Pharmacology Exam: Respiratory, Endocrine, Fluid & Electrolye, Cardiovascular drugs, etc.
Clients taking loop diuretics may require supplemental potassium, folic acid and vitamin B. List some foods that should be encouraged that are high in potassium.
-Avocado -Banana -Potatoes -Spinach -Beans -Citrus juices -Fish
When will you give a loop diuretic (Lasix)?
-Pulmonary edema -Edematous state -Hypertension
List the (6) different classes of anti-diabetics (oral agents).
1. Alpha-glucosidase inhibitors 2. Biguanides 3. Meglitinides 4. Sulfonylureas 5. Thiazolidinediones 6. Dipepitdyl peptidase-4 (DPP-4) inhibitors
What are the 2 main pharmacologic classes for respiratory drugs?
1. Anti-inflammatory agents 2. Bronchodilators
What are the 2 prototypes for glucocorticoids and their adverse effects?
1. Beclomethasone (inhaled) Adverse effects: adrenal suppression (not producing enough hormones), oropharyngeal candidiasi (yeast in mouth), can cause slow growth in children, promotion of bone loss, increased risk of cataracts and glaucoma 2. Prednisone (oral) Adverse effects: (long term therapy) adrenal suppression, osteoporosis, hyperglycemia, pepic ulcer disease, growth suppression in children
List 2 "Combination + LABA (long acting beta agonist)."
1. Budesonide + Formoterol -- (Symbicort) 2. Fluticasone + Salmetrol -- (Advair)
List 3 prototypes of antihistamines (oral and intranasal).
1. Diphenhydramine (Benadryl) 2. Azelastin (Astelin) 3. Loratadine (Claritin)
What are the major side effects of oral anti-diabetics? (List 2)
1. Hypoglycemia 2. Skin rash 3. Allergic reaction 4. Jaundice 5. Vitamin B12 deficiency
What are the major side effects of parenteral (injection) insulin?
1. Hypoglycemia (irritability, tachycardia, hunger, moist skin, tremor, headache, confusion, seizures) 2. Lipodystrophy, injection site reaction 3. Hypokalemia
List the prototype for sympathomimetics (oral and intranasal).
1. Phenylephrine (Neo-Synephrine) -- short acting 2. Oxymetazoline (Afrin) -- long acting
What are the therapeutic uses for osmotic diuretics?
1. Prevent renal failure 2. Manage cerebral edema to reduce intracranial pressure 3. Reduce intraocular pressure
List 2 adverse effects of Theophylline (methylxanthines).
1. Tachycardia 2. Hyperactivity 3. Sleeplessness/insomnia 4. GI distress/upset
List the medications that accelerate metabolism of Levothyroxine (Synthroid)
1. Warfarin 2. Phenytoin (Dilantin)** 3. Sertraline (Zoloft)** 4. Catrcholamines (epineprine, dopamine, dobutamine)** **To ensure adequate levothyrxine levels, patients taking these drugs may need to increase their levothyroxine dosage
What are the prototypes of leukotrine modifiers?
1. Zafirlukast (Accolate) -- oral 2. Montelukast (Singulair)
The patient is prescribed glipizide (Glucotrol), an oral antidiabetic agent, for a male client with type 2 diabetes mellitus who has been having trouble controlling the blood glucose level through diet and exercise. Which medication instruction should the nurse provide? A. "Be sure to take glipizide 30 minutes before meals." B. "Glipizide may cause a low serum sodium level, so make sure you have your sodium level checked monthly." C. "You won't need to check your blood glucose level after you start taking glipizide." D. "Take glipizide after a meal to prevent heartburn."
A. "Be sure to take glipizide 30 minutes before meals." The client should take glipizide twice a day, 30 minutes before a meal, because food decreases its absorption. The drug doesn't cause hyponatremia and therefore doesn't necessitate monthly serum sodium measurement. The client must continue to monitor the blood glucose level during glipizide therapy.
When evaluating an asthmatic client's knowledge of self-care, the nurse recognizes that additional instruction is needed when the client makes which statement? A. "I use my corticosteroid inhaler each time I feel short of breath." B. "I see my doctor if I have an upper respiratory infection and always get a flu shot." C. "I use my bronchodilator inhaler before walking so I don't become short of breath." D. "I use my bronchodilator inhaler before I visit places like the zoo because of my allergies."
A. "I use my corticosteroid inhaler each time I feel short of breath." Inhaled corticosteroids are preferred for long-term control of persistent asthma. They decrease inflammation and reduce bronchial hyperresponsiveness.
