Final exam Pharma
The primary difference between "typical" antipsychotic drugs and "atypical" antipsychotic drugs is.
"Typical" antipsychotic drugs primarily block D2 receptors, whereas "atypical" antipsychotic drugs primarily block 5HT2A receptors.
Typical antipsychotics include? Select all that apply
- Thiothixene -Haldol -Chlorpromazine
Common adverse effects of Psychomotor stimulants include: Select all that apply
- insomnia -restlessness -dry mouth
Health provider Consideration Anti-fungal
-Arrange for appropriate culture and sensitivity test -Administer the entire course of the drug Monitor IV sites -Monitor Hepatic and renal function -Provide Comfort and safety previsions if CNS effects occur -provide small, frequent, nutritious meals
Testosterone is responsible for growth and development of male sex organs and maintenance of secondary sex characteristics. What are the clinical indications of testosterone?
-Erythropoiesis -Testosterone deficiency due to pituitary disorders or testicular failure -Metastatic breast cancer
Identify the most common adverse effect of insulin therapy.
-Hypoglycemia -Blurry vision -Fainting
John is being discharged after sustaining an open fracture from a motor vehicle accident. He is prescribed with Morphine Sulfate extended release. What patient education is important to teach John about Morphine Sulfate extended release? Select all that applies.
-John may develop physical dependence while on Morphine; therefore, it is important to have controlled gradual tapering of the medication over time. -John should check with his physician before taking other over-the-counter medications while on Morphine. -John should not consume alcohol or medications containing alcohol while on Morphine because of the synergy to depress the CNS especially respiration. -John should take the Morphine as prescribed and not to change dose or dose interval unless instructed by the physician.
Heparin is effective for treating:
-Postoperative deep vein thrombosis (DVT) -Pulmonary embolism -Disseminated intravascular coagulation
Michelle takes baby Aspirin once a day to help prevent thrombi, stroke, and heart attack. What patient teaching would you consider for Aspirin?
-Take Aspirin with food to alleviate GI distress -Observe for signs of bleeding and tinnitus with Aspirin
An elderly client with a history of heart failure has presented to the emergency department in respiratory distress. Assessment reveals the presence of pulmonary edema, and an infusion of IV Furosemide (Lasix) has been ordered. For the duration of treatment, the nurse should prioritize assessments related to which expected age-related dysfunctions? Select all that apply.
-cardiac function -renal function -hepatic function
A client prescribed an MAOI should be instructed to avoid foods containing tyramine including? Select all that apply.
-cheese -beer -wine -herring
What are the clinical indications for insulin? Select all that applies
-gestational diabetes mellitus -ketoacidosis -type 1 and type 2 diabetes mellitus -hyperglycemia
The nurse is caring for a client who is being treated with mineralocorticoids. When reviewing the client's latest laboratory findings, what should the nurse focus on? Select all that apply.
-potassium -calcium -sodium
Vincent, a 59-year-old man, is rushed to the hospital after taking an overdose of a certain antiarrhythmic drug. The nurses put him on the cardiac monitor and the monitor showed supraventricular tachycardia. Which of the following drugs is the best acute therapy in this scenario?
Adenosine (Adenocard)
A client receiving an infusion of norepinephrine experiences extravasation (infiltration at the site). What action is most appropriate?
Administer dilute phentolamine to the site, as prescribed
Which of the following healthcare provider considerations is applicable when administering proton pump inhibitors?
Administer drug before meals especially in the morning and ensure patient does not open, chew, or crush capsules.
David is diagnosed with unstable angina. What is the preferred therapy for this form of angina?
Administering antianginal, anticoagulant, and antiplatelet drugs
Identify a difference between agonists and antagonists.
Agonists bind to specific receptors to trigger a drug action, while antagonists bind to specific receptors to block a drug action.
continuous body movement, pacing, restless
Akathisia
Sympathomimetics
Albuterol (Ventolin)
Julian presents with thick and weak bones. He is diagnosed with Paget disease. Which of the following drugs should be used to treat Julian's new diagnosis?
Alendronate (Fosamax)
Alex has been diagnosed with type 2 diabetes and is prescribed Metformin (Glucophage). He is invited to a party by his friend Ryan. Which of the following statements would be accurate for the given situation?
Alex should avoid alcohol use.
A patient with heart failure is prescribed with Digoxin. Which of the following statements is true of the administration of digoxin?
All of the above -The patient should maintain adequate potassium intake. -The patient should avoid taking antacids and laxatives. -The patient's pulse rate should be between 60 and 100 beats per minute.
Mr. Carson has been treated for chronic alcoholism. His doctor prescribed him with Disulfiram (Antabuse) to treat his alcoholism. What patient teaching would you provide as his healthcare provider in regards to drinking alcohol while on Disulfiram (Antabuse)?
All of the above -The patient will have disulfiram reaction such as nausea, vomiting, and headache. -The patient may not drink alcoholic beverages while taking disulfiram. -The patient may not use any OTC products that contain alcohol while taking disulfiram.
Jason's physician diagnosed him with coronary artery disease and angina. He has been prescribed nitroglycerin for the angina. Select the drug that the physician can prescribe to treat Jason's coronary artery disease?
