pharmacology final.
a 16 year old boy is to receieve testosterone cypionate (Depo-testosterone), 50 mg IM every 2 weeks. The medication is available in 100-mg/mL container. How many mL will the nurse draw up in the syringe to administer for each dose?
0.5 ml per dose
A 50-year-old female is suffering from anorexia, anemia, asthenia, weight loss, and altered metabolism resulting in malnutrition. She was previously diagnosed with cancer. Which of the following describes her symptoms?
Cachexia - A general state of ill health involving marked weight loss and muscle loss.
Complex partial seizure
-affects only one part of the brain but the person's conscious state is altered rather than lost -This seizure type is also known as psychomotor seizure give the patient a deja vu, nause heat or tingling. The patient may also start performing automatism such as lip smacking, picking at clothes, walking aimlessly, and repeating nonsense phrases. -These behaviours may also be described as trance-like or robot-like and are called automatisms. The seizure usually lasts for one to two minutes but the person may be confused and drowsy for some minutes to several hours afterwards and have no memory of the seizure or the events just before or after it. They may not have any memory of this seizure.
Methotrexate purpose?
-breast, lung, head, leukemias cancer -This folate antagonistic drug can be used for severe cases of psoriasis and rheumatoid arthritis.
When educating a patient about the use of oral contraceptives, the nurse provides what explanation for the pills having different colors each week? a) "They help you remember which week you are taking." b) "There isn't a reason for the color; it's just the choice of the drug company." c) "The different color pills are because of different amounts of hormones in each week." d) "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, they have different amounts of hormones and are likely the triphasic type of contraceptive.
Trichomoniasis symptoms?
-caused by the one-celled protozoan organism -Trichomoniasis causes a foul-smelling vaginal discharge, genital itching, and painful urination in women. Men typically have no symptoms. Complications include a risk of premature delivery for pregnant women.
Women Gonorreha Symptoms
-symptoms usually in 10 days -4 /5 have no symptoms until advanced disease! -Cervicitis (inflammation of the cervix) *Vaginal discharge - yellow, pus-like -Urethritis = Pain/burning on urination -abdominal pain -Genitals inflamed= Swelling, tenderness
A patient taking oral contraceptives is being treated for a urinary tract infection with antibiotics. Which information should the nurse include as education related to the oral contraceptives? a) "Report any abdominal pain, blood in the urine, or changes in vision." b) "There is no drug interaction between oral contraceptives and antibiotics." c) "Use an alternative method of birth control for up to 1 month during and after antibiotic use." d) "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.
when the nurse is teaching about antigout drugs, which statement by the nurse is accurate? a) "drink only limited amounts of fluid with the drug" b) "this drug may cause limited movement in your joint" c) "there are very few drug interaction with these medication" d) "colchicine is best taken on an empty stomach"
"colchicine is best taken on an empty stomach"
A mother calls the clinic to ask what medication to give her 5 year old child for a fever during a bout of chickenpox. the nurse best response would be:
"you can use children's dosage of acetaminophen or ibuprofen, but aspirin is not recommended
Women Chlamydia Symptoms
-"The Silent Epidemic" -1 of 3 cases have no symptoms until advanced disease (3/4 women have no symptoms & ½ of men have no symptoms) -If symptomatic, the symptoms are usually seen 1-3 weeks after infection -Urethritis (Pain/burning with urination) -Genital irritation -Pelvic Pain -Irregular menses -Cervicitis (Vaginal discharge) -Throat infection (Oral sex) -Pre-term labor & premature births
Men Gonorrhea Symptoms
-May have no symptoms -Onset: 2-5 days after exposure (1-14 days) -Penile Discharge *Starts clear, changes to yellow/green *Thick, pus-like -Urethritis (inflammation of the urethra) *Pain/burning on urination -Pain/swelling of testicles -Swelling, tenderness in the groin *Lymph glands swollen
Secondary stage syphillis, time period, most common symptom
-The secondary stage occurs 2-8 weeks after chancre appears -common symptoms involve the mucous membrane , and lymph nodes. A rash may develop on the trunk and extremities (including palms and soles). The rash may become pustular and turn into wart-like lesions (known as condyloma latum) on the mucus membranes. All of these bumps hold the bacteria and are infectious.
Tonic-clonic seizure
-a person's body stiffens, air is forced past the vocal cords causing a cry or groan and they fall to the ground (tonic phase) -Their limbs then begin to jerk in strong, symmetrical, rhythmic movements (the clonic phase) -As consciousness returns, the person may be confused, drowsy, agitated or depressed. They may have a headache and want to sleep.
the nurse is reviewing the use of multi drug therapy for HIV with a patient. Which statements are correct regarding the reason for using multiple drugs to treat HIV? (3 answers)
-the use of multiple drugs is more effective against resistant strains of HIV - the goal of this treatment results in reduce the viral load - this type of therapy reduces the incidence of opportunistic infections
After a patient receives heparin therapy, their PTT will raise this much?
1.5-2.5 times
The nurse is planning care for a client prescribed once-daily IV gentamicin (Garamycin) therapy. When should the nurse schedule a trough drug level to be drawn? a) 12 hours after completing the antibiotic infusion b) 18 hours after completing the antibiotic infusion c) 30 minutes after beginning the antibiotic infusion d) 60 minutes after beginning the antibiotic infusion
12 hours after completing the antibiotic infusion Trough serum drug levels should be drawn at least 8 to 12 hours after the medication is infused.
The range for INR when the patient is taking coumadin?
2-3
Before administering alteplase (Activase), it is important for the nurse to perform which action? A) Perform all necessary venipunctures. B) Administer aminocaproic acid (Amicar) to prevent adverse reactions. C) Have the patient void. D) Assess for allergies to iodine
A-Perform all necessary venipunctures. : Activase is a thrombolytic drug that can interfere with the body's clotting ability. Therefore all invasive procedures should be completed before administering this drug.
When providing education to a patient undergoing antineoplastic drug therapy, the nurse would teach the patient that which signs and symptoms indicate an oncologic emergency that requires immediate notification of the health care provider? (Select all that apply.) A. Swollen tongue. B. Bleeding gums. C. Difficulty sleeping. D. New and persistent cough. E. Nausea on the day of treatment. F. Blood in urine.
