Supplemental Review Pharmacology I

Aminoglycosides must be used cautiously in children as in adults. Dosage must be accurately calculated according to which factors?

Weight and renal function

Cephalosporins are used to treat which of the following infections?

Urinary tract infections Bone infections Skin infections Nosocomial pneumonias

A client has been taking a urinary tract anti-infective for two days for treatment of a severe urinary tract infection. Today, the client calls the clinic reporting continued burning on urination. What is the nurse's best response?

"Burning on urination is a common side effect of these drugs. This may continue the entire time that you are on the medication."

A client comes to the emergency department reporting a throbbing headache, nausea, vomiting, chest pain, dyspnea, vertigo, and blurred vision. The client reveals taking cefaclor for an infection. Which question would the nurse ask next?

"Have you had any alcohol to drink in the past 72 hours?"

A female patient has been administered metoclopramide (Reglan) for nausea. Which statements indicates that she has understood the teaching provided by the nurse?

"I may experience drowsiness with this medication."

Which statement should the nurse include in the medication instructions for an older adult prescribed tetracycline?

"Increase your fluids to 2 L or more per day to prevent renal crystals."

A client has sought care for the treatment of migraines that have become increasingly severe. The care provider has prescribed abortive therapy. What should the nurse teach the client about this drug regimen?

"Take your medication at the first sign of a migraine."

A client is receiving gentamicin to treat meningitis. The health care provider has ordered a peak serum level be drawn in association with the 07:00 dose, which will finish infusing at 07:30. When should the peak serum level be drawn?

08:00

A nurse is preparing a syringe that contains regular and NPH insulin. To ensure effectiveness, the nurse would administer the insulins within which time frame?

15 minutes

A client is caring for an 8-year-old child who weighs 30 kg. The health care provider orders gentamicin IM for the client. The recommended dosage range is 2-2.5 mg/kg q8h. What is the maximum amount of gentamicin the client will receive in a day?

225 mg

A client is receiving 250 mg of a drug that has a half-life of 12 hours. How much drug would remain after 36 hours?

31 mg

Beta-lactam antibacterial drugs, such as penicillins and cephalosporins, combat infection by binding to proteins in bacterial cell membranes. What does this binding produce?

A defective cell wall

The anatomy and physiology instructor is talking about pain sensations. What responds to stimulation by generating nerve impulses that produce pain sensations?

A-delta sensory nerves

A 54-year-old male client is diagnosed with chronic renal failure and hyperglycemia. He asks if he can be prescribed sulfonylurea because it works well for his friend. If he were to be given sulfonylurea, this client's renal impairment may lead to what effect?

Accumulation and hypoglycemia

The nurse is caring for a client who has been prescribed a nonopioid analgesic in addition to a narcotic analgesic. What effect will the nurse expect?

Additive effect

A client, prescribed promethazine, has an elevated creatinine level. Which action is appropriate when considering any possible related risk to this client?

Administer a lower dose

A nurse is caring for a client diagnosed with migraine headaches. Which nursing intervention should be implemented during an acute headache?

Administer subcutaneous sumatriptan succinate (Imitrex)

A nurse is caring for a 39-year-old client who is taking INH, rifampin, and pyrazinamide. The client reports that her urine is red. What is the most likely cause of this discoloration?

Adverse effect of rifampin

A client is taking Indocin for arthritis. The nurse knows that as a COX-1 inhibitor, this drug inhibits prostaglandins associated with which functions?

All tissues and cell types, especially platelets, endothelial cells, the GI tract, and the kidneys

What effects are exerted by aspirin?

Analgesic Antipyretic Anti-inflammatory

Promethazine (Phenergan) is a derivative of phenothiazine making it an antiemetic and also which type of medication?

Antipsychotic

After administration of an opioid antagonist, the nurse should perform which action?

Assess vital signs every five minutes until the client responds.

When teaching a client who is to receive fosfomycin, the nurse would include what as possible adverse effects?

Vomiting Dysuria Anorexia

Promethazine is the preferred phenothiazine because its action is more like that of the antihistamines than the phenothiazines

Benzquinamide, buclizine, and cyclizine are not the drugs of choice for antiemetic effects in children.

A hospital client with a diagnosis of type 1 diabetes is prescribed Humulin R on a sliding scale. Based on the client's blood glucose reading, the nurse administered 8 units of insulin at 07:45. The nurse should consequently check the client's blood glucose level at what time to monitor peak effectiveness of the medication?

