Nurs 220 (Pharma) CoursePoint Chapter 3

The nurse is assessing a client who may be experiencing an anaphylactic reaction. What assessment finding is most consistent with this diagnosis? a) Shortness of breath b) Sudden somnolence c) Swollen cervical lymph nodes d) Swollen joints

a) Shortness of breath

Upon assessment after giving oral penicillin, the nurse notes that a client has dilated pupils, increased blood pressure, and increased heart rate. The nurse would document these findings as which type of drug allergic reaction? a) Cytotoxic b) Anaphylactic c) Serum sickness d) Delayed

b) Anaphylactic

The nurse is caring for a client with a drug allergy and understands the allergy is the result of the client developing: a) Antigens b) Antibodies c) Antihistamine d) Secondary effects

b) Antibodies

A client is experiencing central nervous system effects related to drug therapy. Which would be most important for the nurse to emphasize in the teaching plan? a) The need for follow-up blood tests b) The importance of a low-stimulation environment c) Safety measures d) Educating about the signs and symptoms of stroke

c) Safety measures

Many drugs that reach the developing fetus or embryo can cause death or congenital defects, which can include skeletal and limb abnormalities, central nervous system alterations, heart defects, and the like. What is the name of the adverse reaction that can cause birth defects? a) Stomatitis b) Blood dyscrasia c) Teratogenicity d) Cytotoxic reactions

c) Teratogenicity

Which skin condition would be most likely to cause increased systemic absorption of a topical medication? a) Multiple nevi b) Rosacea c) Port wine stain of the face d) Severe sunburn

d) Severe sunburn

The nurse is assessing a client who is being admitted to the healthcare facility. When asked about allergies, the client states, "I'm allergic to penicillin." What is the nurse's best initial response? a) "Do you remember what happened the last time you received penicillin?" b) "We'll make sure that none of your antibiotics are similar to penicillin." c) "I'll make sure to pass that information along to the pharmacy." d) "Are there other antibiotics that have worked well for you in the past?"

a) "Do you remember what happened the last time you received penicillin?"

The nurse is conducting an admission assessment of a new client. When asked about any food or drug allergies, the client states that the client is allergic to tetracycline. What action should the nurse next perform? a) Ask the client, "What happens when you take a dose of tetracycline?" b) Ask the client, "Are you allergic to any other antibiotics, or just tetracycline?" c) Document an allergy to tetracycline in the client's health record d) Educate the client about antibiotics that are alternatives to tetracycline.

a) Ask the client, "What happens when you take a dose of tetracycline?"

A client is receiving a drug to lower blood glucose level. What would lead the nurse to suspect that the client's blood glucose level was too low? a) Cold, clammy skin b) Increased urination c) Fruity breath odor d) Increased hunger

a) Cold, clammy skin

A client in the ambulatory care clinic is experiencing shortness of breath and facial and throat edema while receiving a pegloticase infusion. What is the nurse's best action? a) Notify emergency personnel. b) Connect the infusion to an alternate intravenous access site. c) Start a new intravenous line. d) Reassure the client that the symptoms will subside soon.

a) Notify emergency personnel.

Preoperative atropine belongs to what classification of drugs? a) Ccholinergic b) Anticholinergic c) Benzodiazepine d) Diuretic

b) Anticholinergic

A client receiving drug therapy develops numbness and tingling in the extremities and muscle cramps. What assessment should the nurse perform? a) Check the client's blood glucose level. b) Review the client's most recent potassium level. c) Assess the client's level of orientation. d) Check the client's urine output.

b) Review the client's most recent potassium level.

A client develops a skin reaction to one of their prescribed medications. This client also has a specific underlying pathology. This underlying pathology might serve as a: a) Basis for planning the medication regimen. b) Basis for the nursing care plan. c) Prominent part of client teaching. d) Contraindication for the use of certain medications.

d) Contraindication for the use of certain medications.

What changes due to aging in the geriatric client may affect excretion and promote accumulation of drugs in the body? a) Decreased activity b) Decreased gastric motility c) Decreased cognition d) Decreased glomerular filtration rate

d) Decreased glomerular filtration rate

A client who is being treated for cancer developed a serum sickness reaction. The care team has been notified, and the client is being stabilized. What is the nurse's priority action? a) Administer prescribed epinephrine subcutaneously. b) Encourage the use of a MedicAlert identification. c) Administer topical corticosteroids. d) Discontinue the drug immediately as ordered.

d) Discontinue the drug immediately as ordered.