A patient is taking insulin glargine injection daily. The nurse instruct the client that the onset of action will likely happen? A. 2-4 hours after administration B. 4-12 hours after administration C. 6-12 hours after administration D. 18-24 hours after administration
A. 2-4 hours after administration Glargine is a long-acting insulin with an onset of 2-4 hours, no peak, and its duration of action is 24 hours.
A geriatric patient is prescribed with Cimetidine (Tagamet) for the treatment of heartburn. Which of the following is the most frequent CNS side effect? A. Agitation B. Drowsiness C. Somnolence D. Headache
A. Agitation Cimetidine, an H2-receptor antagonist, passes the blood brain barrier, and central nervous system side effects can happen. Most common serious side effects are confusion, agitation, depression, and disorientation
The nurse is developing a teaching plan for a male client diagnosed with diabetes insipidus. The nurse should include information about which hormone lacking in clients with diabetes insipidus? A. Antidiuretic hormone (ADH). B. Thyroid stimulating hormone (TSH). C. Follicle stimulating hormone (FSH). D. Luteinizing hormone (LH).
A. Antidiuretic hormone (ADH)
A client has begun using a methylxanthine bronchodilator. What beverage should the nurse plan to teach the client to avoid while taking this medication. A. Coffee B. Orange juice C. Mineral water D. Cranberry juice
A. Coffee Cola, coffee, and chocolate contain methlyxanthine and should be avoided when taking this medication. It can cause an increase in cardiovascular and CNS side effect.
The health care provider (HCP) has prescribed codeine sulfate (Hydrocodone) for a client with a nonproductive cough to suppress the cough reflex. The nurse should teach the client to monitor for which side effect of the medication? A. Constipation B. Painful coughing C. Increased urination D. Difficulty swallowing
A. Constipation
Besides having diuretic effects for patients with congestive heart failure, thiazides are also used to treat what? Select all that apply. A. Diabetes Insipidus B. Intraocular pressure C. Hepatic failure D. Increased intracranial pressure
A. Diabetes Insipidus C. Hepatic failure
A nurse is giving discharge instructions to a client who is receiving a bulk-forming laxative as part of the home medications. All of which are examples of bulk-forming laxative, except? A. Docusate Sodium (Colace). B. Methylcellulose (Citrucel). C. Polycarbophil (Fibercon). D. Psyllium (Metamucil).
A. Docusate Sodium (Colace). Colace is a surfactant laxative
A client is prescribed with Guaifenesin (Mucinex). The nurse determines that the client understands the proper administration of this medication if the client states that he or she will: A. Drink extra fluids while taking this medication B. Limit oral fluid intake C. Take the medication with meals only D. Take an additional dose if fever and cough persist
A. Drink extra fluids while taking this medication Drinking extra fluids hep loosen congestion and lubricate the throat while taking this medication
Which of the following medications decreases their action while taking thyroid hormone? A. Metformin B. Warfarin C. Zoloft D. Epinephrine
A. Metformin Metformin, an oral hypoglycemic drug when taken with a thyroid hormone decreases their action. Options B (anticoagulant), Option C (antidepressant) and Option D (sympathomimetic) increases their action when taken with a thyroid hormone.
A client has been prescribed with Sucralfate (Carafate) for the treatment of gastric ulcer. The nurse instructs the client that this medication is taken? A. One hour before meals B. One hour after meals C. At the same time with an antacid D. At breakfast
A. One hour before meals Sucralfate is a gastric protective agent. It works by forming a protective layer on the ulcer to serve as a barrier against acid, bile salts, and enzymes in the stomach. Taken by mouth on an empty stomach at least 1 hour before or 2 hours after eating. Do not take an antacid for at least 30 minutes before or after taking sucralfate.
A patient who was in a motor vehicle accident sustained a severe head injury and is brought into the emergency department. The provider orders intravenous mannitol (Osmitrol). The nurse knows that this is given to: A. Reduce intracranial pressure B. Reduce renal perfusion C. Reduce peripheral edema D. Restore extracellular fluid
A. Reduce intracranial pressure Mannitol is an osmotic diuretic that is used to reduce intracranial pressure by relieving cerebral edema The presence of mannitol in blood vessels in the brain creates an osmotic force that draws edematous fluid from the brain into the blood It can cause peripheral edema and is not used to restore extracellular fluid
When caring for a male client with diabetes insipidus, the nurse expects to administer: A. Vasopressin (Pitressin synthetic) B. Furosemide (Lasix) C. Regular insulin D. 10% dextrose
A. Vasopressin (Pitressin synthetic) Diabetes insipidus results from decreased antidiuretic hormone (vasopressin) production, the nurse should expect to administer synthetic vasopressin for hormone replacement. Furosemide (a diuretic) is contraindicated because a client with diabetes insipidus experiences poluyria. Insulin and dextrose are used to treat diabetes mellitus and its complications (NOT diabetes insipidus)
What is the prototype drug for Alpha-glucosidase inhibitors?
