Pharm Exam 2 Practice Q

•Dronabinol

- used for CINV to increase appetite -cannabinoids

•Lorazepam

-suppress chemo induced nausea -side effects: CNS, confusion, lethargy, irritable

•Dexamethasone

-used with other anti ementics to treat CINV -side effects: weight gain, mood changes, hyperglycemia

Matching 1.) Lactulose 2.) Psyllium 3.)Bisacodyl 4.) Docusate sodium 5.) Milk of Magnesia •A. Can control stools for clients with a colostomy and can decrease diarrhea. •B. Helps soften stool for easier passing, especially after surgery. •C. An osmotic laxative to increase the mass of a stool. •D. Stimulant used prior to surgery or after surgery. •E. Must drink with water and can cause diarrhea.

1--> C 2--> A 3--> D 4--> B 4--> E

A nurse is caring for four (4) clients who have peptic ulcer disease. The nurse should identify misoprostol is contraindicated for which of the following clients? •A. A client that is pregnant. •B. A client who has osteoarthritis. •C. A client who has a kidney stone. •D. A client who has a urinary tract infection.

A -Misoprostol can induce labor therefore contraindicated in pregnancy. -Used in clients taking long term NSAID's to prevent gastric ulcers. -Misoprostol is a prostaglandin

A nurse is providing information to a client who has a new prescription for hydrochlorothiazide. Which of the following information should the nurse include in discharge education? •A.Take the medication with food •B. Plan to take the medication at bedtime. •C. Expect increased swelling of the ankles. •D. Fluid intake should be limited in the morning.

A •The client should take the thiazide diuretic with or after meals to prevent GI discomfort, and with a large glass of water. •The client should take the diuretic before noon to prevent nocturia. •The client should see a decrease in edema- hence daily weights should see a decrease in weight,. •Which electrolyte would the nurse monitor for the client on thiazide?

A nurse is teaching a client who has a new prescription for nitrofurantoin. Which of the following information should the nurse include in the client education? SATA •A. Observe for bruising on the skin •B. Take the medication with milk or meals •C. Expect brown discoloration of the urine. •D. Crush the medication if it is difficult to swallow •E. Expect insomnia when taking it.

A, B, C •Bruising can indicate a blood dyscrasia- a SE of nitrofurantoin. Why assessing skin is important. •Nitrofurantoin is an antibiotic only used for UTI's. •Taking with milk or food helps with GI/GU discomfort including N/V, diarrheas and anorexia. •Urine is a brown discoloration and chewing of the pill can stain the teeth. •Can cause drowsiness.

Which dietary choices will the nurse instruct the client taking spironolactone to avoid increasing in their diet? SATA •A. Potatoes •B. Apricots •C. Cantaloupe •D. Avocados •E. Raisins

A, B, C, D, E •Spironolactone is potassium- sparing The nurse would educate the client not to increase food intake high in K+ •These are the foods you would recommend to a client on a loop diuretic- furosemide. •All foods in this questions are high in K+

A nurse is planning to administer ondansetron to a client. For which of the following adverse effects of ondansetron should the nurse monitor? SATA A. Headache B. Diarrhea C. Shortened PT interval D. Hyperglycemia E. Prolonged QT interval

A, B, E •Headache is the most common adverse effect. •Diarrhea or constipation is an adverse effect of ondansetron. •A prolonged QT interval is possible leading to torsades de pointes. Which electrolyte can also cause torsades de pointes? magnesium

A nurse in a clinic is providing discharge teaching to a client who has been prescribed phenazopyridine. Which of the following will the nurse include in their teaching? SATA •A. Phenazopyridine is a urinary tract analgesic. •B. This medication is an antibiotic. •C. Phenazopyridine will help with dysuria, frequency and urgency. •D. This medication can stain your clothes. •E. Your urine will be red-orange will on this medication.

A, C, D, E •Phenazopyridine is a urinary tract analgesic and will change the color of urine to orange and stain clothes. Educate this medication helps with signs and symptoms and does treat the UTI. •Take with meals to minimize GI discomfort •Acute kidney injury and chronic kidney disease are contraindications.

A nurse reviewing a client's medication history and notes an allergy to sulfonamides. This allergy is a contraindication for taking which of the following medications? SATA •A. Hydrochlorothiazide •B. Metoprolol •C. Acetaminophen •D. Glipizide •E. Furosemide

A, D, E •A sulfa allergy is contraindicated for a client taking a thiazide diuretic. •Steven Johnson Syndrome is most common adverse effect caused by a sulfa drug. •Sulfa based drugs are contraindicated in some oral antidiabetic medications, and furosemide.

