PHARMACLGY HLTHCARE PROF - EXAM 1- PRACTICE QS FROM QUIZZES

Match the correct term to its definition. How the medication produces the desired therapeutic effect

Mechanism of action

A patient receives a drug that has a narrow therapeutic range. The nurse administering this medication will expect to do what?

Monitor plasma drug levels.

A patient is taking a drug that has known toxic side effects. What will the nurse do?

Monitor the function of all organs potentially affected by the drug.

Which of the following nursing actions would be most appropriate for ensuring client safety with a medication that has a low therapeutic index?

Monitoring serum peak and trough levels

Which statement is NOT correct?

NOT CORRECT: A. Sympathomimetics (adrenergic agonist) and parasympathomimetics (cholinergics) cause similar responses on organ or tissue. CORRECT: B. Sympatholytics (adrenergic antagonist) and parasympatholytics (anticholinergics) cause opposite responses on organ or tissue. C. Sympathomimetics and parasympatholytics cause similar organ responses D. Sympatholytics and parasympathomimetics cause similar organ responses.

It is expected that the nurse will question the health care provider if a drug with a t½ of >24 hours is ordered to be given more than how often?

Once daily

Match the imbalanced neurotransmitter with the associated health problem: Reduced dopamine level

Parkinson Disease

Match the correct term to its definition. A drug-induced birth defect.

Teratogenic effect

For the cystic fibrosis patients having large amount of mucus secretion, there is no risk to use acetylcysteine (Mucomyst, mucolytic agent) at home. True False

False

The prescriber has ordered an antibiotic for a patient with a bacterial infection. The nurse provides patient education at discharge and instructs the patient to take the drug on an empty stomach. When should the patient take the drug? (Select all that apply.)

-1 hour or more before a meal -At least 2 hours after a meal

Myasthenia Gravis is caused by blocking the effect of ____________

Acetylcholine

A patient is brought to the emergency department in a state of extreme, uncontrolled anxiety. Why would an IV (Intravenous) benzodiazepine be the drug of choice in this situation?

It has a rapid onset of action.

What occurs when a drug binds to a receptor in the body?

It increases or decreases the activity of that receptor.

A nurse is giving an enteral medication. The patient asks why this method is preferable for this drug. How will the nurse reply?

"This route is safer, less expensive, and more convenient."

The prescriber orders a new drug over the telephone for a nursing home patient who has symptoms of a urinary tract infection. The order is for Gantanol, 2 g now and then 1 g every 12 hours for the next 10 days. What further information is most important for the nurse to obtain from the prescriber?

"Do you want the drug given orally or intravenously?"

A nurse provides teaching to a patient who will begin taking a drug with a known risk of hepatotoxicity. Which statement by the patient indicates a need for further teaching?

"Routine testing and early detection of problems will prevent liver failure."

A client has a new prescription for brimonidine (alphagan) ophthalmic, 1 drop twice daily in his right eye. He tells the nurse he also wears soft contact lenses and wants to know if he can put the drop in his eye with the lenses in place. Which of the following should the nurse tell this client?

"Take the contact lens out of your eye, then instill the eye drip and wait at least 15 minutes before putting the contact lenses back in"

Which patients are at increased risk for adverse drug events? (Select all that apply.)

-A 2-month-old infant taking a medication for gastroesophageal reflux disease -A 40-year-old male who is intubated in the intensive care unit and taking antibiotics and cardiac medications -An 80-year-old male taking medications for COPD

Two nurses are discussing theories of drug-receptor interaction. Which statements are true regarding the affinity of a drug and its receptor? (Select all that apply.)

-Affinity refers to the strength of the attraction between a drug and its receptor. -Drugs with high affinity are strongly attracted to their receptors. -The affinity of a drug for its receptors is reflected in its potency.

The nurse is administering morning medications. The nurse gives a patient multiple medications, two of which compete for plasma albumin receptor sites. As a result of this concurrent administration, the nurse can anticipate that what might occur? (Select all that apply.)

-Binding of one or both agents will be reduced. -Plasma levels of free drug will rise. -The increase in free drug will intensify effects.

When administering medications to infants, it is important to remember which of the following? (Select all that apply.)