Acarbose (Precose)
What is the prototype for an SABA (short acting beta agonist)?
Albuterol
What are the prototype drugs for Peptic Ulcer disease?
Antibiotics (for Helicobacter pylori): Amoxicillin/Clarithromycin/omeprazole H2 Receptor Antagonists: Cimetidine (Tagamet) Proton pump inhibitors: Omeprazole (Prilosec) Mucosal Protectants: Sucralfate Antacids: Aluminum hydroxide/magnesium hydroxide
A patient with chronic congestive heart failure has repeated hospitalizations in spite of ongoing treatment with hydrochlorothiazide (HydroDIURIL) and digoxin. The prescriber has ordered spironolactone (Aldactone) to be added to this patient's drug regimen, and the nurse provides education about this medication. Which statement by the patient indicates understanding of the teaching? A. "I can expect improvement within a few hours after taking this drug." B. "I need to stop taking potassium supplements." C. "I should use salt substitutes to prevent toxic side effects." D. "I should watch closely for dehydration."
B. "I need to stop taking potassium supplements." Spironolactone is a potassium-sparing diuretic used to counter the potassium-wasting effects of hydrochlorothiazides. Patients taking potassium supplements are at risk for hyperkalemia when taking this medication, so they should be advised to stop the supplements.
An order reads furosemide (Lasix) 40 mg IV push. You have on hand Lasix 20 mg/2 mL. How should you prepare the correct dose? A. 2 mL B. 4 mL C. 1 mL D. 0.5 mL
B. 4 mL 40 mg x (2mL/20mg) = 4 mL
Cromolyn sodium inhaer is prescribed to a client with asthma. A nurse provides instructions regarding this medication. The nurse tells the client: A. Use this medication to abort an asthma attack B. Administer cromolyn 15 minutes before exercise and exposure to precipitating factors C. Monitor and record PEF, symtpom frequency and symptom intensity D. Dosing can activate beta-1 receptors on the heart, resulting in angina pain and tachydysrhythmias
B. Administer cromolyn 15 minutes before exercise and exposure to precipitating factors C. Monitor and record PEF, symtpom frequency and symptom intensity D is oral beta-2 agonists (albuterol) in high doses -- result in anginal pain and tachydysrhythmias
A nurse is teaching a client about the effects of diphenhydramine (Benadryl), an ingredient in the cough suppressant prescribed for the client. The nurse should plan to tell the client to take which measure while taking this medication? A. Take it on an empty stomach. B. Avoid activities requiring mental alertness. C. Use alcohol for additional effect in reducing cough. D. Avoid chewing sugarless gum or using oral rinses mouth.
B. Avoid activities requiring mental alertness. Diphenhydramine (Benadryl) has several uses, including antihistamine, antitussive, antidyskinetic, and sedative-hypnotic. Because the medication causes drowsiness, the client should avoid use of alcohol or central nervous system (CNS) depressants, operating a car, or engaging in other activities requiring mental acuity during use. It should be taken with food or milk to decrease gastrointestinal upset, and oral rinses, sugarless gum, or hard candy may be used to minimize dry mouth.
A client is receiving Sulfasalazine (Azulfidine) for the treatment of ulcerative colitis. Which of the following assessment finding will concern the nurse most? A. Drowsiness B. Decreased urine output. C. Urine discoloration D. Vomiting
B. Decreased urine output.
Which anti-diabetic drug is also used in women with poycystic ovarian syndrome? A. Acarbose B. Metformin C. Rosiglitazone D. Nateglinide
B. Metformin
Which of the following medications causes hypoglycemia, except: A. Salicylates B. Oral contraceptives C. Sulfonamides D. Anticoagulants
B. Oral contraceptives
A client has been given Loperamide hydrochloride (Imodium). Which of the following situation is the medication indicated? A. Abdominal pain B. Patients with an ileostomy C. Bloody diarrhea D. Acute dysentery
B. Patients with an ileostomy Loperamide hydrochloride is an antidiarrheal agent. It can also be used to reduce the volume of drainage from an ileostomy.
