Pharm Exam 2 Practice Questions

a

The nurse cares for a patient receiving digoxin (Lanoxin). What indicates to the nurse that treatment with this medication is effective? A. Improved cardiac output B. Reduced exercise tolerance C. Increased body weight D. Decreased cardiac contractility

c

A patient has hypertension, type 2 diabetes, and chronic kidney disease. Which goal should the nurse recommend to this patient? A. Blood pressure less than 140/90 mm Hg B. Diastolic blood pressure less than 100 mm Hg C. Blood pressure less than 130/80 mm Hg D. Systolic blood pressure less than 160 mm Hg

a

A nurse administers quinidine sulfate to a patient with atrial fibrillation. The nurse should assess the electrocardiogram (ECG) tracing for what? A. Prolongation of the QT interval B. Prolongation of the PR interval C. Narrowing of the QRS complex D. Tall, peaked T waves

b

A nurse instructs a patient about signs and symptoms of digoxin toxicity. The nurse determines that teaching is successful if the patient makes which statement? "If my heart is racing, the dose may be too high." "I should report any muscle weakness or nausea." "My doctor should be notified if diarrhea occurs." "The dose will be reduced if I develop memory loss."

c

A patient asks what medication would be most effective in the treatment of seasonal hay fever. The nurse will teach the patient about the use of which drug? A. Azelastine (Astelin) B. Chlorpheniramine (Chlor-Trimeton) C. Fluticasone (Flonase) D. Pseudoephedrine (Sudafed)

b

A patient diagnosed with an ST-elevation myocardial infarction has an angioplasty. Which medication should the nurse initiate before this procedure? A. Dobutamine (Dobutrex) B. Abciximab (Reo-Pro) C. Alteplase (Activase) D. Warfarin (Coumadin)

b

A patient diagnosed with heart failure has stage 1 hypertension. Which medication, if ordered by the physician, should the nurse question? A. Angiotensin-converting enzyme inhibitor B. Calcium channel blocker C. Thiazide diuretic D. Beta blocker

b

A patient diagnosed with systemic lupus erythematosus (SLE) develops a dysrhythmia. Which medication, if ordered by the physician, should the nurse question? A. Lidocaine (Xylocaine) B. Procainamide (Procanbid) C. Disopyramide (Norpace) D. Amiodarone (Cordarone)

a

A patient has a serum potassium level of 3.1 mEq/L. It is appropriate for the nurse to take which action? A. Administer sustained-release potassium tablets (K-Dur). B. Offer food and fluids that are low in potassium. C. Prepare an intravenous dose of furosemide (Lasix). D. Give a dose of sodium polystyrene sulfonate (Kayexalate).

d

A patient has a serum potassium level of 6.4 mEq/L and an arterial pH of 7.22. Which medication, if ordered by the physician, should the nurse question? A. Sodium bicarbonate B. Glucose and insulin C. Spironolactone (Aldactone) D. Calcium gluconate

a

A patient has codeine prescribed 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 has indications of an ST-elevation myocardial infarction. Which medications would the nurse consider routine therapy for this patient? A. Beta blocker, angiotensin II receptor blocker, and oxygen B. Aspirin, angiotensin-converting enzyme inhibitor, and diuretics C. Aspirin, beta blocker, oxygen, morphine, and nitroglycerin D. Heparin, nitroprusside, morphine, and calcium channel blocker

b

A patient is prescribed a medication that causes venous dilation. It is most important for the nurse to teach the patient about what? A. Brain natriuretic peptides B. Postural hypotension C. Increased urination D. Intermittent claudication

c

A patient is prescribed a medication that lowers the arterial blood pressure. The nurse should assess for which response by the body to restore the blood pressure? A. Orthostatic hypotension B. Fluid retention C. Reflex tachycardia D. Increased natriuresis

c

A patient is prescribed a nitroglycerin transdermal patch. The nurse should include which statement when teaching the patient how to use this medication? A. "Apply the patch to the chest over the heart." B. "Change the patch each week." C. "Remove the patch at bedtime." D. "Put on the patch before exercising."

