Pharmacology 1 Chapter 3

A client with diabetes is also taking ephedrine to treat asthma. On occasion, the client notes that the drug causes an increase in blood glucose. What should the nurse teach the client about this phenomenon? A. "The active ingredient in ephedrine is mixed with glucose." B. "Insulin is partially inactivated by ephedrine so it cannot work to control sugar levels." C. "Stored glycogen is broken down by ephedrine, causing hyperglycemia." D. "Ephedrine causes existing glucose to stay in circulation longer."

"Stored glycogen is broken down by ephedrine, causing hyperglycemia."

A client taking a beta blocker for hypertension tells the nurse he will no longer take the medication because it is causing an inability for him to maintain an erection. What is the best explanation for this issue by the nurse? You Selected: "This is an expected adverse effect of the medication, but it is very important that you continue to take it. We can talk about other methods for sexual expression."

"This is an expected adverse effect of the medication, but it is very important that you continue to take it. We can talk about other methods for sexual expression."

Some clients are excessively responsive to either the primary or secondary effects of a drug. This is known as hypersensitivity, and it may result from a pathological or underlying condition. Which are examples of hypersensitivity? Select all that apply. A. an anaphylactic reaction to seafood B. A client on postoperative day 2 from a prostatectomy who takes ipratropium C. A client who has chronic renal failure and is taking diphenhydramine D. a pregnant client who takes phenytoin and delivers a child with birth defects

A client on postoperative day 2 from a prostatectomy who takes ipratropium A client who has chronic renal failure and is taking diphenhydramine

Which drug classification is used to treat superinfections? A. antimalarials B. Antibiotics C.Antifungal

Antifungal

Drugs can affect the special senses, including the eyes and ears. Alterations in seeing and hearing can pose safety problems for clients. What are examples of sensory effects of drugs? Select all that apply. A. Aspirin, one of the most commonly used drugs, is often linked to auditory ringing and eighth cranial nerve effects B. A drug used to treat some rheumatoid diseases can cause retinal damage and even blindness. C. Beta-blockers can cause feelings of anxiety, insomnia, and nightmares. D. Drugs that directly or indirectly affect dopamine levels in the brain can cause a syndrome that resembles Parkinson's disease.

Aspirin, one of the most commonly used drugs, is often linked to auditory ringing and eighth cranial nerve effects A drug used to treat some rheumatoid diseases can cause retinal damage and even blindness

How does knowledge of a drug's adverse effects impact the care provided by the nurse? (Select all that apply.) A. Drug teaching can address signs and symptoms the client should be alert for. B. Assessments include monitoring for expected or common adverse effects. C. Baseline can be established to help identify adverse effects that occur. D. Decisions can be made about whether or not to administer the drug. E. Adverse effects can be avoided through interventions made before giving the drug.

Drug teaching can address signs and symptoms the client should be alert for. Assessments include monitoring for expected or common adverse effects. Baseline can be established to help identify adverse effects that occur.

A client with an anxiety disorder has been prescribed alprazolam 0.5 mg PO t.i.d. During a follow-up assessment, the client tells the nurse that the medication causes drowsiness that interferes with the client's work performance. What is the nurse's best action? A. Dialogue with the client about alternative medications. B. Assess the client for any other secondary actions of the medication. C. Instruct the client to stop taking to medication immediately and to come be assessed. D. Educate the client about strategies for managing this primary action.

Educate the client about strategies for managing this primary action

A client is suspected of having a liver injury as a result of drug therapy. What laboratory finding would best support this diagnosis? A. Elevated serum creatinine level B. Elevated aspartate aminotransferase (AST) level C. Elevated blood urea nitrogen (BUN) D. Sudden drops in hemoglobin, hematocrit and red cell count

Elevated aspartate aminotransferase (AST) level

A client comes to the clinic reporting tinnitus and difficulty hearing. What medication in the client's current regimen should the nurse suspect as causing the symptoms? A. Acetaminophen with codeine B. Erythromycin C. Hydrochlorothiazide D. Insulin

Erythromycin

The nurse is preparing to administer antineoplastic medication to a client with cancer who has been receiving these medications for several days. When monitoring for potential adverse effects of this medication, the nurse should perform what assessments? (Select all that apply.) A. Monitor the client's potassium levels. B. Inspect the client's mucous membranes. C. Check the client's blood glucose level every six hours. D. Monitor the client's urine output. E. Monitor the client's blood cell counts.

