ATI: Pharmacology

INR range

2-3

A nurse is preparing to administer Magnesium Hydroxide 1.5 oz PO to a client who has constipation. How many mL should the nurse administer?

45 mL 1 oz/30mL = 1.5 oz/ X mL X= 45 mL

What can a patient experience with brompheniramine, a antihistamine?

A client who takes a first-generation antihistamine such as brompheniramine can experience cholinergic blockade effects that can cause drying of mucous membranes in the mouth, nasal passages, and throat. Taking frequent sips of liquid or sucking on a hard, sugarless candy can help relieve dry mouth.

What medication interferes with the effectiveness of oral contraceptives? A: Carbamazepine B: Sumatriptan C: Atenolol D:Glipizide

A: Carbamazepine. Carbamazepine causes an accelerated inactivation of oral contraceptives because of its action on hepatic medication-metabolizing enzymes. B: Sumatriptan. There is no medication interaction between oral contraceptives and sumatriptan, which is a medication to treat migraines. C: Atenolol, There is no medication interaction between oral contraceptives and atenolol, a beta blocker. D:Glipizide,There is no medication interaction between oral contraceptives and glipizide, an antidiabetic medication.

Medication for newly diagnosed rheumatoid arthritis

A: Celecoxib The nurse should anticipate that the provider will prescribe celecoxib, which is a nonsteroidal anti-inflammatory drug (NSAID). This medication or another NSAID should be initiated for a client who has a new diagnosis of rheumatoid arthritis.

Specific antidote for acetaminophen toxicity

Acetylcysteine

How do you reverse the effects of midazolam?

Administer flumazenil

A nurse is reviewing the ECG of a client who is receiving IV furosemide for heart failure. The nurse should identify which of the following findings as an indication of hypokalemia? A: Tall, tented T waves B: Presence of U-waves C:Widened QRS Complex D: ST Elevation

B: Presence of U-Waves: The nurse should identify the presence of U-waves as a manifestation of hypokalemia, an adverse effect of furosemide. A: The nurse should identify tall, tented T-waves as a manifestation of hyperkalemia. Flattened or inverted T-waves are a manifestation of hypokalemia. C: Widened QRS complexThe nurse should identify a widened QRS complex as a manifestation of hyperkalemia. ST elevation D: The nurse should identify ST elevation is an indication of ischemia. ST depression is a manifestation of hypokalemia.

Full agonist medications act by what?

Binding to receptors and mimicking the actions of the body's regulatory molecules

Adverse effects of Lithium

Blurred vision, tinnitus, and dry mouth

A nurse is providing discharge instructions to a client who has heart failure and a new prescription for captopril. Which of the following client statements indicates an understanding of the teaching? A: I should take the medication with food. B: I should take naproxen if I develop joint pain C:I should tell my provider if I develop a sore throat D: I should expect the medication to cause my urine to look orange

C: I should tell my provider if I develop a sore throat. The client should report a sore throat to the provider because this can indicate neutropenia, a serious adverse effect of captopril. Neutropenia can be reversed if it is identified early and the medication is promptly discontinued.

A nurse is preparing to administer desmopressin 0.3 mcg/kg in 0.9% sodium chloride 50 mL IV over 30 min to a client who weighs 154 lb. How many mcg of medication should the client receive? (Fill in the blank with the numeric value only, round the answer to the nearest whole number, and use a leading zero if applicable. Do not use a trailing zero.)

Correct Answer: 21 Follow these steps for the preliminary conversions: Step 1: What is the unit of measurement to calculate? kg Step 2: Set up an equation and solve for X. 2.2 lb/1 kg = Client's weight in lb/X kg 2.2 lb/1 kg = 154 lb/X kg X = 70 kg Step 3: Round if necessary. Step 4: Reassess to determine whether the conversion makes sense. If 1 kg = 2.2 lb, then 154 lb = 70 kg. Step 5: What is the unit of measurement the nurse should calculate? mcg Step 6: Set up an equation and solve for X. mcg x kg/dose = X 0.3 mcg x 70 kg = 21 mcg Step 7: Round if necessary. Step 8: Reassess to determine whether the amount makes sense. If the prescription reads 0.3 mcg/kg and the client weighs 70 kg, the nurse should administer 21 mcg.

