Finale EXAM Pharmacology
What information should the nurse include when discussing sun protection with parents of young children?
"Apply SPF 30 sunscreen before going out in the sun."
A client is instructed to take diphenhydramine after an allergic reaction. Which statement by the client indicates successful teaching concerning the safe and effective use of diphenhydramine?
"I should not drive my car after taking this medication."
The nurse is educating a client newly diagnosed with a urinary tract infection about the prescribed phenazopyridine hydrochloride. Which statement made by the client establishes the need for further clarification?
"I should report reddish-orange urine immediately to the prescriber."
A 66-year-old man recently diagnosed with benign prostatic hypertrophy is started on tamsulosin 0.4 mg PO daily. Which of the following if stated by the patient indicates that patient teaching has been successful? (Select all that apply.)
"I should swallow the capsule whole and not chew it." "This medication should make it easier for me to urinate and the dribbling of urine should improve." "I should change positions slowly after taking tamsulosin as it could lower my blood pressure."
A client has been prescribed omeprazole by the primary care provider. When questioned by the nurse about the client's perceived effectiveness of the prescribed omeprazole, the client states, "I think it's working quite well, and I've gotten in the routine of taking it every morning before breakfast." How should the nurse respond?
"I'm glad to hear that. It sounds like you're taking it exactly like it should be taken."
A client's medication regimen for treatment of anxiety has been changed from a benzodiazepine. The client asks the nurse what likely prompted the health care provider to change the medication. What is the nurse's best response?
"Long-term use of benzodiazepines can result in dependency."
A client, diagnosed with erectile dysfunction, is taking nitroglycerin for chest pain. What is the best explanation for why a nitrate-like sildenafil would be contraindicated?
"Nitroglycerin and sildenafil cause a severe decrease in blood pressure."
The nurse is providing health education to an 80-year-old woman who has just been diagnosed with osteoporosis. Which is an accurate statement when teaching the client about this diagnosis?
"Osteoporosis causes a risk for fractures."
The nurse is working with parents who are treating their child's cold and flu symptoms at home using over-the-counter (OTC) medications. What guidance should the nurse provide?
"Read the labels clearly to make sure you're not giving the same drug in two different preparations."
A client is taking oral amoxicillin to treat otitis media for the past 6 days. The client has told the nurse that "my ear is now back to normal" and asks about stopping the antibiotics. How should the nurse respond?
"That's excellent that you're feeling better, but it's important to keep taking the antibiotics until they're all finished."
An older client diagnosed with hypertension is requesting an oral nasal decongestant for cold symptoms. Which statement by the nurse best describes the effect of decongestants on blood pressure?
"The administration of a nasal decongestant will increase blood pressure due to vasoconstriction of blood vessels."
A client diagnosed with tuberculosis (TB) and begun multi-drug therapy. The client has asked the nurse why it is necessary to take several different drugs. How should the nurse respond to the client's question?
"The use of multiple drugs prevents the development of drug-resistant TB."
A client is administered mycophenolate to prevent rejection of the transplanted heart. It is recommended that the client have a CBC drawn weekly. The client asks the nurse the reason for the weekly CBC. Which is the nurse's best response?
"The weekly CBC assesses for the development of infection."
What health education should the nurse provide to a client prior to the instillation of atropine eyedrops?
"These drops might sting a little bit, and they will make you temporarily sensitive to light."
A postoperative surgical client is concerned about developing diarrhea with the use of docusate sodium. What would be appropriate teaching to provide to this client?
"this medication will only soften your stools over the next couple of days"
In which of the following men would the use of sildenafil be contraindicated?
58 year old with unstable angina
Which one of the following patients taking vitamin A supplements is of most concern to the nurse?
A 21-year-old woman who is pregnant
Medication reconciliation
A procedure to maintain an accurate and up-to-date list of medications for all patients between all phases of health care delivery.
Prior to elective hip replacement surgery, the nurse is explaining the basic characteristics of general anesthesia to the client. The nurse should perform this education in the understanding that general anesthesia is best understood as what result?
