Pharm 1

A nurse administers naloxone (Narcan) to a postoperative patient experiencing respiratory sedation. What undesirable effect would the nurse anticipate after giving this medication?

A. Nausea and vomiting. B. Increase in pain. C. Drowsiness. D. Tremors. CorrectB.

Mr. Jones is receiving morphine sulfate IV in the Medical Intensive Care Unit. What potential adverse effect should the nurse assess to determine if the client is experiencing side effects of morphine sulfate?

A. Tachypnea. B. Tachycardia. C. Urinary retention. D. Hypertension. CorrectC.

A client is frantic because her two children have been sent home from school with head lice. She has treated her kids' scalps but does not know what else to do. What will be the best teaching by the nurse?

A. "It is imperative to also wash bed linens and clothing in hot water that have come into contact with your children." B. "Continue to apply the medication to their scalps as directed for another week." C. "Do not let your children return to the school until your house is fumigated." D. "Isolate the children from other family members for three days."

A client uses timolol maleate (Timoptic) eye drops. The expected outcome of this beta-adrenergic blocker is to control glaucoma by:

A. Improving the ability of the ciliary muscle to contract. B. Reducing aqueous humor formation. C. Dilating the canals of Schlemm. D. Constricting the pupils. CorrectB.

After a nurse provided instructions about timolol (Timoptic) to a client with a history of chronic heart disease, the client asks, "How can this eye drops affect my heart?" The nurse's best response includes which of the following information?

A.If this ophthalmic medication is systemically absorbed, it can have the same systemic effects as other beta-blocking agents. B. Clients are only at risk if the prescribed ophthalmic medication is pulmonary-selective. C. Clients are at risk if timolol is given at the same time as the oral medications taken for cardiac disease. D. This medication does not have any effects on the cardiac system. CorrectA.

The health care provider has prescribed alendronate (Fosamax) for the patient. Which one of the following should the nurse include in discharge teaching?

A. "Take alendronate in in the evening with orange juice." B. "Take alendronate first thing in the morning with a full glass of water." C. "Take alendronate on a full stomach after breakfast." D. "Take alendronate at bedtime with a glass of milk." CorrectB

Nurse Clarisse is teaching a patient about a newly prescribed drug. What could cause a geriatric patient to have difficulty retaining knowledge about prescribed medications?

A. Decreased plasma drug levels. B. History of Tourette Syndrome. C. Sensory deficits. D. Lack of family support. CorrectC

The nurse concludes that a client newly diagnosed with glaucoma knows the purpose for the prescribed timolol (Timoptic) blocker when the clients makes which statement:

A. "This eyedrop is the only treatment available for glaucoma." B. "The medicine will help to increase my intraocular pressure." C. "This eyedrop will reduce the intraocular pressure." D. "I can stop using the eyedrop once my intraocular pressure is normal." CorrectC.

The first-pass effect or presystemic metabolism, a drug is extensively metabolized in the liver, with only part of the drug dose reaching the systemic circulation for distribution to sites of action. The first-pass effect occurs when some drugs are given by which of the following routes?

A. Subcutaneous. B. Oral. C. Rectal. D. Parenteral. CorrectB.

What is the primary role of a nurse in medication administration?

A. Assure client adherence by watching he client swallow all prescribed medications. B. Ensure medications are administered and delivered in a safe manner. C. Be certain that provider orders are accurate. D. Inform the client that prescribed medications need to be taken only if the client agrees with the treatment plan. CorrectB.

The nurse is caring for a patient who is receiving adalimumab (Humira). The nurse understands that a major complication of this medication is:

A. Pulmonary Embolism. B. Lymphoma. C. Elevated White Blood Cell Count. D. Heart Attack. CorrectB.

A drug is 100% bioavailable when it is administered by which of the following routes?

A. Rectal. B. Enteral. C. Oral. D. Intravenous. CorrectD.

Local anesthetics decrease the permeability of the nerve cells to ions. What is the most significant ion that reduces the excitability of the cell membrane?

A. Sodium. B. Potassium. C. Chloride. D. Magnesium CorrectA.

Which patient should NOT be prescribed alendronate (Fosamax) for osteoporosis?