All of the above (Atenolol, Propanolol, Nadolol)
Which of the following is a clinical indication for the use of nonsteroidal anti-inflammatory drugs (NSAIDs)?
All of the above (Chronic treatment of dysmenorrhea, Control of the signs and symptoms of osteoarthritis and rheumatoid arthritis, Relief of mild to moderate pain where opioids are not indicated or warranted)
In educating a patient about the treatment options for his partial seizures, which of the following should be listed as the adverse effects of carbamazepine (Tegretol)?
All of the above (Convulsions and breathing difficulty, Bone marrow depression and aplastic anemia, Impaired liver function and jaundice)
Identify the most common adverse effects of phenytoin (Dilantin).
All of the above (Dizziness and ataxia, Skin rashes, hirsutism, and gingival hyperplasia, Visual disturbances and postural imbalance)
Which of the following factors can affect drug metabolism by reducing the efficiency with which organs function?
All of the above (Nutritional deficiency, Disease, Genetics)
While treating chronic heart failure, which of the following signs should one look out for after the administration of a vasodilator such as Hydralazine (Apresoline)?
All of the above (Postural hypotension, Reflex tachycardia, Nausea and headache)
Why do aspirin-sensitive patients substitute aspirin with acetaminophen to relieve pain?
All of the above are correct -Acetaminophen does not produce GI irritation or ulceration in therapeutic doses. -Acetaminophen does not affect prothrombin response. -Acetaminophen does not affect platelet aggregation.
A 54 year old male is complaining of chest pain. He is prescribed with Nitroglycerin to be administered sublingual. Which of the following information should be given to an angina patient about nitroglycerin?
All of the above are correct. -Carry the prescribed medication at all times. -Nitroglycerin tablets lose potency if exposed to air or light. -Discard unused nitroglycerin tablets that are more than 6 months old.
Which of following is recommended by the FDA to be used as a black box warning for OTC products that contain a nonsteroidal anti-inflammatory drug (NSAID)?
All of the above statements are correct. - Every OTC product containing an NSAID will have to include a bolded warning advising consumers about the potential risks for "severe stomach bleeding," especially in people who take a blood thinning or steroid drug or take other drugs containing prescription or nonprescription NSAIDs. -Every OTC product containing an NSAID will have to include a bolded warning advising consumers about the potential risks for "severe stomach bleeding," especially in people who have three or more alcoholic drinks a day while using the product or take more of the product than directed. -Every OTC product containing an NSAID will have to include a bolded warning advising consumers about the potential risks for "severe stomach bleeding," especially in people who are aged 60 years or older or have had stomach ulcers or bleeding problems.
When selecting bupropion for treatment of smoking cessation, it is important to differentiate between bupropion and the nicotine replacement products. Which of the following statements is true of bupropion?
All of the above statements are correct. (It is available as PO administration, It is an antidepressant drug, It has an adverse effect profile that includes insomnia, dry mouth, and gastrointestinal (GI) disturbances.
Nurse Mary is discharging a patient with a prescription of enteric-coated products. How should Nurse Mary instruct her patient to take enteric-coated products?
All of these are correct (On an empty stomach with water, Two hours after meals, One hour before meals)
What is the the use of Desmopressin (DDAVP)?
All of these are correct. -Desmopressin is used to prevent or relieve abdominal distention associated with surgical procedures. -Desmopressin is approved for use in conditions other than diabetes insipidus. -Desmopressin is proven effective in the treatment of nocturnal enuresis when administered prior to bedtime.
In the context of fluid balance and electrolytes, which of the following statements is true of sodium?
All of these statements are correct. -Sodium plays a major role in maintaining normal fluid balance. -Significant loss of sodium through vomiting and diarrhea reduces extracellular fluid volume. -The kidneys help maintain normal levels of sodium in plasma and other body fluids.
The mechanism of action for which medication involves converting plasminogen to plasmin?
Alteplase
Which of the following measures should be taken when implementing a treatment plan with Digoxin for a patient who already takes Quinidine for arrhythmias?
An increased risk of digoxin toxicity due to the potentiation of digoxin levels in the plasma when interacted with Quinidine
David is suffering from myasthenia gravis, a disease characterized by skeletal muscle paralysis. His doctor, Pablo, prescribes him with a certain drug that inhibits the enzyme acetylcholinesterase, thereby increasing the concentration of acetylcholine at the nicotinic muscle receptors. This will, in turn, increase the strength of skeletal muscular contraction and improve David's condition. Which of the following drugs has Pablo most likely prescribed?
An indirect-acting cholinergic drug
Raven is under oral contraceptive therapy. Which drug interacts with the effectiveness of oral contraceptives?
Antibiotics
Rapid acting insulin
Asprat (Novolog)
Your client is diagnosed with Myasthenia Gravis and is prescribed with Pyridostigmine (Mestinon). Your client is complaining of nausea, vomiting, diarrhea, blurred vision, excessive sweating, muscular tremors, bronchoconstriction, bradycardia, and hypotension. Recently, started having muscular paralysis and respiratory depression. What is the antidote for indirect-acting cholinergic drugs?
Atropine
Mrs. Garcia is prescribed with Warfarin (Coumadin). What dietary consideration should you teach your client about taking Warfarin (Coumadin)?
Avoid food that are rich in Vitamin K because they will counteract with the anticoagulant action.