-Immaturity of renal function in infancy causes infants to excrete drugs less efficiently. -Infants have immature livers, which slows drug metabolism. -Infants are more sensitive to medications that act on the central nervous system (CNS).

Epinephrine, a nonselective adrenergic agonist, is used to treat allergic reaction. Which of the following organ(s) will be affected by this drug after administration?

1. Eye; 2. Blood vessel; 3. Uterus; 4. Bladder ALL OF THEM

Medication dosages may need to be decreased for which of the following reasons? 1. Increased medication-metabolizing enzymes 2. Liver failure 3. Peripheral vascular disease 4. Chronic renal insufficiency

2 and 4

A nurse is preparing to administer medications. Which patient would the nurse consider to have the greatest predisposition to an adverse reaction?

30-year-old man with kidney disease

A child will receive 750 mg of an antibiotic for 10 days. The child attends day care. The drug may be dosed in several ways and is available in two concentrations. Which dosing regimen will the nurse discuss with the child's provider?

500 mg/5 mL-375 mg PO twice daily

A patient receives 60 mg of a drug at noon, 6 PM, and midnight. The drug has a half-life of 6 hours. How much of the drug remains in the patient at 6 AM the next day?

52.5 mg

A provider has written an order for a medication: drug × 100 mg PO every 6 hours. The half-life for the drug is approximately 6 hours. The nurse is preparing to administer the first dose at 8:00 AM on Tuesday. On Wednesday, when will the serum drug level reach plateau?

8:00 AM

The nurse notices that one of the client's drugs has a low therapeutic index. What is the most important nursing implication of this?

A narrow margin of safety

A home care patient with chronic obstructive pulmonary disease (COPD) has a thick white coating on the tongue and patches on the inside cheeks. What additional information does the nurse obtain from this patient? A. "How often are you using your steroid inhaler?" B. "Do you share a toothbrush with any members of your family?" C. "When was the last time your inhaler drug prescriptions were filled?" D. "Have you taken any over-the-counter drugs for a cold or flu lately?"

A. "How often are you using your steroid inhaler?"

Diphenhydramine (Benadryl) is mainly used for the following health conditions: A. Allergic Rhinitis B. Bacterial Pneumonia C. Viral sinusitis D. Chronic obstructive pulmonary disease (COPD)

A. Allergic Rhinitis

All the statement is true EXCEPT:

A. Cholinergic receptors located on skeletal muscle (or neuromuscular junction) are nicotinic receptors B. Norepinephrine (NE), epinephrine(Epi) and dopamine are broken down by monoamine oxidase (MAO) and catechol-O-methyltransferase (COMT) C. Botulinum toxin causes respiratory paralysis by blocking the release of Norepinephrine (NE) NOT TRUE D. Tricyclic antidepressant (TCA) and cocaine increase sympathetic response by preventing norepinephrine from being pumped back to cell

A nurse is caring for a 6-year-old child who has just been diagnosed with influenza and bilateral otitis media. The child's parent asks the nurse, "Why didn't the doctor want to give my child antibiotics for her ear infection? I think she'd get better sooner if she had them." Which of the following response from the nurse is most appropriate? A. Ear infections caused by a virus are not cured by antibiotics. B. Antibiotic-resistant bacteria can be treated by anti-viral drugs C.The doctor knows what he is doing, you should not have doubt. D. I completely agree with you, let me go ask the doctor to prescribe the antibiotics for your child.

A. Ear infections caused by a virus are not cured by antibiotics.

Which one is NOT neurotransmitter?

A. Glucosamine (NOT A NT) B. Acetylcholine C. Epinephrine D. gamma-aminobutyric acid (GABA)

All of the following drugs can cause sedation or potentiate sedation when co-administered with other central nervous system depressants, EXCEPT: A. Pseudoephedrine (Sudafed, Triaminic) B. Diphenhydramine (Benadryl) C. Dextromethorphan (DM, DMX) D. Guaifenesin (Mucinex)

A. Pseudoephedrine (Sudafed, Triaminic)

The patient is using both Ipratropium bromide (Atrovent) and fluticasone (Flovent) inhalers to control his chronic asthma. Which following instruction should be given to this patients? A. Use Atrovent first, wait at least 5 minutes, then use Flovent B. Use Atrovent alone is as effective as using both Atrovent and Flovent to control chronic asthma. C. Use Flovent 10 minutes before Atrovent D. Use Flovent immediately after using Atrovent

A. Use Atrovent first, wait at least 5 minutes, then use Flovent

A nurse is reviewing a patient's medical record before administering a medication. Which factors can alter the patient's physiologic response to the drug? (Select all that apply.)