A state of reversible unconsciousness
A client receiving morphine sulfate 5 mg IV every 4 hours for the past several days now states that the pain is not being relieved as well as it was in the past. What is the reason for this development?
A tolerance to morphine
A client is diagnosed with diabetes insipidus. The health care provider orders desmopressin, which the nurse knows is the synthetic equivalent of what hormone?
ADH
A client receiving isoniazid (INH) and rifampin has a decreased urinary output and decreased sensation in his or her great toes. Which laboratory values should be assessed?
ALT and AST
Which of the following drug classes are absolutely contraindicated for use in pregnant women? (Select all that apply.)
ARBs Direct renin inhibitors ACE inhibitors
A client diagnosed with Cushing's disease will soon begin treatment with ketoconazole. The nurse should be cognizant of the black box warning for this drug and consequently monitor what laboratory values?
AST, ALT, and GGT
A child has symptoms of influenza, including a fever. Which medication should not be administered to the child because of the risk of Reye's syndrome?
Acetylsalicylic acid
Bacteriostatic
Agent that inhibits bacterial growth and replication
Bactericidal
Agent that kills bacteria
Cholinergic drugs
Agents that stimulate the parasympathetic nervous system in the same manner as acetylcholine
A 17-year-old boy has been admitted to the emergency department after suffering a knee sprain during a football practice. The nurse notes that the client has exceptional muscle mass, and the boy quietly admits that this is mostly attributable to the use of steroids, which he obtains from a teammate. What should the nurse teach the boy about anabolic steroid abuse?
Anabolic steroids are universally dangerous but are especially harmful to adolescents.
Deficiency of which hormone causes polyuria and polydipsia?
Antidiuretic hormone (ADH)
What explanation should the nurse provide for why pregnancy is discouraged in women who are being treated for seizure disorders?
Antiepilepsy drugs are teratogenic.
A 55-year-old man has been diagnosed with coronary artery disease and begun antiplatelet therapy. The man has asked the nurse why he is not taking a "blood thinner like warfarin." What is the most likely rationale for the clinician's use of an antiplatelet agent rather than an anticoagulant?
Antiplatelet agents are more effective against arterial thrombosis; anticoagulants are more effective against venous thrombosis.
A man tells the nurse that he has bought the over-the-counter drug bismuth subsalicylate for the next episode of diarrhea. The nurse should assess for what allergy that would contraindicate use of bismuth subsalicylate?
Aspirin
The nurse prepares to administer tetracycline 500 mg PO every 6 hours to an adult client newly diagnosed with Lyme's disease. The client takes an oral contraceptive for birth control. Which measures would the nurse provide for safe and effective drug administration? Select all that apply.
Assess baseline renal and hepatic profiles, complete blood count, and human chorionic gonadotropin (HCG). Instruct client about the importance of using another form of contraceptive during the antibiotic usage. Educate importance of wearing sunscreen and protective clothing when in the sun while taking the drug. Report severe nausea and vomiting, diarrhea, rash, or perineal itching to the prescriber.
A client is being treated for a urinary tract infection with trimethoprim-sulfamethoxazole. What assessment should the nurse make prior to the administration of the medication?
Assessing for renal insufficiency
A nurse at a long-term care facility is surprised to learn that a new resident's medication administration record runs four pages in length. The nurse knows that polypharmacy carries risks and will include which interventions into the resident's plan of care? Select all that apply.
Assessment focused on possible drug complications. Assessment of cognition and mood. Evaluation of swallowing ability Evaluation of medication adherence
After the nurse administers a cholinergic medication to the client, the nurse would provide which interventions because of the drug's actions on the body? Select all that apply.
Auscultate lung sounds and report bronchoconstriction. Instruct client to report diarrhea. Compare muscle strength to baseline for improvement.
What is the most common first-line therapy for relief of an acute asthma attack?
Beta2-adrenergic agonist
A hospital client with a diagnosis of type 1 diabetes is prescribed Humulin R on a sliding scale. Based on the client's blood glucose reading, the nurse administered 8 units of insulin at 07:45. The nurse should consequently check the client's blood glucose level at what time to monitor peak effectiveness of the medication?
