pharm exam 2

Which statement, made by the patient, indicates an understanding of discharge teaching regarding alendronate (Fosamax)?

"I will take the medication first thing in the morning with 8 ounces of water and remain upright for 30 minutes

Patients taking levothyroxine (Synthroid) and warfarin (Coumadin) concurrently would be monitored for which adverse effect?

Increased risk of bleeding

What education and discharge information for a patient receiving an antilipemic medication would the nurse include for the patient?

"Continue your exercise program, and maintain a diet high in omega-3 fatty acids.

The patient is prescribed 30 units regular insulin and 70 units NPH insulin subcutaneously every morning. The nurse will provide which instruction to the patient?

"Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin.

Which statement, made by the patient, demonstrates a knowledge deficit regarding colestipol (Colestid)?

"I should mix and stir the powder in a small an amount of fluid as possible in order to maintain potency of the medication."

The nurse evaluates and determines the patient has a good understanding of the discharge instructions regarding warfarin (Coumadin) when the patient responds with which statement?

"I should use a soft toothbrush for dental hygiene."

Which statement, if made by your patient, signifies that additional patient teaching regarding antihypertensive treatment is required?

"I will check my blood pressure every day and take my medication when it is over 140/90."

Which statement will indicate to the nurse that the patient understands the discharge instructions regarding cholestyramine (Questran)?

"I will increase fiber in my diet.

Which statement by the patient demonstrates an understanding of discharge instructions on the use of levothyroxine (Synthroid)

"I will take this medication in the morning so as not to interfere with sleep."

A patient receiving propylthiouracil (PTU) asks the nurse how this medication will help relieve his symptoms. What is the nurse's best response?

"Propylthiouracil inhibits the formation of new thyroid hormone, thus gradually returning your metabolism to normal.

A 19-year-old student was diagnosed with hypothyroidism and has started thyroid replacement therapy with levothyroxine (Synthroid). After 1 week, she called the clinic to report that she does not feel better. Which response from the nurse is correct?

"The full therapeutic effects may not occur for 3 to 4 weeks

A 19-year-old student was diagnosed with hypothyroidism and has started thyroid replacement therapy with levothyroxine (Synthroid). After 2 days, she called the clinic to report that she does not feel better. Which response from the nurse is correct?

"The full therapeutic effects may not occur for 6 to 8 weeks."

A patient taking oral contraceptives is being treated for a urinary tract infection with antibiotics. Which information should the nurse include as education related to the oral contraceptives?

"Use an alternative method of birth control this month during antibiotic use."

When teaching a patient about antihypertensive drug therapy, which statements by the nurse are correct? (Select all that apply.)

"You need to have your blood pressure checked once a week and keep track of the readings." "An exercise program may be helpful in treating hypertension, but let's check with your doctor first." "Please continue taking the medication, even if you are feeling better."

A patient's blood pressure elevates to 270/150 mm Hg, and a hypertensive emergency is obvious. He is transferred to the intensive care unit and started on a sodium nitroprusside (Nipride) drip to be titrated per his response. With this medication, the nurse knows that the maximum dose of this drug should be infused for how long?

10 minutes

An intravenous piggyback (IVPB) antibiotic needs to infuse over 90 minutes. The IVPB bag contains 150 mL. Calculate the setting for the infusion pump.

100 mL/hr The infusion pump delivers at mL/hr. Convert 90 minutes to hours: 1.5 hours

The nurse is administering lispro (Humalog) insulin and will keep in mind that this insulin will start to have an effect within which time frame?

15 minutes

The nurse is administering lispro insulin and will keep in mind that this insulin will start to have an effect within which time frame?

15 minutes

Assuming the patient eats breakfast at 9:00 AM, lunch at noon, and dinner at 6:00 PM, he or she is at highest risk of hypoglycemia following an 8:30 AM dose of NPH insulin at what time?

3 PM

The nurse is providing education to a patient about the time to take gliburide . For maximum benefit, the nurse will tell the patient to administer glipizide at which time?

30 min before a meal

The order reads, Give 1500 mL of normal saline over 12 hours. The tubing drop factor is 15 gtt/mL. The nurse will set the gravity drip infusion at how many drops per minute (gtt/min)?

31 gtt/min Calculate mL per hour: 1500 mL ÷ 12 hr = 125 mL/hr Calculate gtt/min: 15 gtt/mL × 125 mL/hr = 125 ÷ 4 = 31.25; set at 31 gtt/min 60 min/hr 31.25 is rounded to 31 gtt/min because one cannot count 0.25 drops.