Age Genetic factors Gender

Match the imbalanced neurotransmitter with the associated health problem: Reduced Acetylcholine (ACh) Level

Alzheimer's

A nurse educator is conducting a continuing education class on pharmacology. To evaluate the learning of the nurses in the class, the nurse educator asks, "Which drug name gives information about the drug's pharmacologic classification?" Which is the correct response?

Amoxicillin

_______________ has the similar drug effect as Sympathomimetic Agent.

Anticholinergic

A nurse is preparing to give an antibiotic to a patient who reports being allergic to antibiotics. Before giving the medication, what will the nurse do first?

Ask whether the patient has taken this antibiotic for other infections

A patient has been prescribed an aerosol inhaler with a spacer. In what order does the nurse teach the patient to perform these steps? 1. Hold breath >10 seconds with closed lips, then breathe normally 2. Insert into the mouth, make good seal 3. Remove cap, attach spacer, and shake vigorously 4. Squeeze the canister and breathe in deeply and slowly, no whistling sound A. 1, 3, 2, 4 B. 3, 2, 4, 1 C. 1, 2, 3, 4 D. 2, 1, 3, 4

B. 3, 2, 4, 1

All the statements regarding the inhaled SABA bronchodilator is correct EXCEPT A. It is the "rescue" drug for asthma attacks B. It reduces heart rates (bradycardia) C. It should be cautiously used in patients with hyperthyroidism. D. Asthma patients should carry SABA inhaler with them all the time, use the spacer for drug administration.

B. It reduces heart rates (bradycardia)

A nurse is caring for a client who states she has been taking phenylephrine (Neo-Synephrine) nasal drops for the past 10 days for her upper respiratory symptoms. For which of the following adverse effects should the nurse assess? A. Sedation B. Nasal congestion C. Productive cough D. Constipation

B. Nasal congestion

Which statement is true? A. Diphenhydramine (Benadryl) causes less drowsiness than cetirizine (Zyrtec) B. Patients with hypertension may avoid to take monoamine oxidase inhibitor(MAOI, antidepressant) and non-steroidal decongestant together. C. Montelukast (Singulair) can be given to children for asthmatic attacks D. Protein meal and caffeinated drinks should be avoided when taking theophylline

B. Patients with hypertension may avoid to take monoamine oxidase inhibitor(MAOI, antidepressant) and non-steroidal decongestant together.

A patient is prescribed Timolo (Timoptic), beta adrenergic antagonist or blocker, to treat primary open-able glaucoma (POAG), it is important for the nurse to monitor the patient for which condition?

Bradycardia

Mary is drinking 1.5 litter cranberry juice daily to prevent urinary tract infection. She is also using the full strength ASA (325 mg) to ease her arthritic pain. What symptom do you think Mary would complaint most?

Bruise easily

A patient with asthma is prescribed albuterol (Proventil) as needed and salmeterol (Serevent) every 12 hours. When the patient asks the nurse why two inhaler drugs are needed, what is the nurse's best response? A. "Albuterol opens your airways and salmeterol decreases the inflammation." B. "I will check with the prescriber to determine whether you can just use one drug." C. "Albuterol is a rescue drug to stop asthma attacks and salmeterol prevents attacks." D. "Salmeterol helps you breathe better and albuterol opens alveoli for gas exchange."

C. "Albuterol is a rescue drug to stop asthma attacks and salmeterol prevents attacks."

Which statement about antitussives is CORRECT? A. Both codeine and dextromethorphan (DXM, DM) are the local anesthetic agents that decrease the sensitivity of stretch receptors in the upper airways, thereby reducing cough. B. Only codeine has potential risk for abuse. C. Concurrent Administration of dextromethorphan (DXM) and Monoamine oxidase inhibitors (MAOI) could potentially cause high fever due to serotonin syndrome. D. Both codeine and dextromethorphan (DXM, DM) are used to treat productive cough

C. Concurrent Administration of dextromethorphan (DXM) and Monoamine oxidase inhibitors (MAOI) could potentially cause high fever due to serotonin syndrome.

