Pharm test 3

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A patient who has undergone treatment for alcoholism several times, with relapse occurring shortly after each treatment, has just completed detoxification. the patient request a medication to help maintain abstinence. Which drug will the nurse expect the provider to prescribed? a. acamprosate (campral) b. chlordiazepoxide (librium) c. disulfiram (anatbuse) d. naltrexone (reVia)

D. naltrexone (revia)

a toddler arrives in the ED by ambulance. The nurse observes that the child's facial and neck muscles are stiff and that the child is hyperreflexive. The parents tell the nurse that the child ingested something at a neighbor's house. the nurse will correctly suspect which agent? a. amphetamines b. chocolate c. caffeine d. strychnine

D. strychnine

The nurse is teaching a class on dysrhythmias and associated therapy. The nurse asks the class, which cardiac dysrhythmia would result in the lowest cardiac output and what treatment would be effective? The class best demonstrates understanding by responding that___ results in the lowest cardiac output, and treatment includes: a. atrial flutter; lidocaine b. tachycardia; atropine c. first degree heart block; verapamil (calan) d. ventricular fibrillation; defibrillation

D. ventricular fibrillation; defibrillation

a patient with hypertension is admitted to the hospital. on admission the patient' HR is 72 beats per minute, and the blood pressure is 140/95mm Hg. After administrating an antihypertensive medication, the nurse notes a HR of 85 beats per minute and blood pressure of 130/80 mm Hg. What does the nurse expect to occur? a. a decrease in the heart rate back to baseline in 1 to 2 days b. an increase in the blood pressure within a few days c. an increase in potassium retention in 1 to 2 days d. a decrease in fluid retention within a week

a. a decrease in the heart rate back to baseline in 1 to 2 days

A psychiatric nurse is caring for a drug addicted patient. The nurse knowns that the goal of drug rehabilitation for this patient is: a. abstinence from the drug b. decreasing episodes of relapse c. minimizing drug cravings d. reduction of drug use

a. abstinence from the drug

A patient with diabetes develops hypertension. The nurse will anticipate administering which type of medication to treat hypertension in this patient? a. ace inhibitors b. beta blockers c. direct acting vasodilators d. thiazide diuretics

a. 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: a. ACE inhibitors and beta blockers b. biventricular pacemakers c. dietary supplements and exercise d. diuretics and digoxin

a. ace inhibitors and beta blockers

A patient who has been taking an antihypertensive medication for several years is recovering from a myocardial infarction. The prescriber changes the patients medication to an ACE inhibitor. The patient asks the nurse why a new drug is necessary. What is the nurses response? a. ace inhibitors can prevent or reverse pathologic changes in the hearts structure b. ace inhibitors help lower LDL cholesterol and raise HDL cholesterol c. ace inhibitors increase venous return to the heart, improving cardiac output d. ace inhibitor regulate electrolytes that affect the cardiac rhythm

a. ace inhibitors can prevent or reverse pathologic changes in the hearts structure

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? a. acetaminophen b. diazepam c. morpine d. thiamine

a. acetaminiphen

A nurse is teaching a group of nursing students about antidysrthythmic medications. Which statement by student indicates understanding of the teaching? a. antidysrhythmic drugs can cause new dysrhythmias or worsen existing ones b. adverse effects of these drugs are mainly noncardiac in nature c. for most antidysrhtymic drugs, there is evidence of reduced mortality d. use of these drugs may be necessary even if the benefits are unknown

a. antidysrhtymic drugs can cause new dysrhythmias or worsen existing ones

A patient arrives in the ED complaining of chest pain that has lasted longer than 1 hour and is unrelieved by nitroglycerin. The patient's electrocardiogram reveals elevation of the ST segment. initial cardiac troponin levels are negative. The patient is receiving oxygen via nasal cannula. Which drug should be given immediately? a. aspirin 325 mg chewable b. beta blocker given IV c. ibuprofen 400 mg orally d. morphine IV

a. aspirin 325 mg chewable

Which two classes of anti-dysrhythmic drugs have nearly identical cardiac effects? a. beta blockers and calcium channel blockers b. beta blockers and potassium channel blockers c. calcium channel blockers and sodium channel blockers d. sodium channel blockers and potassium channel blockers

a. beta blockers and calcium channel blockers

The potassium sparing diuretic spironolactone (aldactone) prolongs survival and improves heart failure symptoms by which mechanism: a. blocking aldosterone receptors b. increasing diuresis c. reducing venous pressure d. reducing afterload