A. A patient on bed rest who must maintain a supine position. B. A patient who is allergic to iodine/shellfish. C. A female patient being treated for high blood pressure with an ACE inhibitor. D. A patient on a calorie restricted diet. Correct A

A client is prescribed colchicine (Colcrys) for gout. The nurse discusses possible common adverse effects of this therapy, including: (Select all that apply.)

A. Abdominal pain. B. Nausea and vomiting. C. Diarrhea. D. Constipation. CorrectA., B, C

Before administering drugs by the enteral route, the nurse should evaluate which of the following?

A. Ability of the client to swallow medications. B. Patency of the injection port. C. Ability of the client to lie supine. D. Compatibility of the drug with IV fluid. Correct A

After listening to the nurse explain the use of the PO version of tretinoin (isotretinoin - Accutane) to a 19 year-old female client, the client demonstrates understanding of the most important point by making which statement at the end of the teaching session:

A. "Apply thick layer of isotretinoin twice a day." B. "Increase exposure to sun for added benefit." C. "Have a pregnancy test prior to beginning therapy and use two forms of contraception." D. "Keep lips moist and lubricated to prevent inflammation." CorrectC.

The mother of a client who has been diagnosed with head lice has completed the application of permethrin (Nix) shampoo. Which of the following is the next step the nurse should teach the mother regarding the treatment of head lice:

A. "Check the heads of your child's friends before allowing them to play together." B. "Keep your child's hair short so it will be easier to treat next time." C. "Remove all nits from the hair shaft with a nit comb or a fine-tooth comb." D. "You are fine now; just watch your child for a reinfection." CorrectC

A client is receiving morphine sulfate IV for acute pain and tells the nurse, "I get dizzy when I stand up." Which of the following is the most appropriate response by the nurse?

A. "Dizziness is not related to the drug, but I will need to ask you a few more questions." B. "This is an expected side effect of the drug, and you should use caution and move slowly when standing up." C. "You may be experiencing a toxic effect of the drug and I will notify the physician." D. "Episodes of dizziness when moving are common symptoms of acute pain." B

Mrs. Smith is scheduled to have a tooth extracted (pulled) at the Dentist's office this morning. She reports that she is taking alendronate (Fosamax). Prior to having her tooth extraction, which statement by the patient would alarm the provider:

A. "I always take my alendronate (Fosamax) with a full glass of water." B. "I sat upright to take my alendronate (Fosamax) yesterday morning." C. "I have been having jaw pain lately." D. "I did not eat anything after midnight last night." CorrectC

A man with an acute gouty flare-up is taking allopurinol (Zyloprim). Which of the following subjective statements indicates that he has developed uric acid kidney stones?

A. "I am urinating every hour-approximately 8 ounces." B. "I have pain in my right toe and left elbow." C. "I have excruciating pain in my lower abdomen." D. "I am dizzy and feel like I am going to faint." CorrectC.

The nurse is discussing the System to Manage Accutane (tretinoin) Related Teratogenicity (SMART) with a client who has severe acne. Which statement by the female client would cause the healthcare provider to Not Prescribe PO tretinoin (Accutane)?

A. "I hope this works because I am so tired of being ugly." B. "The only contraception I use is birth control pills." C. "I will have to come in every month for a pregnancy test." D. "My menstrual cycles have been regular and heavy." CorrectB.

The nurse is teaching a client about safe drug administration when using topical permethrin for the treatment of scabies. The nurse determines that instruction has been effective when the client states:

A. "I need to rinse off the topical medication after it has been on my skin for a few days." B. "I need to sign a consent for this medication." C. "I must promptly report any irritation, broken skin, erythema, rashes, or edema when using this lotion." D. "I should cover the area with a clean cloth when applying the medication." CorrectC.

Mrs. Smith is 12 hours post appendectomy. Her husband asks the nurse to reduce the amount of morphine sulfate that his wife is receiving. He states, "When I had my appendix out, I needed half the pain medication that she does." Based on the nurse's knowledge, what is the best nursing response?

A. "Pain is a subjective experience, we all feel pain differently." B. "I agree she is taking far too much pain medication." C. "You should discuss your wife's pain management with the physician." D. "I will call the physician for an order to decrease the dose and the frequency of your wife's pain medication." Correct A

For which client should the nurse question an order for tramadol (Ultram)?

