NURS 317 Pharmacology Exam 4 Practice Questions
A patient with a congenital coagulation disorder is given aminocaproic acid (Amicar) to stop bleeding following surgery. The nurse will carefully monitor this patient for development of which of the following adverse effects? SATA a. anaphylaxis b. hypertension c. hemorrhage d. headache e. hypotension
a, d, e
. The patient is receiving theophylline (Theo-Dur) for treatment of asthma. Nursing intervention is required if the patient makes which statement? a. "I will check my heart rate each day." b. "I will take my medicine with my coffee each morning." c. "I will notify my doctor if my vision changes." d. "I will use my inhaler if I am wheezing."
b
A nurse is caring for a client receiving the antitussive dextromethorphan (Robitussin A-C). What should the nurse emphasize during medication teaching with the client? a. The medication is irritating to the bronchial tree. b. The cost of the medication can be expensive. c. The medication can cause motor dysfunction. d. The client may use the medication for 14 days.
c
A nurse is caring for a client who is prescribed fluticasone (Afrin) for allergic rhinitis. Which assessment finding should the nurse report immediately to the healthcare provider? a. Headache b. Hypertension c. Sore throat d. Hyperglycemia
c
A nurse is caring for a client who is taking dextromethorphan (Delsym). The client presents at the clinical with symptoms of hypotension and hyperpyrexia. For which drug interaction should the nurse assess in the client? a. Opioids b. Barbiturates c. MAOIs d. Grapefruit juice
c
A patient is receiving a thrombolytic drug, alteplase (Activase), following an acute MI. Which of the following effects is most likely attributed to this drug? a. skin rash with urticaria b. wheezing with labored respirations c. bruising and epistaxis d. temperature elevation of 38.2 degrees celsius
c
A patient presents at the emergency department with an acute asthma attack. The nurse expects that which medication will be used for initial treatment? a. An anticholinergic such as ipratropium (Atrovent) b. A leukotriene receptor antagonist such as montelukast (Singulair) c. A beta-2 agonist such as albuterol (Proventil) d. A corticosteroid such as fluticasone (Flovent)
c
A patient with DVT is receiving an infusion of heparin and will be started on warfarin. While the patient is receiving heparin, what laboratory test will provide the nurse with info about its therapeutic effects? a. PT b. INR c. aPTT d. Platelet count
c
A patient with asthma has a prescription for two inhalers, alvuterol (Proventil) and beclomethasone (Qvar). How should the nurse instruct the patient on the proper use of inhalers? a. use the albuterol inhaler, and use the beclomethasone only if symptoms are not relieved b. use the beclomethasone inhaler, and use the albuterol only if symptoms are not relieved c. use the albuterol inhaler, wait 5-10 minutes, then use the beclomethasone inhaler d. use the beclomethasone inhaler, wait 5-10 minutes, then use the albuterol inhaler
c
A patiet who received a prescription for montelukast (Singulair) returns to his provider's office after three days, complaining that, "The drug is not working." She reports mild but continued dyspnea and has had to maintain consisten use of her bronchodilator inhaler, albuterol (Proventil). What does the nurse suspect is the cause of the failure of montelukast? a. the patient is not taking it correctly b. the patient is not responding to the drug and will need to be switched to another formulation c. the drug has not had sufficient tine of use to have full effects d. the albuterol inhaler is interacting with the montelukast
c
Penicillin G administration alerts
-Observe for possible allergic reactions 30 min after parenteral administration -Don't mix with aminoglycosides in the same IV solution. Give them 1 hour apart -Pregnancy category B
Cefazolin (Ancef) Administration alerts
-administer IM deep into large muscle mass to prevent injury to surrounding tissues -pregnancy category B
Cefazolin (Ancef) drug interactions
-nephrotoxic drugs like aminoglycosides or vancomycine: increase risk for nephrotoxicity -aztreonam, carapenems, penicillins: additive synergistic antimicrobial action -warfarin: increase anticoagulant effect
Penicillin G Drug interactions
-oral contraceptives: decreases effectiveness -Potassium-sparing diuretics: hyperkalemia when used with penicillin G potassium -aminoglycoside antibiotics: antagonizes their effects
Cefazolin (Ancef)
Antibacterial; cell wall inhibitor; first generation cephalosporin. Antibiotic infections caused by gram-positive organisms. Infections of the respiratory tract, urinary tract, skin structures, biliary tract, bones, joints, genital infections, septicemia, and endocarditis. Not effective against MRSA
Penicillin G adverse effects
Diarrhea, nausea, vomiting. Pain at injection site. Anaphylaxis
. The patient is using beclomethasone (Beclovent) for treatment of chronic asthma. Which statement indicates that the patient understands this drug therapy? a. "I will use my bronchodilator if my wheezing increases." b. "I will not need a flu shot now that I'm taking this medicine." c. "This is the only drug I will need to treat my asthma attacks." d. "I will use this drug only when I feel an attack coming on."
