Pharmacology exam 5 questions
A patient is receiving 1400 units of heparin/hr on an IV pump. The aPTT time is 54. The laboratory control is 25. Which action by the nurse is accurate?
Continue with the prescribed rate
Which medication is used in the treatment of gastric reflux esophagitis and diabetic gastroparesis?
Metoclopramide
Which organism or disorder is responsible for many cases of PUD?
H. pylori
Which is a common adverse effect of magnesium-based antacid preparations?
diarrhea
Which symptom is indicative of bleeding in a patient taking warfarin (Coumadin)?
petechiae
A patient receiving IV heparin therapy for a deep vein thrombosis (DVT) in his right calf asks why his calf remains painful, edematous, and warm to touch after 2 days of anticoagulant therapy. Which response by the nurse is most accurate?
"Heparin does not dissolve blood clots but neutralizes clotting factors, preventing extension of the clot and the possibility of it traveling elsewhere in your body."
The nurse has provided instruction to a patient recently prescribed warfarin (Coumadin). Which statement by the patient indicates to the nurse the need for further teaching?
"I will rinse my mouth with mouthwash instead of brushing my teeth."
Which explanation by the nurse is accurate to include when teaching a patient who is beginning therapy for gastroesophageal reflux disease (GERD) with metoclopramide?
"Peristalsis is increased, so food is digested more quickly."
A patient with PUD asks the nurse about the action of prokinetic medications. Which explanation by the nurse is accurate
(B) It increase the lower esophageal sphincter muscle pressure and peristalsis
The nurse is preparing to administer medications and notes that a patient has sucralfate ordered qid. When is the best time to administer this medication?
1 hour before meals
The nurse is planning to administer an antacid to a patient diagnosed with PUD who will receive an H2 antagonist at 8:00 AM. When is the most appropriate time for the nurse to provide the antacid to this patient?
2 hours after the H2 antagonist
Rivaroxaban (Xarelto) is ordered on a patient following knee replacement surgery. When providing education on this medication to the patient, the nurse conveys that treatment will continue
for 12 days postsurgically.
Cimetidine (Tagamet) is an example of which class of drug?
histamine H2 receptor antagonist
The nurse is caring for a 27-year-old woman on the postpartum unit one day following a C-section. To prevent clot formation, the nurse will:
implement deep breathing and coughing exercises.
Which information will the nurse include when teaching a patient with renal failure about antacid therapy for treatment of heartburn? (Select all that apply.)
Aluminum hydroxide antacids exacerbate constipation. Antacids neutralize gastric acid.
The nurse in a long-term care facility is preparing to pass medications to the residents. To which of the following residents should the nurse administer an antidiarrheal? (Select all that apply.)
An 80-year-old woman with diarrhea of sudden onset that has lasted 3 days A 92-year-old man with diarrhea secondary to inflammatory bowel disease A 70-year-old woman with a history chronic diarrhea from GI surgery
A patient expresses concerns about motion sickness. Which medication is most effective in preventing motion sickness?
Anticholinergics
What condition is occurring when a patient experiences nausea immediately on entering the clinic to receive another course of chemotherapy?
Anticipatory nausea and vomiting
Which is the laxative of choice for an older patient who is in the end stage of Alzheimer's disease and requires a daily laxative?
Bulk forming
The nurse is administering medications to various patients during morning medication pass. The patient at the lowest risk of having an adverse reaction is the patient receiving:
Dexamethasone
The nurse is assessing a patient with constipation. Which situation(s) would cause constipation? (Select all that apply.)
Diet low in fiber and/or residue • Iron supplements • Use of morphine
Which action will the nurse implement to decrease the risk of clot formation in an older patient on bed rest?
Encourage passive leg exercises.
Which drug therapy is aimed at reducing gastric acid secretions? (Select all that apply.
H2 antagonists proton pump inhibitors
A friend reports using loperamide (Imodium) for continual diarrhea for a week since returning home from a vacation outside the country. Which is the nurse's best response?
I'd stop taking the Imodium and go in to see a healthcare provider immediately. You may have an infection in your intestinal tract.
What is the purpose of administering filgrastim (Neupogen) to a patient who is post-bowel resection resulting from cancer?
Increase the white blood cell (WBC) counts
What is the rationale for administering fibrinolytic agents, such as streptokinase, within hours of the onset of myocardial infarction?