A patient is in the intensive care unit and receiving an infusion of milrinone (Primacor) for severe heart failure. The prescriber has written an order for an intravenous dose of furosemide (Lasix). How will the nurse give this drug?

Administer the furosemide in a separate intravenous line.

Before administering a dose of an antidysrhythmic drug to an assigned patient, which assessments would be of highest priority?

Apical pulse and blood pressure

The nurse is reviewing the various types of insulins. For each insulin listed below, place in order from shortest duration (1) to longest duration (4).

Aspart insulin Regular insulin. NPH insulin Glargine insulin

A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium level is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the client?

Calcitonin (Miacalcin)

Which is a pharmacodynamic effect of exogenous androgens?

Decreased erythropoiesis

Desmopressin acetate (DDAVP) is prescribed for the treatment of diabetes insipidus. The nurse monitors the client after medication administration for which therapeutic response?

Decreased urinary output

When reviewing the laboratory values of a patient who is taking the antithyroid drug PTU, the nurse will monitor for which adverse effect?

Decreased white blood cell count

The nurse would question the order for estrogen replacement therapy in a patient with a history of which condition?

Deep vein thrombosis

The nurse is conducting a community education program. When explaining different medication regimens to treat hypertension, it would be accurate to state that African Americans probably respond best to which combination of medications?

Diuretics and calcium channel blockers

A nurse is monitoring a client receiving desmopressin acetate (DDAVP) for diabetes insipidus. Which of the following indicates the presence of an adverse effect?

Drowsiness

What common side effect would the nurse include in the discharge teaching for a patient receiving finasteride (Proscar)?

Ejaculatory dysfunction

Which is a priority nursing diagnosis for a patient receiving desmopressin (DDAVP)?

Excess fluid volume

During an infusion of albumin, the nurse monitors the patient closely for the development of which adverse effect?

Fluid volume overload

The nurse recognizes that patient teaching regarding warfarin (Coumadin) has been successful when the patient acknowledges an increased risk of bleeding with concurrent use of which herbal product? (Select all that apply.)

Garlic Ginkgo Dong quai St. John's wort

A patient is being discharged on anticoagulant therapy. The nurse will include in the patient-education conversation that it is important to avoid herbal products that contain which substance?

Ginkgo

A nurse performs an admission assessment on a client who visits a health care clinic for the first time. The client tells the nurse that propylthiouracil (PTU) is taken daily. The nurse continues to collect data from the client, suspecting that the client has a history of:

Graves' disease

The nurse would question an order for simvastatin (Zocor) in a patient with which condition?

Hepatic disease

When administering morning medications for a newly admitted patient, the nurse notes that the patient has an allergy to sulfa drugs. There is an order for the sulfonylurea glipizide (Glucotrol). Which action by the nurse is correct?

Hold the drug, and check the order with the prescriber.

Which statement when made by the patient indicates deficient knowledge regarding warfarin

I will increase the dark green leafy vegetables in my diet."

Hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) are generally administered at which time?

In the evening

By which action does atorvastatin (Lipitor) decrease lipid levels?

Inhibiting HMG-CoA reductase, the enzyme responsible for the biosynthesis of cholesterol in the liver

he nurse is providing education to a patient and his caregiver—his pregnant daughter—about dutasteride (Avodart), which he will be taking for benign prostatic hyperplasia (BPH). What important teaching would the nurse provide to the patient and his daughter about the administration of this medication?

It must not be touched or handled by his daughter due to teratogenic effects.

Which information should be included in a teaching plan for patients taking oral hypoglycemic drugs? (Select all that apply.)

Limit your alcohol consumption. B.Report symptoms of anorexia and fatigue Notify your physician if blood glucose levels rise above the level set for you.

Which test will the nurse use to assess for adverse reactions to HMG-CoA reductase inhibitors?

Liver function tests

Enoxaparin sodium (Lovenox) is an anticoagulant used to prevent and treat deep vein thrombosis and pulmonary embolism. This drug is in which drug group?

Low-molecular-weight heparin

While observing a patient self-administer enoxaparin (Lovenox), the nurse identifies the need for further teaching when the patient completes which action?

Massages the site after administration of the medication

Discharge teaching for a patient receiving simvastatin (Zocor) would include the importance of reporting which symptoms that might indicate a serious adverse reaction to the medication?

Muscle pain

A patient prescribed prazosin (Minipress) does not have a history of hypertension. The nurse would assess for what disorder for which this medication is also used?