a
1. The patient has been prescribed oxymetazoline (Afrin) nasal spray for seasonal rhinitis. The nurse will provide which of the following instructions? a. Limit use of this spray to 5 days or less b. The drug may be sedating so be cautious with activities requiring alertness c. This drug should not be used in conjunction with antihistamines d. This is an OTC drug and may be used as needed for congestion
a
3. A male, age 67, reports taking diphenhydramine (Benadryl) for hay fever. Considering this patient's age, the nurse assesses for which of the following findings? a. A history of prostatic or urinary conditions b. Any recent weight gain c. A history of allergic reactions d. A history of peptic ulcer disease
a
A 65-year-old patient is prescribed ipratropium (Atrovent) for treatment of asthma. Which of the following conditions should be reported to the health care provider before giving the patient the ipratropium? a. a reported allergy to peanuts b. a history of intolerance to albuterol (Proventil) c. a history of bronchospasms d. a reported allergy to chocolate
a
A client is prescribed enoxaparin (Lovenox) for treatment of a newly diagnosed left lower extremity deep vein thrombosis (DVT). What information should the nurse obtain related to the administration of this drug? a. Client's weight b. Serum aPTT c. Serum PT/INR d. Angiogram results
a
A client who has been on antibiotic therapy for peptic ulcer caused by Helicobacter pylori is diagnosed with a superinfection. What is the most appropriate response by the nurse when the client asks why the superinfection occurred? a. "The normal host flora has been destroyed by the antibiotic." b. "The infectious agent has developed resistance to the drug." c. "The infection caused by H. pylori has become severe." d. "The H. pylori restricted the growth of microorganisms."
a
A nurse is caring for a client receiving vancomycin intravenous infusion for treatment of a wound infected with MRSA. Which finding should the nurse report immediately to the healthcare provider? a. Hypotension and red rash on the chest area b. Joint and muscle pain with general malaise c. Chest discomfort and decreased heart rate d. Heel pain along with difficulty walking
a
A nurse is caring for a client with chronic bronchitis and is prescribed acetylcysteine to loosen bronchial secretions. The nurse should administer this medication by which route? a. Inhalation b. Oral c. Intravenous d. Intramuscular injection
a
A nurse is preparing discharge teaching for a client who will be receiving enoxaparin (Lovenox) injection. What should the nurse include in the teaching plan? a. Teaching the client to self-administer subcutaneous injections b. Monitoring the client's lab tests for hepatic impairment c. Teaching the client to observe for symptoms of anemia d. Monitoring the client for development of deep vein thrombosis
a
What patient education should be included for a patient receiving enoxaparin (Lovenox)? SATA a. teach the patient or family to give subcutaneous injections at home b. teach the patient or family not to take any OTC drugs without first consulting with the health care provider c. teach the patient to observe for unexplained bleeding such as pink, red, or dark brown urine or bloodu gums d. teach the patient to monitor for the development of DVT e. teach the patient about the importance of drinking grapefruit juice daily
a, b, c, d
A nurse is caring for a client receiving warfarin (Coumadin) therapy. The nurse should monitor the client for use of which drugs? (Select all that apply.) a. Diuretics b. Steroids c. Nicotine d. Barbiturates e. Alcohol
a, b, e
A nurse is caring for a client who is receiving alteplase (Activase) for treatment of an acute episode of myocardial infarction (MI). For which findings in the client's history should the nurse be alert to determine the client's risk for bleeding? (Select all that apply.) a. Use of ibuprofen for mild arthritis b. Recent antibiotic therapy with erythromycin c. Intake of herbals such as ginger or garlic d. Recent trauma or surgery e. Use of SSRI such as fluoxetine
a, c, d
A nurse is administering oral sulfamethoxazole-trimethoprim (Bactrim) to a client for treatment of urinary tract infection. Which nursing actions are appropriate? (Select all that apply.) a. Ensure the client drinks a full glass of water with each dose. b. Monitor the client's intake of calcium-fortified drinks. c. Administer the medication around the client's meal times. d. Have the client take potassium supplements with this drug. e. Give the client a glass of milk to drink in case of GI upset.
