final review pharm
a
A nurse administers an ACE inhibitor to a patient who is taking the drug for the first time. What will the nurse do? A. Instruct the patient not to get up without assistance. B. Make sure the patient takes a potassium supplement. C. Report the presence of a dry cough to the prescriber. D. Request an order for a diuretic to counter the side effects of the ACE inhibitor.
c
A nurse checks a patient's vital signs in the hospital and notes a blood pressure of 146/98 mm Hg. What will the nurse do? A. Instruct the patient to consume a low-sodium diet. B. Prepare the patient for an electrocardiogram and blood tests. C. Recheck the patient's blood pressure in the other arm. D. Request an order for a thiazide diuretic.
d
A nurse has provided education for a patient newly diagnosed with hypertension who is just beginning therapy with antihypertensive medications. Which statement by the patient indicates a need for further teaching? A. "I may experience serious long-term problems even if I am not having symptoms." B. "I should report side effects to the provider since other drugs may be substituted." C. "I will need to take medications on a long-term basis." D. "When my symptoms subside, I may discontinue the medications."
a
A nurse is discussing how beta blockers work to decrease blood pressure with a nursing student. Which statement by the student indicates a need for further teaching? A. "Beta blockers block the actions of angiotensin II." B. "Beta blockers decrease heart rate and contractility." C. "Beta blockers decrease peripheral vascular resistance." D. "Beta blockers decrease the release of renin."
a
A nurse is giving an enteral medication. The patient asks why this method is preferable for this drug. How will the nurse reply? A."This route is safer, less expensive, and more convenient." B."This route allows more rapid absorption of the drug." C."This route prevents inactivation of the drug by digestive enzymes." D."This route is the best way to control serum drug levels."
d
A nurse is instructing a patient receiving a cholesterol-lowering agent. Which information should the nurse include in the patient education? A. "This medication will replace other interventions you have been trying." B. "It is important for you to double your dose if you miss one to maintain therapeutic blood levels." C. "Stop taking the medication if you experience constipation." D. "You should continue your exercise program to increase your HDL serum levels.
d
A nurse is planning care for a patient who takes fexofenadine for allergic rhinitis. Which outcome should the nurse anticipate? A.Use limited to allergy season B.Absence of rebound congestion C.No complaints of dry mouth D.Relief of sneezing and itching
a
A nurse is teaching a group of nursing students about antidysrhythmic medications. Which statement by a student indicates understanding of the teaching? A. "Antidysrhythmic drugs can cause new dysrhythmias or worsen existing ones." B. "Adverse effects of these drugs are mainly noncardiac in nature." C. "For most antidysrhythmic drugs, there is evidence of reduced mortality." D. "Use of these drugs may be necessary even if the benefits are unknown."
c
A patient begins taking an ACE inhibitor and complains of a dry cough. What does the nurse correctly tell the patient about this symptom? A. It indicates that a serious side effect has occurred. B. It is a common side effect that occurs in almost all patients taking the drug. C. It may be uncomfortable enough that the drug will need to be discontinued. D. It occurs frequently in patients taking the drug but will subside over time.
c
A patient has failed lifestyle modifications and LDL cholesterol remains elevated, statin therapy will be initiated, what lab value will need monitored? A. CBC B. Glucose C. Liver enzymes D. INR
c
A patient has had blood pressures of 150/95 and 148/90 mm Hg on two separate office visits. The patient reports a blood pressure of 145/92 mm Hg taken in an ambulatory setting. The patient's diagnostic tests are all normal. The nurse will expect this patient's provider to order: A. a beta blocker. B. a loop diuretic and spironolactone. C. a thiazide diuretic. D. counseling on lifestyle changes.
