Pharm 2 Practice Questions

12345 If the client's BP is less than 90/60, the medication should be held so that the client will not experience profound hypotension. 2. If the client's apical pulse is less than 60, the medication should be held so that the client's pulse will not plummet to less than 60, which is sinus bradycardia. 3. A side effect of antihypertensive medications is orthostatic hypotension, and the nurse should discuss how to prevent episodes. 4. Thiazide diuretics do not cause excess loss of potassium, but the client should be encouraged to eat potassium-rich foods to prevent hypokalemia, which may occur as a result of increased urination. 5. The nurse should monitor the client's intake and output to determine if the medication is effective.

The nurse is administering the combination medication Tenoretic (chlorthalidone and atenolol), a thiazide diuretic and beta blocker, to a client diagnosed with chronic hypertension. Which interventions should the nurse implement? Select all that apply. 1. Do not administer if the client's BP is less than 90/60. 2. Do not administer if the client's apical pulse is less than 60. 3. Teach the client how to prevent orthostatic hypotension. 4. Encourage the client to eat potassium-rich foods. 5. Monitor the client's oral intake and urinary output.

1 The client has experienced a bleed into the cranium. Plavix interferes with the client's clotting ability. This medication should be held and discussed with the HCP

The nurse is caring for a client diagnosed with a hemorrhagic stroke. Which medication should the nurse question administering? 1. Clopidogrel (Plavix), an antiplatelet. 2. Mannitol (Osmitrol), an osmotic diuretic. 3. Nifedipine (Procardia), a calcium channel blocker. 4. Dexamethasone (Decadron), a glucocorticoid.

4

The nurse is caring for the clients on the telemetry unit. Which medication should the nurse administer first? 1. The antiplatelet medication clopidogrel (Plavix) to the client with arterial occlusive disease. 2. The cardiac glycoside digoxin (Lanoxin) to the client diagnosed with congestive heart failure. 3. The iron dextran infusion to the client diagnosed with iron-deficiency anemia who has pale skin. 4. The antidysrhythmic amiodarone (Cordarone) to the client in ventricular bigeminy on the telemetry monitor.

2 These medications all work in different parts of the body to help decrease the client's blood pressure. The nurse should realize the HCP is having difficulty controlling the client's blood pressure and should monitor the client's blood pressure prior to administering.

The nurse is preparing to administer a calcium channel blocker, a loop diuretic, and a beta blocker to a client diagnosed with arterial hypertension. Which intervention should the nurse implement? 1. Hold the medication and notify the HCP on rounds. 2. Check the client's blood pressure. 3. Contact the pharmacist to discuss the medication. 4. Double-check the health-care provider's orders.

3

The nurse is preparing to administer clopidogrel bisulfate (Plavix), an antiplatelet medication, to the client with coronary artery disease. The client asks the nurse, "Why am I getting this medication?" Which statement by the nurse is most appropriate? 1. "It will help decrease your chance of developing deep vein thrombosis." 2. "Plavix will help decrease your LDL cholesterol levels in about 1 month." 3. "This medication will help prevent your blood from clotting in the arteries." 4. "The medication will help decrease your blood pressure if you take it daily."

1 Clients must be connected to a cardiac monitor prior to and during the infusion of cardiotonic drugs. The client in cardiogenic shock will be in the intensive care department.

The nurse is preparing to administer dopamine, a beta and alpha agonist, to a client in cardiogenic shock. Which intervention should the nurse implement? 1. Ensure the client is on a cardiac monitor. 2. Monitor the blood pressure every 15 minutes. 3. Evaluate the intake and output every hour. 4. Instruct the client to report burning at the intravenous site. 5. Assess the client's neurological status every hour.

4.The nurse would question administering Catapres to a client with decreased cardiac output (heart failure), because this medication acts within the brain stem to suppress sympathetic outflow to the heart and blood vessels. The result is vasodilation and reduced cardiac output, both of which lower blood pressure.

