Pharm Exam 3
T/F An antiemetic drug is primarily used to treat dizziness...
F
A client suspected of having myasthenia gravis (MG) complaining of continuous muscle weakness and exhaustion is sent for a Tensilon (edrophonium) test. Which client response would indicate that the client is having a myasthenia crisis? a. The client shows improvement in the muscle weakness b. The client shows worsening in the muscle weakness c. The client shows no change in condition d. The client complains of muscle spasms
a
A nurse is providing education to a client who has just been given a new prescription for lithium for mania symptoms associated with bipolar disorder. The nurse teaches the patient to be sure to report which symptoms? a. Excessive urination and thirst b. Insomnia and restlessness c. Extreme energy and activity d. Intense hunger and sensitivity
a
A patient is being discharged from the hospital and will be prescribed gabapentin for seizures. Which of the following should the nurse include in teaching about gabapentin? a. Call the health provider for changes in vision. b. Keep the medication in the refrigerator. c. Take gabapentin with antacids for gastric upset. d. Depression is common and will eventually fade.
a
A patient is being discharged with a new prescription of phenytoin. Which instruction by the nurse is most important to include? a. If stopped abruptly, status epilepticus may occur. b. Sulfonamides like sulfamethoxazole trimethoprim will decrease phenytoin levels in the blood. c. Take the medication with antacids to reduce gastric upset. d. Dilantin will not affect contraceptive effectiveness.
a
A patient visits the clinic with symptoms of cystitis and receives a prescription for phenazopyridine hydrochloride. After providing instructions on the medication, the nurse determines the patient requires more teaching because of which statement? a. "I am so glad I have the medication that kills all bacteria, making my pain better." b. "I will drink fluids and add cranberry juice daily." c. "I will take warm tub or sitz baths to help relieve urgency, discomfort, and spasm." d. "I know that my urine may turn bright orange-red and may stain my underwear."
a
A patient with seizure disorder has a gastrostomy feeding tube. All medications are administered through the tube. A new order for carbamazepine is received; however, the medication has a warning "not to crush". After assessment of the patient and medical record, the nurse's priority action is to: a. Contact the health care provider to discuss an alternate medication that can be given via gastrostomy tube. b. Contact the pharmacy and have an oral suspension made from the medication. c. Crush the medication and dissolve in juice. d. Crush the medication and dissolve in normal saline.
a
Adverse effects of raloxifene a. hot flashes b. hyperkalemia c. dizziness d. nausea
a
Antiemetic commonly used to prevent motion sickness? a. scopolamine b. ondansetron c. metoclopramide d. dexamethasone
a
Benzodiazepines are used to treat which disorder? a. anxiety b. anesthesia c. severe head injuries d. pain control
a
Client teaching for cochicine a. decreases joint inflammation b. inhibits uric acid production c. should not be taken with food d. may cause liver fibrosis
a
Clients receiving cyclobenzaprine may also benefit from which medication? a. docusate sodium b. diphenhydramine c. lorazepam d. metoclopramide
a
Clients with sensitivity to sulfonamides, salicylates, and/or thiazide diuretics should avoid: a. 5-aminosalicylates b. probiotics c. alosteron d. lubiprostone
a
For which of the following clients with PUD is misoprostol contraindicated? a. 27 yr old pt who is pregnant b. 75 yr old pt who has osteoarthritis c. 37 yr old pt who has a kidney stone d. 46 yr old pt who has an UTI
a
Patient teaching about laxatives a. can result in dependency b. may cause constipation c. insert suppository just distal to internal sphincter d. any form of laxatives are safer for ulcerative colitis
a
Teaching for a client taking a proton pump inhibitor (PPI) includes... a. smoking cessation b. symptoms of hypermagnesemia c. symptoms of hyperglycemia d. may have constipation
a
The nurse is assessing a patient who has been on phenytoin for 10 years. Which characteristic finding is observed in patients with a long-term history of taking phenytoin sodium? a. Excessive growth of gum tissue. b. Enlarged tonsils. c. Dry scaly skin. d. Mania
a
The nurse is preparing a patient for cataract surgery and administers phenylephrine hydrochloride drops in the surgical eye prior to the procedure. What is the expected outcome? a. Dilation of the pupil and constriction of the vessels. b. Dilation of the pupil and dilation of the vessels. c. Constriction of the pupil and constriction of the blood vessels. d. Constriction of the pupil and dilation of the blood vessels.
a
The nurse is preparing a patient who has a kidney stone for an intravenous pyelogram (IVP) and should include which action as part of the pre-planning for the IVP? a. Checking if the patient is allergic to iodine. b. Checking the record for the previous day's intake and output. c. Checking the record for time and date of last bowel movement. d. Instructing the patient on straining urine following the procedure.