Inspect the client's mucous membranes Monitor the client's blood cell counts Monitor the client's potassium levels

The nurse administers penicillin to a client and monitors the client for an adverse reaction despite the fact that the client claimed not to be allergic to penicillin. What is the rationale for checking for adverse reactions? {Select all that apply.} A. Certain medications react with orange juice to cause toxicity. B. Medications can react with over-the-counter medications to cause toxicity. C. If medications are not taken on an empty stomach, adverse reactions may occur. D. A person can be allergic to any medication at any time. E. Medications can react with other medications prescribed for the client. F. Medications can react with herbal supplements to cause adverse reactions.

Medications can react with herbal supplements to cause adverse reactions Medications can react with other medications prescribed for the client A person can be allergic to any medication at any time Medications can react with over-the-counter medications to cause toxicity

A client is receiving an antineoplastic medication for treatment of breast cancer and begins having tonic-clonic seizure activity. What type of toxicity does the nurse recognize that this client is experiencing? A. Ototoxicity B. Neurotoxicity C. Hepatotoxicity D. Nephrotoxicity

Neurotoxicity

A client with hypertension has been taking spironolactone, a potassium-sparing diuretic, 75 mg PO daily for several weeks. What assessment findings should prompt the nurse to suspect hyperkalemia? (Select all that apply.) A. Reports thigh and calf cramps B. Heart rate of 58 beats per minute C. Blood pressure is 88/63 mmHg D. Urine output of 375 mL over the past 24 hours E. Oral temperature is 37.8° C (100° F)

Reports thigh and calf cramps Heart rate of 58 beats per minute Blood pressure is 88/63 mmHg Urine output of 375 mL over the past 24 hours

A nursing student is learning about disease-modifying antirheumatic drugs. The student learns that these drugs have anti-inflammatory and immunosuppressive properties as well as what? A. Eliminate pain. B. Slow tissue damage. C. Improve joint deformity. D. Decrease the client's sedimentation rate.

Slow tissue damage

One of the most common occurrences in drug therapy is the development of adverse effects from simple overdose. In such cases, the client suffers from effects that are merely an extension of the desired effect. Which are examples of this primary action? (Select all that apply.) A. spontaneous bleeding after taking an anticoagulant B. dizziness after starting an antihypertensive C. drowsiness after taking an antihistamine D. diarrhea after taking an antibiotic

Spontaneous bleeding after taking an anticoagulant Dizziness after starting an antihypertensive

A client is believed to be developing neuroleptic malignant syndrome. What is the nurse's assessment priority? Temperature Cognition

Temperature

Before administering a macrolide antibiotic, the nurse should question the order for what client? A. a 12-year-old boy with hearing loss B. a 30-year-old woman with irritable bowel syndrome C. D.

a 12-year-old boy with hearing loss

The nurse is called to a client's room 15 minutes after the client has received a new medication. The client reports pruritus as well as nausea. The nurse notes that the client appears pale, is sweating, and has begun to cough and wheeze. The nurse determines that the client is experiencing what type of reaction related to the new medication? A. additive B. toxic C. anaphylactic shock D. synergistic

anaphylactic shock

The nurse would assess a client receiving which medication for possible superinfection? A. antibiotics

antibiotics

Which medication classifications have the potential to cause dyscrasias? (Select all that apply.) A. diuretics B. antibiotics C. antihistamines D. antineoplastics E. anticholinergics

antineoplastics antibiotics

A client develops a skin reaction to one of their prescribed medications. This client also has a specific underlying pathology. This underlying pathology might serve as a: A. contraindication for the use of certain medications

contraindication for the use of certain medications

Which drug allergy involves antibodies bound to specific white blood cells? A. anaphylactic reaction B. cytotoxic reaction C. delayed allergic reaction D. serum sickness reaction

delayed allergic reaction

When assessing a client who has developed a serum sickness reaction, which would the nurse expect to find? A. difficulty breathing B. hives C. decreased white blood cell count D. facial edema

facial edema

The nurse administers typical antipsychotic medications to the client who has taken these same drugs for many years. What signs and symptoms should the nurse attribute to secondary actions of the drug? Select all that apply. A. changes in gait B. muscular tremors C. yellow discoloration of the skin and sclera D. fine red rash on the trunk E. drooling

muscular tremors drooling changes in gait

Many drugs can affect the functioning of the nerves in the periphery and central nervous system. Which are examples of potential neurologic effects of drugs? (Select all that apply.) A. teratogenicity B. neuroleptic malignant syndrome C. Parkinson-like syndrome D. atropine-like (anticholinergic) effects

neuroleptic malignant syndrome Parkinson-like syndrome atropine-like (anticholinergic) effects