The nurse is preparing to administer medication to the following clients. Which medication should the nurse question administering? 1. The biguanide metformin (Glucophage) to a client with type 1 diabetes who is receiving insulin. 2. The loop diuretic bumetanide (Bumex) to a client diagnosed with essential hypertension. 3. The biologic response modifier erythropoietin (Procrit) to a client diagnosed with end-stage renal failure. 4. The central-acting alpha agonist clonidine (Catapres) to a client diagnosed with heart failure.

3 The nurse should question this medication if the apical rate is less than 60.

The nurse is preparing to administer medications to the following clients. Which client should the nurse question administering the medication? 1. The client receiving the angiotensin receptor blocker losartan (Cozaar) who has a B/P of 168/94. 2. The client receiving the calcium channel blocker diltiazem (Cardizem) who has 2+ pitting edema. 3. The client receiving the alpha blocker terazosin (Hytrin) who has a regular apical pulse of 56. 4. The client receiving the thiazide diuretic hydrochlorothiazide (HCTZ), who is complaining of a headache.

4, client with MG must take medications on time to ensure muscle function while eating or performing ADLs. Prostigmin is one of the few medications that must be administered exactly on time.

The nurse is preparing to administer morning medications. Which medication should the nurse administer first? 1. Hydrocodone (Vicodin), a narcotic analgesic, to the client with pain rated a 7 on pain scale of 1-10. 2. Furosemide (Lasix), a loop diuretic, IVP to a client with 2+ pitting edema. 3. Metformin (Glucophage), a biguanide, po to a client diagnosed with Type 2 diabetes. 4. Neostigmine (Prostigmin), a anticholinesterase, orally to the client diagnosed with myasthenia gravis.

3

The nurse is teaching the client diagnosed with angina about sublingual nitroglycerin (NTG), a coronary vasodilator. Which statement indicates the client needs more medication teaching? 1. "I will always carry my nitroglycerin in a dark-colored bottle." 2. "If I have chest pain, I will put a tablet underneath my tongue." 3. "If my pain is not relieved with one tablet, I will get medical help." 4. "I should expect to get a headache after taking my nitroglycerin."

3, Clonidine is administered primarily to treat hypertension, but it is also used to reduce the symptoms of withdrawal from opioids, nicotine, and alcohol. The nurse would question administering this medication because of the client's low blood pressure no matter why it is being prescribed

The nurse on the substance abuse unit is administering medications. Which medication should the nurse question administering? 1. Chlordiazepoxide (Librium), a benzodiazepine, to a client admitted for alcohol detoxification. 2. Haloperidol (Haldol), an antipsychotic, to a client diagnosed with phencyclidine (PCP) psychosis. 3. Clonidine (Catapres), an alpha-adrenergic agonist, to client with a blood pressure of 88/60. 4. Thiamine (B1), a vitamin, intravenously to a client diagnosed with Wernicke-Korsakoff syndrome.

3

The teenage client has just delivered a 7-pound baby. The girl has not received any prenatal care. Which medication is administered to the neonate to prevent complications related to sexually transmitted infections? 1. Zidovudine (Retrovir), a nucleoside reverse transcriptase inhibitor (NRTI). 2. Valacyclovir (Valtrex), an antiretroviral. 3. Erythromycin ophthalmic ointment, an antibiotic. 4. Metronidazole (Flagyl), a gastrointestinal anti-infective.

4 Contraindications to using this medication include clients who may be receiving beta-blocker therapy, including clients diagnosed with COPD, asthma, heart block, and heart failure.

Which client should the nurse question administering the beta-adrenergic blocker betaxolol (Betoptic) ophthalmic drops? 1. The client diagnosed with open-angle glaucoma. 2. The client diagnosed with end-stage liver failure. 3. The client diagnosed with allergies to sulfa. 4. The client diagnosed with chronic obstructive pulmonary disease (COPD).

