Prep U - Exam 1 Pharm

A female patient diagnosed with chronic atrial flutter has been prescribed verapamil in conjunction with digoxin to control ventricular rate. To enhance the therapeutic effect of the drug, the nurse will instruct the patient to:

avoid grapefruit and grapefruit juice.

How does captopril contribute to a reduction of a client's blood pressure?

blocking the conversion of angiotensin I to angiotensin II

The nurse is assessing a client who is being admitted to the healthcare facility. When asked about allergies, the client states, "I'm allergic to penicillin." What is the nurse's best initial response?

"Do you remember what happened the last time you received penicillin?"

Which patient statement indicates the need for additional teaching about propranolol?

"I can stop the drug once my blood pressure is controlled."

A 54-year-old client has been prescribed sublingual nitroglycerin. After the nurse has finished teaching the client about the medication, what statement could the client make to suggest that the client understands proper self-administration?

"I can take up to three tablets at five-minute intervals."

An older client is taking an anticholinergic agent. After teaching the client about the drug, which client statement indicates the need for additional teaching?

"I need to exercise frequently outside in the warm weather."

As part of their orientation to a cardiac care unit, a group of recent nursing graduates is receiving a refresher in cardiac physiology from the unit educator. Which teaching point best captures a component of cardiac function?

"The diastolic phase is characterized by relaxation of ventricles and their filling with blood."

A client prescribed nitroglycerin reports to the nurse that he is having headaches. How should the nurse best respond?

"You may experience headaches as an adverse reaction to nitroglycerin."

A client experiencing a ventricular dysrhythmia has received a bolus of lidocaine. What is the recommended rate for continuous infusion of lidocaine IV now prescribed for this client?

1-4 mg/min

The nurse administers epinephrine intravenously to a client diagnosed with heart block. In what order would the nurse predict the steps of signal transduction and intracellular events that occur when the beta-adrenergic receptors are stimulated? Drag the statements into the proper order.

1. Epi, the first messenger, binds to the beta receptor and initiates interecellular activity 2. Epi-beta receptor complex activities G protein, which reacts with guanosine triphosphate. Increases in cyclic adenosine monophosphate occurs 3. Activated G protein then activates enzyme adenyl cyclase 4. Increases in cyclic adenosine monophosphate occurs 5. cAMP is the second messenger beginning intracellular activities including an increase in AV conduction

A client may administer a maximum of how many doses of sublingual nitroglycerin in a 15-minute period?

3

A nurse is administering digoxin intravenously as ordered. The nurse would administer the drug over which time frame?

5 min

What client is most likely to have impaired drug metabolism?

A client who has a diagnosis of hepatitis C

Which client is most likely to benefit from the administration of an adrenergic agonist?

A man who is in cardiogenic shock following a myocardial infarction

The nurse is caring for a client who is receiving lidocaine. What type of arrhythmia is this class of drugs used to treat?

Acute ventricular arrhythmias

When a client is prescribed nitroglycerin transdermal spray, what instructions should the nurse provide the client concerning how to administer the spray?

Administer the spray as soon as chest pain develops.

What action should the nurse perform during the implementation step of the nursing process?

Administrations and documentation of medications.

A client is receiving carvedilol to treat hypertension. The nurse identifies this drug as a(n):

Alpha- and beta-blocker

A client with myasthenia gravis is experiencing rhinorrhea. Which of medication should not be administered to the client?

Atrovent

Nicotinic receptors are found in which area?

Autonomic basal ganglia

A client is experiencing urinary retention. The client has been prescribed terazosin (Hytrin). What condition contributes to the urinary retention?

Benign prostatic hypertrophy

A patient with type 1 diabetes is prescribed acebutolol. What would be most important to monitor?

Blood glucose levels

When considering vital signs, which assessment is focused on the functioning of the body's resistance system

Blood pressure

Which practice has contributed to the problem of resistant bacteria?

Clients saving remaining antibiotics for the next time they feel sick

The nurse receives an order for 2.5 mg of diphenhydramine for a client with a mild allergic reaction. The nurse is aware that this is an unusual order. What is the nurse's best action?

Contact the prescriber for clarification.

A nurse is caring for a patient admitted to the intensive care unit because of heart failure. The patient is prescribed digoxin. Which nursing diagnosis would be appropriate for this patient

Decreased Cardiac Output related to altered cardiac function

What conclusion should the nurse draw when a client's digoxin level is reported to be 2.2 ng/mL?

