Pharmacology Exam 3 NCLEX Questions (Summer)
The patient is prescribed 30 units of regular insulin and 70 units of insulin isophane suspension (NPH insulin) subcutaneously every morning. The nurse would provide what teaching to the patient for insulin administration? "Inject the needle at a 30-degree angle." "Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin." "Rotate sites at least once or twice a week." "Use a 23- to 25-gauge syringe with a 1-inch needle to increase insulin absorption."
"Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin." When insulins are mixed, withdraw the regular insulin (clear) first, followed by withdrawing the NPH insulin (cloudy).
Which statement by a patient best indicates an understanding of the teaching on flunisolide? "I will wash the plastic inhaler casing once a month." "I will rinse my mouth with water after each use." "I will take two puffs to treat an acute asthma attack." "I will not use my albuterol inhaler while I am taking AeroBid."
"I will rinse my mouth with water after each use." Flunisolide is an inhaled corticosteroid. Rinsing the mouth immediately after each use of the inhaler or nebulizer will help prevent oral candidal infections. It is not used to treat an acute asthma attack and should be taken with the patient's bronchodilator medications. The plastic inhaler casing is washed in warm, soapy water every week.
Which statement by the patient indicates an understanding of discharge teachingfor the medication alendronate? "I need to take this medication with food to prevent damage to my esophagus caused by reflux of stomach acid." "I will take the medication in the morning before I eat with 8 oz of water and remain upright for 30 minutes." "This medication will help relieve the bone pain I have from my osteoporosis." "I need to decrease my intake of dairy products to prevent hypercalcemia."
"I will take the medication in the morning before I eat with 8 oz of water and remain upright for 30 minutes." Alendronate can cause erosive esophagitis. To prevent this adverse effect, it is important for the patient to take the medication with an 8-oz glass of water in the morning on an empty stomach without any other medications and maintain an upright position for 30 minutes. These actions facilitate rapid absorption and prevent reflux into the esophagus.
A patient is being prescribed levothyroxine for the first time. Which statement by the patient indicates an understanding of discharge instructions given by the nurse? "I will stop the medication immediately if I feel pain or weakness in my muscles." "I can expect improvement of my symptoms within 1 week." "I will take a double dose to make up for the missed one." "I will take this medication in the morning so it does not affect my sleep at night."
"I will take this medication in the morning so it does not affect my sleep at night." Levothyroxine increases basal metabolic rate and thus may cause insomnia. Patients should not double the dose or stop taking the medication abruptly. It may take up to 4 weeks for a therapeutic response to occur.
A patient receiving propylthiouracil (PTU) asks the nurse, "How does this medication relieve symptoms?" What is the appropriate response by the nurse? "PTU removes thyroid hormones that are already circulating in your bloodstream, thus decreasing the adverse effects of this medication." "PTU helps your thyroid gland synthesize and use iodine, which produces hormones better." "PTU causes the pituitary gland to secrete thyroid-stimulating hormone, which blocks the production of hormones by the thyroid gland." "PTU inhibits the formation of new thyroid hormone, thus returning your metabolism to normal."
"PTU inhibits the formation of new thyroid hormone, thus returning your metabolism to normal." PTU is an antithyroid medication used to treat hyperthyroidism. It works by inhibiting the synthesis of new thyroid hormone. It does not inactivate present hormone.
When educating a patient about the use of oral contraceptives, the nurse provides what explanation for the pills having different colors each week? "The different color pills are because of different amounts of hormones in each week." "There isn't a reason for the color; it's just the choice of the drug company." "They help you remember which week you are taking." "They are color coded for the weeks of the month."
"The different color pills are because of different amounts of hormones in each week." Oral contraceptive pills can be monophasic, biphasic, or triphasic. If the pills are different colors each week, they have different amounts of hormones and are likely the triphasic type of contraceptive.
Which patient statement demonstrates understanding of radioactive iodine (I-131) therapy? "I will need to take this drug on a daily basis for at least 1 year." "This drug will be taken up by the thyroid gland and destroys thyroid tissue." "This drug will help decrease my cold intolerance and weight gain." "I will isolate myself from my family for 1 week so there is no risk of radiation exposure."
"This drug will be taken up by the thyroid gland and destroys thyroid tissue." Radioactive iodine is an antithyroid medication that is administered orally. It concentrates in the thyroid gland, where its radioactivity destroys thyroid tissue.
The nurse performs discharge teaching with a patient who is prescribed the anticholinergic inhaler ipratropium bromide. Which statement by the patient indicates to the nurse that teaching has been successful? "Nausea and vomiting are common adverse effects of this medication." "I will not drink grapefruit juice while taking this drug." "This inhaler is not to be used alone to treat an acute asthma attack." "I may gain weight as a result of taking this medication."