Between 09:45 and 10:45

A client receives regular insulin at 8:00 AM. The nurse would be alert for signs and symptoms of hypoglycemia at which time?

Between 10:00 AM and 12:00 PM

A client is receiving glipizide as treatment for his type 2 diabetes. The nurse understands that this drug acts by:

Binding to potassium channels on pancreatic beta cells

The nurse is educating a client who is beginning therapy with acarbose and tells the client to take the medication with the first bite of each main meal to help prevent what adverse effect?

Bloating and diarrhea

When describing the action of ergot derivatives, the nurse would incorporate understanding of:

Blockage of alpha-adrenergic receptors

Finasteride is a testosterone-blocking agent that may decrease sex drive and produce sexual dysfunction. Finasteride is rated pregnancy category X because of androgen effects and should not be touched by women.

Blood donation should be avoided for at least 6 months after taking the medication. Saw palmetto and finasteride have similar effects and should not be combined.

Obtain a current drug profile and an accurate history of the client's usual abilities and changes in abilities or health status.

By establishing this baseline information, it is possible for the nurse to be alert to any new signs and symptoms in the client that could be drug related.

The nurse educates the client who has just been given a prescription for ergotamine to call the health care provider if the client develops which symptoms?

Chest pain Weakness Palpitations

A patient is taking a medication that is metabolized by the CYP enzymes. Which medication inhibits several of the CYP enzymes?

Cimetidine

Cimetidine is a gastric acid suppressor that inhibits several CYP enzymes and can greatly decrease drug metabolism.

Cisplatin prevents DNA, RNA, and protein synthesis. Acebutolol hydrochloride is a beta1-selective adrenergic blocking agent. Dicloxacillin sodium inhibits the final stage of bacterial cell wall synthesis.

The nurse is aware that premixed insulins (those that contain both regular and NPH insulin) are least effective in what type of client?

Client who has difficulty controlling his diabetes

A client is started on trimethoprim and sulfamethoxazole for a urinary tract infection. The client reports nausea, anorexia, and abdominal pain. What intervention does the nurse discuss with the client?

Consume the medication with food

Prior to administration of fluoroquinolones, which laboratory test should be obtained?

Culture and sensitivity

Which would the nurse identify as an effect of somatostatin on blood glucose

Decreased glucagon release

A client is taking clindamycin for an infectious process and presents to the health care provider's office with symptoms of dehydration. The nurse understands that the client is experiencing what adverse reaction from the administration of clindamycin?

Diarrhea

A patient with benign prostatic hypertrophy is receiving treatment with finasteride (Proscar). What is an appropriate patient instruction?

Do not let your wife handle the pills

A nurse is seeing a client who has been prescribed phenazopyridine in combination with an antibacterial medication to treat a urinary tract infection. What is important for the nurse to tell the client about this treatment?

Do not take this medication for more than two days

Nitrofurantoin does not need a dosage adjustment when used for clients with renal dysfunction.

Dosage adjustments would be necessary for cinoxacin, norfloxacin, and co-trimoxazole.

A nurse administers dronabinol to a patient just prior to starting an infusion of chemotherapy drugs. Before allowing the patient to leave the facility, what should the nurse instruct the patient to avoid?

Driving

A client is prescribed oxybutynin as a transdermal patch. The nurse would instruct the client to change the patch at which frequency?

Every 4 days

The nurse is administering an antidiabetic agent by subcutaneous injection within 60 minutes of the client's breakfast. Which agent would the nurse most likely be administering?

Exenatide

A nurse is preparing to administer ondansetron to a client with vomiting. A nurse should be aware of what drug-related information before administering ondansetron?

For pediatric clients, ondansetron can be used safely. No dosage adjustment is necessary for older adult clients. Constipation is a common adverse effect of the medication. The medication may decrease mental alertness.

All the listed medications are common ones with which the nurse should be familiar. Digoxin is the generic name for Lanoxin

Furosemide may be given twice a day, the dose of metoprolol XL is appropriate, and pravastatin is to be taken in the evening.

What can the tissue damage noted as an adverse effect of antirheumatoid drugs include?

GI motility skin problems hypoglycemia super-infections

Which insulin would the nurse need to administer as a separate injection if the order also included NPH insulin?

Glargine

Compared with penicillins, cephalosporins more appropriate for treating infection by what type of microorganism?

Gram-negative bacteria

The nurse is caring for a client who has just had an episode of vomiting. What is the first intervention that the nurse would complete after the client has finished vomiting?

