Pharmacology Study Guide - Part 2
A 26-year-old professional began using cocaine recreationally several months ago and has begun using the drug on a daily basis over the past few weeks. He has noticed that he now needs to take larger doses of cocaine in order to enjoy the same high that he used to experience when he first used the drug. A nurse should recognize that this pattern exemplifies A) drug tolerance. B) addiction. C) dependence. D) withdrawal.
A
A 46-year-old white American has been prescribed a drug that binds to acid glycoproteins. The nurse understands that white Americans usually receive A) a higher-than-normal dose of drugs that bind to acid glycoproteins. B) a lower-than-normal dose of drugs that bind to acid glycoproteins. C) the recommended normal dose of drugs that bind to acid glycoproteins. D) one half the recommended dose of drugs that bind to acid glycoproteins.
A
A new immigrant to the United States has come to the clinic. She reports having lived in a crowded, poor urban area. Considering her residence and immigration status, which of the following should the nurse screen for? A) Tuberculosis B) Malaria C) Diabetes D) Hypertension
A
A nurse is caring for a patient who abuses marijuana. The treatment for marijuana abuse consists mainly of A) nonpharmacologic interventions combined with an exercise program. B) drug therapy with bromocriptine (Parlodel). C) aggressive respiratory assistance D) no nursing action unless the patient experiences a "bad trip."
A
A patient with a variety of chronic health problems is being seen by her nurse practitioner, who is currently reviewing the patient's medication regimen. Which of the patient's medications should prompt the nurse to teach her to avoid drinking grapefruit juice? A) Atorvastatin (Lipitor) B) Rabeprazole (Aciphex) C) Vitamin D D) Citalopram (Celexa)
A
A traditional Middle Eastern man has type 2 diabetes and is being seen in a primary care clinic with his wife. The nurse would like to provide culturally sensitive education regarding the time of administration of his medication and what he is permitted to eat. The nurse should be careful to A) direct the conversation to the patient regarding his illness. B) educate the patient's wife about his illness. C) inform the patient's employer about his illness. D) inform the patient's medical insurance provider about his illness.
A
A nurse is caring for an adolescent who has a history of alcohol abuse. In order to develop a care plan for this patient, the nurse will need to explore and assess which of the following risk factors? (Select all that apply.) A) Low self-esteem B) Divorced parents C) Financial problems D) Health concerns E) Depression
A B E
A 33-year-old man has been a chronic abuser of alcohol for several years and has been admitted to the emergency department many times because of the consequences of his alcohol use. Most recently, he has been brought in by emergency medical services after being found unconscious outside a local mall. The nurse who is admitting the patient should prioritize what assessments? A) Assessing the patient's patterns of dependence and coping strategies B) Assessing neurological status and assessing for electrolyte imbalances C) Assessing for impaired nutrition D) Assessing for possible interactions between alcohol and other drugs
B
A home health nurse notes that there have been changes to a patient's oral drug regimen. The nurse will closely monitor the new drug regimen to A) track the exact route of metabolism as a research project. B) identify any changes in drug absorption that would change the drug effect. C) monitor only for the adverse effect of immunotoxicity. D) determine the speed of chelation.
B
A nurse is caring for a 46-year-old patient of Chinese origin who has bipolar disorder. The physician has prescribed lithium carbonate (Eskalith) to treat the disorder. The nurse is aware that the lithium dose will likely be given in a A) higher-than-normal dose. B) lower-than-normal dose. C) child's dose. D) weight-based protocol dose.
B
A nurse is caring for a patient who is experiencing nausea and vomiting from chemotherapy. Which of the following would be an appropriate nursing diagnosis for this patient? A) Infection, Risk for related to drug-induced bone marrow suppression B) Nutrition, Imbalanced: Less Than Body Requirement related to adverse effects of drug C) Poisoning, Risk for related to use of a drug with a narrow therapeutic index D) Nutrition, Imbalanced: More Than Body Requirement related to adverse effects of drug
B
A nurse is working in the emergency department and is assigned to a patient brought in by family members. The family thinks that the patient is on methamphetamine. Which of the following will the nurse assess for? A) Increased appetite B) Hypertension C) Bradycardia D) Stupor
B
A nurse who provides care for older adults is aware of the high incidence of drug interactions in this population. When educating a group of seniors about the prevention of drug interactions, the nurse should encourage them to A) take their medications with food unless otherwise instructed. B) consult their care provider before taking new over-the-counter medications. C) maintain a healthy, high-fluid diet, and high levels of physical activity. D) ensure that there is at least 90 minutes between doses of different drugs.