a
A patient is prescribed codeine as an antitussive. Which symptom will the nurse observe for as an adverse effect of this medication? A.Respiratory depression B.Increased heart rate C.Productive cough D.Restlessness
c
A patient who is taking a statin- simvastatin [Zocor] develops an infection and the provider orders azithromycin [Zithromax] to treat the infection. The nurse should be concerned if the patient complains of: A. nausea B. tiredness C. muscle pain. D. headache
d
A patient who takes warfarin [Coumadin] is brought to the emergency department after accidentally taking too much warfarin. The patient's heart rate is 78 beats/min, and the blood pressure is 120/80 mm Hg. A dipstick urinalysis is normal. The patient does not have any obvious hematoma or petechiae and does not complain of pain. The nurse will anticipate an order for: A. vitamin K (phytonadione). B. protamine sulfate. C. a PTT. D. a PT and an INR.
d
A patient who takes warfarin for atrial fibrillation undergoes hip replacement surgery. On the second postoperative day, the nurse assesses the patient and notes an oxygen saturation of 83%, pleuritic chest pain, shortness of breath, and hemoptysis. The nurse will contact the provider to report possible ____ and request an order for ____. A. congestive heart failure; furosemide [Lasix] B. hemorrhage; vitamin K (phytonadione) C. myocardial infarction; tissue plasminogen activator (tPA) D. pulmonary embolism; heparin
a
A patient who uses an inhaled glucocorticoid for chronic asthma calls the nurse to report hoarseness. What will the nurse do? A.Ask whether the patient is rinsing the mouth after each dose. B.Request an order for an antifungal medication C.Suggest that the patient be tested for a bronchial infection D.Tell the patient to discontinue use of the glucocorticoid.
a
A patient with atrial fibrillation is receiving warfarin [Coumadin]. The nurse notes that the patient's INR is 2.7. Before giving the next dose of warfarin, the nurse will notify the provider and: A. administer the dose as ordered. B. request an order to decrease the dose. C. request an order to give vitamin K (phytonadione). D. request an order to increase the dose.
c
A patient with chronic hypertension is admitted to the hospital. During the admission assessment, the nurse notes a heart rate of 96 beats/min, a blood pressure of 150/90 mm Hg, bibasilar crackles, 2+ pitting edema of the ankles, and distension of the jugular veins. The nurse will contact the provider to request an order for which medication? A. ACE inhibitor B. Digoxin [Lanoxin] C. Furosemide [Lasix] D. Spironolactone [Aldactone]
a
A patient with diabetes develops hypertension. The nurse will anticipate administering which type of medication to treat hypertension in this patient? A. ACE inhibitors B. Beta blockers C. Direct-acting vasodilators D. Thiazide diuretics
d
A patient with heart failure who has been taking an ACE inhibitor, a thiazide diuretic, and a beta blocker for several months comes to the clinic for evaluation. As part of the ongoing assessment of this patient, the nurse will expect the provider to evaluate: A. complete blood count. B. ejection fraction. C. maximal exercise capacity. D. serum electrolyte levels.
a
A preschool child recently diagnosed with cystic fibrosis has a new prescription for acetylycysteine. The nurse teaches the client and her family that the purpose of this medication is to do which of the following? A.Loosens secretions B.Decreases pain C.Minimizes nasal congestion D.Suppress cough
b
A provider has ordered an ACE inhibitor- captopril [Capoten] for a patient who has hypertension. The patient reports a history of swelling of the tongue and lips after taking enalapril [Vasotec] in the past. Which action by the nurse is correct? A. Administer the captopril and monitor for adverse effects. B. Hold the dose and notify the provider. C. Request an order to administer fosinopril instead of captopril. D. Reassure the patient that this is not a serious side effect.
a
Albuterol is used in the treatment of Asthma to: A.Promote bronchodilation B. Decrease inflammation C. Suppress the effects of leukotriene compounds D.Decrease airway mucous production
weight control, healthy food, active lifestyle
Describe 1st line therapies for blood pressure management prior to initiating drug therapy?
c
Corticosteroids improve asthma symptoms by which of the following mechanisms? A.Blocking histamine release B.Drying bronchial secretions C.Suppressing inflammation D.Causing bronchodilation
Drugs are mainly excreted either in bile through the liver or urine through the kidneys. This happens when the blood is filtered through these organs and expelled as urine or bile. At the brain, drugs are often filtered back into the blood and through the body because they are unable to pass through the blood-brain barrier. Because these two organs (liver and kidneys) are our main ways to excrete drugs, it's important to be cautious when administering drugs to patients with damage to either organ.
