Pharmacology Exam 2

You should advise a client who is using a beclomethasone oral inhaler to watch for which of the following possible indications of an adverse effect of this drug? a) white coating in mouth b) abdominal pain c) muscle twitching d) palpitations

a) white coating in mouth

What Digoxin level is considered toxic?

greater than 2.4

A nurse is caring for a client who is about to begin taking finasteride to treat benign prostatic hypertrophy. The nurse should explain to the client the need to monitor which of the following laboratory values? ​a) Prostate-specific antigen (PSA) b) BUN c) Creatine phosphokinase (CPK) d) ALT

​a) Prostate-specific antigen (PSA) The nurse should monitor PSA levels at baseline and periodically thereafter. Increases in PSA can indicate prostate cancer. PSA levels should decrease with finasteride therapy.

A nurse is assessing a client who has a new prescription of oxybutynin to treat neurogenic bladder. Which of the following assessment findings should the nurse identify as an adverse effect of the drug? (Select all that apply.) a) Diaphoresis b) Dilated pupils c) Dizziness d) Distended bladder e) Fever

b) Dilated pupils c) Dizziness d) Distended bladder e) Fever

Theraputic digoxin level

0.8-2.0

A provider has prescribed a dinoprostone vaginal insert to promote cervical ripening in a client who is at 40 weeks of gestation. When administering dinoprostone, which of the following actions should the nurse take? (Select all that apply.) a) Encourage the client to urinate prior to insertion. b) Remove the pouch when active labor begins. c) Monitor for uterine hyperstimulation. d) Encourage the client to walk after insertion. e) Monitor the client's temperature.

a) Encourage the client to urinate prior to insertion. b) Remove the pouch when active labor begins. c) Monitor for uterine hyperstimulation. e) Monitor the client's temperature

A nurse is teaching a client who is taking prednisone for an acute asthma exacerbation. Which of the following instructions should the nurse include? a) "Avoid taking nonsteroidal anti-inflammatory drugs." b) "Rinse your mouth after taking the medication to prevent a yeast infection." c) "Stop taking the medication if you become nauseous." d) "Change position slowly when standing up."

a) "Avoid taking nonsteroidal anti-inflammatory drugs." Gastric protective measures are essential for clients who are taking oral glucocorticoids. Anti-inflammatory drugs can cause GI bleeding, so clients should not take them concurrently with prednisone.

You are instructing a client about using cromolyn via inhalation to treat exercise-induced bronchospasm. You advise the client to take the drug a) 15 minutes before exercising b) if needed to stop bronchospasm c) after strenuous activity d) once in the evening at bedtime

a) 15 minutes before exercising

A nurse is providing teaching to a client who is taking bethanechol for urinary retention. Which of the following instructions should the nurse include? (Select all that apply.) a) Avoid driving and activities that require alertness. b) Increase fluid intake. c) Take the drug with food. d) Stay close to a bathroom after taking the drug. e) Increase weight-bearing activities.

a) Avoid driving and activities that require alertness. b) Increase fluid intake. d) Stay close to a bathroom after taking the drug.

A nurse is preparing to administer phenylephrine to a client. The nurse should identify that that which of the following manifestations is an adverse effect of this drug? a) Headache b) Sleepiness c) Hypotension d) Constipation

a) Headache Oral sympathomimetics stimulate the adrenergic receptors, causing blood vessel constriction, which can cause nervousness, headache, blurred vision, and tremors.

A nurse should question the use of ethinyl estradiol and drospirenone by a client who has renal disease due to the increased risk of which of the following? a) Hyperkalemia b) Hyponatremia c) Hypoglycemia d) Respiratory alkalosis

a) Hyperkalemia Ethinyl estradiol and drospirenone can cause potassium retention, so a client who has renal, adrenal, or liver disease should not take the drug combination. The nurse should monitor the serum potassium levels of a client taking the drug and use it with caution with other drugs that can increase serum potassium, such as potassium-sparing diuretics.