The nurse should expect a cient with HYPOTHYROIDISM to report which health concerns? A. Increased appetite and weight loss B. Puffiness of the face and hands C. Nervousness and tremors D. Thyroid gland swelling
B. Puffiness of the face and hands Hypothyroidism (myxedema) causes facial puffiness, extremity edema, and weight gain. Graves': increased appetite, weight loss, nervousness and tremors, and thyroid gland enlargement (goiter)
A nurse is about to administer Naloxone hydrochloride (Narcan) to a client with known opioid overdose. Which of the following equipment should be readily available at the bedside? A. Suction machine B. Resuscitative equipment C. Nasogastric tube D. Dressing tube
B. Resuscitative equipment
Early this morning, a female client had a subtotal thyroidectomy. During evening rounds, nurse Tina assesses the client, who now has nausea, a temperature of 104° F, tachycardia, and extreme restlessness. What is the most likely cause of these signs? A. Diabetic ketoacidosis B. Thyroid crisis C. Hypoglycemia D. Tetany
B. Thyroid crisis Thyroid crisis usually occurs in the first 12 hours after thyroidectomy and causes exaggerated signs of hyperthyroidism, such as high fever, tachycardia, and extreme restlessness. DKA is more likely to produde the 3 P's Hypoglycemia to produce weakness, tremors, profuse perspiration, and hunger Tetany typically causes uncontrollable muscle spasms, stridor, cyanosis, and possibly asphyxia
A nurse is giving discharge instructions a patient who is taking levothyroxine (Synthroid). The nurse instruct the client to notify the physician if which of the following occurs? A. Cold intolerance B. Tremors C. Coarse, dry hair D. Muscle cramps
B. Tremors Excessive doses of levothyroxine can produce signs and symptoms of hyperthyroidism which includes heat tolerance, tremors, nervousness, tachycardia, chest pain, hyperthermia, and insomnia. Options A, C, and D are signs of hypothyroidism.
What are the prototype drugs for laxatives?
Bulk Forming Agents: Methylcelulose (acts like fiber) Surfactants: Docusate Sodium (stool softener) Stimulant laxatives: Bisacodyl (stimulate intestinal mobility and increase amount of water and electrolytes in intestinal lumen) Osmotic laxatives: Magnesium hydroxide (accumulation of water causes fecal mass to soften and swell) Chloride channel activator: Lubiprostone (Amitiza) (enhances motility)
A male client with type 1 diabetes mellitus has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, the nurse would be most accurate in stating: A. "The test needs to be repeated following a 12-hour fast." B. "It looks like you aren't following the prescribed diabetic diet." C. "It tells us about your sugar control for the last 3 months." D. "Your insulin regimen needs to be altered significantly."
C. "It tells us about your sugar control for the last 3 months." The glycosylated Hb test provides an objective measure of glycemic control over a 3-month period. The test helps identify trends or practices that impair glycemic control, and it doesn't require a fasting period before blood is drawn.
A client with a duodenal ulcer is diagnosed with H. pylori infection. The physician prescribed Amoxicillin (Wymox), Pantoprazole (Prevacid), and Clarithromycin (Biaxin). Which statement made by the nurse correctly explains the purpose of these medications? A. "These medicines will control the ulcer and motion sickness" B. "These medicines will minimize acid production and will coat the ulcer" C. "These medicines will stop the acid production and will kill the bacteria" D. "The ulcer will heal because the medications will kill the bacteria".
C. "These medicines will stop the acid production and will kill the bacteria" •The triple therapy treatment of H-pylori infection is the includes 2 antibiotics (Clarithromycin and Amoxicillin) and one proton pump inhibitor such as omeprazole, lansoprazole, pantoprazole, or esomeprazole
A cient who has been receving theophylline by IV has the medication prescription changed to an immediate-release oral form of the medication. After discontinuing the IV medication, when should the nurse schedule the first dose of the oral medication? A. Just after the next meal B. Just before the next meal C. 4 hours after discontinuing the IV form D. Immediately on discontinuing the IV form
C. 4 hours after discontinuing the IV form With immediate-release preparations, oral theophylline shold eb administered 4 to 6 hours after discontinuing the IV form of the medication. If the sustained-release form is used, the first oral dose should be administered immediately on discontinuation of the IV infusion.
