pharm final
A nurse is caring for a patient who is receiving verapamil for hypertension and digoxin for heart failure. The nurse will observe this patient for:
AV block
A patient who is an active alcoholic is admitted to the hospital for surgery. The nurse reviewing orders for this patient would be correct to question which postoperative medication for this patient?
Acetaminophen
Which drugs are considered the "cornerstone" of heart failure therapy because the long-term benefits show slowed heart failure progression and extended life expectancy?
ACE inhibitors
A patient is recovering from a myocardial infarction but does not have symptoms of heart failure. The nurse will expect to teach this patient about:
ACE inhibitors and beta blockers
A nurse is caring for a patient who started on haloperidol 3 days ago to treat schizophrenia. The nurse notes the patient has spasms of the tongue, face, and neck and suspects the patient is experiencing which extrapyramidal symptom?
Acute dystonia
A patient with hypokalemia should be monitored closely for:
Dysrhythmias
A male patient who has been diagnosed with active TB has been prescribed isoniazid, rifampin, ethambutol, and pyrazinamide. The patient asks the nurse why he has to take so many drugs. The basis of the nurse's response should include that this multidrug therapy has which effect (s)? Select all that apply
- No increased risk of superinfection - Elimination of actively dividing and resting tuberculosis mycobacteria - Decreased risk of relapse
A nurse provides teaching for a patient who is newly diagnosed with Parkinson disease. Which statement by the patient indicates understanding of the drug therapy for this disease?
"A levodopa/carbidopa combination is used to improve motor function"
A patient who has been taking an anti-hypertensive medication for years is recovering from a myocardial infarction. The prescriber changes the patient's medications to an ACE inhibitor. The patient asks the nurse why? How should the nurse respond?
"ACE inhibitors can prevent or reverse pathologic changes in the heart's structure"
A patient complains to the nurse that the clonidine recently prescribed for hypertension is causing drowsiness. Which response by the nurse is appropriate?
"Drowsiness is a common side effect initially, but should lesson with time"
The spouse of a patient who is newly diagnosed with Alzheimer's disease asks the nurse if medications will prevent the need for nursing home care. Which response by the nurse is correct?
"Drugs to treat alzheimer's disease may slow the progression of memory loss, but do not stop disease progression"
HCTZ has been prescribed for a patient who is pre-diabetic. The nurse knows that the teaching has been successful when the patient makes which statement?
"I will have my blood sugar checked regularly"
A nurse provides teaching for a 25-year-old patient who will receive mitoxantrone [Novantrone] for worsening relapsing-remitting multiple sclerosis. Which statement by the patient indicates a need for further teaching?
"I will need an infusion of this medication once weekly"
The nurse knows that the patient has understood the teaching about furosemide when the patient makes which statement?
"I will weigh myself daily on the same scale"
A patient prefers not to take the daily allergy pill this morning because it causes drowsiness throughout the day. Which response by the nurse is best?
"Let's see if we can change the time you take your pill to 9pm, so the drowsiness occurs when you would normally be sleeping"
The nurse is teaching a nursing student about management of controlled substances in medication administration. Which statement by the nursing student indicates understanding of the teaching?
"Prescriptions for drugs in schedules III and IV may be written to include up to 5 refills"
A newly-diagnosed type 2 diabetic nurse asks the nurse "Why do I need to rotate my injection sites?" Which nursing response is correct?
"Rotating injection sites in the abdomen promotes insulin absorption" (reduces risk of lipodystrophy)
The nurse is reviewing discharge instructions with a patient. The patient asks why the oral dose of the pain medication is higher than the intravenous dose he has been receiving while in the hospital. Which of the following is the nurse's best response?
"The oral form of the drug passes through the liver and is partially metabolized before being distributed to the body, so a higher dose is required."
A patient who takes nitroglycerin to treat stable angina reports having erectile dysfunction and states that he plans to ask his primary provider for a prescription for tadalafil. What will the nurse tell this patient?
"You should discuss another anti-angina medication with your provider"
Which of the following would be desirable qualities for a drug? Select all that apply.
