Pharmacology 2 Final***

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Study Guide for 3/29/13

Your patient was started on buspirone (Buspar) for his anxiety disorders 3 days ago. The patient now calls the physician's office, stating that it "just isn't working." The nurse's best response would be:

1. "Buspar should give you immediate relief. I will notify the physician this medication is not effective."
2. "It will take 3-4 weeks for the Buspar to be fully effective."
3. "You may need an increased dose of Buspar for it to work."
4. "You will need additional medications to ease your anxiety."

Answer:
2. "It will take 3-4 weeks for the Buspar to be fully effective.

The patient is sleeping at the time the next sedative is ordered. The nurse should:

1. Wake the patient and administer the next dose of sedative.
2. Notify physician.
3. Hold the dose and document the reason.
4. Hold this dose and administer it with the next dose.

Answer:
3. Hold the dose and document the reason.

The nurse educates the patient on zolpidem (Ambien) by saying that it:
1. Will take a week for the medication to be effective.
2. May be taken 2-3 hours before bedtime.
3. Should be taken just prior to going to bed.
4. Must be used long term to be effective.

Answer:
3. Should be taken just prior to going to bed.

The patient has been taking barbiturates for the last few months for difficulty with sleeping. The nurse's main concern for the patient that stopped taking the barbiturate would be:

1. Respiratory depression.
2. Severe withdrawal.
3. Hypotension.
4. Shock.

Answer:
2. Severe withdrawal.

Which of the following nursing interventions would be most appropriate for a patient who has been just administered a sedative?
1. Orient to surroundings.
2. Assess for respiratory dysfunction.
3. Shut off the lights and close the door.
4. Make sure the call light is within the patient's reach.

Answer:
4. Make sure the call light is within the patient's reach.

The patient has been diagnosed with a panic disorder. The nurse recognizes symptoms of panic disorder, including:

1. Fatigue, muscle tension, and nervousness.
2. Dry mouth, diarrhea, and restlessness.
3. Feelings of immediate apprehension, terror, and impending doom.
4. Chronic insomnia, terror, and nervousness.

Answer:
3. Feelings of immediate apprehension, terror, and impending doom.

It is important to teach the patient to avoid ___________, which can increase the effects of sedatives.

1. Nicotine
2. Alcohol
3. Chocolate
4. Tea

Answer:
2. Alcohol

Which of the following is not used in the treatment of panic disorders?

1. Amitryptyline (Elavil)
2. Amobarbital (Amytal)
3. Diazepam (Valium)
4. Phenelzine (Nardil)

Answer:
2. Amorbabital (Amytal)

During this stage of sleep, dreaming occurs.

1. REM
2. NREM
3. NREM stage 4
4. NREM stage 1

Answer:
1. REM

Patient education for the patient started on antidepressants would include:

1. Directions to avoid tyramine-containing foods.
2. The signs and symptoms of hypertension.
3. A warning that drowsiness is a common side effect.
4. An explanation that is may take a combination of antidepressants for effectives to occur.

Answer:
3. A warning that drowsiness is a common side effect.

If a patient taking MAO inhibitors experiences a hypertensive crisis, what may be given as an antidote?

1. Meperidine (Demerol)
2. Dextromethorphan
3. Calcium channel blockers
4. Carbamazepine (Tegretol)

Answer:
3. Calcium channel blockers

When the patient on lithium is dehydrated, this could lead to:

1. Lower serum lithium levels.
2. Increased effectiveness.
3. The need to increase the lithium dosage.
4. Lithium toxicity.

Answer:
4. Lithium toxicity.

The patient on methylphenidate (Ritalin) should be assessed for:

1. Signs of weight loss.
2. Hypotension.
3. Kidney toxicity.
4. Extreme euphoria and insomnia.

Answer:
1. Signs of weight loss.

Which of the following symptoms would indicate to the nurse that a patient is experiencing lithium toxicity?

1. Increased urination, diarrhea, tremors
2. Dry mouth, vomiting, hypotension
3. Constipation, blurred vision, hypertension
4. Increased appetite, increased energy, memory loss

Answer:
1. Increased urination, diarrhea, tremors

Imipramine (Tofranil) has been ordered for a patient experiencing depression. Patient teaching would include which of the following?
1. The use of alcohol is permitted with this drug.
2. Avoid standing up too quickly.
3. Effectiveness occurs within a few hours of administration.
4. If a dose is missed, double up on the next dose.