Glipizide (Glucotrol) is prescribed to a patient with diabetes mellitus. The nurse instruct the patient to avoid which of the following? A. Soft drinks B. Oatmeal C. Alcohol D. Organ meats
C. Alcohol Alcohol when combined with glipizide, a disulfiram-like reaction (flushing, headache, and nausea) happens. In addition, large amounts of alcohol cause hypoglycemia.
A nurse is administering an IV bolus of Cimetidine (Tagamet). Which of the following should the nurse monitor closely follow the administration? A. Respiratory rate B. Skin turgor C. Blood pressure D. Temperature
C. Blood pressure Intravenous administration of Cimetidine causes hypotension
The nurse is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse would expect to find: A. Hypotension B. Thick, course skin C. Deposits of adipose tissue in the trunk and dorsocervical area D. Weight gain in arms and legs
C. Deposits of adipose tissue in the trunk and dorsocervical area Because of changes in fat distribution, adipose tissue accumulates in the trunk, face (moonface), and dorsocervical areas (buffalo hump)
A nurse is performing an assessment on a newly admit patient who is taking propylthiouracil (PTU) daily. The nurse suspects that the client has a history of? A. Addison's B. Cushing's C. Graves' D. Myedema
C. Graves' Propylthiouracil inhibits the synthesis of thyroid hormone and is used to treat Grave's disease or hypothyroidism. Options A and B are disorders related to adrenal function. Option D indicates hypothyroidism.
A client with a chronic obstructive pulmonary disease is prescribed with Ipratropium (ATROvent). Upon reviewing the medical history of the patient, the nurse questions the prescription if which of the following is noted? A. History of smoking B. History of allergy to egg C. History of allergy to peanut D. History of a previous infection
C. History of allergy to peanut Atrovennt contains soy lecithin, which is in the same plant family as peanuts
The client has been receiving spironolactone (Aldactone) 50 mg/day for heart failure. The nurse should closely monitor the client for which condition? A. Hypermagnesemia B. Hypogcemia C. Hyperkalemia D. Hypokalemia
C. Hyperkalemia
Zafirlukast (Accolate) is prescribed for a client with bronchial asthma. What lab test does the nurse expect to be prescribed before the administration of this medication? A. Platelet count B. Neutrophil count C. Liver function tests D. Complete blood count
C. Liver function tests Zafirlukast (Accolate) is a leukotrine receptor antagonist used in the prophylaxis and long-term treatment of bronchial asthma. It is used with caution in those with impaired hepatic function. Liver function labs should be performed to obtain a baseline, and the levels should be monitored during administration of the medication.
A nurse is preparing to administer albuterol to a client. Which parameters should the nurse assess before and during therapy? A. Nausea and vomiting B. Headache and level of consciousness C. Lung sounds and presence of dyspnea D. Urine output and BUN level
C. Lung sounds and presence of dyspnea Albuterol is an arenergic bronchodilator. The nurse assess respiratory pattern, lung sounds, pulse, and blood pressure before and during therapy. The nurse also notes the color, character, and amount of sputum.
A patient with Crohn's disease is receiving an infusion therapy of Infliximab (Remicade). Which of the following should the nurse do while the patient is on this medication? A. Monitoring liver function test prior the infusion. B. Monitoring the vomiting episodes. C. Monitoring the frequency and consistency of bowel movements D. Monitoring urine output and orientation
C. Monitoring the frequency and consistency of bowel movements Crohn's disease is a condition in which the body attacks the lining of the digestive tract, causing pain, diarrhea, weight loss, and fever. Infliximab works by reducing the inflammation in the colon, thereby decreasing diarrhea
Capillary glucose monitoring is being performed every 4 hours for a female client diagnosed with diabetic ketoacidosis. Insulin is administered using a scale of regular insulin according to glucose results. At 2 p.m., the client has a capillary glucose level of 250 mg/dl for which he receives 8 U of regular insulin. The nurse should expect the dose's: A. Onset to be at 2 p.m. and its peak to be at 3 p.m. B. Onset to be at 2:15 p.m. and its peak to be at 3 p.m. C. Onset to be at 2:30 p.m. and its peak to be at 4 p.m. D. Onset to be at 4 p.m. and its peak to be at 6 p.m.
