Pharm exam 3 resource questions

C (Chloroquine is a standard drug used for the treatment of malaria in an acute stage.)

A nurse is caring for a client diagnosed with malaria. What drug would the nurse expect to be prescribed? A. Pentamidine (Pentam) B. Penicillin C. Chloroquine (Aralen) D. Metronidazole (Flagyl)

D (Clients taking allopurinol should be informed to increase fluid intake to 3 L per day, avoid hazardous activities if dizziness or drowsiness occurs with the medication, and avoid the use of alcohol and caffeine because these drugs will increase uric acid levels and decrease the levels of allopurinol.)

A nurse teaching a client receiving allopurinol (Zyloprim) should include which information? "Take the medication with an antacid to minimize GI distress." "This medication may cause your urine to turn orange." "Include salmon and organ meats in your diet on a weekly basis." "Increase your fluid intake to 3 L per day."

A (Isoniazid can cause neurotoxicity. Pyridoxine, vitamin B6, is the drug of choice to prevent this adverse reaction. It is not an antiinfective drug and thus will not work to destroy the mycobacterium or prevent drug resistance.)

Before discharge, the nurse is reviewing a client's prescribed medication regimen for tuberculosis (TB). The client asks the nurse why pyridoxine (vitamin B6) has been prescribed while continuing to take isoniazid (Nydrazid) to treat TB. What is the nurse's best response? A. "Pyridoxine will help prevent numbness, and tingling that can occur secondary to the isoniazid." B. "Pyridoxine is another antitubercular drug that will work synergistically with the isoniazid." C. "You really should not be on that drug. I will check with the health care provider." D. "Multidrug therapy is necessary to prevent the occurrence of resistant bacteria."

A.B.C (NSAIDs are known for their antiinflammatory effects. Indomethacin, in addition, is also used for its antirheumatic and antipyretic properties. NSAIDs are often known to have nausea as a common adverse effect. Indomethacin is not used as an anticonvulsant.)

The acetic acid derivative indomethacin (Indocin) has which properties? (Select all that apply.) Select all that apply. A. Antirheumatic B. Antiinflammatory C. Antipyretic D. Antinausea E. Anticonvulsant

B (There is evidence that clients would benefit from glucosamine and chondroitin supplements to decrease the pain of osteoarthritis. However, they should always be used in consultation with a health care provider.)

The client asks the nurse about the use of herbal and dietary supplements to treat arthritis pain. What is the nurse's best response? A. "Ginkgo biloba has shown tremendous benefit as an antiinflammatory drug and is used to treat the symptoms of pain." B. "There is evidence that glucosamine sulfate with chondroitin does decrease joint stiffness and pain. Discuss this with your health care provider." C. "There really are no safe herbal treatments for pain. Your best action would be to take your prescription medications." D. "High doses of vitamins and minerals have been used for many years to help maintain joint health."

A (Impetigo is a bacterial skin infection and would not be classified as a fungal skin infection. If the client included this in the discussion, further teaching is needed. All other skin infections listed are fungal and would be treated with antifungal medications.)

The nurse has provided education to a client about fungal skin infections. Further client teaching is necessary when the client includes which condition in the discussion of fungal skin infections? A. Impetigo B. Vaginal yeast infection C. Athlete's foot D. Thrush

B ("I will have my partner evaluated and treated." Inform the client taking metronidazole for a sexually transmitted infection to avoid sexual intercourse until the prescriber states otherwise. The partner, and any sexual partners possibly exposed, need to be evaluated and treated if positive. All other statements would require further teaching by the nurse.)

The nurse is providing education to a client who is prescribed metronidazole (Flagyl) for trichomoniasis. What client statement indicates that the client understood the teaching? "I won't get this again because I have had it once." "I will have my partner evaluated and treated." "I will stop taking the medication when the discharge stops." "I can continue to have intercourse as long as we use condoms."

B (Treatment for malaria prophylaxis is usually started 2 weeks before travel and continues for 8 weeks after travel is completed.)

The nurse is teaching a client who is preparing to travel to a malarious country about the prophylactic medication chloroquine (Aralen). The nurse would instruct the client to take this drug for how long after leaving the affected area? A. 12 weeks B. 8 weeks C. 4 weeks D. 2 weeks

C (Colchicine works by inhibiting the metabolism and migration of leukocytes into joints affected by gout, thus resulting in decreased inflammation.)

The nurse knows colchicine (Colcrys) exerts its therapeutic effect by what action? A. Increases production of lactic acid B. Increases process of phagocytosis C. Decreases mobility of leukocytes D. Increases uric acid metabolism

C (The major adverse effects caused by antifungal drugs are encountered most commonly in conjunction with amphotericin B treatment. Drug interactions and hepatotoxicity are the primary concerns in clients receiving other antifungal drugs, but the IV administration of amphotericin B is associated with a multitude of adverse effects.)

The nurse needs to know that major adverse effects are MOST common by which drug? A. Griseofulvin (Fulvicin P/G) B. Ketoconazole (Nizoral) C. Amphotericin B (Amphocin) D. Fluconazole (Diflucan)

C (Aspirin should never be administered to children with flulike symptoms. The use of aspirin in children with flulike symptoms has been associated with Reye's syndrome.)