Kasey, a 4 year old child, caught the flu at day care. Kasey weighs 35 lbs. Mother brought her in to the pediatrician's office and the doctor prescribed Ibuprofen (Motrin) 10 mg/kg. What is your desired dose for this pediatric patient? A. 350 mg B. 160 mg C. 250 mg D. 180 mg
B. 160
Which muscle relaxant would be used in the treatment of a patient with a spinal cord injury?
Baclofen
Select the therapy of choice for patients suffering from insomnia that is complicated with anxiety or stressful situations.
Benzodiazepines
Which of the following medications is used for its sedative effects in the treatment of hallucinogenic drug intoxication?
Benzodiazepines
Select the drug class that can be used in combination with nitrates for patients who require more than one drug to control angina.
Beta-adrenergic blockers
Mrs. Ryan has a chronic heart failure. She is prescribed with Propanolol (Inderal). Which of the following accurately describes the therapeutic action of the beta-blockers in the treatment of chronic heart failure?
Beta-blockers decrease the rate at which the heart beats and reduce the force of the contractions of the heart.
Identify a direct-acting cholinergic drug that is used to stimulate the urinary tract and is also used systemically.
Bethanechol
George took a dose of his Nitroglycerin extended release capsule. 10 hours after administration, George started complaining of adverse reactions. Which of the following is NOT an adverse effect of nitrates?
Bradycardia
Meera experiences premature rupture of obstetrical membranes, which might lead to the premature birth of her baby during the 32nd week of gestation. Which of the following drugs should be given to Meera?
Brethine (Terbutaline)
A 4-year-old is admitted to the emergency department in shock after a motor vehicle accident. The client weighs 12.5 kg. What would be the minimum effective dose of adrenalin if the pediatric dose is 0.005 to 0.01 mg/kg IV? A. 75 mcg B. 80 mcg C. 62.5 mcg D. 87.5 mcg
C. 62.5 mcg
For bisphosphonates to be optimally effective, these medications must be taken with an adequate amount of:
Calcium and Vitamin D
A nurse is caring for a 9-year-old client and has received an order for diazepam 10 mg given orally q.i.d. What is the nurse's priority action?
Call the prescriber and question the order.
Beast Cancer Drug
Capecitabine (xeloda)
Patty is a 32 year old woman, who has been smoking since she was 12 years old. Patty found out she is 12 weeks pregnant. Nicotine has been shown to be harmful to the fetus. What FDA category does nicotine fall under?
Category D
Varenicline, which is used in the treatment of smoking cessation, is sold under the trade name _____.
Chantix
What is the prototype for anti malaria
Chloroquine (Aralen)
Alex has developed a severe cough. He visits Dr. Harrison's clinic for a checkup. After a thorough examination, Dr. Harrison instructs him to take a certain opioid drug for its good antitussive activity. Which of the following drugs has Dr. Harrison most likely prescribed?
Codeine
You are providing teaching about a newly prescribed atypical antipsychotic for a client. You caution the client against actions that may cause increased central nervous system (CNS) depression. What should you caution the client against?
Consumption of alcohol
Martha, a patient suffering from hypothyroidism, has just found out that she is pregnant. She contacts Dr. Hudson to find out whether she should continue her Levothyroxine (Synthroid) during her pregnancy. What is the healthcare provider consideration for Levothyroxine (Synthroid)?
Continue treatment as usual because the thyroid hormones administered to pregnant women do not readily cross the placental barrier to affect fetal development.
Determine the correct dose of a drug 15 mg/kg to be administered for a patient who weighs 55 pounds and is 8 years old. A. 250 mg B. 425 mg C. 125 mg D. 375 mg
D. 375 mg
The nurse receives a prescription to begin a dopamine infusion at 5 mcg/kg/minute. The client weighs 50 kg. Each milliliter of solution contains 3 mg of dopamine. How many mL/hour should the nurse set the pump to deliver? A. 3,000mL/hr B. 3 mL/hr C. 83.3 mL/hr D. 5 mL/Hr
D. 5 mL/hr 50X5=250 (weight times iR) 250/1,000=.25 (divid by to make mg) .25/3=0.0833(divide by avable) 0.0833X 60= 5 (hours)
A 4-year-old is brought to the emergency room. The child is in shock. The mother states she found the child eating her iron-fortified vitamin pills about 2½ hours ago. The mother estimates the child ate close to 200 tablets. What medication would you expect the physician to order for the treatment iron toxicity?
Deferoxamine mesylate
Therapeutic effect
Desired effect
_____ is a synthetic antitussive drug and is the only opioid that is not a scheduled drug.
Dextromethorphan
A patient who is under Digoxin therapy to treat chronic heart failure presents with symptoms such as nausea, vomiting, headache, and visual disturbances. A couple of hours later, this patient was rushed to the emergency department for cardiac arrhythmias and premature ventricular contractions. What is the best treatment for these signs and symptoms?
Digoxin Immune Fab
You are caring for a client who discontinued their SSRI's and has complaints of dizziness, nausea, insomnia, and anxiety. You suspect the client is experiencing?
Discontinuation syndrome
A 2-year-old client is placed on a course of prednisone following a series of hypersensitivity responses. What instruction the nurse provide the client's family about this drug?
