Pharmacology Exams # 1 and 2 Final - chapter 3, 15, & 20
The nurse is administering parenteral drugs. Which statement is true regarding parenteral drugs?
Parenteral drugs bypass the first-pass effect.
A factory worker has been admitted to the emergency department after an industrial accident involving organophosphate insecticides. The nurse will prepare to administer which drug?
Physostigmine (Antilirium)
Which intervention would be considered to reduce accumulation of a drug in a patient who has decreased liver function?
Reducing the dosage
What do drug blood levels indicate?
They determine if the amount of drug in the body is in a therapeutic range.
Which drugs would be affected by the first-pass effect? (Select all that apply.)
a. Levothyroxine (Synthroid) tablets b. Diphenhydramine (Benadryl) elixir c. Penicillin given by IV piggyback infusion d. Transdermal nicotine patches e. Sublingual nitroglycerin tablets
Which statements are true regarding pediatric patients and pharmacokinetics? (Select all that apply.)
a. Perfusion to the kidneys may be decreased and may result in reduced renal function. b. First-pass elimination is reduced because of the immaturity of the liver. d. Gastric emptying is slowed because of slow or irregular peristalsis.
When reviewing pharmacology terms for a group of newly graduated nurses, the nurse explains that a drug's half-life is the time it takes for
one half of the original amount of a drug to be removed from the body.
A patient has been taking selegiline (Eldepryl) for a few months, and recently the prescriber increased his dose to 20 mg/day. Today, during his office visit, he tells the nurse that he forgot and had a beer with dinner last evening, and "felt awful." What did the patient most likely experience?
Hypertension
The nurse is assessing the medication history of a patient with a new diagnosis of Parkinson's disease. Which condition is a contraindication for the patient, who will be taking entacapone (Comtan)?
Liver failure
A cholinergic drug is prescribed for a patient with a new diagnosis of myasthenia gravis, and the nurse provides instructions to the patient about the medication. What is important to include in the teaching?
Take the medication 30 minutes before eating to improve swallowing and chewing.
When administering a new medication to a patient, the nurse reads that it is highly protein bound. Assuming that the patient's albumin levels are normal, the nurse would expect which result, as compared to a medication that is not highly protein bound?
The duration of action of the medication will be longer.
When a patient is taking an anticholinergic such as benztropine (Cogentin) as part of the treatment for Parkinson's disease, the nurse should include which information in the teaching plan?
Use artificial saliva, sugarless gum, or hard candy to counteract dry mouth.
A patient with Parkinson's disease asks the nurse why anticholinergics are used in the treatment. Which response by the nurse is most accurate
"These drugs inhibit the action of acetylcholine."
Which of the following drugs dry up body secretions?
. metoprolol (Lopressor) b. doxazosin (Cardura) c. atropine (Atro-Pen) d. bethanechol (Urecholine)
Which age-related change would affect transdermal drug absorption in geriatric patients the most?
Altered circulatory status
The nurse is developing a care plan for a patient who is taking an anticholinergic drug. Which human needs statement would be appropriate for this patient?
Altered urinary elimination
Before the initiation of anticholinergic medications, it is important for the nurse to screen patients for which condition?
Closed-angle glaucoma
Which adverse effects associated with levodopa therapy would support the nursing diagnosis risk for injury?
Orthostatic hypotension
While a patient is receiving drug therapy for Parkinson's disease, the nurse monitors for dyskinesia, which is manifested by which finding?
Difficulty in performing voluntary movements
The nurse is administering medications to the patient who is in liver failure resulting from end-stage cirrhosis. The nurse is aware that patients with liver failure would most likely have problems with which pharmacokinetic phase?
Distribution b. Excretion c. Absorption d. Metabolism
Parkinson's disease is a degenerative disorder of the nervous system caused by the death of neurons that produce:
Dopamine
What is the rationale for administering levodopa instead of dopamine for treatment of Parkinson's disease?
Dopamine does not cross the blood-brain barrier when administered orally.
The nurse notes in a patient's medication history that the patient is taking pilocarpine (Pilocar). Based on this finding, the nurse interprets that the patient has which disorder?
Glaucoma
When obtaining a patient's health history, which assessment data would the nurse identify as having the most effect on drug metabolism?
History of liver disease
Which instruction(s) given by the nurse will assist a patient to cope with the common adverse effects of anticholinergic medications? (Select all that apply.)
a. "Increase fluids daily." b. "Decrease fiber in the diet." c. "Suck on candy or ice chips." d. "Take the medication with meals." e. "Monitor blood glucose."
The nurse administers 50 mg of a drug at 6:00 AM that has a half-life of 8 hours. What time will it be when 25 mg of the drug has been eliminated from the body?
a. 6:00 PM b. 11:00 AM c. 2:00 PM d. 8:00 AM
A cholinergic drug is prescribed for a patient. The nurse checks the patient's medical history, knowing that this drug is contraindicated in which disorders? (Select all that apply.)
a. Alzheimer's disease b. Bladder atony c. Hypotension d. Chronic obstructive pulmonary disease e. Bradycardia
The nurse is monitoring a patient who is in the 26th week of pregnancy and has developed gestational diabetes and pneumonia. She is given medications that pose a possible fetal risk, but the potential benefits may warrant the use of the medications in her situation. The nurse recognizes that these medications are in which U.S. Food and Drug Administration pregnancy safety category?
a. Category B b. Category X c. Category C d. Category D
The nurse can prevent medication errors by following which principles?(Select all that apply.)
a. Do not give a medication that another nurse has drawn up in a syringe. b. Assess for allergies after giving medications. c. Use trade names instead of generic names to avoid confusion. d. Use two patient identifiers before giving medications. e. Minimize the use of verbal and telephone orders.
Carbidopa-levodopa (Sinemet) is prescribed for a patient with Parkinson's disease. The nurse informs the patient that which common adverse effects can occur with this medication?
a. Heart palpitations, hypotension, urinary retention b. Dizziness, insomnia, nausea c. Drowsiness, headache, weight loss d. Peripheral edema, fatigue, syncope
Which adverse effect(s) is/are common when a patient is receiving a cholinergic agent? (Select all that apply.)
a. Hypertension b. Bradycardia c. Nausea d. Constipation e. Dizziness
When a patient taking a monoamine oxidase B inhibitor receives his dietary tray, the nurse knows to remove the
cheese.
Which drugs cause birth defects?
teratogens
The nurse is caring for a patient taking a cholinergic agent. When auscultating lung sounds, the nurse notes inspiratory and expiratory wheezing bilaterally. The best action for the nurse to take would be to
withhold the next dose and notify the physician.
A patient calls the clinic to speak to the nurse about taking an herbal product that contains ginkgo (Ginkgo biloba) to "help my memory." He states that he has read much information about the herbal product. Which statement by the patient indicates a need for further education?
"I will take aspirin or ibuprofen (Motrin) if I have a headache."
Study of what the body does to the drug as it passes through the digestive tract is called
pharmacokinetics
When administering drugs, the nurse remembers that the duration of action of a drug is defined as the time
period when a drug's concentration is sufficient to cause a therapeutic response.