A. Swollen tongue. B. Bleeding gums. D. New and persistent cough. F. Blood in urine.
A patient is experiencing a seizure that has lasted for several minutes and he has not regained consciousness. The nurse recognizes that this is a life-threatening emergency known as: A. status epilepticus B. tonic-clonic confulsion C. epilepsy D. secondary epilepsy
A. status epilepticus
A client who has a new antibacterial drug order needs to take a dose on an empty stomach three times daily. After learning that the client awakens at 7:00 AM each morning and leaves the house at 8:30 AM for work, the nurse plans with the client that the doses should be taken at 1. 7:00 AM, 3:00 PM, and 11:00 PM. 2. 8:00 AM, 12:00 PM, and 4:00 PM. 3. 8:30 AM, 2:30 PM, and 6:30 PM. 4. 9:00 AM, 5:00 PM, and 12:00 AM.
7:00 AM, 3:00 PM, and 11:00 PM. The times of antibacterial drug administration should be spaced as evenly as possible over a 24-hour period to ensure stable and consistent serum levels. Antibacterials to be given four times daily should be administered every 6 hours; those administered three times daily are given every 8 hours.
The nurse should question a prescription to administer acetylsalicylic acid (aspirin) to which client? a) A 62-year-old patient with a history of stroke b) A 45-year-old patient with a history of heart attack c) A 28-year-old patient with a history of sports injury d) A 14-year-old patient with a history of flulike symptoms
A 14-year-old patient with a history of flulike symptoms Aspirin should never be administered to children with flulike symptoms. The use of aspirin in children with flulike symptoms has been associated with Reye's syndrome
When handling and administering vesicant drugs the nurse will: A. double-flush the patient's bodily secretions in the commode. B. use sterile towels to clean up after chemotherapy spills. C. mix chemotherapeutic drugs in the patient's room. D. teach the patient how to administer parenteral chemotherapeutic drugs.
A. When providing care to patients receiving vesicant drugs as well as handling and administering these drugs the nurse should double-flush the patient's bodily secretions in the commode and use special hampers for the disposal of all items that come in contact with the patient, including used personal protective equipment. If a spill should occur, the nurse should use special spill kits to clean up even the smallest chemotherapy spills. Nurses who are specially trained, current and certified should administer chemotherapeutic agents.
When chemotherapy with alkylating drugs is planned, the nurse expects to implement which intervention to prevent nephrotoxicity? A. Hydrating the patient with intravenous fluids before chemotherapy. B. Limiting fluids before chemotherapy. C. Monitoring drug levels during chemotherapy. D. Assess creatinine clearance during chemotherapy
A. Hydrating the patient with intravenous fluids before chemotherapy.
What are the major adverse effects specific to the cytotoxic antibiotics? A. Liver toxicity. B. Cardiovascular toxicity. C. Pneumonitis. D. Neurotoxicity. E. Nephrotoxicity.
A. Liver toxicity. B. Cardiovascular toxicity. C. Pneumonitis. E. Nephrotoxicity.
Which are known adverse effects of alkylating agents? (Select all that apply.) A. Nephrotoxicity. B. Neurotoxicity. C. Ototoxicity. D. Bone marrow suppression. E. Cardiotoxicity.
A. Nephrotoxicity. B. Neurotoxicity. C. Ototoxicity. D. Bone marrow suppression.
progesterone
A sex hormone that is produced by the corpus luteum and serves to prepare the uterus for possible implantation.
Nursing care for a patient receiving alteplase (Activase) would include which action? (Select all that apply.) A) Record vital signs and report changes. B) Observe for signs and symptoms of bleeding. C) Monitor liver enzymes. D) Assess for cardiac dysrhythmias.
A,- Record vital signs and report changes B- observe for signs and symptoms of bleeding D) Assess for cardiac dysrhythmias. Alteplase can cause bleeding as well as cardiac dysrhythmias. Vital sign changes can alert the nurse to these complications. Alteplase does not directly affect liver enzymes. Injections should not be administered intramuscularly because of the increased risk of bleeding.
Combinations of chemotherapeutic drugs are frequently used for which purpose? (Select all that apply.) A. Preventing drug resistance. B. Providing a synergistic action. C. Decreasing cost of treatment. D. Decreasing the severity of adverse effects. E. Decreasing drug tolerance.
A. Preventing drug resistance. B. Providing a synergistic action. D. Decreasing the severity of adverse effects.
3. During administration of oxytocin (Pitocin) to a woman in labor, the nurse should plan to monitor drug effectiveness. This monitoring should include 1. assessment of maternal and fetal vital signs at least every 15 minutes. 2. assessment of the blood pressure and pulse during administration of the oxytocic agent. 3. continuing the agent if uterine hyperactivity occurs. 4. asking no questions about fetal movement except for those concerning age and parity.
ANS: 1 Checking maternal blood pressure and pulse every 15 minutes and maintaining continuous fetal monitoring should occur with the administration of oxytocin.
Fluorouracil is ordered as an adjunct therapy to surgery. The nurse recalls that this drug is classified as which of the following types of chemotherapy drugs? 1. Antimetabolite agent 2. Antibiotic antitumor agent 3. Alkylating agent 4. Hormonal antitumor agent
ANS: 1 Fluorouracil is an antimetabolite drug that interferes with the synthesis of DNA and RNA
1. Estrogen therapy is given cyclically or with the use of progestins to decrease the risk of 1. ovarian cancer. 2. endometrial cancer. 3. breast cancer. 4. vaginal cancer.
ANS: 2 Estrogens are administered at the lowest effective dosage, and the client should be evaluated annually to determine continuance of therapy. To reduce the risk of endometrial hyperplasia or cancer, the concurrent use of a progestin for 10 to 14 days of the cycle is recommended for women with an intact uterus.
6. The nurse who works with hypertensive clients concludes that the client taking which of the following antihypertensive drugs is at lowest risk for experiencing sexual dysfunction as an adverse drug effect? 1. Propranolol (Inderal) 2. Lisinopril (Prinivil) 3. Diltiazem (Cardizem) 4. Methyldopa (Aldomet)
ANS: 2 Propranolol (Inderal) and other -adrenergic blockers have been associated with decreased libido and erectile dysfunction. The calcium channel blockers, including nifedipine (Adalat, Procardia), diltiazem, and verapamil (Calan, Isoptin) may cause erectile dysfunction.
5. The school nurse conducting health teaching about the risks of androgen abuse would target which of the following groups as being at highest risk? 1. Students who do not socialize well in school 2. Students who act out in class excessively 3. Students who are on athletic teams 4. Students with excessive absence or tardiness
ANS: 3 Androgens are also potent anabolic agents; they stimulate the formation and maintenance of muscular and skeletal protein. Athletes have used androgens to increase weight, musculature, and muscle strength. Many major sporting events disqualify athletes who have documented use of such products.