- easy administration - simple generic name
Which of the following would be undesirable qualities for a drug? Select all that apply.
- irreversible action - unpredictability - sensitivity to light
Which plasma lipoprotein level is most concerning when considering the risk of coronary atherosclerosis?
Elevated low-density lipoprotein
A patient is receiving morphine sulfate 4mg IV every 4 hours for pain. The half-life of morphine sulfate is approximately 3 hours. The first dose of morphine was administered at 8am. At 11am, what is the expected amount of morphine present?
2 mg
When should the nurse anticipate diuresis following the administration of oral furosemide?
30 to 60 minutes
Alcohol differs from other drugs because of its rate of metabolism. The nurse knows that the rate of alcohol metabolism is:
A constant rate
A 24 year old female presents to the emergency department reporting three days of severe nausea, vomiting, and diarrhea. The nurse should anticipate providing which type of IV fluids?
A hypotonic solution such as 0.45% sodium chloride
A 50 year old male patient is admitted to the hospital for treatment of heat exhaustion. He works as a landscaper and became dizzy and nauseated after working outside in the summer heat. The nurse should anticipate providing which type of IV fluids?
A hypotonic solution, such as 0.45% sodium chloride
After shift change on a cardiovascular unit, the new nurse is looking over her assignments to determine the order in which they should be assessed. Which patient should be assessed last?
A patient with chronic knee pain
A nurse just started her shift, which of the following patients should be assessed first?
A patient with heart failure complaining of shortness of breath after receiving mannitol
Which opioid is the best choice to treat persistent, severe pain in a patient who is opioid tolerant?
A strong opioid agonist such as fentanyl
Which of these are host factors that modify drug choice, route of administration, or drug dosage (select all that apply):
Host immune defenses Site of infection Previous allergic reaction Genetic factors
A male patient is admitted to the emergency department (ED) with chest pain. The patient is diagnosed with angina pectoris. He is being discharged with an order for nitroglycerin SL PRN. What action should the nurse take when the patient reports chest pain?
Administer a tablet under the patient's tongue and repeat the action in 5 and 10 minutes if the pain has not subsided
Ten minutes after receiving a dose of IV morphine the nurse finds the patient on the floor with pinpoint pupils and a RR 6. Which intervention is priority?
Administer prn naloxone (narcan)
A nurse is caring for a patient who is receiving pain medication through a saline lock. After obtaining a good blood return when the nurse is flushing the patient's peripheral IV, the patient reports pain. Upon assessment, the nurse notices a red streak that is warm and tender to the touch. What is the nurse's initial action?
Administer the pain medication slowly
Warfarin binds with which molecule in the body?
Albumin
What are the therapeutic uses of verapamil? (Select all that apply)
Angina of effort (exercise-induced angina) Cardiac dysrhythmias Essential hypertension
What is the method of action of the drug varenicline (Chantix) that allows it to be a successful drug for smoking cessation?
As a partial nicotinic receptor agonist, it prevents most of the nicotine from binding
The nurse takes a medication to a client, and the client tells the nurse to take it away because she is not going to take it. The nurse's first action should be to:
Ask the client;s reason for refusal
Which of the following medication orders is a complete order?
Aspirin 81 mg po daily
A patient who has been receiving ketoconazole for 5 days experiences nausea and vomiting. What should be the initial response of the nurse?
Asses the skin, mucus membranes, urine, and stool
An hour after taking a new medication, the nurse notes that the patient is displaying moderate urticaria and pruritus. The nurse's priority action for this patient is to:
Assess for difficulty breathing, wheezing, or any facial swelling
A new graduate nurse is wondering which patient she/he should assess first. Based on priority, which of the following is a good strategy?
Assess the most unstable patients first
A patient with multiple sclerosis needs pharmacologic treatment for spasticity to begin strengthening exercises to improve walking ability. The nurse anticipates which medication will be ordered for spasticity?
Baclofen
Which one describes the method of action of an antibiotic that slows bacterial growth but does not cause cell death?
Bacteriostatic
Penicillins, cephalosporins, and carbapenems are also called this type of antibiotic:
Beta-lactams
Which of the following is a priority assessment following the administration of a diuretic?