Don't stop this medication suddenly; you will have to taper dosage gradually
muscle spasms, twitching, facial grimacing, and torticollis
Dystonic reaction
Clinical indication for Oral anti fungal
Endocarditis, meningitis, septicemia, UTI
William, a 16-year-old epileptic patient, is being treated for absence seizures. When left alone, William often forgets to take his medicine in time or consumes more than the required dosage. To prevent this, William's medicine intake is monitored by his mother who has a regular day job. Which of the following drugs would decrease William's absence seizure activity?
Ethosuximide
A client prescribed captopril (Capoten) earlier in the week states, Now I have a nagging, dry cough. How should the nurse best follow-up the client's statement?
Explain that drugs like captopril often cause a cough.
Adverse effects associated with the administration of Vitamin B12 include rash, bone marrow suppression, itching, and constipation. True or False?
False
Well-controlled body movements in Parkinson's Disease depend on a balance between the neurotransmitters acetylcholine and norepinephrine.
False
A patient is complaining of psychiatric disturbances, mental depression, and even suicidal ideation. Determine the probable cause of these adverse effects based on the patient's medication profile.
Ganglionic Stimulants
Long acting insulin
Glargine (Lantus)
A client informs you that he has been smoking about 4-5 packs of cigarettes per day. Identify a consequence of sympathetic stimulation by the use of nicotine products.
Heart rate will increase
A patient with a tendency to form blood clots is in the recovery room after having hip replacement surgery. Which anticoagulant would best serve the patient's needs?
Heparin
Mechanism of Action
How a drug produces its effects
An adult client, unresponsive to other antidepressant therapy, has started taking phenelzine 10 days ago. The client has told the nurse of the intent to stop taking the drug, stating, "I don't feel any less depressed than I did before I started taking these pills." What is the best response to the client's statement?
I'd encourage you to continue with the drug; it can take 2-4 weeks to produce maximum effect.
Esmolol is a short-acting drug, administered intravenously, that is used for emergencies and has a half-life of 10 minutes. Use the definition of half-life to select the correct statement about esmolol.
In 10 minutes, the concentration of esmolol will be reduced to 50 percent of the initial dose.
During the administration of epinephrine, the healthcare provider would be correct in expecting what primary effects of stimulation on beta-1 receptors?
Increase in heart rate and increase in the force of cardiac contractions
Antagonist
Inhibits drug action
The nurse is caring for a client with diabetes insipidus. What is the preferred route of administration for Desmopressin (DDAVP)?
Intranasal
Intermediate acting insulin
Isophane (NPH, Humulin N)
Identify an accurate statement about opioid analgesics.
It is held that opioid analgesics can relieve virtually any type of pain.
Lamar Jackson has a history of angina and erectile dysfunction. He wants to surprise his wife for her birthday and took Sildenafil (Viagra). During Lamar and his wife's special moment, Lamar starts to have a sharp pain to his chest. What should Lamar do?
Lamar should seek immediate care to the nearest emergency room
Proton pump inhibitor
Lansoprazole (Prevacid)
Identify the drugs that fall into the category of amide local anesthetics.
Lidocaine, bupivacaine, and mepivacaine
The site of action of diazepam (Valium) to relieve anxiety is the?
Limbic system
What is the mechanism of action of local anesthetics on the pain response?
Local anesthetics block sensory nerves
Site of action
Location where a drug exerts it effect
Jack, a drug addict, is rushed to the hospital when he starts convulsing after taking a large dose of amphetamines. At the hospital, Dr. Ross starts making preparations to provide Jack with symptomatic therapy. Which of the following drugs will Dr. Ross most likely use to bring Jack's seizures under control?
Lorazepam
Dr. Patrick diagnoses 65-year-old Alex with glaucoma. He advises Alex to start using eyedrops containing a certain type of drug that will stimulate Alex's pupils to constrict, thereby facilitating the better drainage of intraocular fluid from Alex's eyes. Which of the following types of drugs is most likely NOT advised for Alex to take?
Mecamylamine
Which drug is useful in the treatment of opioid addiction because it satisfies the opioid hunger and does not produce severe withdrawal symptoms?
Methadone
A patient is being administered opioids to help ease his pain following extensive back surgery. He starts suffering from constipation that is induced by the opioid analgesics. Select the drug that should be used for the treatment of constipation.
Methylnaltrexone bromide
A doctor is scheduled to perform an endoscopic procedure on a child. The anesthetic should have a rapid onset of action as the child is anxious and agitated. Which of the following anesthetics is the best choice in this scenario?
Midazolam (Versed)
Prostaglandin
Misoprostol (Cytotec)
A client with type 1 diabetes has been prescribed regular insulin and NPH insulin in the morning. What is the health care consideration of insulin administration?
Monitor blood glucose regularly such as before meals and at bedtime.
Anya has just been diagnosed with Parkinson's disease. As the disease has been diagnosed late and the symptoms are severe, Dr. Potter prescribes the drug levodopa for treatment. Which of the following instructions is Dr. Potter most likely to give Anya about using the drug?
Monoamine oxidase-A inhibitors can be taken in combination with levodopa
dysentery Drug
Mrthronidazole (Flagyl)
Identify a difference between muscarinic receptors and nicotinic-muscle (Nm) receptors.
