Pharm Exam - Respiratory, Anti-Microbials, Anti-fungals, Anti-virals, Diabetic, Thyroid

Other indications for acetylcysteine?

1) Renal prophylaxis prior to administration of contrast dye for diagnostic testing, 2) acetaminophen overdose

A nurse monitoring a client who is receiving intravenous theophylline checks the client's most recent blood theophylline level. The nurse documents that the level is in the therapeutic range if which value is reported? 1. 8 mcg/mL 2. 14 mcg/mL 3. 24 mcg/mL 4. 32 mcg/mL

2. 14 mcg/mL

Which question should the nurse ask a pt prior to the initiation of treatment with IV infusions of gentamicin sulfate? A. "Are you having difficulty hearing?" B. "Have you ever been diagnosed with cancer?" C. "Do you have any type of diabetes mellitus?" D. "Have you ever had anemia?"

A Rationale: Complications of gentamicin sulfate therapy include ototoxicity, nephrotoxicity, and neurotoxicity. Determining if the client is hard of hearing prior to initiation of this aminoglycoside will be helpful as the treatment progresses and ototoxicity is identified as a possible complication. Options B, C, and D are important elements of any medical history, but they do not have the priority of option A when assessing for complications of aminoglycoside therapy.

1) The nurse is planning health teaching about tetracycline for a 28-year-old patient. Which drug interactions should be included in the patient teaching? Select all that apply a. Tetracycline increases the effects of oral anticoagulants. b. Tetracycline decreases the effects of oral contraceptives. c. Tetracycline increases the effects of oral contraceptives. d. Antacids decrease absorption of tetracycline.

A B D

Histamine

A chemical mediator that, when released by cells in response to injury and in allergic and inflammatory reactions, causes contraction of smooth muscle and dilation of capillaries.

Minocycline, 50 mg PO every 8 hours, is prescribed for an adolescent girl diagnosed with acne. The nurse discusses self-care with the client while she is taking the medication. Which teaching points should be included in the discussion? (Select all that apply.) A. Report vaginal itching or discharge. B. Take the medication at 0800, 1500, and 2200 hours. C. Protect skin from natural and artificial ultraviolet light. D. Avoid driving until response to medication is known. E. Take with an antacid tablet to prevent nausea. F. Use a nonhormonal method of contraception if sexually active.

A,C,D,F Rationale:Adverse effects of tetracyclines include superinfections, photosensitivity, and decreased efficacy of oral contraceptives. Therefore, the client should report vaginal itching or discharge (A), protect the skin from ultraviolet light (C), and use a nonhormonal method of contraception (F) while on the medication. Minocycline is known to cause dizziness and ataxia, so until the client's response to the medication is known, driving (D) should be avoided. Tetracyclines should be taken around the clock (B) but exhibit decreased absorption when taken with antacids, so (E) is contraindicated.

A female pt with trichomoniasis (Trichomonas vaginalis) receives a prescription for metronidazole. Which instruction is most important for the nurse to include in this client's teaching plan? A. Avoid alcohol consumption. B. Complete the medication regimen. C. Use a barrier contraceptive method. D. Treat partner(s) concurrently.

A. Clients should be instructed to avoid alcohol and products containing alcohol while taking metronidazole because of the possibility of a disulfiram-like reaction. Option B helps prevent the development of metronidazole-resistant T. vaginalis. To prevent reinfection, clients should abstain from sexual contact or use a barrier contraceptive while taking metronidazole, and their partner(s) should be treated concurrently. The most important instruction for client well-being is option A.

A client is receiving antiinfective drug therapy for a postoperative infection. Which complaint should alert the nurse to the possibility that the client has contracted a superinfection? A. "My mouth feels sore. B. "I have a headache." C. "My ears feel plugged up." D. "I feel constipated."