For which of the following reasons should a nurse instruct a client to avoid taking guaifenesin with combination over-the-counter cold products? a) Over-the-counter cold products can also contain guaifenesin. b) Blood glucose levels are increased. c) Rebound congestion is likely. d) Drug tolerance is likely.

a) Over-the-counter cold products can also contain guaifenesin. Many combination over-the-counter cold products contain guaifenesin. A client taking both might be taking excessive amounts of the drug.

A nurse is providing teaching to a client about using leuprolide to treat endometriosis. Which of the following instructions should the nurse include? a) Perform weight-bearing activities. b) Wear sunscreen or protective clothing. c) Take the drug with food to increase absorption. d) Avoid drinking grapefruit juice.

a) Perform weight-bearing activities. Leuprolide suppresses estrogen and can cause bone loss. The nurse should instruct the client to perform weight-bearing activities and increase their intake of calcium and vitamin D.

A nurse is teaching a client about the adverse effects of pseudoephedrine. Which of the following should the nurse include? (Select all that apply.) a) Restlessness b) Bradycardia c) Insomnia d) Muscle pain e) Anxiety

a) Restlessness c) Insomnia e) Anxiety

A nurse is teaching a client about ipratropium. The nurse should include that this drug has which of the following adverse effects? (Select all that apply.) a) Muscle tremors b) Urinary retention c) Dry mouth d) Insomnia e) Tachycardia

b) Urinary retention c) Dry mouth

A nurse is teaching a client who has a new prescription for transdermal testosterone gel to treat delayed puberty. Which of the following instructions should the nurse include? (Select all that apply.) a) "Apply the gel to the scrotum." b) "Cover the area of application with clothing." c) "Wash your hands after applying the gel." d) "Do not shower for several hours after applying the gel." e) "Apply the gel to the gums above an upper incisor."

b) "Cover the area of application with clothing." c) "Wash your hands after applying the gel." d) "Do not shower for several hours after applying the gel."

A nurse is caring for a male client who has hyperthyroidism and is not responding to treatment. The nurse should identify that hyperthyroidism is a contraindication for which of the following drugs? a) Sildenafil b) Bethanechol c) Tamsulosin d) Finasteride

b) Bethanechol Bethanechol, a cholinergic drug, can cause cardiac dysrhythmias in clients who have hyperthyroidism by triggering the release of norepinephrine. This reaction does not occur in clients who do not have hyperthyroidism.

Legal restrictions apply to the purchase of pseudoephedrine because of which of the following risks? a) Respiratory depression b) Drug abuse c) Drug tolerance d) Rebound congestion

b) Drug abuse Because it is possible to alter pseudoephedrine and epinephrine into methamphetamine, a commonly abused drug, the law restricts the drugs' purchase.

A nurse is teaching a client about ipratropium. Which of the following instructions should the nurse include? a) Do not drink anything for 30 min after using the drug. b) Wait 5 min between using the drug and another inhaled drug. c) This drug is used to thin respiratory secretions. d) Check pulse rate after inhaling the drug.

b) Wait 5 min between using the drug and another inhaled drug. Ipratropium, an inhaled anticholinergic, requires a 5-min wait between its administration and that of another inhaled drug to allow for bronchodilation to take effect.

A nurse is caring for a client who is having difficulty mobilizing thick respiratory secretions. Which of the following drugs should the nurse expect to administer to the client? a) Ipratropium b) Beclomethasone c) Acetylcysteine d) Azelastine

c) Acetylcysteine Acetylcysteine is a mucolytic that loosens thick respiratory secretions.

A nurse is teaching a client about the use of beclomethasone to treat asthma. The nurse should explain that the drug has which of the following therapeutic effects? a) Thins mucus b) Relaxes bronchial smooth muscle c) Decreases inflammation d) Increases the cough threshold

c) Decreases inflammation Beclomethasone, an intranasal glucocorticoid, treats asthma by reducing inflammation.