"This inhaler is not to be used alone to treat an acute asthma attack." Although ipratropium works to prevent bronchoconstriction and thus secondarily leads to bronchodilation, a direct-acting bronchodilator is needed to treat an acute asthma attack.
What statement by the patient demonstrates an understanding about beclomethasone dipropionate mechanism of action? "This medication will help prevent the inflammatory response of my allergies." "I only need to take this medication when my symptoms get bad." "I will monitor my blood sugar because I may develop drug-induced diabetes." "I will need to taper off the medication to prevent acute adrenal crisis."
"This medication will help prevent the inflammatory response of my allergies." Beclomethasone dipropionate is a steroid spray administered nasally. It is used to prevent and treat allergy symptoms. Its effect is localized, and therefore does not have systemic adverse effects with the recommended dose. There is no need to taper off gradually as with oral corticosteroids.
The nurse is teaching a patient about the use of leukotriene receptor antagonists (LTRAs) drugs such as zafirlukast. Which statement would be appropriate by the nurse? "Take the medication when you are short of breath and begin wheezing." "It will take about 3 or 4 weeks before you notice a therapeutic effect." "This medication works by preventing the inflammation that causes your asthma attack." "Increase fiber and fluid in your diet to prevent the common adverse effect of constipation."
"This medication works by preventing the inflammation that causes your asthma attack." LTRAs drugs block the inflammatory response of leukotrienes and thus the trigger for asthma attacks. Response to these drugs is usually noticed within 1 week. They are not used to treat acute asthma attacks. Diarrhea, not constipation, is a common adverse effect of montelukast and zafirlukast.
A patient taking oral contraceptives is being treated for a urinary tract infection with antibiotics. What information would the nurse include as education related to the oral contraceptives? "There is no drug interaction between oral contraceptives and antibiotics." "Report any abdominal pain, blood in the urine, or changes in vision." "Use an alternative method of birth control for up to 1 month during and after antibiotic use." "Your sexual partner should use a nonprescription test kit that will detect a urinary tract infection."
"Use an alternative method of birth control for up to 1 month during and after antibiotic use." When a patient takes oral contraceptives and is prescribed an antibiotic, the oral contraceptive effectiveness can be decreased, and an alternative method of birth control should be used for at least 1 month during and after taking certain antibiotics.
Which statement by the nurse would be included when teaching a patient about the proper use of metered-dose inhalers? "Wait 1 to 2 minutes before you take a second puff of the same drug." "Hold the inhaler in your mouth, take a deep breath, and then compress the inhaler." "After you inhale the medication once, repeat until you obtain relief." "Make sure that you puff out air several times after you inhale the medication."
"Wait 1 to 2 minutes before you take a second puff of the same drug." If a second puff of the same drug is ordered, instruct the patient to wait 1 to 2 minutes between puffs. If a second type of inhaled drug is prescribed, instruct the patient to wait 2 to 5 minutes between the medications or to take as prescribed.
When teaching a patient about insulin glargine, which statement by the nurse about this drug is correct? "It is often combined with regular insulin to decrease the number of insulin injections per day." "You cannot mix this insulin with regular insulin, you will have to take two injections." "You can mix this insulin with NPH insulin to enhance its effects on glucose metabolism." "The duration of action for this insulin is 8 to 10 hours, so you will need to take it twice a day."
"You cannot mix this insulin with regular insulin, you will have to take two injections." Insulin glargine is a long-acting insulin with duration of action up to 24 hours. It should not be mixed with any other insulins. It is usually dosed once daily, but it may be dosed every 12 hours depending on the patient's glycemic response.
The nurse is providing education to a patient for the prescription glipizide. The nurse explains this medication is more effective when administered at which time? 30 minutes before a meal At bedtime In the morning 15 minutes postprandial
30 minutes before a meal Glipizide works best if given 30 minutes before meals. This allows the timing of the insulin secretion induced by the glipizide to correspond to the elevation in the blood glucose level induced by the meal.
Assuming the patient eats breakfast at 8:30 A.M., lunch at noon, and dinner at 6:00 P.M., he or she is at highest risk of hypoglycemia after an 8:00 A.M. dose of NPH insulin at what time? 8:00 P.M. 2:00 P.M. 5:00 P.M. 10:00 A.M.
5:00 P.M. Breakfast eaten at 8:30 A.M. would cover the onset of NPH insulin, and lunch will cover the 2 P.M. time frame. However, if the patient does not eat a mid-afternoon snack, the NPH insulin may be peaking just before dinner without sufficient glucose on hand to prevent hypoglycemia.
