Pharmacology Test 2
Which explanation provides rationale for why beta blockers are used cautiously in patients with respiratory conditions? a. Mask the signs and symptoms of acute hypoglycemia. b. Cause extensive vasodilation and cardiac overload. c. May produce severe bronchoconstriction. d. Increase hypertensive episodes.
c. May produce severe bronchoconstriction.
Which term is used to define an awareness of pain? a. Tolerance b. Threshold c. Perception d. Sensation
c. Perception
Which important nursing interventions(s) is/are associated with administration of diazepam (Valium) 10 mg IV stat for a patient admitted with status epilepticus? (Select all that apply.) a. Apply a cardiac monitor to the patient to assess for continuous heart rate, if not already done. b. Administer the prescribed dosage over 1 minute. c. Mix diazepam in a primary IV solution to avoid overdosing. d. Continuously assess the patient's airway. e. Obtain the correct dose (10 mg) and administer over slow IV push.
a. Apply a cardiac monitor to the patient to assess for continuous heart rate, if not already done. d. Continuously assess the patient's airway. e. Obtain the correct dose (10 mg) and administer over slow IV push.
Which medication is contraindicated when a patient is taking warfarin (Coumadin)? a. Aspirin b. Acetaminophen (Tylenol) c. Propoxyphene (Darvon) d. Morphine (Roxanol)
a. Aspirin
Which adverse effect(s) should patients taking phenytoin (Dilantin) for control of seizures be aware can occur? (Select all that apply.) a. Blood dyscrasias b. Hyperglycemia c. Urinary retention d. Gingival hyperplasia e. Insomnia f. Sedation
a. Blood dyscrasias b. Hyperglycemia d. Gingival hyperplasia f. Sedation
Which premedication assessment by the nurse is most important prior to the initiation of carbamazepine (Tegretol) therapy? a. Determine patient's ancestry. b. Monitor blood pressure (BP) lying, sitting, and standing. c. Auscultate lung sounds. d. Obtain smoking history.
a. Determine patient's ancestry.
Which common adverse effect(s) is/are associated with opiate agonists? (Select all that apply.) a. Dizziness b. Orthostatic hypotension c. Respiratory depression d. Confusion e. Diarrhea f. Urinary urgency
a. Dizziness b. Orthostatic hypotension c. Respiratory depression d. Confusion
Which terms identify neurotransmitter(s)? (Select all that apply.) a. Gamma aminobutyric acid b. Acetylcholine c. Serotonin d. Glucose e. Histamine f. Epinephrine
a. Gamma aminobutyric acid b. Acetylcholine c. Serotonin e. Histamine f. Epinephrine
Which adverse effect(s) is/are common when a patient is receiving a cholinergic agent? (Select all that apply.) a. Nausea b. Hypertension c. Dizziness d. Bradycardia e. Constipation
a. Nausea c. Dizziness d. Bradycardia
Which common adverse effect(s) will the nurse include in discharge teaching for a patient on an adrenergic bronchodilator? (Select all that apply.) a. Palpitations b. Dizziness c. Orthostatic hypotension d. Hypoglycemia e. Tremors f. Bradycardia
a. Palpitations b. Dizziness c. Orthostatic hypotension e. Tremors
Which additional nursing intervention(s) would be effective with pain management in the pediatric population? (Select all that apply.) a. Provide diversional activities such as coloring, puzzles, and games. b. Allow uninterrupted sleep and rest. c. Perform hygiene measures. d. Encourage parental participation with caregiving to diminish the child's anxiety. e. With the healthcare provider's approval, encourage the child to drink eight to ten 8-ounce glasses of fluid daily.
a. Provide diversional activities such as coloring, puzzles, and games. b. Allow uninterrupted sleep and rest c. Perform hygiene measures. d. Encourage parental participation with caregiving to diminish the child's anxiety.