a, c, e
A patient is receiving treatment for asthma with albuterol (Proventil). The nurse teaches the patient that while serious adverse effects are uncommon, the following may occur. Select all that apply. a. tachycardia b. sedation c. temporary dyspnea d. nervousness e. headache
a, d, e
Penicillin G
antibacterial; cell wall inhibitor; natural penicillin. Drug of choice against streptococci, pneumococci, and staphylococci. Medication of choice for gonorrhea and syphilis. Low oral absorption and usually given IV or IM.
. A nurse is preparing to administer a broad-spectrum antibiotic to a client with a severe respiratory infection. Which is an important nursing action to take prior to administering the medication? a. Reviewing the results of the culture and sensitivity test b. Obtaining a specimen for culture and sensitivity testing c. Performing a peak and trough level of the antibiotic d. Determining the course antibiotic therapy based on half-life
b
5. A patient has been prescribed fluticasone (Flonase) to use with oxymetazoline (Afrin). How should the patient be taught to use these drugs? a. Use the fluticasone first, then the oxymetazoline b. Use the oxymetazoline first, then the fluticasone after waiting 5 min c. The drugs may be used in either order d. The fluticasone should be used only if the oxymetazoline fails to relieve nasal congestion
b
A client is being prescribed penicillin for an upper respiratory infection. What information should the nurse emphasize in providing instructions to the client? a. The antibiotic therapy can be taken while breast-feeding. b. The entire prescription must be completed as instructed. c. The medication can be taken without regard to eating. d. The most common side effect is urinary discoloration.
b
A client is receiving an antihistamine through intranasal route for treatment of an upper respiratory condition. The nurse should expect to administer which medication? a. Beclomethasone (Beconase) b. Azelastine (Astelin) c. Cetirizine (Zyrtec) d. Mometasone (Nasonex)
b
A client is using an intranasal oxymetazoline (Afrin) for treatment of nasal congestion. Which instruction should the nurse include during client teaching? a. Monitor respiratory rate. b. Limit use of the drug to 3-5 days. c. Drink plenty of fluids. d. Use with caution with SSRIs.
b
A client will be receiving an opioid antitussive for a cough associated with a cold infection. For what should the nurse assess in the client prior to administering the medication? a. Hypertension b. Asthma c. Headache d. Sore throat
b
A patient has prescriptions for two inhalers. One inhaler is a bronchodilator, and the other is a corticosteroid. Which instruction regarding these inhalers should the nurse give to the patient? a. "The corticosteroid should be taken first." b. "The bronchodilator should be taken first." c. "The two drugs should be taken at least 2 hours apart." d. "The order of administration does not matter with these two drugs."
b
A patient has started clopidogrel (Plavix) after experiencing a transient ischemic attack. What is the desired therapeutic effect of this drug? a. anti-inflammatory and antipyretic effects b. to reduce the risk of a stroke from a blood clot c. analgesic as well as clot-dissolving effects d. to stop clots from becoming emboli
b
A patient receiving treatment for a respiratory condition asks the nurse why the medication is given through aerosol therapy. What is the nurse's best response? a. The aerosol has no systemic side effects. b. The medication is delivered to the site of action. c. The patient requires no skill to use it. d. The delivery method is safe for all patients.
b
A patient using a beta-adrenergic agonist for treatment of asthma asks the nurse how the medication works. What is the nurse's best response? a. The drug reduces mucus production. b. The drug causes bronchodilation. c. The drug liquefies thick mucus. d. The drug suppresses the cough reflex.