An older adult client has an elevated serum creatinine level. This client is at greatest risk for which medication-related effect? a) Toxicity b) Increased absorption c) Delayed gastric emptying d) Idiosyncratic effects

a) Toxicity

When reviewing the medication list of a client being seen in the clinic, the nurse notes that the client is receiving glipizide. Based on the nurse's understanding, this drug is used to treat: a) Hypokalemia b) Hyperkalemia c) Hypoglycemia d) Hyperglycemia

d) Hyperglycemia

When instructing a client who is taking an antibiotic about the possibility of nausea and diarrhea, the nurse understands that these effects are examples of: a) Primary actions b) Secondary actions c) Drug allergy d) Hypersensitivity

b) Secondary actions

An elderly client has been taking a new medication for 2 months. During a follow-up visit, the client's son tells the nurse that he feels his mother's memory is getting worse. What concerns should the nurse have at this time? a) The nurse should not be concerned. Medication is not the cause of the client's confusion. b) The client probably has the onset of Alzheimer disease. c) This may be coincidental, and the memory loss may be attributed to changes with aging. d) All elderly clients have dementia at some point in life, and the medication is making it worse.

c) This may be coincidental, and the memory loss may be attributed to changes with aging.

The nurse is caring for a client with hypertension who was prescribed a loop diuretic one week ago. The client reports malaise and weakness and the nurse's assessment reveals an irregular heart rate. The nurse should prioritize assessment of the client's: a) Potassium levels b) Liver enzyme levels c) Cognition d) Renal function

a) Potassium levels

The pharmacology instructor explains to the students that adverse effects can be extensions of: a) Primary action of a drug b) Anaphylaxis c) Fourth level effects d) Anticholenergic responses to the drug

a) Primary action of a drug

The nurse is called to a client's room 15 minutes after the client has received a new medication. The client reports pruritus as well as nausea. The nurse notes that the client appears pale, is sweating, and has begun to cough and wheeze. The nurse determines that the client is experiencing what type of reaction related to the new medication? a) Toxic b) Anaphylactic shock c) Additive d) Synergistic

b) Anaphylactic shock

A nurse is instructing a client concerning a newly prescribed drug. What should be included to help improve client compliance and safety? a) A list of pharmacies where the drug can be obtained. b) Measures to alleviate any discomfort associated with adverse effects. c) The cost of the brand-name drug compared with the generic form. d) Statistics related to phase III of testing for the prescribed drug.

b) Measures to alleviate any discomfort associated with adverse effects.

The nurse administers typical antipsychotic medications to the client who has taken these same drugs for many years. What signs and symptoms should the nurse attribute to secondary actions of the drug? Select all that apply. a) Muscular tremors b) Drooling c) Changes in gait d) Yellow discoloration of the skin and sclera e) Fine red rash on the trunk

a) Muscular tremors b) Drooling c) Changes in gait

A client began a new medication four days ago and presents with a temperature of 38.2° C (100.8 °F), dependent edema, and swollen cervical lymph nodes. The nurse has informed the client's provider, who has discontinued the medication. What subsequent intervention should the nurse prioritize? a) Provide supportive care to manage fever and inflammation. b) Administer subcutaneous epinephrine as prescribed. c) Initiate emergency resuscitation measures. d) Administer naloxone as prescribed.

a) Provide supportive care to manage fever and inflammation.

Many drugs that reach the developing fetus or embryo can cause death or congenital defects. What are examples of congenital defects? Select all that apply. a) Skeletal and limb abnormalities b) Central nervous system alterations c) Birth at 40 weeks' gestation d) Heart defects

a) Skeletal and limb abnormalities b) Central nervous system alterations d) Heart defects

What would the nurse include in the teaching plan for a client who is to receive a drug that is associated with anticholinergic effects? a) Try to stay as warm as possible to prevent chilling. b) Be sure to drink plenty of fluids to prevent dehydration. c) Avoid strenuous exercise to minimize calorie loss. d) Eat a low-fiber diet to prevent constipation.

b) Be sure to drink plenty of fluids to prevent dehydration.

What does the nurse need to do when there is any indication of an allergic reaction in clients? a) Obtain early warning of noncompliance in drug therapy. b) Maintain the client's safety during drug therapy. c) Reduce the risk of adverse effects during drug therapy. d) Increase the effectiveness of a specific medication.

b) Maintain the client's safety during drug therapy.

A client is on antibiotic therapy for an axillary abscess. The client has been outside working in the yard and observes a rash everywhere that is not covered by clothing. What should the client be told about this finding? a) The client is allergic to the penicillin and should stop taking it immediately. b) The client is having photosensitivity and this can occur even with brief exposure to the sun or UV rays. c) The client had a reaction to something in the environment while working in the yard and should take an antihistamine. d) This is a normal reaction for anyone who takes antibiotics and is nothing to be concerned about.

b) The client is having photosensitivity and this can occur even with brief exposure to the sun or UV rays.