2. Which of the following active problems in a client's history would be a contraindication to the administration of estrogen? 1. Hypertension 2. Dysmenorrhea 3. Thrombophlebitis 4. Weight gain
ANS: 3 Estrogen therapy is contraindicated with breast cancer, abnormal or undiagnosed vaginal bleeding (possible endometrial hyperplasia or carcinoma), and active thromboembolic disorders.
If extravasation of intravenous fluorouracil occurs, the most appropriate nursing intervention would be to stop the infusion and 1. apply warm compresses. 2. give 25% hydrocortisone intramuscularly. 3. apply cold compresses. 4. give 20% lidocaine intravenously.
ANS: 3 If extravasation occurs, fluorouracil administration should be stopped immediately, and the remaining dose should be injected into another vein. Cold compresses may reduce local tissue damage.
4. The client who is receiving finasteride (Proscar), which causes shrinkage of the enlarged prostate gland, should be monitored for which of the following adverse effects? 1. Bradycardia 2. Increased amount of ejaculate 3. Increased libido 4. Impotence
ANS: 4 The adverse effects of finasteride are a decreased libido, impotence, and a decreased amount of ejaculate.
Just before the second course of chemotherapy, the lab calls to report that a patient's absolute neutrophil count is 600 cells/mm3. The nurse expects that the oncologist will follow which course of treatment? A. Chemotherapy will continue as scheduled. B. Chemotherapy will resume with a lowered dosage. C. Chemotherapy will be withheld until the neutrophil count returns toward normal levels. D. Chemotherapy will resume after a transfusion of neutrophils.
ANS: C The normal range for neutrophils is above 2000 cells/mm3. If neutrophils are decreased to levels of less than 1800 to 2000 cells/mm3 (neutropenia), there is risk for severe infection. Chemotherapy will be held until the count returns toward normal levels.
What is the appropriate method of administering an antiepileptic drug? 1. Give the medication every 8 hours 2. Administer the medication during the day 3. Give one dose of the medication and obtain a serum level 4. Establish a drug regimen based on the half-life of the medication
ANS: Establish a drug regimen based on the half-life of the medication Antiepileptic drugs should be administered by using as long an interval between doses as possible, depending on their half-life.
If a client has a very high serum level of phenytoin (Dilantin) of 35 mg/mL, the nurse would assess for which of the following problems? 1. Tachycardia 2. Hypertension 3. Nystagmus 4. Nightmares
ANS: Nystagmus Very high levels of phenytoin can result in nystagmus (eye twitching), or diplopia, and may actually increase seizure risk.
2)When teaching a client about medications before discharge, the nurse should realize that antiepileptic drug therapy failure is most commonly caused by 1. drug tolerance and chronic administration. 2. mismanagement of medications by the client. 3. inadequate liver metabolism. 4. drug and dietary interactions.
ANS: mismanagement of medications by the client. One of the most common causes of seizure exacerbations is the mismanagement of medications by the client.
The nurse is assessing a patient who has experienced severe neutropnia after chemotherapy and will monitor for which possible signs of infection? (Select all that apply.) A- Elevated WBC count B- Fever C- Nausea D- Sore throat E- Chills
ANSWER-B, D, E Fever Sore throat chills
If extravasation of an antineoplastic medication occurs, which intervention will the nurse perform first? A- Apply cold compresses to the site while elevating the arm B- Inject subcutaneous doses of epinephrine around the IV site every 2 hours C- Stop the infusion immediately while leaving the catheter in place D- Inject the appropriate antidote through the IV catheter
ANSWER-C Stop the infusion immediately while leaving the catheter in place
Medications used to treat HIV infections are more specifically classified as what type of drugs? a) Antiviral b) Antifungal c) Antiparasitic d) Antiretroviral
Antiretroviral HIV is a member of the retrovirus family; therefore, drugs used to treat this virus are classified as antiretroviral drugs. Although antiretroviral drugs also fall under the broader category of antiviral drugs in general, their mechanisms of action are unique to the acquired immune deficiency syndrome virus. So, they are more commonly referred to by their subclassification as antiretroviral drugs
Treatment for Chlamydia?
Azithromycin 1 gm po x 1 (perferred) OR Doxycycline 100 mg BID x 7 days
The patient asks what the difference is between dalteparin (Fragmin) and heparin. What is the nurse's best response? A) "There is really no difference, but dalteparin is preferred because it is less expensive." B) "Dalteparin is a low molecular weight heparin that has a more predictable anticoagulant effect." C) "I'm not really sure why some physicians choose dalteparin and some heparin, so you should ask your doctor." D) "The only difference is that heparin dosing is based on the patient' s weight."
B. "Dalteparin is a low-molecular-weight heparin that has a more predictable anticoagulant effect." A low-molecular-weight heparin is more predictable in its effect than regular heparin. Dalteparin is more expensive than heparin and is dosed based upon the patient's weight.
A patient is started on oral anticoagulant therapy while still receiving intravenous heparin. The patient is concerned about risk for bleeding. What is the nurse's best response? A) "Your concern is valid in that you are at an increased risk for bleeding, so I will call the doctor to discontinue the heparin." B) "It usually takes 4 to 5 days to achieve a full therapeutic effect for warfarin, so the heparin is continued to help prevent blood clots until the warfarin is working up to speed." C) "Because of your valve replacement, it is especially important for you to be fully anticoagulated, and the heparin and warfarin together are more effective than one alone." D) "Because you are now up and walking, you have a higher risk of blood clots and therefore need to be on both medications."
B. "It usually takes 4 to 5 days to achieve a full therapeutic effect for warfarin, so the heparin is continued to help prevent blood clots until the warfarin is working up to speed." Warfarin works by decreasing the production of clotting factors. However, it takes 4 to 5 days for the body to use up present clotting factors and thus achieve a full therapeutic anticoagulant effect. Because of this, heparin is continued until this is achieved.
The nurse would assess which laboratory value to determine the effectiveness of intravenous heparin? A) Complete blood count (CBC) B) Activated partial thromboplastin time (aPTT) C) Prothrombin time (PT) D) BUN
B. Activated partial thromboplastin time (aPTT) Rationale Heparin dosing is based on aPTT results. The PT is reflective of warfarin's anticoagulant effect.
What is considered a major dose-limiting side effect of doxorubicin (Adriamycin)? A. Hemorrhagic cystitis B. Cardiomyopathy C. Hepatoxicity D. Nephrotoxicity
B. Cardiomyopathy
A patient who is taking an anticoagulant requests an aspirin for headache relief. What is the nurse's best action? A) Administer 650 mg of acetylsalicylic acid (ASA), and reassess pain in 30 minutes. B) Inform the patient of potential drug interactions with anticoagulants. C) Explain to the patient that ASA is contraindicated, and administer ibuprofen as ordered. D) Explain that the headache is an expected side effect and will subside shortly.