a. blocking aldosterone receptors

a patient has been taking digoxin (lanoxin) 0.25 mg and furosemide (lasix) 40mg daily. upon routine assessment by the nurse, the patient sates, "i see yellow halos around the lights" the nurse should perform which action based on this assessment? a. check the patient for other symptoms of digitalis toxicity b. withhold the next dose of furosemide c. continue to monitor the patient for heart failure d. document the findings and reassess in one hour

a. check the patient for other symptoms of digitalis toxicity

a nurse is assessing a patient who has heart failure. The patient complains of shortness of breath, and the nurse auscultates crackles in both lungs. The nurse understands that these symptoms are the result of: a. decreased force of ventricular contraction b. increased force of ventricular contraction c. decreased ventricular filling d. increased ventricular filling

a. decreased force of ventricular contraction

A patient is brought to the ED with shortness of breath, a respiratory rate of 30 breaths per minute, intercostal retractions and frothy pink sputum. The nurse caring for this patient will expect to administer which drug? a. furosemide (lasix) b. hydrochlorothizide (hydroDIURIL) c. mannitol (osmitrol) d. spironolactone (aldactone)

a. furosemide (lasix)

Which two drug regimen would be appropriate for a patient with hypertension who does not have other compelling conditions? a. hydrochlorothiazide and nadolol b. hydralazine and minoxidil c. spironalactone and amiloride d. trichlormethiazide and hydrochlorothiazide

a. hydrocholrothiazide and nadolol

A nurse is teaching a patient who will begin taking verapamil (calcan) for hypertension about the drug's side effects. Which statement by the patient indicates understanding of the teaching? a. i may become constipated, so i should increase fluids and fiber b. i may experience a rapid heart rate as a result of taking this drug c. i may have swelling of my hands and feet, but this will subside d. i may need to increase my digoxin dose while taking this drug

a. i may become constipated, so i should increase fluids and fiber

in discussing the rationale for using methadone to ease opioid withdrawal, the nurse would explain that it has which pharmacologic properties of characteristics? a. methadone can prevent abstinence syndrome b. methadone has a shorter duration of action that other opioids c. methadone is a non-opioid agent d. methadone lacks cross tolerances with other opioids

a. methadone can prevent abstinence syndrome

A patient with hypertension with a BP of 169/110 mmHg begins taking hydrochlorothiazide (dhydroDIRUIL) and nifedipine (Procardia). the patient returns to the clinic after 2 weeks of drug therapy, and the nurse notes a blood pressure of 140/85 mm Hg and a heart rate of 98 beats per minute. What will the nurse do? a. notify the provider and ask about adding a beta blocker medication b.reassure the patient that the medications are working c. remind the patient to drink at least 36 ounces of fluid daily d. request an order for an electrocardiogram

a. notify the provider and ask about adding a beta blocker medication

a patient who was in a motor vehicle accident sustained a severe head injury and is brought into the ED. The provider orders IV mannitol (osmitrol). The nurse knows this is given to: a. reduce intracranial pressure b. reduce renal perfusion c. reduce peripheral edema d. restore extracellular fluid

a. reduce intracranial pressure

A patient who is an alcoholic is prescribed disulfiram (antabuse) to help prevent relapse and the nurse provides teaching about the use of this drug. Which statement by the patient indicates understanding of the teaching? a. i may use alcohol in cooking since heating foods destroys the alcohol b i should avoid shaving lotion and mouthwashes that contain even the small amounts of alcohol c. if i decide to drink, i should stop taking the disulfiram at least one week prior to consuming alcohol d. if i use alcohol, the effects will be uncomfortable but are not dangerous

b. i should avoid shaving lotion and mouthwashes that contain even small amounts of alcohol

A patient will begin taking atorvastatin (lipitor) to treat elevated LDL levels. The patient asks the nurse what to do to minimize the risk of myositis associated with taking this drug. What will the nurse counsel the patient? a. consume an increased amount of citrus fruits while taking this drug b. take vitamin d and coenzyme Q supplements c. ask your provider about adding a fibrate medication to your regimen d. have your creatine kinase levels checked every 4 weeks

b. take vitamin D and coenzyme Q supplements

An alcoholic patient's spouse asks a nurse about recovery from chronic alcoholism. The patient is confused and has abnormal eye movements and nystagmus. Which statement by the nurse is correct? a. the symptoms your spouse shows are partly reversible in most people b. these symptoms can be revered with vitamin therapy and good nutrition c. your spouse has symptoms of an irreversible encephalopathy d. your spouse will probably recover completely after detoxification