Answer:
2. Avoid standing up too quickly.

The nurse teaches the patient taking phenelzine (Nardil), to avoid eating:

1. Eggs.
2. Aged cheeses.
3. Onion.
4. Apples.

Answer:
2. Aged cheeses.

Which of the following antiseizure medication may be used as a mood stabilizer?
1. Diazepam
2. Phenytoin (Dilantin)
3. Valporic Acid (Depakene)
4. Lorazepam (Ativan)

Answer:
3. Valporic Acid (Depakene)

The patient has been started on an MAOI for depression and is now asking if she can add St. John's wort to increase the effectiveness of the antidepressant. The nurse's best response would be?

1. "St John's wort is highly effective for depression. Adding it to your current medication will increase its effectiveness."
2. "Although St. John's wort has been found to be effective, you should consult with your physician before adding it to your current medication routine."
3. "St. John's wort, cannot be mixed with MAO inhibitors because of the possibility of drug interactions."
4. "Because St. John's wort is effective for depression, you will not need your medication."

Answer:
2. "Although St. John's wort has been found to be effective, you should consult with your physician before adding it to your current medication routine."

Antidepressants improve mood by increasing levels of:

1. Epinephrine and norepinephrine.
2. Reticular formation within the hypothalamus.
3. Norepinephrine and serotonin.
4. GABA and serotonin.

Answer:
3. Norepinephrine and serotonin.

Which of the following statement is true?

1. Antipsychotic medications cure mental illness.
2. The severe side effects of antipsychotic drugs can lead to noncompliance.
3. Antipsychotic medications are only administered when the patient is symptomatic.
4. Antipsychotic drugs improve symptoms within hours of administration.

Answer:
2. The severe side effects of antipsychotic drugs can lead to noncompliance.

The patient taking levodopa must avoid foods high in what?

1. Vitamin A
2. Vitamin B12
3. Folic acid
4. Vitamin B6

Answer:
4. Vitamin B6

Which of the following symptoms does the nurse recognize as an anticholinergic effect of chlorpromazine (Thorazine)?

1. Hallucinations, illusions, paranoia
2. Hypertension, polyuria, increased salivation.
3. Dry mouth, postural hypotension, urinary retention
4. Fever, flu-like symptoms, decreased WBC count

Answer:
3. Dry mouth, postural hypotension, urinary retention

This lipoprotein is responsible for transporting cholesterol from the blood to the liver.
1. Low- density lipoprotein (LDL)
2. Very low density lipoprotein (VLDL)
3. High density lipoprotein (HDL)
4. Triglycerides

Answer:
3. High density lipoprotein (HDL)

Which of the HMG-CoA inhibitors should be taken with meals?
1. Atorvastatin (Lipitor)
2. Simvastatin (Zocor)
3. Lovastatin (Mevacor)
4. Digoxin (Lanoxin)

Answer:
3. Lovastatin (Mevacor)

Statin drugs are most effective when administered:
1. In the morning
2. In the evening
3. With other medications
4. On an empty stomach

Answer:
2. In the evening

When asked how an HMG-CoA inhibitor lowers cholesterol, the nurse correctly answers, " by inhibiting the manufacture of cholesterol or by:
1. Increasing the secretion of bile acids."
2. Decreasing triglyceride production."
3. Removing cholesterol from the small intestine."
4. Promoting the breakdown of cholesterol

Answer:
4. Promoting the breakdown of cholesterol

Which of the following patient concerns would the nurse consider as an adverse reaction to a bile acid sequestrant?
1. Constipation
2. Headache
3. Anxiety
4. Double vision

Answer:
1. Constipation

When administering colestipol (Colestid) the nurse:
1. Administers the drug with meals to prevent GI upset.
2. Administers the drug 30 minutes prior to meals
3. Administers the drug at least 1 hour before or 4 hours after any other medications or vitamins are taken.
4. Administers the drugs at bedtime.

Answer:
3. Administers the drug at least 1 hour before or 4 hours after any other medications or vitamins are taken.