Obstructive benign prostatic hyperplasia

Adenosine is used to treat which condition?

Paroxysmal supraventricular tachycardia (PSVT)

Nursing care for a patient receiving alteplase (Activase) would include which action? (Select all that apply.)

Record vital signs and report changes. Observe for signs and symptoms of bleeding. Assess for cardiac dysrhythmias.

A PATIENT IS ADMITTED TO THE EMERGENCY DEPARTMENT IN DIABETIC KETOACIDOSIS (DKA) WITH A BLOOD GLUCOSE LEVEL OF 533. THE PHYSICIAN ORDERS AN INITIAL DOSE OF 25 U INSULIN INTRAVANEOUSLY(IV). WHICH TYPE OF INSULIN WILL BE ADMINISTERED?

Regular insulin

What action is often recommended to help reduce tolerance to transdermal nitroglycerin therapy?

Remove the patch at bedtime, and then apply a new one in the morning.

When reviewing the health history of a patient, the nurse will note that a potential contraindication to potassium supplements exists if the patient has which problem?

Renal disease

To prevent oral candidiasis, it is most important for the nurse to teach a patient using a steroid inhaler to perform which action?

Rinse the mouth after each use.

The nurse is teaching the patient taking an antithyroid medication to avoid foods high in iodine. Which food will the nurse advise the patient against?

Seafood

A woman who lives in New York City is preparing to take a plane trip to China. She has been taking the SERM raloxifene (Evista) for 6 months. The nurse will provide which instructions to this patient?

She needs to stop taking the drug at least 72 hours before the trip.

A patient has been instructed to take one enteric-coated low-dose aspirin a day as part of therapy to prevent strokes. The nurse will provide which instruction when providing patient teaching about this medication?

Take the medication with 6 to 8 ounces of water and food.

When teaching a patient who is starting metformin (Glucophage), which instruction by the nurse is correct?

Take the medication with food to reduce gastrointestinal (GI) effects.

The health care provider (HCP) prescribes exenatide (Byetta) for a client with type 1 diabetes mellitus who takes insulin. The nurse knows that which of the following is the appropriate intervention?

The medication is withheld and the HCP is called to question the prescription for the client

The nurse interprets a patient's international normalized ratio (INR) value of 2.5. What is the meaning of this reported value?

The patient's warfarin dose is therapeutic. A therapeutic INR is 2 to 3.

A 16-year-old boy who is taking somatropin comes into the office because he had an asthma attack during a race at school. Because of this new development, the nurse expects which intervention to occur next?

The somatropin dosage may be adjusted

Which patient statement demonstrates understanding of radioactive iodine (I-131) therapy?

This drug will be taken up by the thyroid gland and destroy the cells to reduce my hyperthyroidism.

A patient has been diagnosed with metabolic syndrome and is started on the biguanide metformin (Glucophage). The nurse knows that the purpose of the metformin, in this situation, is which of these?

To decrease insulin resistance

The nurse would question an order for steroids in a patient with which condition?

Uncontrolled diabetes mellitus

A patient has been prescribed lidocaine (Xylocaine). What does the nurse understand as the reason for this medication order?

Ventricular arrhythmias

A patient with diabetes insipidus is taking Vasopressin . He is complaining of drowsiness, lightheadedness, and headache. What does the nurse suspect that he is experiencing?

Water intoxication

Mrs. James has been diagnosed with diabetes insipidus and will be started on nasal Vasopressin. A. What is diabetes insipidus, and what hormone is involved in this condition? b. What is the mechanism of action for Vasopressin?

a. body cannot regulate fluids b. ADH-stop voiding so much

Glimepiride (Amaryl) is prescribed for a client with diabetes mellitus. A nurse reinforces instructions for the client and tells the client to avoid which of the following while taking this medication?

alcohol

A patient is in the intensive care unit because of an acute myocardial infarction. He is experiencing severe ventricular dysrhythmias. The nurse will prepare to give which drug of choice for this dysrhythmia?

amiodarone (Cordarone)

THE NURSE IS CARING FOR A 10-YEAR-OLD BOY WITH GROWTH HORMONE DEFICIENCY. THE CHILD ASKS THE NURSE HOW LONG HE WILL BE ABLE TO TAKE HIS MEDICINE. WHAT IS THE NURSES BEST RESPONSE?

c. Until your epiphyseal plates close

The nurse is caring for a patient scheduled to undergo a cardiac catheterization procedure utilizing iodine-based contrast material. The nurse would question an order for which medication to be given to this patient the day of the scheduled procedure?

metformin

Patients prescribed sildenafil (Viagra) should be instructed regarding the potential fatal drug interaction with which medication(s)?

nitroglycerin

The nurse admitting a patient with acromegaly anticipates administering which medication?

octreotide (Sandostatin)

A nurse reinforces instructions to a client who is taking levothyroxine (Synthroid). The nurse tells the client to take the medication:

on empty stomach

What are potential side effects of pioglitazone? Select all that apply

osteoporosis bladder cancer fluid retention

ACE inhibitors and angiotensin receptor blockers both work to decrease blood pressure by

preventing aldosterone secretion

The nurse would assess which laboratory value to determine the effectiveness of intravenous heparin?

