Pharmacology Exam 2

The nurse is teaching a student nurse about the administration of various eyedrops for the treatment of infection. Which statement by the student indicates teaching was effective?

"After the administration of fluorescein, a stain should appear in the cornea of the patient's eye."

Which instruction does a nurse provide a patient who is prescribed nitroglycerin patches in order to prevent the development of tolerance to nitrates?

"Apply the nitroglycerin patch each day, and remove it for 10 hours at night."

The nurse is teaching a student nurse about the administration of gentamicin sulfate eyedrops. Which response by the student indicates teaching was effective?

"Gentamicin sulfate is known for being ototoxic."

Which statement made by a patient demonstrates a need for further instruction regarding the use of sublingual nitroglycerin?

"I can take up to five tablets at 3-minute intervals for chest pain if necessary."

A nurse is teaching a patient about the treatment of acne vulgaris and psoriasis. Which statement made by the patient indicates the need for further teaching? Select all that apply.

"I should continue with treatment even after conception, because the treatment does not affect pregnancy." "I should clean my skin once a day with a strong cleanser."

The nurse is providing education to a patient diagnosed with otitis externa (OE). Which statement by the patient indicates an understanding of the treatment plan?

"I will use the eardrops in the ear canal to treat this condition."

A nurse compares the side effects of drugs commonly used to treat psoriasis. Which statement is true regarding side effects?

"Methoxsalen causes erythema, pruritus, and xeroderma."

A patient prescribed tretinoin asks the nurse, "How will this help my acne?" Which response would the nurse provide?

"The medication will help unblock pores and increase skin cell turnover."

A nurse is teaching a nursing student about the assessment of acne vulgaris and psoriasis skin conditions. Which statement made by a student indicates that additional teaching is required?

"The psychologic effect of lesion-forming conditions is not part of the assessment."

Which information would the nurse include when teaching a patient about the administration of acetazolamide therapy?

"You may have increased urine output."

Which serum digoxin concentration is suggestive of digitalis toxicity?

2.2

The nurse is teaching a group of nursing students about the anatomy of the ear. In which order, from external to internal, would the nurse discuss the structures?

4 regions: external, outer, middle, and inner. The external auditory meatus, or the pinna, is the external projection of the ear. The middle ear is composed of the tympanic membrane (eardrum) and three ear bones. These structures are connected to the eustachian tube. The middle ear is followed by the inner ear, which contains the cochlea and semicircular canals.

Which finding would a nurse expect during the assessment of a patient who is diagnosed with sinoatrial (SA) node dysfunction?

A patient with SA node dysfunction would exhibit bradycardia because the ventricle picks up the work that the atria cannot do but at a slower rhythm.

Which patient can safely receive nitroglycerin with no concern?

A patient with coronary heart disease who complains of chest pain

Which patient assessment would assist a nurse in evaluating therapeutic effects of a calcium channel blocker for angina?

Absence of chest pain. The workload in the heart should be decreased with the vasodilation from the calcium channel blocker. With less strain, the patient should have fewer incidences of angina as afterload is decreased.

Isotretinoin and tretinoin are common dermatologic drugs used to treat which condition?

Acne vulgaris

Which phrase describes the mechanism of action for benzoyl peroxide?

Acts as an antibacterial agent

A patient involved in a factory fire presents with extensive burns. The patient's skin is white in color, and no pain is felt. Which phrase describes the tissue depth of the burns?

All layers extending into the subcutaneous tissues

Which otic antimicrobial may cause ototoxicity?

Aminoglycoside

Which medication is considered a first-line treatment for a child who is diagnosed with acute otitis media (AOM)?

Amoxicillin

Which condition is associated with an increase in intraocular pressure due to accumulation of aqueous humor?

Angle-closure glaucoma

A patient with acute otitis media (AOM) is allergic to amoxicillin. Which antibiotic may be used instead of a penicillin-based drug?

Azithromycin

Which statement by the nurse about beta blockers is accurate?

Beta blockers decrease the effects of the sympathetic nervous system by blocking the action of the catecholamines, epinephrine and norepinephrine, thereby decreasing the heart rate and blood pressure.

