Pharmacology UNIT 1: Quizzes/Assignments

A 72-year-old client has been diagnosed with benign prostatic hypertrophy (BPH) and will begin treatment with tamsulosin. The client admits that he is skeptical about the drug's ability to relieve his distressing symptoms. The nurse should respond in what way?

"Tamsulosin can relax your prostate and your bladder neck, making it easier to pass urine."

You are precepting a nursing student and together you are caring for a patient who is to receive interleukins. The student nurse asks you what happens physiologically when a patient receives interleukins. What would be your best response?

"The patient has increases in the number of natural killer cells."

The nurse is caring for a client who is receiving epoetin alfa. What adjunct treatment will the nurse expect the health care provider to order for this client?

Iron supplement

The nurse instructs the client taking medication for erectile dysfunction to call the health care provider if which adverse effect occurs after taking the medication? a. Flushing of the face b. Lack of erection c. Priapism d. Nasal congestion

c. Priapism

A nurse has an order to administer heparin. Before initiating this therapy, a priority nursing assessment will be the client's: a. sodium and potassium levels. b. blood glucose level. c. aPTT. d. heart rate and pulse.

c. aPTT.

A nurse is providing education to a client who is preparing to begin chemotherapy for the treatment of cancer. What action should the nurse encourage the client to implement to minimize the effects of chemotherapy-triggered mucositis?

thoroughly rinse the mouth often, especially before and after meals

A pregnant client is concerned that she will be unable to get her yearly flu shot. Which of the following is the best response the nurse can give to this client?

"As long as it is not a live-virus vaccine, it will be safe."

A menopausal client prescribed estrogen asks what the implications of taking the medication are. Which response by the nurse best demonstrates an understanding of the associated implications?

"Estrogen increases the risk of certain cancers, myocardial infarctions, and blood clots."

After teaching a client about prescribed statin therapy, the nurse determines that additional teaching is needed when the client makes which statement?

"I can take the drug with grape juice"

The nurse tells a 9-year-old child that the child will be receiving an injection today. What statement by the child is most indicative of the fear that children of this age group feels?

"I hate getting shots. The last time I got one it hurt so bad."

A nurse is caring for a 25-year-old clinic client who is starting on birth control pills. What statement by the client indicates that she needs further teaching?

"I will exercise more if I experience chest or leg pain."

A client diagnosed with diabetes and currently prescribed prednisone reports blood sugar levels that are higher than normal. What is the nurse's best statement related to this change in glucose levels?

"Prednisone can cause increased blood sugar levels."

The nurse is caring for a client with a WBC of 700 cells/mm3. Which discharge instruction is most important for the nurse to share with this client?

"Stay out of crowded places such as grocery stores."

A client is diagnosed with a brain tumor. The client is told that the cancer cells proliferate. The client asks the nurse what this means. What is the nurse's best response?

"The proliferation is the growth of cancer cells and the rate of growth."

A school nurse is educating a group of adolescents on the dangers of anabolic steroids. What statement by the nurse would explain why they are dangerous specifically to this age group?

"These drugs can damage the heart, liver, and kidneys."

A primiparous woman tells the nurse that she and her partner are highly reluctant to have their infant vaccinated, stating, "We've read that vaccines can potentially cause a lot of harm, so we're not sure we want to take that risk." How should the nurse respond to this family's concerns?

"Vaccinations are not without some risks, but these are far exceeded by the potential benefits."

What are the rights to medication administration?

1. right medication 2. right patient 3. right dosage 4. right route 5. right time 5. right reason 6. right documentation

A client is receiving a medroxyprogesterone contraceptive injection. The nurse would instruct the client to return for the next dose at which time?

3 months

The nurse who is caring for an older client sees that the latest laboratory report reveals a decreased creatinine clearance. The nurse anticipates what modification to the client's drug regimen?

A decrease in the dosage of medication

Which statements best indicates the client understands recommended vaccines following the 65th birthday?

A tetanus-diphtheria booster every 10 years, annual influenza vaccine, and a one-time administration of pneumococcal vaccine at 65 years of age

A nurse is caring for a client who has just had organ transplant surgery. Which nursing intervention should the nurse perform in case a rejection response is seen in the client?

Administer prescribed specific anti-rejection medication

A nurse is aware of the high incidence and prevalence of hyperlipidemia and the consequent need for antihyperlipidemics. Treatment of high cholesterol using statins would be contraindicated in which client?

An obese male client who is a heavy alcohol user and who has cirrhosis of the liver

In today's health care environment, there is often more contact between the client and the nurse than between the client and the health care provider. What does this put the nurse in the bestposition to do?

Assess the therapeutic success of the drug therapy.