Discharge teaching for a patient receiving glucocorticoids would include the use of which medication for pain management? Acetaminophen Ibuprofen Naprosyn Aspirin
Acetaminophen Acetaminophen does not cause GI distress as do aspirin, ibuprofen, naproxen, and glucocorticoids. Acetaminophen is the medication of choice for treatment of pain in a patient receiving glucocorticoids.
The nurse has a prescription for a patient to receive prednisone to treat contact dermatitis. The nurse would question this prescription for this patient with what condition? Chronic obstructive pulmonary disease Multiple sclerosis Asthma Acquired immune deficiency syndrome
Acquired immune deficiency syndrome Because of their immunosuppressant properties, glucocorticoids are often avoided in the presence of any serious infection, including septicemia, systemic fungal infections, and varicella. These drugs would be contraindicated in patients with active AIDS infection because it could potentially decrease the immune system further. One exception is tuberculous meningitis, for which glucocorticoids may be used to prevent inflammatory central nervous system damage.
The nurse would question a prescription for somatropin in a patient with which condition? Acromegaly Dwarfism Growth failure Hypopituitarism
Acromegaly Somatropin is a synthetic form of human growth hormone. Acromegaly is caused by excessive growth hormone, and thus this drug would be contraindicated.
The nurse should question a prescription for aminoglutethimide in a patient with which condition? Metastatic breast cancer Adrenal malignancy Cushing's syndrome Addison's disease
Addison's disease Aminoglutethimide suppresses the adrenal cortex. Addison's disease presents with decreased adrenal secretion; thus, you would not want to exacerbate this by administering aminoglutethimide. All of the other choices are diagnosis and indications for use for aminoglutethimide.
Which conditions is aminoglutethimide used to treat? (Select all that apply.) Select all that apply. Testicular cancer Thyroid cancer Adrenal cancer Cushing's syndrome Metastatic breast cancer
Adrenal cancer Cushing's syndrome Metastatic breast cancer Aminoglutethimide is an adrenal steroid inhibitor. Aminoglutethimide obstructs the normal actions of the adrenal cortex by inhibiting the conversion of cholesterol into adrenal corticosteroids. Aminoglutethimide is used in the treatment of Cushing's syndrome, metastatic breast cancer, and adrenal cancer.
Which information would the nurse include in a teaching plan for patients taking oral hypoglycemic drugs? (Select all that apply.) Select all that apply. Explain dietary changes are not necessary. Take your medication only as needed. Instruct that it is okay to skip breakfast 1 to 2 times per week. Advise to avoid smoking and alcohol consumption. Report symptoms of anorexia and fatigue.
Advise to avoid smoking and alcohol consumption. Report symptoms of anorexia and fatigue. Oral hypoglycemic drugs must be taken on a daily scheduled basis to maintain euglycemia and prevent long-term complications of diabetes. Skipping meals can cause low blood glucose levels and should be avoided. Patients with type 2 diabetes mellitus are managed with lifestyle changes.
Based on the nurse's knowledge of glucocorticoids, what instructions should be given for this drug? Inform the patient that the drug can be taken with coffee. Advise that the drug does not have to be tapered before stopped. Take the medication every evening. Advise to take drug with milk, other dairy products, or food.
Advise to take drug with milk, other dairy products, or food. Glucocorticoids can cause gastrointestinal (GI) distress and should be given with milk or food. They should not be administered with coffee, which contains caffeine and may increase gastric irritation. The best time to give exogenous glucocorticoids is early in the morning (6 A.M. to 9 A.M.) to minimize the amount of adrenal suppression. These medications should be tapered off slowly to prevent adrenal crisis and can be administered intravenously (IV).
A patient is making an appointment for allergy testing. The nurse instructs the patient not take what class of medications at least 4 days before allergy testing? Antihistamines Decongestants Antitussives Bronchodilators
Antihistamines An allergist will usually recommend discontinuation of antihistamine drug therapy at least 4 days before allergy testing.
The nurse is discussing with the patient management of symptoms of an upper respiratory tract infection. What classes of medications are often used in treating the symptoms of upper respiratory tract infections? (Select all that apply.) Select all that apply. Antihistamines Expectorants Nasal decongestants Antitussives Antibiotics
Antihistamines Expectorants Nasal decongestants Antitussives Treatment of the common symptoms of upper respiratory tract infections involves the combined use of antihistamines, nasal decongestants, antitussives, and expectorants. Upper respiratory tract infections are often viral or allergic in nature and the symptoms would not be managed with antibiotics.