A. "My mouth feels sore. " Stomatitis caused by a thrush infection, which can cause mouth pain, is a sign of superinfection. Options B, C, and D are more typical side effects, rather than symptoms, of a superinfection

A female client who has started long-term corticosteroid therapy tells the nurse that she is careful to take her daily dose at bedtime with a snack of crackers and milk. Which is the best response by the nurse? A. Advise the client to take the medication in the morning, rather than at bedtime. B. Teach the client that dairy products should not be taken with her medication. C. Tell the client that absorption is improved when taken on an empty stomach. D. Affirm that the client has a safe and effective routine for taking the medication.

A. Advise the client to take the medication in the morning, rather than at bedtime. Rationale: Daily doses of long-term corticosteroid therapy should be administered in the morning to coincide with the body's normal secretion of cortisol. Clients receiving long-term corticosteroids need to increase their intake of calcium, which generally means an increase in dairy products. Corticosteroids can often cause gastrointestinal distress and should be administered with meals. The client has established a safe routine by taking the medication with a snack, but the routine will be more effective if done in the morning.

The nurse is providing discharge instructions to a client who has received a prescription for an antibiotic that is hepatotoxic. Which information should the nurse include in the instructions? A. Avoid ingesting any alcohol or acetaminophen. B. Schedule a follow-up visit for a liver biopsy in 1 month. C. Activities that are strenuous should be avoided. D. Notify the health care provider of any increase in appetite.

A. Avoid ingesting any alcohol or acetaminophen. Rationale: Combining hepatotoxic drugs, such as acetaminophen and alcohol, increases the risk of liver damage, so option A is an important discharge instruction. Although clients who receive hepatotoxic drugs should be screened for any changes in serum liver function test (LFT) results, option B is not indicated. Rest is advantageous during an infectious process, but activity restriction is unnecessary. A client who is receiving a hepatotoxic drug should report any hepatotoxic symptoms, such as jaundice, dark urine, or light-colored stools, but an increased appetite does not need medical attention.

A client receives a prescription for theophylline PO to be initiated in the morning after the dose of theophylline IV is complete. The nurse determines that a theophylline level drawn yesterday was 22 mcg/mL. Based on this information, which action should the nurse implement? A. Hold the theophylline dose and notify the health care provider. B. Start the client on a half-dose of theophylline PO.

A. Hold the theophylline dose and notify the health care provider. Rationale: The therapeutic range for theophylline is 10 to 20 mcg/mL, so the theophylline dose should be held for fear of causing toxicity. Options B, C, and D are not indicated actions based on the reported theophylline level.

A female client is receiving tetracycline for acne. Which client teaching should the nurse include? A. Oral contraceptives may not be effective. B. Drinking cranberry juice will promote healing. C. Breast tenderness may occur as a side effect. D. The urine will turn a red-orange color.

A. Oral contraceptives may not be effective. Rationale: Certain antibiotics, such as tetracycline, decrease the effectiveness of oral contraceptives. Options B, C, and D do not convey accurate information related to client teaching about this medication

The nurse is preparing to administer amphotericin B IV to a client. What laboratory data is most important for the nurse to assess before initiating an IV infusion of this medication? A. Serum potassium level B. Platelet count C. Serum creatinine level D. Hemoglobin level

A. Serum potassium level Rationale: The nurse should obtain baseline potassium levels prior to beginning drug therapy because amphotericin B changes cellular permeability, allowing potassium to escape from the cell, which could lead to a decrease in the serum potassium level and severe hypokalemia. Options B, C, and D are helpful laboratory values, but they do not have the importance of option A in determining if amphotericin B can be administered safely via IV infusion.

A pediatric patient is ordered to receive cefadroxil (Duricef) postoperatively. The nurse questions the order because A. The client has an allergy to penicillin. B. The medication is contraindicated for children. C. Duricef cannot be given with pain medication. D. The medication cannot be given by mouth

A. The client has an allergy to penicillin. Rationale: Approximately 10% of persons allergic to penicillin are also allergic to cephalosporins.

The nurse plans to draw blood samples for the determination of peak and trough levels of gentamicin sulfate in a client receiving IV doses of this medication. When should the nurse plan to obtain the peak level? A. Thirty minutes after the dose is administered B. Immediately before giving the next dose C. When the next electrolyte levels are drawn D. Sixty minutes after the dose is administered

A. Thirty minutes after the dose is administered Rationale: Peak drug serum levels are achieved 30 minutes after the IV administration of aminoglycosides, so option A is the optimum time to get a peak level. Options B, C, and D are not appropriate times associated with peak levels for gentamicin.