What conditions is an indication for the use of warfarin (Coumadin)?

Atrial Fibrillation, Venous Thrombosis, and Pulmonary Embolism

What schedule of medication dosing assists older adults in adhering to a medication regimen?

Begin with a low dose to minimize adverse effects

Dosage form is a major determinant of which drug characteristic?

Bioavailability

A client has been receiving regular doses of epoetin alfa for several weeks, and the home care nurse has been monitoring the client's condition closely. When taking the client's vital signs, the nurse should pay particular attention to what assessment datum?

Blood pressure

A 27-year-old woman is concerned that she is pregnant even though she has been using oral contraceptives. During the assessment, the nurse discovers the client has been using various herbs. Which of the following herbs is contraindicated for use with oral contraceptives? A. Chamomile B. Pennyroyal C. St. John's wort D. Valerian

C. St. John's wort

Which of the 6 rights of medication administration is a consideration of medication administration?

Check for allergies, assess the patient, education, and the 3 checks.

What are examples of drugs with local effects?

Cold sore medicine Wart medicine Sunscreen sore medicine

What is the primary role of protein binding on drug action?

Decreasing the medication's speed of action

Heparin is most likely indicated for which conditions?

Deep vein thrombosis (DVT) and Pulmonary Embolism

What are the most common medical problems seen in older adults?

Diabetes mellitus Heart disease Arthritis

The nurse receives a call from a male client who takes finasteride (Proscar) for treatment of BPH, and tells the nurse that his wife may be pregnant. What does the nurse expect the health care provider to do?

Discontinue the medication.

The client is prescribed warfarin. His INR is 5.2. At what level is this dose?

Elevated

The nurse is caring for an older adult client who has been prescribed multiple medications. How can the nurse best work with the care team to prevent polypharmacy-related issues?

Ensure that each of the client's medications is genuinely necessary and discontinue those that are not.

Administration of the tetanus toxoid in adults involves two initial injections given four weeks apart, a booster injection given six months to a year later, and periodic injections thereafter. What is the recommended interval for the periodic injections for a 66 year old client ?

Every 10 years

Which mechanism of action or pharmacological action is best associated with statins?

HMG-CoA reductase inhibitors, Decrease LDL, Increase HDL, and Decrease Triglycerides.

During your assessment if a patient taking heparin, what side effect is most likely to be seen?

Hemorrhage

The perinatal nurse recognizes that what vaccine can be safely given to a neonate?

Hepatitis B

The nurse knows that a client is at high risk for developing drug tolerance because the client will be taking which drug for a long period of time?

Hydromorphone (Dilaudid) for pain

What is the fastest medication route?

IV

The nurse is preparing to teach the client about diet therapy when beginning bile sequestrant medication to lower lipid levels. What important point will the nurse include in the teaching plan?

Increasing fiber intake

Which would a nurse identify as the primary issue associated with anemias?

Ineffective red blood cells

A 53-year-old man is receiving cyclosporine in order to prevent rejection of a transplanted kidney. The nurse should prioritize assessments related to:

Infection

What is the mechanism of action of warfarin (Coumadin)?

Inhibits clotting factors

A 59-year-old client is on warfarin therapy. On follow-up visits to the clinic, the nurse will assess the client's:

Intake of vitamin k

A client has a low erythrocyte count. How may a colony-stimulating factor affect the client's erythrocyte count?

It stimulates the growth of red blood cells.

What type of vaccine is contraindicated in clients who have active malignant disease?

Live vaccines

An 18-week-gestation pregnant woman has been diagnosed with fetal demise. What medication can be administered to initiate the birthing process?

Misoprostol

Which of the following drugs is considered the prototype of opioid analgesics?

Morphine

A 75-year-old client presents to the health care provider's office with bleeding gums and multiple bruises. When the nurse reviews the client's drug history, the nurse finds that the client is prescribed aspirin 81 mg/d. What drug may cause increased bleeding when used in conjunction with the aspirin?

NSAIDS

A nurse is reviewing the medication history of a client. The nurse understands that a PDE5 inhibitor would be inappropriate for a client taking:

Nitroglycerin

What should be monitored in patients taking warfarin (Coumadin)?

Observe for bleeding

A client is to receive clopidogrel. The nurse would expect to administer this agent by which route?

Oral

What is the slowest medication route?

PO (oral)

What laboratory values should be monitored in patients taking warfarin (Coumadin)?

PT/INR Levels

Which factor accounts for the increased risk for drug reactions among clients aged 65 years and older?

Physiologic changes affecting all pharmacokinetic processes

When educating a client prescribed testosterone transdermal patch therapy, the nurse will provide what information regarding patch placement?

Place the patches on the back, abdomen, upper arms, or thighs.