Which medication is used to control seizures or prevent migraine headaches? a. Topiramate (Topamax) b. Zonisamide (Zonegran) c. Valproic acid (Depakene) d. Tiagabine (Gabitril)
a. Topiramate (Topamax)
Which drugs should be addressed when teaching a patient who is starting therapy with NSAIDs? (Select all that apply.) a. Warfarin (Coumadin) b. Lithium (Eskalith) c. Hydroxyzine (Vistaril) d. Insulin e. Diuretics f. Digitalis (Digoxin)
a. Warfarin (Coumadin) b. Lithium (Eskalith) e. Diuretics
Which statement by the patient recently prescribed pregabalin (Lyrica) indicates a need for further instruction? a. "I may feel tired at first, but this should improve with continued use." b. "Once my pain improves, I will stop taking this medication." c. "Taking sleeping aids will increase the sedative effect of this medication." d. "This drug may affect my mental alertness, so I need to be careful around machinery."
b. "Once my pain improves, I will stop taking this medication."
Which information is most accurate regarding the nurse's understanding of pain management? a. Older patients have difficulty describing their pain level. b. Encourage patients to report pain before the pain becomes too severe. c. Use the smallest dose of medication possible to control pain. d. Pain medication administration ordered PRN will maintain a constant blood level.
b. Encourage patients to report pain before the pain becomes too severe.
Which dose is within the acceptable range for administering IV phenytoin (Dilantin) to a patient with a seizure disorder? a. 5 mg/min b. 30 mg/min c. 60 mg/min d. 100 mg/min
b. 30 mg/min
Which time period identifies how long after the administration of a parenteral pain medication the nurse will complete the next pain assessment to evaluate the effectiveness of the medication? a. 10 minutes b. 30 minutes c. 1 hour d. 2 hours
b. 30 minutes
Which nerve endings liberate norepinephrine? a. Cholinergic b. Adrenergic c. Anticholinergic d. Muscarinic
b. Adrenergic
Which category of medications is used for peripheral vascular diseases characterized by excessive vasoconstriction, such as Raynaud's disease? a. Adrenergic agents b. Alpha-adrenergic blocking agents c. Beta-adrenergic blocking agents d. Cholinergic agents
b. Alpha-adrenergic blocking agents
Which sign or symptom displayed by a patient would be indicative of opiate withdrawal? a. Bradycardia b. Diarrhea c. Lethargy d. Hypothermia
b. Diarrhea
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. Take the medication with meals. b. Increase fluids daily. c. Decrease fiber in the diet. d. Suck on candy or ice chips. e. Monitor blood glucose.
b. Increase fluids daily. d. Suck on candy or ice chips.
Which medication would the nurse administer to a patient who is rating the pain at 8 on a 0 to 10 scale? a. Acetaminophen (Tylenol) b. Morphine (Roxanol) c. Oxycodone (OxyContin) d. Oxycodone and aspirin (Percodan)
b. Morphine (Roxanol)
Which patient characteristic(s) will be assessed when performing a baseline neurologic assessment prior to the administration of an NSAID medication? (Select all that apply.) a. Vital signs b. Orientation to date, time, and place c. Mental alertness d. Bowel sounds e. Concurrent use of anticoagulant agents
b. Orientation to date, time, and place c. Mental alertness
Which patient statement indicates a need for further teaching about phenytoin (Dilantin) prescribed to manage a seizure disorder? a. "I need to avoid or limit caffeine intake." b. "I will check with the pharmacist before taking over-the-counter medication." c. "If I develop enlarged gums, I will stop taking the medication." d. "It is important for me to take my medicine at the same time daily."
c. "If I develop enlarged gums, I will stop taking the medication."
Which statement by the patient indicates a need for further teaching when a patient with a history of type 1 diabetes after myocardial infarction has been placed on a beta-adrenergic blocking agent? a. This medication should not be discontinued suddenly. b. This medication lowers my blood pressure by helping me get rid of fluid. c. I may not have my usual symptoms of a hypoglycemic reaction while on this drug d. This medication may take a few weeks to work.
b. This medication lowers my blood pressure by helping me get rid of fluid.
