pharm final eaqs
4
A nurse is teaching a patient about ibandronate [Boniva]. Which information is essential to include in the teaching session? 1 "Take this medicine right before bedtime." 2 "Take this medicine with a full glass of milk or water." 3 "Sit or stand for at least 30 minutes after taking this medicine." 4 "Do not eat anything for at least 60 minutes after taking this medicine."
A,B,E
A nurse is teaching adolescents about bone health. Which information should be included in the teaching session? Select all that apply. A Avoid smoking. B Avoid excessive alcohol. C Obtain 1200 mg of calcium a day. D Have a bone mineral density test done. E Perform regular weight-bearing exercise.
2
A patient has refused to take his prescribed medication and is adamant that the tablet is worsening his condition. What does the nurse do? 1 Mix the medication in the patient's food or drink. 2 Respect the patient's right to refuse and notify the provider. 3 Try to give the medication to the patient again after a few hours. 4 Return the unwrapped medication to the container for safe future use.
1
A patient is prescribed calcium gluconate for treatment of hypocalcemia. Which statement by the patient indicates a need for further teaching? 1 "I will take the calcium 1 hour before eating." 2 "I will need to avoid eating whole-grain cereals." 3 "I should drink a large glass of water each time I take my calcium." 4 "I will need to call my healthcare provider if I develop vomiting, constipation, or frequency of urination."
B,C,D,E
A patient is taking valerian root for the promotion of sleep. What should the nurse teach the patient about the adverse effects of valerian root? Select all that apply. A Urinary retention can occur. B Avoid driving while taking valerian root. C If you feel depressed, call your provider. D Prolonged use can cause cardiac abnormalities. E If you become pregnant, stop taking valerian root.
4
A patient who has depression is admitted to the emergency department with serotonin syndrome. The nurse learns that the patient is taking an herbal medication and citalopram [Celexa]. Which herbal medication is the patient most likely taking? 1 Valerian 2 Cranberry 3 Saw palmetto 4 St. John's wort
2
A patient with Parkinson's disease is treated with levodopa [Parcopa]. During the follow-up visit, the nurse finds that the patient is having an on-off phenomenon caused by the medication. Which findings would likely cause the nurse to come to this conclusion? 1 Sudden increase in respiratory rate 2 Uncontrollable voluntary movements 3 Frequent delusions and hallucinations 4 Suicidal intentions and aggressive behavior
4
A patient with Parkinson's disease who takes levodopa/carbidopa [Sinemet] comes to the clinic for a semiannual physical examination. Which question is the most important for the nurse to ask? 1 "Have you had your flu vaccine?" 2 "Have you noticed any swelling in your feet?" 3 "Have you noticed any changes in your stool?" 4 "Are you having vivid dreams or hallucinations?"
4
A patient with multiple sclerosis (MS) is participating in a rehabilitation program. The patient has just been started on baclofen [Lioresal] 5 mg three times a day to help manage spasticity. How will the baclofen interfere with rehabilitation activities? 1 By causing gastrointestinal distress 2 By impairing coordinated movements 3 By reducing sensation in the extremities 4 By producing drowsiness, lethargy, and blurred vision
3
A patient, who is postmenopausal, is scheduled to begin taking alendronate [Fosamax] to prevent osteoporosis. Which instruction should the nurse give the patient? 1 "It will be normal to experience some heartburn." 2 "Take the medication with orange juice or coffee." 3 "After taking the medication, sit or stand for 30 minutes." 4 "For the best absorption, take the drug while eating a meal."
1
How should the nurse instruct a patient who is prescribed pyridostigmine [Mestinon]? 1 "Seek medical help for nausea and vomiting." 2 "Ask for help to change positions or to stand." 3 "Take the medication 30 minutes after eating." 4 "Lower the dose if the usual dose results in ptosis."
4
The emergency department nurse is documenting the medication history of an Asian immigrant. The patient denies taking any medications, but the nurse notes a bottle of capsules in the patient's bag. What information will the nurse collect next? 1 Vital signs 2 Insurance information 3 Primary care provider name 4 Use of herbs or over-the-counter medications
4
The nurse asks a patient to provide a list of all medications including herbal and over-the-counter drugs that the patient takes. Which term best describes the nurse's action? 1 Error reporting 2 Patient notification 3 Quality improvement 4 Medication reconciliation
A,B,D,E
The nurse collects a medication history on a patient admitted with gastrointestinal bleeding. Which herbal drugs taken by the patient likely contributed to the bleeding? A Garlic B Ginger C Valerian D Feverfew E Ginkgo biloba
3
The nurse has made a medication error. What is the nurse's initial action? 1 Notify the shift supervisor. 2 Notify the healthcare provider. 3 Assess the patient's condition. 4 Verify the drug that should have been given.
4
The nurse is caring for a geriatric patient. During the assessment, the nurse finds that the patient has tremors in the fingers, a mask-like facial expression, and bradykinesia. Which drug would the nurse expect the primary healthcare provider to prescribe to the patient? 1 Modafinil [Provigil] 2 Bromocriptine [Parlodel] 3 Methylphenidate [Ritalin] 4 Carbidopa-levodopa [Sinemet]
1
The nurse is caring for a patient who has a respiratory rate of 6 breaths/min following a large dose of pain medication. Which term most accurately describes this reaction? 1 Toxicity 2 Side effect 3 Allergic reaction 4 Idiosyncratic effect
3
The nurse is caring for a patient who has been diagnosed with multiple sclerosis. The healthcare provider opts to include baclofen [Lioresal] as part of this patient's treatment regimen. The nurse recognizes that this is an appropriate medication for this patient because the drug will treat which symptom? 1 Muscle aching 2 Muscle wasting 3 Muscle spasticity 4 Muscle deterioration
1
The nurse is caring for a patient who tells the nurse, "I cannot take this medication because this tablet is white, and I take pink tablets at home." Which action is most appropriate? 1 Verify the patient's prescription. 2 Suggest the patient take the medication. 3 Inform the patient that a new medication is prescribed. 4 Notify the primary healthcare provider to change the medication.