Muscarinic receptors are located at parasympathetic postganglionic nerve endings, whereas Nm receptors are located at the neuromuscular junction of skeletal muscles.
Dr. Hampton administers the same dose of Atenolol drug to two of his patients, Nathaniel, who is 65 years of age, and Mark, who is 25 years of age. Which of the following is most likely going to happen?
Nathaniel will experience a more intense pharmacological drug effect than Mark will experience.
hyperthermia, muscular rigidity, catatonia
Neuroleptic Malignant syndrome
Ashley is 20 weeks pregnant and complaining of heartburn. As a healthcare provider, identify the mechanism of action of antacids.
Neutralizing gastric acid
Kelly is complaining of flu-like symptoms. She has a fever of 38.8 and experiencing headache and muscle stiffness. She is taking acetaminophen every 4 hours to control her headache and NSAIDs every 6 hours for fever and muscle stiffness. Why is acetaminophen effective in the treatment of headaches but not in the treatment of muscle aches and inflammation?
None of the above are correct. -Acetaminophen is effective against the pain of headache because it stimulates prostaglandin synthesis within the CNS but does not affect platelet aggregation or prothrombin time, which accounts for the lack of anti-inflammatory activity. -Acetaminophen is effective against the pain of headache because it inhibits prostaglandin synthesis within the CNS but does not significantly inhibit the synthesis of prostaglandins in peripheral systems, which accounts for the lack of anti-inflammatory activity. -Acetaminophen is effective against the pain of headache because it stimulates prostaglandin synthesis within the CNS but does not significantly stimulate the synthesis of prostaglandins in peripheral systems, which accounts for the lack of anti-inflammatory activity.
Health provider Consideration for Oral anti fungal
Notify if rash, fever sore throat, yellowing of the skin or eyes, changes in stole or urine, bleeding or weakness
A client is experiencing nausea and vomiting as a response to chemotherapy. Which antiemetic agent is administered to control nausea and vomiting?
Ondansetron (Zofran)
A female client is slow to progress during the active stage of labor and the nurse-midwife is considering treating the patient with Oxytocin. What is the mechanism of action of Oxytocin?
Oxytocin stimulates contraction of the uterus to facilitate delivery of babies.
Simon is going to travel to another country on a business trip. He is informed by his colleagues that the water supplied in that region is unlikely to be pure and that people who have previously visited the place have suffered from diarrhea. Simon wants to know how he can take if he gets diarrhea while on his business trip. Which of the following drugs Simon can take?
Pepto-Bismol
Allison is prescribed with Clopidogrel Bisulfate (Plavix). She has a scheduled knee replacement surgery in a month. What is your healthcare provider consideration for the drug Clopidogrel Bisulfate (Plavix)?
Plavix prolongs bleeding time. Allison should discontinue her Plavix prescription 7 days before surgery
Corticosteroids
Prednisone
Select the drugs preferred for the treatment of acute gout attacks, relief of pain, and interruption of the inflammatory process.
Probenecid and allopurinol
Alpha and Beta-agonists are also known as Sympathomimetics. It can be concluded that these agonists:
Produce similar effects to the sympathetic nervous systems
Which of the following can be used to relieve menopause symptoms such as hot flashes, sleep disturbances and vaginal dryness?
Progestin
Select the statement that best explains the reason why propofol is the preferred agent for the induction and maintenance of anesthesia.
Propofol does not lead to the development of nausea and vomiting, nor does it accumulate in the tissues.
Patients on oral anticoagulant therapy should be monitored by which tests?
Protime (PT) or INR
_____ are considered the first-line therapy in treating GERD.
Proton pump inhibitors
A 9-year-old child has received an order for oral lovastatin (Mevacor) 40 mg/d for genetically linked hyperlipidemia. In preparation for client teaching concerning this drug, what initial action should the nurse take?
Question the provider concerning the prescribed dosage
Antihistamine (H2) receptor antagonist
Ranitidine (Zantac)
What physical characteristics would you expect to see in a person who habitually smokes marijuana?
Red eyes and increased heart rate
Short acting insulin
Regular U100
Which antidepressant drug class is considered to be the preferred therapy for depression?
SSRI's
Sally has a scheduled back surgery in a week. She is taking baby Aspirin to reduce having a heart attack. What is the healthcare consideration for surgery and use of Aspirin?
Sally will need to discontinue her Aspirin about 1-2 weeks before surgery because of the risk of postoperative bleeding.
Alice experiences periods of angina, and she places a sublingual nitroglycerin tablet under her tongue as directed by her physician. After 5 minutes, she does not feel any relief. What step should be taken next?
She should place another sublingual nitroglycerin tablet under her tongue.
Undesired effect
Side effect, adverse effect, toxic effect
Anticholinergics
Singulair (Montelukast)
Antacid
Sodium Bicarbonate
Which of the following diuretic agents has the ability to increase the potassium levels in the body?
Spironolactone (Aldactone)
George is undergoing a major abdominal surgery and prescribed with low-molecular-weight heparin to prevent deep vein thrombosis (DVT) and pulmonary embolism. Which route of administration should you consider for low-molecular-weight heparin?
Subcutaneous
Hannah has type 1 diabetes. She receives insulin Regular (U100) after meals and Glargine (Lantus) at bedtime. How is insulin administered?