A nurse is caring for a client who received human menopausal gonadotropin (hMG). Which of the following findings should the nurse expect? a) Prolactin secretion b) Estrogen release c) Follicular maturation d) Oxytocin secretion

c) Follicular maturation Before a client receives human chorionic gonadotropin (hCG) to stimulate ovulation, they must receive a drug that induces follicular maturation, such as hMG, which is a mixture of LH and FSH, clomiphene, or follitropin

A nurse is caring for a client who is about to begin taking epoetin. An increase in which of the following laboratory values should indicate to the nurse that the therapy is effective? a) PT b) WBC c) Hgb d) Platelets

c) Hgb

A nurse is teaching a client about the use of antihistamines to treat allergic rhinitis. The nurse should explain that these drugs are effective because they perform which of the following actions? a) Decrease viscosity of nasal secretions b) Block H2 receptors c) Prevent histamine from binding to receptors d) Reduce nasal congestion

c) Prevent histamine from binding to receptors Antihistamines treat allergic rhinitis and reduce swelling by blocking histamine from binding to the receptor sites.

A nurse is caring for a client who is taking codeine. The nurse should identify that which of the following assessments is priority to make? a) Blood pressure b) Apical heart rate c) Respirations d) Level of consciousness

c) Respirations The greatest risk to clients who are taking codeine, an opioid agonist, is severe respiratory depression. Therefore, the respiratory rate is the priority assessment.

A nurse is caring for a client who missed a dose of her oral contraceptive. Which of the following instructions should the nurse give the client? a) Take a pregnancy test. b) Double up on pills for remainder of the pack. c) Take the missed dose as soon as possible. d) Stop the oral contraceptive and use a different contraceptive.

c) Take the missed dose as soon as possible. The nurse should tell the client to take the missed dose along with the next dose. Should the client miss two doses, she should take an additional dose each day for the next 2 days and add an additional method of birth control for the remainder of the cycle.

A nurse is teaching a client about the use of a mucolytic to treat a cough. The nurse should include that a mucolytic has which of the following therapeutic effects? a) Suppresses the cough stimulus b) Reduces inflammation c) Thins and loosens mucus d) Dries secretions

c) Thins and loosens mucus Mucolytics make mucus less viscous to increase a cough's productivity.

A nurse is preparing to administer finasteride to a client who has benign prostatic hypertrophy (BPH). Which of the following precautions should the nurse plan to take when administering this drug? a) Administer medication while client is sitting or reclining. b) Withhold the medication if the client doesn't eat. c) Wear gloves when handling the tablet. d) Monitor heart rate prior to administration.

c) Wear gloves when handling the tablet. The nurse should avoid touching the drug because it can be absorbed through the skin. For women, this can potentially cause harm if they are pregnant and have a male fetus. Women should also avoid exposure to semen from individuals who are taking finasteride.

A nurse is teaching a client who has a new prescription for a testosterone transdermal patch. Which of the following statements made by the client indicates an understanding of the teaching? a) "I should have pancreatic function tests obtained while taking this drug." b) "I should have my white blood cell count checked annually." c) "I should take off the patch to shower." d) "I should apply the medication to a different site each time."

d) "I should apply the medication to a different site each time." The client should rotate the application sites with each application to prevent skin irritation.

A nurse is caring for a client who is taking combination oral contraceptive ethinyl estradiol and drospirenone and is about to begin taking rifampin to treat tuberculosis. Which of the following instructions should the nurse give the client due to a possible drug interaction? a) "Increase the rifampin dose." b) "Increase the oral contraceptive dose." c) "Wait 2 hours between taking each drug." d) "Use additional birth control methods."

d) "Use additional birth control methods." Rifampin can increase the metabolism of oral contraceptives, reducing the effectiveness. Clients who are taking oral contraceptives and rifampin should use additional contraceptive methods to prevent an unwanted pregnancy.

A nurse should question the use of conjugated equine estrogen by a client who has a history of which of the following? a) Osteoporosis b) Peptic ulcer disease c) Rheumatoid arthritis d) Blood clots

d) Blood clots Clients who have a history of thromboembolic disease should not use estrogen replacement therapy because of the risks of thrombophlebitis, myocardial infarction, pulmonary embolism, and cerebrovascular accident.

A nurse is teaching a client about montelukast. Which of the following instructions should the nurse include? a) Use a spacer to improve inhalation. b) Take the drug at the onset of bronchospasm. c) Rinse mouth to prevent an oral fungal infection. d) Take the drug once a day in the evening.

d) Take the drug once a day in the evening. Montelukast, a leukotriene modifier, is most effective when taken once per day in the evening.