A client is experiencing both tingling of the extremities and tetany. The nurse will review the client's lab results to check for which electrolyte abnormality? •A. Hypokalemia •B. Hypocalcemia •C. Hyponatremia •D. Hypochloremia

B

A client with a history of severe diarrhea for the past three days is admitted for dehydration. The nurse anticaptes administering which IV solution? •A. 3% sodium chloride (3% NS) •B. 0.9% sodium chloride. (0.9% NS) •C. 5% dextrose and 0.9% sodium chloride (D5NS) •D. 5% dextrose in Lactated Ringers solution (D5LR)

B •0.9% is the correct IVF since it is an isotonic fluid. •LR without dextrose is isotonic. •Isotonic acts as a volume expander and replaces volume. •3% sodium chloride is hypertonic fluid and used for clients with hyponatremia. •Sodium and water are good "friends"—where one goes the other one follows

A nurse is teaching a client who will be taking aluminum hydroxide. Which of the following information should the nurse include in the teaching? •A. If constipation develops switch to a calcium based antacid. •B. Take this medication two hours before or after other medications. •C. This medication increases the risk for pneumonia. •D. Have your magnesium level monitored while taking this medication.

B •Antacids decrease the absorption of several medications including cimetidine. Should take medication one hour before or after taking an antiacid. •Aluminum hydroxide can cause constipation. •Magnesium hydroxide can cause diarrhea. •Calcium carbonate- Tums •Sodium bicarbonate is an acid base agent- slide 17 (fluid retention)

A nurse is caring for a client who has diabetes and is experiencing nausea due to gastroparesis. The nurse should expect a prescription for which of the following medications? •A. Pancrelipase •B. Metoclopramide •C. Bisacodyl •D. Loperamide

B •Metoclopramide being a prokinetic is used to treat nausea and helps relieve bloating. •Loperamide is an antidiarrheal agent. Bisacodyl is a laxative. •Pancrelipase used for CF patients. Taken right before takes first bite of food. Capsules can not be chewed or broken apart—must swallow capsule for full effect or sprinkle over food like applesauce.

A client has a new prescription for omeprazole. Which of the following information should the nurse include in the teaching? •A. Take this medication at bedtime •B. This medication decreases the production of gastric acid. •C. Take this medication two hours after eating. •D. This medication can cause hyperkalemia.

B •Omeprazole a PPI is administrated in the morning or before meals with a glass of water. •Omeprazole can cause hypomagnesemia (tremors, muscle cramps) and can increase the risk for pneumonia. Educate for s/sx of respiratory infection. •Would you recommend omeprazole for a client with COPD or asthma?--> no can cause pneumonia

The nurse teaches a client about the dangers of using sodium bicarbonate regularly. Which effect of sodium bicarbonate is the nurse trying to prevent? •A. Gastric distension •B. Metabolic alkalosis •C. Respiratory acidosis •D. Cardia dysrhythmias

B •Sodium bicarbonate is an acid-base agent. •Prolonged use of sodium bicarbonate can cause metabolic alkalosis as well retain sodium and water. (Remember sodium and water are always together) •Home remedy to use baking soda to help relieve GI discomfort can develop metabolic alkalosis.

A nurse is planning care for a client who is receiving furosemide IV for peripheral edema. Which of the following interventions should the nurse include in the plan of care? SATA A. Monitor for respiratory acidosis. B. Monitor lab values for hypokalemia. C. Asses vital signs for hypotension. D. Assess for tinnitus. E. Monitor for ventricular dysrhythmias.

B, C, D, and E -Hypokalemia is an adverse effect of a loop diuretic. Hypokalemia can cause ventricular dysrhythmias -With a loop diuretic need to monitor for hypotension and ototoxicity.

A client with severe hyperkalemia develops acidosis. Immediate administration of which medication can help prevent a life-threatening crisis? •A. 50% dextrose •B. Furosemide •C. Sodium bicarbonate •D. Epinephrine

C Sodium bicarbonate decreases potassium levels if acidosis is present.

The nurse is administering a histamine H2 antagonist to a client who has extensive burns. Which complication will it prevent? •A. Colitis •B. Gastritis •C. Stress ulcer •D. Metabolic acidosis

C •An H2 antagonist decreases acid secretion (HCl acid)- MOA. •Prototype is cimetidine

In which category of fluids would the nurse classify an intravenous solution of 0.45% sodium chloride (1/2 NS)? •A. Isotonic •B. Colloid •C. Hypotonic •D. Hypertonic

C •Hypotonic solutions are less concentrated than body fluids. •Colloids are blood products and remember IgG and Albumin are considered blood products.

A nurse is caring for a client who has increased intracranial pressure (ICP) and is receiving mannitol. Which of the following findings should the nurse report to the provider? A. Blood glucose of 139mg/dL B. Urine output of 40mL/hr C. Dyspnea D. Bilateral equal pupil size.

C •Mannitol is an osmotic diuretic. •Dyspnea is a manifestation of heart failure-- an adverse effect of mannitol. The nurse would stop the infusion and notify the provider. •Bilateral equal pupil size indicates a decrease in ICP. •The nurse uses a filter needle to draw up the mannitol.