Blood pressure
ARBs have a similar hemodynamic benefit to ACE-Inhibitors, but ARBs do not have the same favorable impact to the slowing of cardiac remodeling. This is because ACE-Inhibitors impact what peptide compound that ARBs do not?
Bradykinin
Imipenem is used to treat a wide range of bacteria. This is an example of what kind of antibiotic?
Broad spectrum
Which medication, used for smoking cessation, blocks the uptake of norepinephrine and dopamine, which affects the pleasure center and decreases withdrawal symptoms?
Bupropion
Thirty minutes after administering the first dose of amoxicillin to a patient who denies any previous drug allergies, the patient calls out to the nurse complaining of wheezing and difficulty breathing. The nurses first action is to:
Call for help and be ready to support respirations if necessary
A patient is taking the anticoagulant warfarin. The nurse is providing patient education and should include teaching about which foods to avoid or minimize? (Select all that apply.)
Canola oil Collard greens Mayonnaise
Which complication of diabetes causes the most deaths?
Cardiovascular effects
Which of the following does not describe Primary (Essential) Hypertension?
Caused by another reason such as renal artery stenosis
A patient is taking a vasodilator that relaxes smooth muscles in veins. To help minimize drug side effects, the nurse caring for this patient will:
Caution the patient not to get up abruptly
Clonidine is an effective anti-hypertensive, but it's mechanism of action is different from the other anti-hypertensive medications. How is clonidine classified?
Centrally acting alpha 2 agonist
Which antibiotic has a cross allergy with penicillins?
Cephalosporin
The nurse is caring for a patient admitted with pneumonia who is receiving a scheduled dose of IV cefepine (a cephalosporin). The patient expressed anxiety and the provider has ordered midazolam (a benzodiazepine) IV PRN. Upon administration of the dose of IV midazolam, the nurse notices a precipitate forming in the IV line. What is the nurses next step?
Clamp off the IV infusion so neither drug reaches the patient
A patient with hypertension has a previous history of opioid dependence. Which medication would the nurse question?
Clonidine
A nurse on a busy telemetry unit is preparing to pass 2100 medications. Which aspect of the preadministration assessment would be most important prior to giving a new pain medication?
Confirmation of the patient's allergies
A patient is admitted in a state of diabetic ketoacidosis. The resident orders insulin detemir 0.1 mg/kg/hr to be administered by intravenous (IV) drip. What should the nurse do?
Consult the provider immediately
The nurse receives an order to administer levadopa, a medication used to treat Parkinson's Disease, but the nurse is not aware that the patient has this condition. What is the nurse's priority action?
Contact the prescriber to ask about the reason for ordering this medication
A nurse is assessing a patient who becomes motionless and seems to stare at the wall and then experiences about 60 seconds of lip smacking and hand wringing. What should the nurse do?
Contact the provider to report symptoms of a complex partial seizure
An older adult patient who has hypertension is prescribed enalapril, a drug that is eliminated by the kidneys. Before the patient begins the drug, the health care professional should assess which of the following blood values?
Creatinine clearance
The nurse is preparing to administer IV ciprofloxacin to a patient with septic arthritis after arthroscopic surgery. It would be a priority to review which ordered diagnostic test result as soon as it is available?
Culture and sensitivity (C&S)
There are many different triggers that cause a migraine to start. These include anxiety, fatigue, stress, changes in weather, menstruation, alcohol, and foods that contain tyramine. Which of the following foods contain tyramine and should be included in your teaching?
Cured meats such as sausage Cheese Red wine Overripe fruits [also soy sauce]
Which drug is used as aversion therapy for unhealthy alcohol use?
Disulfiram
When talking to a patient about naproxen enteric coated tablets, which of the following should the health care professional include?
Do not crush or chew the tablet
A patient is ready for discharge home from a lengthy hospital stay after a motor vehicle accident. The patient suffered multiple fractures and required large doses of morphine for several weeks. The nurse preparing the patient for discharge notes that the patient requests the maximum dose of the oral opioid analgesic at the exact intervals it is prescribed. The nurse is correct to suspect what has occurred?