Between 09:45 and 10:45
A client, taking warfarin after open heart surgery, tells the home care nurse she has pain in both knees that began this week. The nurse notes bruises on both knees. Based on the effects of her medications and the report of pain, what should the nurse suspect is the cause of the pain?
Bleeding
When appraising an older adult's ability to excrete medications, what laboratory or diagnostic finding should the nurse prioritize?
Blood urea nitrogen (BUN) and creatinine levels
A client with a long-standing diagnosis of asthma is prescribed a beta-blocker for the treatment of angina. The nurse should consequently prioritize assessment for what health problem?
Bronchospasm
A client with a diagnosis of renal failure is being treated with epoetin alfa. Frequent assessment of which laboratory values should be prioritized before and during treatment?
CBC
A client's low ionized calcium levels have necessitated an infusion of an IV calcium preparation. During the administration of this medication, the nurse should prioritize what assessment?
Cardiac monitoring
A client previously experienced an anaphylactic reaction to penicillin G. Which medication should not be administered to this client due to the potential for cross-sensitivity?
Cefazolin
The nurse prepares to administer amoxicillin to an adult client newly diagnosed with acute otitis media of right ear. Which measures would the nurse provide for safe and effective drug administration? Select all that apply.
Check for possible drug interactions and report to prescriber. Report sudden onset of rash, wheezing, or shortness of breath. Assess for improvement of otalgia, otorrhea, and improvement of hearing.
Generic name
Chemical or official name of the drug that is independent of the manufacturer and often indicates the drug group
A client is admitted to an alcohol rehabilitation program. What medication will the client most likely be prescribed to treat alcohol withdrawal syndromes?
Chlordiazepoxide
A client is scheduled to receive an immunization. In which client may the administration of a live vaccine be contraindicated?
Client taking steroid therapy
The primary function of the thyroid gland includes:
Control of cellular metabolic activity
A client, being treated for hypothyroidism, has developed symptoms of adrenal insufficiency. What medication will be added to the client's medication regimen?
Corticosteroid agent
Cross sensitivity
Cross-sensitivity, is the allergy to a drug of another class with a similar chemical structure.
A client is to be started on an antibiotic. Which factor is most important to take into consideration before beginning the antibiotic regimen?
Culture and susceptibility
Culture and Sensitivity
Culture identifies the causative microorganism. The sensitivity is the laboratory test to determine the susceptibility of an antimicrobial agent in the treatment of the causative microorganism.
What is the expected result of timolol maleate therapy?
Decreased intraocular pressure (IOP)
When describing the benefits of second-generation H1 receptor antagonists to those of first-generation H1 receptor antagonists, the nurse should cite what advantage?
Decreased sedation
What is the primary role of protein binding on drug action?
Decreasing the medication's speed of action
A client receiving frequent blood transfusions for the treatment of chronic anemia has developed iron overload. The provider has prescribed a chelating agent to lower the excess iron. Which of the following medications will the nurse anticipate to be admistered to this client?
Deferoxamine
A child has received a diagnosis of Addison's disease, and the nurse is providing health education to the child's family around hormone replacement therapy. When planning this child's care, the nurse should know that hormone replacement therapy constitutes a risk for what nursing diagnosis?
Delayed growth and development
A community health is conducting a health promotion session with a group from a local seniors' center. The nurse has addressed the issue of laxative overuse in this population. The nurse should highlight what consequence of the overuse of laxatives?
Dependence
A patient is started on Mylanta for peptic ulcer disease. It is important for the nurse to inform the patient about which of the following adverse effects?
Diarrhea and constipation
What medication may be administered intravenously (IV) to assist in reducing status epilepticus seizure activity?
Diazepam
A patient being digitalized in the cardiac intensive care unit is noted to have frequent PVCs. What should the nurse suspect in this patient?
Digitalis toxicity
Which class IV calcium channel blocker is exclusively administered to treat acute supraventricular tachycardia?