c

A patient is prescribed digoxin (Lanoxin) and furosemide (Lasix). It is most important for the nurse to assess which value before administration of these medications? A. Serum sodium B. Blood urea nitrogen C. Serum potassium D. Plasma B-natriuretic peptide

b

A patient is prescribed hydralazine (Apresoline). What is most important for the nurse to teach the patient? A. Precautions for postural hypotension B. Prevention of reflex tachycardia C. High initial dose for slow acetylators D. Recognition of hypertrichosis

c

A patient is prescribed spironolactone (Aldactone) for treatment of hypertension. Which foods should the nurse teach the patient to avoid? A. Baked fish B. Low-fat milk C. Salt substitutes D. Green beans

d

A patient is prescribed sustained-release oral nitroglycerin capsules for chronic stable angina. The nurse should include which instruction? A. "Maintain a sedentary lifestyle to prevent chest pain." B. "Place the capsule under the tongue if chest pain occurs." C. "Take the capsule as needed before exercise or exertion." D. "Sit or lie down if dizziness or lightheadedness occurs."

c

A patient is prescribed verapamil (Calan). The nurse should assess the patient for which common adverse effects? A. Atrial fibrillation, photosensitivity, and blurred vision B. Tachycardia, stomatitis, and inflammation of the joints C. Constipation, headache, and edema of the ankles and feet D. Dry mouth, lymphadenopathy, and decreased appetite

a

A patient is receiving an intravenous infusion of heparin to treat a pulmonary embolism. What laboratory value will the nurse monitor to evaluate treatment with this medication? A. Activated partial thromboplastin time (aPTT) B. Prothrombin time (PT) C. Platelet count D. Hemoglobin and hematocrit

d

A patient is to receive a scheduled dose of diltiazem (Cardizem). The nurse should hold the medication and contact the prescriber if what occurs? A. The patient's blood pressure is 112/64 mm Hg. B. The patient's cardiac rhythm is atrial fibrillation. C. The patient is complaining of chest pain. D. The patient is in second-degree heart block.

c

A patient receives an intravenous infusion of amiodarone (Coredarone) to prevent recurrent episodes of ventricular fibrillation. The nurse should assess the patient for what? A. Urinary retention B. Hypercalcemia C. Hypotension D. Metallic taste

b

A patient who is hospitalized for an infection takes eplerenone (Inspra) for heart failure. Which medication, if ordered by the physician, should the nurse question? A. Ciprofloxacin (Cipro) B. Itraconazole (Sporanox) C. Tetracycline (Sumycin) D. Ampicillin (Principen)

c

A patient who is receiving intravenous nitroprusside (Nitropress) is disoriented and unable to recognize family members. The nurse should take which action first? A. Perform a complete neurologic examination. B. Provide reality orientation as needed. C. Stop the intravenous nitroprusside. D. Review the patient's liver function tests.

c

A patient who is taking spironolactone (Aldactone) is prescribed losartan (Cozaar). The nurse should take which action? A. Assess for symptoms of hyperkalemia. B. Observe for a hypertensive crisis. C. Administer the medications as scheduled. D. Evaluate for first-dose hypotension.

b

A patient who is vomiting has the following arterial blood gases: pH 7.49, PaCO2 42.5 mm Hg, and HCO3 28.2 mEq/L. What treatment does the nurse anticipate will be prescribed to correct this imbalance? A. Sodium bicarbonate intravenous infusion B. Infusion of sodium chloride with potassium chloride C. Rebreathe expired air through a paper bag D. Hypertonic solution of 3% sodium chloride

b

A patient with a serum magnesium level of 0.5 mEq/L receives an intravenous infusion of 10% magnesium at 1.5 mL/min. The nurse should assess the patient for which adverse effects? A. Skeletal muscle paralysis, bloating, and ileus B. Respiratory paralysis, hypotension, and lethargy C. Muscle twitching, disorientation, and seizures D. Peaked T wave, tingling of the lips, and anxiety

a

A patient with angina pectoris is prescribed sublingual nitroglycerin. Which statement made by the patient indicates understanding of the medication teaching? A. "I may experience a headache as a side effect." B. "The chest pain should be relieved within 20 minutes." C. "I should swallow the tablet and drink a glass of water." D. "I should take this medication in the morning before breakfast."