Subcutaneous
While Kendall is taking a stroll in a park near his house, his chest starts hurting. Assuming that Kendall is carrying the appropriate medication for his condition, which of the following routes of administration is he most likely to use?
Sublingual
Barrier enhancers
Sucralfate (Carafate)
David takes a dose of lysergic acid diethylamide (LSD). An hour after administration, David begins to experience the hallucinogenic effects of the drug. His perception of the sounds he hears and the objects he sees becomes distorted. He also begins to feel as though his arms have detached themselves from his body. Which of the following neurological phenomena is David most likely experiencing?
Synesthesia
involuntary movements of the lips, jaw, tongue, and extremities.
Tardive Dyskinesia
Three days after discontinuing diazepam with medical guidance, an older adult continues to demonstrate impaired memory and confusion. The healthcare assistant should consider what possible explanation for the client's current status?
The adverse effects of benzodiazepines can persist for several days after stopping the drug.
After assessing the client receiving erythropoietin (Procrit) drug therapy, the nurse suspects what finding is an adverse effect of erythropoietin drug therapy?
The client has complaints of arthralgia
Which of the following age-related changes is responsible for the decrease in the rate of drug metabolism in elderly patients?
The decrease in liver blood flow
The client is given a prescription for Acetaminophen for 850 mg dose every 4 hours for the next few days for his flu-like symptoms. What important healthcare provider consideration do you have for this client?
The dose is too high for the client and toxicity may develop
A client taking a calcium channel blocker is seen in the clinic and diagnosed with drug toxicity. When collecting the nursing history, what finding would indicate the likely cause of this drug toxicity?
The ingestion of grapefruit juice
A client, newly diagnosed with chronic obstructive pulmonary disease (COPD), calls the clinic and asks the nurse to explain again what the Ipatropium is prescribed for. What would be the most appropriate response by the nurse?
The medications that have been ordered to help relax smooth muscle in the bronchi and open your airways
Ray is prescribed with Sucralfate (Carafate) for the treatment of peptic ulcers. What is the pharmacokinetics for this barrier enhancer?
The onset is 30 minutes and last for 5 hours, should be taken four times a day on an empty stomach.
Which of the following statements is true of toxicity?
The toxic effects of a drug can be life-threatening.
Xanthines
Theophylline
How do loop diuretics and thiazide diuretics differ in their mechanisms of action?
Thiazides are more potent than loop diuretics
You are providing patient education regarding when a client should take their newly prescribed sulfonylurea for the diagnosis of type II diabetes. Which statement most accurately describes when a client should take the medication?
This medication should be taken 30 minutes before meals
As a healthcare provider, how would you explain to your patient the drug administration of thyroid hormone replacement such as Levothyroxine (Synthroid)?
Thyroid hormone replacement is a lifelong treatment
Beau has hypothyroidism. He has been taking his Levothyroxine (Synthroid) daily. He is concerned that he may have diabetes because he is having symptoms of polyuria, polydipsia and polyphagia. What is your healthcare provider consideration on thyroid hormone and insulin?
Thyroid hormone therapy in patients who have diabetes may exacerbate the underlying disease, leading to an increased requirement of insulin.
Your patient is experiencing thromboembolisms and is prescribed with Warfarin (Coumadin)? Why should a patient who has thromboembolisms be given Warfarin (Coumadin)?
To increase the production of several Vitamin K dependent clotting factors
A female client has been admitted to the hospital for observation and treatment. The admitting physician has prescribed a tocolytic. The primary function of tocolytics is?
Tocolytic drugs inhibit uterine contractions, thereby preventing premature births.
A major adverse effect caused by the excessive administration of Oxytocin (Pitocin), can result in uterine tetany, or rupture, and subsequent fetal distress, injury, or death. True or False?
True
Andrenergic Agonists - AKA - Sympathomimetics are drugs that stimulate the heart and blood pressure but also causes a renal and splanchnic arteriole dilation that increases blood flow to the kidneys.
True
Diphendydramine (Benadryl) selectively blocks the effects of histamine at the histamine-1 receptor sites, decreasing the allergic response anticholinergic and antipruritic effects. True or False?
True
Ferrous sulfate elevates the serum iron concentration and is then converted into hemoglobin or stored for eventual conversion to a usable form of iron. True or False?
True
Isoproterenol (Isuprel): is used in the treatment of shock, cardiac standstill, heart block in transplanted hearts; prevention of bronchospasm during anesthesia; inhaled to treat bronchospasm
True
Isoproterenol is probably the most potent drug of the beta-adrenergic agonists and is the prototype?
True
Proton pump inhibitors decrease gastric acid secretion by inhibiting the acid proton H+ pump in the parietal cells. True or False
True
The butyrophenones, haloperidol, in particular, produce the highest incidence of extrapyramidal symptoms (EPS).
True
The mechanism of action of Lithium is that is alters sodium transport in nerve and muscle cells and inhibits the release of norepinephrine and dopamine, but not serotonin, from stimulated neurons
True
Venlafaxine has a black box warning advising that there is an increased risk of suicidal ideation in children and teenagers, and young adults <24 yrs of age taking the drug.
True
Infiltration of the skin by alpha-adrenergic drugs such as dopamine during IV administration can lead to necrosis and gangrene of the skin cells. Select the reason for this effect
Vasoconstriction leads to decreased blood flow.