Drug tolerance
Patients in late stages of renal failure who are taking medications are at an increased risk of which of the following?
Drug toxicity
This describes an antibiotic therapy that is given when a severe infection is present and the drug choice is based on informed guess because the culture and sensitivity is not yet resulted.
Empiric therapy
Which antibiotic is the drug of choice when the patient is allergic to penicillin, though it is frequently not tolerated well because of its severe GI side effects?
Erythromycin
The nurse assesses a newly diagnosed patient for short-term complications of diabetes. What does this assessment include?
Evaluation for hyperglycemia, hypoglycemia, and ketoacidosis
Which medication is non-insulin injectable agent for the treatment of type 2 diabetes mellitus?
Exenatide
Which of the following is a common adverse effect of long-term aspirin therapy?
Gastric ulcers
Drug absorption can be affected by many variables. Which of the following variables is least likely to have an impact on absorption? the presence of food gastric emptying time intestinal motility gender
Gender
A hospitalized patient complains of acute chest pain. The nurse administers a 0.4mg sublingual nitroglycerin tablet, but the patient continues to complain of pain. Vital signs remain stable. What is the nurse's next step?
Give a second dose of nitroglycerin in 5 minutes
A patient is taking lisinopril. The nurse understands that patients taking this type of drug for heart failure need to be monitored carefully for:
Hyperkalemia
Trimethoprim suppresses renal excretion of potassium. Which electrolyte imbalance would the nurse monitor for?
Hyperkalemia
This electrolyte imbalance can occur if insulin dosage is excessive
Hypokalemia
Which insulin has no significant peak and provides a steady dosing all day?
Glargine
The nurse is preparing to give penicillin (PCN G) IM to a patient. Before administering this medication, the nurse will look up which lab result?
Glomerular filtration rate
A nurse is assessing an unconscious adult who is covered in sweat. The person has a history of diabetes. A blood glucose of 20mg/dL is obtained. What should the nurse administer first?
Glucagon
The nurse is providing education for a patient taking phenelzine and would include that the patient avoid which foods (Select all that apply):
Guacamole Sushi dipped in soy sauce Mac & cheese Pepperoni pizza
A nurse admits a patient with a diagnosis of schizophrenia. Which of the following manifestations describes positive symptoms of this condition?
Hallucinations, delusions, agitation, and paranoia
A patient is receiving vancomycin. Which function is the priority for the nurses to assess?
Hearing
A child will begin taking methylphenidate for attention-deficit/hyperactivity disorder. Important baseline information about this patient will include:
Height and weight
A patient who has type 2 DM has been unable to follow the recommended diet and exercise regimen. He tries to alter his laboratory test results by eating less than usual before having blood testing performed. Which test would be most accurate for this patient because it evaluates his glucose control over the past 3 months?
Hemoglobin A1C
Why is the dose of oral morphine is higher than the dose of IV morphine?
Hepatic first pass effect
A patient already takes Drug Y, and is now prescribed Drug X, which is known to be an inducer for the CYP enzyme that metabolizes Drug Y. The nurse knows that the patient will most likely need _____ doses of Drug ___.
Higher; Y
The nurse is preparing to administer lithium to a patient with bipolar disorder and observes a fine hand tremor. Upon further review of systems, the patient admits to general muscle weakness, nausea, and mild diarrhea. What is the nurse's next step?
Hold the lithium dose and request an order for a lithium level from the provider
Which of the following are adverse effects of diuretics? (Select all that apply)
Hypovolemia acid/base imbalances Electrolyte imbalances
The nurse would expect to see systemic effects from a drug the quickest after which route of administration? PR IM topical PO
IM
A patient with a serum potassium level of 2.9 who is also having muscle weakness, fatigue, and dysrhythmias would likely receive potassium via which route of administration?
IV
A nurse is reviewing a patient's medications and realizes that gemfibrozil and warfarin are to be administered concomitantly. Which effect will the nurse anticipate in this patient?