There are four main classifications of drug allergies. Which classification would be described as an immune system reaction to injected proteins used to treat immune conditions? serum sickness cytotonic reaction delayed reaction anaphylactic reaction

serum sickness

One of the most common occurrences in drug therapy is the development of adverse effects from simple overdose. In such cases, the client suffers from effects that are merely an extension of the desired effect. Which are examples of this primary action? Select all that apply. A. spontaneous bleeding after taking warfarin B. drowsiness after taking diphenhydramine C. diarrhea after taking cefuroxime D. dizziness after starting amlodipine

spontaneous bleeding after taking warfarin dizziness after starting amlodipine

What would lead the nurse to suspect that a client has developed a blood dyscrasia related to drug therapy? (Select all that apply.) thrombocytopenia dilute urine leukocytosis sore throat anemia headache

thrombocytopenia anemia sore throat

A client began a new medication 4 days ago and has been reporting increasing malaise for the past 72 hours. The nurse is reviewing the client's most recent laboratory findings. What findings should suggest the possibility of a cytotoxic reaction? (Select all that apply.) A. decreased potassium B. increased sodium and chloride C. decreased leukocytes D. decreased hematocrit E. increased liver enzymes

decreased hematocrit decreased leukocytes increased liver enzymes

Organ and tissue damage is one adverse reaction caused by drugs. What are examples of such organ and tissue damage? Select all that apply. A. dermatological reactions B. blood dyscrasia C. poisoning D. stomatitis

dermatological reactions stomatitis blood dyscrasia poisoning

The nurse administers a medication and the client has an immediate anaphylactic reaction following injection. What symptoms assessed by the nurse would indicate anaphylaxis? (Select all that apply.) A. difficulty breathing B. increased blood pressure C. diaphoresis D. constricted pupils E. slow heart rate

difficulty breathing increased blood pressure diaphoresis

What would the nurse expect to assess in a client experiencing an anaphylactic reaction? (Select all that apply.) A. feeling of panic B. swollen joints C. high fever D. dilated pupils E. difficulty breathing

dilated pupils feeling of panic difficulty breathing

Drugs can produce a wide variety of effects in addition to the desired pharmacological effect. Sometimes the drug dose can be adjusted so that the desired effect is achieved without producing undesired secondary reactions. Which are examples of this secondary action? Select all that apply. spontaneous bleeding after taking an anticoagulant dizziness after starting an antihypertensive drowsiness after taking an antihistamine diarrhea after taking an antibiotics

drowsiness after taking an antihistamine diarrhea after taking an antibiotic

What would the nurse expect to assess if a client develops neuroleptic malignant syndrome? A. hypothermia B. hyperactive reflexes C. mental confusion D. hypertension

hypertension

What factors can potentially contribute to a hypersensitivity reaction? (Select all that apply.) A. infrequent administration of a drug B. age-related changes C. pathological condition D. creation of antibodies E. unique receptors and cellular responses

pathological condition unique receptors and cellular responses age-related change

Which skin condition would be most likely to cause increased systemic absorption of a topical medication? A. severe sunburn B. port wine stain of the face C. rosacea D. multiple nevi

severe sunburn

What would the nurse expect the prescribing health care provider to order for a client with a delayed allergic reaction? A. topical corticosteroid B. epinephrine C. antipyretic D. anti-inflammatory

topical corticosteroid

The most serious allergic response is called anaphylaxis. Which clients exhibit possible symptoms of anaphylaxis? (Select all that apply.) A. A client with marked hypotension and experiences convulsions. B. A client showing signs of acute respiratory distress. C. A client who has a high fever. D. A client with laryngeal edema and pale, cool skin.

A client showing signs of acute respiratory distress A client with marked hypotension and experiences convulsions A client with laryngeal edema and pale, cool skin

If an adult client is having an anaphylactic reaction, which actions would the nurse initiate for this client? Select all that apply. A. Continue current drug therapy until you receive a physician order to hold it. B. Administer antipyretics or anti-inflammatory agents, as appropriate. Notify the physician immediately. C. Support the client to conserve energy until the allergic response is over. D. Administer epinephrine 0.3ml SubQ as ordered.