Help the client rinse his mouth.

A nurse should monitor a client taking glimepiride (Amaryl) for which of adverse effects?

Hypoglycemia Heartburn Nausea

The nurse is explaining to a client about the analgesic and its possible adverse effects. The client is receiving an opioid analgesic. What would be important to teach this client is a possible adverse effect of this drug?

Hypotension

The nurse is providing education to a client who has been prescribed hydroxyzine. Which statement indicates that the client has understood the teaching?

I may experience drowsiness with this medication."

Antispasmodics may cause dry mouth, constipation, and drowsiness.

Ice or hard candy will treat dry mouth, but caffeine will not prevent drowsiness, and milk of magnesia is too harsh for constipation that can be controlled with fiber, fluid, and exercise. Patients with urinary tract conditions should maintain fluid intake.

Half of the drug would be gone in 12 hours, leaving 125 mg. Twelve hours more, or 24 hours total, would leave 62.5 mg.

In 36 hours, there would be half of what was available at 24 hours, or 31.25 mg. Twelve hours later, or 48 hours total, there would be 15.625 mg remaining.

A nurse is educating a patient undergoing treatment for genitourinary tract bacterial infections on an outpatient basis. What instructions should the nurse offer the patient as part of the patient teaching plan?

Increase fluid intake to at least 2000 ml/d.

The nurse is explaining the action of exenatide to a patient. Which would the nurse include?

Increase in insulin resistance

Daptomycin belongs to the lipopeptide class of antibiotics that kills gram-positive bacteria. What is the mechanism of action for this antibiotic?

Inhibition of synthesis of bacterial proteins

A nurse must recognize the duration of insulin so as not to cause harm to the client with administration of the improper type of insulin. Which insulins are rapid acting?

Insulin aspart (NovoLog) Insulin glulisine (Apidra)

A client has been prescribed oxacillin after the prescriber reviewed the results of culture and sensitivity testing. The nurse should explain what unique benefit of this medication?

It is effective against many pathogens that have developed resistance to penicillins

Instruct patients who are using phenazopyridine that it should not be taken for more than 2 days when used in combination with an antibacterial drug to treat a UTI. When used for more than 2 days, the drug may mask the symptoms of a more serious disorder.

It is not normal for urine to have blood in it with this medication. Loss of appetite is not one of the known adverse effects of this medication. This is, however, a common side effect of several anti-infective drugs. This medication is not an anti-infective, it is an analgesic. A bacterial superinfection would not result from taking this medication.

As a diabetic educator, the nurse is teaching a newly diagnosed diabetic client about aspects of the disease process. What would the nurse tell the client about the body's control of glucose?

It is related to fat and protein metabolism

The nurse who has admitted a client with diabetic ketoacidosis should look for what assessment findings that are consistent with this diagnosis?

Ketones in the urine Flushed, dry skin

A client diagnosed with diabetes is demonstrating slow, deep respirations and is difficult to arouse. Which nursing intervention is directed specifically at treating this serious complication of diabetes?

Maintaining adequate intravenous fluid delivery

Several neurotransmitters have been identified with nausea and vomiting. In this capacity, they act as neuromediators. What neuromediator is thought to be involved in the nausea and vomiting that accompanies chemotherapy?

Serotonin

A hospitalized toddler has been prescribed an antiemetic. The nurse will implement which intervention based on the child's unique needs?

Monitoring for electrolyte imbalances

A client is being given a prescription for ciprofloxacin (Cipro) to treat a urinary tract infection. The nurse should warn the client about which of the following common adverse reactions?

Nausea Headache Dizziness

A client has a history of renal dysfunction. Which agent would the nurse expect to administer as the usual dosage?

Nitrofurantoin

What antiemetic is the most common first-line drug for the treatment of postoperative nausea and vomiting?

Ondansetron

Dronabinol, which may be administered prior to chemotherapy drugs to control nausea and vomiting, can cause dizziness, drowsiness, mood changes, and other mind-altering effects.

Patients receiving dronabinol should not drive or perform hazardous tasks requiring alertness, coordination, or physical dexterity, to decrease risks of injury. Additionally, patients should avoid alcohol and other drugs that cause drowsiness.

A client has been prescribed a phenothiazine for chemotherapy related nausea and vomiting. Which urinary side effect should the nurse include when educating the client on this medication?

Pink to red brown urine

A 1-year-old postoperative client has been experiencing repeated vomiting. What antiemetic drug has a black box warning against use in a client of this age?