a
What is a contraindication for laxative use? a. undiagnosed abd pain b. mild abd cramping c. weakness d. bloating
a
What is a side effect of Barbiturates? a. alteration in motor skills b. dry mouth c. headache d. elevated heart rate
a
What is the onset of time for an SSRI medication? a. 3-4 weeks b. 6 months c. 1 week d. several hours
a
What is the primary nursing assessment for SSRIs? a. suicide risk b. weight c. hx of seizures d. diet
a
What should be priority teaching for diarrhea? a. treat the cause of diarrhea b. instruct pt that they need to have a BM daily c. drink plenty of fluids d. decrease fiber consumption in their diet
a
Which disorder are antidepressants used to treat? a. bipolar disorder b. GERD c. insomnia d. seizures
a
Which findings are most concerning for the nurse to report to the health care provider in a patient who has just started taking citalopram? a. Agitation and restlessness b. Depression and anxiety c. Anhedonia and crying d. Nausea and dizziness
a
Which statement by the nursing student should be corrected by the nursing instructor? a. "Antacids and cimetidine can be administered at the same time to patients." b. "Famotidine and ranitidine do not have to be administered with food." c. "Ranitidine is a histamine (H2) receptor antagonist used to suppress gastric acid." d. "The dosage of cimetidine should be reduced in patients with renal impairment."
a
Which symptom of a client taking haloperidol indicates neuroleptic malignant syndrome (NMS)? a. fever b. bradycardia c. hypotension d. muscle flaccidity
a
Which teaching is appropriate for the nurse to teach the patient taking aluminum hydroxide? a. Encourage a diet high in fruits and vegetables b. Be sure to not drive while taking this medication c. Take loperamide as needed for cramping and diarrhea d. Remind this medication takes 2-3 days to work
a
The nurse is assessing a female 30-year-old patient with a history of seizures, which are controlled with the medication clonazepam. What questions are important for the nurse to ask? Select all that apply. a. Is the patient pregnant? b. Does the patient drink alcohol? c. When was the last seizure? d. Does the patient drink sugary carbonated beverages? e. How much clonazepam does the patient take daily?
a, b, c
The nurse is conducting teaching with an elderly pt newly rx'd terazosin. Which instruction(s) should be included in the teaching plan? SATA a. it is not necessary to avoid foods that contain grapefruit b. make sure to change positions slowly while on this med c. I will not take this med with antacids d. do not take sildenafil while on this med e. if you forget a dose of this med, take 2 pills as soon as you remember
a, b, c, d
A patient takes lamotrigine for seizure control and comes to the clinic reporting muscle pain and fatigue. The nurse should complete a focused assessment on which of the following priority findings that are present in Steven Johnson Syndrome (SLS)? Select all that apply. a. Reports of muscle pain b. Dizziness c. Splinter hemorrhages d. Blisters on neck and face e. Loss of taste
a, b, d
Which medication(s) have the most potential risk for injury? SATA a. amitriptyline b. diphenhydramine c. colace d. alprazolam e. buspirone
a, b, d
The nurse identifies which antidepressants as selective serotonin reuptake inhibitors (SSRIs)? Select all that apply. a. Sertraline b. Fluoxetine c. Amitriptyline d. Duloxetine e. Citalopram
a, b, e
The nurse is aware which medications are in the benzodiazepine class and are used to alleviate anxiety symptoms? Select all that apply. a. Clonazepam b. Escitalopram c. Diazepam d. Alprazolam e. Lorazepam
a, c, d, e
Which combination of drugs should the nurse question? SATA a. sertraline and selegiline b. alprazolam and citalopram c. buspirone and pheneizine d. lithium and ketorolac d. st john's wort and buspirone
a, d
A patient with schizophrenia is taking haloperidol daily. Which finding(s) would indicate the patient has developed serious side effects associated with use of this medication? Select all that apply. a. High fever b. Blurred vision c. Nervousness d. Lip smacking e. Muscle stiffness
a, d, e
A 35-year old female takes ethinyl estradiol for birth control. Which patient report is most concerning to the nurse? a. Vaginal spotting b. Recent leg pain c. Increased depression d. Pelvic cramping
b
A nurse is providing care for a client who is in preterm labor at 29 weeks of gestation. Which of the following medications should the nurse expect the provider to prescribe to accelerate fetal lung maturity? a. Oxytocin b. Betamethasone c. Methylergometrine d. Magnesium sulfate
b
A patient reports, "I have been taking this new antidepressant for a full week and it is not working!" The patient requests a prescription for a different antidepressant. Which response is most appropriate for the nurse to give to the patient? a. "I will let the provider know so we can call in another prescription for you." b. "Keep taking the medication as prescribed. It could take 2-6 weeks to work." c. "Your new medication could take 2-4 months to work so try to be patient." d. "You should have felt better in 2-3 days, let me schedule you to see the provider."