Which consideration is most applicable to heparin?

Preferred (Safe) during pregnancy

What is a contraindication for the use of warfarin (Coumadin)?

Pregnancy

What is a contraindication to an MMR booster for an adolescent female?

Pregnancy

The health care provider discovers a clot in the client's left lower leg. Anticoagulant drugs are prescribed to prevent formation of new clots and to achieve which other effect?

Prevent extension of clots already present

What medication is the reversal agent/antidote used for heparin?

Protamine Sulfate

A client exhibits signs and symptoms of heparin overdose. The nurse would anticipate administering:

Protamine sulfate

A patient who is receiving an immune modulator has been admitted to the unit. What would be a priority action by the nurse?

Protect the patient from exposure to infection.

The nurse is caring for a client who is going home on warfarin. What lab test(s) will the client require to evaluate therapeutic effects of the drug?

Prothrombin time (PT) and international normalized ratio (INR)

When administering magnesium sulfate, for what should the nurse assess the patient?

Respiratory depression

A client with hyperlipidemia has been taking atorvastatin for several months. How can the therapeutic effect of the medication be best determined?

Reviewing the client's laboratory blood work results

What is a possible side effect of statins?

Rhabdomyolysis

Which of the 6 rights of medication administration involves proper written communication and reports?

Right documentation

Which of the 6 rights of medication administration involves comparing the amount of medication to the MAR?

Right dose

Which of the 6 rights of medication administration involves comparing the strength, concentration, and type of medication to the order?

Right medication

Which of the 6 rights of medication administration involves verifying the name on the patients armband prior to administering any medications?

Right patient

Which of the 6 rights of medication administration involves the method of delivery of medications?

Right route

Which of the 6 rights of medication administration involves knowing when medications should be administered?

Right time

The nurse is administering medications and knows that there is a longer distribution time when the drug is intended for what area?

Skin

The client receives a prescription for niacin. The nurse is providing education about the medication and possible adverse effects. Which adverse affect would the nurse include?

Some people get very flushed skin when they take this medication."

Which single class drug is known to be most effective in reducing the major types of dyslipidemia?

Statins

The client receiving a first infusion of paclitaxel reports chills and dyspnea. The oncology nurse assesses the client and observes facial flushing, wheezing, and extreme anxiety. What is the priority intervention by the nurse?

Stop the infusion.

What mechanism of action or pharmacological action is best associated with heparin?

Suppresses coagulation

A woman diagnosed with obsessive-compulsive disorder has been prescribed oral paroxetine hydrochloride. What is the expected effect for this prescription?

Systemic effect on symptoms

A nurse is responsible for maintaining an accurate count and record of the controlled substances on the nursing division. This nursing action is regulated by which U.S. law or agency?

The Drug Enforcement Administration

A 32-year-old female client is being treated with a cytotoxic antineoplastic agent. Which is the most important instruction related to the potential for teratogenicity?

The client should not become pregnant for several months.

A 6-month-old child has developed skin irritation due to an allergic reaction. The child is prescribed a topical skin ointment. The nurse will consider what information before administering the drug?

The infant's skin has greater permeability than that of an adult.

What is the relation between the activity level of older adults and the response to medication?

The older adult who is more physically active is less likely to have an adverse drug effect.

When considering physiologic variables that influence safe pharmacotherapy in clients younger than 18, which principle should the nurse integrate into care?

The younger the client, the greater the variation in medication action compared to an adult.

A client with moderately elevated lipid levels requests immediate pharmacotherapy for dyslipidemia. The nurse explains that a period of intensive diet therapy and lifestyle modification will be utilized before drug therapy is considered based on what rationale?

Therapeutic lifestyle changes are the preferred method for lowering blood lipids.

The health care provider changes a female client's immunosuppressant to a newer drug. The client asks why this is necessary. What is true about the newer immunosuppressants?

They have fewer severe adverse effects.

A 7 months' pregnant woman is experiencing contractions. She is admitted to the hospital in preterm labor. What will be prescribed to stop the labor?

Tocolytics

An older adult client has an elevated serum creatinine level. This client is at greatest risk for which medication-related effect?

Toxicity

A male client is prescribed interferon. What is his probable diagnosis?

Viral hepatitis

Women generally do not eat foods high in calcium, which means that women of all ages generally consume less than the recommended amount of calcium. What supplement may be helpful in reducing bone loss?

Vitamin D

Which medications are used to reverse the effects of warfarin?