The nurse is reviewing the adverse effects of antithyroid medications for a patient prescribed propylthiouracil (PTU). What potential serious adverse effects would the nurse discuss with the patient during discharge teaching? (Select all that apply.) Select all that apply. Bone marrow toxicity Joint pain Kidney damage Liver toxicity Increased urination
Bone marrow toxicity Joint pain Liver toxicity The most damaging or serious adverse effects of the antithyroid medications are liver and bone marrow toxicities. Myalgias and arthralgias (joint pain) may also occur with PTU.
A nurse is providing education to a group of athletes on the topic of anabolic steroids. What serious adverse effects would the nurse include in the discussion with the group of athletes? (Select all that apply.) Select all that apply. Cardiovascular disease Liver cancer Stroke Sterility Impotence
Cardiovascular disease Liver cancer Sterility Anabolic steroids have a great potential for misuse by athletes, especially bodybuilders and weight lifters, because of their muscle-building properties. Improper use of these substances can have many serious consequences, such as sterility, cardiovascular diseases, and even liver cancer. For this reason, anabolic steroids are currently classified as Schedule III controlled substances by the U.S. Drug Enforcement Administration. This classification implies that misuse of these drugs can lead to psychological or physical dependence or both.
What body system will the nurse assess for known common adverse effects of traditional antihistamines? Respiratory Cardiovascular Central nervous Gastrointestinal
Central nervous The most common adverse effect of antihistamines is drowsiness, but the sedative effects vary among antihistamine drug classes.
The nurse is discussing use of antihistamines for allergic rhinitis. What medications would be included in the list of H1 antagonists used in the treatment of allergic rhinitis? (Select all that apply.) Select all that apply. Cetirizine Nizatidine Ranitidine Fexofenadine Loratadine
Cetirizine Fexofenadine Loratadine Antihistamines are drugs that directly compete with histamine for specific receptor sites. For this reason, they are also called histamine antagonists. H1 antagonists include drugs such as diphenhydramine, chlorpheniramine, fexofenadine, loratadine, and cetirizine.
Exam 3
Chapters 30,31,32,33,34,35,36,37
When assessing for potential serious adverse effects to propylthiouracil (PTU), the nurse will monitor which laboratory test? Complete blood count (CBC) Brain natriuretic peptide Serum electrolytes Kidney function
Complete blood count (CBC) With antithyroid medications, the nurse should monitor for possible serious adverse reactions such as agranulocytosis, leukopenia, and thrombocytopenia. These would be present in a complete blood count (CBC) as abnormal values and indicate bone marrow dysfunction.
The nurse is providing care to a patient prescribed a nonselective adrenergic agonist bronchodilator. Which condition documented in the patient's medical history would alert the nurse to question this medication order? Thrombocytopenia Chronic obstructive pulmonary disease Coronary artery disease Mycobacterium tuberculosis
Coronary artery disease Nonselective adrenergic agonist bronchodilators stimulate beta1 receptors in the heart and beta2 receptors in the lungs. Stimulation of beta1 receptors can increase heart rate and contractility, increasing oxygen demand. This increased oxygen demand may lead to angina or myocardial ischemia in patients with coronary artery disease.
The nurse is caring for a patient with diabetes insipidus (DI) who is receiving vasopressin. What therapeutic effect does the nurse anticipate with the use of this medication? Increase in thirst Improved skin turgor Decrease in urine output Normal serum albumin level
Decrease in urine output Vasopressin increases the water reabsorption in the kidneys, thus decreasing urine output. It is used to treat diabetes insipidus, which presents with polydipsia, polyuria, and dehydration.
The nurse would question a prescription for estrogen replacement therapy in a patient with a history of which condition? Dysmenorrhea Deep vein thrombosis Vaginal bleeding Weight loss
Deep vein thrombosis Increased coagulation and risk of deep vein thrombosis are serious adverse effects of hormone replacement therapy and is a Black Box Warning noted on many hormonal medications.
An elderly female patient is being treated for osteoporosis with a selective estrogen receptor modulator (SERM). What condition note in the patient's history would be of concerns and indicate a need to notify the provider writing the SERM? Deep vein thrombosis Hypercalcemia Coronary heart disease Hypertension
Deep vein thrombosis The use of SERMs is contraindicated in postmenopausal women with venous thromboembolic disorders, such as deep vein thrombosis.
A patient has developed diabetes insipidus after a head injury. Which medication would the nurse anticipate to be prescribed for the management of DI in this patient? Desmopressin Corticotrophin Somatropin Octreotide
Desmopressin Vasopressin and desmopressin are used to prevent or control polydipsia (excessive thirst), polyuria, and dehydration in patients with diabetes insipidus (DI) caused by a deficiency of endogenous antidiuretic hormone.
