Pharm final lesson questions
Because acetaminophen has a short half-life, it can be administered every__hours as needed for pain relief.
4
A nurse is caring for a patient who is receiving 4 mg of intravenous methylprednisolone. What equivalent dose of prednisone in milligrams would this patient receive at discharge? ____________mg
5
Which patients does a nurse determine cannot safely receive prednisone?
A 33-year-old patient with active tuberculosis A 78-year-old patient with cataracts
Which patient cannot safely receive therapy with fludrocortisone?
A 40-year-old patient with pulmonary aspergillosis
Which patient does a nurse identify cannot safely receive therapy with naproxen?
A 59-year-old patient receiving dialysis three times weekly
Which statement correctly identifies the pharmacologic properties of acetaminophen?
Acetaminophen is a nonopioid drug but is not an NSAID
A patient presents to the emergency department with nausea, vomiting, abdominal pain, and yellow sclera. The patient's liver function tests are elevated, and the serum acetaminophen level is 10. Which conclusion will the nurse draw?
Acetaminophen is not likely playing a role
Which antigout therapies inhibit xanthine oxidase?
Allopurinol Febuxostat
Which statement accurately describes inflammation?
Arachidonic acid is released upon injury to yield inflammation, swelling, and headache.
A patient in the emergency department has mild pain and asks for acetaminophen. Which intervention by the nurse is appropriate?
Ask the patient if he or she has taken any acetaminophen earlier that day
Which nonsteroidal antiinflammatory drug (NSAID) is an irreversible cyclooxygenase (COX) inhibitor?
Aspirin
Match the chemical class to the nonsteroidal antiinflammatory drug (NSAID) that belongs to the class.
Aspirin- Salicylate Diclofenac sodium- Acetic Acid Derivative PiroxicamEnolic- Acid Derivative NaproxenPropionic- Acid Derivative
Which conditions may be treated with ibuprofen?
Closure of patent ductus arteriosus Dysmenorrhea Fever Inflammation Pain
Which statement accurately describes the glucocorticoid that is secreted from the adrenal cortex along with its effect in the body?
Cortisol, which impacts carbohydrate metabolism
Which adverse effects may be experienced by a patient taking morphine, and should be reported to the health care provider?
Dizziness Headaches Difficulty breathing
Which categories can be used for classifying glucocorticoids?
Duration of action Route of administration natural versus synthetic analog potential for sodium and water retention
A patient is recovering from surgery and wishes to avoid taking morphine if possible. Which intervention by the nurse is appropriate?
Encourage nonpharmacologic measures to relieve pain
Which antigout drugs are associated with an increased risk for stroke and myocardial infarction?
Febuxostat Lesinurad
Which corticosteroid is the treatment of choice for a patient with Addison disease?
Fludrocortisone
Which statement about fludrocortisone is accurate?
Fludrocortisone possesses both mineralocorticoid and glucocorticoid activity.
Which statement accurately describes corticosteroids?
Glucocorticoids affect carbohydrate metabolism, and mineralocorticoids regulate electrolytes.
Which drugs currently taken by Mrs. Gabriel are anticipated to interact with prednisone?
HCTZ Metformin
Which questions will the nurse ask a patient who is taking acetaminophen in order to identify contraindications that would preclude the patient from using the medication?
How often do you drink alcohol? Do you have any history of liver disease?
A nurse instructs a patient with rheumatoid arthritis who was prescribed prednisone 20 mg PO daily. Which statements by the patient indicate that patient teaching was effective?
I will make sure to have a diet rich in vitamin D and calcium to reduce my risk for osteoporosis." "I will make sure to take the prednisone with food to avoid an upset stomach." "I may experience side effects and adverse effects such as insomnia, weight gain, and mood swings."
Which effect would a nurse be concerned with for a patient who is receiving ibuprofen in addition to alendronate, a bisphosphonate?
Increased risk for gastrointestinal bleeding
Which statement describes the pharmacodynamic profile of ibuprofen?
Its duration of action is 4 to 6 hours.
Which statement accurately describes the pharmacokinetics of lesinurad?
Lesinurad is excreted in both urine and feces
A nurse is caring for a patient (a documented overproducer of uric acid) who was recently prescribed lesinurad 200 mg PO daily for management of gout. In addition to lesinurad, the patient is also receiving colchicine for gout and amlodipine for hypertension. Which rationale explains why the nurse would call the health care provider before administering lesinurad?