B. Inform the patient of potential drug interactions with anticoagulants. Patients taking an anticoagulant should not use medications that would further increase the risk of bleeding.
How would the nurse define the term nadir to a patient? A. The average number of days it takes the bone marrow to recover from a dose of chemotherapy B. The average number of days it takes for chemotherapy to have its peak effect on the bone marrow C. The patient's tolerance to the chemotherapy's bone marrow suppressant effect D. The maximum dose for a chemotherapy drug in reference to bone marrow suppression
B. The average number of days it takes for chemotherapy to have its peak effect on the bone marrow.
The nurse understands that a patient's international normalized ratio (INR) value of 2.5 means that A) the patient is not receiving enough warfarin for a therapeutic effect. B) The patient's warfarin dose is within the therapeutic range C) the patient is not receiving enough subcutaneous heparin for a therapeutic effect. D) the patient is receiving a dangerously high amount of heparin.
B. The patient's warfarin dose is within the therapeutic range INR determination is a routine test to evaluate coagulation while patients are taking warfarin, not heparin. A therapeutic INR is 2 to 3.
The nurse is discussing the use of alkylating drugs with the patient. What is the best way to describe the mechanism of action of alkylating drugs on cancer cells? A. They interact with the cell through intercalation. B. They alter the chemical structure of the DNA. C. They change the structure of the RNA. D. They stop the meiosis of the cell.
B. They alter the chemical structure of the DNA.
Which are general adverse effects of chemotherapy? (Select all that apply.) A. Leukocytosis. B. Thrombocytopenia. C. Alopecia. D. Urinary retention. E. Hypertension.
B. Thrombocytopenia. C. Alopecia (sudden hair loss). Bone marrow suppression leads to leukopenia, neutropenia, and thrombocytopenia. Alopecia is a common adverse reaction to antineoplastic drugs.
A patient has been diagnosed with metabolic syndrome and is started on the biguanide metformin (Glucophage). The nurse knows that the purpose of the metformin, in this situation, is which of these? A. To increase the pancreatic secretion of insulin B. To decrease insulin resistance C. To increase blood glucose levels D. To decrease the pancreatic secretion of insulin
B. To decrease insulin resistance
the nurse is giving an intravenous dose of phenytoin (Dilantin). which guidelines will the nurse follow for administration? (select all that apply) A. phenytoin should be injected quickly B. phenytoin should be injected slowly C. phenytoin should be followed by an injection of sterile saline D. continuous infusion should be avoided
B. phenytoin should be injected slowly C. phenytoin should be followed by an injection of sterile saline D. continuous infusion should be avoided
A patient who has been anticoagulated with warfarin (Coumadin) is admitted with gastrointestinal bleeding. The nurse will anticipate administering which substance? A) vitamin E B) vitamin K C) protamine sulfate D) calcium gluconate
B. vitamin K Vitamin K is the antagonist for warfarin.
Treatment for Syphilis?
Benzathine is given to treat with 1 dose of 2.4 million units IM No sex for a week
When administering Streptokinase it is important to watch for this major side effect.
Blood loss
A pregnant woman has been diagnosed with cancer and is meeting with her oncologist to plan treatment. Which statement about chemotherapy and pregnancy is true? A. She will have to wait until the baby is born before starting chemotherapy. B. The greatest risk of fetal harm from chemotherapy is during the third trimester. C. Chemotherapy treatment during the second or third trimester poses less risk to the fetus. D. Chemotherapy is unsafe during pregnancy, but radiation therapy is safe in low doses.
C. Both radiation and chemotherapy treatments can cause significant permanent fetal harm or death. The greatest risk is during the first trimester. Chemotherapy treatment during the second or third trimester is more likely to improve maternal outcome without significant fetal risk. However, radiation treatment poses great risk to the fetus throughout pregnancy and should be reserved for the postpartum period if possible. Prepubertal patients are more resilient, however, and can have normal puberty and fertility.
The nurse is caring for a patient who received chemotherapy 24 hours ago. The patient's white blood cell count is 4,400 mcL. Which symptom, if experienced by the patient, should the nurse report to the prescriber immediately? A. Fatigue. B. Diarrhea. C. Fever. D. Nausea and vomiting.
C. Fever is the principal early sign of infection, especially in those with a low white blood cell count. The presence of a fever is of utmost concern and should be reported immediately. Normal white blood cell count is 4,500-10,000 mcL.
When working with a patient who is neutropenic, the nurse identifies which as the most effective measure to prevent the patient from developing an infection? A. Administer prophylactic antibiotics B. Stop administration of the chemotherapeutic drug C. Perform hand hygiene D. Vaccinate the patient to prevent bacterial infection
C. Risk of infection from leukopenia or neutropenia and/or immunosuppression is one of the more significant adverse effects that requires close attention. Following Standard Precautions and using good handwashing technique are most important in preventing transmission of infection in the hospital and home settings.
Which statement when made by the patient indicates deficient knowledge regarding warfarin? A) "I will avoid contact sports." B) "I will take my medication in the early evening each day." C) "I will increase the dark green leafy vegetables in my diet." D) "I will contact my physician if I develop excessive bruising."
C. "I will increase the dark green leafy vegetables in my diet." Rationale Dark green leafy vegetables are rich in vitamin K, which would antagonize the effects of warfarin. Therefore, it is important to maintain a consistent daily intake of vitamin K and avoid eating large amounts of these foods.
During treatment with doxorubicin (Adriamycin), the nurse must monitor closely for which potentially life-threatening adverse effect? A. Nephrotoxicity. B. Peripheral neuritis. C. Cardiomyopathy. D. Ototoxicity.
C. Cardiomyopathy
Current research has lead to discovery of cancer-causing viruses. Which virus that is linked to cancer can be prevented by vaccination in humans? A. Rous sarcoma virus. B. Shope papillomavirus. C. Human papillomavirus. D. Leukemia viruses.
C. Human papillomavirus
The nurse would anticipate administering which medication to patients receiving high-dose methotrexate (Trexall)? A. bleomycin (Blenoxane) B. cisplatin (Platinol) C. leucovorin D. dactinomycin (Cosmegen)
C. leucovorin
Nausea and vomiting are frequent adverse effects associated with antineoplastic therapy. Patients who are experiencing this unpleasant effect will be advised A. to avoid eating any food during chemotherapy. B. that nothing can be done for this effect and that it will pass with time. C. to try to maintain hydration and nutrition, which are very important during treatment. D. to use antacids to relieve the irritation to the stomach, which should stop the nausea.