Vitamin K and Fresh Frozen Plasma

What is the best source of information for current recommendations regarding immunizations and immunization schedules? a. Centers for Disease Control and Prevention b. Department of Epidemiology c. Local health care provider's office d. Department of Public Health

a. Centers for Disease Control and Prevention

A patient with very high serum triglyceride levels is prescribed the fibric acid derivative clofibrate. In which of the following categories of patients is the use of clofibrate contraindicated? a. Patients with primary biliary cirrhosis b. Patients with endocrine disorder c. Patients with arterial bleeding d. Patients with respiratory depression

a. Patients with primary biliary cirrhosis

A 70-year-old resident of a long-term care facility has experienced increasing pain, swelling, and redness to her lower leg over the past 12 hours, prompting the care providers at the facility to have the woman brought to the local emergency department. Diagnostic testing has confirmed deep vein thrombosis (DVT) and an IV infusion of alteplase (Activase) has been initiated. Unlike anticoagulants, a thrombolytic such as alteplase can: a. break down existing clots. b. inhibit platelet aggregation. c. potentiate the action of vitamin K. d. prevent the formation of new clots.

a. break down existing clots

What should be monitored in a patient taking heparin?

aPTT

A forest ranger arrives at a community clinic for prophylactic vaccination. Which vaccine would be most important to be administered to the ranger? a. Rotavirus vaccine b. Rabies vaccine c. Measles, mumps, and rubella (MMR) vaccine d. Varicella vaccine

b. Rabies vaccine

A client is to receive enoxaparin. The nurse would administer this drug by which route? a. Orally b. Subcutaneous injection c. Intravenous infusion d. Intramuscular injection

b. Subcutaneous injection

A patient with hyperlipidemia is prescribed ezetimibe. Which ongoing assessment should the nurse perform during treatment? a. Inspect skin and eyelids for evidence of xanthomas. b. Obtain reports of fasting blood sugar levels. c. Frequently monitor blood cholesterol. d. Take a dietary history of the patient.

c. Frequently monitor blood cholesterol.

What would the nurse identify as a vaccine that is a toxoid? a. Hepatitis A b. Pneumococcal polyvalent c. Tetanus d. Haemophilus influenza B

c. Tetanus

The oncology nurse understands that chemotherapeutic agents are most effective during a particular phase of the cell cycle. This means the agents are:

cell cycle-specific

What is a contraindication to an MMR booster for an adolescent female? a. A positive titer b. History of rubeola c. Current menses d. Pregnancy

d. Pregnancy

A client has had cholestyramine added to his or her treatment plan for dyslipidemia. What effect will cholestyramine have on the pharmacokinetics of the thiazide diuretic that the client is currently prescribed? a. increased first-pass effect b. increased metabolism c. faster excretion d. decreased absorption

d. decreased absorption

What actions should the nurse engage when providing appropriate, effective nursing care?

diagnosing implementation assessing planning

The nurse understands the importance of correctly reading drug labels when calculating dosages. Which are included on labels and needed to administer a drug correctly?

drug form drug name dosage strength

A 49-year-old female client is asking the nurse about how her changing hormones relate to menopause. The nurse explains that atrophic vaginitis is a common problem during menopause. The treatment for atrophic vaginitis requires replacing:

estrogen

The nurse administered a scheduled dose of hydrochlorothiazide, a diuretic, 45 minutes ago. The nurse is now preparing to assess the client's blood pressure. In what phase of the nursing process should the nurse perform this action?

evaluation

The nurse is counseling a pregnant client on drug-induced teratogenicity. The nurse should inform the client that this is most likely to occur during what time?

first trimester

A client is diagnosed with atrial fibrillation and prescribed the drug Coumadin (warfarin). The nurse would instruct the client to avoid what foods?

foods with vitamin K

A drug is 100% bioavailable when it is administered by what routes?

intravenous

The nurse is assessing a 6-month-old infant prior to scheduled immunizations. What finding would the nurse immediately recognize as a reason to reschedule administration?

low-grade fever

What patient recommendation is most likely associated with warfarin (Coumadin) use?

maintain same diet

A client in the first trimester of pregnancy has been experiencing severe nausea and vomiting, and the client has consequently developed a fluid volume deficit and hypokalemia. What antiemetic should the nurse anticipate administering to this client?

ondansetron

What is the branch of pharmacology that uses drugs to treat, prevent, and diagnose disease?

pharmacotherapeutics

Student nurses are discussing rheumatoid arthritis (RA) in their pathology class. The students learn that RA is treated with leflunomide because it relieves symptoms and

slows the progression of joint destruction.

The community health nurse is planning care for a client who will be prescribed an oral chemotherapy drug for the next several months while recovering at home. What health education topic should the nurse emphasize?

techniques for safely handling the drug

A nurse is taking care of a woman receiving an abortifacient. The nurse is aware that the most serious adverse effect is:

vaginal bleeding