Lesinurad must be administered with allopurinol or febuxostat.
A patient has been taking morphine frequently after a recent surgery. The nurse would suggest monitoring of which laboratory test?
Liver function panel
A patient is on a continuous infusion of morphine after surgery. Which interventions will the nurse perform?
Monitor urinary output and respiratory rate
A patient in severe pain is unable to swallow and does not have intravenous (IV) access. Which prescription would the nurse request from the health care provider?
Morphine by rectum (PR)
Respiratory depression is a side effect of activation of which central nervous system (CNS) receptors?
Mu
Which laboratory results would a nurse assess in a patient before initiation of ibuprofen for an extended period of time?
Platelet Count Renal Function Liver Function Tests Hemoglobin/Hematocrit
A patient has been newly prescribed theophylline for asthma management. In addition to theophylline, the patient is also receiving prednisone. Which drug interaction between theophylline and prednisone does a nurse anticipate for this patient?
Prednisone will interact with theophylline, causing decreased effects of prednisone.
Which statement accurately describes the pharmacokinetics of probenecid?
Probenecid undergoes glucuronide conjugation and oxidation.
Which statements regarding the pharmacokinetics of glucocorticoids are accurate?
Rate of absorption varies depending on the glucocorticoid and route of administration. Rapid absorption occurs when sodium phosphate and sodium succinate esters are given intramuscularly. Glucocorticoids undergo hepatic metabolism to produce inactive metabolites.
Opioids primarily activate the mu receptors, causing which effects?
Sedation Euphoria Analgesia
Which statements accurately describe the actions glucocorticoids exert in the inflammatory process?
Stimulation of erythroid cells Reduction of interleukin-1 release from white blood cells Promotion of protein metabolism, glycogen production, and fat redistribution Stabilization of lysosomal cell membranes to reduce capillary permeability and leukocyte migration
Which side/adverse effects and/or laboratory results would a nurse monitor for while a patient is receiving fludrocortisone?
Swelling of the extremities increased blood sugars Hypertension decreased bone mineral density
A parent calls the health care provider and reports that her 5-year-old daughter took several acetaminophen tablets. Which intervention is appropriate?
Tell the parent to take her daughter to the emergency department
Which rationale accurately describes a nurse's concern for the initiation of meloxicam, a nonsteroidal antiinflammatory drug (NSAID), in a patient taking lisinopril and metformin concurrently?
The combination of lisinopril and meloxicam may lead to reduced antihypertensive effects, increasing the patient's blood pressure
A nurse is providing care to a patient with chronic kidney disease (CKD) who has been prescribed methylprednisolone. Which statement describes the appropriate nursing action for this patient and the rationale for this action?
The nurse should monitor for side effects because methylprednisolone is renally excreted.
A patient has been prescribed prednisone 10 mg PO daily for worsening systemic lupus erythematous (SLE). The patient is also on hydroxychloroquine (for SLE) and warfarin (for venous thromboembolism). Which effect does the nurse anticipate will occur if prednisone is administered to this patient?
The prednisone will interact with warfarin, increasing the effects of warfarin.
Which parameters will a nurse ensure have been assessed before administering prednisone to a patient newly diagnosed with systemic lupus erythematous?
Weight Sodium level Glucose level Blood pressure Presence of preexisting edema
Which statements accurately describe what occurs in the body of patients with gout?
When crystals deposit, symptoms of inflammation may result. Gout may be caused by overproduction of uric acid, decreased uric acid excretion, or both. Hyperuricemia is too much uric acid in the blood, which can lead to formation of uric acid crystals. Uric acid is formed when the body converts purines to hypoxanthine, which then converts to xanthine and finally the end product of uric acid.
A patient with nausea and vomiting is not able to tolerate oral medications. The patient has a fever, and the health care provider prescribes acetaminophen to be given rectally. The nurse understands that the medication may not be absorbed properly in a patient with which concurrent condition?
constipation
Which manifestations are considered cardinal signs of inflammation?
edema errythma heat pain
Acetaminophen is approved for the treatment of which conditions?
fever headaches mild to moderate pain
Which pharmacokinetic trait is important to consider with oral morphine administration?
undergoes first hepatic pass
Which parameters would be assessed in a patient who has been prescribed prednisone?
vital signs glucose levels potassium levels presence of preexisting edema skin color, turgor, and temperature