Diltiazem
An adult client has reported experiencing a dry mouth and urinary retention after several nights of taking an over-the-counter (OTC) sleep aid. The nurse should suspect that this medication contains what antihistamine?
Diphenhydramine
A woman with diarrhea begins to complain of eye pain after administration of diphenoxylate with atropine. The nurse should do which of the following?
Discontinue the diphenoxylate with atropine and notify the provider.
A client has been prescribed ciprofloxacin IV for the treatment of cellulitis. After initiating the infusion of the client's first scheduled dose, the client develops a pronounced rash on the chest and arms. How should the nurse respond initially to this event?
Discontinue the infusion and inform the care provider promptly.
A client with depression has been prescribed a monoamine oxidase inhibitor (MAOI). What education should the nurse provide to this client? Select all that apply.
Do not take over-the-counter (OTC) drugs without talking to physician. Monitor blood pressure closely. Avoid foods containing tyramines.
A client is diagnosed with Alzheimer's disease. The nurse should anticipate administering which medication?
Donepezil
Loading dose
Dose larger than the regular prescribed daily dosage of a medication; used to attain a therapeutic blood level
Pharmacokinetics
Drug movement through the body to reach sites of action, metabolism, and excretion
An adult client being administered hydroxyzine for nausea should be monitored for which adverse effect?
Dry mouth
Excretion
Elimination of a drug from the body; effective excretion requires adequate functioning of the circulatory system and of the organs of excretion (kidneys, bowel, lungs, and skin)
A client is admitted with thrombophlebitis and sent home on enoxaparin therapy. Which statement indicates a good understanding of why enoxaparin is being administered?
Enoxaparin inhibits the formation of additional clots
A client has been diagnosed with chronic renal failure. Which agent will assist in raising the client's hemoglobin levels?
Epoetin alfa
An older adult client is diagnosed with generalized anxiety disorder. The use of benzodiazepines in this client population creates a specific need for which intervention?
Falls risk assessment
A 69-year-old female client has been diagnosed with malignant melanoma. The care team has collaborated with the client and her family and agreed on a plan of care that includes administration of interferon alfa-2b. After administering interferon alfa-2b, the oncology nurse should anticipate that the client may develop which adverse effect?
Flu-like symptoms
A woman is seen in the clinic for treatment of vaginal itching and discharge. The nurse should be prepared to provide the client with information concerning which single dose medication?
Fluconazole
A youngster has just returned home from the family's tropical vacation and is now reporting worsening tenderness in the right ear. When the child is diagnosed with otitis externa, what causative factor of this infection should the nurse focus upon?
Frequent swimming and water sports while the child was on vacation
The nurse is educating new parents on prevention and treatment of constipation with infants. What is the most effective and safest way to treat constipation in a 2-year-old prior to bowel training?
Glycerin suppositories
A client with schizophrenia has been taking haloperidol for several years. The care team and the client have collaborated and chosen to transition the client to an atypical antipsychotic in an effort to reduce adverse effects and maximize therapeutic effects. In order to reduce the client's risk of extrapyramidal effects during the transition from haloperidol to an atypical antipsycotic, the care team should implement which intervention?
Gradually taper the dose of haloperidol
Drug classifications
Groups of medications that are classified according to their effects on particular body systems, their therapeutic uses, and their chemical characteristics
Adverse effects of cimetidine include which of the following? (Select all that apply)
Headache Gynecomastia Diarrhea Confusion
What assessment should the nurse perform prior to administration of a scheduled dose of levothyroxine?
Heart rate
A client is taking cimetidine for increased gastric pain and hypersecretion. Nurses should use extreme caution when administering cimetidine to clients with which condition?
Hepatic disease
A client is admitted to the emergency department with a suspected overdose of acetaminophen. What adverse effect is the most common in acute or chronic overdose of acetaminophen?
Hepatotoxicity
The nurse is preparing to administer gentamicin when the client mentions having experienced diminished hearing. What action should the nurse take based on this statement?
Hold the dosage and notify the health care provider of the alteration in hearing.