Which class of drugs is used in the treatment of angina pectoris?

Beta blockers, nitrates/nitrites, and calcium channel blockers are all used in the management of angina pectoris. Beta blockers reduce heart rate, contractility, and oxygen demand. Nitrates and nitrites cause venous dilation and relax coronary arteries. Calcium channel blockers relax coronary arteries and dilate the arterioles.

Which medication is used to treat age-related macular degeneration (AMD)?

Bevacizumab

Which chamber of the heart will have to work harder to pump blood as a result of aortic valve dysfunction?

Blood goes from the left ventricle through the aortic valve to be circulated throughout the body. If the aortic valve does not work properly, then the left ventricle must work harder to eject the blood to the aorta.

Which statement regarding normal pulmonary circulation is correct?

Blood travels to the lungs to exchange CO2 for oxygen.

Which adverse reaction attributed to the administration of mafenide acetate for the treatment of burns can be life-threatening?

Bone marrow suppression

Which laboratory value would the nurse assess if a patient has a new-onset abnormal cardiac rhythm?

Calcium and Potassium

Calcium channel blockers inhibit the activation of calcium channels, thereby inhibiting its release.

Calcium causes contraction of the myocardium and increases the workload on the heart. Calcium channel blockers decrease the workload on the heart and are used in the treatment of angina pectoris.

Which medication is used in the treatment of the common wart?

Cantharidin (Cantharone)

Which glaucoma drugs decrease intraocular pressure (IOP) by decreasing the production of aqueous humor?

Carbonic anhydrase inhibitors

The patient has been prescribed diclofenac sodium. The nurse recognizes that the patient has probably undergone which procedure?

Cataract surgery

Which information would the nurse discuss with a patient who has received fluorescein sodium eyedrops into the eyes before an ophthalmic examination?

Causes brief color change of the external eye

A patient is prescribed natamycin 5% ophthalmic suspension for an external ocular fungal infection. Which allergy listed on the patient's medical record indicates the patient may have sensitivity to natamycin?

Cheese

Which therapy is a topical treatment for psoriasis? Select all that apply. One, some, or all responses may be correct.

Coal tar Salicylic acid Corticosteroids

The health care provider prescribes neomycin and polymyxin B for a 6-year-old who presents with acute otitis media (AOM) of the right ear. Which action would the nurse perform first?

Contact the HCP.

Which medication can mask infections, can delay healing, and is contraindicated for patients with untreated ocular infections?

Corticosteroids

While assessing a patient who was on drug therapy over the past 2 months for skin infection, a nurse observes thinning of the skin with atrophy of the epidermis. Which medication would the nurse suspect to be responsible for this symptom?

Dexamethasone

Which class of drugs is used as the first line of therapy for reducing fluid volume in patients with heart failure (HF)?

Diuretics promote the formation of urine by the kidneys

A patient has been prescribed a beta-adrenergic blocking agent for the treatment of ocular hypertension. Which adverse effect of the drug would the nurse monitor for in the patient?

Dizziness Bradycardia Hypotension

Which manifestation is a side effect associated with use of calcipotriene? Select all that apply. One, some, or all responses may be correct.

Edema Pruritus Hypercalcemia Suppression of parathyroid hormone

Which occurrence is a potential side effect of sulfa antibiotics?

Epidermal necrolysis

A patient is receiving silver sulfadiazine for third-degree burns. Which side effect would the nurse monitor the patient for? Select all that apply.

Erythema Skin necrosis

A patient has a wick in the right ear due to otitis externa (OE) with significant swelling of the external ear canal (EAC). How frequently would the wick be replaced?

Every 24 to 48 hours

A patient who is on antibiotic drug therapy has erythema of the skin, loss of body hair, and itching. Which drug-induced dermatitis would the nurse suspect in this patient?

Exfoliative dermatitis

Which drug would the nurse anticipate incorporating into the plan of care for a patient diagnosed with blepharitis?

Gentamicin sulfate

The nurse is teaching a patient about the administration of neomycin and polymyxin B with hydrocortisone for the treatment of an ear infection. Which adverse effect would the nurse include in the teaching?

Hearing ability

Which ocular infection is characterized by the formation of a cyst at the follicles of the eyelashes?

