Pharmacology Exam 2

Intravenous morphine is prescribed for a patient who has had surgery. The nurse informs the patient that which common adverse effects can occur with this medication?

Constipation, Pruritus, Nausea

The nurse is reviewing the prescriptions for a patient who will be discharged to home after being hospitalized for a hysterectomy. The patient asked for sleeping pill, & the surgeon wrote a prescription for Ambien, 10mg at bedtime as needed for sleep. What is the nurse's priority action at this time?

Contact the prescriber to question the dose of the Ambien.

The nurse is reviewing dietary supplements & US FDA requirements. Which of these actions are required by the FDA for manufacturers of dietary supplements?

Identify the active ingredient on the label

When taking a patient's drug history, the nurse asks about use of OTC drugs. The patient responds by saying "Oh, I frequently take aspirin for my headaches, but i didn't mention it because apirin is nonprescription" What is the nurse's best response?

"Although aspirin is over thew counter it's still important to know why you take it, how much you take, and how often."

When the nurse is teaching about anti-gout drugs, which statement by the nurse is accurate?

"Colchicine is best taken on an empty stomach."

The nurse is reviewing a patient's medication list during a preoperative visit. The patient is scheduled for diagnostic laparoscopy in 2 weeks. he asks the nurse, "I hope I can continue the Motrin, because I really ache if I don't take it. It's just minor surgery right?" What is the nurse's best response?

"I'll check with your prescriber, but this drug is usually stopped a week before the surgery because it can cause increased bleeding tendencies."

A patient is discussing his wish to use herbal products instead of medications and exclaims, "They work! The government tests them!" How will the nurse respond?

"In the United States, herbal products are classified as dietary supplements and do not undergo testing for effectiveness."

A patient is receiving treatment with allopurinol (Zyloprim) for an acute flare-up of gout. Which statements will the nurse include during patient teaching? (Select all that apply).

"Take the medication with meals to prevent stomach problems". "Be sure to avoid alcohol and caffeine" "Call your provider immediately if you note any skin rashes or abnormalities." "You need to increase fluid intake to up to 3 liters per day."

A mother calls the clinic to ask what medication to give her 5y/o child for a fever during a bout of chickenpox. The nurse's best response would be:

"You can use children's dosages of acetaminophen or ibuprofen, but aspirin is not recommended."

the nurse is reviewing medication therapy with the parents of an adolescent with ADHD. Which statement is correct? (select)

"the last dose should be taken 4-6 hrs before bedtime to avoid interference with sleep." "be sure to contact the physician right away if you notice expression of suicidal thoughts." "we will need to check your child's height & weight periodically to monitor physical growth."

In which time frame should the nurse expects the greatest risk for hypotension after the administration of muscle relaxants?

10 minutes after administation

When evaluating the paient's drug history, the nurse notes that the patient is taking an opioid twice a day for pain. Which additional drug,taken concurrently, would concern the nurse the most?

A monamine oxidase inhibitor

Several patients have standards orders for acetaminophen as needed for pain. While receiving their histories & assessments, the nurse discovers that one of the patients has a contraindication to acetaminophen therapy. Which patient should receive an alternate medication?

A patient admitted with severe hepatitis

A 13-year-old patient has the flu and her mother is concerned about her fever of 103 F (39.4 C). Which of these medications will the prescriber suggest to treat the teen's fever?

Acetaminophen (Tylenol)

A patient is receiving an opioid vis a PCA pump as part of his postoperative pain management program. During rounds, the nurse finds him unresponsive, with respirations of 8 breaths/min & blood pressure of 102/58 mmHg. After stopping the opioid infusion, what shoudld the nurse do next?

Administer an opiate antagonist per standing orders

A patient has been admitted to the emergency department because of an overdose of an oral benzodiazepine. He is very drowsy but still responsive. The nurse will prepare for which immediate intervention?

Administration of flumazenil

A patient will be receiving the barbiturate phenobarbital as part of a treatment for seizures. The nurse assesses the pattiemnt's current list of medications. Which medication(s) is/are known to cause interactions with barbiturates? (Select all that apply).

Anticoagulants Monamine oxidase inhibitors (MAOIs) Oral contraceptives Benzodiazepines

Acetaminophen is similar to nonsteroidal antiinflammatory drugs with the exception that it lacks which effect(s)? Select all that apply)

Antipyretic

The best results when treating sever pain associated with pathologic spinal fractures related to metastatic bone cancer, the nurse should remember that the best type of dosage schedule is to administer the pain medication is which of these?

Around the clock, with additional doses as needed for breakthrough pain

A patient with back muscle spasm is being treated with a skeletal muscle relaxant. To ensure that these drugs are most effective, the nurse will make sure what other treatment is ordered?