b. these symptoms can be reversed with vitamin therapy and good nutrition

A patient has a blood pressure of 150/95 mm Hg and 148/90 mm Hg on two separate office visits. The patient reports a blood pressure of 145/92 mm Gh taken in an ambulatory setting. The patient's diagnostic tests are all normal. The nurse will expect this patient's provider to order: a. a beta blocker b. a loop diuretic and spironolactone c. a thiazide diuretic d. a counseling on lifestyle changes

c. a thiazide diuretic

A patient is diagnosed with anxiety after describing symptoms of tension, poor concentration, and difficulty sleeping that have persisted for over 6 months. Which medication will the nurse expect the provider to order for this patient? a. alprazolam (xanax) b. amitriptyline (elavil) c. buspirone (buspar) d. paroxetine (paxil)

c. buspirone (buspar)

A postoperative patient reports pain in the left lower extremity. the nurse notes swelling in the lower leg, which feels warm to the touch. the nurse will anticipate giving which medication? a. aspirin b. clopidogrel (plavis) c. enoxaparin (lovenox) d. warfarin (coumadin)

c. enoxaparin (lovenox)

a patient with chronic hypertension is admitted to the hospital. during admission assessment, the nurse notes a HR of 96, a BP of 150/90mm Hg, bibasilar crackles, 2+ pitting edema of the ankles and distension of the jugular veins. The nurse will contact the provider to request an order for which medication? a. ace inhibitor b. digoxin (lanoxin) c. furosemide (lasix) d. spironolactone (aldactone)

c. furosemide (lasix)

a nurse is administering a vasodilator that dilates resistance vessels. The nurse understands that this drug will have which effect on the patient: a. decreased cardiac preload b. decreased cardiac output c. increased tissue perfusion d. increased ventricular contraction

c. increased tissue prefusion

a patient begins taking an ACE inhibitor and complains of a dry cough. What does the nurse correctly tell the patient about this symptom? a. it indicates that a serious side effect has occurred b. it is a common side effect that occurs in almost all patients taking the drug c. it may be uncomfortable enough that the drug will need to be discontinued d. it occurs frequently in patients taking the drug but will subside over time

c. it may be uncomfortable enough that the drug will need to be discontinued

A nurse is discussing alcohol abuse with a group of nursing students. One of the students asks whether alcohol consumption has any beneficial effects. The nurse replies that, in moderate amounts, alcohol: a. helps people to sleep well b. improves sexual responsiveness c. may protect against dementia d. prevents hypothermia

c. may protect against demintia

A provider orders clonidine (catapres) for a patient withdrawing from opioids. When explaining the rationale for this drug of choice, the nurse will tell the patient that clonidine (catapress) is used to: a. prevent opioid craving b. reduce somnolence and drowsiness c. relieve symptoms of nausea, vomiting, and diarrhea d. stimulate autonomic acitivity

c. relieve symptoms of nausea, vomiting, and diarrhea

A patient is taking gentamicin (garamycin) and furosemide (lasix). the nurse should counsel this patient to report which symptom? a frequent nocturia b. headaches c. ringing in the ears d. urinary retention

c. ringing in the ears

A patient reports having occasional periods of tremors, palpitations, nausea, and a sense of fear which usually dissipate within 30 minutes. to treat this condition, the nurse anticipates the provider will prescribed a drug in which drug class? a. benzodiazepines b. monoamine oxidase inhibitors c. selective serotonin reuptake inhibitors d. tricyclic antidepressants

c. selective serotonin reuptake inhibitors

a nurse is evaluating a patient admitted to the emergency department with an evolving sTEMI for possible administration of thrombolytic therapy. Which information, identified during history taking, would contraindicate this type of therapy? a. the patient just completed her last menstrual cycle b. that patient states that the chest pain started 1 hour ago c. the patient has a history of a small cerebral aneurysm d. the patient has hypertension that is well controlled by diuretic therapy

c. the patient has a history of a small cerebral aneurysm

A patient has been taking warfarin (coumadin) for atrial fibrillation. The provider has ordered dabigatran etexilate (pradaxa) to replace the warfarin. The nurse teaches the patient about the change in drug regimen. Which statement by the patient indicates understanding of the teaching? a. i may need to adjust the dose of dabigatran after weaning off the warfarin b. i should continue to take the warfarin after beginning the dabigatran until my INR is greater than 3 c. i should stop taking the warfarin 3 days before staring the dabigatran d. i will stop taking the warfarin and will start taking the dabigatran when my INR is less than 2

d. I will stop taking the warfarin and will start taking the dabigatran when my INR is less than 2