An 86-year-old patient who was admitted with GI bleeding as a result of salicylate therapy is being discharged. As the nurse reviews the discharge medication list, the patient states that she doesn't understand why Tylenol doesn't work as well as the aspirin she had been taking. Which response is best? a. "Tylenol and aspirin are chemically the same drug." b. "Tylenol is appropriate for only minor pain." c. "Tylenol does not help with inflammatory discomfort." d. "A therapeutic blood level must be established with Tylenol."
c. "Tylenol does not help with inflammatory discomfort."
Which types of adrenergic receptors subdivide the autonomic nervous system? a. Nicotinic and muscarinic b. Afferent and efferent c. Alpha and beta d. Agonists and antagonists
c. Alpha and beta
Which response by the nurse is most accurate when a patient with the diagnosis of Parkinson's disease asks the nurse why anticholinergics are used in the treatment? a. These drugs help you urinate. b. These drugs will decrease your eye pressure. c. These drugs inhibit the action of acetylcholine. d. These drugs will assist in lowering your heart rate.
c. These drugs inhibit the action of acetylcholine.
Which patient assessment would indicate to the nurse that salicylate toxicity is occurring? a. Gastrointestinal (GI) bleeding b. Increased bleeding times c. Tinnitus d. Occasional nausea
c. Tinnitus
Which condition may the patient have carbamazepine (Tegretol) prescribed to treat symptoms? a. Tardive dyskinesia b. Psychotic episodes c. Trigeminal neuralgia pain d. Sedation
c. Trigeminal neuralgia pain
Which guideline should be followed when administering phenytoin (Dilantin) intravenously? a. Deliver rapidly. b. Monitor for signs of tachycardia. c. Assess for hypertensive crisis. d. Administer without mixing with other medications.
d. Administer without mixing with other medications.
Which response by the nurse is accurate when a patient who has been on lamotrigine (Lamictal) for seizure control reports a skin rash and urticaria? a. Reassure the patient that this is a common adverse effect of the medication and not to worry. b. Instruct the patient to discontinue use of the drug immediately. c. Instruct the patient to decrease the dosage of the medication until the rash disappears. d. Advise the patient that this adverse effect usually resolves but should be reported to the healthcare provider.
d. Advise the patient that this adverse effect usually resolves but should be reported to the healthcare provider.
Which condition is important to screen a patient for before the initiation of anticholinergic medications? a. Hypertension b. Infectious diseases c. Diabetes d. Closed-angle glaucoma
d. Closed-angle glaucoma
An older adult patient is to receive atenolol, a beta-adrenergic blocking agent. Prior to administration of the drug, the nurse assesses an apical pulse rate of 58 and notes ankle edema. Which action will the nurse take first? a. Determine the therapeutic blood level. b. Encourage the patient to decrease water intake. c. Elevate the patient's legs. d. Withhold the medication.
d. Withhold the medication.
Which condition is associated with hydantoin therapy? a. Postictal state b. Atonia c. Seizure threshold reduction d. Gingival hyperplasia
d. Gingival hyperplasia
Which action is the most appropriate to take when a patient hospitalized in an acute care setting reports to the nurse that since starting on an adrenergic medication, he has been feeling "dizzy and weak"? a. Immediately notify the physician. b. Teach the patient to move slowly from standing to sitting. c. Discontinue the adrenergic blocker. d. Monitor the blood pressure in both the supine and standing positions.
d. Monitor the blood pressure in both the supine and standing positions.
Which action will the nurse take when a patient receiving morphine sulfate via percutaneous coronary angioplasty (PCA) has a shallow, irregular respiratory rate of 6 breaths/min? a. Elevate the patient's head of bed to facilitate lung expansion. b. Increase the patient's primary intravenous (IV) flow rate. c. Complete the FLACC scale. d. Notify the healthcare provider and prepare to administer naloxone (Narcan).
d. Notify the healthcare provider and prepare to administer naloxone (Narcan).