Combination drug commonly used to treat COPD?

Advair (Fluticasone + salmeterol). Purple disk. NOT a rescue drug, keeps airway open for longer period of time.

Before administration of intravenous amphotericin B, what will the nurse do? A. Set up an IV solution with potassium. B. Premedicate the client with an antipyretic, antihistamine, and antiemetic as ordered. C. Administer insulin as ordered to prevent severe hyperglycemia. D. Administer intravenous dextrose as ordered to prevent severe hypoglycemia

Answer: B Side effects to Amphotericin B can be severe. Pre-medication to minimize these side effects are often ordered

A patient asks the nurse why she gets yeast infections after a course of antibiotics. The nurse explains: A. The antibiotics lower your white blood cell count." B. "People are poorly nourished and hydrated after an infection." C. "Yeast infections happen if the antibiotic is not taken for the full course." D. "Superinfections are common when the normal body flora are disrupted."

Answer: D The patient should be advised to ingest buttermilk or yogurt to prevent superinfection of the body's normal flora. Acidophillus supplements are often recommended. If antibiotics are therapeutic the WBC count should trend downward

A nurse is teaching a patient how to recognize symptoms of hypoglycemia. Which symptoms should be included in the teaching? (Select all that apply.) a. Headache b. Nervousness c. Bradycardia d. Sweating e. Thirst f. Sweet breath odor

Answers: a, b, d;

-ines

Anti-Histamines. Benadryl, Zyrtec, Claritin. Diphenhydramine

Anticholinergic Indications

Asthma, COPD

Respiratory Beta 2 agonist indications

Asthma, COPD

Fluticasone propionate and salmeterol combination inhalation is ordered for a patient with chronic obstructive pulmonary disease. What does the nurse know about this medication? (Select all that apply.) a. It can be used to treat an acute attack. b. It is delivered as a dry-powder inhaler. c.. It contains a beta1 agonist and cromolyn. d. It is taken as one puff two times a day. e. It promotes bronchodilation.

B, D, E

The nurse is preparing a plan of care for a client receiving the glucocorticoid methylprednisolone. Which nursing diagnosis reflects a problem related to this medication that should be included in the care plan? A. Ineffective airway clearance B. Risk for infection D. Impaired gas exchange

B. Risk for infection Rationale: Corticosteroids depress the immune system, placing the client at risk for infection. Although options A, C, and D reflect diagnostic statements that may be applicable to this client, only option B is directly related to the administration of this medication

Which type of insulin has an ONSET of 30 min, PEAK of 2 hrs? A. Rapid-acting B. Short-acting C. Intermediate-acting D. Long-acting

B. Short-acting

A middle-aged adult is diagnosed with tuberculosis. Which of the following is true of treatment for this diagnosis? A. Treatment may take about 10 days to 2 weeks. B. Usually two to three agents are needed. C. The bacteria is usually resistant to treatment therapy. D. Treatment for tuberculosis is usually without side effects.

B. Usually two to three agents are needed.

MoA of B2 agonists?

Binds to B2 receptors in airway smooth muscle ==> BRONCHODILATION

Anticholinergic MoA

Blocks ACh receptors in airway smooth muscle ==> bronchodilation

Leukotriene antagonist MoA

Blocks the action of leukotrienes at the receptor site ==> decreases inflammation

Pts on inhaled corticosteroids and bronchodilators should be administered which drugs first?

Bronchodilator. Dilates airway, anything that follows will be more effective because open airway.