A nurse is providing teaching to a client with hypertension and type 1 diabetes mellitus who has a new prescription for metoprolol. Which of the following statements by the client indicates an understanding of the teaching? A. "I might have difficulty recognizing when my blood sugar is low." B. "I will have a lower risk of developing an infection while I take this medication." C. "I should be concerned about losing excess weight while I take this medication." D. "I could have more problems with high blood sugar while taking this medication."

Correct Answer: A. "I might have difficulty recognizing when my blood sugar is low." Metoprolol, a beta-adrenergic blocker, is used to treat hypertension. Because it decreases the heart rate, this common manifestation of hypoglycemia can be masked, and hypoglycemia might become more difficult to recognize. The client should be taught to recognize hypoglycemia by other manifestations such as hunger, nausea, and sweating. Incorrect Answers: B. Metoprolol does not decrease the risk of an infection. C. Metoprolol can cause weight gain due to fluid retention. The client should be taught to report unexpected weight gain, edema, and coughing while taking beta-adrenergic blockers. D. Metoprolol does not extend or increase the risk of hyperglycemia. However, hypoglycemia can be prolonged while taking this medication.

A nurse is teaching about adverse effects of ergotamine with a client who has migraine headaches. Which of the following client statements should indicate an understanding of the teaching? A. "If I overuse this medication, I might become addicted to it." B. "This medication is okay to use during pregnancy." C. "Tingling in my fingers and toes is an adverse effect that goes away with continued use." x D. "I will experience restlessness as an adverse effect when I begin taking this medication"

Correct Answer: A. "If I overuse this medication, I might become addicted to it." The client should take the ergotamine according to the prescribed dose and should only take the medication when needed to avoid developing a physical dependence. Incorrect Answers: B. Ergotamine is not safe during pregnancy because the medication can stimulate uterine contractions. Clients who are pregnant or might become pregnant should not use ergotamine to treat migraine headaches. C. A client who is taking ergotamine and is experiencing tingling in the fingers and toes should notify the provider immediately because this is a manifestation of ergotism or toxicity. Overuse of the medication can cause physical dependence, and signs of withdrawal can include headaches, nausea, vomiting, and restlessness during medication-free periods. D. A client who experiences a manifestation of withdrawal such as restlessness, headaches, nausea, and vomiting should notify the provider.

A nurse is educating a client with urethritis who has a new prescription for oral erythromycin. Which of the following statements should the nurse include in the teaching? A. "Report persistent diarrhea to the provider." B. "Take this medication with a full glass of milk." C. "Some people who take erythromycin experience vision loss." D. "Antacids will reduce the extent of absorption of this medication."

Correct Answer: A. "Report persistent diarrhea to the provider." Although gastrointestinal disturbances are the most common adverse effects of erythromycin, clients should report persistent or severe gastrointestinal reactions to the provider. Erythromycin can cause superinfection of the bowel because it destroys some sensitive flora in the gastrointestinal system. Incorrect Answers: B. The nurse should instruct the client to take the medication on an empty stomach and with 240 mL (8 oz) of water. The client should avoid milk and other chelating agents to ensure efficacy of the medication. C. Erythromycin is more likely to cause hearing loss than vision loss. High-dose therapy with erythromycin can cause transient hearing loss. D. Antacids that contain aluminum and magnesium reduce the rate of absorption of azithromycin, not erythromycin. However, for azithromycin, they do not reduce the extent of absorption.