b
The client is prescribed diphenhydramine (Benadryl) for treatment of a respiratory allergy. Which statement best indicates that the client understands the drug therapy? a. "I will use my bronchodilator if my wheezing increases." b. "I will report blurred vision, constipation, or urinary retention." c. "This is the only drug I will need to treat my asthma attacks." d. "I will use this drug only when I feel an attack coming on."
b
The client is receiving an antitussive with codeine for treatment of a cough. Which statement made by the client requires further teaching by the nurse? a. "I will avoid driving while I am on this medication." b. "I will take my medicine with red wine to help me sleep." c. "I will notify my doctor if my breathing changes." d. "I will keep this medication away from my children."
b
The patient receiving heparin therapy asks how the "blood thinner" works. What is the best response by the nurse? a. "Heparin makes the blood less thick" b. "Heparin does not thin the blood but prevents clots from forming as easily in the blood vessels." c. "Heparin decreases the number of platelets so that blood clots more slowly." d. Heparin dissolves the clot"
b
For which client conditions should the nurse anticipate administering antibiotic therapy for chemoprophylactic purposes? (Select all that apply.) a. Neurologic abnormality b. Prosthetic heart valve c. Dental surgical procedure d. Chronic respiratory infection e. Kidney transplantation
b, c, e
6. Which of the following is the best advice that the nurse can give a patient with viral rhinitis who intends to purchase an OTC combination cold remedy? a. Dosages in these remedies provide precise dosing for each symptom that you are experiencing b. These drugs are best used in conjunction with an antibiotic c. It is safer to use a single-drug preparation if you are experiencing only one symptom d. Since these drugs are available OTC, it is safe to use any of them as long as needed
c
A client has been prescribed oral tetracycline for treatment of severe acne. Which assessment finding is most important for the nurse to communicate with the healthcare provider? a. The client's nutritional status b. The pathogen causing the acne c. The client's pregnancy status d. The presence of open lesions
c
Alteplase (Activase) is prescribed for a client with an acute episode of stroke. Which client evaluation is the nurse's priority action? a. Monitoring aPTT and platelet count b. Monitoring PT and INR serum levels c. Monitoring level of consciousness (LOC) d. Monitoring injection sites
c
An elderly male patient with benign prostatic hypertrophy is prescribed ipratropium (Atrovent) for the treatment of asthma. Which nursing intervention is most appropriate? a. Teaching the patient to avoid caffeine in the diet b. Assessing the patient for enlarged liver c. Teaching the patient to report inability to urinate d. Monitoring for development of diarrhea
c
The client receiving heparin therapy asks how the medication works. Which response by the nurse is most accurate? a. "Heparin makes the blood less viscous, preventing further clotting." b. "Heparin dissolves the clot specifically in the affected blood vessels." c. "Heparin inhibits clotting factors, thereby preventing formation of new clots." d. "Heparin decreases the number of platelets, so that blood clots more slowly."
c
The healthcare provider prescribes pentoxifylline (Trental) to a client, who asks the nurse how the medication works. Which response by the nurse is most accurate? a. By dissolving clots in the blood vessels b. By decreasing platelet aggregation c. By reducing the viscosity of red blood cells d. By increasing platelet production
c
Which intervention should the nurse implement when caring for a patient on long-term oral glucocorticoids? a. Monitoring liver function tests b. Monitoring for cardiac dysrhythmias c. Monitoring for signs of GI bleeding d. Monitoring blood glucose levels
c
Which of the following drugs is most immediately helpful in treating a severe acute asthma attack? a. Beclomethasone (Qvar) b. Ziletuon (Zyflo CR) c. Albuterol (Proventil, Ventolin) d. Salmeterol (Serevent Diskus)
c
2. A patient has a prescription for fluticasone (Flonase). Plave the following instructions in the order in which the nurse will instruct the patient to use the drug. a. Instill one spray directed high into the nasal cavity b. Clear the nose by blowing c. Prime the inhaler prior to the first use d. Spit out any excess liquid that drains into the mouth C, b, a, d
c, b, a, d
4. The nurse is teaching a patient about the use of dextromethorphan with guaifenesin (Robitussin-DM) syrup for a cough accompanied by thick mucus. Which instruction should be included in the patient's teaching? a. Lie supine for 30 minutes after taking the liquid b. Drink minimal fluids to avoid stimulating the cough reflex c. Take with food for best results d. Avoid drinking fluids immediately after the syrup but increase overall fluid intake throughout the day
d
A client asks the nurse why the healthcare provider did not prescribe the usual antibiotic for the same infection. Which is the best response by the nurse? a. "It does not matter which antibiotic is taken." b. "If you are not better in 10 days, return to the office." c. "You do not want to take the same antibiotic all the time." d. "Bacteria can become resistant to some antibiotics."