C. Onset to be at 2:30 p.m. and its peak to be at 4 p.m. Regular insulin, which is a short-acting insulin, has an onset of 15 to 30 minutes and a peak of 2 to 4 hours
Which of the following condition can the nurse safely administer Metoclopramide (Reglan)? A. Patient with bowel obstruction B. Patient with GI hemorrhage C. Patient undergoing radiation D. Patients with pheochromocytoma
C. Patient undergoing radiation Metoclopramide can be safely administered to patients having vomiting episodes following radiation, chemotherapy, and surgery. Options A and B: It is contraindicated in patients with conditions where stimulation of gastrointestinal motility might be harmful, such as mechanical bowel obstruction, bowel perforation, or gastrointestinal hemorrhage. Option D: Hypertensive crises may occur in patients with pheochromocytoma due to induction of catecholamine release from the tumor.
An osmotic laxative will be prescribed for a client. The nurse understands that which medications are osmotic laxative? Select all that apply. A. Senna (Senokot). B. Mineral Oil. C. Polyethylene glycol and electrolytes (GoLYTELY). D. Sodium Phosphate (Fleet enema). E. Bisacodyl (Dulcolax).
C. Polyethylene glycol and electrolytes (GoLYTELY). D. Sodium Phosphate (Fleet enema). Osmotics are used to attract water into the large intestines to produce bulk and stimulate peristalsis. Other osmotics are Magnesium hydroxide (Milk of Magnesia) and Magnesium citrate (Citrate of Magnesia). Senna and Bisacodyl are stimuants Mineral oil is a lubricant
A patient is taking gentamicin (Garamycin) and furosemide (Lasix). The nurse should counsel this patient to report which symptom? A. Frequent nocturia B. Headaches C. Ringing in the ears D. Urinary retention
C. Ringing in the ears Patients taking furosemide should be advised that the risk of furosemide-induced hearing loss can be increased when other ototoxic drugs, such as gentamicin, are also taken. Patients should be told to report tinnitus or dizziness or hearing loss. Nocturia may be an expected effect of furosemide. Headaches are not likely to occur with concomitant use of gentamicin and furosemide. Urinary retention is not an expected side effect.
A pediatric client with asthma has just received Omalizumab (Xolair). The nurse determines that the client might be suffering a life-threatening effect in which of the following? A. Headache and dizziness. B. Nausea and vomiting. C. Swelling of the tongue. D. Joint pain.
C. Swelling of the tongue Xolair is anti-inflammatory that is used to treat moderate to severe asthma that is caused by allergies. An anaphylactic reaction may happen (such as flushing, rash, wheezing, or swelling of face, lips or tongue)
A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg PO daily. Which finding should the nurse recognize as an adverse drug reaction? A. Dysuria B. Leg cramps C. Tachycardia D. Blurred vision
C. Tachycardia Levothyroxine, a synthetic thyroid hormone, is given to a cient with hypothyrodism to stimulate the effects of thyroxine Adverse effects of this agent include tachycardia, angina, nervousness, insomnia, and hyperthermia/sweating
Which anti-diabetic agent works best in patients with insulin resistance? A. Biguanides B. Dipeptidyl peptidase-4 inhibitors C. Thiazolidinesdiones D. Meglitinides
C. Thiazolidinesdiones Thiazolidinediones (pioglitazone and rosiglitazone) work by decreasing insulin resistance
A patient has 2+ pitting edema of the lower extremities bilaterally. Auscultation of the lungs reveals crackles bilaterally, and the serum potassium level is 6 mEq/L. Which diuretic agent ordered by the prescriber should the nurse question? A.Bumetanide (Bumex) B.Furosemide (Lasix) C.Spironolactone (Aldactone) D.Hydrochlorothiazide (HydroDIURIL)
C.Spironolactone (Aldactone) Spironolactone is a non-potassium-wasting diuretic; therefore, if the patient has a serum potassium level of 6 mEq/L, indicating hyperkalemia, an order for this drug should be questioned
List a mast cell stabilizer.
Cromolyn (inhaler)
Which of the following statements by a client taking montelukast (Singulair) should indicate the need for further teaching? A. "I will need to have my liver function checked." B. "I can take the medication with food or without." C. "I may be able to decrease the use of my metered-dose inhaler." D. "I will take the medication when I first notice I am having trouble breathing."
D. "I will take the medication when I first notice I am having trouble breathing." Montelukast cannot be used for quick relief of an asthma attack because effects of the medication develop too slowly. For prophylaxis and maintenance therapy of asthma, maximal effects develop within 24 hours of the first dose and are maintained with once-daily dosing in the evening.
A client who experiences allergic rhinitis asks the nurse about a nasal corticosteroid. How should the nurse reply? A. "Clear the nasal passages after use" B. "Take the mediction only as needed" C. "The medication should start to work immediately" D. "The medication works locally and decreases inflammation"
D. "The medication works locally and decreases inflammation" Intranasal corticosteroids may be used to treat allergic rhinitis. The medication works locally and decreases inflammation. The client should be instructed to clear the nasal passages before use for best medication effectiveness.