A client recently diagnosed with ovarian cancer is concerned about alopecia while taking cyclophosphamide (Cytoxan). The nurse knows that effective teaching has taken place when the client states:

1. " I don't need to worry about losing my hair."
2. "My hair will probably grow back."
3. "I will never have hair again!"
4. " Wigs only exacerbate the alopecia."

Answer:
2. "My hair will probably grow back."

A client diagnosed with bine cancer and is placed on methotrexate (Mexate.) the nurse knows that methotrexate (Mexate) inhibits folic acid metabolism and is classified as:

1. An alkylating agent
2. An antitumor antibody
3. An antimetabolite
4. An alkaloid

Answer:
3. An antimetabolite

The nurse knows that the adverse effects of anticancer drugs include, but are not limited to, which of the following? Select all that apply.

A. Alopecia
B. Anemia
C. Anorexia
D. Fatigue
E. PMS

Answer:
A. Alopecia
B. Anemia
C. Anorexia
D. Fatigue

A client with breast cancers started on chemotherapy. Her daughter is started on the same drug prophylactically. Because the daughter is at high risk to develop breast cancer, the nurse suspects the hormone blocker prescribed is:

A. Goserelin (Zoladex)
B. Anastrozole (Arimidex)
C. Medoxyprogesterone (Provera)
D. Tamoxifen (Nolvadex)

Answer:
D. Tamoxifen (Nolvadex)

A client with hairy cell leukemia complains of flu-like symptoms including fever, chill, dizziness, and fatigue during the first few weeks of chemotherapy. The nurse suspects the drug responsible for the client's symptoms is:

A. Interferon alfa-2 (Roferon A)
B. Letrozole (femara)
C. Paclitaxel (Taxol)
D. Daunorubicin (Cerubidine)

Answer:
A. Interferon alfa-2 (Roferon A)

The type of insulin that is given at bedtime, with or without other types is:

A. Regular insulin
B. Isophane insulin suspension (Humulin N)
C. NPH 70/30 (Humulin 70/30).
D. Insulin glargine (Lantus)

Answer:

D. Insulin glargine (Lantus)

A client taking levothyroxine (Synthroid) and cholestyramine (questran) should be alert to symptoms of:

A. Hypothyroid
B. Hyperthyroid
C. Hyperlipidemia
D. Hypolipidemia

Answer:
A. Hypothyroid

Aside from having potent anti-inflammatory effects, glucocorticoids also promote homeostasis of which system?

A. Cardiovascular
B. Gastric
C. Reproductive
D. Hematopoietic

Answer:
A. Cardiovascular

Long -term therapy with corticoids can produce a variety of adverse effects including which of the following? Select all that apply.

A. Delayed wound healing
B. Sodium retention
C. Mood changes
D. Diarrhea
E. Headache
F. Increased risk for infections

Answer:
A. Delayed wound healing
B. Sodium retention
C. Mood changes
F. Increased risk for infections

A preparations of anti diuretic hormone (ADH) that is occasionally used by intranasal route to treat enuresis (bedwetting) is:

A. Desmopressin (Stimate)
B. Lypressin (Diapid)
C. Vasopressin (pitressin)
D. Betamethasone (celestrone)

Answer:
A. Desmopressin (Stimate)

The nurse is being educated on treatment of clients following a nuclear accident. Objectives have been met when the nurse makes this statement:

A. " Clients will be given potassium iodide tablets."
B. " Iodide 131 will protect the clients vital organs."
C. "Potassium iodide will provide protection if taken within days of a nuclear accident."

Answer:
A. " Clients will be given potassium iodide tablets."

The client has been diagnosed with acute glaucoma. The nurse understands that common causes include which of the following?

A. Diabetes mellitus or renal disease
B. Trauma or hemorrhage
C. Increased intraocular pressure
D. Increased intracranial pressure

Answer:
B. Trauma or hemorrhage

The client complaints of blurry vision after using Isopto. The nurse gives this explanation:

A. " You have an allergy and should stop using the drops."
B. "This is a common reaction, but should be temporary."
C. "Use only half the dose and monitor the results."
D. "I will have the physician prescribe something different for you."

Answer:
B. "This is a common reaction, but should be temporary."