A client has been prescribed Lansoprazole (Prevacid) for the treatment of GERD. Which drug-to-drug interaction will alert the healthcare provider?
Warfarin (Coumadin)
Health provider Consideration for Topical anti fungal
Watch for adverse effects
Peak
When a drug reaches its highest concentration
Duration of action
When enough drug is absorbed to reach the minimum effect concentration
A patient is administered 1250 mcg of digoxin. When is the concentration of digoxin in the patient's body likely to reduce to 625 mcg?
Within 1.5 to 2 days
The doctor ordered 210 mg of Acetaminophen for pain and fever. The child weighs 39 lbs. The recommended dose range for Acetaminophen is 10-15 mg/kg/dose. Did the doctor prescribe a safe dose for the child?
Yes, it is safe to administer the Acetaminophen dose because it is within the safe dose.
Onset
beginning
Robert presents to his primary care providers office with a chief complaint of frequent urination with decreased urine flow. Roberts primary care provider examines Roberts and prescribes Tamsulosin (Flomax) 0.4mg tab once daily in the am. While providing education the healthcare assistant explains to Robert that the medication prescribed is for the treatment of
benign prostatic hyperplasia
The main action of typical antipsychotics in the treatment of schizophrenia is?
blockage of D 2 receptors more than 5HT 2A receptors
Which of the following conditions is lidocaine, a local anesthetic, used to treat?
cardiac arrhythmias
Tommy owns a farm and he sprays the field with pesticides. He started experiencing symptoms of respiratory paralysis. What term describes his symptom that also can be found in patients with Myasthenia Gravis showing excessive drug dosage?
cholinergic crisis
Donepezil (Aricept) is used for Alzheimers Disease, which is a degenerative brain condition that occurs in some individuals with aging. What type inhibitor increases ACH levels in the brain?
cholinesterase
Identify the most common adverse effect associated with the use of opioid analgesics.
constipation
A client is prescribed a nonselective beta-adrenergic blocking drug. You are explaining the effects of the medication and include. Select all that apply.
decrease in force of mycardial contraction, a decrease in heart rate, lowering of blood pressure
A client prescribed Albuterol should be educated on identifying and managing which adverse reaction?
diarrhea
Tonya turned 55 years old a couple of months ago. Since her birthday, she has been noticing hot flashes, sleep disturbances, and vaginal dryness. What is the most effective treatment for her symptoms?
hormone replacement therapy
What is the primary mechanism of action of Phenobarbital (Luminal)?
increase inhibitory effects of GABA
Meghan starts taking oral contraceptives to prevent pregnancy. What is the mechanism of action of oral contraceptives?
increase the levels of estrogen and progesterone
A patient is diagnosed with erectile dysfunction and is prescribed the drug Sildenafil (Viagra). The drug work by:
increasing blood flow to the penis
David is suffering from hyperthyroidism and prescribed with Methimazole (Tapazole). What is the mechanism of action of Methimazole (Tapazole)?
inhibits the synthesis of thyroid hormones
Clinical indication for Topical anti fungal
intestinal candidasis vaginal candidiisis tinea pedias tinea cruis tinea corporis
A pregnant woman with a history of blood clots came in for a consult to start an oral anticoagulant. Low molecular weight (LMW) heparin is preferred for pregnant patients needing an anticoagulant because:
its molecular size does not allow it to cross the placenta to affect the offspring.
half-life
length of time required for half of it concentration
Nonopioid analgesics include all of the following except:
meperidine
Your client is scheduled to take Ibuprofen every six hours for one week for his tendonitis. What important education would you teach your patient?
mmediately report signs of GI bleeding such as bloody vomitus, black tarry stool and blood in urine.
Levi presents to the clinic with complaints of cold-like symptoms for the past three days. After examining Levi, the physician assistant explains to Levi that he can use over the counter cold remedies containing phenylephrine. When providing education regarding the side effects of medication containing phenylephrine the physician assistant would be certain to include. Select all that apply
nausea, blurred vision, numbness in extremities, changes in blood pressure.
Alex is suffering from Parkinson's disease and is undergoing drug therapy. In spite of taking his medications regularly, Alex has started experiencing alternating periods of mobility and immobility. When he informs his doctor of these episodes, what does his doctor tell him these episodes are called?
on-off phenomenon
A client presents to the hospital in shock. The client's vital signs are as follows: blood pressure (BP) 78/40 mm Hg, heart rate (HR) 45, respiratory rate (RR) 22. Because norepinephrine is mediated by adrenergic receptors that cause vasoconstriction and increase blood pressure, the physician orders norepinephrine to be administered intravenously. When administered IV which of the following best describes the pharmacokinetics of norepinephrine?
onset is immediate and peaks quickly
Patients with asthma should be careful when using _______ because of the effect histamine may have on the bronchioles of the lungs.
opioid analgesics
Examples of common adverse effects include all of the following except:
persistent diarrhea.
agonist
produces drug action
Kevin has been receiving heparin and started hemorrhaging. What is the specific antidote in heparin toxicity?
protamine sulfate
The major toxicity associated with neuromuscular blocker overdose is:
respiratory paralysis
A patient complains of hoarseness and changes in his voice after using an inhaled corticosteroid. You advise the patient that the best way to avoid these adverse effects is to:
rinse his mouth with water after inhaling the medication to reduce the amount of steroid that remains in his mouth and throat.