A. A 50 year-old male with a seizure disorder. B. A 35-year-old female with migraine headaches. C. A 60 year-old female with osteoarthritis. D. A 55 year-old male with a history of anxiety disorder. CorrectA.

Which clients would the nurse evaluate as unsuitable for the administration of fentanyl as adjunct to anesthesia?(Select all that apply.)

A. A 60-year-old with history of emphysema. B. A 58-year-old with Type 2 Diabetes Mellitus. C. A breast-feeding mother. D. A 17-year-old who sustained a head injury in a motor vehicle accident. Correct A, C, D

The provider has ordered topical tretinoin (Retin-A) for the treatment of a teenager's acne vulgaris. When caring for a client who is prescribed this medication, the nurse should instruct the client to:

A. Avoid additional sun exposure or apply sunscreen when going outside during the day when taking this topical medication. B. If the topical medication causes pain, you do not need to report this side effect to the healthcare provider. C. It is recommended to only tan in tanning beds while taking this topical medication. D. It is okay to take your friend's PO version of the acne medication. CorrectA.

A client has been treated for chronic open-angle glaucoma for 5 years asks the nurse, "How does glaucoma damage my eyesight." The nurse's reply should be based on the knowledge that open-angle glaucoma:

A. Causes increased intraocular pressure and damage to the optic nerve. B. Leads to detatchment of the retina. C. Is caused by decreased blood flow to the retina. D. Results from chronic eye inflammation. Correct A

The nurse is developing a teaching plan for the client with glaucoma. Which of the following instructions would the nurse include in the plan of care?

A. Decrease fluid intake to control the intraocular pressure. B. Avoid overuse of the eyes. C. Decrease the amount of salt in the diet. D. Eye medications will need to be administered lifelong. CorrectD.

Which of the following medications increases the effectiveness of local anesthetics?

A. Dopamine. B. Calcium. C. Phosphorus. D. Epinephrine. CorrectD.

Because of the physiologic and biochemical changes of aging in the geriatric patient, the nurse recognizes which adjustment in medications may be necessary?

A. Dosages of medications may need to be decreased. B. Drugs should be given in the early AM. C. Medications will need to be given more frequently. D. The parental route of administration is preferred. Correct A

Mrs. Kline has been started on Enbrel for her treatment of rheumatoid arthritis. The medication is to be given in an injection form once per week. Mrs. Kline asks the nurse why she cannot receive the medication daily. Your best response to Mrs. Kline is based on the dosing interval knowledge of the drug's:

A. Efficacy. B. Bioavailability. C. Excretion. D. Half-life (t ½) CorrectD

The nurse should assess clients with chronic open-angle glaucoma for:

A. Excessive lacrimation. B. Eye pain. C. Colored light flashes. D. Decreasing peripheral vision. CorrectD

Jackie is a 27 year-old female who is admitted to the Digestive Health Unit with painful pancreatitis and cirrhosis of the liver. The medical team reduces the client's pain medication due to the decrease ability of her liver to:

A. Excrete the pain medication. B. Absorb the pain medication. C. Distribute the pain medication. D. Metabolize the pain mediation. CorrectD.

Some PO medications are inactivated through the liver and may require a higher dose to achieve a therapeutic effect. This process is referred to the:

A. First-pass effect. B. Pro drug process. C. Half-life (t ½). D. Therapeutic response. CorrectA.

A client with glaucoma has been prescribed timolol eyedrops. Timolol should be used with caution in the client with a history of:

A. Gastric Ulcers. B. Pancreatitis. C. High Cholesterol. D. Emphysema. CorrectD.

A patient is prescribed adalimumab (Humira) for the treatment of rheumatoid arthritis. The nurse understands that patient teaching will involve:

A. It is okay to receive live vaccines). B. How to administer the medication via the subcutaneous route. C. It is okay to be around others who have symptoms of the common cold. D. How to administer the medication via the intramuscular route. CorrectB.

The client asks the nurse to explain how colchicine (Colcrys) works. The nurse would base the response on which physiological principle?

A. It prevents the accumulation of uric acid crystals in the joints. B. It reduces the pain associated with joint inflammation from gouty arthritis. C. It increases the deposits of uric acid in the synovial spaces of the joints. D. It increases the renal excretion of uric acid crystals. CorrectB.