b
Bismuth, metronidazole, and amoxicillin are all used to treat which GI issue? a. GERD b. H. pylori c. diarrhea d. IBS
b
For a client taking an antacid, which instruction would be included in the teaching plan? a. decreased activity while taking antacid b. avoid taking other meds within 2 hrs of admin c. okay to take with other meds d. okay to take with milk and vitamin D
b
Medication used to treat malignant hyperthermia a. succinylcholine b. dantrolene c. baclofen d. diazepam
b
Patient teaching for NSAIDs a. can be used for peptic ulcer pain b. take with or after food or milk c. pair with corticosteroids for reduction of inflammation d. acts to reduce inflammation by decreasing uric acid levels
b
The nurse is caring for a patient admitted with alcohol withdrawal. The patient's vital signs change from 120/62 mm Hg and pulse of 84 to 168/92 mm Hg and pulse of 110. Which action will the nurse perform next? a. Administer atenolol b. Administer lorazepam c. Administer potassium d. Administer sodium
b
What is a major adverse effect of Lithium, a mood stabilizer? a. severe rash b. toxicity c. high sodium level d. hyperkalemia
b
What is a side effect of bupropion, an atypical antidepressant? a. diarrhea b. CNS excitation c. CNS depression d. bradycardia
b
What is an adverse effect of aluminum-based antacid use? a. hypotension b. constipation c. renal damage d. diarrhea
b
What is an adverse effect of benzodiazepines? a. blurred vision b. respiratory depression c. agitation d. impaired concentration
b
What is the appropriate nursing action when the nurse receives the patient's serum lithium level results of 1.0 mEq/L? a. Withhold lithium and notify the healthcare provider b. Continue prescribed lithium and serum lab tests c. Administer half of the lithium prescription and call provider d. Contact the health care provider immediately
b
What is the therapeutic range for phenytoin? a. 1-2 mcg/dl b. 10-20 mcg/dl c. 100-200 mcg/dl d. 5-10 mcg/dl
b
Which action by the nurse will most impact the effectiveness of the patient's ophthalmic solution prescribed to prevent infection post cataract surgery? a. Teaching the patient to wash their hands prior to using the ophthalmic solution b. Teaching the patient how to place the ophthalmic solution in the eye c. Teaching the patient to wear the eye patch during sleeping hours d. Teaching the patient the importance of returning for the follow up visit
b
Which statement by patient shows need for further teaching about muscle relaxers? a. I should avoid alcohol while taking this medication b. I will stop taking the med right away if I become dizzy c. I should not drive while taking muscle relaxers d. I should report abdominal pain or jaundice
b
Which value falls within the normal range for lithum? a. 2 b. 1 c. 0.5 d. 2.7
b
Which are expected side effects of oxybutynin? SATA a. hypertension b. dry eyes c. dry mouth d. diarrhea e. hypokalemia
b, c
The nurse is assessing a patient who is having a 6-month check-up to monitor carbamazepine and the neurologic system because of seizure activity. The patient has been taking carbamazepine for 2 years, but recently had the dose adjusted from 200 mg twice daily to 500 mg twice daily. What important adverse side effects of the drug will the nurse monitor? Select all that apply. a. Urine retention b. Sore throat c. Bruising d. Light-colored stool e. Mental status change
b, c, d
The nurse is teaching a patient on toxicity while taking phenytoin sodium. The nurse determines the teaching is successful after the patient describes which of the following should be reported to the health provider? Select all that apply. a. Hyperactivity b. Diplopia c. Bruising d. Slurred speech e. Hearing impairment.
b, d
Which medication(s) does the nurse expect the healthcare provider to order for a patient's new gastroesophageal reflux disease symptoms? Select all that apply. a. Lactulose b. Ranitidine c. Amoxicillin d. Esomeprazole e. Misoprostol
b, d
Which statement(s) by the patient indicate(s) understanding of the newly prescribed medication, tamsulosin? Select all that apply. a. "This medication is a beta-blocker, so it will lower my blood pressure." b. "This medication will help be able to completely empty my bladder." c. "I should expect to have frequent urination, especially at night with this medication." d. "I need to let my health care provider know if I desire to have children." e. "If I ever have chest pain, I will not be able to take nitroglycerin."
