Pharm final
A patient with gout is receiving pegloticase. Which actions should the nurse take? Select all that apply.
Monitor for anaphylaxis Monitor for infusion reactions Premedicate with an antihistamine Premedicate with a glucocorticoid
A nursing instructor is teaching a lecture about medication therapy for gout. Which statement, if made by a student, indicates a need for further teaching?
"Colchicine is currently considered a first-line drug for gout."
A female patient who takes lorazepam for anxiety tells the nurse that she plans to become pregnant. What is the best instruction for the nurse to give the patient?
"Discuss tapering the drug with the provider before conception."
What is the most important information for the nurse to include in a teaching plan for the patient receiving allopurinol?
"Do not take this medication for an acute attack of gout."
A patient with schizophrenia begins a course of first-generation antipsychotic medications. What should the nurse teach the patient?
"Full effects of this drug may not be seen for 4 weeks or more."
Which statement made by a patient demonstrates a lack of understanding of patient teaching regarding buspirone drug therapy?
"I can drink grapefruit juice."
Which statement made by a patient demonstrates understanding of patient teaching regarding phenothiazine drug therapy? Select all that apply.
"I need to change positions slowly to prevent dizziness." "I will need to wear sunscreen and protective clothing when outdoors." "I should call my provider if I notice any uncontrollable movements of my tongue."
Which statement by a patient indicates understanding of the nurse's teaching about leflunomide?
"I'll need to be extremely conscientious about taking my birth control pills."
Prior to administering etanercept to a pediatric patient with rheumatoid arthritis, which question is priority for the nurse to ask the child's parent?
"Is your child current for vaccinations?"
A patient with gout asks the nurse about the mechanism of the action of the antigout drugs. What should the nurse tell the patient?
"It decreases the serum uric acid level."
A patient who has taken fluoxetine for 2 weeks to treat an anxiety disorder complains of dissatisfaction with the therapy. What is the best information for the nurse to include in patient education to promote adherence to the therapeutic regimen?
"It may take 2 more months for full effects to be seen."
The nurse is teaching a patient with rheumatoid arthritis who is scheduled to start a treatment regimen that includes nonsteroidal antiinflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), and glucocorticoids. Which statement by the nurse is correct?
"It will take at least 1 to 5 months for the DMARD to produce effects.
A patient taking buspirone for anxiety states, "I have been taking this antianxiety medication for a week and don't feel any better. I am stopping it now!" What is the nurse's best response?
"This medication may not be therapeutic for several more weeks."
A patient diagnosed with schizophrenia has been prescribed lorazepam. What should the nurse teach as the reason for this therapy? Select all that apply.
"This medication will help you sleep." "This medication will decrease irritability." "This medication will help decrease anxiety."
A nurse is teaching a patient with chronic tophaceous gout who is scheduled to start taking allopurinol. Which statement should the nurse include in the teaching?
"You may notice an increase in your pain attacks in the first month."
The nurse is reviewing the treatment of high-dose colchicine with a patient diagnosed with acute gouty arthritis. Which statement made by the nurse reflects the expected outcome of the treatment?
"You should be able to walk again in a few hours."
Patient on coumadin, what is therapeutic INR?
2-3
Patient with prosthetic valve, what is the INR?
3-4
A patient is taking methotrexate for rheumatoid arthritis. Which therapeutic action should a nurse expect if the medication is having the desired effect?
Suppression of T and B lymphocytes
A patient who has Paget's disease is receiving calcitonin-salmon nasal spray. A nurse should expect the patient to have which therapeutic response if the medication is having the desired effect?
A decrease in bone pain
The nurse administers slow-release haloperidol decanoate to a patient every 2 weeks. What precaution should the nurse take during this procedure?
Administer by deep intramuscular (IM) injection
A patient develops neuroleptic malignant syndrome (NMS) following treatment with antipsychotic drugs. What treatment should the nurse expect the primary healthcare provider to prescribe for this patient? Select all that apply.
Administration of an antipyretic Administration of a muscle relaxant Application of a hypothermia blanket
A nurse teaches a patient taking a monoamine oxidase inhibitor (MAOI) about important dietary restrictions. Which foods will the nurse caution the patient to avoid?