Digitalis toxicity is a possibility.

Which agency is responsible for the enforcement of controlled substances?

Drug Enforcement Agency

An instructor is preparing for a class focusing on drug evaluation. The instructor plans to explain why male volunteers are usually selected for drug testing during a phase I study. What would the instructor include as the major reason?

Drugs may harm a woman's ova, which cannot be replaced after birth

The nurse is teaching a client with angina who is prescribed sublingual tablets. The nurse would instruct the client to use a tablet at which frequency when experiencing an acute attack?

Every 5 minutes

A client prescribed ramipril earlier in the week states, "Now I have a nagging, dry cough." How should the nurse best follow up the client's statement?

Explain that drugs like ramipril often cause a cough.

The client has been ordered a nonselective beta-blocking agent called propranolol, PO. Propranolol is used in the treatment of which disorders?

HTN, Arrhythnias, angina

A nurse is providing care to a client who has elevated levels of low-density lipoprotein (LDL). A review of the client's history reveals a sedentary lifestyle and a history of being overweight. The nurse understands that this combination of factors places the client at risk for which condition?

Heart disease

The nurse knows that a client is at high risk for developing drug tolerance because the client will be taking which drug for a long period of time?

Hydromorphone (Dilaudid) for pain

A drug is 100% bioavailable when it is administered by what routes?

IV

Lidocaine (Xylocaine) is available in a variety of dosage forms. How should a nurse administer lidocaine to a client with a ventricular arrhythmia?

IV

The nurse is administering quinidine to a client who is also taking digoxin. The nurse will assess this client for which important adverse effect?

Increased digoxin level

The patient has been placed on a nitroprusside drip for the treatment of a hypertensive crisis. Which mechanism of action does the nurse know is true for nitroprusside?

It directly relaxes vascular smooth muscle, allowing dilation of peripheral arteries and veins.

The health care provider prescribes fibrate for a client with elevated triglycerides. The client begins to self-administer niacin approximately 3 mg daily. What would the nurse expect the provider to order?

LFTs

client is admitted to the emergency department after having taken several barbiturates and drinking a pint of vodka. What is important for the nurse to continuously monitor for this client?

Monitor for respiratory depression.

A client develops bone marrow suppression related to a drug's effects. What would be most important for the nurse to do?

Monitor laboratory blood values.

Epinephrine can be administered by multiple routes. Which is not an appropriate route?

Oral

A patient has received the evening meal and is recovering from surgery. What nervous system is stimulated?

Parasympathetic nervous system

Sodium ion concentrations are equal inside and outside the cell during which phase of the action potential of the cardiac muscle?

Phase 1

A client has received a dose of dopamine intravenously. The client's IV was infiltrated, and the dopamine was injected into the subcutaneous tissues. Which medication will prevent the vasoconstriction and tissue necrosis based on this action?

Phentolamine mesylate (Regitine)

A patient, admitted to a health care facility with cardiac arrhythmia, is prescribed propranolol. Which factor should the nurse closely monitor as a part of the ongoing assessment during the therapy?

Pulse rate

A student asks the instructor what the goal of drug therapy is in hypotension and shock. What would the instructor respond?

Restore and maintain adequate tissue perfusion.

A female client is going on a cruise to Nova Scotia with her husband to celebrate their 15th wedding anniversary. She is concerned because she has experienced severe, debilitating seasickness in the past. What would the nurse expect the health care provider to order?

Scopolamine

Which anticholinergic agent is sometimes used to manage motion sickness when delivered by transdermal patch?

Scopolamine

The nurse is reviewing a patient's ECG and notes that the ECG is normal, but the rate is 110 beats/minute. The nurse would identify this as:

Sinus tachycardia

What should the nurse suggest to assist a client to improve his cholesterol levels?

Smoking cessation

A graduate of a nursing program is scheduled to take the NCLEX today. The test-taker's heart is racing and pupils are dilated. What can the test-taker attribute to this reaction?

Sympathetic nervous system

A client is on antibiotic therapy for an axillary abscess. The client has been outside working in the yard and observes a rash everywhere that is not covered by clothing. What should the client be told about this finding?

The client is having photosensitivity and this can occur even with brief exposure to the sun or UV rays.