Amoxicillin, 500 mg PO every 8 hours, is prescribed for a client with an infection. The drug is available in a suspension of 125 mg/5 mL. How many milliliters should the nurse administer with each dose? A. 10 B. 15 C. 20 D. 25

C

The nurse teaches a patient taking amphotericin B to report which signs and symptoms to the health care provider? a. Change in sight b. Decrease in hearing c. Decrease in urine d. Painful red rash and blisters

C

The patient diagnosed with HIV associated infection is about to receive an initial dose of amphotericin B, an anti-fungal agent. Which intervention should the nurse implement first? a. Administer the drug in 500mL D5W over 6 hours b. Administer morphine 2 mg IVP over 5 minutes c. Administer a test dose of 1mg over 20 minutes d. Administer acetaminophen 650 mg PO

C

A patient enters the emergency department with a draining wound. Once the patient is admitted and assessed, the priority nursing intervention is to A. Administer the ordered antibiotics B. Teach the client about the ordered antibiotics C. Culture the wound D. Enforce droplet isolation precautions

C Rationale: The priority nursing intervention is to obtain a culture and antibiotic sensitivity testing of infective organism (C&S). Antibiotic therapy can interfere with proper identification of the organism and correct sensitivity.

The nurse is scheduling a client's antibiotic peak and trough levels with the laboratory personnel. What is the best schedule for drawing the trough level? A. Give the dose of medication, and call the laboratory to draw the trough STAT. B. Arrange for the laboratory to draw the trough 1 hour after the dose is given. C. Instruct the laboratory to draw the trough immediately before the next scheduled dose. D. Give the first dose of medication after the laboratory reports that the trough has been drawn.

C Rationale:The best time to draw a trough is the closest time to the next administration. Option A will provide a peak level. Option B will not provide the most accurate trough level. The medication is given before peak and trough levels are obtained.

What should the nurse teach a client who is taking isoniazid (INH)? a. "You will need to take vitamin C to potentiate the action of INH." b. "You should not be on that drug. I will check with the health care provider." c. "Pyridoxine will prevent numbness and tingling that can occur when taking INH." d. "Multidrug therapy is necessary to prevent the occurrence of resistant bacteria."

C Pyridoxine (Vitamin B6) should be taken to prevent peripheral neuropathy

Which of the following findings in this patient requires immediate attention? A) Fingerstick glucose reading of 285 mg/dL B) Numbness and tingling in both feet C) Complaint of feeling too warm in the room w/ mild perspiration D) Small open wound on the left great toe

C) Complaint of feeling too warm in the room w/ mild perspiration

Opioid agonist used as cough suppressant?

Codeine

Which of the following statements will the nurse include when teaching a patient about cephalosporin therapy? A, "Avoid ingesting yogurt when taking this medication." B. "Stop taking the medication when you feel better." C. "Immediately stop taking the medication if you develop nausea." D. "Inform your healthcare provider if you develop mouth ulcers."

Correct Answer: D The patient should be instructed to report signs of superinfection, such as mouth ulcers, vaginal discharge, diarrhea. Ingestion of buttermilk or yogurt may prevent superinfection of the intestinal flora. The entire course of the medication should be taken; and the medication should be taken with food if nausea develops.

An infant is diagnosed with thrush. The nurse anticipates that the client will be treated with: A. Metronidazole (Flagyl) B. Amphotericin B C. Isoniazid (INH) D. Fluconazole (Diflucan)

Correct Answer: D Thrush = candidiasis, a fungal infection Many anti-fungals end in ZOLE

-sones

Corticosteroids (glucocorticoids). Fluticasone. NOT rescue therapy

Beclomethasone has been prescribed for a patient with allergic rhinitis. What should the nurse teach the patient regarding this medication? a. This may be used for an acute attack. b. An oral form is available if the patient prefers to use it. c. Avoid large amounts of caffeine intake because an increased heart rate may occur. d. With continuous use, dryness of the nasal mucosa/lining may occur.

D

Zanamivir is ordered for a patient. What does the nurse know about use of this drug? a. It is a treatment for herpes simplex virus type 2. b. Oral administration is for treatment of herpes simplex virus type 1. c. It treats varicella-zoster virus. d. Administration must be within 48 hours of onset of symptoms to be effective.