1

Which client should the nurse question when administering the muscarinic antagonist atropine? 1. The 69-year-old client diagnosed with glaucoma. 2. The 60-year-old client diagnosed with symptomatic sinus bradycardia. 3. The 55-year-old client being prepped for an abdominal surgery. 4. The 28-year-old client with severe diarrhea.

2

Which is the preferred treatment for the diagnosis of primary syphilis in a teenage client? 1. Doxycycline (Vibramycin), a tetracycline, po every 4 hours for 10 days. 2. Benzathine penicillin G, an antibiotic, IM one time only. 3. Miconazole (Monistat), an antifungal, topical daily for 1 week. 4. Nitrofurantoin (Macrodantin), a macrolide, b.i.d. for 1 month.

2

nurse administered edrophonium (Tensilon), a cholinesterase inhibitor, to a client diagnosed with rule-out myasthenia gravis (MG). Which response by the client indicates the client has myasthenia gravis? 1. The client loses the ability to breathe without mechanical support. 2. The client's strength improves briefly without signs of fasciculations. 3. The client cannot gaze at the ceiling for 2 minutes without fatigue. 4. The client's paroxysmal atrial tachycardia converts to normal sinus rhythm.

3

3, the book said 3 but because we did not learn that I think it should be 2

4

84. The client receiving telemetry is showing ventricular fibrillation and has no pulse. Which medication should the nurse administer first? 1. Lidocaine. 2. Atropine. 3. Adenosine. 4. Epinephrine.

1. Epinephrine is the first medication administered in a code because it constricts the periphery and shunts the blood to the trunk of the body.

A code has been called for the client experiencing ventricular fibrillation. Which medication should the nurse prepare to administer to the client? 1. Epinephrine, an adrenergic agonist, intravenous push. 2. Lidocaine, an antidysrhythmic, intravenous push. 3. Atropine, an antidysrhythmic, intravenous push. 4. Digoxin, a cardiac glycoside, intravenous push.

1 Consuming alcohol concurrently with Flagyl can cause a severe reaction. This statement indicates the need for more teaching.

The 17-year-old client is prescribed metronidazole (Flagyl) and erythromycin (E Mycin) for a persistent Chlamydia infection. Which statements by the client indicate the need for further teaching? Select all that apply. 1. "I can have a beer or two while taking these medications." 2. "My boyfriend will have to take the medications too." 3. "I can develop more problems if I don't treat this disease." 4. "My birth control pills may not work because of the medications." 5. "Chlamydia is a sexually transmitted infection I got from my boyfriend."

4

The 6-year-old child is experiencing an acute exacerbation of reactive airway disease. The child passed out, and the parents brought the child to the emergency department. Which intervention should the nurse implement first? 1. Administer subcutaneous epinephrine via a tuberculin syringe. 2. Administer a beta2-adrenergic agonist, albuterol (Ventolin), via nebulizer. 3. Administer intravenous methylprednisolone, a glucocorticoid. 4. Administer oxygen to maintain oxygen saturation above 95%.

4

The HCP has instructed the 21-year-old female client diagnosed with allergies to take the over-the-counter medication pseudoephedrine (Sudafed). Which specific information should the nurse tell the client? 1. An expected side effect is drowsiness, so plan for rest periods. 2. Plan to use a second method of birth control while taking this medication. 3. The medication will cause a developing fetus to become deformed. 4. Take a driver's license to the pharmacy when purchasing this medication.

3

The client being discharged after sustaining an acute myocardial infarction is prescribed the ACE inhibitor lisinopril (Zestril). Which instruction should the nurse include when teaching about this medication? 1. Instruct the client to monitor the blood pressure weekly. 2. Encourage the client to take medication on an empty stomach. 3. Discuss the need to rise slowly from lying to a standing position. 4. Teach the client to take the medication at night only.

4

The client calls the clinic and says, "I am having chest pain. I think I am having another heart attack." Which intervention should the nurse implement first? 1. Call 911 emergency medical services. 2. Instruct the client to take an aspirin. 3. Determine if the client is at home alone. 4. Ask if the client has any sublingual nitroglycerin.