Aged cheese and Chianti
The nurse should assess a patient for what potentially fatal complication of clozapine therapy?
Agranulocytosis
A nurse assesses a patient receiving haloperidol. The nurse notes that the patient is shifting in the chair, rocking back and forth, and tapping both feet constantly. What is the most accurate term to document these findings?
Akathisia
The nurse is caring for a patient whose medication regimen includes chlordiazepoxide. The patient denies a history of anxiety. The nurse recognizes that this drug also may be prescribed for which condition?
Alcohol withdrawal
The nurse is caring for a patient with severe generalized anxiety disorder. Which agent would be most effective for immediate stabilization?
Alprazolam
What medication would the nurse anticipate a provider prescribing for treatment of generalized anxiety disorder?
Alprazolam
To normalize a low serum calcium level, the body releases parathyroid hormone (PTH). This results in which therapeutic effect?
An increase in bone resorption of calcium
A nurse receives a new order for probenecid to a patient with gout and an infection. Which action will the nurse take?
Encourage an initial daily consumption of 3 L of fluid
The nurse is assessing a patient with depression who has been prescribed nortriptyline. Following the assessment, the nurse finds that the patient has constipation and urinary retention due to interaction between the prescribed medications. Which class of medication found in the patient's prescription is responsible for these effects?
Anticholinergics
A patient is prescribed a sedative-hypnotic agent. The nurse realizes the patient is most likely diagnosed with which disorder?
Anxiety
A patient receiving clozapine is complaining of increased urination and thirst. What nursing intervention is essential for this patient?
Assessing blood glucose level
The nurse is reviewing a patient's medication history and notes that the patient recently began taking lithium. What intervention is a priority for this patient?
Assessing lithium levels twice a week
When comparing benzodiazepines to barbiturates, the nurse identifies which statements as true? Select all that apply.
Benzodiazepines have a higher safety profile. Benzodiazepines are less likely to cause tolerance. Benzodiazepines have a decreased abuse potential.
A nurse obtains a health history from a patient who has gout and has been prescribed a glucocorticoid. The nurse should report which finding to the prescriber?
Blood glucose level of 140 mg/dL
Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) both function by which mechanism?
By blocking the reuptake of neurotransmitters at nerve endings
The nurse is caring for a patient who is prescribed a sedative-hypnotic. What is a primary effect of this class of medications?
Central nervous system depression
A patient with rheumatoid arthritis is receiving infliximab. Which adverse effects will the nurse monitor for in this patient? Select all that apply.
Chills Fever Dyspnea Headache
The nurse should be concerned about which finding in a patient on long-term, low-dose colchicine therapy to prevent gout?
Complaints of muscle pain and weakness
Which laboratory test should be monitored frequently to assess for a potential life-threatening adverse reaction to clozapine?
Complete blood count
The nurse is providing teaching to a patient prior to administering zoledronate. Which procedure does the nurse instruct the patient to avoid once the zoledronate has been administered?
Dental procedures
First-generation antipsychotic agents block psychosis by blocking what receptor in the central nervous system?
Dopamine
The nurse monitors a patient taking an antipsychotic medication for extrapyramidal side effects. For what should the nurse assess in the patient?
Dystonia
A patient with obsessive-compulsive disorder (OCD) is prescribed sertraline. After 2 weeks of therapy, the patient shows no sign of improvement. What is the nurse's best action?
Encourage the patient to continue the medication
The nurse would question the prescription for which medication in the pretreatment plan for a patient who is to receive an infusion of infliximab?
Epinephrine
The nurse is caring for a patient who has been prescribed haloperidol. What should the nurse teach the patient?
Extrapyramidal reactions may occur.
In addition to local joint pain and limited range of motion, a nurse should recognize which finding(s) as systemic manifestations of rheumatoid arthritis? Select all that apply.
Fatigue Vasculitis Corneal ulcers
When planning interventions for pain control in a patient with gouty arthritis, the nurse should assess for pain in which joints?
Feet
The nurse should further investigate which finding if it is identified in a patient receiving periodic intravenous infusions of abatacept for rheumatoid arthritis?