Benzodiazapines

When reviewing the health history of a patient who is to receive NSAID therapy, the nurse keeps in mind that contraindications for the us of these drugs include which condition?

Bleeding disorders

The nurse will monitor the patient who is taking a muscle relaxant for which adverse effect?

CNS depression

The nurse is reviewing interactions between drugs & herbal products. Which of these herbal products may interact with anticoagulants, resulting in altered bleeding? (Select all that apply)

Chamomile, Ginkgo, Garlic

Which drug represents the only drug that acts directly on skeletal muscle?

Dantrolene (Dantrium)

During a teaching session about anti-gout drugs, the nurse tells the patient that anti-gout drugs work by which mechanism?

Decreasing serum uric acid levels

The nurse is reviewing a policy for local anesthesia. Local anesthesia is indicated for which procedure(s). (Select all that apply).

Dental procedure Suturing a skin laceration Diagnostic procedures

The nurse would be correct in identifying which description as the method of action of probenecid in the treatment of gout?

INCREASE uric acid secretion.

The nurse is admitting a patient who has a diagnosis of right lower lobe pneumonia. Upon assessment, the nurse learns that the patient is wearing an herbal pack on her chest. What will the nurse do first?

Document the presence of the herbal pack.

A patient is taking paroxetine (Paxil), a selective serotonin re-uptake inhibitor (SSRI), as part of treatment for depression. The patient tells the nurse that he has taken herbal products in the past and shows a list to the nurse. Which herbal product, if taken by the patient who is taking an SSRI, would cause an interaction?

Famotadine (Pepcid AC) Omeprazole (Prilosec OTC)

Moderate to severe pain is best treated with which of these medication?

Fentanyl (Duragesic)

The patient visits the warfarin (Coumadin) clinic for follow up and to get the results of the latst PT-INR. The nurse notes the INR levels indicate a significant risk for hemorrhage cause by prolonged clotting times. In conversation with the patient, the nurse obtains a list of all current medications. Which medication would the nurse suspect is contributing to the prolonged time?

Garlic

An older adult is eating breakfast. The nurse knows this patient is taking a variety of different types of medications. Which item on the patient's tray would most concern the nurse about possible effects of drug metabolism?

Grapefriut juice

When teaching a patient about the common adverse effects of drug therapy witth nonsteroidal antiinflammatory drugs (NSAIDs), the nurse will mention which possible averse effect?

Heartburn

While monitoring a patient who took an overdose barbiturates, the nurse keeps in mind that the cause of death would be which of these?

Hypertension

During a procedure, the nurse is monitoring a patient who has received dexmedetomidine (Precedex) for moderate sedation. The nurse will observe for which potential adverse effect?

Hypotension

Which of the following is an identified advantage for the use of nitrous oxide?

It has good analgesic properties.

To decrease the possibility of a headache after spinal anesthesia, the nurse will provide which instruction to the patient?

Maintain strict bedrest.

A patient with renal cancer needs an opiate for pain control. Which opioid medication would be the safest choice for this patient?

Methadone (Dolophine)

The nurse is providing care for a patient who has accidentally taken an overdose of benzodiazepines. Which drug would be used to treat this patient?

Methamphetamine

When a patient is receiving long-term NSAID therapy, which drug may be given to prevent the serious gastrointestinal adverse effects of NSAIDs

Misoprostal (Cytotec)

A patient with a narcolepsy is having problems with excessive daytime sleepiness. the nurse expects which drug to be prescribed to improve the patient's wakefulness?

Modafinil (Provigil)

A patient with bone pain caused by metastatic cancer will be receiving transdermal fentanyl patches. The patient asks the nurse what benefits these patches have. The nurse's best response includes which of these features?

More constant drug levels for analgesia

When the effects of local anesthetics begin to wear off, which physiologic response is the first to occur?

Motor activity returns

A young man has been admitted to the emergency department because of a suspected overdose of morphine tablets. The nurse prepares to administer which drug?

Naloxine (Narcan)

The nurse is preparing to administer an opioid analgesic. Which factors should be assessed before the dose is given? (Select all that apply).

The level of pain rated on a scale Allergies Prior analgesic use (time, type, amount, effectiveness)

Which drug classes are commonly used as over-the-counter (OTC) remedies?

Nonsterodial anti-inflammatory drugs Cold remedies Smoking deterrent systems Histamine-2 (H_2) blockers

Which drug classes are used as adjunctive drugs with anesthesia? (Select all that apply).

Opiod analgesics Anticholinergics

An older adult has been given a benzodiazepine for sleep induction, but the night nurse noted that the patient was awake most of the night, watching television and reading in bed. The nurse documents that the patient has had which type of reaction to the medication?

Paradoxical

The nurse is reviewing drug therapy with OTC medications. Which is an advantage of OTC remedies?