The nurse would question a prescription for steroids in a patient with which condition? Diabetes mellitus Asthma Spinal cord injury Rheumatoid arthritis
Diabetes mellitus A common adverse effect of steroid therapy is hyperglycemia; therefore, diabetes mellitus is a contraindication to steroid therapy.
When providing general education on use of over-the-counter (OTC) medications for allergies, what instruction would the nurse to include? It may cause dry mouth and difficulty urinating. Do not use in children younger than 2 years of age unless prescribed. Discontinue use 2 days before allergy testing. The medication treats the signs and symptoms but is not a cure.
Do not use in children younger than 2 years of age unless prescribed. OTC medications for allergies are not recommended for children younger than 2 years of age unless prescribed by a health care provider.
The nurse is discussing use of antitussive medications with a patient. What common adverse effect does the nurse include in the patient teaching? Flushing and decreased heart rate Tremors and palpitations Diarrhea and abdominal cramping Drowsiness and dizziness
Drowsiness and dizziness Antitussive medications suppress cough through its action on the central nervous system, thus causing drowsiness and dizziness.
What possible common adverse effect would the nurse include in the discharge teaching for a patient prescribed finasteride? Hair loss Ejaculatory dysfunction Muscle weakness Increased libido
Ejaculatory dysfunction Possible adverse effects of finasteride include ejaculatory dysfunction, loss of libido, loss of erection, hypersensitivity reactions, gynecomastia, and severe myopathy. It is also used to treat male pattern baldness and thus would cause hair growth, not hair loss.
The nurse is providing education to a patient and the patient's caregiver, who is pregnant, on the medication dutasteride for treatment of benign prostatic hyperplasia (BPH). What important teaching would the nurse provide to the patient and the patient's caregiver about this medication? Take the medication with dairy containing products such as milk or yogurt. Instruct to put the drug into a container with other medications. Notify your health care provider for an erection that lasts 2 hours. Emphasize it must not be touched or handled by pregnant women because of teratogenic effects.
Emphasize it must not be touched or handled by pregnant women because of teratogenic effects. Finasteride and dutasteride are indicated for BPH. Both drugs are contraindicated in patients who have shown hypersensitivity and in pregnant women and children. It is considered potentially dangerous for a pregnant woman even to handle crushed or broken tablets. Both drugs are classified as pregnancy Category X.
The combined continuous administration of progestin and estrogen reduces the risk of which cancer? Breast Endometrial Vaginal Ovarian
Endometrial Estrogen, given alone, has been associated with an increased risk of endometrial hyperplasia, which can lead to endometrial cancer. Progestin reduces the incidence of endometrial hyperplasia. The combined administration reduces risk of endometrial cancer as compared to estrogen only medications.
Which is a priority nursing diagnosis for a patient receiving desmopressin (DDAVP)? Acute pain Excess fluid volume Risk for injury Deficient knowledge regarding medication
Excess fluid volume Desmopressin is a form of antidiuretic hormone, which increases sodium and water retention, leading to an alteration in fluid volume. Although the other nursing diagnoses may be appropriate, they are not a priority using Maslow's hierarchy of needs.
When caring for a pregnant patient with gestational diabetes, the nurse would question a prescription for which drug? NPH insulin Insulin glulisine Insulin glargine Glipizide
Glipizide Oral antidiabetic drugs are classified as pregnancy B or C drugs and are generally not recommended for pregnant patients.
The nurse will instruct the patient to treat hypoglycemia with which drug? Propranolol Bumetanide Glucagon Acarbose
Glucagon Glucagon stimulates glycogenolysis, raising serum glucose levels and is used to treat hypoglycemia.
After administering somatropin to a patient, the nurse would assess for potential adverse effects of this medication by monitoring which laboratory test result? Magnesium Potassium Platelets Glucose
Glucose Hyperglycemia and hypoglycemia are potential adverse effects of somatropin therapy therefor glucose levels need to be monitored.
The nurse would question the administration of testosterone to a patient with which condition noted in the history? Hypovolemia Hyperkalemia Hyponatremia Hypocalcemia
Hyperkalemia Testosterone can cause increased serum potassium levels.
The nurse would question a prescription for pseudoephedrine in a patient with a history of what condition? Hypertension Pneumonia Osteoporosis Peptic ulcer disease
Hypertension Adrenergic drugs are contraindicated in patients with hypertension, narrow-angle glaucoma, diabetes, uncontrolled cardiovascular disease, hyperthyroidism, prostatitis, or a known hypersensitivity to such drugs.