b, d
A patient with schizophrenia believes the nurse is a CIA special agent and has placed cameras in the patient's room to monitor spy activity. Those that come in the room are plotting a revolt against the government and have asked the patient to be their leader. Which class of medication is the nurse expecting the health care provider to prescribe to treat these symptoms? a. Lorazepam b. Clozapine c. Lithium d. Memantine
c
A postpartum patient is experiencing excessive bleeding within the first 24 hours after delivery. Which medication does the registered nurse expect the physician to order to help reduce bleeding? a. Estrogen b. Betamethasone c. Methylergometrine d. Magnesium sulfate
c
All classes of antidepressants have a black box warning for... a. hypertensive crisis b. seizures c. suicide d. anticholinergic effects
c
How long should the nurse stop tube feeding before and after admin of phenytoin? a. 20-30 min b. 3-4 hrs c. 1-2 hrs d. 5-10 min
c
Most anxiety medications work to reduce anxiety by... a. increasing CNS activity b. reducing PNS activity c. decreasing CNS activity d. decreasing PNS activity
c
Patient takes omeprazole and warfarin at bedtime. The nurse should be concerned because: a. omeprazole can cause encephalopathy if mixed with other meds b. omeprazole should be taken before meals c. omeprazole magnifies the effects of warfarin d. omeprazole may inhibit warfarin absorption
c
Patient teaching for sildenafil a. take with grapefruit juice b. a high-fat diet is recommended with this medication c. avoid taking with nitrates d. take this medication 2 hrs before sexual activity
c
Patient teaching for timing of antiemetic medications for chemotherapy-related nausea a. take at the first sign of nausea b. take at the beginning of chemotherapy infusion c. take 30 min prior to chemotherapy d. take 4 hrs prior to chemotherapy
c
Priority monitoring for client receiving succinylcholine a. pain b. LOC c. respiratory status d. urine output
c
Proton Pump Inhibitors perform which function? a. vasoconstriction of gastric vessels b. vasodilation of gastric vessels c. reduction of gastric acid secretion d. block histamine receptors
c
The nurse is caring for a pregnant client with preeclampsia who is on magnesium sulfate therapy. The nurse finds that the patient is very drowsy with a respiratory rate of 10 breaths per minute. The patient's deep tendon reflexes are decreasing. Which medication would the nurse anticipate the physician to prescribe? a. Intravenous protamine sulfate b. Intramuscular methylergometrine c. Intravenous calcium gluconate d. Subcutaneous betamethasonea
c
The patient taking paroxetine reports not being compliant with taking the newly prescribed antidepressant, paroxetine. Which side effect is commonly stated as the reason for discontinuing use of paroxetine? a. Bradycardia b. Sun sensitivity c. Impotence d. Hematuria
c
Treatment of h.pylori includes... a. 2 or more antibiotics b. corticosteroids c. 2 or more antibiotics + an anti secretory agent d. antifungals
c
What happens when a client takes either Melatonin, Kava, or Valarian? a. insomnia b. CNS excitation c. decreased mental alertness d. nausea and vomiting
c
What is a priority when teaching your client about lithium, a mood stabilizer? a. eat a low sodium diet b. drink caffeinated beverages c. maintain fluid intake of 2-3 L daily d. restrict fluid intake to less than 2 L daily
c
When providing education to a patient who is newly prescribed cyclobenzaprine, which instructions should be included? Select all that apply. a. Notify the provider of a temperature greater than 99.5 F b. Report any drowsiness to the health care provider. c. Do not stop taking this medicationa abruptly. d. Limit wine consumption to 3-4 glasses per day while taking this medication. e. Avoid taking ibuprofen while taking this medication.
c
Which action should the nurse perform for a patient with a seizure disorder prescribed phenytoin 100 mg intravenous? a. Administer the drug at 100 mg/min IV push b. Mix the phenytoin in a dextrose solution before administration c. Mix the phenytoin in a saline solution before administration d. Administer the drug at 50 mg/min IV push
c
Which non-pharm suggestions can be used to treat nausea? a. hot yoga b. vigorous exercise c. sea bands d. sunlight
c
Which of the following is inappropriate teaching for a client on phenytoin? a. this medication has multiple drug to drug interactions b. you should see your dentist regularly c. this medication can be stopped once your seizures stop d. you should use a barrier form of birth control
c
A patient is prescribed timolol ophthalmic drops to decrease the intraocular eye pressure associated with glaucoma. Which comorbidity should the nurse notify the health care provider about? Select all that apply. a. Cataracts b. Diabetes c. Asthma d. Heart failure e. Bradycardia
c, d
A nurse is assessing a client who has preeclampsia with severe symptoms and is receiving IV magnesium sulfate. What should the nurse monitor in this patient related to the potential side effects? Select all that apply. a. Fundal firmness b. Fetal lung maturity c. Tendon reflexes d. Vaginal bleeding e. Respiratory rate
c, e
A client with Parkinson's disease (PD) was prescribed carbidopa and levodopa a few months ago. How does the nurse evaluate if the medication is therapeutically effective in the client? a. The client has increased urinary output b. The client has increased diarrhea c. The client has increased shuffling d. The client has decreased tremors at rest
d
A patient taking oxybutynin for urinary incontinence asks why she is having trouble having bowel movements. What is the appropriate response from the nurse? a. Oxybutynin decreases the need to void, as well as the need to relieve the bowels. b. Oxybutynin relaxes the muscle contractions in the bowel and bladder to control frequency. c. Oxybutynin increases muscle spasticity, resulting in constipation. d. Oxybutynin suppresses peristalsis in the gut, resulting in constipation.
