Pharm Exam 1 ?'s
A client who is postoperative hip replacement is receiving morphine by patient-controlled analgesia and has a respiratory rate of 6 breaths/min. What intervention should the nurse anticipate? 1Nasotracheal suction 2Mechanical ventilation 3Naloxone administration 4Cardiopulmonary resuscitation
3 Naloxone is an opioid antagonist and will reverse respiratory depression caused by opioids. Nasotracheal suction, mechanical ventilation, and cardiopulmonary resuscitation are not needed; naloxone will correct the respiratory depression.
A child being treated with cardiac drugs developed vomiting, bradycardia, anorexia, and dysrhythmias. Which drug toxicity is responsible for these symptoms? 1. Digoxin 2. Nesiritide 3. Dobutamine 4. Spironolactone
1 Digoxin helps improve pumping efficacy of the heart, but overdose can cause toxicity leading to nausea, vomiting, bradycardia, anorexia, and dysrhythmias. The side effects of nesiritide may include effects like headache, insomnia, and hypotension. Dobutamine does not cause nausea or vomiting but may cause hypertension and hypotension. Spironolactone may cause edema.
A 5-year-old child is given fluoroquinolones. Which potential adverse effect unique to pediatric clients should the nurse anticipate? 1. Tendon rupture 2. Cartilage erosion 3. Staining of developing teeth 4. Central nervous system toxicity
1 Fluoroquinolones may cause tendon rupture in children. Nalidixic acid can cause cartilage erosion, and tetracycline can cause staining of developing teeth. Hexachlorophene may cause central nervous system toxicity in infants.
A healthcare provider prescribes digoxin for a client. The nurse teaches the client to be alert for which common early indication of digoxin toxicity? 1Nausea 2Urticaria 3PhotophobiaIncorrect 4Yellow vision
1 Nausea Nausea and loss of appetite are the first indications of toxicity in approximately 50% of clients who take a cardiac glycoside, such as digoxin. Urticaria is a rare, not common, manifestation of digoxin toxicity. Photophobia is a later, not early, manifestation of digoxin toxicity. Yellow vision is a later, not early, manifestation of digoxin toxicity.
Trimethoprim-sulfamethoxazole is prescribed for a client with cystitis. When teaching about the medication, what does the nurse instruct the client to do? 1Drink 8 to 10 glasses of water daily. 2Drink two glasses of orange juice daily. 3Take the medication with meals. 4Take the medication until symptoms subside.
1, 2, 4 A urinary output of at least 1500 mL daily should be maintained to prevent crystalluria (crystals in the urine). Orange juice produces an alkaline ash, which results in an alkaline urine that supports the growth of bacteria. Trimethoprim-sulfamethoxazole should be taken 1 hour before meals for maximum absorption. A prescribed course of antibiotics must be completed to eliminate the infection, which can exist on a subclinical level after symptoms subside.
Which nursing interventions may promote safe drug administration in a child diagnosed with heart failure who is receiving digoxin? Select all that apply. 1Checking for compliance with the client's drug regimen 2Monitoring the client's serum potassium and magnesium levels regularly 3Aministering digoxin only through the intramuscular route 4Calculating the correct dosage form, prescribed amounts, and the prescriber's order 5Monitoring and recording the client's intake and output, heart rate, blood pressure, daily weight, and respiration rate regularly
1, 2, 4, 5 Digoxin may alter the serum potassium and serum magnesium levels, which affects heart function. Calculating the correct dose according to the healthcare provider's orders helps to prevent drug toxicity. Checking for compliance with the client's drug regimen is important so that the child does not have drug to drug interactions. Monitoring and recording drug intake and output, heart rate, blood pressure, daily weight, and respiration rate is a part of general nursing care. Administering digoxin through the intramuscular route is not advised because this method is very painful.
A client reports nausea, vomiting, and seeing a yellow light around objects. A diagnosis of hypokalemia is made. Upon a review of the client's prescribed medication list, the nurse determines that what is the likely cause of the clinical findings?1Digoxin (Lanoxin)2Furosemide (Lasix)3Propranolol (Inderal)4Spironolactone (Aldactone)
1Digoxin (Lanoxin) These are signs of digitalis toxicity, which is more likely to occur in the presence of hypokalemia. Although furosemide most likely contributed to the hypokalemia, the client's symptoms are consistent with digitalis toxicity. Although propranolol can cause nausea, vomiting, and blurred vision, the presence of hypokalemia and yellow vision are more suggestive of digitalis toxicity. A side effect of spironolactone is hyperkalemia, not hypokalemia.
A client with tuberculosis is started on a chemotherapy protocol that includes rifampin. The nurse evaluates that the teaching about rifampin is effective when the client makes which statement? 1"I need to drink a lot of fluid while I take this medication." 2"I can expect my urine to turn orange from this medication." 3"I should have my hearing tested while I take this medication." 4"I might get a skin rash because it is an expected side effect of this medication."