d
A client has been prescribed ciprofloxacin (Cipro) 500 mg twice daily by mouth. Which information should the nurse include during client teaching about administration of this medication? a. The dose must be taken on an empty stomach to increase absorption. b. The client can have an unlimited amount of caffeinated drinks. c. The drug can be taken with an antacid to decrease GI symptoms. d. The dose should not be taken with supplements containing iron.
d
A nurse is caring for a client receiving gentamicin for treatment of a Pseudomonas infection. Which assessment finding should the nurse report to the healthcare provider immediately? a. Dysrhythmia b. Constipation c. Diuresis d. Tinnitus
d
A nurse is caring for a client who is prescribed benzonatate (Tessalon) to suppress coughing from a cold infection. Which instruction should the nurse include during client teaching? a. Monitor blood pressure. b. Chew the gel tablet thoroughly. c. Check pulse before taking the drug. d. Stand up slowly and carefully.
d
A nurse is caring for a client with epidural anesthesia following back surgery. The client is also receiving subcutaneous heparin 5,000 units twice daily for dep vein thrombosis (DVT) prophylaxis. What is the nurse's priority action? a. Monitor dose of the epidural anesthesia. b. Monitor effectiveness of pain management. c. Monitor the client for respiratory depression. d. Monitor the client's neurological status.
d
A nurse is reviewing lab values of a client who is on warfarin (Coumadin) drug therapy. Which lab finding should the nurse report immediately to the healthcare provider? a. aPTT 48 seconds b. Bleeding time 7 seconds c. Platelet count 140,000 d. INR 1.2
d
A patient has been using a fluticasone (Flovent) inhaler as a component of his asthma therapy. He returns to his helath care provider's office complaining of a sore mouth. On inspection, the nurse notices white patches in the patient's mouth. What is a possible explanation for this? a. the patient has been consuming hot beverages after the use of inhaler b. the patient has limited his fluid intake, resulting in dry mouth c. the residue of the inhaler propellant is coating the inside of the mouth d. the patient has developed thrush as a result of the fluticasone
d
The nurse completes a physical assessment on a client receiving heparin therapy for deep vein thrombosis (DVT). The client complains of severe lumbar pain. What is the most appropriate action by the nurse? a. Reposition the client to promote comfort. b. Document the finding, and report it to the next nurse. c. Administer pain medication as prescribed. d. Evaluate further; this could indicate a complication of drug therapy.
d
When educating a patient recently placed on inhaled corticosteroids, the nurse will discuss which potential adverse effects? a. Fatigue and depression b. Anxiety and peripheral vasoconstriction c. Headache and rapid heart rate d. Oral candidiasis and dry mouth
d
Which information should the nurse include during patient teaching on long-term therapy with beta-adrenergic agonists for asthma treatment? a. Discontinuing the drug if heart rate increases b. Monitoring daily intake and output c. Reducing dosage of the drug if insomnia occurs d. Notifying the healthcare provider if the drug no longer seems effective
d
Cefazolin (Ancef) effect on lab tests
false positive glucose results and positive Coomb's test
Cefazolin (Ancef) contraindications
hypersensitivity to drug in cephalosporin class. Severe renal disease
Penicillin G Contraindications
hypersensitivity, severe renal disease
Penicillin G effects on lab tests
positive Coomb's test and false positive urinary or serum proteins
Cefazolin (Ancef) adverse effects
rash, diarrhea, and superinfections when used for long periods. Hypersensitivity reactions. Pain and phlebitis at injection sites. Seizures