The nurse should question a prescription to administer acetylsalicylic acid (aspirin) to which client? A 45-year-old patient with a history of heart attack A 62-year-old patient with a history of stroke A 14-year-old patient with a history of flulike symptoms A 28-year-old patient with a history of sports injury

B. (valproic acid- Concurrent use of chloroquine with valproic acid may reduce serum drug levels of valproic acid and thus increase the risk of seizure activity. Chloroquine may be given concurrently with clindamycin or doxycycline for synergistic actions.)

The nurse would question a prescription for chloroquine (Aralen) in a client also prescribed which medication? A.Doxycycline (Doryx) b.Valproic acid (Depakote) c. Diazepam (Valium) d. Clindamycin (Cleocin)

B (Quinidine The nurse would question a prescription for quinidine because both voriconazole and quinidine are metabolized by the cytochrome P-450 enzyme system. The drugs will compete for the limited number of enzymes, and one of the drugs will end up accumulating.)

The nurse would question a prescription for voriconazole (Vfend) if the client was taking which medication? A. Prednisone (Deltasone) B. Quinidine C. Clindamycin (Cleocin) D. Captopril (Capoten)

D (Misoprostol is an abortifacient and thus is contraindicated in pregnancy.)

The nurse would question a prescription to administer misoprostol (Cytotec) to a client with which condition? 1. Gastroesophageal reflux disease 2. Peptic ulcer 3. Chronic obstructive pulmonary disease 4. Pregnancy

A.B.C.E (Nursing interventions appropriate to clients receiving antifungal drugs vary depending on the particular drug. However, it is important for the nurse to monitor all clients for indications of possible medication-induced renal damage so that prompt interventions can occur to prevent further dysfunction. Monitoring intake and output amounts, daily weights, and renal function tests will help prevent such damage.)

What are important for the nurse to monitor in a client receiving an antifungal medication? (Select all that apply.) Select all that apply. A. Blood urea nitrogen B. Daily weights C. Creatinine D. Mental status E. Intake and output

D.E (Drug allergy, liver failure, kidney failure, and porphyria (for griseofulvin) are the most common contraindications for antifungal drugs.)

What conditions are considered contradictions for use of antifungal medications? (Select all that apply.) Select all that apply. A. Heart failure B. Respiratory failure C. Pancreatic failure D. Liver failure E. Kidney failure

C (Red-orange-brown discoloration of the skin, sweat, tears, urine, feces, sputum, saliva, and tongue as an adverse effect of the drug, but it is not harmful. Rifampin does not cause peripheral neuropathies (isoniazid does), but it does interfere with the effectiveness of oral contraceptives. All antitubercular drugs need to be taken long term to eradicate the slow-growing mycobacterium lying deep within the tissues.)

What information should the nurse provide to a client prescribed rifampin (Rifadin)? a. Peripheral neuropathy is an expected side effect, and the patient should report any numbness or tingling of the extremities. B. Oral contraception is the preferred method of birth control when using rifampin. c. A nonharmful adverse effect of this medication is red-orange discoloration of urine, sweat, tears, skin, salvia, and feces. D. The patient will only need to take this medication for the prescribed 14-day period.

C (Women taking oral contraceptives who are prescribed rifampin must be switched to another form of birth control because oral contraceptives become ineffective when given with rifampin. These medications must be taken long term because mycobacterium is slow growing. They can cause photosensitivity, necessitating the use of sunscreen. Finally, isoniazid may increase, not decrease, serum glucose levels.)

What instruction should the nurse include for a client prescribed rifampin (Rifadin) and isoniazid (Nydrazid) prophylactically secondary to TB exposure? A. Remind that sunscreen is not needed during outdoor activities. B. Explain that isoniazid may decrease blood serum glucose in susceptible people. C. Emphasize that oral contraceptives become ineffective when given with rifampin. D. Advise that these drugs will only need to be taken for 7 to 10 days.

B. (By not inhibiting the COX-1 enzyme to maintain an intact gastric mucosal barrier by increasing secretion of mucus, the risks of GI adverse effects are decreased.)

What is advantage of COX-2 inhibitors over other NSAIDs? A. Are less likely to cause hepatic toxicity B. Maintain GI mucosa C. Have a longer duration of action D. Have a more rapid onset of action

D (ystatin (Mycostatin) Nystatin is an antifungal drug that is used for a variety of candidal infections. It is applied topically as a cream, ointment, or powder. It is also available as a troche and an oral liquid or tablet.)

What is the MOST common drug used to treat oral candidiasis? A. Oseltamivir (Tamiflu) B. Griseofulvin (Fulvicin P/G) C. Amantadine (Symmetrel) D. Nystatin (Mycostatin)

D (Almost all clients given IV amphotericin B experience fever, chills, hypotension, tachycardia, malaise, muscle and joint pain, anorexia, nausea and vomiting, and headache. Pretreatment with an antipyretic, antihistamine, and antiemetic can minimize or prevent these adverse reactions. The other choices are appropriate nursing actions after the IV infusion has begun.)