1

The client diagnosed with adult respiratory distress syndrome (ARDS) has been found to have a disease-causing organism resistant to the antibiotics being given. Which intervention should the nurse implement? 1. Monitor for therapeutic blood levels of the aminoglycoside antibiotic prescribed. 2. Prepare to administer the glucocorticoid medication ordered intramuscularly. 3. Obtain an order for repeat cultures to confirm the identity of the resistant organism. 4. Place the client on airborne isolation precautions.

1

The client diagnosed with angina is prescribed nitroglycerin (Nitrobid) and tells the nurse, "I don't understand why I can't take my Viagra. I need to take it so that I can make love to my wife." Which statement is the nurse's best response? 1. "If you take the medications together, you may get very low blood pressure." 2. "You are worried your wife will be concerned if you cannot make love." 3. "If you wait at least 8 hours after taking your nitroglycerin (NTG), you can take your Viagra." 4. "You should get clarification with your HCP about your taking Viagra."

3

The client diagnosed with cancer is being prepared for surgery. Which information should the outpatient surgery nurse convey to the surgeon immediately? 1. The client takes digoxin (Lanoxin) for heart problems. 2. The client stopped taking acetylsalicylic acid (aspirin) last week. 3. The client has been taking clopidogrel (Plavix) every day. 4. The client becomes nauseated after receiving anesthesia.

1 Hypertension is a risk factor for developing a stroke. Some clients require multiple medications to control their hypertension.

The client diagnosed with chronic hypertension is prescribed furosemide (Lasix), a loop diuretic, and enalapril (Vasotec), an ACE inhibitor. The client's blood pressures for the last 3 weeks have averaged 178/95, and the HCP has added atenolol (Tenormin), a beta blocker, to the client's current medication regimen. Which statement is the scientific rationale for including this medication in the client's regimen? 1. Achieving a lower average blood pressure will help to prevent a stroke. 2. The other medications are not effective without the addition of atenolol. 3. The atenolol will potentiate the effects of loop diuretics. 4. The HCP will taper off the ACE inhibitor and eventually discontinue it.

3

The client diagnosed with coronary artery disease is instructed to take 81 mg of aspirin ("baby aspirin," "children's aspirin" or "adult low-dose aspirin") daily. Which statement best describes the scientific rationale for prescribing this medication? 1. This medication will help thin the client's blood. 2. Daily aspirin will decrease the incidence of angina. 3. This medication will prevent platelet aggregation. 4. Baby aspirin will not cause gastric distress.

2

The client diagnosed with coronary artery disease is prescribed atorvastatin (Lipitor), an HMG-CoA reductase inhibitor. Which statement by the client indicates the medication is effective? 1. "I really haven't changed my diet, but I am taking my medication every day." 2. "I am feeling good since my doctor told me my cholesterol level came down." 3. "I am swimming at the local pool about three times a week for 30 minutes." 4. "Since I have been taking this medication the swelling in my legs is better."

2

The client diagnosed with coronary artery disease is prescribed atorvastatin (Lipitor), an HMG-CoA reductase inhibitor. Which statement by the client warrants the nurse notifying the health-care provider? 1. "I really haven't changed my diet, but I am taking my medication every day." 2. "I am feeling pretty good except I am having muscle pain all over my body." 3. "I am swimming at the local pool about three times a week for 30 minutes." 4. "I am taking this medication first thing in the morning with a bowl of oatmeal."

3 This is a beta blocker that if absorbed systemically may cause bradycardia and hypotension. The nurse should discuss ways to prevent orthostatic hypotension.

The client diagnosed with glaucoma is prescribed betaxolol (Betoptic), a beta-adrenergic blocker, ophthalmic drops. Which information should the nurse discuss with the client? 1. Instruct the client to call the HCP if dizziness occurs when getting up too fast. 2. Discuss that the drops will cause the vision to get worse initially. 3. Teach the client how to prevent orthostatic hypotension. 4. Explain the importance of applying pressure at the outer canthus.