c

A patient with asthma is prescribed albuterol (Proventil), two puffs 3 times per day. The nurse should teach the patient to do what? A. Rinse the mouth after taking the prescribed dose. B. Take an extra dose if breathing is compromised. C. Wait 1 minute between puffs from the inhaler. D. Take adequate amounts of calcium and vitamin D.

b

A patient with asthma is prescribed triamcinolone acetonide (Azmacort). The nurse should do what? A. Take the pulse before administration of the medication. B. Teach the patient to use a spacer to prevent a fungal infection. C. Instruct the patient to use the inhaler to treat an acute attack. D. Encourage the patient to avoid weight-bearing activity.

b

A patient with heart failure who takes furosemide (Lasix) is diagnosed with bacterial pneumonia. Which medication, if ordered by the physician, should the nurse question? A. Ciprofloxacin (Cipro) B. Gentamicin (Garamycin) C. Amoxicillin (Amoxcil) D. Erythromycin (E-Mycin)

b

A patient with severe hypertension is prescribed minoxidil. Which medications will the nurse expect to be administered to reduce adverse responses to minoxidil? A. Adenosine (Adenocard) and ticlopidine (Ticlid) B. Furosemide (Lasix) and propranolol (Inderal) C. Digoxin (Lanoxin) and captopril (Capoten) D. Donepezil (Aricept) and clonidine (Catapres)

b

A patient with stage 2 hypertension is prescribed a thiazide diuretic and an angiotensin-converting enzyme inhibitor. Which action by the nurse is best? A. Contact the healthcare provider. B. Administer both drugs to the patient. C. Give the thiazide diuretic at bedtime. D. Hold the medications if the blood pressure is normal.

b

A patient's cardiac output is 8 liters per minute. Which hemodynamic effect would the nurse expect? A. Decreased contractility B. Increased stroke volume C. Decreased preload D. Increased arterial pressure

c

The nurse cares for a patient receiving an intravenous heparin infusion. Which medications would the nurse administer as an antidote if the patient develops uncontrolled bleeding? A. Ferrous sulfate B. Atropine sulfate C. Protamine sulfate D. Magnesium sulfate

c

During administration of alteplase (Activase), the patient's IV site starts to ooze blood around the catheter. Which action by the nurse is most appropriate? A. Discontinue the infusion of alteplase. B. Assess the patient's vital signs. C. Apply direct pressure over the puncture site. D. Administer aminocaproic acid (Amicar).

d

The nurse cares for a patient in the emergency department with chest pain and an ST-elevation myocardial infarction. The patient is prescribed aspirin. Which action by the nurse is appropriate? A. Give the medication to the patient if a headache occurs. B. Administer the medication with a full glass of water. C. Instruct the patient to swallow an enteric-coated tablet. D. Tell the patient to chew the tablet thoroughly.

d

The nurse cares for a patient who is prescribed oral bumetanide twice daily. It is most important for the nurse to take which action? A. Monitor the patient for signs and symptoms of hyperkalemia. B. Insert a urinary catheter and assess hourly urine output. C. Weigh the patient before administering each dose. D. Schedule the medication to be given at 0800 and 1400.

a

The nurse cares for a patient with a digoxin level of 1.9 ng/mL. Which action would be most appropriate for the nurse to take initially? A. Start continuous heart monitoring. B. Check the patient's serum creatinine. C. Administer digoxin as prescribed. D. Give Fab antibody fragments (Digibind).

d

The nurse gives discharge instructions to a diabetic patient who had an ST-elevation myocardial infarction. Which statement, if made by the patient to the nurse, indicates that further teaching is required? A. "Medications are needed to prevent heart failure." B. "I will take aspirin, atenolol, and captopril indefinitely." C. "My blood pressure should be less than 130/80 mm Hg." D. "Daily estrogen will prevent another heart attack."

b

The nurse instructs a patient about taking nifedipine (Procardia XL). Which statement made by the patient indicates an understanding of medication teaching? A. "I will stop taking my beta blocker." B. "The pill should be swallowed whole." C. "The drug will cause constipation." D. "This drug treats heart rhythm problems."