Fever and malaise
A patient is admitted to the emergency department after an overdose of oxazepam. Which antagonist may be used to treat this patient?
Flumazenil
The patient is suspected of having overdosed on a benzodiazepine medication. The nurse expects that the healthcare provider will prescribe which medication?
Flumazenil
Alprazolam is prescribed for an adult with panic attacks. The nurse recognizes that this drug exerts its therapeutic effect by interacting with which neurotransmitter?
Gamma-aminobutyric acid (GABA)
A family member of a patient who is experiencing a severe manic episode asks the nurse why the patient is receiving an antipsychotic medication. The nurse informs the family member that antipsychotics are used to do what in the treatment of severe manic episodes?
Help control symptoms during the severe manic episode
A nurse just received a prescription for denosumab. After reviewing the chart, which finding will cause the nurse to intervene?
Hypocalcemia
A nurse is monitoring a patient who is receiving an intravenous infusion of rituximab for severe rheumatoid arthritis. Which finding is a complication of this treatment that would require the nurse to stop the infusion?
Hypotension
A patient presents to the emergency department for pain in the big toe, and acute gouty arthritis is diagnosed. Which medication should the nurse be prepared to administer?
Indomethacin
Upon admission, the nurse notes zolpidem on a patient's drug history. The nurse recognizes that this drug is commonly prescribed to treat which condition?
Insomnia
Which interventions should the nurse implement for a patient who is prescribed a first-generation antipsychotic? Select all that apply.
Instruct the patient to change positions slowly. Instruct the patient to avoid alcohol during therapy Instruct the patient not to drive until the effects of the drug are known
A patient is prescribed haloperidol. Why should the nurse ask the patient to avoid alcohol during therapy?
It increases sedation.
A patient is prescribed methotrexate for rheumatoid arthritis. How often will the nurse teach the patient to take this drug for maintenance?
It is given once per week
Which medication requires screening for tuberculosis before treatment is started?
Leflunomide
The patient takes clozapine for schizophrenic symptoms. What diagnostic studies will the nurse monitor as a priority? Select all that apply.
Lipid panel Fasting plasma glucose Oral glucose tolerance test
The nurse identifies which drug(s) as the principal mood stabilizers used in the treatment of bipolar disorder? Select all that apply.
Lithium Carbamazepine Divalproex sodium
After reviewing the chart of a patient taking leflunomide for rheumatoid arthritis, which finding will prompt the nurse to contact the prescriber?
Liver injury
A patient with schizophrenia presents to a clinic with a poorly healing leg ulcer and hyperglycemia. Which side effect of antipsychotic therapy would increase the patient's risk of this complication?
Metabolic syndrome
Which statements about the treatment of bipolar disorder does the nurse identify as true? Select all that apply.
Mood stabilizers are used to prevent recurrent manic-depressive episodes. Lithium and valproate are the preferred mood stabilizers for bipolar disorder. Antidepressants should be used with mood stabilizers in the treatment of patients with bipolar depression.
A nurse monitors the calcium level of a patient who has had a thyroidectomy. The nurse should anticipate which finding if the patient's calcium level is 6.4 mg/dL?
Muscle twitching and tetany
Antagonist of morphine
Naloxone (Narcan)
The nurse teaches a patient with gout that naproxen is an agent of first choice for treatment over colchicine. The nurse should use which rationale for the teaching?
Naproxen achieves more predicable pain relief with fewer side effects.
Which clinical manifestation in a patient taking etanercept requires a prompt call by the nurse to the prescriber?
New onset of an S3 heart sound and crackles in the lower third of the lungs
Which assessment is essential before treatment with hydroxychloroquine is started for a patient with rheumatoid arthritis (RA)?
Ophthalmic examination
A nurse administered prednisone to a patient with gout. Which finding indicates a therapeutic effect of the drug?
Pain is decreased
he nurse identifies which antidepressants as effective in the treatment of generalized anxiety disorder (GAD)? Select all that apply.
Paroxetine Duloxetine Escitalopram Venlafaxine
A nurse is educating a patient who is to start taking infliximab for rheumatoid arthritis. Which cardiac finding should the nurse instruct the patient to report as a complication of the treatment?