An adult client with a diagnosis of asthma has been prescribed Zafirlukast. The nurse should teach the client that this drug will help relieve symptoms by which mechanism?
selectively blocks the leukotriene receptor thereby, reduces bronchoconstriction and inflammation.
Implementing a treatment plan that includes mecamylamine is indicative of a diagnosis of _____.
severe hypertension
receptor site
site on a cell where a drug exerts its effect
Levothyroxine (Synthroid) is the drug of choice for thyroid hormone replacement and thyroid-stimulating (TSH) suppression therapy. What adverse effect would you consider?
tachycardia
Joshua has hypogonadism. His doctor has prescribed androgen therapy. Which of the following is an adverse effect caused by the chronic use of testosterone in adult males?
testicular atrophy
You are reviewing dosage calculations for a pediatric client. You summarize the dosage calculations based on weight as:
the amount of drug in mg ordered per unit of weight in kg.
Pharmacokinetics is the area of pharmacology that deals with the study of:
the processes of drug absorption, distribution, metabolism, and excretion.
Mast cell stabilizers such as cromolyn work by blocking
the release of histamine from mast cells
Robert is a 56-year-old male with a history of hypertension. He has been taking an ACE inhibitor for five years and his Primary care provider has recently prescribed a diuretic for better blood pressure control. Which diuretic is preferred in the treatment of hypertension?
thiazide-diuretics
A patient came in the ED who cardiac arrested while at work. You are the healthcare provider and you have an order of Succinylcholine 1mg/kg dose before intubation. What is the onset time for the drug Succinylcholine?
tracheal relaxation occurs within 30 seconds lasting up to 10 minutes
Naloxone (Narcan) should not be given to an opioid addict because:
withdrawal symptoms will occur
Samuel is prescribed sublingual nitroglycerin to treat angina pain. How long will it take for nitroglycerin to take effect?
5 minutes
While providing education to a client newly prescribed Erythropoietin (Procrit), the healthcare assistant informs the client that the medication will take how many days before onset?
7-14 days
A 2-year-old child weighing 32 lb is to take ferrous sulfate 6 mg/kg/d PO. How many milligrams should the child receive per dose?
87 mg
The nurse administers prednisone orally at 08:00. When would the nurse expect the drug to reach peak effect?
9:00 to 10:00 am
An elderly patient was on medication for diabetes and hypertension before suffering a heart attack. Her cardiologist gave her thorough directions on taking her new heart medications. What would be a probable outcome of this situation?
A decrease in patient compliance
Physician ordered 60 mg of Prednisone that is available in 30-mg tablets. How many tablets should you administer? A. 2 tablets B. 1 tablets C. 1.5 tablets D. 0.5 tablets
A. 2 tablets
The nurse caring for a client prepares to administer nifedipine (Procardia) for the client's diagnosis of hypertension. The nurse explains to the patient that the medication will last approximately for:
12 hours
A client is receiving Furosemide (Lasix). When monitoring daily laboratory values, what should the potassium level be for this client?
3.5 to 5.0 mEq/L
A client, admitted to the hospital with a diagnosis of heart failure, is prescribed Furosemide (Lasix) 40 mg IV. How soon after administration should the nurse expect to see evidence of diuretic effects?
5 minutes
Morphine is an opioid analgesics that binds to specific receptors and produce a drug action are called
agonists
Michelle Smith has been diagnosed with peptic ulcer caused by H.pylori. In the context of the treatment of peptic ulcer caused by H. pylori, triple therapy refers to using _____.
an antibiotic, a bismuth compound, and a proton pump inhibitor
A client is diagnosed with hypertension and is being treated with Captopril (Capoten). Which adverse effect would you be MOST concerned with?
angioedema
Mrs. Garcia, a patient at St. Agnes Hospital, almost became comatose after receiving an overdose of morphine. In order to reverse this effect, the doctor ordered the administration of naloxone, which served as a(n):
antagonist
Antipsychotic medications may decrease the effectiveness of levodopa because they block:
dopamine receptors
A client is admitted to the emergency room with anaphylaxis from an acute allergic reaction. When anticipating treatment, which medication will the nurse prepare for administration?
epinephrine
During the fight or flight response, the adrenal medulla predominantly releases
epinephrine
When caring for a client receiving a benzodiazepine, which medication will reduce the effects of sedation and respiratory depression in a client suspected of experiencing benzodiazepine toxicity?
flumazenil
Diphenhydramine is the ______. Benadryl is the ______.
generic name; brand name
Clinical indications for Alpha-Specific Andrenergic Agonists include? Select all that apply
glaucoma, hypertension, chronic pain,
Lewis is prescribed Uroxatral for the treatment of benign prostatic hyperplasia. Each Uroxatral tablet contains 10 mg of alfuzosin, and the common daily dosage is one tablet. However, considering that Lewis's condition is not as severe, the doctor prescribes a daily dosage of 5 mg. How many tablets should Lewis take in a day?
half
A client recently began taking lovastatin (Mevacor). The nurse should assess the client for what potential adverse effects?
headache, flatulence, and constipation