A nurse is assessing a client who has a new prescription for chlorpromazine to treat schizophrenia. The client has a mask-like facial expression and is experiencing involuntary movements and tremors. Which of the following medications should the nurse anticipate administering? A:Amantadine B: Buproprion C: Phenelzine D: Hydroxyzine

Correct Answer: A. Amantadine This client is experiencing Parkinsonism, which is an adverse effect of the antipsychotic medication chlorpromazine. Amantadine is an antiparkinsonian medication used to treat the extrapyramidal manifestations that can occur with chlorpromazine therapy. Incorrect Answers: B. Bupropion is an atypical antidepressant. It is not used to treat Parkinsonism adverse effects caused by chlorpromazine. C. Phenelzine is an MAOI antidepressant. It is not used to treat Parkinsonism adverse effects caused by chlorpromazine. D. Hydroxyzine is an antihistamine used to treat mild to moderate anxiety. It is not used to treat Parkinsonism adverse effects caused by chlorpromazine.

A nurse is caring for a client who is at 6 weeks of gestation and has just received a diagnosis of hyperthyroidism. The nurse should anticipate a prescription from the provider for which of the following medications? A. Propylthiouracil B. Liothyronine C. Methimazole D. Iodine-131

Correct Answer: A. Propylthiouracil This medication is used to treat hyperthyroidism during the first trimester of pregnancy because it does not cross the placental barrier well, posing little risk to the fetus. However, methimazole is the preferred medication in the second and third trimesters of pregnancy. Incorrect Answers: B. This is a synthetic thyroid hormone preparation that treats hypothyroidism, not hyperthyroidism. C. This medication poses several risks to the fetus during the first trimester, including neonatal and congenital hypothyroidism as well as goiter. D. This medication is radioactive and is pregnancy risk category X. Pregnancy is a contraindication for receiving this medication.

A nurse in a postpartum unit is caring for a client who plans to breastfeed her newborn exclusively. The client has a prescription for depot medroxyprogesterone acetate (DMPA). At which of the following times should the nurse schedule the client to receive the first dose of the medication? A. After 3 months postpartum B. At 6 weeks postpartum C. Within the first 5 days postpartum D. During the first week of the first postpartum menstrual cycle

Correct Answer: B. At 6 weeks postpartum The nurse should tell the client that the first dose should be administered at 6 weeks postpartum if the client is exclusively breastfeeding and after ensuring the client is not pregnant. Incorrect Answers: A. The second dose is administered 3 months after the first dose. C. The first dose should be administered within the first 5 days postpartum only if the client is not breastfeeding and after ensuring the client is not pregnant. D. The first dose should be administered during the first 5 days of a normal menstrual period for a client who is not postpartum and after ensuring the client is not pregnant

A nurse is caring for a client with Alzheimer's disease who has a new prescription for memantine. Which of the following laboratory results should the nurse identify as increasing the client's risk for decreased clearance of the medication? A. Alanine aminotransferase (ALT) 30 units/L B. Creatinine clearance 35 mL/min C. HbA1c 5% D. BMI 31

Correct Answer: B. Creatinine clearance 35 mL/min Creatinine clearance is an estimate of the glomerular filtration rate and the kidney's ability to filter waste. A creatinine clearance of 35 mL/min indicates moderate renal impairment. The kidneys excrete memantine, and decreased clearance occurs with moderate renal impairment. Incorrect Answers: A. ALT is a liver enzyme. Severe liver disease requires caution when prescribing memantine. However, this client's level is within the expected reference range. C. Glycosylated hemoglobin (HbA1c) is a laboratory value that calculates the average blood glucose level over a period time, usually 3 months. An increased HbA1c indicates diabetes mellitus. However, an HbA1c of 5% is within the expected reference range and is not a value that would cause decreased clearance of memantine. D. BMI is a calculation of body fat based on height and weight. A BMI of 31 is above the normal range. Although a higher BMI increases the risk of certain chronic diseases, it does not lead to decreased clearance of memantine.

A nurse is monitoring a client who received diphenoxylate-atropine. Which of the following statements by the client should indicate to the nurse that the medication has been effective? A. "I feel a little drowsy with this medication." B. "I am now drinking much more water." C. "I have not had a bowel movement today." D. "I no longer feel chest tightness."