1 The medications used to treat hyperplasia of the prostate were originally developed to treat high blood pressure. The client may develop hypotension when taking these medications. This side effect makes them useful for clients who are also hypertensive.

The client diagnosed with moderate benign prostatic hypertrophy (BPH) is being treated with the alpha-adrenergic antagonist tamsulosin (Flomax). Which intervention should the nurse implement? 1. Check the client's blood pressure. 2. Send a urinalysis to the laboratory. 3. Determine if the client has nocturia. 4. Plan a scheduled voiding pattern.

3

The client in cardiogenic shock is receiving dopamine, a beta and alpha agonist. The peripheral intravenous site becomes infiltrated. Which intervention should the nurse implement? 1. Assess the client's blood pressure and apical pulse. 2. Elevate the arm and apply ice to the infiltrated area. 3. Inject phentolamine (Regitine) at the site of infiltration. 4. Discontinue the IV and take no other action.

1

The client is admitted into the emergency department complaining of profuse salivation, excessive tearing, and diarrhea. The client tells the nurse he had been camping and living off the land. Which medication should the nurse anticipate administering? 1. Atropine, a muscarinic antagonist. 2. Diphenhydramine (Benadryl), an antihistamine. 3. Magnesium/aluminum hydroxide (Maalox), an antacid. 4. Pantoprazole (Protonix), a proton-pump inhibitor.

1

The client is having an acute exacerbation of asthma. The health-care provider has prescribed epinephrine (adrenaline) subcutaneously. Which intervention should the nurse implement when administering this medication? 1. Administer the medication using a tuberculin syringe. 2. Dilute the medication to a 5-mL bolus prior to administering. 3. Perform a complete respiratory assessment. 4. Monitor the client's serum epinephrine level.

2

The client with a serum cholesterol level of 320 mg/dL is taking the antihyperlipidemic medication ezetimibe (Zetia). Which statement by the client indicates the client needs more teaching concerning this medication? 1. "This medication helps decrease the absorption of cholesterol in my intestines." 2. "I cannot take this medication with any other cholesterol-lowering medication." 3. "I need to eat a low-fat, low-cholesterol diet even when taking the medication." 4. "It will take a few months for my cholesterol level to get down to normal levels."

1

The client with arterial occlusive disease is taking clopidogrel (Plavix), an antiplatelet medication. Which statement by the client warrants intervention by the nurse? 1. "I am taking the herb ginkgo to help improve my memory." 2. "I am a vegetarian and eat a lot of green, leafy vegetables." 3. "I have not had any blood drawn in more than a year." 4. "I always use a soft-bristled toothbrush to brush my teeth."

1

The client with cardiac disease is prescribed amiodarone (Cordarone), an antidysrhythmic, orally. Which teaching intervention should the nurse implement? 1. Notify the health-care provider of dyspnea, fatigue, and cough. 2. Instruct the client to take the medication prior to going to bed. 3. Tell the client not to take the medication if the apical pulse is less than 60. 4. Explain that this medication may cause the stool to turn black.

2

The client with essential hypertension is prescribed the beta blocker metoprolol (Lopressor). Which assessment data should make the nurse question administering this medication? 1. The client's blood pressure is 112/90. 2. The client's apical pulse is 56. 3. The client has an occipital headache. 4. The client is complaining of a yellow haze.

2 The nurse would question administering a beta blocker if the client's apical pulse was less than 60 because this medication decreases the heart rate.

The client with essential hypertension is prescribed the beta blocker metoprolol (Lopressor). Which assessment data should make the nurse question administering this medication? 1. The client's blood pressure is 112/90. 2. The client's apical pulse is 56. 3. The client has an occipital headache. 4. The client is complaining of a yellow haze.

1

The client with glaucoma is prescribed epinephrine (Epitrate), mydriatic ophthalmic drops. Which statement indicates the client understands the client teaching? 1. "I will call my health-care provider if I start experiencing any eye pain." 2. "This medication does not interfere with any over-the-counter medication." 3. "I will probably experience anxiety, nervousness, and muscle tremors." 4. "After putting the medication in my eyes I must lie down for 1 hour."