The class of drugs used for the acute management of asthma attack: A. Steroids B. Mucolytics C. SABA bronchodilators D. Mast cell stabilizers

C. SABA bronchodilators

Which statement is true for anticholinergics: A. The "rescue" drugs for asthma attack B. Can be used for patients having peanut allergy C. Used for patients having emphysema or chronic bronchitis D. The receptor agonists

C. Used for patients having emphysema or chronic bronchitis

The prescriber orders atenolol (Tenormin) 25 mg to be given orally once a day to control a patient's high blood pressure. The nurse takes the patient's vital signs and finds that the blood pressure is 128/80 mm Hg and the heart rate is 60 beats per minute. What does the nurse do first before giving this drug?

Check the order for prescriber specific instructions on when the drug should be given

A nurse consults a drug manual before giving a medication to an 80-year-old patient. The manual states that older-adult patients are at increased risk for hepatic side effects. Which action by the nurse is correct?

Contact the provider to discuss an order for pretreatment laboratory work

A nurse is concerned about renal function in an 84-year-old patient who is taking several medications. What will the nurse assess?

Creatinine clearance

A patient with chronic asthma is prescribed the steroids inhaler. He reports hating the inhaler and asks why the drug can't be taken as a pill. What is your best response? A. "Inhaled drugs work more slowly." B. "Inhaled drugs have no side effects." C. "Oral drugs are usually more expensive." D. "Oral drugs have more systemic side effects."

D. "Oral drugs have more systemic side effects."

ALL of the following drugs reduce the inflammation by inhibiting histamine release EXCEPT: A. Loratadine (Claritin) B. Fluticasone (Flonase) C. Cromolyn sodium (NasalCrom) D. Acetylcysteine (Mucomyst, Acetadote)

D. Acetylcysteine (Mucomyst, Acetadote)

Which response is not the side effects of SABA bronchodilators? A. Difficulty sleeping B. Rapid heart rate C. Hypertension D. Diarrhea

D. Diarrhea

Beclomethasone (Beconase) has been prescribed for a client with allergic rhinitis. Which is the most common side effect from continuous use? A. Dizziness B. Rhinorrhea C. Hallucinations D. Dry nasal mucosa

D. Dry nasal mucosa

A client is prescribed the decongestant oxymetazoline (Afrin) nasal spray. What should you teach the client? A. Take this drug at bedtime as a sleep aid. B. Report fever, cough, or nasal congestion lasting longer than 1 day C. This drug may be used in maintenance treatment for asthma. D. Limit the drug to 5 days of use to prevent rebound nasal congestion.

D. Limit the drug to 5 days of use to prevent rebound nasal congestion.

Match the drug with its associated mechanism of action (MOA) Beta- adrenergic blocker

Decrease the production of aqueous humor

Match the imbalanced neurotransmitter with the associated health problem: Decreased Serotonin (5-HT) level

Depression

Which following conditions will always decrease drug absorption by oral route:

Diarrhea

Match the drug with its associated mechanism of action (MOA) Osmotic agent

Draw fluid rapidly from the anterior chamber of the eye via osmotic pressure gradient

A nurse is teaching a class to a group of pregnant patients. The nurse correctly teaches that the highest risk of teratogen-induced gross malformations exists during which time?

During the first trimester

Before administering a medication, what does the nurse need to know to evaluate how individual patient variability might affect the patient's response to the medication? (Select all that apply.)

Family medical history Patient's age Patient's diagnosis

Atrophine, a muscarinic antagonist, is used to treat bradycardia, which one of the following is least likely to be reported by the patient after administration?

Frequent perspiration (dry eye, dry mouth, constipation)

A nurse is reviewing a medication administration record before administering medications. Which order will the nurse implement?

Furosemide [Lasix] 20 mg PO daily

Mr. Spencer is taking warfarin after his orthopedic surgery. He lost 35 pounds due to decreased appetite during his recovery. He is more likely to be admitted to ED for

GI bleed

Match the correct term to its definition. This concept defines the time span needed to eliminate 50% of drug dose

Half-life

The nurse reviews the client's medication regimen, including the interval of drug dosage, which is related to which of the following?