Which is the best action for the nurse to take when auscultating inspiratory and expiratory wheezing bilaterally on a patient taking a cholinergic agent? a. Provide the next dose of the cholinergic agent immediately. b. Assess heart rate and blood pressure. c. Reposition the patient. d. Withhold the next dose and notify the physician
d. Withhold the next dose and notify the physician
Which is most important for the nurse to assess prior to the administration of metoprolol, a beta-adrenergic blocking agent? a. Blood pressure b. Lung sounds c. Mental status d. Urine output
a. Blood pressure
Which body function(s) is/are controlled by the autonomic nervous system? (Select all that apply.) a. Blood pressure b. Skeletal muscle contraction c. GI secretion d. Body temperature e. Urination
a. Blood pressure c. GI secretion d. Body temperature e. Urination
Which action(s) is/are appropriate in the nursing management of a patient with generalized tonic-clonic seizure activity? (Select all that apply.) a. Restraining the patient's arms to avoid further injury b. Placing padding around or under the patient's head c. Attempting to insert a tongue depressor into the patient's mouth d. Positioning the patient on the side once the relaxation stage is entered to allow oral secretions to drain e. Requesting additional assistance and/or necessary equipment in case the patient does not begin breathing spontaneously when the seizure is over
b. Placing padding around or under the patient's head d. Positioning the patient on the side once the relaxation stage is entered to allow oral secretions to drain e. Requesting additional assistance and/or necessary equipment in case the patient does not begin breathing spontaneously when the seizure is over
A patient on anticonvulsant therapy confides to the nurse at an outpatient clinic that she suspects she may be pregnant. Which action(s) should the nurse encourage the patient to take? (Select all that apply.) a. Consult an obstetrician. b. Discontinue medications. c. Carry an identification card. d. Provide a list of seizure medications. e. Consider oral contraception.
a. Consult an obstetrician. c. Carry an identification card. d. Provide a list of seizure medications.
The nurse is preparing to administer zonisamide (Zonegran) to a newly admitted patient with the diagnosis of adult partial seizures. Which sign(s) or symptom(s) would cause the nurse to hold this medication? (Select all that apply.) a. Skin rash b. Urinary frequency c. Drowsiness d. Allergy to Bactrim e. Pruritus
a. Skin rash d. Allergy to Bactrim e. Pruritus
h type of pain scale assessment tool is the most accurate to use when completing an assessment on a nonverbal adult patient? a. TPPPS b. FLACC c. POCIS d. MOPS
b. FLACC
Which symptom is most likely to be assessed in a patient prescribed hydantoin therapy with a history of diabetes who has just been diagnosed with seizure disorder? a. Hunger b. Hyperglycemia c. Diarrhea d. Pupil dilation
b. Hyperglycemia
Which statement(s) is/are true about efferent nerves? (Select all that apply.) a. Transmit signals to the spinal cord and brain. b. Leave the CNS to carry impulses to other body parts. c. Are part of the peripheral nervous system. d. Transmit signals that control contractions of smooth and skeletal muscles. e. Transmit signals that control contractions of some glandular secretions.
b. Leave the CNS to carry impulses to other body parts. c. Are part of the peripheral nervous system. d. Transmit signals that control contractions of smooth and skeletal muscles. e. Transmit signals that control contractions of some glandular secretions.
Which condition would indicate to the nurse that a patient has phenytoin (Dilantin) toxicity? a. Oculogyric crisis b. Nystagmus c. Strabismus d. Amblyopia
b. Nystagmus
A patient is taking meperidine (Demerol) as needed for moderate to severe pain following an open appendectomy. The nurse assesses the following: current pain level 2, temperature 99 F, BP 130/76, respirations 10, lung sounds clear, abdomen soft and tender, bowel sounds present. Which is the primary problem based on this assessment information? a. Breathing pattern alteration b. Altered body temperature c. Constipation d. Pain
a. Breathing pattern alteration
Which condition(s) may be managed by salicylates? (Select all that apply.) a. Migraine headache b. Swollen joints c. Fever d. Muscle aches e. Myocardial infarction
b. Swollen joints c. Fever d. Muscle aches e. Myocardial infarction
Which explanation by the nurse is most accurate when a patient with chronic obstructive pulmonary disease (COPD) reports having insomnia and a racing heart after starting terbutaline therapy? a. The symptoms are typical and indicate that the medication is at a therapeutic level. b. The symptoms will tend to resolve with continued therapy c. The symptoms are unusual and need to be reported to the healthcare provider immediately d. The symptoms are indicative of toxicity
b. The symptoms will tend to resolve with continued therapy
Which advantage relates to taking a nonsteroidal antiinflammatory drug (NSAID) that is a COX-2 inhibitor? a. The medication is cheaper than aspirin. b. There are fewer GI adverse effects. c. They are more effective than COX-1 inhibitors. d. They have no known adverse effects.