What is the MOST important action for the nurse to complete before administration of intravenous (IV) amphotericin B? A. Monitor for cardiac dysrhythmias. B. Assess for nausea and vomiting. C. Monitor IV site for signs of phlebitis. D. Check for premedication prescriptions.

A (Prostaglandins are produced in response to activation of the arachidonic pathway. NSAIDs work by blocking cyclooxygenase (COX-1 and COX-2), the enzyme responsible for conversion of arachidonic acid into prostaglandins. Decreasing the synthesis of prostaglandins results in decreased pain and inflammation)

What is the mechanism of action of nonsteroidal antiinflammatory drugs (NSAIDs)? A. Inhibiting prostaglandin production B. Increasing the supply of natural endorphins C. Increasing blood flow to painful areas D. Enhancing pain perception

D (Dizziness or confusion During use of this drug, metronidazole administered intravenously, report to the health care provider any changes in neurologic status (e.g., dizziness, confusion).)

When a client is receiving an IV infusion of metronidazole (Flagyl), what adverse effect would the nurse immediately report to the health care provider? A. Elevated blood pressure B. Dark colored urine C. Diminished breath sounds D. Dizziness or confusion

A (Iodoquinol and paromomycin are used to treat intestinal amebiasis, and albendazole is used to treat helminthic infections.)

When admitting a client to a medical-surgical unit with a diagnosis of Pneumocystis jirovecii pneumonia, the nurse will anticipate administering which medication? A. Pentamidine (Pentam) B. Paromomycin (Humatin) C. Iodoquinol (Yodoxin) D. Albendazole (Albenza)

A.B (Rifamate can lead to impairment of liver function as well as hematologic disorders. Assessment of sputum cultures confirms the diagnosis but is not related to adverse effects. The drug does not affect uric acid levels or cholesterol.)

When assessing for adverse effects to Rifamate (combination isoniazid and rifampin), the nurse would monitor which laboratory values? (Select all that apply.) Select all that apply. A. Liver function tests B. Complete blood cell count C. Sputum cultures D. Uric acid levels E. Cholesterol

30 to 60 (Infuse IV doses of metronidazole as prescribed and generally are to infuse over 30 to 60 minutes and never as an IV bolus.)

When preparing to administer an intravenous (IV) infusion of metronidazole (Flagyl), the nurse will anticipate infusing the medication over how many minutes?

B (A major adverse effect of NSAID therapy is gastrointestinal (GI) distress with potential GI bleeding. Black or tarry stools are indicative of a GI bleed.)

When teaching a client about potential adverse effects of NSAID therapy, the nurse will teach the client to immediately notify the health care provider of which effect? A. Nonproductive cough B. Black tarry stools C. Diarrhea D. Mild indigestion

C (Ketorolac can be administered by injection (intramuscularly or intravenously) and is indicated for the short-term treatment of moderate to severe acute pain.)

Which NSAID would the nurse anticipate administering parenterally for the treatment of acute postoperative pain? A. Indomethacin (Indocin) B. Allopurinol (Zyloprim) C. Ketorolac (Toradol) D. Diclofenac (Cataflam)

C (Fluconazole is an antifungal drug that does not cause the major adverse effects of amphotericin when given intravenously. It is also very effective against vaginal yeast infections, and a single dose is often sufficient to treat vaginal infections.)

Which antifungal drug can be given intravenously to treat severe yeast infections as well as a one-time oral dose to treat vaginal yeast infections? A. Nystatin (mycostatin) B. Caspofungin C. Fluconazole D. Voriconazole

D ("I will need to have my vision checked periodically while I am taking this drug." Ethambutol can cause optic neuritis. Ophthalmologic examinations should be performed periodically to assess visual acuity.)

Which client statement indicates to the nurse that the client understands the discharge teaching for ethambutol (Myambutol)? A. "Constipation will be a problem, so I will increase the fiber in my diet." B. "This medication may cause my bodily secretions to turn red-orange-brown." C. "Dizziness and drowsiness are common adverse effects with this drug." D. "I will need to have my vision checked periodically while I am taking this drug."

C (Colchicine is administered on an hourly basis until pain is relieved, the client develops severe nausea and diarrhea, or the maximum dose (6 mg) has been administered. Bleeding into the GI or urinary tracts is a potential serious adverse effect of colchicine.)

Which nursing diagnosis is appropriate for a client prescribed colchicine (Colcrys)? Risk for injury related to adverse effect of life threatening seizures Constipation related to adverse effect of the medication Risk for fluid volume deficient related to nausea, vomiting, and diarrhea Risk for infection related to medication-induced leukocytosis

C (Pyridoxine (vitamin B6) is often given concurrently with isoniazid to prevent the adverse effect of isoniazid induced peripheral neuropathy associated with neurotoxicity.)

he nurse anticipates a prescription for vitamin supplementation for a client who is receiving isoniazid (Nydrazid) therapy. What vitamin supplement is usually prescribed with isoniazid? A. Vitamin E B. Calcium C. Vitamin B6 D. Folate