3
The nurse is caring for a patient with myasthenia gravis who has been prescribed cholinergic medications. Which nursing action should the nurse adopt while caring for the patient? 1 The nurse should administer the medication at bedtime. 2 The nurse should avoid giving oats and beetroot to the patient. 3 The nurse should administer the medication 30 minutes before meals. 4 The nurse should avoid giving fruit juices and corn soup to the patient.
2
The nurse is completing an admission assessment for a patient who requires treatment of an anxiety disorder. The patient states, "I take the dietary supplement kava every day to help my anxiety and stress." The nurse understands the patient is at risk for which serious adverse effect? 1 Stroke 2 Hepatotoxicity 3 Suicidal behavior 4 Acute renal failure
1
Upon assessing a patient who is being treated for muscle spasms, the nurse finds that the patient has hypotension, dizziness, and nausea. What should the nurse infer as the reason for these complications in the patient? 1 Overdose of baclofen [Lioresal] 2 Overdose of neostigmine [Prostigmin] 3 Overdose of orphenadrine citrate [Norflex] 4 Overdose of pyridostigmine bromide [Mestinon]
3
The nurse is interviewing a patient who has chronic obstructive pulmonary disease (COPD). The patient wants to use herbal medications rather than conventional medications to treat a cold. Which statement made by the nurse is appropriate? 1 "Herbal supplements have more side effects than conventional medications." 2 "Many herbal medications are very expensive compared to conventional medications." 3 "You should discuss any plans to take herbal medications with your primary healthcare provider." 4 "You will need a prescription from your primary healthcare provider for herbal medications."
4
The nurse is providing education to a group of patients interested in complementary medicine. Which teaching point should the nurse include as priority education for the group? 1 "Understand the use of any herb before taking it." 2 "Stop taking any herb if you note any adverse effects." 3 "Read the directions and labels of all herbs before taking." 4 "Confirm with your healthcare provider that any herbs you take will not interact with prescribed medications."
1
The nurse is teaching a patient about his medications. The nurse notes that the patient has difficulty understanding instructions because of a language barrier. Which action will help the patient understand the instructions? 1 The nurse will obtain a translator to assist with teaching. 2 The nurse will instruct the patient to read the black box warnings. 3 The nurse will advise the patient to call the provider for more information. 4 The nurse will demonstrate how to administer the medication and provide written information.
2
The nurse is unable to read the drug name on a medication order. What action will the nurse perform first? 1 The nurse will call the pharmacy. 2 The nurse will call the healthcare provider. 3 The nurse will look up the generic name of the medication. 4 The nurse will ask the patient what medications he or she was taking at home.
A,B,C,D
The nurse monitors for adverse effects in a patient prescribed isoniazid for the treatment of tuberculosis. Which signs and symptoms would alert the nurse to the presence of drug-induced liver toxicity? Select all that apply. A Nausea B Malaise C Jaundice D Vomiting E Cloudy urine
3
The nurse notes that a patient has taken an excessive dose of baclofen [Lioresal]. Which action does the nurse implement immediately? 1 Comfort measures 2 Seizure precautions 3 Airway maintenance 4 Antidote preparation
2
The nurse should question the use of kava in a patient with a history of which condition? 1 Anxiety 2 Hepatitis 3 Hypertension 4 Cardiovascular disease
A,D,E
The patient is prescribed warfarin [Coumadin] to treat deep vein thrombosis. The nurse is teaching the patient about dietary supplements that have the potential to interfere with Coumadin therapy. What herbs should the nurse include in the teaching? Select all that apply. A Garlic B Valerian C Echinacea D Ginger root E Gingko biloba
4
Which clinical indicators should the nurse monitor when a patient takes a cholinesterase inhibitor? 1 Urinary retention 2 Increased heart rate 3 Decreased gastric secretion 4 Increased bronchial secretion
1
Which statement made by a patient indicates a need for further discharge instruction about baclofen [Lioresal]? 1 "I'm glad I can still have a glass or two of wine at dinner." 2 "If I develop any difficulty urinating, I will call my physician." 3 "I'll contact my healthcare provider when I feel I no longer need the medication." 4 "I'll need to check with my healthcare provider before taking my allergy medications."
1
Which statement should the nurse include in the teaching plan for a patient being started on levodopa/carbidopa [Sinemet] for newly diagnosed Parkinson's disease? 1 Change positions slowly. 2 Carbidopa has many adverse effects. 3 Take the medication on a full stomach. 4 The drug may cause the urine to be very diluted.
2
While performing an admission interview, which question would be the most appropriate for the nurse to ask the patient concerning the use of herbal supplements? 1 "What is your opinion about herbal supplements?" 2 "What supplements do you take, and how often do you take them?" 3 "Is your healthcare provider aware of the herbal supplements you take?" 4 "Are you aware that you must stop all herbal supplements before being admitted?"