Dipivefrin hydrochloride (Propine) effectively decreases intraocular pressure by:

A. Converting to epinephrine and increasing outflow of aqueous humor.
B. Decreasing the formation of aqueous humor.
C. Reducing plasma volume very quickly.
D. The exact mechanism is not fully understood.

Answer:
A. Converting to epinephrine and increasing outflow of aqueous humor.

A client asks about using aloe vera for eye irritation. For the client to obtain therapeutic effect, the nurse recommends:

A. Placing aloe in the eye
B. Treating the areas around the eyes.
C. That the client refrain from using this natural alternative.
D. Ask for a prescription for an anti-inflammatory medication instead.

Answer:
B. Treating the areas around the eyes.

The client has a medical diagnosis of schizophrenia and receives aripiprazole (Abilify). What is the primary expected client outcome related to dopamine reduction?
a. Client will have reduced psychotic behavior.
b. Client will improve social relationships.
c. Client will decrease anxiety.
d. Client will have improved sleep patterns.

Answer:
a. Client will have reduced psychotic behavior.

A client receives risperidone(Risperdal). The nurse observes that the client is experiencing severe muscle spasms of his back and neck. Which nursing action is a priority for this client?
a. Withhold riseridone(Risperdal)
b. Administer benztropine(Cogentin) IM.
c. Encourage the client to take a warm shower to relax the muscles.
d. Administer an additional dose of risperidone(Risperdal).

Answer:
b. Administer benztropine(Cogentin) IM.

The client receives clozapine(Clozaril). Before this drug is administered, the nurse should check which lab data?
a. liver function.
b. renal function.
c. serum protein.
d. white blood count.

Answer:
d. white blood count.

The client receives clozaping(Clozaril). Which clinical finding is most important for the nurse to repot immediately?
a. drowsiness
b. increased appetite
c. sore throat
d. constipation

Answer:
c. sore throat

The client takes ginkgo biloba at home for memory impairment. Which statement by the client indicates that teaching by the nurse has been effective?
a. "I can have increased bleeding if I have to take a anticoagulant drug."
b. "Ginkgo biloba will keep me from developing Alzheimer's disease."
c. "I can't take any other medication with ginkgo biloba."
d. "I need to be on a low-fat diet while I am taking ginkgo biloba."

Answer:
a. "I can have increased bleeding if I have to take a anticoagulant drug."

The client receives levodopa(L arodopa). The nursed plans to teach the client which foods may beincluded in the diet. Select all that apply.
a. banana
b. citrus fruit
c. rice
d. chocolate
c. fish
f. green leafy vegetables

Answer:
b. citrus fruit
c. rice
d. chocolate

The client has a medical diagnosis of multiple sclerosis and receives modafinil(Provigil). Which evaluation by the nurse would most likely indicate a therapeutic response to this drug?
a. improved appetite and ability to eat
b. reduction of pain and anxiety
c. decreased myelin swelling and inflammation
d. increased alertness and energy

Answer:
d. increased alertness and energy

Which assessment data is most indicative of a potential complication in a patient who receives tacrine(Cognex)?
a. flu-like symptoms
b. jaundice
c. depression
d. psychosis

Answer:
b. jaundice

Which assessment data is a priority for a client who is receiving olanzapine(Zyprexa)?
a. history of cancer
b. history of heart disease
c. history of migraine headaches
d. history of diabetes mellitus

Answer:
d. history of diabetes mellitus

The client has been diafnosed with Parkinson's disease and wants to know the goal of pharmacotherapy. Which is the nurse's best response?
a. "To hopefully cure your illness."
b. "To alleviate your depression associated with your illness."
c. "To increase your ability to perform normal daily activities."
d. "To prevent progressive memory loss and confusion."

Answer:
c. "To increase your ability to perform normal daily activities."

The client receives ziprasidone(Geodon). What is priority teaching at time of discharge?
a. To avoid drinking alcohol.
b. To be on a low-fat diet.
c. To exercise at least 60 minutes per day.
d. To stop smoking.

Answer:
a. To avoid drinking alcohol.

The nurse is admitting a client to the orthopedic unit following a total hip replacement. The physician has ordered enoxaparin(Lovenox) 30mg subQ every 12 hours. Which of the following nursing diagnosis should be given priority?
a. deficient knowledge
b. risk for injury(bleeding)
c. pain.
d. ineffective individual coping.