A client is admitted to the intensive care unit with an electrolyte imbalance. Which imbalance will contraindicate the administration of digoxin?
Hypokalemia
Significant pharmacodynamics variations exist between adult clients and pediatric clients. Which factor is known to contribute to differences in the ways that drugs affect target cells in children and infants? Select all that apply.
Immaturity of children's organ systems. Differences in the body composition of children
Hypersensitivity
Immune-mediated reaction to a drug
A client is receiving hydrocortisone 40 mg PO daily for treatment of severe autoimmune inflammation. Which nursing intervention is the most important to implement?
Implement infection control measures.
A nurse is performing health education with a woman who has just learned that she is pregnant. The nurse has explained the concept of teratogenic drugs and emphasized the need to have her care provider assess any medications she should consider taking. The nurse should teach the woman that drug-induced teratogenicity is most likely to occur at what point in her pregnancy?
In the first trimester during organogenesis
The nurse prepares to administer a selective alpha-adrenergic agonist medication to a client diagnosed with shock. Which of the following would the nurse consider to be therapeutic or desired effects based upon the characteristics of the prescribed medication? Select all that apply.
Increased blood pressure Increased cardiac output Bronchodilation
A nurse notes that a newly admitted client is currently prescribed both a loop diuretic as well as a thiazide diuretic. The nurse understands what primary rationale for the concurrent use of these two drugs?
Increased diuretic effect
Following the administration of naloxone to a client with moderate pain, the nurse should assess for what change in the client's vital sign?
Increased respiratory rate
How do inhaled corticosteroid agents assist in the treatment of asthma?
Inhaled corticosteroid agents will reduce airway inflammation.
An older adult was diagnosed with depression several decades and has been taking tricyclic antidepressants (TCAs) ever since, with good effect. The nurse should recognize what therapeutic action of this client's medication?
Inhibiting reuptake of norepinephrine and serotonin
What information should the nurse provide a client newly prescribed propylthiouracil about its primary mode of action?
Inhibits production of thyroid hormone
The nurse is caring for a pregnant client diagnosed with pregnancy-induced diabetes. What antidiabetic agent is best suited for administration to this client?
Insulin
A client is using psyllium hydrophilic mucilloid to promote evacuation of stool. What is the action of this medication?
It increases mass and water content of stool, promoting evacuation.
A client is prescribed penicillin V orally for a strep throat. What is the mechanism of action of this medication?
It inhibits cell wall synthesis.
A client diagnosed with myasthenia gravis is administered a cholinergic drug named neostigmine. How does this drug produce its therapeutic effect?
It stimulates the parasympathetic nervous system.
What is the rationale for not administering tetracycline to children under the age of 8 years?
It will interfere with enamel development.
An adult client has begun treatment with fluconazole. The nurse should recognize the need to likely discontinue the drug if the client develops which sign or symptom?
Jaundice
Serum drug level
Laboratory measurement of the amount of a drug in the blood at a particular time
A client is being treated for Parkinson's disease and has been prescribed both levodopa and carbidopa. Why is this course of combination treatment most effective?
Levodopa restores dopamine, and carbidopa decreases peripheral breakdown of levodopa.
An elderly client with dyslipidemia has had fenofibrate added to the existing medication regimen. In addition to having the lipid profile drawn on a regular basis, the nurse should educate the client about the need for what ongoing laboratory testing during therapy?
Liver panel
Brand name
Manufacturer's chosen name for a drug, which is protected by a patent
Laboratory testing of an older adult client, who is well known to the clinic nurse, indicates that liver function has been gradually decreasing over the last several years. How will this age-related physiological change influence drug metabolism?
Many of the client's medications will remain in the body for a longer time.
A 13-year-old has been prescribed dextroamphetamine for the treatment of attention deficit hyperactivity disorder (ADHD) since age 10, achieving significant improvements in behavior and mood. When assessing the child during a scheduled follow-up appointment, the nurse should prioritize what physical assessment to monitor for a potential adverse reaction to the therapy?
Measurement of height and body weight
During administration of dopamine, a patient complains of pain at the infusion site. The nurse should recognize which of the following?