Montelukast (Singulair) is prescribed to a client with asthma. During the medication therapy, which of the following laboratories should be monitored? A. Complete blood count (CBC) B. Sodium and potassium C. Calcium and platelet count D. ALT and AST
D. ALT and AST Singulair is a leukotrine and is used with caution in clients with impaired renal function. ALT and AST assess liver function.
A nurse is about to administer Albuterol (Ventolin HFA) 2 puff and Budesonide/formoterol (Symbicort)) 2 puff by metered dose inhaler. The nurse plans to administer by? A. Alternating with a single puff each, starting with albuterol B. Alternating with a single puff each, starting with budesonide C. Budesonide inhaler first then the albuterol D. Albuterol inhaler firt then the budesonide
D. Albuterol inhaler firt then the budesonide Inhaling a SABA (short acting-- albuterol) allow for the widening of the air passages by the bronchodilator, making corticosteroid more effective (budesonide)
The nurse is giving medication teachings to a client receiving theophylline. The nurse instruct the client to limit the intake of which of the following? A. Apple and banana. B. Yogurt and cheese. C. Tuna and oysters. D. Cola and chocolate.
D. Cola and chocolate Theophylline is a methyxanthine bronchodilator. Caffeine should be avoided due to tachycardia.
A client with diabetes insipidus is taking an antidiuretic hormone. Which of the following symptoms would alert the need to decrease the dosage? A. Alopecia B. Jaundice C. Diarrhea D. Drowsiness
D. Drowsiness One of the side effects of taking antidiuretic hormone is water intoxication which is manifested by a headache, drowsiness, light-headedness, and shortness of breath. This could indicate the need to reduce the dosage.
A patient is brought to the ED with SOB, a repiratory rate of 30 breaths per minute, intercostal retractions and frothy, pink sputum. The nurse caring for this patient will expect to administer which drug? A. Spironolactone (Aldactone) B. Mannitol (Osmitrol) C. Hydrochlorothiazide (HydroDIURIL) D. Furosemide (Lasix)
D. Furosemide (Lasix) Furosemide, a potent diuretic, is used when rapid or massive mobilization of fluids is needed. This patient shows severe signs of congestive heart failure with respiratory distress and pulmonary edema and needs immediate mobilization of fluid
What is the priority nursing intervention for a client receiving an antiemetic? A. Monitor intake and output. B. Keep items far away from the bed. C. Keep the emesis basin at the bedside. D. Keep bed in low position with side rails up
D. Keep bed in low position with side rails up Antiemetics can cause drowsiness; hence the priority nursing intervention is to protect the client from injury such as raising the side rails and keeping the bed in low position
A home care nurse has observed a client self-administer a dose of an adrenergic bronchodilator via metered-dose inhaler. Within a short time, the client begins to wheeze loudly. The nurse understands that this is the result of which occurrence? A. Insufficient dosage of the medication, which needs to be increased B. Probable interation of this medication with an over-the-counter cold remedy C. Tolerance to the medication, indicating a need for a stonger type of bronchodilator D. Paradoxical bronchospasm, which must be reported to the health care provider (HCP)
D. Paradoxical bronchospasm, which must be reported to the HCP The client taking adrenergic bronchodilators may experience paradoxical bronchospasm, which is evidenced by the client's wheezing. This can occur with excessive use of inhalers. Further medication should be withheld and the HCP should be notified.
A client is prescribed with Omeprazole (Prilosec). The nurse determines that the client is receiving its therapeutic effect if which of the following is stated by the client: A. Relief of nausea and vomiting B. Decreased diarrhea episodes C. The absence of constipation D. Relief from GERD
D. Relief from GERD
A nurse is giving instructions a patient who is taking levothyroxine (Synthroid). The nurse tells the client that the best time to take this medication is? A. During bedtime B. After lunch C. Taken with food D. Taken on an empty stomach
D. Taken on an empty stomach Levothyroxine is taken on an empty stomach usually 30 to 60 minutes before breakfast to enhance the absorption
A client is receiving theophylline intravenously. After several dosages, the client started to become restless and complains of palpitations. The nurse determines that the client is experiencing theophylline toxicity in which of the following? A. Theophylline level of 10mcg/ml B. Theophylline level of 15mcg/ml C. Theophylline level of 20mcg/ml D. Theophylline level of 25mcg/ml
D. Theophylline level of 25mcg/ml Toxicity occurs if serum level is higher than 20mcg/mL Early signs of toxicity include restlesness, nervousness, tachycardia, tremors and palpitations
A client is scheduled to receive acetylcysteine (Mucomyst) 20% solution diluted in 0.9% normal saline by nebulizer. Which outcome would the nurse expect to see as a result of the administration of this medication? A. Bronchodilation B. Decreased coughing C. Absence of wheezing D. Thinning of respiratory secretions
D. Thinning of respiratory secretions Acetylcysteine is administered to thin bronchial secretions and is considered a mucolytic.