Increased anticoagulant effects
Nicotine causes release of epinephrine and norepinephrine. At the patient level the nurse would expect to see:
Increased heart rate and hypertension
A patient who has received morphine becomes slightly disoriented. If this adverse effect is due to the morphine, which intervention by the nurse might aid in reversing it?
Instruct the patient to take slow, deep breaths
Which information is necessary to collect as baseline data before the administration of nitroglycerin? (Select all that apply.)
Intensity of the attacks Factors that precipitate the attacks Location of the anginal pain Frequency of the attacks
What are the benefits of using buspirone to treat anxiety disorders (Select all that apply)?
It is not a CNS depressant It has no abuse potential It does not intensify other CNS depressants
Why is it important for nurses to know how the effectiveness of a drug will be evaluated before they administer the drug?
Knowledge of evaluation criteria will determine pre-administration assessments, so that a comparison can be made
Which medication is used to treat hypothyroidism?
Levothyroxine
Which diuretic can be effective even when renal blood flow and GFR are low?
Loop diuretic
Daily medications used in the treatment of heart failure hope to accomplish what? (Select all that apply)
Manage volume overload Directly improve cardiac output Slow cardiac remodeling Indirectly improve cardiac output
Which diuretic is given to prevent renal failure in a patient with severe hypovolemic shock?
Mannitol IV
A young adult patient is admitted to the hospital for evaluation of severe weight loss. The nurse admitting this patient notes that the patient has missing teeth and severe tooth decay. The patient's blood pressure is 160/98 mm Hg. The patient has difficulty answering questions and has trouble remembering simple details. The nurse suspects abuse of which substance?
Methamphetamine
What is the priority reason why the nurse teaches a patient who is prescribed sulfamethoxazole to take this medication with a full glass of water?
Minimize crystal formation in the urine
Which drug, used to treat bipolar disorder, is used to relieve symptoms, prevent recurrence, and doesn't worsen symptoms of mania, depression, nor accelerate the rate of cycling?
Mood stabilizers
First generation (FSA) and second generation (SGA) antipsychotics are equally effective, but SGAs have effects that FSAs do not, which include (Select all that apply):
More expensive Less likely to cause extrapyramidal symptoms Serious metabolic effects such as weight gain, diabetes, and dyslipidemia
Which opioid receptors produce respiratory depression?
Mu
Which insulin is a cloudy suspension?
NPH
Which of the following statements about nicotine are correct? (select all that apply)
Nicotine improves cognition Nicotine reduces aggression Nicotine suppresses appetite
The nurse is providing teaching to a client who is at risk for hyperlipidemia. The nurse tells the client that hyperlipidemia has many risk factors. The nurse knows which risk factors can be controlled or modified?
Obesity, inactivity, diet, and smoking
Upon assessment, the nurse finds a patient who has Type 2 diabetes is awake, alert, pale, and complaining of weakness and nervousness. Which action should the nurse take first?
Obtain a blood glucose level
What is the priority step before administering an IV antibiotic to a patient with suspected sepsis?
Obtain blood cultures
Which dosing option is the best type of pain control in the postoperative patient?
Patient-controlled analgesia (PCA) pump
A nurse is receiving isoniazid therapy for latent TB. It would be of greatest priority to contact the prescriber if the nurse experiences
Persistent nausea
Besides monitoring the glucose level, which electrolyte is the priority assessment for a patient in DKA who has received regular insulin IV?
Potassium
Which electrolyte level is part of a priority assessment for the nurse when administering digoxin to a patient?
Potassium
A patient begins taking nifedipine, along with metoprolol, to treat hypertension. The nurse understands that metoprolol is used to:
Prevent reflex tachycardia
When educating patients and providers on ways to prevent antibiotic resistance, the nurse should include (select all that apply):
Promoting adherence to prescribing guidelines Reducing demand for antibiotics among healthy patients Emphasizing adherence to prescribed antibiotic regimens
A 24 year old female patient has been newly diagnosed with hyperthyrodiism. She is hoping to get pregnant within the next year. Which medication to treat hyperthyroidism would be the best choice for her?