Pedal edema
The nurse is caring for a patient diagnosed with hyperparathyroidism. Which clinical assessment finding does the nurse anticipate?
Polyuria
A patient is taking glucocorticoids and methotrexate for rheumatoid arthritis. Which goal is the priority?
Reduce risk of infection
A nurse is administering raloxifene to a postmenopausal patient for osteoporosis. Which risks should the nurse monitor for in this patient? Select all that apply.
Risk for stroke Risk for pulmonary embolism Risk for deep vein thrombosis Risk for extended periods of immobility
Which drug does the nurse identify as a selective serotonin reuptake inhibitor? Select all that apply.
Sertraline Fluoxetine
A patient asks the nurse how long it will take for escitalopram to be completely effective. Which time frame should the nurse include in patient teaching?
Several weeks
The nurse is caring for a patient receiving fluoxetine for depression. Which side effect is most likely associated with this drug?
Sexual dysfunction
A nurse is monitoring a patient who takes etanercept for rheumatoid arthritis. The nurse should obtain the results of which laboratory test when evaluating for adverse effects?
Skin test for tuberculosis
The nurse is caring for a patient with bipolar disorder who is taking lithium. Which abnormal laboratory value is most essential for the nurse to communicate to the health care provider because this patient is taking lithium?
Sodium level of 128 mEq/L
What interventions does the nurse implement for a patient who is prescribed a benzodiazepine for anxiety? Select all that apply.
Teach relaxation methods. Instruct the patient not to drive during therapy. Instruct the patient to change positions slowly. Teach the patient to avoid alcohol during therapy.
The nurse has just administered the first dose of haloperidol to a patient with schizophrenia. Which finding, if present, is the most important for the nurse to report to the healthcare provider before administering the next dose of medication?
Temperature of 102°F
A nurse administered a drug to a patient for osteoporosis. The nurse explained that the drug would increase bone formation. Which drug did the nurse administer?
Teriparatide
A nurse should establish which outcome(s) when planning care for optimal bone health in a child? Select all that apply.
The child has daily exposure to sunlight. The child has absence of skeletal deformities. The child takes a multivitamin containing vitamin D. The child has a daily intake of cereal, cheese, and milk
A new medication becomes available for the treatment of a debilitating neurologic disease. What would be a nurse's expectation about the safety of the drug?
The drug has passed the FDA approval process
The nurse is caring for a patient with acute mania who has been prescribed lithium carbonate. The blood tests of the patient indicate the serum lithium level to be 1.2 mEq/L. What does the nurse interpret from this?
The patient should have effective relief from the manic symptoms
The nurse should hold the next dose of antipsychotic medication for which patients? Select all that apply.
The patient who has a sudden high fever The patient who has smacking movements of the lips The patient who presents with protrusion and rolling of the tongue
Which patient symptoms would arouse the nurse's suspicions that the patient has stopped taking a prescribed antipsychotic drug? Select all that apply.
Tremors Agitation Dyspnea Sleepiness
When evaluating the effects of probenecid, the nurse should monitor which laboratory result?
Uric acid level
The nurse is reviewing the chart of a patient who is in the third step of the protocol for discontinuing leflunomide prior to becoming pregnant. Which action does the nurse anticipate the health care provider would take?
Verify the plasma drug levels.
Febuxostat will be administered by the nurse in which patient situation?
When the patient has chronic gout
A patient who has taken fluoxetine for 2 weeks to treat an anxiety disorder complains of dissatisfaction with the therapy. What is the best information for the nurse to include in patient education to promote adherence to the therapeutic regimen?
You have not given the medication enough time to work
Which agent is most likely to be currently prescribed for short-term management of insomnia?
Zolpidem
Which food will the nurse teach the patient to avoid while taking a monoamine oxidase inhibitor (MAOI)? Select all that apply.
figs pepperoni cheese smoked salmon
Which drug classes are considered antirheumatic? Select all that apply.
glucocorticoids, NSAIDs, and DMARDs.
When would you administer Lantus?
once a day; same time
A patient in the ICU requires IV insulin. Which of the following is true?
only regular insulin can be given IV