A nurse is monitoring a client who is receiving spironolactone. Which of the following findings should the nurse report to the provider? •A. Blood (serum) sodium 144 mEq/L •B. Urinary output of 120mL/Hr over four hours. •C. Blood (serum) potassium of 5.9 mEq/L •D. Blood pressure 140/90 mm Hg

C •Spironolactone is a potassium sparing diuretic and can cause hyperkalemia. • A potassium level of 5.9 is hyperkalemia and can cause cardiac arrythmias. A spiked (elevated) T wave = hyperkalemia.

A client is taking phenytoin for a seizure disorder and has a new order for sucralfate tablets. Which of the following instructions should the nurse include? •A. Take an antacid with the sucralfate. •B. Take sucralfate with a glass of milk. •C. Allow a two hour interval between these medications. •D. Chew the sucralfate thoroughly before swallowing.

C •Sucralfate should be taken on an empty stomach one hour before meals. •To prevent constipation, educate client to increase fiber in the diet. •Should take 30 minutes after an antacid and a two hour interval between medications. •May dissolve in water but do not crush or chew.

A nurse is teaching a client about cimetidine. Which of the following are adverse effects of cimetidine? SATA •A. Increased libido •B. Insomnia •C. Enlargement of breast tissue •D. Confusion •E .Decreased sperm count.

C, D, E •Gynecomastia is an adverse effect of cimetidine. •Confusion, impotence and lethargy are also adverse effects. •Adverse effects reverse when discontinued.

A nurse is caring for a client who received prochlorperazine 4 hours ago. The client reports spasms of the face. The nurse should expect a prescription for which of the following medication? •A. Fomepizole •B. Naloxone •C. Phytonadione •D. Diphenhydramine

D •A side effect of prochlorperazine (a dopamine antagonist) is dystonia which is evidenced by spasms of the face, neck and tongue. •Diphenhydramine is used to suppress extrapyramidal effects.

Which intravenous fluid is a hypertonic solution? •A. 0.9% Normal Saline (NS) •B. 5% dextrose in water (D5W) •C. Lactated Ringers solution (LR) •D. 5% dextrose in normal saline (D5NS)

D •All other fluids listed in this question are isotonic. •5% dextrose in water is slightly hyptotonic, but when the body metabolizes the glucose (D5) the solution becomes isotonic.

The healthcare provider prescribes finasteride for a client with benign prostatic hyperplasia (BPH). What education will the nurse proved the client? •A. Male pattern baldness can occur. •B. Results can be expected in 4 to 6 weeks. •C. The medication relaxes the muscles in the bladder neck. •D. A condom should be used during intercourse with a pregnant female.

D •Contact with the semen of a client taking finasteride can affect a developing male fetus during pregnancy. •Finasteride can help with male pattern baldness and take 6-12 months to take effect. •Finasteride is used to shrink an enlarged prostrate while tamsulosin relaxes the muscles in the prostrate and bladder neck. -Tamsulosin •Monitor BP •Confusion -Finasteride •Can take up 6 months to take effect •Decreased libido

A nurse is providing education to a group of nursing students about diuretics and hypokalemia. Which of the following symptom will the nurse included in his teaching? •A. Insomnia •B. Nasal congestion •C. Increased thirst •D. Generalized weakness

D •Generalized weakness (muscle weakness) is a symptom of hypokalemia.

This medication can cause opioid effect since it attaches to the mu receptor in the GI tract just like opioids. •A. loperamide •B. simethicone •C. sulfasalazine •D. diphenoxylate with atropine

D •Is a Scheduled V drug. Atropine is in the medication to act as an antidote to the opioid effect. •Watch F/E balance, I/O's, drink an electrolyte solution like Pedialyte/Gatorade not water. Electrolyte solution replaces electrolytes lost in the diarrhea. •Monitor for dehydrationà which IVF's is given for a patient with dehyradtion caused by diarrhea? •Caffeine exacerbates diarrhea

A nurse is planning discharge teaching for a female client who has a new prescription for trimethoprim - sulfamethoxazole. Which of the following information should the nurse include? •A. Take the medication even if pregnant. •B. Maintain a fluid restriction while taking the medication. •C. Take the medication with food. •D. Do not stop taking the medications when manifestations subside.

D •You can take sulfa on an empty stomach with a glass of water. •Taking a sulfa medication during pregnancy can cause birth defects. •A client should drink at least 8 oz of water when taking the medication to prevent crystals that can lead to kidney injury. •Always take the entire course of antibiotics- even when signs and symptoms have subsided.

Vitamin A

fat soluble vitamin liver

•Oxybutynin

•Anticholergenicà dry mouth, eyes, constipation, •Used for urinary retention and neurogenic bladder- helps relax

•Bethanechol

•Opposite of oxybutyninà diarrhea, sweating, increased urination •Increases urination and empties the bladder •Increases saliva production