Answer:
b. risk for injury(bleeding)

Aclient presents to the ED with complaints of slurred speech and left-sided weakness. The physician has ordered heparin IV to be given. Which of the following nursing interventions should be completed prior to beginning the therapy?
a. obtain white blood cell count
b. obtain urinalysis
c. insert Foley catheter
d. talk to the family

Answer:
c. insert Foley catheter

The client is receiving heparin IV. Which of the following lab tests should the nurse monitor closely?
a. white blood cell count
b. aPTT
c. PT
d. sed rate

Answer:
b. aPTT

The client is being discharged of warfarin(Coumadin) 5mg PO q day. Which of the following lab tests should the client have checked regularly?
a. aPTT
b. PT
c. sed rate
d. white blood cell count

Answer:
b. PT

The nurse is caring for a client on heparin IV. Which of the following medications should the burse have readily available?
a. vitamin K
b. morphine sulfate
c. protamin sulfate
d. acetaminophen

Answer:
c. protamin sulfate

The nurse is caring for a client of wafarin(Coumadin). Which of the following medications should the nurse have readily available?
a. vitamin K
b. morphine sulfate
c. protamine sulfate
d. acetaminophen

Answer:
a. vitamin K

A client in a state of consciousness, yet insensitive to pain and unaware of the surroundings, caused by combing the opioid fentanyl(Sublimaze) with the antipsychotic agent droperidol(Inasine), is said to be in a state of:
a. dissociative analgesia
b. surface analgesia
c. neurolept analgesia
d. regional analgesia

Answer:
c. neurolept analgesia

The nurse knows that the only depolarizing blocker is succinylcholine(Anectine), which works by binding to acetycholine receptors at neuromuscular junctions causing:
a. total skeletal muscle relaxation.
b. Prevention of muscle contractions.
c. loss of consciousness.
d. light sedation.

Answer:
a. total skeletal muscle relaxation.

A client with a hx of depression is having thyroidectomy. The nurse knows this client has a hx of using herbal remedies. What drug would the nurse anasthetist need to know about prior to surgery?
a. St. John's wort
b. echinacea
c. comfrey
d. senna

Answer:
a. St. John's wort

A client comes into the clinic complaining of jaw pain and admits to teeth grinding at night. The client wants natural remedies, no prescriptive drugs. The nurse knows to inform the client of what over-the-counter remedy?
a. Acetaminophen(Tylenol)
b. Eugenia
c. Pimpinella
d. cooking sherry

Answer:
c. Pimpinella

Consequences of HTN include which of the following? Select all that apply.
a. heart failure
b. stroke
c. atherosclerosis
d. heart attack
e. gout
f. renal failure
g. DM

Answer:
a. heart failure
b. stroke
c. atherosclerosis
d. heart attack
f. renal failure

In response to a fall in BP, which of the following homeostatic mechanisms act to increase BP back towards normal?
a. activation of th renin-angiotensin system
b. decreased (ADH)
c. baroreceptors reflex-induced vasodilation
d. suppression of aldosterone release from the adrenal glands

Answer:
a. activation of th renin-angiotensin system

Which of the following is true regarding nonpharmacologic therapy of HTN?
a. In HTN clients who are overweight, weight loss can be an effective means to lower blood pressure.
b. In clients who require drug therapy to control their BP, nonpharmacologic therapy should be dc.
c. Sodium restriction is not necessary in clients taking diuretics.
D Smoking cessation may raise BP in HTN clients.

Answer:
a. In HTN clients who are overweight, weight loss can be an effective means to lower blood pressure.

When used to treat HTN, diuretics such as hydrochlorothiazide(Hydrodiuril):
a. are prescribed as second line therapy.
b. cause increased K levels in the blood.
c. act of the kidney tubule to increase the reabsorption of Na.
d. cause a reduction in blood volume.

Answer:
d. cause a reduction in blood volume.

The Ca channel blocker nifedipine(Procardia, Adalat) lowers BP by:
a. reducing BP
b. causing reflex tachycardia.
c. reducing CO
d. reducing peripheral vascular resistance.

Answer:
d. reducing peripheral vascular resistance.

