recommend?
a. Set up a simple reminder system b. Take the three tablets at the same time c. Reduce fluid intake to increase effectiveness d. Take the drug with meals to reduce gastric irritation A) Set up a simple reminder system
25. A health care professional should tell a patient who is taking etanercept (Enbrel) for rheumatoid arthritis to report which of the following?
a. Skin rash b. Tinnitus c. Diarrhea d. Dysphagia A) Skin rash
18. A health care professional is caring for a patient who is taking prednisone and also takes 1500 mg/day of calcium carbonate (Tums) to reduce the risk of osteoporosis. Which of the following information should the health care professional include? (Select all that apply)
a. Take the calcium tablets with food b. Drink 8 oz of water with the calcium tablets c. Chew calcium tablets before swallowing them d. Take the drugs 1 hr aparte. Divide the daily dose into three 500 mg-doses B, C, D, E
38. When instructing the patient about alendronate, which of the following information should the health care provider include? (Select all that apply)
a. Take the drug on an empty stomach b. Take the drug before bedtime c. Take the drug with an antacid d. Sit upright for 30 minutes following dosage e. Take the drug with a full glass of water.
35. The health care provider explains to the patient that there may be a drug interaction between the glucocorticoid and the calcium supplement. Which of the following may occur?
a. The glucocorticoid may cause reduced absorption of the calcium supplement b. The glucocorticoid may potentiate the effects of the calcium supplement c. The calcium supplement used with the glucocorticoid may cause bradycardia d. The calcium supplement may increase the risk for peptic ulcer disease A) The glucocorticoid may cause reduced absorption of the calcium supplement
4. A health care professional is talking about self-administering methotrexate to a patient who has rheumatoid arthritis. The health care professional should tell the patient to
a. Use a NSAID to reduce toxicity b. Take it with food to reduce gastric irritation c. Drink 2 to 3 L of water per day to promote the drug's excretion d. Take it in the morning to prevent insomnia C) Drink 2-3 L of water per day to promote the drug's excretion
24. A health care professional is preparing to administer alendronate (Fosamax) to a patient who has osteoporosis. The health care professional should recognize which of the following as an adverse effect of alendronate?
a. Venous thromboemboli b. Ventricular dysrhythmias c. Breast cancerd. Joint pain D) Joint pain