Hordeolum

The nurse is caring for a patient with anogenital warts who has a history of skin cancer. Which medication would the nurse anticipate incorporating into the plan of care?

Imiquimod

A patient is administered echothiophate for the treatment of accommodative esotropia. Which phrase describes how the drug exerts its therapeutic effect?

Inactivates cholinesterases

Oral nitroglycerin goes to the liver and is metabolized before it can become active in the body. As a result, a large amount of nitroglycerin is removed from the circulation. This is known as a large first-pass effect.

Intravenous nitroglycerin is quickly absorbed in the blood because it has an onset of action of 1 to 2 minutes.

Which drug is used to treat severe cystic acne?

Isotretinoin

Benzoyl peroxide belongs to which classification of drugs?

Keratolytic agent

Which ocular drug belongs to the category of nonsteroidal antiinflammatory drugs (NSAIDs)?

Ketorolac Diclofenac

Which statement by a nurse about the use of medicinal nitrates indicates effective understanding? Medicinal nitrates dilate all blood vessels.

Medicinal nitrates cause generalized vascular and coronary vasodilation, which increases blood flow through the coronary arteries to the myocardial cells.

Which medication is used for the treatment of baldness in men and women?

Minoxidil (Rogaine)

Parasympathomimetic ophthalmic drugs, such as pilocarpine, reduce intraocular pressure in the treatment of glaucoma by which mechanism of action?

Miosis

The nurse is caring for a child with a staphylococcus skin infection. Which medication would the nurse anticipate incorporating into the plan of care?

Mupirocin

Which nonsteroidal antiinflammatory drug (NSAID) interacts with methotrexate? Select all that apply.

Naproxen Salicylates Ibuprofen

Which side effect is associated with the use of nitroglycerin?

Nitroglycerin is an antianginal drug that causes dry mouth as a side effect.

Which drug may cause bronchoconstriction?

Nonselective beta blockers such as propranolol, nadolol, and pindolol block both beta 1 and beta 2 receptors, decreasing the heart rate and causing bronchoconstriction.

A 20-year-old female patient is starting isotretinoin therapy. Which nursing intervention would the nurse implement before the start of therapy?

Obtain a pregnancy test

The nurse is teaching a patient about living with angle-closure glaucoma. Which medication classification should the patient with glaucoma avoid?

Ocular decongestants

Which disorder is related to dysfunction of the eustachian canal?

Otitis media

Which manifestation is a side effect of tazarotene?

Photosensitivity

Which technique would a nurse use to ensure eardrops are reaching the inner recesses of the external ear canal (EAC)?

Place a wick into the edematous canal.

Which medication for venereal warts is contraindicated in a pregnant patient?

Podophyllum

Which category of medication permanently turns hazel or bluish-brown eyes into a brown color after long-term use?

Prostaglandin analogues

The nurse is providing instructions to an older patient regarding use of eyedrops in the home setting. The patient states, "I hope I remember to do all of this stuff you are telling me." Which action would the nurse take?

Provide written instruction

When assessing a patient who complains of a burning sensation in the lower back, the nurse finds scaling plaques. Which manifestation would the nurse anticipate providing care for?

Psoriasis

Which assessment finding in a patient receiving pilocarpine would indicate a therapeutic effect of the medication?

Pupils are constricted to 2 mm

Which information will a nurse include in the plan of care for a patient who plans to use a sunscreen with a sun protection factor (SPF) of 10 to protect against sunburn?

Reapplying the sunscreen at least every 2 hours

Which structure within the eye connects to the brain by the optic nerve?

Retina

Which structure is found in the inner ear?

Semicircular canals

When planning care for a burn patient, the nurse would anticipate applying which topical medication?

Silver sulfadiazine

Which intervention would the nurse anticipate providing to a patient with second-degree burns?

Silver sulfadiazine cream

Which information would the nurse provide to a patient about the pharmacologic treatment for wet age-related macular degeneration (AMD)?

The drugs prohibit the growth of abnormal blood vessels in the retina.

Upon assessment of a patient taking digoxin for the management of heart failure, the nurse documents a heart rate of 52 beats per minute, nausea, and a yellowish hue in the patient's vision. What would the nurse expect to hear from the health care provider about the management of this patient?