an agitated, extremely anxious patient is brought to the ED. The prescriber orders a benzodiazepine. The nurse understands that these meds are used in this clinical situation based on which principle? a. benzodiazepines have a very short half life b. physical dependence is not a risk when taking benzodiazepines c. benzodiazepines are known to cure generalized anxiety d. benzodiazepines have a rapid onset of action

d. benzodiazepines have a rapid onset of action

A patient takes an ace inhibitor to treat hypertension and tells the nurse that she wants to become pregnant. she asks whether she should continue taking the medication while she is pregnant. What will the nurse tell her? a. controlling her blood pressure will decrease her risk of preeclampsia b. ask the provider about changing to an ARB during pregnancy c. continue taking ACE inhibitor during her pregnancy d. discuss using methyldopa instead while she is pregnant

d. discuss using methyldopa instead while she is pregnant

A nursing student asks a nurse how beta blockers increase the oxygen supply to the heart in the treatment of anginas pain. The nurse tells the student that beta blockers: a. dilate arterioles to improve myocardial circulation b. improve cardiac contractility, which makes the heart more efficient c. increase arterial pressure to improve cardiac after load d. increase the time the heart is in diastole

d. increase the time the heart is in diastole

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 160/89 mmHg. The patient has difficulty answering questions and has trouble remembering simple details. The nurse suspects abuse of which substances? a. cocaine b. ecstasy c. marijuana d. methamphetamine

d. methamphetamine

A patient arrives in the ED acutely intoxicated and difficult to arouse. The patient's friend tells the nurse that the patient took a handful of diazepam (valium) pills while at a party several hours ago. The nurse will expect to administer what drug? a. buprenorphine (subutex) b. flumazenil (romazicon_ c. nalmefene (fevex) d. naloxone (narcan)

d. naloxone (naran)

A patient begins taking nifedipine (procardia), along with a beta blocker, to treat hypertension. The nurse understands that the beta blocker is used to: a. reduce flushing b. minimize gingival hyperplasia c. prevent constipation d. prevent reflex tachycardia

d. prevent reflex tachycardia

A patient asks a nurse how nitroglycerin works to relive anginal pain. The nurse correctly states, nitroglycerin: a. dilates coronary arteries to increase blood flow to heart b. increases oxygen supply to cardiac muscle c. increases ventricular filling to improve cardiac output d. promotes vasodilation, which reduces preload and oxygen demand

d. promotes vasodilation, which reduces preload and oxygen demand

A patient with hypertension is prescribed an angiotensin converting enzyme (ACE) inhibitor. The nurse reviewing this patient's chart before administering the medication will be most concerned about which other disease process: a. bronchial asthma b. coronary artery disease c. diabetes mellitus d. renal artery stenosis

d. renal artery stenosis

a university student who is agitated and restless and has tremors is brought to the emergency department. The patients heart rate is 110 beats per minute, the RR is 18 breaths per minute, and the blood pressure is 160/95mm Hg. The patient reports using concentrated energy drinks to stay awake during finals week. What complication will the nurse monitor for in this patient? a. CNS depression b. cardiac arrest c. respiratory failure d. seizures

d. seizures

a patient is admitted with severe hypertensive crisis. the nurse will anticipate administering which medication? a. captopril (capoten) PO b. hydralazine (apresoline) 25 mgPO c. minoxidil (loniten) 20 mg PO d. sodium nitroprusside (nitropress) IV

d. sodium nitroprusside (nitropress) IV

A patient who has been taking a medication with a side effect of drowsiness stops taking the medication after several weeks. The patient reports feeling anxious and jittery. The nurse understands that this response is due to: a. addiction b. psychologic dependence c. tolerance d. withdrawal syndrome

d. withdrawal syndrome

A patient who wants to quit smoking has begun taking varenicline (chantix). the patient reports experiencing mood swings and depression and a desire to cause harm to herself. What will the nurse tell the patient? a. these symptoms are common and will disappear over time b. these symptoms may indicate an underlying psychiatric disorder c. you may need an increased dose to overcome these symptoms of nicotine d. you should notify your provider of these symptoms immediately

d. you should notify your provider of these symptoms immediately

A patient with a history of elevated triglycerides and LDL cholesterol begins taking nicotinic acid (niacin). the patient reports uncomfrotable flushing of the face, neck, and ears when taking the drug. What will the nurse advise the patient? a. ask your provider about taking an immediate release form of the medication b. ask your provider about assessing your serum uric acid levels which may be elevated c. you should stop taking niacin immediately since this is a serious adverse effect d. you should take 325 mg of aspirin a half hour before each dose of niacin to prevent this effect

d. you should take 325 mg of aspirin a half hour before each dose of niacin to prevent this effect


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