Correct Answer: C. "I have not had a bowel movement today." The nurse should identify that diphenoxylate-atropine is an opioid used to treat diarrhea. The therapeutic response of this medication is a decrease in the frequency of watery stools due to reduced motility of the intestinal lining. Incorrect Answers: A. Drowsiness is an adverse effect of diphenoxylate-atropine. The nurse should monitor the client closely and verify the dosage. Excessive doses can elicit morphine-like subjective effects. If drowsiness continues, the nurse should notify the provider. B. Dry mouth is an adverse effect of diphenoxylate-atropine. The nurse should offer the client fluid to relieve dryness of the mouth. D. Bronchodilation is not an expected response of diphenoxylate-atropine; however, the atropine component can cause bronchial plugging and stimulate asthma-like manifestations.

A nurse is providing discharge teaching to a client who had a bleeding duodenal ulcer and has been prescribed omeprazole. Which of the following statements should the nurse include in the teaching? A. "You will need to take this medication for the next 6 months." B. "Taking this medication will decrease your risk of acquiring pneumonia." C. "You should take this medication before breakfast every day." D. "Watch for the serious adverse effects of tachycardia and heart palpitations while taking this medication."

Correct Answer: C. "You should take this medication before breakfast every day." Clients who have active duodenal ulcer or gastric reflux disease should take omeprazole once daily before a meal (usually breakfast) because the medication is less effective when taken with food. Incorrect Answers: A. Omeprazole should be used for no more than 1 to 2 months due to long-term adverse effects, which include an increased risk of fractures and hypomagnesemia. B. Omeprazole increases the risk of acquiring pneumonia in acute care health facilities and at home during the first few days of use. D. When used as prescribed, the adverse effects of omeprazole are infrequent but include diarrhea, nausea/vomiting, and headaches. The nurse should instruct the client to report severe diarrhea to the provider.

A nurse is monitoring a client who has diabetes insipidus and was administered desmopressin. Which of the following findings should indicate to the nurse the client is experiencing an adverse effect of this medication? A. Thirst B. Nocturia C. Headache x D. Heart palpitations

Correct Answer: C. Headache Headaches are an indicator of the adverse effect of water intoxication, which can occur as a result of taking desmopressin. This medication causes fluid retention and places the client at risk of water intoxication. Incorrect Answers: A. A client who has diabetes insipidus will report frequent thirst due to a lack of antidiuretic hormone (ADH). Desmopressin is administered to stop the manifestations of diabetes insipidus such as thirst by improving the reabsorption of water in the kidneys. B. A client who has diabetes insipidus will report nocturia and excessive urination due to a lack of antidiuretic hormone (ADH). Desmopressin is administered to stop the manifestations of diabetes insipidus (e.g. nocturia and excessive urination) by improving the reabsorption of water in the kidneys. D. A client who has diabetes insipidus is at risk for dehydration. As the body attempts to compensate, the heart rate increases, causing heart palpitations. Desmopressin is administered to stop these manifestations of diabetes insipidus by improving the reabsorption of water in the kidneys.

A nurse is teaching a female client about vitamin A supplementation. Which of the following client statements indicates an understanding of the teaching? A. "Vitamin A supplements are usually prescribed during pregnancy." B. "Vitamin A can be taken in high doses because it is water-soluble." C. "Vitamin A is encouraged for women who have osteoporosis." D. "A deficiency of vitamin A can cause night blindness."

Correct Answer: D. "A deficiency of vitamin A can cause night blindness." The nurse should identify that vitamin A is required for dark light adaptation. When a client has a deficiency of vitamin A, night blindness is often the first sign. As the deficiency continues, other eye conditions can arise such as a dry and thickened conjunctiva and degeneration of the cornea. Incorrect Answers: A. The nurse should identify that vitamin A is highly teratogenic. Therefore, excessive intake during pregnancy can cause malformation of the fetal heart, skull, and other structures. Clients who are pregnant should not exceed the recommended daily allowance for females. B. The nurse should identify the client is at risk for toxicity when vitamin A is taken in high doses. Vitamin A is a fat-soluble vitamin, which is absorbed and then stored in the liver. C. The nurse should identify that vitamin A can cause damage to the bones. It can also increase the risk of hip fractures in female clients by blocking the absorption of vitamin D.