What is the prototype drug for loop diuretics?
Furosemide (Lasix)
What is the prototype drug for Sulfonylureas?
Glyburide (Diabeta) Avoid taking with alcohol (has disulfiram effect) Causes weight gain so not ideal for those that are overweight
What is the prototype drug for thiazide diuretics?
Hydrochlorothiazide (Hydrodiuril)
What is the safety alert for glucocorticoids?
If patient suddenly stops glucocorticoids, may cause death If patient undergoes stress (surgery), another glucocorticoid may need to be added to supply for endogenous hormone
What is the prototype for anticholinergic bronchodilators and the purpose of it?
Ipratoprium (Atrovent) Blocks parasympathetic nerve reflexes that cause airway to constrict; also help with rhinorrhea (runny nose)
What is the prototype drug for osmotic diuretics?
Mannitol (Osmitrol)
What is the prototype drug for Biguanides?
Metformin (Glucophage)
In what circumstances would you hold or question for diuretics?
NO PUDG LID P: pregnancy U: uric acid (increased?) D: diabetes G: gout Li: Lithium (can increase) D: digoxin (K-low toxic)
What is the purpose of antacids (Aluminum hydroxide/magnesium hydroxide)?
Neutralize stomach acid (used in PUD and GERD)
What is the prototype drug for antiemetics?
Ondansetron (Zofran) Can prevent the anticipatory nausea and vomiting associated with cytotoxic drugs
List the prototype drugs for opioid and non-opioid antitussives.
Opioid: Hydrocodone Non-opioid: Dextromethorphan (Robitussin), Diphenhydramine (Benadryl)
What is the prototype drug for Thiazolidenediones (Glitazones)?
Piolitazone (Actos)
What is the purpose of Mucosal protectants (Sucralfate)?
Promotes ulcer healing by creating a protective barrier against acid and pepsin Sucralfate has been used for the prevention of stress ulcers commonly seen in burn victims Sucralfate reacts with existing stomach acid to form thick coating that covers the surface of an ulcer and protects it from further damge Sucralfate does not inhibit gastric acid production
What is the purpose of Antisecretory agents (Cimetidine)?
Reduces gastric acidity **ALL Histamine2-Receptor Antagonists Antisecretrory end is -TIDINE
What is the prototype drug for Meglitinides?
Repaglimide (Prandin)
What EKG abnormalities are present in a patient experiencing hypokalemia?
ST segment depression, flattened t-wave
What is the prototype for an LABA (long acting beta agonist)?
Salmeterol
A patient who is taking digoxin is admitted to the hospital for treatment of congestive heart failure. The prescriber has ordered furosemide (Lasix). The nurse notes an irregular heart rate of 86 beats per minute, a respiratory rate of 22 breaths per minute, and a blood pressure of 130/82 mm Hg. The nurse auscultates crackles in both lungs. Which laboratory value causes the nurse the most concern? A. Blood glucose level of 120 mg/dL B. Oxygen saturation 90% C. Potassium level of 3.3 mEq/L D. Sodium level of 140 mEq/L
This patient has an irregular, rapid heartbeat that might be caused by a dysrhythmia. This patient's serum potassium level is low (below 3.5 mEq/L), which can trigger fatal dysrhythmias, especially in patients taking digoxin. Furosemide contributes to loss of potassium through its effects on the distal nephron. Potassium-sparing diuretics often are used in conjunction with furosemide to prevent this complication.
True or false: Hydrochlorothiazide cannot be taken if the patient has an allergy to sulfa.
True
True or false: Hydrochlorothiazide requires an adequate kidney function.
True
What is the prototype drug for potassium-sparing diuretics?
aldosterone antagonists: Spironolactone (Aldactone) Non-aldosterone antagonists: Triamterene (Dyrenium)
What indicates toxicity of digoxin?
hypokalemia