Half-life

Match the drug with its associated mechanism of action (MOA) Prostaglandin analog

Increase aqueous humor outflow

A client is given epinephrine (Adrenalin), an adrenergic agonist (sympathomimetic), for anaphylactic reaction. The nurse should monitor the client for which condition?

Increased blood pressure or hypertension (HTN)

The nurse realizes that beta1 receptor stimulation is differentiated from beta2 stimulation in that stimulation of beta1 receptor leads to which condition?

Increased heart contraction force or myocardial contractility

A drug that has "high affinity" means that the drug:

Is strongly attracted (bound) to the receptor.

The nurse is teaching a patient how a medication works to treat an illness. To do this, the nurse will rely on knowledge of which topic?

Pharmacotherapeutics

The literature about a drug found in the drug monograph identifies that the drug is POTENT. This means the drug:

Produces its effect at low doses

Match the drug with its associated mechanism of action (MOA) Carbonic Anhydrase Inhibitor

Reduce aqueous humor production by systemic diuresis through renal effects

A health care provider prescribes simvastatin (Zocor) 40 mg PO every day at bedtime. The nurse should recognize this as which of the following types of order?

Routine order

Match the imbalanced neurotransmitter with the associated health problem: Overproduction of Dopamine

Schizophrenia

A patient is receiving intravenous gentamicin. A serum drug test reveals toxic levels. The dosing is correct, and this medication has been tolerated by this patient in the past. Which could be a probable cause of the test result?

The patient is taking another medication that binds to serum albumin.

Match the correct term to its definition. It is a concept used to measure safety of drugs, and it is the ratio of the lethal dose divided by the therapeutic dose for 50% of population.

Therapeutic index

A nursing student is preparing to give a medication that has a boxed warning. The student asks the nurse what this means. What will the nurse explain about boxed warnings?

They alert prescribers to measures to mitigate potential harm from side effects.

A nurse is teaching nursing students about the use of nonproprietary names for drugs. The nurse tells them which fact about nonproprietary names?

They are assigned by the U.S. Adopted Names Council.

A nurse is preparing to give medications to four older patients who are all taking multiple medications. Which patient is most likely to have an adverse drug reaction related to increased drug effects?

Thin patient with a chronically low appetite

Dextromethorphan (DXM or DM) is used for nonproductive cough, while guaifenesin (Mucinex) is used for productive cough. True False

True

You were told that Tom, the radiology tech, called you regarding some lab value of your patient, Mr. Lee (89 years old). Tom is going to take Mr. Lee for CT scan. Which of the following lab value would Tom be most interested?

Urine creatinine clearance

Match adrenergic receptors with he primary organ/tissue: alpha1

alpha1 - blood vessels

A patient reports becoming "immune" to a medication because it no longer works to alleviate symptoms. The nurse recognizes that this decreased effectiveness is likely caused by:

desensitization of receptor sites by continual exposure to the drug.

Match adrenergic receptors with he primary organ/tissue: beta1

heart

A patient is taking drug X and receives a new prescription for drug Y, which is listed as an inducing agent. The nurse caring for this patient understands that this patient may require ____ doses of drug ____.

higher; X

The nurse is caring for a child who has ingested a toxic amount of aspirin. The provider orders an intravenous drug that will increase pH in the blood and urine. The nurse understands that this effect is necessary to:

increase the urinary excretion of aspirin

An elderly client is taking a drug that is highly protein-bound (98%). Several days later, he also begins taking a second drug that is also 98% protein-bound and competes for the same albumin binding sites. The effect of the first drug would be:

increased

_________ will be experienced and/or observed after the patients take a cholinergic agonist.

increased pupil constriction

Match adrenergic receptors with he primary organ/tissue: beta2

lungs

A patient asks a nurse why a friend who is taking the same drug responds differently to that drug. The nurse knows that the most common variation in drug response is due to differences in each patient's:

metabolism of drugs.

Match adrenergic receptors with he primary organ/tissue: alpha2

postganglionic sympathetic nerve endings