Promethazine

A postoperative school-age pediatric client is experiencing nausea and vomiting. What is the antiemetic drug of choice in children?

Promethazine

Why is buclizine an effective antiemetic?

Promotes anticholinergic effects

A client began a new medication four days ago and presents with a temperature of 38.2° C (100.8 °F), dependent edema, and swollen cervical lymph nodes. The nurse has informed the client's provider, who has discontinued the medication. What subsequent intervention should the nurse prioritize?

Provide supportive care to manage fever and inflammation.

A 4-year-old female child is diabetic with a blood glucose level of 120 mg/dL. The child's mother brings her to the health care provider's office with symptoms of the flu and dehydration. What would the nurse expect the provider to order?

Regular sodas, clear juices, and regular gelatin desserts

A client, being treated in the intensive care unit, has been diagnosed with ventilator-associated pneumonia. Culture and sensitivity testing of the client's sputum indicates that erythromycin is a treatment option. Which nursing assessment is most appropriate to rule out contraindications for this medication therapy?

Review lab results to confirm normal liver function.

Which agent would a nurse expect to administer as a single oral dose in the morning?

Rosiglitazone

Ondansetron (Zofran) belongs to which pharmacological category of medications?

Selective 5-HT3 receptor antagonist

The 5-HT3 (serotonin) receptor blockers have proven especially helpful in treating the nausea and vomiting associated with antineoplastic chemotherapy, radiation therapy, and postoperative nausea and vomiting.

Serotonin is believed to be involved in the nausea and emesis associated with cancer chemotherapy and radiation therapy. Serotonin antagonists (e.g., granisetron and ondansetron) are effective in treating the nausea and vomiting associated with these stimuli. The other answers are incorrect.

Which is an appropriate intervention for a side effect of a urinary antispasmodic medication?

Suck on ice or hard candy to treat dry mouth

Which condition should the nurse monitor for in the patient receiving an opioid antagonist?

Sweating

Many drugs that reach the developing fetus or embryo can cause death or congenital defects, which can include skeletal and limb abnormalities, central nervous system alterations, heart defects, and the like. What is the name of the adverse reaction that can cause birth defects?

Teratogenicity

The nurse is discussing the possible side effects of chemotherapy with a client. What information obtained during the client's admission assessment and interview will have a direct influence on the management of nausea and vomiting

The client has been prescribed phenothiazine for anxiety

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

Which intervention has priority when caring for an older adult client who has been prescribed a phenothiazine for reported nausea?

The client is identified as a possible falls risk

A nurse is caring for a client who required an opioid antagonist. Which should the nurse confirm to ensure that administration of the opioid antagonist is not contraindicated in the client?

The client is not hypersensitive to the opioid antagonist

Hydroxyzine will produce drowsiness in the client. Repeated doses are unsafe.

The client should not eat with nausea. The client does not need to take potassium with hydroxyzine.

The nurse should instruct the patient to increase the fluid intake to at least 2000 ml/d to help remove bacteria from the genitourinary tract when caring for a patient with a genitourinary tract bacterial infection. The nurse need not instruct the patient to notify the PHCP if abdominal pain occurs, discontinue the therapy if symptoms vanish, or decrease fluid intake if symptoms subside

The nurse should stress the importance of continued therapy even if symptoms vanish or the patient feels better after a few doses. The nurse should encourage continued increased fluid intake even if the symptoms subside. Abdominal pain is not known in patients with genitourinary tract bacterial infections, and so the nurse need not educate the patient to monitor for the same.

Metoclopramide will produce drowsiness in the patient. The patient should not drink clear liquids with nausea. The patient should not eat with nausea

The patient should not take potassium with metoclopramide.

A patient is to begin taking tobramycin (Nebcin) for a nosocomial infection. Which of the following assessments should the nurse prioritize?

The peak and trough blood levels

An adult hospital client has been experiencing intractable nausea and vomiting for several hours, so the nurse has obtained a prescription for an antiemetic from the health care provider. The prescription reads: "Promethazine 25 mg subcutaneously every 6 hours PRN." The nurse should contact the health care provider to question what aspect of this prescription?

The route

As the first-line treatment, a client with type 2 diabetes has tried diet and exercise. When these fail, what may be added as monotherapy or in combination with metformin to control their disease process?

Thiazolidinediones

Why is it important for the nurse to obtain baseline information from a client, such as a drug profile, an accurate history of the client's usual abilities, and changes in abilities or health status?