D

A client is ordered 22 mg of gentamicin by IM injection. The drug is available in 20 mg/2 mL. How many milliliters should be administered? A. 1.8 B. 2.0 C. 2.4 D. 2.2

D. 2.2

The health care provider prescribes ipratropium for a client. An allergic reaction to which other medication would cause the nurse to question the prescription for? A. Albuterol B. Theophylline C. Metaproterenol D. Atropine sulfate

D. Atropine sulfate Rationale: Clients who have experienced allergic reactions to atropine sulfate and belladonna alkaloids may also be allergic to ipratropium, so the prescription for Atrovent should be questioned. Allergies to options A, B, and C would not cause the nurse to question a prescription for ipratropium.

Corticosteroid MoA

Decreases obstruction in airway by reducing inflammation.

How is Acetylcysteine (Mucomyst)administered?

Given via nebulizer.

What type of infection is TB?

Gram +: Mycobacterium tuberculosis

Antihistamines

H1 Receptor Antagonists, 1st Gen • Chlorpheniramine • Diphenhydramine • Terfenadine H1 Receptor Antagonists, 2nd Gen • Desloratadine • Fexofenadine • Loratadine • Cetirizine

How do you monitor a pt's response to anticholinergic?

If SoB & RR decrease, drug has been effective.

Theophylline MOA

Inhibits phosphodiesterase → more cAMP → bronchodilation

Theophylline SE

NARROW THERAPEUTIC INDEX!(10-20) 21 = toxic: cardiotoxicity (tachycardia, use with caution), neurotoxicity ( contraindicated in pts w/seizure disorders)

Rifampin SE

Orange body fluids Drug interactions (induces p450) Hepatotoxicity

SE of B2 agonists?

Primary SE = TACHYCARDIA (because of overflow to B1)

MOA of mucolytic agents

Promote the removal of excessive respiratory secretions bythinning mucus and facilitating ciliary action ==> promoting effective cough. Expectorant effect.

example of leukotriene antagonist

Singulair (montelukast)

During the initial nursing assessment history, a client tells the nurse that he is taking tetracycline hydrochloride for urethritis. The nurse is most concerned if the client reports taking which medication concurrently? A.Sucralfate B. Hydrochlorothiazide C. Acetaminophen D. Phenytoin

Sucralfate Rationale: Sucralfate is used to treat duodenal ulcers and will bind with tetracycline hydrochloride, inhibiting this antibiotic's absorption. Options B, C, and D have no drug interaction properties that prohibit concurrent use with tetracycline hydrochloride.

You should never mix Lantus or Levimir. T/F?

True

Examples of allergic responses

Urticaria Rash Allergic rhinitis Bronchospasm

A client with tuberculosis has been taking isoniazid, and now the health care provider has added rifampin to the medication regimen. The client calls the nurse and reports that her urine has been red-orange since she started taking the rifampin. Which response should the nurse give to the client? a. "This is an expected side effect of the rifampin." b. "Bring a urine specimen to the health care provider's office for analysis." c. "The change in urine color is a result of the combination of medications." d. "Increase your fluid intake. The medication may be causing hemorrhagic cystitis."

a

Which nursing intervention(s) should the nurse consider for the patient taking ciprofloxacin? (Select all that apply.) a. Obtain culture before drug administration. b. Tell the patient to avoid taking ciprofloxacin with antacids. c. Monitor the patient for tinnitus. d. Encourage fluids to prevent crystalluria. e. Infuse intravenous ciprofloxacin over 60 minutes. f. Monitor blood glucose because ciprofloxacin can decrease effects of oral hypoglycemics.

a, b, c, d, e;

The nurse is teaching a patient about trimethoprim-sulfamethoxazole. Which instructions will the nurse plan to include? (Select all that apply.) a. Report any bruising or bleeding. b. Report any diarrhea or bloody stools. c. Report any fever, rash, or sore throat. d. Avoid unprotected exposure to sunlight. e. Report thirst and polyuria.

a, b, c, d.