Activated partial thromboplastin time (aPTT)

The nurse plans which intervention to decrease the flushing reaction of niacin?

Administer aspirin 30 minutes before nicotinic acid.

When teaching a patient regarding proper application of a Testoderm transdermal patch, the nurse will instruct the patient to perform which action?

Place the patch on clean, dry, shaved scrotal skin

A client with diabetes mellitus visits a health care clinic. The client's diabetes mellitus previously had been well controlled with glyburide (DiaBeta) daily, but recently the fasting blood glucose level has been 180 to 200 mg/dL. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia?

Prednisone

The nurse is providing care to a patient following a non-accidental traumatic brain injury. The patient has developed diabetes insipidus due to the injury. What medication is most often used in the management of diabetes insipidus?

desmopressin (DDAVP

A 33 year old man, newly admitted to the medical-surgical unit from the stepdown ICU, underwent a thyroidectomy 2 days earlier. The nurse reviews the orders and this patient is to receive thyroid medication upon arrival to the unit. The written orders specify that 25mcg of levothyroxine is to be given once daily. However, the pharmacy only has liothyroxine 25 mcg in stock. What is the nurses priority action?

do not give, not the same med. T3 when doc ordered t4

A client received 20 units of NPH insulin subcutaneously at 8:30 AM. Breakfast was eaten at 0900 and lunch was eaten at 1200. The nurse should check the client for a potential hypoglycemic reaction at what time?

3:00 PM

When reviewing patients' histories, the nurse recognizes that which patient would be a likely candidate for drug therapy for cholesterol reduction?

A patient who has coronary heart disease and an LDL level of 165 mg/dL

A nurse is caring for a client after thyroidectomy and notes that calcium gluconate is prescribed for the client. The nurse determines that this medication has been prescribed to:

Treat hypocalcemic tetany

A nurse reinforces medication instructions to a client who is taking levothyroxine (Synthroid). The nurse instructs the client to notify the health care provider (HCP) if which of the following occurs?

Tremors

Which medication has antiplatelet properties?

clopidogrel

When a male patient is receiving androgen therapy, the nurse will monitor for signs of excessive androgens such as

fluid retention

Which oral hypoglycemic drug has a quick onset and short duration of action, enabling the patient to take the medication 30 minutes before eating and skip the dose if he or she does not eat?

glipiside

When caring for a patient newly diagnosed with gestational diabetes, the nurse would question an order for which drug?

glipizide

The nurse will advise the patient to treat hypoglycemia with which drug?

glucagon

Which long-acting insulin mimics natural, basal insulin with no peak action and a duration of 24 hours?

insulin glargine (Lantus

A patient is being treated for secondary amenorrhea. The nurse expects which drug to be used to treat this problem?

medroxyprogesterone

During a postpartum assessment, the nurse notes a boggy uterus and increased vaginal bleeding. Based upon this assessment and standing physician orders, the nurse prepares to administer which medication?

oxytocin

A Child is experiencing delayed Growth due to an endocrine disorder. Which pituitary drug is used to treat this condition? What is the best way for the nurse to measure the patient's response to the drug therapy?

somatropin 3-5 inches in first year

The nurse will monitor a patient for signs and symptoms of hyperkalemia if the patient is taking which of these diuretics?

spironolactone (Aldactone)

The nurse is discussing with a patient the time of day for taking prednisone. What information would the nurse include in the teaching based on knowledge of glucocorticoids?

t should be administered with food to diminish the risk of gastric irritation.

A patient is taking thyroid drugs for about 16 months and has recently noted palpitations and some heat intolerance, What are the nurses priority actions at this time?

thyroid toxicity

Explain the difference between diabetes mellitus type 1 and type 2. . What are the key teaching points for patients taking oral antidiabetic agents?

type 1= need insulin type 2= have insulin but need help using it effectively know relationship of food, hypoglycemia signs