To determine any new signs and symptoms in the client that could be related to drug therapy

In which of the following scenarios would the nurse question the order for ondansetron (Zofran)?

Treatment of gastresophageal reflux

Many drugs can affect the functioning of the nerves in the periphery and central nervous system. Which are examples of potential neurologic effects of drugs?

a postoperative client with extrapyramidal symptoms, hyperthermia, and autonomic disturbances a client taking an antipsychotic who exhibits akinesia, muscular tremors, drooling, changes in gait, jitters (akathisia), or spasms (dyskinesia) a postoperative client who had atropine and exhibits dry mouth, altered taste perception, dysphagia, heartburn, constipation, and bloating

A client is experiencing bursitis in the right elbow. Which orally administered medication will diminish inflammation and assist in relieving this pain?

acetylsalicylic acid

A woman has presented to the emergency department after cutting her hand badly on the blade of a food processor. The pain that this woman is currently experiencing is the result of

activation of the woman's delta and C nociceptors

After administering the prescribed trimethoprim/sulfamethoxazole to a client, the nurse would assess the client for which adverse reactions?

anorexia glossitis allergic skin reaction

How should a nurse best explain the presence of the inflammation process?

as an attempt by the body to remove the damaging agent and repair the damaged tissue

A nurse is reviewing the medical record of a client who is prescribed nonsteroidal anti-inflammatory drug (NSAID) therapy. The nurse determines that the drug would be contraindicated for the client if a hypersensitivity to which drug was found?

aspirin

A nurse is caring for a client with elevated blood glucose levels who is to receive alpha-glucosidase inhibitor drug therapy. The nurse understands that this therapy would be contraindicated if the client had which condition

cirrhosis chronic intestinal diseases colonic ulceration

An elderly client is being admitted to the hospital for surgery. The nurse is reconciling the client's medications. The client is prescribed digoxin 0.125 mg daily, furosemide 40 mg two times a day, Lanoxin 0.125 mg daily, metoprolol XL 25 mg once a day, and pravastatin (Pravachol) 40 mg at hours of sleep daily. The nurse recognizes a problem when the nurse notes:

digoxin and Lanoxin are the same medications

A client reports having had a "bad reaction" the last time receiving penicillin. Prior to a scheduled dental procedure, the client is likely to be prescribed what drug?

erythromycin

The nurse administering ibuprofen should assess an adult client for which potential symptoms?

fever inflammation moderate pain

A nurse should not administer an opioid antagonist to a client with which finding?

hypersensitivity to naloxone

The client has been prescribed a fluoroquinolone. The nurse knows that nursing interventions for clients taking fluoroquinolones include which?

increase fluid intake.

What is isoniazid's mechanism of action?

inhibits cell wall formation

Ondansetron (Zofran)

is a selective 5-HT3 receptor antagonist.

Specifically, promethazine (Phenergan) inhibits dopaminergic receptors and depresses the release of hormones in the hypothalamus along with other CNS depressant activities

making it an antipsychotic.

A dose reduction may be necessary in clients with renal impairment to avoid the possibility of adverse effects, toxicity,

or increased sensitivity to phenothiazines.

Gentamicin therapy is indicated in the treatment of what medical diagnosis?

osteomyelitis

When administering aminoglycosides, the nurse should focus assessments on what adverse reaction?

ototoxicity nephrotoxicity

The pharmacology instructor explains to the students that adverse effects can be extensions of:

primary action of a drug.

A nurse is caring for a client who is taking a urinary anti-infectives. The nurse would need to assess this client for:

signs and symptoms of continuing UTI

One of the most common occurrences in drug therapy is the development of adverse effects from simple overdose. In such cases, the client suffers from effects that are merely an extension of the desired effect. Which are examples of this primary action?

spontaneous bleeding after taking an anticoagulant dizziness after starting an antihypertensive

The nurse should include what information when educating a client prescribed insulin regarding the characteristics of hypoglycemia?

the onset of symptoms/signs is sudden affected by increased emotion triggered by missing a regular meal

When given by the transdermal patch, oxybutynin has a duration of 96 hours

thus, the patch should be replaced every 4 days.

A client with a deep wound producing large amounts of purulent drainage is prescribed an antibiotic. The nurse should express concern about the potential effectiveness of the treatment if which medication is prescribed?

trimethoprim-sulfamethoxazole

The nurse is caring for a client taking insulin. The nurse realizes the client is experiencing symptoms of hypoglycemia when the client displays:

weakness, sweating, and decreased mentation.