A patient is taking a cephalosporin. The nurse anticipates which appropriate nursing intervention(s) for this medication? (Select all that apply.) a. Monitoring renal function studies b. Monitoring liver function studies c. Infusing intravenous medication over 30 minutes d. Monitoring the patient for mouth ulcers e. Advising the patient to stop the medication when he or she feels better

a, b, c, d;

Which instruction(s) will the nurse include when teaching patients about gentamicin? (Select all that apply.) a. Patients should report any hearing loss. b. Patients should use sunscreen when taking gentamicin. c. Intravenous gentamicin will be given over 20 minutes. d. Patients are monitored for mouth ulcers and vaginitis. e. Peak levels will be drawn 30 minutes before the intravenous dose. f. Patients should increase fluid intake.

a, b, d, f;

Penicillin G has been prescribed for a patient. Which nursing intervention(s) should the nurse perform for this patient? (Select all that apply.) a. Collect culture and sensitivity before the first dose. b. Monitor the patient for mouth ulcers. c. Instruct the patient to limit fluid intake to 1000 mL/day. d. Have epinephrine on hand for a potential severe allergic reaction. e. No particular interventions are required for this patient.

a, b, d;

The nurse will monitor the patient taking albuterol for which conditions? (Select all that apply.) a. Palpitations b. Hypertension c. Hypoglycemia d. Bronchospasm e. Uterine contractions

a, b, d;

5. A patient is taking azithromycin. Which nursing intervention(s) would the nurse plan to implement for this patient? (Select all that apply.) a. Monitor periodic liver function tests. b. Dilute with 50 mL of 5% dextrose in water for intravenous administration. c. Instruct the patient to report any loose stools or diarrhea. d. Instruct the patient to report evidence of superinfection. e. Teach the patient to take oral drug 1 hour before or 2 hours after meals. f. Advise the patient to avoid antacids from 2 hours prior to 2 hours after administration.

a, c, d, e, f;

A patient has been diagnosed with tuberculosis and is to begin antitubercular therapy with isoniazid, rifampin, and ethambutol. What should the nurse do? (Select all that apply.) a. Encourage periodic eye examinations. b. Instruct the patient to take medications with meals. c. Suggest that the patient take antacids with medications to prevent gastrointestinal distress. d. Advise the patient to report numbness and tingling of the hands or feet. e. Alert the patient that body fluids may develop a red-orange color. f. Teach the patient to avoid direct sunlight and to use sunblock.

a, d, e, f;

Acyclovir has been ordered for a patient with genital herpes. Which nursing interventions are appropriate for this patient? (Select all that apply.) a. Monitor the patient's blood urea nitrogen and creatinine. b. Monitor the patient's blood pressure for hypertension. c. Administer intravenous acyclovir over 30 minutes. d. Advise maintenance of adequate fluid intake. e. Monitor complete blood count for blood dyscrasias.

a, d, e;

A patient with chronic obstructive pulmonary disease is taking the leukotriene antagonist montelukast. The nurse is aware that this medication is given for which purpose? a. Maintenance treatment of asthma b. Treatment of acute asthmatic attack. c. Reversing bronchospasm associated with chronic obstructive pulmonary disease d. Treatment of inflammation in chronic bronchitis

a.

A patient is beginning isoniazid and rifampin treatment for tuberculosis. The nurse gives the patient which instruction? a. Do not skip doses. b. Take both drugs three times daily with food. c. Take an antacid with the drugs to decrease gastrointestinal distress. d. Take rifampin initially, and begin isoniazid after 2 months.

a. Do not skip doses.

The nurse enters a patient's room to find that his heart rate is 120, his blood pressure is 70/50, and he has red blotching of his face and neck. Vancomycin is running intravenous piggyback. The nurse believes that this patient is experiencing a severe adverse effect called red man syndrome. What action will the nurse take? a. Stop the infusion and call the health care provider. b. Reduce the infusion to 10 mg/minute. c. Encourage the patient to drink more fluids, up to 2 L/day. d. Report onset of Stevens-Johnson syndrome to the health care provider.

a. Stop the infusion and call the health care provider.

A patient is receiving tetracycline. Which advice should the nurse include when teaching this patient about tetracycline? a. Take sunscreen precautions when at the beach. b. Take an antacid with the drug to prevent severe gastrointestinal distress. c. Obtain frequent hearing tests for early detection of hearing loss. d. Obtain frequent eye checkups for early detection of retinal damage.

a. Take sunscreen precautions when at the beach.