C. to try to maintain hydration and nutrition, which are very important during treatment.
Gonorhea treatments?
Ceftriaxone 250 mg IM x 1 PLUS Azithromycin 1 gm PO x 1 (perferred) or Doxycycline 100 mg PO BID 7 days
a patient is experiencing stomatitis after a round of chemotherapy. Which intervention by the nurse is correct? A- Clean the mouth with a soft-bristle toothbrush and warm solution B- Rinse the mouth with commercial mouthwash twice a day C- Use lemon-glycerin swabs to keep the mouth moist D- Keep dentures in the mouth between meals
Clean the mouth with a soft-bristle toothbrush and warm solution
A patient is receiving chemotherapy is experiencing severe bone marrow suppression. Which nursing diagnoses is most appropriate at this time? A- Activity intolerance B- Risk for infection C- Disturbed body image D- Impaired physical mobility
Risk for infection
cephalosporin side effects? patient teaching? drug interaction?
SIDE EFFECTS: LIKE PENICILLIN PATIENT TEACHING: assess for penicillin allergy, give orally with food to decrease GI upset, avoid alcohol DRUG INTERACTION: NSAIDS, OCP, WAFARIN, OTHER
a newly admitted patient reports a penicillin allergy. the prescriber has ordered a second-generation cephalosporin as part of the therapy. which nursing action is appropriate?
call the prescriber to clarify the order because of patient allergy
A patient who is receiving high-dose chemotherapy with methotrexate is also receiving leucovorin. The purpose of the leucovorin is to: A. produce an additive effect with the methotrexate by increasing its potency against the cancer cells. B. reduce the incidence of cardiomyopathy caused by the methotrexate. C. add its antiinflammatory effects to the treatment regimen. D. reduce the bone marrow suppression caused by the methotrexate.
D. Leucovorin "rescue" is prescribed to reduce the bone marrow suppression that is associated with high-dose methotrexate therapy.
A patient who is receiving chemotherapy with cisplatin (Platinol) has developed pneumonia. The nurse would be concerned about nephrotoxicity if which antibiotic was ordered as treament for the pneumonia at this time? A. Penicillin. B. Sulfa drug. C. Fluoroquinolone. D. Aminoglycoside.
D. Aminoglycoside
A patient is receiving her third course of 5-fluorouracil therapy and knows that stomatitis is a potential adverse effect of antineoplastic therapy. What will the nurse teach her about this problem? A. Aspirin should be taken to prevent the development of stomatitis. B. She should watch for and report black, tarry stools immediately. C. She should increase her intake of foods containing fiber and citric acid. D. She should examine her mouth daily for bleeding, painful areas and ulcerations.
D. Examine mouth daily for bleeding, painful areas and ulcerations.
Before emergency surgery, the nurse would anticipate administering which medication to a patient receiving heparin? A) vitamin K B) vitamin E C) phenytoin D) protamine sulfate
D. protamine sulfate Protamine sulfate binds with heparin in the bloodstream to inactivate it and thus reverse its effect.
A patient has been taking antiepileptic drugs for a year. the nurse is reviewing his recent history and will monitor for which condition that may develop during this time? A. loss of appetite B. jaundice C. weight loss D. suicidal thoughts or behavior
D. suicidal thoughts or behavior
The nurse would question a prescription for estrogen replacement therapy in a patient with a history of which condition? a) Weight loss b) Dysmenorrhea c) Vaginal bleeding d) Deep vein thrombosis
Deep vein thrombosis Increased coagulation and risk of deep vein thrombosis are serious adverse effects of hormone replacement therapy.
An elderly female patient being treated for osteoporosis with a selective estrogen receptor modulator (SERM) should alert the nurse for an increased risk of which condition? a) Hypertension b) Hypercalcemia c) Deep vein thrombosis d) Coronary heart disease
Deep vein thrombosis The use of SERMs is contraindicated in postmenopausal women with venous thromboembolic disorders, such as deep vein thrombosis.
oral contraceptive become less effective when mix which drugs?
The effectiveness of this drug is decreased when mixed with antibiotics, barbiturates, isoniazid, rifampin. Also this drug may decrease of the effect of these drugs; Anticonvulsants, beta-blockers, hypoglycemic drugs, oral anticoagulants, theophylline, TCAs, vitamins, and hypnotics.
benign prostatic hyperplasia (BPH)
a nonmalignant enlargement of the prostate gland.
What possible common adverse effect would the nurse include in the discharge teaching for a patient prescribed finasteride (Proscar)? a) Hair loss b) Increased libido c) Muscle weakness d) Ejaculatory dysfunction
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 (Avodart) 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? a) Instruct to put the drug into a container with other medications. b) Notify your health care provider for an erection that lasts 2 hours. c) Take the medication with dairy containing products such as milk or yogurt. d) 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 (Proscar) and dutasteride (Avodart) 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? a) Breast b) Vaginal c) Ovarian d) Endometrial
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 nurse monitors a patient who is experiencing thrombocytopenia from severe bone marrow suppression by looking for A- Severe weakness and fatigue B- Elevated body temperature C- Decreased skin turgor D- Excessive bleeding and bruising
Excessive bleeding and bruising
what is Methotrexate drug?
Folate antagonist drug used to interfere with the folic acid preventing the production DNA thereby causing cell death.
The nurse should assess a client for nephrotoxicity and ototoxicity when administering which antimicrobial? a) Cefazolin (Ancef) b) Clindamycin (Cleocin) c) Gentamicin (Garamycin) d) Erythromycin
Gentamicin (Garamycin) Aminoglycoside antibiotics, including gentamicin, have a high risk for nephrotoxicity and ototoxicity.
The nurse would question the administration of testosterone (Androderm) to a patient with which condition? a) Hypovolemia b) Hypocalcemia c) Hyponatremia d) Hyperkalemia
Hyperkalemia Testosterone can cause increased serum potassium levels.
A mother suspects that her toddler has eaten an entire bottle of chewable aspirin tablets. The nurse will assess for which most common signs of salicylate intoxication in children? A. Photosensitivity and nervousness B. Tinnitus and hearing loss C. Acute gastrointestinal bleeding and anorexia D. Hyperventilation and behavioral changes
Hyperventilation and behavioral changes
When administering a nonsteroidal antiinflammatory drug and a penicillin drug together, the displacement of the penicillin antibiotic from the protein-binding sites will result in which effect? a) Increased free drug in blood b) Decreased free drug in blood c) No change in free drug in blood d) Absence of free drug in the blood
Increased free drug in blood Drugs that are not bound to protein are free and thus active to exert their therapeutic (or toxic, if too much free) effect.