When assessing for potential adverse effects of fludrocortisone, the nurse monitors for signs and symptoms of which condition? Hypokalemia Hypercalcemia Hypovolemia Hyponatremia
Hypokalemia Fludrocortisone has mineralocorticoid properties, resulting in sodium and fluid retention along with potassium excretion. Thus, a potential adverse effect is hypokalemia. Assessing for signs and symptoms of hypokalemia and close monitoring of electrolytes are needed.
What instruction would the nurse include when teaching a patient who is prescribed an expectorant? Take the medication once a day at bedtime. Take a drug with oral codeine when cough worsens. Increase fluid intake to decrease viscosity of secretions. Restrict fluids to decrease mucus production.
Increase fluid intake to decrease viscosity of secretions. Expectorant drugs are used to decrease viscosity of secretions and allow them to be more easily expectorated. Increasing fluid intake helps this action.
For a patient taking levothyroxine and warfarin concurrently, the nurse would closely monitor for which possible serious adverse effect? Acute confusion Orthostatic hypotension Cardiac dysrhythmias Increased bruising
Increased bruising Levothyroxine can compete with protein-binding sites of warfarin, allowing more warfarin to be unbound or free, thus increasing effects of warfarin and risk of bleeding. Bleeding commonly presents as bruising.
What is a pharmacodynamic effect of exogenous androgens? Increased nitrogen excretion Decreased erythropoiesis Decreased sperm production Increased protein synthesis
Increased protein synthesis Androgens retard the breakdown of amino acids, contributing to an increased synthesis of body proteins, which aids in the formation and maintenance of muscle tissue. Additionally, they stimulate the production of erythropoietin by the kidneys, resulting in enhanced erythropoiesis (red blood cell synthesis); increase the retention of nitrogen which is essential protein synthesis; and may suppress sperm production when given in large doses as a result of the feedback inhibition of pituitary follicle-stimulating hormone.
Which actions describe the beneficial effects produced by sulfonylurea oral hypoglycemics? (Select all that apply.) Select all that apply. Inhibit breakdown of insulin by liver Increase hepatic glucose production Enhance action of insulin in various tissues Stimulate insulin secretion from beta cells
Inhibit breakdown of insulin by liver Enhance action of insulin in various tissues Stimulate insulin secretion from beta cells The sulfonylureas stimulate insulin secretion from the beta cells of the pancreas; enhance the actions of insulin in muscle, liver, and adipose tissue; and prevent the liver from breaking insulin down as fast as it ordinarily would (reduced hepatic clearance). Increased hepatic glucose production would serve to increase serum glucose levels, the opposite effect of oral hypoglycemic drugs.
When teaching a patient regarding proper application of a testosterone transdermal patch, the nurse will provide what information about application of this medication? Explain to apply the patch on the back, abdomen, or upper arms. Advise to replace the patch every 36 hours. Remind to remove the patch every 72 hours. Instruct to place the patch on clean, dry, shaved scrotal skin.
Instruct to place the patch on clean, dry, shaved scrotal skin. Testosterone transdermal patches should be placed on clean, dry, and scrotal skin that has been shaved for optimal skin contact. The patch should be replaced every 24 hours.
Which is a rapid-acting insulin with an onset of action of less than 15 minutes? Insulin aspart Insulin glargine Regular insulin Insulin detemir
Insulin aspart
Which long-acting insulin mimics natural, basal insulin with no peak action and a duration of 24 hours? Insulin glulisine Insulin glargine NPH insulin Regular insulin
Insulin glargine Insulin glargine has a duration of action of 24 hours with no peaks, mimicking the natural, basal insulin secretion of the pancreas.
The nurse is providing education to a patient with a history of chronic nasal congestion secondary to allergic rhinitis. What class of medications would the nurse anticipate the provider prescribe for the patient to use on a long-term basis? Intranasal steroids Antihistamines Antitussives Expectorants
Intranasal steroids Inhaled intranasal steroids and anticholinergic drugs are not associated with rebound congestion and are often used prophylactically to prevent nasal congestion in patients with chronic upper respiratory tract symptoms. Local intranasal steroids would have the least likely possible systemic adverse effects of all the medication classes possible to use for chronic and long-term use.
The nurse would suspect a patient is taking too much levothyroxine when the patient exhibits which adverse effect? Lethargy Weight gain Irritability Feeling cold
Irritability Irritability is a symptom of hyperthyroidism and may indicate toxicity of the medication. The other choices are signs of hypothyroidism.
What advantage does loratadine have compared with traditional antihistamines such as diphenhydramine? Less sedative effect Increase in bronchodilation Decreased risk of cardiac dysrhythmias Minimal gastrointestinal upset
Less sedative effect Loratadine is a nonsedating antihistamine and it does not readily distribute into the central nervous system, what diminishes the sedative effects associated with traditional antihistamines.