B
A patient has been admitted to the hospital with acute cocaine intoxication. Family members are present and are observing prolonged seizure activity. The family is upset and asks the nurse how long the patient will experience the seizures. An appropriate response by the nurse would be A) "Not long, he should be fine in a few minutes." B) "It's very hard to tell, but the seizure activity might not end right away." C) "It is possible that the seizure activity could last a week or more." D) "Once a person has had a seizure there is always a possibility of other seizures."
B
A patient has been hospitalized for treatment of substance abuse after being arrested and jailed for the past 24 hours. The patient is experiencing severe muscle and abdominal cramps, seizures, and acute psychosis due to abrupt withdrawal. Which of the following drug classes is the most likely cause of these severe and potentially fatal withdrawal symptoms? A) Amphetamines B) Sedative-hypnotic drugs C) Benzodiazepines D) Opioids
B
A patient is suffering from acute inhalant intoxication. The priority nursing intervention will be to A) administer epinephrine. B) administer oxygen therapy. C) provide an emesis basin. D) assess the patient's psychosocial status.
B
A 22-year-old woman has given birth to an infant who exhibits the signs and symptoms of maternal cocaine use during pregnancy. These signs and symptoms are a result of what pathophysiological effect of cocaine use during pregnancy? A) Changes in blood chemistry as a result of nephrotoxicity and hepatotoxicity B) Impaired maternal nutrition as a result of drug use C) Vasoconstriction leading to reduced placental blood flow D) Hypoxia as a result of a prolonged second stage of labor
C
A 32-year-old Asian female who has just arrived in the United States has been diagnosed with hypertension. She has come to the clinic for an office visit and states that she has always used "traditional healing preparations" when ill. In discussing her new antihypertensive drug, the nurse will assess her use of A) analgesics. B) diuretics. C) ginseng. D) antidepressants.
C
A Native American man who lives a traditional lifestyle is scheduled to have heart surgery. The tribal chief has requested that the tribe's medicine man perform a ritual before the patient goes to surgery. The nurse's response to this request should be A) "I'm sorry, but that will not be possible." B) "I will need to inform the doctor and see if he will allow this." C) "As long as the ritual does not interfere with the patient's preoperative care, it will be okay." D) "I don't think that will help, but you have the right to perform the ritual."
C
A hospital patient has been prescribed an antiemetic and an antibiotic, both of which are to be administered intravenously. What action should the nurse prioritize before administering the drugs using the same tubing? A) Warn the patient about the possibility of idiosyncratic drug effects B) Assess the possibility that the antibiotic is causing the patient's nausea C) Check the compatibility of the two drugs D) Review the patient's most recent blood work
C
A nurse has administered a medication to a patient with hypertension. The prescribed drug is supposed to decrease cardiac output. A decrease in cardiac output would most likely A) increase the serum creatinine level. B) decrease drug absorption in the blood. C) decrease the amount of circulating blood sent through the kidneys. D) increase the synergistic effect of the drug.
C
A nurse is admitting a Mexican woman to the hospital who cannot speak or understand English. The patient is alone, and there is no interpreter available. When trying to communicate with the patient the nurse will A) speak loudly. B) exaggerate her mouth movements. C) use nonverbal language. D) speak fast.
C
A nurse is caring for a middle-aged man of Navajo Indian origin who has type 2 diabetes and who is living a traditional Navajo lifestyle. The nurse will be sure to discuss the adverse effects of drug therapy with which of the following family members? A) The patient's father B) The patient's spouse C) The patient's grandmother D) The patient's grandfather
C
A nurse is caring for a patient with cancer who has been prescribed dronabinol (Marinol) to help reduce nausea and vomiting from chemotherapy. The nurse will inform the patient that he or she is taking an oral form of A) methamphetamine. B) cocaine. C) marijuana. D) nicotine.