b. There are fewer GI adverse effects.
A patient experiencing chronic pain as a result of metastatic cancer has a new order for fentanyl (Duragesic) transdermal patch. The initial patch is applied at 8 AM on Monday. At 8 PM on Monday, the patient reports a pain level of 8. Which action should be taken? a. Immediately contact the physician. b. Reassess pain level in 30 to 45 minutes. c. Remove current patch and reapply a new patch. d. Provide a PRN analgesic medication as ordered.
d. Provide a PRN analgesic medication as ordered.
Which situation indicates the need to withhold an opiate agonist? a. Evidence of postural hypotension b. Presence of constipation c. Pain rating of 7 on a 0 to 10 scale d. Respiratory rate of 10 breaths/min
d. Respiratory rate of 10 breaths/min
Which statement is true about neuropathic pain? a. This pain is the result of a stimulus to pain receptors. b. Patients describe it as dull and aching. c. It commonly originates in the abdominal region. d. The pain is a result of nerve injury.
d. The pain is a result of nerve injury.
Which way is best for the nurse to evaluate the effectiveness of the patient's opiate agonist? a. Ability of the patient to tolerate more activity b. Increased sleep time throughout the night c. Reduction of respiratory rate from 24 to 18 breaths/min d. Verbal report of 2 on a 1 to 10 scale
d. Verbal report of 2 on a 1 to 10 scale
Which response is the primary response to alpha-1-receptor stimulation? a. Bronchodilation b. Tachycardia c. Vasoconstriction d. Uterine relaxation
c. Vasoconstriction
Which component of the pain history is being addressed when a patient describes pain as cramping and burning? a. Depth b. Location c. Quality d. Severity
c. Quality
Which drug of choice is prescribed for treating a generalized tonic-clonic seizure? a. Diazepam (Valium) b. Haloperidol (Haldol) c. Valproic acid (Depakene) d. Risperidone (Risperdal)
c. Valproic acid (Depakene)
Which information would be most important for the nurse to provide to a patient when teaching about the adverse effects of succinimide therapy? a. Nausea, vomiting, and indigestion are common during the initiation of therapy. b. Avoid taking the medication with food or milk to minimize adverse effects. c. Sedation, drowsiness, and dizziness tend to worsen with continued therapy. d. Reducing the dosage of medication will relieve symptoms of nausea.
a. Nausea, vomiting, and indigestion are common during the initiation of therapy.
Which disorder(s) would indicate the use of anticholinergic agents? (Select all that apply.) a. Glaucoma b. Benign prostatic hypertrophy c. Bradycardia d. Parkinson's disease e. Preparation for surgery f. Stimulation of the vagus nerve
c. Bradycardia d. Parkinson's disease e. Preparation for surgery
Which food should be removed from the tray of a pediatric patient on a ketogenic diet for refractory seizure control? a. Fat b. Salt c. Carbohydrates d. Vitamin K
c. Carbohydrates
Which condition would alert the nurse of the need to use beta-adrenergic blockers cautiously? a. Hypertension b. Raynaud's phenomenon c. Emphysema d. Cardiac dysrhythmias
c. Emphysema
Which priority nursing action needs to be implemented when a long-term care resident taking an anticholinergic agent is observed to be disoriented and hallucinating? a. Report development of alterations to the charge nurse. b. Assess blood glucose. c. Provide for resident's safety. d. Medicate with antianxiety medication.
c. Provide for resident's safety.