Which laboratory value would the nurse assess before administering zafirlukast to a patient? Renal function tests Complete blood count Liver enzymes Cardiac enzymes
Liver enzymes Because use of zafirlukast may lead to liver dysfunction, liver enzyme levels should be monitored regularly, especially early in the course of therapy.
Which laboratory test would the nurse anticipate the health care provider to order to monitor a patient for adverse effects related to progestin medications? Complete blood count Cardiac enzymes Liver function tests Serum creatinine level
Liver function tests One of the most serious undesirable adverse effects of progestins is liver dysfunction, which would be assessed by monitoring liver enzymes.
A nurse is providing education to a patient taking two different bronchodilator medications. The nurse identifies which characteristic as the advantage of salmeterol over other beta2 agonists such as albuterol? Longer duration of action Extended time of action Quicker peak action Shorter onset of action
Longer duration of action Salmeterol has a longer duration of action, requiring the patient to use it only twice a day instead of three or four times a day with albuterol.
The nurse is preparing a patient for a computed tomography scan using iodine contrast media. What medication would the nurse question if prescribed 1 day before the scheduled procedure? Repaglinide Pioglitazone Acarbose Metformin
Metformin The concurrent use of metformin with iodinated (iodine-containing) radiologic contrast media has been associated with both acute renal failure and lactic acidosis. Therefore, metformin should be discontinued the day of the test and for at least 48 hours after the patient undergoes any radiologic study that requires the use of such contrast media.
Patients prescribed sildenafil would be instructed regarding the potential life-threatening drug interaction with what medication? Nitroglycerin Acetaminophen Warfarin Aspirin
Nitroglycerin Sildenafil and other drugs for erectile dysfunction should not be taken with nitroglycerin. Use of erectile dysfunction medication with nitroglycerin may lead to life-threatening hypotension.
The nurse admitting a patient with acromegaly anticipates administering which medication? Somatropin Octreotide Desmopressin Corticotropin
Octreotide Octreotide suppresses growth hormone. Growth hormone is the cause of acromegaly and therefore is suppressed with medication.
What is the most common drug used for induction of labor in pregnant women and to promote ejection of milk during lactation? Mifepristone Misoprostol Oxytocin Clomiphene
Oxytocin Oxytocin is a naturally occurring hormone that can be given in synthetic form for induction of labor.
During a postpartum patient assessment, the nurse notes a boggy uterus and increased vaginal bleeding. Based on this assessment data, the nurse prepares to administer which medication? Oxytocin Dinoprostone Terbutaline Clomiphene
Oxytocin Oxytocin is a uterine stimulant that causes uterine contractions, which would decrease the vaginal bleeding via the contract and treatment of the atonic uterus.
Before administering an LTRA medication, the nurse would assess the patient for allergies to which substance? (Select all that apply.) Select all that apply. Povidone Chlorhexidine Lactose Latex Cellulose
Povidone Lactose Cellulose Allergies to povidone, lactose, titanium dioxide, or cellulose derivatives are important to note because these are inactive ingredients in LTRAs.
Pramlintide is prescribed as supplemental drug therapy to the treatment plan for a patient with type 1 diabetes mellitus. What information would the nurse include when teaching the patient about the action of this medication? Pramlintide slows gastric emptying. Pramlintide increases glucagon excretion. Pramlintide stimulates glucose production. Pramlintide corrects insulin receptor sensitivity.
Pramlintide slows gastric emptying. Pramlintide is a synthetic form of the naturally occurring hormone amylin. It works by slowing gastric emptying, suppressing glucagon secretion and hepatic glucose production, and increasing satiety (sense of having eaten enough). It is only administered via subcutaneously injection.
Which insulin can be administered by continuous intravenous (IV) infusion? Insulin detemir Insulin glargine Regular insulin Insulin aspart
Regular insulin Regular insulin is the only insulin used for IV therapy.
What oral hypoglycemic drug has a quick onset and short duration of action, enabling the patient to take the medication 30 minutes before eating and skip the dose if he or she does not eat? Acarbose Metformin Repaglinide Pioglitazone
Repaglinide Repaglinide is known as the "Humalog of oral hypoglycemic drugs." The drug's very fast onset of action allows patients to take the drug with meals and skip a dose when they skip a meal.
To prevent the development of oral candidiasis when using corticosteroid inhalers, which instruction is accurate for the nurse to teach the patient? Rinse the mouth after each use. Report any gingival irritation to the health care provider. Minimize use of an inhaler to every other day. Swish and swallow with Mycostatin after each use.