Propylthiouracil (PTU)
Which of the following are the pharmacologic effects of benzodiazepines when given intravenously (Select all that apply)?
Reduce anxiety Promote sleep Induce muscle relaxation Hypotension
Which of the following are mechanisms that promote acquired resistance to antimicrobial drugs (select all that apply):
Reduction of drug concentration at its site of action Drug inactivation Spontaneous mutation Superinfection Conjugation
A nurse is teaching clients in an outpatient facility about the use of insulin to treat Type 1 diabetes mellitus. For which of the following types of insulin should the nurse tell the clients to expect a peak effect 1 to 5 hours after administration?
Regular insulin
A patient reports that they take a medication with a long half-life at breakfast, lunch, and dinner. What would the nurse do first in the situation?
Report these findings to the health care provider
Which of the following does morphine commonly cause?
Respiratory depression
A nurse has just administered a dose of fentanyl to a client. Based on the action of this medication, the nurse would initially assess
Respiratory rate
Which symptoms suggests that blood levels of a salicylate such as aspirin are too high?
Ringing in the ears [tinnitus]
In general, antibiotics are effective because they can harm or kill bacteria without harming host cells. This is called
Selective toxicity
A nurse is caring for a patient with depression who is newly prescribed a selective serotonin reuptake inhibitor(SSRI). Upon assessment the nurse finds the patient is agitated and confused with sweating, slight hand tremors, and a temperature of 100.5. The nurse suspects the patient is showing signs of:
Serotonin syndrome
A nurse is administering two medications that are highly protein bound. The nurse should monitor the patient for what?
Signs and symptoms of drug toxicity
Which lifestyle modifications should the nurse provide education for the patient with hypertension? (Select all that apply)
Sodium restriction in diet Limiting the intake of alcohol Recommending regular aerobic exercise Smoking cessation information A modest reduction in weight for BMI >30
When reviewing the electrolyte panel results of a patient taking furosemide for treatment of hypertension, the nurse observes that the patient's potassium level is 3.2 mEq/L. Which diuretic should the nurse administer to the patient to counteract this effect of furosemide?
Spironolactone
Based on maslow's hierarchy of needs, which of the following should be the nurse's first priority?
Starting the feeding tube on an unconscious patient
A patient on a continuous nitroglycerin infusion develops confusion. The nurse assesses the patient and the BP is 60/40. Which action by the nurse is priority?
Stop the infusion
What are the manifestations of hypoglycemia (select all that apply)?
Tachycardia Palpitations Sweating Nervousness
A patient with alcohol dependence is admitted to the hospital. The nurse know that symptoms for alcohol withdrawal include (select all that apply):
Tachycardia and hypertension Hallucinations Hand tremors
A patient newly diagnosed with Parkinson disease has been taking levodopa/carbidopa [Sinemet] for several weeks and complains of nausea and vomiting. The nurse tells the patient to discuss what with the provider?
Taking a lower dose with a low-protein snack [empty stomach is ideal for absorption but taking it w food could help -- high protein = abrupt loss of effect so it needs to be low protein]
The nurse is educating a patient on metformin. Which topics are important to include (select all that apply)?
Taking this medication with food will lessen the GI side effects This medication can cause vitamin B12 and folate deficiencies, a supplement may be needed This medication dose may need to be lowered if the patient has decreased kidney function The patient should avoid alcohol while taking this medication
A patient with Addison's Disease presents to her primary care provider and is diagnosed with influenza A. She currently takes prednisone 30mg po daily. The nurse expects the provider to do what to this patient's dose of steroid:
Temporarily increase the daily dose
A patient presents to urgent care reporting a headache that is described as non-throbbing, with a "headband" feeling, around the head, and tightness in the head and neck. The patient is a auditor and routinely uses a computer all day. The nurse suspects which type of headache:
Tension
When the serum T4 level falls:
The TSH level rises
A patient has signs/symptoms of acute pulmonary edema and the RN receives an order for furosemide (a strong diuretic medication which will treat this condition) IV STAT. Which of the following is an appropriate implementation of this order?