Administer epinephrine 0.3ml SubQ as ordered Notify the physician immediately

A client is being discharged from the emergency department (ED) after being treated for an anaphylactic reaction to shrimp the client ate for dinner. The client asks the nurse to explain food reactions. Which would be correct responses? Select all that apply. A. Anaphylactic reactions involve an antibody that causes the release of histamine. B Histamines produce immediate reactions. C. This allergy involves antibodies that circulate in the blood and cause damage to various tissues by depositing in blood vessels. D. Anaphylactic reactions can lead to respiratory distress and even respiratory arrest. E. This reaction occurs several hours after exposure and involves antibodies that are bound to specific white blood cells.

Anaphylactic reactions involve an antibody that causes the release of histamine Histamines produce immediate reactions Anaphylactic reactions can lead to respiratory distress and even respiratory arrest

A client with a history of schizophrenia was admitted during a psychotic episode and has received several doses of haloperidol. The client's cognitive status has stabilized but assessment reveals clammy skin, respiratory rate of 31 breaths per minute, and heart rate of 102 beats per minute. What is the nurse's best action? A. Arrange for cardiac monitoring B. Assess the client's blood glucose level. C. Perform a mental status assessment. D. Check the client's most recent potassium level.

Assess the client's blood glucose level

A client with urinary urgency and frequency has been prescribed an anticholinergic medication. The nurse should educate the client about what potential adverse effects related to secondary actions? A. Decreased bowel motility B. Urinary hesitancy C. Anaphylaxis D. Urinary incontinence

Decreased bowel motility

A client has been prescribed a tricyclic antidepressant and the nurse recognizes the client's associated risk for anticholinergic effects. What should the nurse teach the client about preventing and managing these adverse effects? (Select all that apply.) Maintain good oral hygiene to minimize dry mouth. Void before taking the medication so urinary hesitation is less problematic. Avoid situations where bruising or lacerations are a possibility. Eat several small meals daily rather than three larger meals. Use caution in situations where it may be possible to become overheated.

Maintain good oral hygiene to minimize dry mouth. Void before taking the medication so urinary hesitation is less problematic. Use caution in situations where it may be possible to become overheated.

The nurse on a busy medical floor is caring for several clients whose medication regimens vary widely. What action best addresses a client's risk for adverse effects related to primary actions? A. Monitoring the international normalized ratio (INR) of a client taking warfarin B. Checking the potassium level of a client who is taking a loop diuretic C. D.

Monitoring the international normalized ratio (INR) of a client taking warfarin

A hospital client began taking a newly prescribed antihypertensive 12 hours ago and has developed a full body rash with edema and pruritis. What is the nurse's best action? A. Promptly inform the prescriber of the client's status. B. Establish intravenous access and administer 25 mg diphenhydramine IV. C. Call an emergency code and monitor the client's respiratory and cardiac status. D. Discontinue the medication and document the assessment findings.

Promptly inform the prescriber of the client's status

The nurse is caring for a client who is receiving an antidiabetic agent. What assessment finding should the nurse attribute to a possible adverse reaction? A. The client states, "I just can't seem to quench my thirst." B. The client has voided three times in the past hour. C. The client reports feeling unusually drowsy and fatigued. D. The nurse's assessment reveals Kussmaul respirations.

The client reports feeling unusually drowsy and fatigued

A client on a multimedication therapy regimen is demonstrating elevated liver enzymes that suggest hepatotoxicity. What is the most likely explanation for the elevation of the client's liver enzymes? A. The cells in the liver filter, concentrate, and eliminate toxic as well as nontoxic materials, increasing the chances of damaging the organ. B. The liver is exposed to relatively large concentrations of ingested drugs or other potentially toxic substances due to the hepatic anatomy. C. The liver cannot metabolize hepatotoxic drugs and paradoxical reactions occur. D. The liver is always the first organ of the body to be affected by any toxic substance.