Rinse the mouth after each use. It is most important to teach patients to rinse their mouths with lukewarm water after each use of a steroid inhaler to prevent the occurrence of oral candidiasis, a fungal infection. Mycostatin is not routinely used to prevent this infection unless the patient is immunocompromised. Reporting irritation after it has occurred does not prevent the infection. Minimizing the use of the inhaler to every other day negates its therapeutic effect.
The nurse is teaching a patient taking an antithyroid medication to avoid food items high in iodine. Which food item would the nurse instruct the patient to avoid? Seafood Chicken Milk Eggs
Seafood Seafood contains high amounts of iodine and should be avoided. The other options do not contain high amounts of iodine.
Which herbal product, when taken with theophylline, can decrease theophylline's serum drug levels? Peppermint oil St. John's wort Echinacea Garlic
St. John's wort St. John's wort has been shown to enhance the rate of theophylline metabolism, thus decreasing serum levels.
A patient complains of worsening nasal congestion despite the use of oxymetazoline nasal spray every 2 to 4 hours for the past 5 days. The nurse explains this based on what knowledge? Oxymetazoline should be administered in an hourly regimen for severe congestion Oxymetazoline is not an effective nasal decongestant Sustained use of nasal decongestants over several days may result in rebound congestion The patient is probably displaying an idiosyncratic reaction to oxymetazoline
Sustained use of nasal decongestants over several days may result in rebound congestion Oxymetazoline is an effective nasal decongestant, but overuse results in worsening or "rebound" congestion. The medication should be used twice daily for no more than 3 days total.
The nurse is providing discharge teaching to a patient receiving a beta-agonist bronchodilator. What side effect would the nurse emphasize the patient needs to report? Hypoglycemia Nonproductive cough Sedation Tachycardia
Tachycardia A beta-agonist bronchodilator stimulates the beta receptors of the sympathetic nervous system, resulting in tachycardia, bronchodilation, hyperglycemia, and increased alertness.
The nurse is educating a patient about medications used to treat erectile dysfunction. Which erectile dysfunction medications have the longest therapeutic effect when taken orally? (Select all that apply.) Select all that apply. Sildenafil Tadalafil Avanafil Vardenafil Alprostadil
Tadalafil Vardenafil Phosphodiesterase inhibitors (PDIs) are used in the treatment of erectile dysfunction. Sildenafil was the first oral drug approved for the treatment of erectile dysfunction. Two drugs that are similar but have a longer duration of action are vardenafil and tadalafil. Collectively, these drugs are referred to as erectile dysfunction drugs. Avanafil is the newest PDI approved for erectile dysfunction. A second type of drug used to treat erectile dysfunction is the prostaglandin alprostadil. This drug must be given by injecting it directly into the erectile tissue of the penis or pushing a suppository form of the drug into the urethra.
The nurse receives laboratory values for a patient with a theophylline level of 14 mcg/mL. How does the nurse interpret this theophylline level? Life threatening Toxic Therapeutic Subtherapeutic
Therapeutic The therapeutic theophylline level is 10 to 20 mcg/mL.
What is the role of corticosteroids in the treatment of acute respiratory disorders? They stimulate the immune system. They increase gas exchange in the alveoli. They decrease inflammation. They directly dilate the bronchi.
They decrease inflammation. Corticosteroids can suppress the immune system. They do not directly affect bronchodilation but rather prevent bronchoconstriction as a response to inflammation.
When discussing glucocorticoids to a patient, what statement by the nurse is accurate regarding the action of these medications? They stimulate defense mechanisms to produce immunity. They are produced in lower amounts during times of stress. They decrease serum sodium and glucose levels. They regulate carbohydrate, fat, and protein metabolism.
They regulate carbohydrate, fat, and protein metabolism. Glucocorticoids play a major role in carbohydrate, lipid, and protein metabolism within the body. They are produced in increasing amounts during stress, increase sodium and glucose levels, and suppress the immune system.
A female patient arrives to the clinic for counseling on potential hormone replacement therapy. When taking the patient's history, what condition would the nurse consider as a contraindication to use of hormone replacement therapy for the patient? Osteoporosis Hyperlipidemia Thromboembolic events Early onset of menarche
Thromboembolic events A contraindication for estrogen administration is any history of thromboembolic disorder.
When teaching a patient the adverse effects of desmopressin the nurse will instruct the patient to monitor for which potential side effects? (Select all that apply.) Select all that apply. Weight gain Hypotension Hyperglycemia Nasal irritation Headache
Weight gain Nasal irritation Headache Desmopressin works to decrease urine output; thus, the patient could retain fluid and gain weight. Other common side effects include increased blood pressure, fever, headache, abdominal cramps, and nausea. Desmopressin does not affect serum glucose levels. Because it is administered intranasally, it can be irritating; thus, nostrils should be rotated.