The patient is exhibiting signs of digoxin toxicitywith bradycardia, nausea, and visual changes. Therefore the nurse would anticipate the health care provider to ask for a digoxin level.

A teenage female patient is prescribed isotretinoin for acne. Which information is most important for the nurse to include when teaching the patient about isotretinoin therapy?

The patient must use at least two forms of contraception while taking this medication.

The nurse instills betaxolol hydrochloride 0.5% ophthalmic solution and then gently applies pressure over the inner canthus. Which phrase accurately describes the rationale for this nursing action?

To minimize systemic absorption

Sublingual nitroglycerin has an onset of action of 2 to 3 minutes and is absorbed quickly because the area under the tongue is highly vascular.

Transdermal nitroglycerin has an onset of action of 30 to 60 minutes. It is used for long-term management of angina pectoris because it allows for the continuous slow delivery of nitroglycerin.

A nurse observes that a patient has mild to moderate acne. Which medication would the nurse anticipate being utilized to treat this patient? Select all that apply. One, some, or all responses may be correct.

Tretinoin Salicylic acid Azelaic acid

The nurse is caring for a patient who is infected with herpes simplex virus (HSV). The patient subsequently develops keratoconjunctivitis. Which medication would the nurse anticipate administrating?

Trifluridine

Which instruction would the nurse provide to a patient who is prescribed a topical antiinfective agent for an ear infection?

Use a portable hair dryer

Which action would the nurse perform to administer eyedrops to a patient who has been prescribed timolol 1 drop in the right eye and latanoprost 1 drop in the right eye?

Wait 5 minutes between drugs

Which action would the nurse take to prevent nausea and vomiting in a patient being prepped for irrigation of the ear canal?

Warm the irrigation solution.

The nurse is teaching a group of nursing students about the pathophysiology of glaucoma. Which information regarding the cause of glaucoma would the nurse include in the teaching?

accumulation of aqueous humor

Which drug is a class III antidysrhythmic?

amiodarone, prolong repolarization in phase 3.

Which assessment will the nurse make before administering isosorbide dinitrate (vasodilator)?

assess blood pressure

Verapamil HCl is a calcium channel blocker, and its use is

associated with headaches, dizziness, peripheral edema, hypotension, and constipation.

Which information would the nurse provide to a patient newly prescribed amiodarone to prevent complications?

avoid midday sunlight because the drug causes photosensitivity

Which intervention would a nurse include when planning care for a patient receiving oral digoxin for new onset heart failure

avoiding herbal supplements because many affect the metabolism of digoxin, also weigh the patient every day to assess for signs of fluid retention, patient would need to have routine digoxin levels obtained to prevent drug toxicity.

Atenolol is a cardioselective beta blocker that

blocks only beta 1 receptors in the heart.

Which mechanism of action describes how digoxin immune Fab works?

by binding to the digoxin molecules that are then excreted in the urine. Digoxin toxicity can cause a heart block.

Nitrates act by

dilating the blood vessels, facilitating blood flow. These drugs are effective in the treatment of myocardial ischemia.

Which condition indicates an excessive dose of digoxin?

halo vision, a condition in which colored or luminous rings are seen around lights. Other signs and symptoms of toxicity include anorexia, N/V/D, bradycardia (HR < 60 BPM), premature ventricular contractions, cardiac dysrhythmias, headaches, malaise, blurred vision, confusion, and delirium.

Nicardipine is a calcium channel blocker, and it may cause

headache, dizziness, peripheral edema, and light-headedness.

The nurse is assessing a patient with plaque psoriasis who has been prescribed ustekinumab. The nurse would teach this patient about which risk associated with this drug?

infection

Which information would the nurse provide to a patient with atrial fibrillation regarding the possible adverse effects of diltiazem?

instruct that diltiazem can cause fluid retention that manifests as peripheral edema.

Beta blockers decrease the effects of the

sympathetic nervous system, thereby reducing the heart rate and blood pressure. They find their use in the treatment of angina pectoris.

Which class of drug is used to treat pain due to otalgia?

topical analgesia