What kind of food is high in tyramine and can cause hypertensive crisis to patients taking MAOIs? A: Grapefruit juice B: Dark green vegetables C:Greek yogurt D: Fish

D: Fish

Dark green vegetables can do what to the anticoagulant effects of warfarin

Decrease

Doxazosin can do what to blood pressure

Decrease blood pressure -Nonselective alpha 1 adrenergic antagonist block sympathetic receptors in the blood vessels

Adverse effects of metformin

Decreased B12 levels and abdominal bloating and diarrhea

Gingo biloba cause cause what?

Decreased platelet aggregation

Serotonin syndrome symptoms

Delirium, tachycardia, hyperreflexia, shivering, agitation, sweating, muscle spasms, coarse tremors

Prednisone can cause what to the bones which can lead to what?

Demineralization of the bones and can lead to osteoporosis

Digoxin slows what

Digoxin slows the conduction rate through the SA and AV nodes, thereby decreasing the heart rate. The nurse should withhold the medication and notify the provider for a heart rate of 55/min because this is an early indication of digoxin toxicity.

Zolpidem (Ambien) can cause what kind of adverse effects?

Dizziness and drowsiness It can cause confusion in the older adult clients

Adverse effect of selegiline includes what?

Drowsiness and diarrhea can be an adverse effect of selegiline and a manifestation of serotonin syndrome. The nurse should notify the provider about this finding immediately.

Three medications for and classifications of moderate sedation

Fentanyl (opioid) Propofol (anesthetic) Midazolam (benzodiazepine)

hypokalemia expected findings EKG

Flattened T wave, prominent U waves, ST depression, prolonged PR interval

What is given for benzodiazepine toxicity?

Flumazenil

Lithium bicarbonate side effects?

GI distress, fine hand tremors, polyuria, third, weight gain, renal toxicity, goiter, hypotension, electrolyte imbalances

What increases a risk for bleeding? A: Soy B: Garlic C: Black Cohosh D: Green Tea

Garlic

A client has a lithium level of 2.1 mEq/L/ What is an appropriate action?

Gastric lavage -Hemodialysis is if it is greater than >2.5 mEq/L

Allergy that is a contraindication for varicella vaccine

Gelatin

Propylthiouracil is known to be what?

Hepatotoxic and can cause severe liver injury

Chenodiol is what kind of drug and can do what? What is required during treatment?

Hepatotoxic and can injure the liver. LFT are required during treatment

High doses of vitamins can cause what to the body?

High doses of vitamins can cause harm to the body. Any vitamin supplements consumed should not exceed the recommended dietary allowance. Elevated levels of vitamin A can increase the risk of developing osteoporosis and cause birth defects when taken during pregnancy. Excessive intake of beta-carotene can increase the risk of lung cancer in clients who smoke. In addition, increased doses of vitamin E can increase the risk of death in clients who have chronic illnesses.

Methylprednisolone can cause

Hyperglycemia and glycosuria

Greek yogurt is a source of what that can do what to levodopa?

Increase the metabolism

Rare reaction to linezolid

Irreversible peripheral neuropathy and reversible optic neuropathy

Dobutamine (Dobutrex) is a what that does what to the clients

Is a vasopressor that improves cardiac output and hemodynamic status in clients

Isoniazid can be what to the liver?

Isoniazid can be toxic to the liver. Therefore, it is important to monitor liver enzymes such as AST during therapy with isoniazid. In addition, the nurse should instruct the client to notify the provider of jaundice, nausea, dark-colored urine, or other findings indicating hepatitis.

Prednisone is for what?

It is a glucocorticoid and is indicated for clients who have severe RA. It is only used short term

What to give for the adverse effects of paroxetine?