What is a pharmacodynamic effect of exogenous androgens? a) Decreased erythropoiesis b) Increased protein synthesis c) Increased nitrogen excretion d) Decreased sperm production
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.
When teaching a patient regarding proper application of a testosterone (Testoderm) transdermal patch, the nurse will provide which information about this medication? a) Advise to replace the patch every 36 hours. b) Remind to remove the patch every 72 hours. c) Instruct to place the patch on clean, dry, shaved scrotal skin. d) Explain to apply the patch on the back, abdomen, or upper arms.
Instruct to place the patch on clean, dry, shaved scrotal skin. Testoderm transdermal patches should be placed on clean, dry scrotal skin that has been shaved for optimal skin contact. A patch should be replaced every 24 hours.
Which laboratory test would the nurse expect the health care provider to prescribe to monitor a patient for adverse effects related to progestin medications? a) Cardiac enzymes b) Liver function tests c) Complete blood count d) 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.
The nurse recognizes that the patient understands the teaching about warfarin (Coumadin) when the patient verbalizes an increased risk of bleeding with concurrent use of which herbal product? (Select all that apply.) a) Garlic b) Ginkgo c) Dong quai d) Glucosamine e) St. John's wort
a) Garlic b) Ginkgo c) Dong quai e) St. John's wort Garlic, ginkgo, dong quai, and St. John's wort alter blood coagulation and may increase the risk of bleeding when given concurrently with oral anticoagulants. Glucosamine does not affect coagulation.
Bacterial Vaginosis Treatment?
Metronidazole 500 mg orally twice a day for 7 days OR Metronidazole gel 0.75%, one full applicator (5 g) intravaginally, once a day for 5 days OR Clindamycin cream 2%, one full applicator (5 g) intravaginally at bedtime for 7 days
the nurse recognizes that manifestation of NSAID toxicity include
Nausea and vomiting
Patients prescribed sildenafil (Viagra) should be instructed regarding the potential life-threatening drug interaction with which medication? a) Warfarin (Coumadin) b) Nitroglycerin (Nitrostat) c) Acetaminophen (Tylenol) d) Aspirin (Acetylsalicylic acid)
Nitroglycerin (Nitrostat) Sildenafil and other drugs for erectile dysfunction should not be taken with nitroglycerin because it may lead to a significant hypotension that could be life threatening.
What is the most common drug used for induction of labor in pregnant women and to promote ejection of milk during lactation? a) Oxytocin (Pitocin) b) Clomiphene (Clomid) c) Misoprostol (Cytotec) d) Mifepristone (Mifeprex)
Oxytocin (Pitocin) 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? a) Oxytocin (Pitocin) b) Clomiphene (Clomid) c) Terbutaline (Brethine) d) Dinoprostone (Prostin E2)
Oxytocin (Pitocin) Oxytocin is a uterine stimulant that causes uterine contractions, which would decrease the vaginal bleeding.
A patient has been taking finasteride (Proscar) for almost a year. The nurse knows that which is most important to evaluate this time? a) CBC B) PSA levels c) blood pressure d) fluid retention
PSA level
If a sexually active 15 year old boy presents with a 3 day history of a sore on his penis which appears to be a shallow, nontender ulcer that is 1 centimeter in diameter, what is the most likely diagnosis?
Primary syphilis
The nurse is caring for a patient who becomes severely nauseated during chemotherapy. Which intervention is most appropriate? A- Encourage light activity during chemotherapy as a distraction B- Provide antiemetic medications 30 to 60 minutes before chemotherapy begins C- Provide antiemetic medications only upon request of the patient D- Hold fluids during chemotherapy to avoid vomiting
Provide antiemetic medications 30 to 60 minutes before chemotherapy begins
A female patient arrives to the clinic for counseling on potential hormone replacement therapy. When taking the patient's history, which condition would the nurse consider as a contraindication to use of hormone replacement therapy for the patient? a) Osteoporosis b) Hyperlipidemia c) Thromboembolic events d) Early onset of menarche
Thromboembolic events A contraindication for estrogen administration is any history of thromboembolic disorder.
What is a chancre?
The round, usually painless, sore that is the first stage of a syphilis infection
Estrogen symptoms?
The sx of this include (1)headaches (2)n&v (3)diarrhea/ constipation (4)adb cramping (5)tender breasts
Biguanides (Metformin / Glucophage®)
This Oral diabetes medication works by decreasing production and absorption of glucose. It also does not cause hypoglycemia. This drug is contraindicated for people who use alcohol, have AKI, heart failure, and metabolic acidosis.
5-Alpha-Reductase Inhibitors what are the two drugs in this class?
This class of sex hormone drugs is used to block the naturally occurring androgens. It's indicated for BPH and male pattern baldness. Finasteride and dutasteride are the only two drugs in this class.
Gn-RH Analogs
This drug class is indicated to treat prostate cancer. They work by inhibiting the secretion of pituitary gonadotropin which decreases testosterone production.
Cephalosporin 4th Generation
This generation of Cephalosporins has a broader spectrum of antibacterial activity than third generation (especially against gram-positive bacteria), treats un/complicated UTIs, and has cefepime (Maxipime) as their only drug in their class
Cephalosporin 5th Generation
This generation of Cephalosporins has a broader spectrum of antibacterial activity, effective against a wide variety of organisms, is effective towards MRSA, and has ceftaroline (Teflaro) as their only drug in their class
Cephalosporin 2nd Generation
This generation of Cephalosporins has good gram positive and has better gram negative coverage, has specific medications that may kill anaerobes, and may be used prophylactically for abdominal and colorectal surgeries
Cephalosporin 1st Generation
This generation of Cephalosporins has good gram positive coverage, have parental and PO forms, and are used as surgical prophylaxis for susceptible staphylococcal infections.
Cephalosporin 3rd Generation
This generation of Cephalosporins have the most potent gram negative coverage and less gram positive coverage, used for difficult-to-treat organisms (such as pseudomonas), and may easily pass the meninges to diffuse into the CSF to treat CNS infections
what is Tumor lysis syndrome?
This is a common metabolic complication of chemotherapy for rapidly growing tumors. It is characterized by the presence of excessive cellular waste products and electrolytes, including uric acid, phosphate, and potassium, and by reduced serum calcium levels.
progestin
This is a synthetic derivative of a primary sex hormone that is used for the treatment of: (1) uterine bleeding (caused by hormonal imbalance, fibroids, or uterine cancer) (2) Treatment of primary and secondary amenorrhea (3) palliative treatment of some cancers and endometriosis (4) prevention of threatened miscarriage and (5) the alleviation of PMS symptoms.