C
A patient comes to the clinic asking for help to quit drinking alcohol. She has a 21-year history of heavy drinking and is worried about developing cirrhosis of the liver. The patient agrees to take disulfiram (Antabuse). The nurse will teach the patient that the combination of alcohol and Antabuse will cause which of the following? A) Bradycardia B) Diarrhea C) Nausea D) Slight headache
C
Which of the following affects drug distribution throughout the body? A) Presence of food in the gastrointestinal tract B) Increase in hepatic enzymes C) Protein binding D) High blood levels
C
A 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man's most recent visit to his care provider, routine blood work was ordered and the results indicated an unprecedented rise in the man's serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings? A) The man may be experiencing a paradoxical effect of aspirin B) The man may be allergic to aspirin C) The man may be experiencing liver toxicity from the aspirin D) The man may be experiencing nephrotoxic effects of aspirin
D
A Hispanic woman is hospitalized for complications of type 1 diabetes. The nurse speaks only English; the patient understands only Spanish. The patient is being discharged from the hospital, and the nurse needs to provide education related to her diabetes. However, the discharge instructions are in English. The nurse should use A) body language to educate her and then give her the discharge instructions. B) an interpreter to educate her and then give her the English version of the discharge instructions, so she can begin to learn the language. C) a translator to translate the materials and give them to her. D) an interpreter to review the discharge instructions with the patient and then give her the printed material translated into Spanish.
D
A Native-American man is admitted to the emergency department exhibiting a reddened face and an increased heart rate. He reports that he does not normally drink alcohol but at a party had punch that contained vodka. The nurse recognizes that this reaction may be related to the ethanol exposure and caused by A) retarded absorption from the small intestine. B) immediate distribution at the rate proportional to blood flow and water content. C) metabolism using the enzyme alcohol dehydrogenase. D) deficiency in the enzyme aldehyde dehydrogenase.
D
A nurse is assigned to a Caucasian patient who has a phenotype in which the CYP2D6 gene is duplicated. In order to plan appropriate care with regard to drug therapy, the nurse is aware that the patient would A) exhibit no change in metabolic activity through the CYP2D6 pathway. B) metabolize drugs poorly through the CYP2D6 pathway. C) exhibit reduced CYP2D6 activity. D) exhibit ultra-rapid metabolism through the CYP2D6 pathway.
D
A nurse is caring for a patient who has been admitted with acute cocaine intoxication. Which of the following vital signs would the nurse expect to find initially when assessing the patient? A) BP: 98/50, P: 120, R: 40 B) BP: 130/88, P: 92, R: 28 C) BP: 150/90, P: 80, R: 16 D) BP: 170/98, P:110, R: 20
D
A patient is being seen in the emergency department for a sprained ankle and is given a drug to relieve pain. When a second dose of the pain medication is given, the patient develops redness of the skin, itching, and swelling at the site of injection of the drug. The most likely cause of this response is A) a hepatotoxic response. B) an idiosyncratic response. C) a paradoxical response. D) an allergic response.
D
A school nurse has been teaching high school students about the risks associated with marijuana use. However, the nurse has been met with considerable skepticism on the part of students, most of whom believe that marijuana is a benign drug. Which of the following teaching points should the nurse provide? A) "Most people don't know that marijuana can be just as addictive as heroin or cocaine over time." B) "Marijuana can easily interact with other drugs and cause potentially fatal reactions." C) "Every year, thousands of Americans end up in emergency departments with marijuana overdoses." D) "Smoking marijuana is just as bad, or worse, for your lungs as smoking cigarettes."
D
In light of her recent high blood pressure readings, a patient has been started on a thiazide diuretic and metoprolol (Lopressor), which is a beta-adrenergic blocker. What is the most likely rationale for using two medications to address the patient's hypertension? A) The adverse effects of each drug may cancel each other out. B) Using two drugs for a health problem tends to increase patient compliance with the drug regimen. C) Using lower doses of two separate drugs may lessen the risk of adverse reactions. D) Using the two drugs to treat a health problem may create a synergistic effect.
D
Paramedics have brought a patient to the emergency department with a suspected heroin overdose. The nurse should recognize that the patient's most acute threat to health at this time is A) hypokalemia or hyponatremia. B) acute gastrointestinal bleed. C) increased intracranial pressure. D) respiratory depression.
D