Timolol (Timoptic), beta-adrenergic agent, may be used to treat glaucoma. The nurse should teach the clients and family to:

A. Monitor respiratory rate. B. Monitor pulse and blood pressure. C. Monitor blood glucose. D. Monitor urine output. CorrectB.

The client diagnosed with a head injury after a skiing accident is ordered to have a head CT scan. The client is requesting to receive morphine sulfate IV prior to being transported to the radiology department. What teaching should the nurse include when discussing the administration of morphine sulfate to the client?

A. Morphine sulfate can not be taken with any other routine medications; therefore, the client should not receive the drug. B. Inform the client that an intravenous line (IV) will be started prior to the procedure and the client can receive the morphine sulfate at that time. C. Explain to the client that fentanyl will work best to control pain. D. Explain to the client that morphine sulfate is contraindicated because this could put the client at potential risk of increased cerebrospinal fluid (CSF) pressure. CorrectD.

After surgery, a client was given morphine sulfate 7mg IV for analgesia. In the recovery room the nurse assesses that the client has a change in LOC . The nurse also notes that the client's vital signs are HR: 66, RR: 5, and BP 100/ 60. Which of the following is the priority action of the nurse?

A. Obtain a 12-lead Electrocardiogram (ECG). B. Prepare to administer naloxone (Narcan). C. Continue monitoring the client's vital signs. D. Prepare Atrophine sulfate from the 'Emergency'-cart. CorrectB.

The names of therapeutic classifications usually reflect which of the following?

A. Possible generic names of the medications. B. Conditions for which the medication is used. C. Possible adverse reactions to the medications. D. Actions of the medication. CorrectB.

The nurse prepares a pediatric client for an ear irrigation as ordered by the physician. Which of the following procedure correctly performed by the nurse?

A. Pull the pinna down and back. B. Position the client with the affected side up after the irrigation. C. Directs a slow steady current of irrigating solution into the eardrum. D. Warm the irrigating solution to 60º Fahrenheit. Correct A

The nurse is teaching a client about a new eye-drop prescription for timolol (Timoptic) for treatment of open-angle glaucoma. The client has a history of seasonal allergies and hypertension. What is an important administration technique to stress for this client?

A. Take any eyedrops for allergies 5 minutes before administering the timolol drops. B. Gently put pressure on the inner canthus (tear duct) for 1-2 minutes after instilling the timolol drop. C. Do not use the timolol drops while concurrently taking allergy medication. D. The timolol drops may temporarily worsen seasonal allergies. CorrectB.

The nurse is preparing to administer a 9:00 AM medication of morphine sulfate 1 mg IV to the following clients. Which client should the nurse QUESTION administering the medication?

A. The client who is complaining of lower back pain. B. The client who has a blood pressure of 88/58 mm/Hg. C. The client who drank a full glass water and ate a large meal. D. The client who has a a normal platelet count. CorrectB.

The main goal of current drug laws and standards is to ensure which of the following?

A. The drugs are patented. B. The drugs are available to all, regardless of cost. C. The drugs are cost effective. D. The drugs marketed for therapeutic purposes are safe & effective. CorrectD.

Which term defines the time required for the serum concentration of a drug to decrease by 50%?

A. Therapeutic index. B. Bioavailability. C. Mechanism of action. D. Half-life. CorrectD

A nurse is preparing to administer an IV dose of morphine sulfate to a client who states she received morphine sulfate 3 years ago & developed shortness of breath. Which of the following is an appropriate nursing action?

A. Withhold the medication. B. Administer an oral antihistamine at the same time. C. Administer the prescribed dose. D. Ask the provider to change the prescription to an oral form. Correct A

Mr. Jones calls the outpatient surgery clinic and states that he has been taking his morphine-like medication, but he has noticed that he has not had a bowel movement in 3 days. What is the nurse's best response:

A. You should stop taking the medication. B. You are experiencing a side effect of the medication and will need to increase fluids, eat a high fiber diet, and try to exercise as tolerated. C. You should switch medications and start taking ibuprofen instead. D. You need to be seen by the provider as soon as possible. CorrectB.

Which medication helps to alleviate the onset of a migraine headache:

A. sumatriptan (Imitrex) B. morphine C. ibuprofen D. acetaminophen Correct A