Generalized seizure
This seizure type emerges from one local point and spreads. It projects to the cortical surface of the brain where it manifestations of the seizure emerge. The patient may have rhythmic jerks associated with this seizure
partial seizure
This seizure type has an onset in one particular part of the brain and expresses these Focal Symptoms: • Twitching in arm or face • Sensory change • Memory change, occurring in temporal lobe
absence seizure
This seizure type is associated with childhood but may continue into adulthood. It is characterized by staring spells that last for several seconds, eyelid fluttering or head nodding. The direction the eyes move during this indicate which side of the brain is being affected from the seizure. (ex: Eyes moving left means the right side is affected) The patient had no memory of this seizure.
myoclonic seizure
This seizure type is characterized by the unsustained jerk or series of jerks. They are often less organized than rhythmic jerking. The patient may also experience muscle contracts and trembling during the seizure followed by a soft release
atonic seizure
This seizure type results in epileptic drop attacks. It occurs in children or adults with widespread brain injuries. The patient may suddenly become limp and fall to the ground.
testosterone
This sex hormone is responsible for normal development and maintenance of primary and secondary male sex characteristics, the development of bone and muscle tissue, the inhibition of protein catabolism (metabolic breakdown), and the retention of various electrolytes.
Estrogen contraindications
This sex hormone should be avoided by those with any related cancer, undiagnosed abnormal vaginal bleeding, pregnancy, and active thromboembolic disorder or history
Simple partial seizure
This type of seizure may affect motor function resulting in twitching, abnormal visions, sounds or smells, and distortions of perception They may spread to autonomic nervous system, which may result in: -Flushing -Tingling
Antidote for Coumadin?
VITAMIN K
The nurse is aware that viruses can enter the body through various routes. Through which routes can viruses enter the body? (name least 4)
Viruses can enter the body through at least four routes: (1) inhalation through the respiratory tract, (2) ingestion via the GI tract, (3) transplacentally via mother to infant, and (4) inoculation via skin or mucous membranes. The inoculation route can take several forms, including sexual contact, blood transfusions, sharing of syringes or needles, organ transplantation, and animal bites (including human, animal, insect, spider, and others). Viruses cannot enter the body through an allergic reaction caused by medication
Methotrexate drug interactions?
When taking this drug, you should not take it with aspirin because of myelosuppression (decreased production of WBC, RBC, and thrombocytes) You can take with ibuprofen or tylenol.
a patient calls the clinic because she realized she missed dose of an oral contraceptive. Which statement from the nurse is appropriate? (select all that apply) a) "Go ahead and take the missed dose now, along with today dose" b) "Don't worry, you are still protected from pregnancy" c) "please come to the clinic a reevaluation of your therapy" d) "wait 7 days and then start a new pack of pills" e) "you will need to use a backup form of contraception concurrently for 7 days"
a) "Go ahead and take the missed dose now, along with today dose" e) "you will need to use a backup form of contraception concurrently for 7 days"
the nurse has provided patient education regarding therapy with the SERM raloxifene (Evista). Which statement from the patient reflects a good understanding of the instruction? a) "when I take that long flight to Asia, I will need to stop taking this drug at least 3 days before I travel" b) "I can continue this drug even when traveling as long as I take it with a full glass of water each time." c) "After i take this drug, I must sit upright for at least 30 minute." d) One advantage of this drug is that it will reduce my hot flashes"
a) "when I take that long flight to Asia, I will need to stop taking this drug at least 3 days before I travel"
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.) a) Tadalafil (Cialis) b) Sildenafil (Viagra) c) Avanafil (Stendra) d) Vardenafil (Levitra) e) Alprostadil (Caverject)
a) Tadalafil (Cialis) d) Vardenafil (Levitra) Phosphodiesterase inhibitors (PDIs) are used in the treatment of erectile dysfunction. Sildenafil (Viagra) 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 (Levitra) and tadalafil (Cialis). Collectively, these drugs are referred to as erectile dysfunction drugs. Avanafil (Stendra) is the newest PDI approved for erectile dysfunction. A second type of drug used to treat erectile dysfunction is the prostaglandin alprostadil (Caverject). 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.
during a counseling session for a group of teenage athletes, the use of androgenic steroids is discussed. The nurse will explain the which problem is a rare but devastating effect of androgenic steroid use? a) peliosis of the liver b) bradycardia c) kidney failure d) tachydysrhythmias
a) peliosis of the liver Peliosis hepatis is typically an asymptomatic disorder in which multiple blood-filled cystic spaces develop randomly in the liver
The nurse determines the patient has a good understanding of the discharge instructions regarding warfarin (Coumadin) with which patient statement? a) "I should keep taking ibuprofen for my arthritis." b) "I should use a soft toothbrush for dental hygiene." c) "I should decrease the dose if I start bruising easily." d) "I will double my dose if I forget to take it the day before.
b) "I should use a soft toothbrush for dental hygiene." The patient should reduce the risk of bleeding, such as using a soft toothbrush. The other choices are inaccurate.
While observing a patient self-administer enoxaparin (Lovenox), the nurse identifies the need for further teaching when the patient performs which self-injection action? a) Does not aspirate before injecting the medication b) Massages the site after administration of the medication c) Administers the medication into subcutaneous (fatty) tissue d) Injects the medication greater than 2 inches away from the umbilicus
b) Massages the site after administration of the medication It is not recommended to massage the area of injection of anticoagulants because of the increased risk of hematoma formation.
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.) a) Stroke b) Sterility c) Impotence d) Liver cancer e) Cardiovascular disease
b) Sterility d) Liver cancer e) Cardiovascular disease 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.
A patient has been taking an AED for several years as part of his treatment for partial seizures. His wife has called because he ran out of medication this morning and wonders if he can go without it for a week until she has a chance to go to the drugstore. What is the nurse's best response? a. "He is taking another antiepileptic drug, so he can go without the medication for a week." b. "Stopping this medication abruptly may cause withdrawal seizures. A refill is needed right away." c. "He should temporarily increase the dosage of his other antiseizure medications." d. "He can probably stop all medication because he has been treated for several years now."
b. "Stopping this medication abruptly may cause withdrawal seizures. A refill is needed right away."