Low dose of buspirone

Phenelzine is what kind of drug?

MAOI

Manitol is what kind of medication? What should be happening to stop an infusion?

Mannitol, an osmotic diuretic, can precipitate heart failure and pulmonary edema. Therefore, the nurse should recognize lung crackles as an indicator of a potential complication and stop the infusion.

Grapefruit juice interferes with the what of many medications?

Metabolism

What type of medication is the first choice of treatment for relieving the manifestation of an acute gout attack

Naproxen

Should NSAIDs be given to patients with Lithium?

No, it can cause an increase of renal reabsorption of Lithium

Where should you place the nitroglycerin patch?

On a hairless area of the skin and rotate sites Remove the patch at night to reduce the risk of developing tolerance to nitroglycerin

A nurse is caring for a client who reports a headache following an epidural? What should you do nect?

Place the head of the bed flat

Risk factors for Vitamin D deficiency

Pregnancy, obesity, and dark pigmented skin

Adverse effect of rifampin

Red tinged urine, saliva, and tears

What is the differences of the forms of nitroglycerin? Oral, sublingual, and transdermal

Sublingual tablets/spray: treat an angina attack Oral Tablets,transdermal patch and ointment: prevent angina

Amitriptyline (Elavil) for depression can cause what?

Tachycardia and EKG changes -older adult is at risk

Amitriptyline can cause what?

Tachycardia and EKG changes, blurred vision

Adverse Reactions of Epinephrine include

Tachycardia and dysrhytmias due to cardiac stimulations Epinephrine is an adrenergic agonist

Contraindication for ciprofloxacin

Tendonitis because of risk of tendon rupture

What kind of insulin should be used to deliver a baseline infusion of insulin?

The client should plan to use short-duration insulin such as regular, lispro, aspart, or glulisine insulin in the infusion pump to deliver a baseline infusion of insulin. The client should also administer bolus doses of insulin before each meal.

Fentanyl is to treat what?

The nurse should expect a prescription for fentanyl transmucosal (nasal spray) to treat breakthrough pain. Fentanyl is an opioid agonist with a rapid onset and a duration of 2 to 4 hours. Fentanyl should not interfere with the client's long-term opioid medication but should relieve breakthrough pain.

A client who is taking entanercept is at risk for what? To reduce this risk what should be done?

The nurse should identify that a client who is taking etanercept is at risk for infections such as tuberculosis (TB). To reduce this risk, the client should be tested for latent TB; if the test is positive, the client should undergo TB treatment before receiving etanercept. During treatment with etanercept, the client should be monitored closely for the development of TB.

What should be known about hydrocodone and acetominophen

The nurse should instruct the client that hydrocodone with acetaminophen might cause respiratory depression, which is an adverse effect of the medication. The client should avoid taking over-the-counter medications or newly prescribed medications without consulting their provider to avoid increased respiratory depression.

Isotretinoin has what kind of effects?

The nurse should instruct the client that isotretinoin has teratogenic effects; therefore, pregnancy must be ruled out before the client can obtain a refill. The client must provide two negative pregnancy tests for the initial prescription and one negative test before monthly refills.

A client has a new prescription for valproic acid. The nurse should instruct what blood work to be done?

Thrombocyte count, amylase, liver function tests

Expected findings of acute levothyroxine overdose

Tremors and anxiety

Famotidine is used for what? What can it be?

Used for gastric ulcers. Famotidine can be hepatotoxic and cause jaundice. The nurse should instruct the client to monitor for and report yellowing of the skin or eyes to the provider.

Buspirone is used to treat

anxiety -Low risk for dependency

Atropine treats what?

bradycardia

digoxin should be withheld when....

client's HR is <60

Lithium toxicity symptoms

course hand tremors confusion hypotension seizures tinnitus coma, death **DO NOT GIVE** diuretics, anti-cholinergics, or nsaids

paroxetine is used for

depression and OCD -Takes several weeks to take effect

dantrolene is used to treat

malignant hyperthermia