You are instructing a client who has a new prescription for cetirizine. Which of the following information should you be sure to include? a) restrict fluids to minimize the drugs adverse effects b) take the drug in the morning to reduce adverse effects c) take the drug on an empty stomach to increase absorbtion d) administer the drug prophylactically during allergy seasons

d) administer the drug prophylactically during allergy seasons

You should monitor a client taking dextromethorphan because of the potential for which of the following? a) tachycardia b) fluid retention c) blurred vision d) drug abuse

d) drug abuse

A nurse is teaching a client about conjugated estrogen and medroxyprogesterone. Which of the following instructions should the nurse include? a) Monitor for rectal bleeding. b) Avoid drinking alcoholic beverages. ​c) Have blood pressure checked regularly. d) Sit up for 30 min after taking the drug.

​c) Have blood pressure checked regularly. ​Using conjugated estrogen and medroxyprogesterone, a combination of estrogen and progestin for hormone replacement, can cause hypertension. Clients taking the drug combination should have their blood pressure checked regularly and report headache or edema.

A nurse is caring for a client who has a new prescription for conjugated equine estrogen. The nurse should instruct the client to report which of the following indications of a serious adverse reaction? a) Hot flashes b) Urinary tract infection ​c) Vaginal bleeding d) Bone pain

​c) Vaginal bleeding Estrogen hormone replacement therapy increases the risk of endometrial cancer. The nurse should instruct clients using the drugs to report recurrent or persistent vaginal bleeding and pelvic pain.

A nurse is teaching a client who has a prescription for albuterol via inhaler and fluticasone via inhaler for asthma management. For which of the following reasons should the nurse instruct the client to use the albuterol inhaler before using the fluticasone inhaler? a) Albuterol will increase the absorption of fluticasone. b) Albuterol will decrease inflammation. c) Albuterol will reduce nasal secretions. d) Fluticasone will reduce the adverse effects of albuterol.

a) Albuterol will increase the absorption of fluticasone. Albuterol, an inhaled, short-acting beta2 agonist, causes bronchodilation, which will increase the absorption of fluticasone, an inhaled glucocorticoid.

A nurse is providing safety education to a client who is scheduled to begin treatment with tamsulosin for benign prostatic hypertrophy (BPH). Which of the following instructions should the nurse include in the teaching? a) Change positions slowly. b) Crush the medication. c) Take the medication on an empty stomach. d) Report increased urinary output immediately.

a) Change positions slowly. Alpha adrenergic blockers such as tamsulosin are also used to treat hypertension. These drugs can cause the blood pressure to drop, leading to orthostatic hypotension.

A nurse is caring for a client who has a new prescription for transdermal conjugated estrogen and medroxyprogesterone to treat postmenopausal symptoms. The nurse should explain to the client that this drug combination includes which of the following therapeutic effects? (Select all that apply.) a) Reduces the risk of ovarian cancer b) Relieves hot flashes c) Prevents osteoporosis d) Reduces the risk of breast cancer e) Reduces the risk of thromboembolism

a) Reduces the risk of ovarian cancer b) Relieves hot flashes c) Prevents osteoporosis

A nurse is monitoring plasma drug levels in a client who is taking theophylline. Which of the following findings should the nurse expect to see if the client's drug level indicates toxicity? a) Seizures b) Constipation c) Normal sinus rhythm d) Somnolence

a) Seizures Seizures are likely when plasma drug levels of theophylline, a methylxanthine, are higher than 30 mcg/mL, which indicates toxicity.

A nurse is teaching a client about receiving leuprolide to treat endometriosis. The nurse should instruct the client to expect which of the following side effects? a) Vaginal dryness b) Hypertension c) Blurred vision d) Orthostatic hypotension

a) Vaginal dryness Leuprolide can cause vaginal dryness. The nurse should suggest that the client use water-based vaginal lubricants to help minimize this effect.