The nurse is teaching a patient about self-administration of enoxaparin (Lovenox). Which statement should be included in this teaching session? a. "We will need to teach a family member how to give this drug in your arm." b. "This drug is given in the folds of your abdomen, but at least 2 inches away from your navel." c. "This drug needs to be taken at the same time every day with a full glass of water." d. "Be sure to massage the injection site thoroughly after giving the drug."
b. "This drug is given in the folds of your abdomen, but at least 2 inches away from your navel."
A patient is starting warfarin (Coumadin) therapy as a part of treatment for atrial fibrillation. The nurse will follow which principles of warfarin therapy? (Select all that apply.) a. Teach proper subcutaneous administration b. Administer the oral dose at the same time every day c. Assess carefully for excessive bruising or unusual bleeding d. Monitor laboratory results for a target INR of 2 to 3 e. Monitor laboratory results for a therapeutic aPTT value of 1.5 to 2.5 times the control value.
b. Administer the oral dose at the same time every day c. Assess carefully for excessive bruising or unusual bleeding d. Monitor laboratory results for a target INR of 2 to 3
A patient has received a double dose of heparin during surgery and is bleeding through the incision site. While the surgeons are working to stop the bleeding at the incision site, the nurse will prepare to take what action at this time? a. Give IV vitamin K as an antidote b. Give IV protamine sulfate as an antidote c. Call the blood bank for an immediate platelet transfusion. d. Obtain an order for packed red blood cells.
b. Give IV protamine sulfate as an antidote
When teaching a patient about potential side effects of NSAID therapy, the nurse will teach the patient to report which effect?
black tarry stools A major adverse effect of NSAID therapy is gastrointestinal (GI) distress with potential GI bleeding. Black or tarry stools are indicative of a GI bleed.
the nurse is performing an assessment of a patient who is asking for a prescription for sildenafil (Viagra). Which finding would be a contraindication to its use? a) age of 65 years b) history of thyroid use c) medication list that includes nitrate d) medication list that include saw palmetto
c) medication list that includes nitrate
a patient is asking about the use of saw palmetto for prostate health. The nurse tells hi mthat drugs interact with saw palmetto include: a) acetaminophen (tylenol) b) nitrates c) nonsteroidal antiinflammatory drugs d) antihypertensive drugs
c) nonsteroidal antiinflammatory drugs
A patient has a 9-year history of a seizure disorder that has been managed well with oral phenytoin (Dilantin) therapy. He is to be NPO (consume nothing by mouth for surgery in the morning. What will the nurse do about his morning dose of phenytoin? a. Give the same dose intravenously. b. Give him the morning dose with a small sip of water. c. Contact the prescriber for another dosage form of the medication. d. Notify the operating room that the medication has been withheld.
c. Contact the prescriber for another dosage form of the medication.
A patient is receiving instructions regarding warfarin therapy and asks the nurse about what medications she can take for headaches. The nurse will tell her to avoid which type of medications? a. Opioids b. acetaminophen (Tylenol) c. NSAIDs d. There are no restrictions while taking warfarin.
c. NSAIDs
Complication with chlamydia during newborn delivery?
conjunctivitis and pneumonia
the nurse is teaching a patient about the possible adverse effect of priapism, which may occur when taking erectile dysfunction drugs. The nurse emphasizes that, if this occur, the most important action is to a) stay in bed until the erection ceases b) apply an ice pack for 30 min c) turn toward his left side and rest d) seek medical attention immediately
d) seek medical attention immediately
The nurse understands that laboratory tests must be assessed while a client is on drug therapy for HIV AIDS. Choose the typically most significant lab test for medication administration decisions for the patient with HIV AIDS? a. CBC b. clotting factors c. HIV RNA d. CD4 lymphocyte count e. BUN
d. CD4 lymphocyte count
the nurse is monitoring a patient who is receiving antithrombolytic therapy in the emergency department because of possible MI. which adverse effect would be of the greatest concern at this time? a. Dizziness b. Blood pressure of 130/98 mm Hg c. Slight bloody oozing from the IV insertion site d. Irregular heart rhythm
d. Irregular heart rhythm
The nurse is assessing a patient who is to recieve dinoprostone (prostin e2). which condition would be a contraindication to the use of this drug? a) pregnancy at 15 weeks gestation b) GI upsets or ulcer disease c) ectopic pregnancy d) incomplete abortion
ectopic pregnancy
tonic seizure
greatly increase normal muscle tone and the body, arms or legs make sudden stiffening movements. These seizures often occur in clusters during sleep, although they can occur when the person is awake. If the person is standing they will fall quite heavily, often injuring their head. Wearing protective headwear may minimise the risk of injury. Seizures usually last less than 20 seconds.
the nurse is reviewing the use of obstetric drugs. Which situation is an indication for an oxytocin (pitocin) infusion? a) termination of a pregnancy at 12 weeks b) hypertonic uterus c) cervical sternosis in a patient who is in labor d) induction of labor at full term
induction of labor at full term
PEP (post-exposure prophylaxis)
means taking antiretroviral medicines (ART) after being potentially exposed to HIV to prevent becoming infected. PEP should be used only in emergency situations and must be started within 72 hours after a recent possible exposure to HIV. but the sooner you start PEP, the better. Every hour counts. If you're prescribed PEP, you'll need to take it once or twice daily for 28 days.
Trichomoniasis Treatment?
metronidazole 2 gm PO x 1 dose or Tinidazole 2 gm PO x 1 dose
the nurse is administering an intravenous aminoglyoside to a patient who has had a gastrointestinal surgery. Which nursing measures are appropriate?
monitor serum creatinine levels, instruct patient to report dizziness or a feeling of fullness in the ears
the nurse is discussing therapy with clomiphene (clomid) with a husband and wife who are considering trying this drug as part of treatment for infertility. Is it important that they be informed of which possible effect of this drug? a) increased menstrual flow b) increased menstrual cramping c) multiple pregnancy (twin or more) d) sedation
multiple pregnancy (twin or more)
A nurse is ordered to draw blood levels for a person receiving an antibiotic. The nurse is aware that peaks and troughs of serum antibiotic levels are monitored for drugs with a: a. narrow therapeutic index. b. large therapeutic index. c. long half-life. d. short half-life.
narrow therapeutic index. Medications with a narrow therapeutic index have a limited range between the therapeutic dose and the lethal dose.
when teaching a patient who is taking oral contraceptive therapy for the first time, the nurse relates that adverse effects may include which of the following? a)dizziness b) nausea c) tingling in the extremities d) polyuria
nausea
a 49 year old patient has been admitted with possible chronic salicylate intoxication after self-treatment for arthritis pain. the nurse will assess for which symptoms of salicylate intoxication?
tinnitus - ringing or buzzing in the ears, headache, nausea