Medication should be stopped, phentolamine should be infused, and the infusion site should be changed.
Metabolism
Metabolism, or biotransformation, is the method by which drugs are inactivated or biotransformed by the body. Most often, an active drug is changed into inactive metabolites, which are then excreted. Some active drugs yield metabolites that are also active and that continue to exert their effects on body cells until they are metabolized further or excreted.
A client who regularly takes metformin has developed a severe infection. How will the infection change the established diabetic regimen?
Metformin is contraindicated in the presence of an infection.
What assessment findings would suggest to the nurse that a client may be experiencing an adverse effect to levothyroxine?
Nervousness and insomnia
A client with a history of angina has sustained a mild head injury in a motor vehicle accident. When the client reports chest pain, what explanation should the nurse provide to support the decision not to treat the angina-related pain with nitroglycerin tablets?
Nitroglycerin will increase intracranial pressure.
When the nurse responds to hypotension due to hypovolemic shock, which of the following should the nurse anticipate will be administered first?
Normal saline (IV)
The nurse prepares to administer gentamicin intravenous every 8 hours to an older adult client. Which interventions should the nurse provide to decrease nephrotoxicity and ototoxicity? Select all that apply.
Obtain baseline assessment of cranial nerve eight and periodic measurements during therapy. Monitor estimated creatinine clearance and BUN at baseline and periodically during therapy. Provide the client with 2 to 3 L of non-caffeinated oral fluids daily, unless contraindicated.
Prototype
Often the first drug of a particular drug class to be developed; usually the standard against which newer, similar drugs are compared
A client is unconscious and experiencing increasing intracranial pressure. What type of diuretic will the client most likely be prescribed?
Osmotic diuretic
Necrotizing otitis externa has the potential to progress to which condition?
Osteomyelitis
A patient receives intravenous (IV) furosemide 80 mg for symptoms of severe heart failure. The nurse recognizes that administering the drug slowly by IV push reduces the likelihood of which of the following adverse effects of drug therapy?
Ototoxicity
A group of nursing students are learning about the factors that underlie recent increases in the incidence and prevalence of antibiotic-resistant microorganisms. What factor is known to contribute to antibiotic resistance?
Overuse of antibiotics
A client is taking warfarin to prevent clot formation related to atrial fibrillation. How are the effects of the warfarin monitored?
PT and INR
A client is prescribed captopril. What adverse effect should the client be instructed on that can occur with angiotensin-converting enzyme (ACE) inhibitors?
Persistent cough
When acetylsalicylic acid is administered in low doses, it blocks the synthesis of thromboxane A2. What physiologic effect results from this action?
Platelet aggregation is inhibited.
A client is being prescribed dextroamphetamine for the treatment of attention deficit hyperactivity disorder (ADHD). During health education, the nurse should make the client aware of the black box warning relating to what potential risk issue?
Potential for abuse
The nurse would question the use of misoprostol (Cytotec) in which population?
Pregnant women at all stages of pregnancy
Absorption
Process that occurs from the time a drug enters the body to the time it enters the bloodstream to be circulated
Mr. Johnson, a 42-year-old architect, is more than 40 lb overweight, and he has a 14-year history of type 1 diabetes mellitus. He is placed on phentermine and has been taking it for the last 8 weeks. His latest serum glycosylated (A1c) hemoglobin levels have risen to 9% despite the fact that he has maintained a healthy diet and routine exercise program. Phentermine may cause an elevation of A1c levels by doing which of the following?
Producing stimulant effects to the sympathetic nervous system
Epinephrine performs what function when administered with lidocaine to affect local anesthesia?
Prolonging the effects of lidocaine
A 1-year-old postoperative client has been experiencing repeated vomiting. What antiemetic drug has a black box warning against use in a client of this age?
Promethazine
A nursing student in a pharmacology class should be encouraged to study the medications according to which categorization? Select all that apply.