Explain how drugs are excreted and specifically what organs require monitoring.
a
The nurse administers 100 mg of drug X by mouth. After the drug moves through the hepatic system, very little active drug is left in the general circulation as a result of what? A.First pass effect B.Therapeutic range C.Plasma protein binding D.Drug half-life
b
The nurse identifies what as the goal of drug therapy in the treatment of patients? A.Follow-up with the prescriber B.Production of maximum benefit with minimum harm C.Correct administration technique D.Cure of the disease
a
The nurse is preparing a staff education inservice about specific safety measures that reduce patient medication errors. Which measure improves safety for patients during care transition? A.Risk Evaluation and Mitigation Strategy B.Medication reconciliation C.Regional Medication Safety Program. D.Medwatch Progra
d
The nurse is preparing to administer a medication with the following order: "Aldomet250 mg daily." What should the nurse do? A.Ask the patient how this medication is usually given B.Administer the medication by mouth. C.Administer the medication as it was given last time. D.Verify the order with the prescriber
a
The nurse prepares to give a drug that will prevent receptor activation. Which term would describe this drug? A.Anatagonist B.Agonist C.Potent D.Selective
d
The nurse reviews a patient's admission orders written by the healthcare provider. Which medication order should the nurse question? A.Cyanocobalamin 100 mcg intramuscularly every month B.Levothyroxine 75 mcg orally every morning C.Enoxaparin 40 mg subQ every day for 7 days D.MSO4 2.0 mg IV every 2 to 4 hours as needed for pain
b
To achieve therapeutic effectiveness, a nurse teaches a patient with chronic asthma to use an inhaled glucocorticoid medication according to which schedule? A.To abort an asthma attack B.On a continuing, daily basis C.2 weeks on, 2 weeks off D.Only in an emergency
anaphylaxis
What is the most serious adverse effect nurses need to assess for and monitor regarding drug administration? What is the name of this serious reaction?
6 rights of medication administration
What is the nurses responsibility in medication administration? Why do you think nursing students are required to obtain education in the topics related to pharmacology
a
What is the primary action of an antitussive? A.Suppress the cough reflex B.Block histamine release C.Reduce the viscosity of bronchial secretions D.Dry bronchial secretions
c
What is the term for study of drug movement throughout the body which includes drug metabolism and drug excretion? A.Pharmacodynamics B.Biotransformation C.Pharmacokinetics D.First pass effect
a
When studying the impact a drug has on the body, the nurse is reviewing what? A.The drug's pharmacodynamics B.Drug's selectivity C.Drug's predictability D.Drug's pharmacokinetics
a, b
Which groups of people are especially sensitive to medication effects? (Select all that apply.) A.Older adults B.Infants C.Caucasians D.Minorities E.Women
a
Which of the following drug classes is most effective for relieving acute bronchospasm? A.Beta 2 agonist B.Anticholinergics C.Mast cell stabilizers D.Methylxanthines
a
Which statement about drug agonists does the nurse identify as being true. A. An agonist exerts effects by causing receptor activation. B.An agonist is a dynamic component C.An agonist has moderate intrinsic activity. D.An agonist makes physiologic processes go faster.
antagonist
binds to the receptor either on the primary site, or on another site, which all together stops the receptor from producing a response
agonist
binds to the receptor, producing a similar response to the intended chemical and receptor
protamine sulfate
coumadin antidote
vitamin k
heparin antidote
LABA
long acting bronchodilators, and should not be taken PRN, but should be taken consistently to prevent attacks
SABA
short term rescue when a patient is having an acute attack/sometimes before exercise to prevent attack, taken PRN, albuterol