Amoxicillin is prescribed for a patient who has a respiratory infection. The nurse is teaching the patient about this medication and realizes that more teaching is needed when the patient makes which statement? a. This medication should not be taken with food. b. I will take my entire prescription of medication. c. I should report to the physician any genital itching. d. If I experience any excess bleeding, I will contact the health care provider.

a. This medication should not be taken with food.

A patient has been admitted to the unit with a stage IV pressure ulcer. After 2 days, the wound culture results come back positive for MRSA. The nurse knows that the drug of choice for the treatment of MRSA infections is which drug? a. vancomycin b. gentamicin c. ciprofloxacin (Cipro) d. metronidazole (Flagyl)

a. vancomycin

Antidiabetic drugs are designed to control signs and symptoms of diabetes mellitus. The nurse primarily expects a decrease in which? a. Blood glucose b. Fat metabolism c. Glycogen storage d. Protein mobilization

a;

-tropiums

anticholinergic bronchodilators. Ipratropium & titotropium. Maintenance therapy, NOT rescue therapy. Pts usually prescribed both anticholinergics & b2 agonists.

A patient diagnosed w/ TB is being administered rifampin. Which information should the nurse tell the patient? a) Instruct the patient to consume fewer dark green leafy vegetables b) Explain that the urine and other body fluids will turn orange c) Encourage the patient to stop smoking while taking this medication d) Tell the patient to increase fluid intake to 3 L per day.

b) Explain that the urine and other body fluids will turn orange

The nurse is teaching a patient about diphenhydramine. Which instructions should the nurse include in the patient's teaching plan? (Select all that apply.) a. Take medication on an empty stomach to facilitate absorption. b. Avoid alcohol and other central nervous system depressants. c. Notify a health care provider if confusion or hypotension occurs. d. Use sugarless candy, gum, or ice chips for temporary relief of dry mouth. e. Avoid handling dangerous equipment or performing dangerous activities until stabilized on the medication.

b, c, d, e.

A patient who is taking epinephrine is also taking several other medications. The nurse should realize that there is a possible drug interaction with which drugs? (Select all that apply.) a. Albuterol b. Metoprolol c. Propranolol d. Digoxin e. Methyldopa

b, c, d;

A patient is newly diagnosed with type 1 diabetes mellitus and requires daily insulin injections. Which instructions should the nurse include in the teaching of insulin administration? a. Teach family members how to administer glucagon by injection when the patient has a hyperglycemic reaction. b. Instruct the patient about the necessity for compliance with prescribed insulin therapy. c. Teach the patient that hypoglycemic reactions are more likely to occur at the onset of action time. d. Instruct the patient in the care and handling of the insulin container and syringe.

b, d.

A patient is prescribed glipizide. The nurse knows that which side effects and adverse effects may be expected? (Select all that apply.) a. Tachypnea b. Tachycardia c. Increased alertness d. Increased weight gain e. Visual disturbances f. Hunger

b, e, f;

A patient tells the nurse that he has started to take an over-the-counter antihistamine, diphenhydramine. In teaching about side effects, what is most important for the nurse to tell the patient? a. To avoid insomnia, do not to take this drug at bedtime. b. Avoid driving a motor vehicle until stabilized on the drug. c. Nightmares and nervousness are more likely in an adult. d. Medication may cause excessive secretions.

b. Avoid driving a motor vehicle until stabilized on the drug.