Inhibiting clotting mechanism
Which is an accurate nursing action when administering subcutaneous enoxaparin, a low-molecular-weight heparin product?
Leave the needle in place for 10 seconds after injection.
Which explanation by the nurse is accurate?
NSAIDs often cause GI irritation that can result in peptic ulcers.
A patient is beginning the second round of high-dose cisplatin. Severe, chemotherapy-induced nausea and vomiting (CINV) occurred following the first treatment, requiring 72 hours of continuous IV hydration. In addition to her chemotherapy regimen, which medication would be best to administer?
Parenteral ondansetron 1 hour before chemotherapy, with oral ondansetron to continue for the next 4 days
The nurse is performing a premedication assessment. For which patient would laxative use be contraindicated?
Patient with appendicitis
The pharmacologic agents used to treat DVT may act in which way(s)? (Select all that apply.)
Prevent platelet aggregation. Prevent the extension of existing clots. c. Inhibit steps in the fibrin clot formation cascade. Prolong bleeding time.
What is the purpose for the nurse administering metoclopramide (Reglan) IV postoperatively?
Prevent postoperative nausea and vomiting
What is the mechanism of action of drugs used to treat thromboembolic disease?
Preventing platelet aggregation and inhibiting clot formation
Which factor(s) prevent(s) breakdown of the body's normal defense barriers that protect against ulcer formation? (Select all that apply.)
Prostaglandins Mucous cells
Which instruction by the nurse will assist in the patient's understanding of lactulose, an osmotic laxative?
This medication draws water into the intestine and stimulates defecation."
Why is drug therapy important for selected causes of nausea and vomiting? (Select all that apply.)
Relieves the distress associated with nausea and vomiting Prevents aspiration of gastric contents into the lung Prevents dehydration Prevents electrolyte imbalances
A patient is receiving IV heparin therapy. The aPTT is 90; the laboratory control is 30 seconds. Which nursing intervention is most accurate?
STOP the heparin drip
A patient is receiving morphine for pain control. What will the nurse emphasize about preventing constipation?
Stool softeners are taken on a regular basis during opioid use.
What is an advantage of using benzodiazepines as an adjunctive treatment for nausea and vomiting associated with chemotherapy?
The antianxiety effect helps, in addition to reducing the frequency of nausea and vomiting.
Anticoagulant therapy may be used for which situation(s)? (Select all that apply.)
To prevent stroke in patients at high risk • Following a myocardial infarction • Following total hip or knee joint replacement surgery With DVT • To prevent thrombosis in immobilized patients
Why does the nurse monitor daily weights prior to the administration of antiemetic medications to chemotherapy patients?
Weight loss is a common adverse effect associated with chemotherapy, and dosages may need to be readjusted.
Which factor(s) contribute(s) to the development of PUD? (Select all that apply.)
a. Cigarette smoking c. Genetics e. H. pylori
Which are important nursing considerations when administering prokinetic agents? (Select all that apply.)
a. These agents are used to treat esophagitis associated with gastric reflux. b. They are used to treat GERD when lifestyle changes and diet are ineffective. c. They may be useful in treating nausea associated with chemotherapy treatment. d. They may be administered intravenously.
The nurse is assessing a patient taking lactulose to treat chronic constipation. Which adverse effect should the nurse immediately report to the healthcare provider?
abdominal tenderness
What is the mechanism of action of a stimulant laxative?
d. Irritates the intestine directly, promoting peristalsis and evacuation
Which drug would be most effective for an obstetric patient who is complaining of constipation as a result of her enlarging uterus and use of prenatal vitamins?
lubricant laxative
The nurse is caring for a patient receiving palliative care with opioid-induced constipation. Laxative therapy has been unsuccessful in treating this patient. Which PRN medication should the nurse provide to best alleviate this type of constipation?
methylnaltrexone
A trauma patient arrives in the emergency department via EMS. He is bleeding profusely. A medical alert bracelet indicates that he is on heparin therapy. The nurse will most likely administer which medication that counteracts the action of heparin?
protamine sulfate
The nurse is teaching a patient about dietary implications while on warfarin (Coumadin) therapy. Which salad is highest in vitamin K?
spinach
A patient who has had a myocardial infarction is advised to avoid straining with defecation. Which medication would be prescribed to this patient?
stool softeners
A patient taking misoprostol (Cytotec) to treat a gastric ulcer reports recurrent diarrhea. The nurse should encourage this patient to:
take the medication with meals.