The nurse received an order for furosemide (Lasix). Why should the nurse write the generic name on the order sent to the pharmacy?

There is less chance of the wrong drug being given, because trade names can be similar.

A client's angina pectoris is being successfully treated on an outclient basis with sublingual nitroglycerin. What teaching point should the nurse convey to the client when reporting concern about the headache that follows the use of the medication?

This is a common adverse effect of nitroglycerin; try taking acetaminophen to treat your headache."

An elderly client has been taking a new medication for 2 months. During a follow-up visit, the client's son tells the nurse that he feels his mother's memory is getting worse. What concerns should the nurse have at this time?

This may be coincidental, and the memory loss may be attributed to changes with aging.

Which process occurs between the time the drug enters the body and the time that it enters the bloodstream?

absorption

A client's most recent laboratory result indicate an elevated potassium level. What drug in this client's medication regimen should the care team consider discontinuing?

diuretic

Which medication will most likely be administered to a client experiencing anaphylaxis?

epi

Effectiveness of medication therapy is associated with which phase of the nursing process?

eval

St. John's wort is an alternative therapy that interacts with few drugs.

false

Cimetidine (Tagamet) is an OTC drug used to treat:

heartburn

A nurse is working in the emergency department and is assigned to a client brought in by family members. The family thinks that the client is on methamphetamine. The nurse should assess for:

hypertension.

A nurse in the intensive care unit is caring for a client in shock and has started IV administration of dopamine (Intropin). For a client in shock, dopamine helps to:

increase blood pressure.

A client has been prescribed lovastatin for high cholesterol. The nurse's teaching plan will include a basic explanation of how the drug produces its therapeutic effect. The nurse will explain that lovastatin lowers cholesterol levels in which manner?

inhibits cholesterol syntheses.

Which phase of drug development is associated with continual evaluation of the drug?

phase 4

Plants and plant parts have been used as medicines since prehistoric times. Morphine (roxanol) is derived from which plant?

poppy

Which enzyme is produced in the kidney?

renin

The client has been taking rosuvastatin for hyperlipidemia. The client now presents with severe weakness and states barely being able to move the extremities. The nurse suspects the client has which?

rhabdomyolysis.

The nurse is caring for a male client with a history of hypertension and Prinzmetal's angina who is currently taking amlodipine 10 mg orally every day, and minoxidil 25 mg orally twice a day. The client stated that he is concerned about a recent enlargement of his breasts. What is the <b>best</b> therapeutic response to the client's concern?

"The increase in breast size is an adverse effect of minoxidil, and I will notify your primary care provider so other options may be explored."

The main goal of current drug laws and standards is to ensure that drugs:

marketed for therapeutic purposes are safe and effective.

When planning treatment for substance abuse disorder, what goal should the nurse first address?

safe detox

Many drugs that reach the developing fetus or embryo can cause death or congenital defects. What are examples of congenital defects? Select all that apply.

skeletal & limb abnormalities, heart defects, cns abnormalities

The nurse is caring for a client with asthma who has been administered albuterol in order to promote bronchodilation and relieve shortness of breath. When giving this medication, the nurse has affected the client's autonomic nervous system by:

stimulating beta2-receptors.

Some anticholinergic drugs have the same clinical indications in the pediatric population as in the adult population. Which statement accurately describes a difference between the populations related to the use of anticholinergics?

Adverse effects tend to be more severe in children.

A 57-year-old female client has a history of two myocardial infarctions in the past 3 years. She presents to the health care provider's office with symptoms of an overactive bladder. She requests an anticholinergic medication that she saw advertised on television. What does the nurse expect the provider to do for this client?

Explain to the client that the medication is contraindicated because of her medical history

After teaching a group of students about fats and biotransformation, the instructor determines that the teaching was successful when the students identify what as the storage location of bile acids?

GB

The nurse is teaching a client about safe use of adrenergic drugs. Which statement should be included in the teaching?

Talk to your health care provider before taking any other medications."

The nurse is providing care for a client who has been prescribed a diuretic to treat hypertension. The client states that the effects of the drug are problematic, causing the client to wake up numerous times during the night to urinate. What assessment question should the nurse prioritize?

When are you taking your medication?

A client is receiving digoxin and experiences severe bradycardia. Which medication would the nurse anticipate administering if prescribed?

atropine