Prototype Therapeutic classification
Maintenance dose
Quantity of drug that is needed to keep blood levels and/or tissue levels at a steady state or constant level
Pharmacodynamics
Reactions between living systems and drugs; drug actions on target cells and the resulting alterations in cellular biochemical reactions and functions
When giving a drug with beta1 agonist activity, the nurse knows that which of the following would provide therapeutic benefit? (Select all that apply.)
Relaxation of bronchial smooth muscle and bronchodilation Elevated heart rate and improved force of myocardial contraction Vasoconstriction and elevation of the blood pressure
When considering migraine headaches, what is the primary goal of abortive therapy?
Relief of the symptoms associated with migraines
A client has informed the nurse that he has begun supplementing his medication regimen with a series of herbal remedies recommended by his sister-in-law. Which is the most important nursing intervention regarding the safe use of herbal supplements?
Research for potential interactions with medications
A client will undergo an endoscopy with conscious sedation using midazolam. The nurse who is participating in this procedure should monitor the client closely for which signs of adverse reaction?
Respiratory depression
A hospital nurse is vigilant in ensuring the safe use of medications and consistently applies the rights of medication administration. What are the rights of medication administration? Select all that apply.
Right to refuse prescribed medication. Right route for effective medication therapy. Right to effective medication education. Right evaluation of expected results.
A client has received a rubella immunization. The client was unaware that she was pregnant. What risk is associated with the administration of the rubella immunization in this client?
Risk of birth defects
Route of Administration
Routes of administration affect drug actions and patient responses largely by influencing absorption and distribution. For rapid drug action and response, the IV route is most effective because the drug is injected directly into the bloodstream. For some drugs, the IM route also produces drug action within a few minutes because muscles have a large blood supply. The oral route usually produces slower drug action than parenteral routes. Absorption and action of topical drugs vary according to the drug formulation, whether the drug is applied to the skin or mucous membranes, and other factors.
Prior to administering propylthiouracil, the nurse has reviewed the relevant black box warning and should teach the client about the need for what form of follow-up?
Routine liver function testing
A client, being treated for bipolar disorder with lithium carbonate, has a history of congestive heart failure and hypertension. The client has an increased fluid volume and has recently had difficulty breathing. What laboratory value should the nurse monitor to provide for affect the action of the client's lithium carbonate therapy?
Serum sodium
Which side effect of fluoxetine is most commonly the cause for poor client adherence?
Sexual dysfunction
Hydrocortisone has been prescribed to a client for the treatment of Addison's disease. What action should the nurse should encourage the client to take regarding the self-administration of this medication?
Should be taken before 09:00 each morning.
A male client has been diagnosed with moderately increased LDL, and his primary care provider wishes to begin him on a statin. What is a potential disadvantage of statins that the care provider should consider? Select all that apply.
Statins are expensive Statins require regularly scheduled blood work
The nurse should prioritize which assessment when caring for a teenager who has recently been prescribed a selective serotonin reuptake inhibitor (SSRI)?
Suicidal ideation
In order to maximize therapeutic benefit while reducing the risk of adverse effects of sumatriptan, the nurse should encourage the client to implement which intervention?
Take the medication as soon as the earliest symptoms of migraine are sensed.
A client diagnosed with hypothyroidism is started on levothyroxine. What should the client be taught regarding medication administration in the home setting? (select all that apply)
Take the medication on an empty stomach. Take the medication early in the morning
The nurse, providing education to a client prescribed erythromycin, recognizes a need for additional instruction when the client makes which suggestion? Select all that apply.
Taking the medication with or without food Recognizing dark urine is a normal side effect Swallowing the medication with milk
In order to minimize the chances of withdrawal symptoms, the nurse knows that the client prescribed a benzodiazepine taken daily will likely be advised to take which precaution?
Tapering the dose of drug over a prolonged period of time
A client has been discharged from the hospital after a kidney transplant. Which nursing interventions is the first line of defense against the immunosuppressed client developing an infection?
Teach the client the importance of personal hygiene.
What aspect of a client's history would contraindicate imipenem-cilastatin drug therapy?
The client has a documented allergy to penicillin.