The liver is exposed to relatively large concentrations of ingested drugs or other potentially toxic substances due to the hepatic anatomy

Many drugs can affect the functioning of the nerves in the periphery and central nervous system. Which are examples of potential neurologic effects of drugs? Select all that apply. A. a postoperative client who had atropine and exhibits dry mouth, altered taste perception, dysphagia, heartburn, constipation, and bloating B. a postoperative client with extrapyramidal symptoms, hyperthermia, and autonomic disturbances C. a client taking an antipsychotic who exhibits akinesia, muscular tremors, drooling, changes in gait, jitters (akathisia), or spasms (dyskinesia) D. a pregnant woman who takes tamoxifen (Nolvadex) and delivers a baby with birth defects

a postoperative client with extrapyramidal symptoms, hyperthermia, and autonomic disturbances a client taking an antipsychotic who exhibits akinesia, muscular tremors, drooling, changes in gait, jitters (akathisia), or spasms (dyskinesia) a postoperative client who had atropine and exhibits dry mouth, altered taste perception, dysphagia, heartburn, constipation, and bloating

The nurse's assessment of a client reveals that the client has been greatly exceeding recommended safe doses of acetaminophen for the past week. When reviewing the client's laboratory results for indications of toxicity, what finding should the nurse prioritize? A. white cell count and white cell differential B. blood urea nitrogen, creatinine and potassium levels C. C-reactive protein level and platelet count D. aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels

aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels

The nurse administers chloroquine to a client to treat rheumatoid disease. The client has been taking this medication for several years. What assessment should the nurse prioritize? A. potassium levels B. hearing ability C. assessment for anticholinergic effects D. assessment of visual acuity

assessment of visual acuity

Many drugs, if taken during pregnancy, can cause adverse effects to the fetus. It is important for nurses to teach women the potential risks of fetal drug exposure. What are some potential risks? (Select all that apply.) A. blindness B. central nervous system defects C. heart anomalies D. limb deformities E. facial defects

blindness central nervous system defects heart anomalies limb deformities facial defects

For several days, a client with hypertension has been inadvertently taking an excessive dose of spironolactone, a potassium-sparing diuretic. The client has presented to the emergency department with signs and symptoms that suggest hyperkalemia. What assessment should the nurse prioritize? A. cardiac monitoring

cardiac monitoring

A client is suspected to have nephrotoxicity from administration of a nephrotoxic medication. What laboratory results may indicate renal damage related to the administration of this medication? (Select all that apply.) A. decreased sedimentation rate B. elevated blood urea nitrogen (BUN) C. elevated potassium level D. elevated white blood cell count E. elevated creatinine level

elevated blood urea nitrogen (BUN) elevated creatinine level elevated potassium level

When reviewing the medication list of a client being seen in the clinic, the nurse notes that the client is receiving glipizide. Based on the nurse's understanding, this drug can cause: A. hyperkalemia. B. hypokalemia. C. hypoglycemia. D. hyperglycemia.

hypoglycemia

The nurse is providing care for a client whose most recent laboratory results indicate a potassium level of 6.1 mEq/L (6.1 mmol/L). After completing assessment and informing the provider, the nurse should administer: acetylcysteine intravenously as prescribed. sodium polystyrene sulfonate as prescribed. hypotonic intravenous solution as prescribed. potassium-wasting diuretics as prescribed.

sodium polystyrene sulfonate as prescribed

When administering drug therapy for a client, how can the nurse ensure beneficial outcomes? (Select all that apply.) A. Make sure the client can explain about the drug classifications. B. Minimize adverse effects and drug interactions. C. Provide appropriate drug education for the client and family. D. Order laboratory studies to determine effectiveness of drug therapy. E. Maximize therapeutic effects.

Maximize therapeutic effects Minimize adverse effects and drug interactions Provide appropriate drug education for the client and family

The nurse is caring for a client who has been admitted after an acetaminophen overdosage. Which of the nurse's assessment findings suggest liver damage? (Select all that apply.) A. The client's skin and eyes are visibly jaundiced. B. The client's AST and ALT levels are elevated. C. The client's temperature is 102.5° F (39.2° C). D. The client has an elevated red blood cell count. E. The client's eyes are sensitive to light.

The client's skin and eyes are visibly jaundiced The client's AST and ALT levels are elevated The client's temperature is 102.5° F (39.2° C)

The nurse is assessing a number of clients on the acute medicine unit. What client is most likely experiencing an adverse effect from the primary action of the medication? A. a client whose upper gastrointestinal bleed is attributed to nonsteroidal anti-inflammatories B. a client whose antidepressant has caused sexual dysfunction in the past C. a client taking oral antibiotics who has experienced nausea after each dose D. a client taking antihypertensives who reports dizziness upon standing

a client taking antihypertensives who reports dizziness upon standing