d

The nurse is preparing to administer adenosine (Adenocard) to a patient to treat paroxysmal supraventricular tachycardia. Which action by the nurse is most appropriate? A. Inject the medication into the peripheral intravenous (IV) line. B. Infuse the dose by diluting the drug in 100 mL of saline. C. Administer a small test dose to determine hypersensitivity. D. Give the medication through the central line catheter.

a

The nurse teaches a patient about benazepril (Lotensin). Which statement by the patient requires an intervention by the nurse? A. "I use NoSalt for seasoning foods instead of salt." B. "I eat sweet potatoes once or twice a week." C. "I drink 4 ounces of prune juice each morning." D. "I like asparagus because it is high in vitamin K."

c

The nurse teaches a patient diagnosed with chronic stable angina about the mechanism of action of nitroglycerin. The nurse should include which instruction? A. "Nitroglycerin reduces vasospasms of the heart's arteries, which improves blood supply." B. "Nitroglycerin opens the arteries to allow more oxygen to be delivered to the heart muscle." C. "Nitroglycerin dilates veins, which decreases the amount of oxygen needed by the heart." D. "Nitroglycerin improves blood flow to the heart muscle by increasing blood pressure."

a

The nurse teaches a patient who is taking furosemide (Lasix) about foods and beverages that should be consumed. Which dietary items, if selected by the patient, would indicate an understanding of the instructions? A. Oranges, spinach, and potatoes B. Baked fish, chicken, and cauliflower C. Tomato juice, skim milk, and cottage cheese D. Oatmeal, cabbage, and bran flakes

b

The nurse will teach a patient who is prescribed niacin (Niacor) to prevent flushing of the face by doing what? A. Drinking a full glass of water after taking the medication B. Taking 325 mg of aspirin 30 minutes before each dose C. Ingesting a meal before taking the medication D. Increasing dietary fiber before and after each dose

b

The patient is prescribed lovastatin (Mevacor). The nurse will teach the patient to take the medication at which time? A. At any meal B. With the evening meal C. 1 hour before breakfast D. 2 hours after a meal

a

The physician prescribes sustained-release verapamil (Calan SR) to an 82-year-old patient who takes digoxin (Lanoxin) daily. Which action by the nurse is best? A. Monitor the patient's cardiac rhythm continuously. B. Assess the patient for tachycardia and hypertension. C. Maintain the patient on bed rest for 8 to 10 hours. D. Reduce dietary fiber to prevent loose, watery diarrhea.

d

Which patient would be a candidate for both lifestyle changes and drug therapy with an antihypertensive medication? A. A 47-year-old patient with blood pressure of 110/78 mm Hg and with type 2 diabetes mellitus B. A 76-year-old patient with blood pressure of 128/88 mm Hg and a history of dyslipidemia C. A 52-year-old patient with blood pressure of 136/89 mm Hg who smokes 1 pack of cigarettes per day D. A 32-year-old patient with blood pressure of 142/94 mm Hg who is sedentary

d

Which patient would most likely be prescribed sodium nitroprusside (Nitropress)? A. A patient with a recent diagnosis of essential hypertension B. A patient with heart failure who receives weekly home visits C. A patient who is hypotensive after a myocardial infarction D. A patient with a hypertensive crisis in the intensive care unit

d

Which patient would the nurse expect to have the highest risk for postural hypotension? A. A patient who is prescribed a drug that acts primarily on the arterioles B. A patient who is prescribed a drug that blocks the renin-angiotensin-aldosterone system C. A patient who is prescribed a drug that triggers the baroreceptor reflex D. A patient who is prescribed a drug that promotes venous vasodilation

c

Which patients may need an increased dose of warfarin (Coumadin) to have the same anticoagulant effect? A. A patient taking acetaminophen (Tylenol) for back pain B. A patient taking cimetidine (Tagamet) to prevent gastric ulcers C. A patient taking oral contraceptives to prevent pregnancy D. A patient taking prednisone (Deltasone) for rheumatoid arthritis