Patients can self-treat minor ailments & reduce physician visits

The nurse is reviewing the use of the COX-2 inhibitor celecoxib (Celebrex). Which conditions are indications for celecoxib? (Select all that apply).

Primary dysmenorrhea Rheumatoid arthritis Osteoarthritis

A hospitalized patient is complaining of having difficulty sleeping. Which action will the nurse take first to address this problem?

Provide an environment that is restful & reduce loud noises.

A patient is asking about omega-3 fatty acids to reduce his cholesterol levels because he has a family history of coronary artery disease. Which nursing diagnosis is most appropriate for this patient?

Readiness for enhanced self-health management

A patient tells the nurse that he has been using an herbal supplement that contains kava for several years to help him to relax in the evening. However, the nurse notes that he has a yellow tinge to his skin & sclera and is concerned about liver toxicity. The nurse advises the patient to stop taking the kava and to see his health care provider for an examination. What else, if anything, should the nurse do at this time?

Report this incident to MedWatch

The nurse monitoring a patient after surgery keeps in mind that the primary concern with use of a neuromuscular blocking drug is which adverse effect?

Respiratory arrest

An opioid analgesic is prescribed for a patient. The nurse checks the patient's medical history knowing this medication is contraindicated in which disorder?

Severe asthma, Sleep apnea, Severe head injury

A patient has a new prescription for sumatriptan (Imitrex). The nurse providing patient teaching on self-administration will include which information?

Take the medication before the headache worsens.

A patient who ha been taking a benzodiazepine for 5 weeks ha been instructed to sop the medication. Which instruction will the nurse provide to the patient on how to discontinue the medication?

Take the medication every other day for a number of weeks.

When educating patients about the safe use of herbal products, the nurse remembers to include which concept?

Take the products with caution because labels may not contain reliable information

The nurse is reviewing the drug history of a apatient and during the interview the patient asks, "Why are some drugs OTC and others not?" The nurse keeps in mind that criteria for OTC status include:

The condition must be diagnosed by a HCP. The drug is easy to use. The drug company sells OTC drugs at lower prices.

Which considerations are important for the nurse to remember when administering a benzodiazepine as a sedative-hypnotic drug? (select)

The dose needs to be given approximately 1 hour before the patient's bedtime.

The nurse is preparing to administer suvorexant (Belsomra) for sleep. The nurse will need to include which teaching about the drug? (Select)

This drug needs to be taken approximately 30 mins before bedtime. The patient needs to be cautioned about the high incidence of daytime somnolence & unconscious nighttime behaviors that may occur.

A 49y/o patient has been admitted with possible chronic salicylate intoxication after self-treatment for arthritis pain. The nurse will assess for which symptoms of salicylate intoxication? (select)

Tinnitus, Headache, Nausea

A patient will be undergoing a brief surgical procedure to obtain a biopsy from a superficial mass on his am. The nurse expects that which type of barbiturate will be used at this time

Ultrashort

The nurse is reviewing definitions for pharmacology review class. Which of these products would be categorized as "Legend Drugs"?

Warfarin, Morphine sulfate

A patient with narcolepsy will begin treatment with a CNS stimulant. The nurse expects to see which adverse effects?

anxiety, increased blood pressure, tremors

The nurse is developing a plan of care for the patient receiving an anorexiant. Which human need statement is most appropriate?

altered food & nutrient intake

The nurse is reviewing the history of a patient who will be starting the triptan sumatriptan (Imitrex) as part of treatment for migraine headaches. which condition, of present, may be a contraindication to triptan therapy?

cardiovascular disease

A patient at a weight management clinic who was given a prescription for orlistat (Xenical) calls the clinic hotline complaining of a "terrible side effect". The nurse suspects that the patient is referring to which problem?

fecal incotinence

While assisting with a procedure in the emergency department, the nurse prepares lidocaine (Xylocaine) for use with which type of anestthesia?

infiltration

A patient who has just returned from surgery has suddenly developed a severe elevation in body temperature. The nurse recognizes that this change may indicate which condition?

malignant hyperthermia

The nurse is reviewing a patient's medications and sees an order for ketorolac (Toradol). This drug is ordered for which condition?

moderate to severe acute pain

The nurse recognizes that manifestation of nonsalicylate NSAID toxicity include which of these? (select)

nausea & vomiting, numbness, drowsiness

When reviewing actions of drugs, the nurse recognizes that a hypnotic is a drug that performs which action?

produces sleep

An anticonvulsant drug has been ordered as part of a patient's pain management program. The nurse explains to the patient that the purpose of the anticonvulsant is to

relieve neuropathic pain

During a marathon, a runner had to drop out after 16 miles because of severe muscle spasms. Which type of pain is the runner experiencing?

somatic pain