A 76-year-old man with COPD has been taking ipratropium. What change in the client's health status is most likely to require a change in the client's drug regimen?
The client is diagnosed with benign prostatic hypertrophy.
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 young client has been prescribed an antipsychotic agent to relieve psychotic symptoms. Which goal of care is the priority?
The client will remain safe.
A client with a diagnosis of breast cancer is administered a corticosteroid in addition to chemotherapy agents. What effect will the corticosteroids have on this client's course of recovery?
The corticosteroid will decrease signs and symptoms of cancer.
Mr. Conley, who is 53 years of age, is about to be discharged from the hospital after treatment for recurrent ventricular fibrillation. To prevent breakthrough ventricular ectopy, his prescriber orders amiodarone, 1000 mg PO daily as a loading dose for 2 weeks. What patient teaching implications are important regarding this loading dose?
The drug has a long serum half-life
A client has been prescribed a medication that is known to be a drug agonist. This drug will have what effect?
The drug will interact directly with receptor sites to cause the same activity that the natural chemical would cause at that site.
A client, diagnosed with a genitourinary infection, is being treated with a fluoroquinolone. What is the advantage of a fluoroquinolone over an aminoglycoside?
The fluoroquinolone can be given orally.
An adult client has been prescribed oral prednisone for the treatment of an acute dermatological condition. When teaching this client about this course of treatment, what teaching point should the nurse emphasize?
The importance of gradually reducing rather than abruptly stopping the drug
An adult client with a long-standing dysrhythmia has been taking oral propranolol for the last several months resulting in acceptable symptom control. What is a priority teaching point for the nurse to communicate to this client?
The importance of not stopping the medication abruptly
An infant who recently experienced seizures is being treated in the neonatal intensive care unit with phenytoin. The infant's low plasma protein levels during the first year of life have what consequence?
The infant may have an increased risk of toxicity.
A client being treated for a seizure disorder with phenytoin is admitted to the emergency room with sinus bradycardia. What action will occur regarding the phenytoin?
The medication will be discontinued.
Which statement accurately describes the concept of a medication's serum half-life?
The time needed for the serum level to fall by 50%
A client with a diagnosis of bladder cancer is started on a chemotherapeutic regimen that includes three agents. What is the rationale for using multiple antineoplastic agents?
The use of three agents decreases the development of cell resistance.
When considering physiological 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 nurse is instructing a pregnant client concerning the potential risk to her fetus from a Pregnancy Category D drug. What should the nurse inform the client?
There is evidence of human fetal risk, but the potential benefits from use of the drug may be acceptable despite potential risks.
The assessment of a client with a history of alcoholism identifies significant nutritional deficits. Which of the following is the client likely to be prescribed to help address these deficiencies?
Thiamine (vitamin B1)
A patient reports a drug allergy to sulfonamides. Which diuretic drug class should the nurse question if ordered for the patient?
Thiazides
Which medication when taken concurrently can dangerously increase the effects of pseudoephedrine?
Thyroid preparations
What is the purpose of a "drug holiday" for a teenager prescribed an amphetamine for attention deficit hyperactivity disorder (ADHD)?
To minimize weight loss
A client, who sustained a burn from a gas grill, has been prescribed a sulfonamide to prevent a burn infection. What route is preferred in the prevention of a burn infection?
Topical
Distribution
Transport of drug molecules within the body; after a drug is injected or absorbed into the bloodstream, it is carried by the blood and tissue fluids to its sites of action, metabolism, and excretion
Pharmacotherapy
Use of drugs to prevent, diagnose, or treat signs, symptoms, and disease processes
Polypharmacy
Use of several drugs during the same period
A client has a decreased calcium level. Which vitamin will participate in raising the client's calcium level?
Vitamin D
A hospitalized patient on antibiotic therapy begins to experience fever, abdominal pain, and diarrhea containing mucus, pus, and blood. The best nursing intervention in this situation is to do which of the following?
Withhold the antibiotic and notify the provider of the patient's condition.
A client has begun taking cholestyramine. Which are noted as the most common adverse effects?
nausea flatulence constipation