You instruct a patient who is taking zileuton to report which of the following possible indications of a serious adverse effect of this drug? a) abdominal pain b) dysphagia c) blurred vision d) bradycardia

a) abdominal pain

You should recognize that which of the following is a contraindication for taking codeine? a) emphysema b) cataracts c) hyperthiroidism d) nonproductive cough

a) emphysema

You should instruct a client using phenylephrine spray for nasal congestion to do which of the following to avoid rebound congestion? a) limit the drug's use to 3-5 days b) add an intranasal glucocorticoid c) taper the dose before discontinuation d) restrict the drug's use to one nostril at a time

a) limit the drug's use to 3-5 days

A nurse is providing teaching to a client about sildenafil to treat erectile dysfunction. Which of the following instructions should the nurse include? a) Take the drug with a glass of grapefruit juice. b) Do not take the drug with high-fat foods. c) Increase intake of foods rich in vitamin K. d) Avoid aged cheeses and red wine.

b) Do not take the drug with high-fat foods. High-fat foods delay absorption and reduce peak effects of sildenafil. Clients who take the drug should not take it with high-fat foods.

A nurse is teaching an adult client about diphenhydramine. The nurse should inform the client to expect which of the following adverse effects while taking this drug? a) Muscle tremors b) Drowsiness c) Excitation d) Insomnia

b) Drowsiness

A nurse is caring for a client who has benign prostatic hypertrophy and is taking tamsulosin. The nurse should question the use of the drug if the client also has which of the following? a) A seizure disorder for which he takes carbamazepine b) Erectile dysfunction for which he takes sildenafil c) Diabetes mellitus for which he takes glyburide d) Angle-closure glaucoma for which he takes pilocarpine

b) Erectile dysfunction for which he takes sildenafil Drugs that lower blood pressure, such as sildenafil, can exacerbate hypotension in combination with tamsulosin. Clients who take sildenafil should not take tamsulosin.

A nurse should identify that dextromethorphan can have which of the following effects when combined with morphine? a) Reduced antitussive effect of dextromethorphan b) Potentiation of depression of CNS actions c) Increased renal reabsorption of the dextromethorphan d) Delayed analgesic effect of the opioid

b) Potentiation of depression of CNS actions Combining dextromethorphan with an opioid, such as morphine, increases the risk for decreased respirations and other depressed CNS responses.

A nurse is teaching a client about the use of an expectorant to treat a cough. The nurse should include that an expectorant has which of the following therapeutic effects? a) Suppresses the cough stimulus b) Reduces surface tension c) Reduces inflammation d) Dries mucous membranes

b) Reduces surface tension Expectorants act by reducing the surface tension and viscosity of respiratory secretions. This results in thinning thick mucus, making it easier to cough out of the lungs and drain out of the nose and sinuses.

A nurse is assessing a client who has a new prescription for the combination oral contraceptive ethinyl estradiol and drospirenone. Which of the following findings should the nurse identify as a contraindication to use of this medication? a) Drinks a glass of wine each night b) Smokes half a pack of cigarettes a day c) Runs marathons regularly d) Drives a school bus

b) Smokes half a pack of cigarettes a day Smoking increases the risks of thromboembolic events, hypertension, and cardiovascular disease for clients who are taking combination oral contraceptives, especially for those clients who are older than 35 years. Clients should quit smoking before starting this drug therapy.

A nurse should recognize that using pseudoephedrine to treat allergic rhinitis requires cautious use with clients who have which of the following conditions? a) Peptic ulcer disease b) A seizure disorder c) Anemia d) Coronary artery disease

d) Coronary artery disease Because pseudoephedrine, an oral sympathomimetic, can cause systemic vasoconstriction, it requires cautious use with clients who have severe hypertension or coronary artery disease.

A nurse is teaching a client who has a prescription for zileuton. Which of the following instructions should the nurse include? a) Check apical pulse before taking the drug. b) Take the drug only as needed before exercising. c) Rinse mouth after using the drug. d) Have laboratory tests performed at regular intervals.

d) Have laboratory tests performed at regular intervals. Zileuton, a leukotriene modifier, can cause liver injury. The nurse should monitor liver function once a month for 3 months, then every 2 to 3 months during the first year of treatment.