. Which of the following should be expected with the use of digoxin(Lanoxin)?
1. increased weight.
2. decreased edema
3. increased blood volume
4. increased HR

Answer:
2. decreased edema

The patient with heart failure is also experiencing angina. Which of the following drugs would be appropriate for use?
1. Isosorbide dinitrate (Isordil)
2. Hydralazine (Apresoline)
3. Chlorothiazide (Diuril)
4. Milrinone (Primacor)

Answer:
1. Isosorbide dinitrate (Isordil)

The pt is admitted with CHF. The physician orders IV milrinone(Primacor). The most serious side effect of milrinone(Primacor) is:
1. headache
2. dysrhythmia
3. confusion
4. drowsiness

Answer:
2. dysrhythmia

Which of the following should not be included in the education provided to a pt on lisinopril (Prinivil)?
1. "It may take several months for your BP to return to normal."
2. "You must have your K monitored from time to time."
3. "This medication may change your vision from time to time."
4. "You may notice a change in your sensation of taste."

Answer:
3. "This medication may change your vision from time to time."

In addition to decreasing cardiac contractility, beta blockers:
1. Lower HR and BP
2. increase HR and afterload
3. Produce systemic vasoconstriction
4. Increase the force of myocardial contractions.

Answer:
1. Lower HR and BP

Which drug would the nurse expect to be ordered for a pt with digoxin toxicity?
1. Digoxin Immune Fab
2. Milrinone
3. Amrinone
4. Flecainide (Tambocor)

Answer:
1. Digoxin Immune Fab

This electrolyte produces depolarization.
1. Potassium
2. Magnesium
3. Sodium
4. Chloride

Answer:
3. Sodium

Sodium channel blockers:
1. Increase automaticity.
2. Slow the impulse conduction.
3. Decrease the refractory period.
4. Increase impulse conduction.

Answer:
2. Slow the impulse conduction.

This antiseizure medication is used off label to treat dysrhythmias.
1. Phenobarbital
2. Topriamate (Topamax)
3. Flecainide (Tambacor)
4. Phenytoin (Dilantin)

Answer:
4. Phenytoin (Dilantin)

When the pt is on quinidine sulfate (Quinidex), the digoxin must be:
1. discontinued CO
2. increased
3. decreased
4. doubled

Answer:
3. decreased

An expected outcome of a pt taking an antidysrhythmic drug would be:
1. Decreased CO
2. Increased CO
3. Increased renal insufficiency
4. Increased hepatic insufficiency

Answer:
2. Increased CO

The most common side effect of nitroglycerin is:
1. headache
2. HTN
3. diuresis
4. bradycardia

Answer:
1. headache

This class of medications decreases HR, contractility, and BP and is used to increase survival rates in post-myocardial infarction (MI) paitents.
1. calcium channel blockers
2. beta blockers
3. vasodilators
4. diuretics.

Answer:
2. beta blockers

The nurse assesses for the most common side effect of reteplase(Retavase), which is:
1. dehydration
2. bleeding
3. confusion
4. increased clotting times

Answer:
2. bleeding

The pt has a hx of a cerebrovascular accident (CVA). Which of the following drugs would not be recommended for this pt?
1. Aspirin
2. Warfarin (Coumadin)
3. Protamine sulfate
4. Ticlopidine (Ticlid)

Answer:
3. Protamine sulfate

The patient should remove the transdermal nitroglycerin patch at night to:
1 prevent overdose
2. prevent adverse reactions
3. ensure the dosage is appropriate
4. delay development of tolerance

Answer:
4. delay development of tolerance

The patient is on thioridazine (Mellaril) and has developed muscle spasms, difficulty sleeping, and shuffling gait. The nurse recognizes this as:

1. The drug's anticholingeric effects
2. The drug's cholinergic effects
3. Extrapyramidal side effects of the drug
4. Parkinson's disease

Answer:
3. Extrapyramidal side effects of the drug

The patient has developed a degenerative CNS disease that is exhibited by progressive dementia and involuntary muscle spasms. The disease is :

1. Parkinson's disease
2. Huntington's chorea
3. Multiple sclerosis
4. Alzheimer's disease

Answer:
2. Huntington's chorea

Drug therapy for the patient with Parkinson's disease focuses on:

1. Increased cholinergic stimulation within the brain
2. Restoring acetylcholine and blocking dopamine within the brain
3. Restoring dopamine function and blocking acetylcholine within the brain
4. Destroying dopamine receptors within the brain

Answer:
3. Restoring dopamine function and blocking acetylcholine within the brain

The Alzheimer's patient has been started on rivastigmine (Exelon). The nurse assess the patient for:

1. Liver toxicity
2. Weight loss
3. Kidney failure
4. Extrapyramidal side effects

Answer:
2. Weight loss

The patient taking Ginkgo biloba must be assess for use of which of the following drugs?