A patient with chronic obstructive pulmonary disease has an acute bronchospasm. The nurse anticipates that the health care provider will prescribe which medication? a. Zafirlukast b. Epinephrine c. Dexamethasone d. Beclomethasone

b. Epinephrine

A patient taking isoniazid is worried about the side effects. Which of the following does the nurse realize is an adverse effect of the drug? a. Ototoxicity b. Hepatotoxicity c. Nephrotoxicity d. Optic nerve toxicity

b. Hepatotoxicity

A patient is to receive insulin before breakfast, and the time of breakfast tray delivery is variable. The nurse knows that which insulin should not be administered until the breakfast tray has arrived and the patient is ready to eat? a. NPH b. Lispro c. Glargine d. Regular

b. Lispro

A patient has been prescribed guaifenesin. The nurse understands that the purpose of the drug is to accomplish what? a. Treat allergic rhinitis and prevent motion sickness b. Loosen bronchial secretions so coughing can eliminate them c. Compete with histamine for receptor sites, thus preventing a histamine response d. Stimulate alpha-adrenergic receptors, thus producing vascular constriction of capillaries in nasal mucosa

b. Loosen bronchial secretions so coughing can eliminate them

-terols

beta 2 agonists (albuterol, levalbuterol). RESCUE THERAPY drugs.

A patient is receiving a daily dose of NPH insulin at 7:30 am. The nurse expects the peak effect of this drug to occur at what time? a. 8:15 am b. 10:30 am c. 5:00 pm d. 11:00 pm

c. 5:00pm

Nadolol is prescribed for a patient. The nurse realizes that this drug is a beta-adrenergic blocker and that this drug classification is contraindicated for patients with which condition? a. Hypothyroidism b. Angina pectoris c. Bronchial asthma d. Liver dysfunction

c. Bronchial asthma

A patient is prescribed aminophylline-theophylline. For what adverse effect should the nurse monitor the patient? a. Drowsiness b. Hypoglycemia c. Increased heart rate d. Decreased white blood cell count

c. Increased heart rate

A patient is receiving intravenous aminophylline. The nurse checks the patient's lab values and sees the serum theophylline level is 32 mcg/mL. What action should the nurse take? a. Assess the patient's breath sounds for improvement. b. Increase the dosage per sliding-scale directions. c. Notify the health care provider of the level. d. Have the laboratory collect another sample to verify the results.

c. Notify the health care provider of the level.

A patient complains of a sore throat and has been told it is due to beta-hemolytic streptococcal infection. The nurse anticipates that the patient has which acute condition? a. Rhinitis b. Sinusitis c. Pharyngitis d. Rhinorrhea

c. Pharyngitis

A patient is diagnosed with type 2 diabetes mellitus. The nurse is aware that which statement is true about this patient? a. The patient is most likely a teenager. b. The patient is most likely a child younger than 10 years. c. Heredity and obesity are major causative factors. d. Viral infections contribute most to disease development.

c;

The nurse is preparing to administer the following medications. Which of the following should the nurse question? a) The patient receiving prednisone whose fasting glucose is 140 mg/dL b) The patient receiving ceftriaxone (Rocephin), an anti-biotic, who has a WBC count of 15,000 c) The patient receiving phenytoin (Dilantin) whose phenytoin drug level is 19 mcg/mL. d) The patient receiving Advair for an acute asthma attack

d) The patient receiving Advair for an acute asthma attack

A patient is taking levofloxacin. What does the nurse know to be true regarding this drug? a. It is administered by intravenous only. b. Levofloxacin may cause hypertension. c. This drug is classified as an aminoglycoside. d. An adverse effect is dysrhythmia.

d. An adverse effect is dysrhythmia.

A patient is prescribed a decongestant nasal spray that contains oxymetazoline. What will the nurse teach the patient? a. Take this drug at bedtime because it may cause drowsiness. b. Directly spray the medication away from the nasal septum and gently sniff. c. This drug may be used in maintenance treatment for asthma. d. Limit use of the drug to 5 to 7 days to prevent rebound nasal congestion.

d. Limit use of the drug to 5 to 7 days to prevent rebound nasal congestion.

A patient is given epinephrine, an adrenergic agonist (sympathomimetic). The nurse should monitor the patient for which condition? a. Decreased pulse b. Pupil constriction c. Bronchial constriction d. Increased blood pressure

d;

Anticholinergic SE

dry mouth, hoarseness

Ethambutol SE

hepatotoxicity, electrolyte imbalances, GI distress

What are leukotrienes?

potent bronchoconstrictors, cause bronchospasm, inflammation and mucus production.