The drug should be given within 5 minutes of the order being received
When educating a patient on how to properly use nicotine replacement patches, the nurses should include:
The patch should be applied in the morning and removed at bedtime The patch should not be applied over hairy skin The patch should not be applied on areas of skin that become sweaty The patch causes skin irritation in 25% of patients, so the sites should be rotated
A female patient taking an ACE inhibitor learns that she is pregnant. What will the nurse tell this patient?
The patient should stop taking the medication and contact her provider immediately
A patient with a form of epilepsy that may have spontaneous remission has been taking an AED for a year. The patient reports being seizure free for 6 months and asks the nurse when the drug can be discontinued. What will the nurse tell the patient?
The provider will withdraw the drug over a 6 to 12 week period
Following oral administration, a drug is absorbed into the body, where it can exert its action. For a drug given orally, the primary site of drug absorption is:
The upper portion of the small intestine
What are the major differences in insulin preparations? (Select all that apply)
Time course Appearance concentration
A patient's seizure disorder is treated with an antiepileptic drug that has a narrow therapeutic range. If the patient takes another drug that reduces metabolism of the seizure medication, the patient is mostly likely at risk of which of the following?
Toxicity from the seizure medication
Major adverse effects of aminoglycoside antibiotics include damage to (Select all that apply)
Vestibular apparatus Kidneys Cochlea
Insulin is available in the following forms for administration (select all that apply):
Vial and syringe Insulin pen Insulin pump
The nurse knows that oral rifampin may not reach therapeutic levels if it is administered
With food With other drugs that are metabolized by the hepatic cytochrome P450 enzymes
The nurse is assessing a patient who is scheduled to receive a dose of gentamicin (Garamycin). In the last 12 hours, fluid intake has been 900 mL, urine output has been 300 mL, and the patient's bladder is not distended. What should the nurse do?
Withhold the drug and notify the prescriber of the output
A patient with chronic pain has been receiving morphine sulfate but now has decreased pain. The prescriber changes the medication to pentazocine [Talwin]. The nurse will monitor the patient for:
Yawning and sweating
A patient with a history of elevated triglycerides and LDL cholesterol begins taking nicotinic acid (Niacin). The patient reports uncomfortable flushing of the face, neck, and ears when taking the drug. What will the nurse advise the patient?
You should take 325 mg of aspirin a half hour before each dose of Niacin to prevent this effect
Four patients all require the attention of the nurse. Who should the nurse see first? a.) a 55 year old patient complaining of crushing chest pain 8 on a 1-10 scale b.) a 30 year old patient complaining of epigastric burning after eating lunch c.) a 62 year old patient with COPD scheduled to receive their corticosteroid inhaler d.) a 78 year old patient with a blood pressure of 170/96 complaining of a headache
a
Which serum lab value should be assessed for a patient who is taking heparin?
aPTT
Four patients all require the attention of the nurse. Who should the nurse see first? a.) a 19 year old patient with asthma scheduled to receive their corticosteroid inhaler b.) a 19 year old with a pneumothorax complaining of shortness of breath who also just received pain medication c.) a 30 year old waiting to receive their prescription to be discharged home d.) a 21 year old complaining of pain 3 on 0-10 scale and is requesting pain medication
b
Which of the following is an appropriate action by the registered nurse to help meet the therapeutic objective of drug therapy? a.) prescribing a drug with the fewest possible number of adverse effects b.) prescribing a drug with the smallest amount of serious harmful effects c.) frequently assessing a patient for any adverse effects from medications d.) instructing a patient to stop taking a prescribed medication due to the number of possible adverse effects
c
Morphine is significantly inactivated by the liver. Based on this, what should the nurse anticipate when the patient is switched from a parenteral administration of the drug to PO administration? a.) the PO and parenteral doses will be about the same b.) the switch to PO administration will require loading doses c.) the PO dose will be smaller than the parenteral dose d.) the PO dose will be larger than the parenteral dose
d
A patient who has begun using transdermal nitroglycerin for angina reports occasional periods of tachycardia. The nurse will expect the prescriber to order:
verapamil as an adjunct to nitroglycerin therapy