1. Digoxin (Lanoxin)
2. Warfarin (Coumadin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin)

Answer:
2. Warfarin (Coumadin)

A client has to have major surgery. The OR nurse knows that three of the five major routes for applying local anesthetics include:
a. Topical
b. Mouth swab
c. Tendon block
d. Spinal
e. Epidural

Answer:
a. Topical
d. Spinal
e. Epidural

When explaining the surgical procedure to a client, the nurse tells the client that a small amount of which drug is sometimes added to the anesthetic solution to lengthen the duration of action of the anesthetic?
a. Xylocaine
b. Epinephrine
c. Valium
d. Benadryl

Answer:
b. Epinephrine

The nurse knows that local anesthetics works by:
a. Blocking calcium channels
b. Blocking sodium channels
c. Numbing the skin
d. Increasing sensation

Answer:
b. Blocking sodium channels

A client comes into the dentist office for a root canal. The nurse knows that in the mid 1900s to the 1960s that the ester of choice for dental procedures was:
a. Benzocaine (Solarcaine)
b. Cocaine
c. Lidocaine (Xylocaine)
d. Procaine (Novocaine)

Answer:
d. Procaine (Novocaine)

A client is having major surgery tomorrow. The nurse knows the client understands pre-op teaching by what statement?
a. "I won't feel a thing because I will be asleep."
b. "I will lose consciousness, movement, and memory."
c. "I will retain all memory of my procedure."
d. "I will probably feel pain during the procedure."

Answer:
b. "I will lose consciousness, movement, and memory."

A client having an abdominal resection also has a history of myasthenia gravis. The OR nurse knows that using nitrous oxide with this client causes a greater risk for:
a. Respiratory depression and prolonged hypnotic effects
b. Nausea and vomiting during surgery
c. Increased cranial pressure and vomiting
d. Increased intracranial pressure and respiratory depression

Answer:
a. Respiratory depression and prolonged hypnotic effects

The nurse is caring for a client receiving morphine sulfate 2-4mg IV every 4 hours as needed for pain. The client's family calls the nurses' station to request pain medication for the client. When the nurse arrives in the room, the client is lying in the bed. The nurse obtains the following vital signs: BP 120/80, P 80, R 10. What is the nurse's first action?
a. Withhold the medication
b. Find out when the client had last had the dose of medication
c. Call the physician
d. Call the physician after giving the medication

Answer:
a. Withhold the medication

The nurse is caring for a client who is 24 hours postoperative cholcystectomy. The client has a meperidine (Demerol) PCA pump. Which of the following symptoms should be reported to the physician immediately?
a. Urine output of 15ml per hour
b. Urine output of 35ml per hour
c. Constipation
d. Respiratory rate of 18 breaths per minute

Answer:
a. Urine output of 15ml per hour

When caring for a client who is taking acetaminophen (Tylenol), the nurse should pay particular attention to:
a. Severe upper or lower abdominal pain
b. Respiratory rate
c. Blood pressure
d. Pulse rate

Answer:
a. Severe upper or lower abdominal pain

The nurse is caring for a client who is taking Co-Gesic every 4 hours as needed for pain. The nurse should instruct the client to avoid which of the following medications while taking this drug?
a. Aspirin
b. Motrin
c. Advil
d. Acetaminophen (Tylenol)

Answer:
d. Acetaminophen (Tylenol)

The nurse is caring for a client who has a morphine PCA. Which of the following medications should the nurse assure is readily available.

a. butorphanol tartrate (Stadol)
b. naltrexone hydrochloride (Trexan)
c. naloxone hydrochloride (Narcan)
d. mepiridine (Demerol)

Answer:
c. naloxone hydrochloride (Narcan)

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