d
A patient who has been successfully taking clonazepam for anxiety and seizures the past year arrives at the clinic four days after being out of the medication. The patient tells the nurse, "I did not have the money to buy my medication." Which is the best response by the nurse? a. "You seem to be handling your anxiety and seizures fine, so I would not buy any more of your medication." b. "Come back in a week to see if you are really able to manage your anxiety and seizures without medication." c. "If you feel fine now, you should be able to manage your symptoms without medications." d. "Clonazepam is a benzodiazepine and you could have withdrawal symptoms for days to weeks."
d
An antihistamine can be administered with reglan for what reason? a. dry up gastric secretions b. promote sleep c. decrease diarrhea d. decrease EPS side effects
d
Benzodiazepines work with which neurotransmitter? a. epinephrine b. acetylcholine c. norepinephrine d. GABA
d
Extrapyramidal Symptoms are similar to which disorder? a. Alzheimers symptoms b. anxiety disorders c. manic disorders d. Parkinson's symptoms
d
H2 antagonists, are used to treat which disorder? a. gastric and duodenal ulcers b. gastric hypersecretory disorders c. GERD d. all of the above
d
Hepatic fibrosis is an adverse effect of what medication? a. acetaminophen b. cyclobenzaprine c. pancuronium d. methotrexate
d
Opioid-related drugs, such as loperamide are used to treat which side effect? a. constipation b. vomiting c. nausea d. diarrhea
d
Patient receiving an anticholinergic drug to treat nausea should be taught to expect what? a. diarrhea b. lacrimation c. bradycardia d. dry mouth
d
The nurse instructs a patient taking a calcium based antacid about which common side effect? a. Gastric pH of 3 b. Miscarriage c. Peptic ulcer d. Constipation
d
The nurse is reviewing a patient's medication list and identifies which medication ending with which suffix as a proton-pump inhibitor? a. "-tidine" b. "-statin" c. "-sone" d. "prazole"
d
The patient's spouse comments to the clinic nurse, "I am so glad the antidepressant has started working. It has been a long two weeks. Now, I don't have to worry that she will try to commit suicide." What is the nurse's best and most therapeutic response? a. "If I was you, I would never trust that she won't commit suicide. Once you consider it, it is always a risk." b. "There is no need to worry about that now. You got her in just in time." c. "Why would you worry about her committing suicide. She has you and a beautiful family." d. "You should continue to watch her because now she may have the energy to act on her intentions."
d
The psychiatric health care provider orders fluphenazine for a patient with schizophrenia. The nurse administering the medication will monitor for which side effect? a. Increased confusion. b. Low blood sugar. c. Hypervigilance d. Dry mouth.
d
What is the action of osmotic laxatives? a. softens stool by increasing bulk b. increases water secretion and intestinal motility c. soften stool by lowering surface tension d. draws water into the intestinal lumen to promote peristalsis
d
What is the most common over the counter medication used to treat depression? a. ginko b. kava c. valarian d. St. John's wort
d
What medication classification can be used to treat Peptic Ulcer Disease (PUD)? a. antivirals b. antidiarrheals c. antiemetics d. proton pump inhibitors
d
When a client is given sucralfate, the nurse knows that its mode of action is what? a. to neutralize gastric acidity b. inhibit gastric acid secretion c. suppress gastric acid by inhibiting the H2/K ATPase enzyme d. to form a viscous substance covering of ulcer
d
Which class of medications are used to treat epilepsy? a. SSRIs b. SNRIs c. herbal perparation d. benzodiazepines
d
Which is NOT a symptom of tardive dyskinesia? a. tongue thrusting b. eye blinking c. repetitive involuntary movements d. fine tremors
d