After administering terbutaline to a client to inhibit preterm labor, the nurse should assess which of the following? a) Peripheral pulses b) Temperature c) Vision d) Heart rate

d) Heart rate Terbutaline can cause tachycardia, chest pain, and palpitations. The nurse should monitor the client's ECG for tachycardia and other dysrhythmias and monitor fetal heart rate and rhythm.

A nurse is caring for a client who is about to begin taking cabergoline to treat infertility. The nurse should explain to the client the need to monitor which of the following laboratory values? a) Potassium b) Glucose c) BUN and creatinine d) Prolactin level

d) Prolactin level Cabergoline inhibits the secretion of prolactin. The provider should monitor prolactin levels to determine the appropriate dosage.

A nurse is teaching a client about the use of cromolyn sodium to prevent bronchospasm. The nurse should explain that the drug has which of the following therapeutic effects? a) Increases leukocyte activity b) Blocks muscarinic receptors c) Causes bronchodilation d) Reduces inflammation

d) Reduces inflammation Cromolyn sodium, a mast cell stabilizer, reduces inflammation by inhibiting the inflammatory response.

A nurse is caring for a client who is about to begin clomiphene therapy to treat infertility. The nurse should monitor the client for which of the following adverse effects? a) Breast cancer b) Deep-vein thrombosis c) Ovarian hyperstimulation syndrome d) Restless leg syndrome

c) Ovarian hyperstimulation syndrome Pelvic pain can indicate ovarian hyperstimulation and can lead to ovarian cyst rupture. The nurse should monitor a client who is taking clomiphene for ovarian enlargement and advise them to seek medical attention immediately for sudden or severe pelvic pain.

Which of the following information indicates that a client who is taking theophylline needs further instruction? a) the patient drives a school bus every day b) the patient drinks 8 oz of wine with dinner c) the patient exercises 1 hr each day d) the patient drinks two cups of coffee each morning

d) the patient drinks two cups of coffee each morning

For which of the following reasons should a client attach a spacer to a metered-dose inhaler? ​a) To increase the amount of drug delivered to the lungs b) To increase the amount of drug delivered to the oropharynx c) To increase the amount of drug delivered on exhalation d) To increase the speed of drug delivery into the mouth

​a) To increase the amount of drug delivered to the lungs A spacer increases the amount of drug that reaches the lungs.

A nurse is teaching a client who is beginning fluticasone propionate/salmeterol therapy. Which of the following instructions should the nurse include? a) Take the drug as needed for acute asthma. b) Follow a low-sodium diet. c) Use an alternate-day dosing schedule. d) Increase weight-bearing activity.

d) Increase weight-bearing activity. Weight-bearing activity can help minimize bone loss, which is an adverse effect of fluticasone propionate/salmeterol, an inhaled glucocorticoid and inhaled long-acting beta2 agonist (LABA) combination medication.

A nurse is teaching a client about albuterol. The nurse should instruct the client to monitor for and report which of the following as an adverse effect of this drug? a) Fever b) Bruising c) Polyuria d) Palpitations

d) Palpitations Although not common at therapeutic doses, beta2 agonists can cause cardiac stimulation, resulting in chest pain, palpitations, hypertension, and arrhythmias.

You are obtaining a health history from a client who is to start using a new ipratropium inhaler. Which of the following information from the client's history alerts you to take further action? (Select all that apply.) a) seizure disorder b) urinary retention c) depression treated with MAOIs d) hypothyroidism treated with synthetic thyroid hormone e) glaucoma

b) urinary retention e) glaucoma

Which of the following information should you include when teaching a patient about the use of an albuterol inhaler for asthma management? a) use it every 12 hours b) use it periodically to prevent exercise induced asthma c) store the drug canister in the refrigerator d) watch for an oral yeast infection

b) use it periodically to prevent exercise induced asthma

A nurse is teaching a client about using intranasal glucocorticoids. Which of the following instructions should the nurse give? a) Start at a low dose and gradually increase it. b) Take the drug as needed for nasal congestion. c) Allow at least 2 weeks for the full therapeutic effect. d) Use the drug prior to exercise.

c) Allow at least 2 weeks for the full therapeutic effect. It can take 2 or 3 weeks to see the full therapeutic effect of intranasal glucocorticoids.