2 Rifampin causes body fluids, such as sweat, tears, and urine, to turn orange. It is not necessary to drink large amounts of fluid with this drug; it is not nephrotoxic. Damage to the eighth cranial nerve is not a side effect of rifampin; it is a side effect of streptomycin sulfate, sometimes used to treat tuberculosis. A skin rash is not a side effect of rifampin.
A client receiving intravenous vancomycin reports ringing in both ears. Which initial action should the nurse take? 1Notify the primary healthcare provider. 2Consult an audiologist. 3Stop the infusion. 4Document the finding and continue to monitor the client.
3Stop the infusion The first action the nurse should take is to stop the infusion immediately. Vancomycin can cause temporary or permanent hearing loss. The nurse should stop the medication infusion and then notify the healthcare provider at once if a client reports any hearing problems or ringing in the ears. An audiologist may need to be consulted at a later date, but this is not the best first action. The nurse should document the findings; however, it is not the initial action.
After receiving streptomycin sulfate for 2 weeks as part of the medical regimen for tuberculosis, the client states, "I feel dizzy and I can't hear as well as usual." The nurse withholds the drug and promptly reports the problem to the healthcare provider. Which part of the body does the nurse determine is being affected as indicated by the symptom reported by the client? 1Pyramidal tracts 2Cerebellar tissue 3Peripheral motor end-plates 4Eighth cranial nerve's vestibular branch
4 Streptomycin sulfate is ototoxic and may cause damage to auditory and vestibular portions of the eighth cranial nerve. Pyramidal tracts, cerebellar tissue, and peripheral motor end-plates are not affected by streptomycin.
A client is receiving dexamethasone to treat acute exacerbation of asthma. For what side effect should the nurse monitor the client? 1Hyperkalemia 2Liver dysfunction 3Orthostatic hypotension 4Increased blood glucose
4 Dexamethasone increases gluconeog enesis, which may cause hyperglycemia. Hypokalemia, not hyperkalemia, is a side effect. Liver dysfunction is not a side effect. Hypertension, not hypotension, is a side effect.
What response will a nurse monitor for when assessing a client for side effects of long-term cortisone therapy? 1Hypoglycemia 2Severe anorexia 3Anaphylactic shock 4Behavioral changes
4Behavioral changes Development of mood swings and psychosis is possible during long-term therapy with glucocorticoids because of fluid and electrolyte alterations. Hypoglycemia, severe anorexia, and anaphylactic shock are not responses to long-term glucocorticoid therapy.
Which drug increases the risk of Reye syndrome in children? Aspirin Naloxone Ibuprofen Acetaminophen
Aspirin Aspirin increases the risk of Reye syndrome in children. Naloxone, ibuprofen, and acetaminophen can be used, but the child should be assessed for renal and liver functioning before prescribing.
Which is the drug of choice for treating Reye syndrome in pediatric clients? Aspirin Mannitol Ibuprofen Furosemide
Mannitol Mannitol is a diuretic that helps in reducing cerebral edema and intracranial pressure. Reye syndrome is caused by the administration of aspirin in pediatric clients with viral infections like chicken pox, so aspirin and drugs that contain aspirin must not be given to reduce fever during the viral infections. Ibuprofen helps reduce fever associated with viral disease but is not useful in the treatment of Reye syndrome. Furosemide is a loop-diuretic which relieves pulmonary edema, but it has no effect on cerebral edema.
Which vaccine may cause intussusception in children?Correct Rotavirus Hepatitis Measles, mumps, and rubella Diphtheria, tetanus, and pertussis
Rotavirus vaccines Rotavirus vaccines very rarely cause intussusception, a form of bowel obstruction in which the bowel telescopes in on itself. Hepatitis vaccines can cause anaphylactic reactions. The measles, mumps, and rubella vaccine may cause thrombocytopenia. The diphtheria, tetanus, and pertussis vaccine carries a small risk of causing acute encephalopathy, convulsions, and a shock-like state.
Which drug class may cause kernicterus in neonates? Salicylates Tetracyclines Sulfonamides Glucocorticoids
Sulfonamides Sulfonamides may cause kernicterus in neonates. Salicylates may cause Reye syndrome. Tetracyclines may cause the discoloration of developing teeth. Glucocorticoids may cause growth suppression
A 10-year-old child is prescribed tetracycline. Which possible drug-related reactions are associated with this drug?1Kernicterus2Gray syndrome3Reye syndromeCorrect4Staining of teeth
Tetracycline Tetracycline causes staining or discoloration of developing teeth in children. Sulfonamides may cause kernicterus in neonates. Chloramphenicol may cause Gray syndrome in infants. Aspirin may cause Reye syndrome in pediatric clients with a history of chickenpox or influenza.
