Pharm test 4 practice questions

7. A client with osteoporosis has been prescribed raloxifene (Evista). What laboratory data would suggest an adverse effect of this drug? a. Decreased serum calcium level b. Elevated cholesterol level c. Elevated liver function tests d. Decreased serum potassium level

ANS: C Raloxifene (Evista) can cause liver function tests to rise or worsen pre-existing hepatic disease. The nurse should monitor the clients liver function tests.

10. The client is experiencing status epilepticus. Which of the following drugs should the nurse have ready to administer? a. Atropine b. Lorazepam c. Propranolol d. Theophylline

ANS: B Initially, intravenous lorazepam is administered to stop motor movements; this is followed by administration of phenytoin.

21. A client who experienced a spinal cord injury 1 hour ago is brought to the emergency room. Which medication should the nurse prepare to administer to this client? a. Intrathecal baclofen b. Methylprednisolone c. Atropine sulfate d. Epinephrine

ANS: B Methylprednisolone (Solu-Medrol) should be given within 8 hours of the injury. Clients given this therapy usually show improvement in motor and sensory function.

15. A client is taking each of the following medications. Which ones would increase the clients risk for osteoporosis? (Select all that apply.) a. Insulin b. Methylprednisolone (Solu-Cortef) c. Phenytoin (Dilantin) d. Acetaminophen e. Atenolol (Tenormin) f. Avapro

ANS: B, C Chronic use of certain anticonvulsants and corticosteroids such as methylprednisolone increases resorption of mineral from the bone, decreasing bone density and increasing the risk for osteoporosis.

To induce vasodilation for a client experiencing a Meniere's attack, the nurse should administer which of the following? a. Nicotinic acid (Niaspan) b. Dimenhydrinate (Dramamine) c. Diphenhydramine (Benadryl) d. Diazepam (Valium)

ANS: A All of the above listed drugs may be helpful during a Meniere's attack; however, only nicotinic acid has a systemic vasodilatory effect.

19. Which drug should the nurse be prepared to administer to the client diagnosed with renal calculi from hyperuricemia? a. Allopurinol (Zyloprim) b. Captopril (Capoten) c. Chlorothiazide (Diuril) d. Phenazopyridine (Pyridium)

ANS: A Allopurinol inhibits the enzyme that converts purine metabolites into uric acid, thereby reducing the amount of uric acid present for precipitation into stones.

33. The client with relapsing-remitting multiple sclerosis asks why continuous treatment with interferon beta-1a (Avonex) is necessary. What is the nurses best response? e. This medication will help decrease the number and severity of relapses. f. This medication is given weekly to halt progression of the disease. g. This medication is given continuously for 1 year to effect cure. h. This medication will protect your muscles from spasticity.

ANS: A Interferon beta-1a is a biological response modifier that is given IM once weekly to decrease the number and severity of relapses.

33. Which laboratory data should be monitored for a client prescribed donepezil (Aricept)? a. Serum electrolyte levels b. Liver function tests c. Complete blood cell count d. Antinuclear antibodies

ANS: B Adverse effects of donepezil (Aricept) include gastrointestinal upset and liver toxicity.

32. A client with advanced Alzheimers disease has been prescribed haloperidol (Haldol). What clinical manifestation suggests that the client is experiencing side effects from this medication? a. Cough b. Tremors c. Diarrhea d. Pitting edema

ANS: B Clients taking haloperidol, a psychotropic drug, can experience extrapyramidal symptoms, such as rigidity and tremors. These effects should be reported to the health care provider.

22. The client with Parkinsons disease has been taking a combination carbidopa-levodopa drug (Sinemet) for 3 years. Which of the following side effects should the nurse be alert for in this client as a result of this medication? a. Constipation b. Abnormal movements c. Malabsorption syndrome d. Increased resting heart rate

ANS: B Following 3 or more years of treatment, about one third of clients develop involuntary movements that are thought to be treatment-related.

28. A nurse is giving eye drops to a client with acute angle glaucoma. Which of the following medications should the nurse question? (Select all that apply.) a. Acetazolamide (Diamox) b. Pilocarpine (Pilocar) c. Atropine (Isopto Atropine) d. Latanoprost (Xalatan) e. Timolol (Timoptic) f. Epinephrine

ANS: C, E, F Rationale: Atropine and epinephrine are mydriatics, which decrease the outflow of aqueous humor, resulting in increased intraocular pressure (IOP). Diamox is a carbonic anhydrase inhibitor that decreases the formation of aqueous humor, Pilocar is a miotic that enhances outflow of aqueous humor, Xalatan is a prostaglandin agonist that improves outflow, and Timoptic is a beta blocker that decreases the formation of aqueous humor. All of these help decrease IOP.

11. The client who has experienced status epilepticus treated with IV diazepam has been ordered to receive phenytoin to prevent a recurrence. What statement indicates that the client understands how to take this medication? a. I must drink at least 2 L of water daily. b. This will stop me from getting an aura before a seizure. c. I will not be able to be employed while taking this medication. d. Even when my seizures stop, I will take this drug.

ANS: D Discontinuing antiepileptic drugs can lead to recurrence of seizures or status epilepticus.

32. A client presents with an acute exacerbation of multiple sclerosis. Which drug should the nurse be prepared to administer? a. Baclofen b. Betaseron c. Dantrolene sodium d. Methylprednisolone

ANS: D Methylprednisolone is the drug of choice for acute exacerbations of the disease

9. The client reports the regular use of all the following medications. Which one alerts the nurse to the possibility of renal impairment when used consistently? a. Antacids b. Penicillin c. Antihistamine nasal sprays d. Nonsteroidal anti-inflammatory drugs

ANS: D NSAIDs inhibit prostaglandin production and decrease blood flow to the nephrons. They can cause an interstitial nephritis and renal impairment.

12. What statement made by a client with newly diagnosed epilepsy indicates that further teaching concerning the drug regimen is necessary? a. I will avoid alcohol. b. I will wear a medical alert bracelet. c. I will let my doctor know about this drug when I receive a new prescription other conditions. d. I can miss up to two pills if I run out of them or they make me ill.

ANS: D The nurse needs to emphasize that antiepileptic drugs must be taken even if seizure activity has stopped. Discontinuing the medication can predispose the client to seizure activity and status epilepticus.

9. The client is prescribed phenytoin (Dilantin) for treatment of a seizure disorder. What precautions or instructions should be taught to this client? a. Do not take aspirin or aspirin-containing products while on this medication. b. Avoid contact sports and heavy physical exercise while on this medication. c. Avoid direct exposure to sunlight while on this medication. d. Do not take warfarin (Coumadin) while on this medication.

ANS: D Warfarin inhibits the metabolism of phenytoin, increasing the half-life of phenytoin and the risk of toxic levels.