1

The client with otitis media is prescribed clarithromycin (Biaxin), an antibiotic, 500 mg PO every 12 hours for 10 days. Which medication teaching should the nurse discuss with the client? 1. Discuss the need to take medication with food. 2. Tell the client to wear sunglasses when going outdoors. 3. Instruct the client to get cultures after completing medications. 4. Encourage the client to eat yogurt or buttermilk daily.

4

The client working in a chemical plant that processes malathion for agricultural use presents to the emergency department with profuse sweating, visual disturbances, gastrointestinal disturbances, and bradycardia. Which medication should the nurse prepare to administer? 1.Dilantin, an anticonvulsant, IV every 4 hours. 2. Solu-Medrol, a glucocorticosteroid, IV every 8 hours. 3. Activated charcoal, an absorbent agent, PO every 2 hours. 4. Atropine, an anticholinergic, IV every 5 minutes.

3. Photosensitivity (sun reaction) may occur in persons taking tetracycline; therefore, the client should be taught to use safety precautions when in the sunlight. Using the hair dryer at the high heat setting will further dry out the scalp and increase dandruff production.

The female client diagnosed with acne is prescribed tetracycline. Which intervention should the nurse include in the medication teaching? 1. Take the medication with milk or milk products. 2. Explain that this medication may cause the teeth to discolor. 3. Tell the client to use sunscreen and protective clothing when outside. 4. Advise the client to take birth control pills.

1

The health-care provider prescribed a beta blocker for the client diagnosed with arterial hypertension. Which statement is the scientific rationale for administering this medication? 1.This medication decreases the sympathetic stimulation to the heart, thereby decreasing the client's heart rate and blood pressure. 2. This medication prevents the calcium from entering the cell, which helps decrease the client's blood pressure. 3. This medication prevents the release of aldosterone, which decreases absorption of sodium and water, which, in turn, decreases blood pressure. 4. This medication will cause an increased excretion of water from the vascular system, which will decrease the blood pressure.

2, This medication relaxes the urinary sphincters and increases voiding pressure by contracting the detrusor muscle of the bladder; therefore, the client will need to have a urinal available for frequent urination

The male client diagnosed with urinary retention is receiving bethanechol (Urecholine), a muscarinic agonist, medication. Which intervention should the nurse implement? 1. Limit the client's fluid intake to 1000 mL daily. 2. Have the client's urinal readily available. 3. Maintain hourly intake and output for the client. 4. Monitor the client's serum creatinine level.

2345

The male client is diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) of the urine and is receiving vancomycin (IVPB). Which interventions should the nurse implement when administering this medication? Select all that apply. 1. Hold the medication if the trough level is 5 mg/dL. 2. Ask the client if he is allergic to any medication. 3. Administer the medication via an infusion pump. 4. Check the client's BUN and creatinine levels. 5. Assess the client's intravenous insertion site.

1

The nurse is administering 0900 medications to the following clients. Which client should the nurse question administering the medication? 1. The client receiving a calcium channel blocker who drank a glass of grapefruit juice. 2. The client receiving a beta blocker who has an apical pulse of 62 beats per minute. 3. The client receiving a nitroglycerin patch who has a blood pressure of 148/92. 4. The client receiving an antiplatelet medication who has a platelet count of 150,000.

2

The nurse is administering medications to clients on a urology floor. Which medication should the nurse question? 1. Ceftriaxone (Rocephin), a third-generation cephalosporin, to a client who is pregnant. 2. Cephalexin (Keflex), a cephalosporin, to a client who is allergic to penicillin. 3. Trimethoprim sulfa (Bactrim), a sulfa antibiotic, to a client post-prostate surgery. 4. Nitrofurantoin (Macrodantin), a sulfa antibiotic, to a client with urinary stasis.