The nurse is caring for a client receiving an aminoglycoside (antibiotic) that can be nephrotoxic. Which will alert the nurse that the client may be experiencing nephrotoxicity? a) Visual disturbances b) Yellowing of the skin c) A decrease in urine output d) Ringing noise in the ears

c) A decrease in urine output

An instructor is preparing a class that describes the toxic effects of drugs. Which effect would the instructor expect to include? a) Many drugs are potentially harmless if used correctly. b) Any effect results from the alteration of several chemical factors. c) Most reactions occurring with present-day therapy are less severe than before. d) Drugs cause unexpected or unacceptable reactions despite screening and testing.

d) Drugs cause unexpected or unacceptable reactions despite screening and testing.

A client is receiving an antineoplastic medication for treatment of breast cancer and begins having tonic-clonic seizure activity. What type of toxicity does the nurse recognize that this client is experiencing? a) Ototoxicity b) Hepatotoxicity c) Nephrotoxicity d) Neurotoxicity

d) Neurotoxicity

The nurse is reviewing the laboratory test results of a client receiving drug therapy. What would the nurse suspect if the results reveal an elevation in the blood urea nitrogen level and creatinine concentration? a) Liver injury b) Hypoglycemia c) Hyperkalemia d) Renal injury

d) Renal injury

One of the most common occurrences in drug therapy is the development of adverse effects from simple overdose. In such cases, the client suffers from effects that are merely an extension of the desired effect. Which are examples of this primary action? (Select all that apply.) a) Spontaneous bleeding after taking an anticoagulant b) Drowsiness after taking an antihistamine c) Dizziness after starting an antihypertensive d) Diarrhea after taking an antibiotic

a) Spontaneous bleeding after taking an anticoagulant c) Dizziness after starting an antihypertensive

A newly admitting client has signs and symptoms of an infection and the nurse anticipates that the client will be prescribed antibiotics. What assessment should the nurse prioritize when determining the client's risk for an excessive drug response due to impaired excretion? a) The client's blood urea nitrogen level and creatinine clearance rate. b) The client's body mass index and hydration status. c) The client's albumin, bilirubin, AST and ALT levels. d) The client's fasting blood glucose level.

a) The client's blood urea nitrogen level and creatinine clearance rate.

A client with a diagnosis of bipolar disorder has begun lithium therapy. What is the primaryrationale for the nurse's instructions regarding the need for regular monitoring of the client's serum drug levels? a) It is necessary to regularly test for blood-drug incompatibilities that may develop during treatment. b) It is necessary to ensure that the client's drug levels are therapeutic but not toxic. c) It is needed to determine if additional medications will be needed to potentiate the effects of lithium. d) It is needed in order to confirm the client's adherence to the drug regimen.

b) It is necessary to ensure that the client's drug levels are therapeutic but not toxic.

A client taking a beta blocker for hypertension tells the nurse he will no longer take the medication because it is causing an inability for him to maintain an erection. What is the best explanation for this issue by the nurse? a) "The sexual dysfunction is caused by an allergic reaction to the medication. We need to stop this drug immediately." b) "This is an idiosyncratic response to the medication, not an expected result. Such responses are genetically predetermined so you will not be able to take this medication." c) "This is an expected adverse effect of the medication, but it is very important that you continue to take it. We can talk about other methods for sexual expression." d) "This is a toxic reaction to the medication and can cause permanent damage. We need to take you off this medication immediately."

c) "This is an expected adverse effect of the medication, but it is very important that you continue to take it. We can talk about other methods for sexual expression."

A client comes to the clinic reporting of a ringing sound in the ears and dizziness. When the nurse takes the client's history, the nurse discovers that the client has been taking several ibuprofen every day for various discomforts. What does the nurse understand has occurred with this client? a) Immunotoxicity from the ibuprofen b) Allergic reaction to the ibuprofen c) Ototoxicity from the ibuprofen d) Anaphylactic reaction to the ibuprofen

c) Ototoxicity from the ibuprofen

A client with lymphoma is scheduled to begin chemotherapy tomorrow. When providing health education for the client regarding the risk for stomatitis, what should the nurse teach the client? a) The importance of sitting upright while eating and for 30 minutes afterwards. b) The rationale for prophylactic antibiotics. c) Techniques for providing safe and effective mouth care. d) The rationale for taking probiotics for the duration of treatment.

c) Techniques for providing safe and effective mouth care.

A 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man's most recent visit to his care provider, routine blood work was ordered and the results indicated an unprecedented rise in the man's serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings? a) The man may be experiencing a paradoxical effect of aspirin. b) The man may be allergic to aspirin. c) The man may be experiencing liver toxicity from the aspirin. d) The man may be experiencing nephrotoxic effects of aspirin.

d) The man may be experiencing nephrotoxic effects of aspirin.