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Pharmacology Exam 3

Terms in this set (54)

Acarbose (Precose) is:
A) used in treatment of cushings disease.
B) a medication that requires levels to be monitored.
C) used in conjunction with diet and exercise for reducing blood sugar in patients with type 2 diabetes.
D) a antibiotic that is used for highly resistant organisms.
C) used in conjunction with diet and exercise for reducing blood sugar in patients with type 2 diabetes.
A patient is taking trimethoprim/sulfamethoxazole (TMP-SMZ). To help the patient avoid the side effects associated with this drug, the nurse should encourage the patient to
A) take the medication with food.
B) maintain adequate hydration.
C) avoid the use of Tylenol.
D) limit alcohol intake.
B) maintain adequate hydration.
What is the MBC?
A) The lowest concentration of an antibiotic needed to completely suppress bacterial growth
B) The lowest concentration of an antibiotic needed to reduce the number of bacterial colonies by 99.9%
C) The lowest concentration of an antibiotic needed to produce effects
D) The lowest dose of an antibiotic needed to eradicate bacteria
B) The lowest concentration of an antibiotic needed to reduce the number of bacterial colonies by 99.9%
A nurse is providing education for a patient beginning thyroid replacement therapy for hypothyroidism. Which information provided by the nurse is most important?
A) Therapy should continue until all symptoms have resolved.
B) Medication should be taken as directed for 3 to 6 months.
C) Most patients require therapy for at least 1 year.
D) In most cases, treatment is likely to be lifelong.
D) In most cases, treatment is likely to be lifelong.
A patient has just received a prescription for a 10-day course of penicillin for the treatment of strep throat. What patient education is essential for the nurse to provide?
A) Family members who have the same symptoms should also receive treatment.
B) The agent should be discontinued as soon as symptoms resolve to prevent allergic reactions.
C) The entire course of the drug must be taken to prevent the recurrence of infection and potential resistance.
D) The medication should be discontinued as soon as symptoms resolve to reduce the risk of resistance.
C) The entire course of the drug must be taken to prevent the recurrence of infection and potential resistance.
The patient's prescriber has ordered antibiotic combination therapy. The patient asks the nurse why two antibiotics are required. Which response by the nurse best describes the rationale for combination therapy?
A) "Additional coverage is provided in case one of the antibiotics is ineffective."
B) "The first antibiotic potentiates the effect of the second antibiotic."
C) "This is the only effective treatment for fever of unknown origin."
D) "An allergic response is less likely if two antibiotics are administered."
B) "The first antibiotic potentiates the effect of the second antibiotic."
A patient is brought to the emergency department by the family. Upon assessment, the prescriber suspects sepsis. Vital signs are: temperature 105.2° F, pulse 132/minute, respirations 26/minute, blood pressure 89/43 mm Hg. The nurse also documents findings of agitation, tremor, and unresponsiveness. The spouse states that the patient has a history of hyperthyroidism. The nurse should anticipate which of the following interventions? (Select all that apply.)
A) Administration of high doses of potassium iodide
B) Administration of propylthiouracil (PTU)
C) Administration of an angiotensin-converting enzyme (ACE) inhibitor
D) Administration of a beta blocker
E) Administration of glucocorticoids
F) Cooling blankets
A) Administration of high doses of potassium iodide
B) Administration of propylthiouracil (PTU)
D) Administration of a beta blocker
E) Administration of glucocorticoids
F) Cooling blankets
A patient with a history of transient ischemic attacks (TIAs) is being treated with warfarin (Coumadin) and begins therapy with trimethoprim/sulfamethoxazole (Bactrim). Which of the following findings would most concern the nurse?
A) Thrombophlebitis
B) Increased bleeding
C) Decreased effect of the antibiotic
D) Decreased effect of warfarin
B) Increased bleeding
A patient with Graves' disease is treated with iodine-131 (Iodope) therapy. Which of these statements, if made by the patient, would indicate that the patient has the correct understanding of the treatment's effects?
A) "I'll have to isolate myself from my family so I don't expose them to radiation."
B) "I'm looking forward to feeling better immediately after this treatment."
C) "I'll tell my doctor if I have fatigue, hair loss, or cold intolerance."
D) "I'll need to take this drug on a daily basis for at least 1 year."
C) "I'll tell my doctor if I have fatigue, hair loss, or cold intolerance."
When assessing a patient who has Cushing's syndrome, a nurse associates the patient with which of these clinical manifestations? Select all that apply.
A) Osteoporosis
B) Moon face
C) Glycosuria
D) Ketonuria
E) Mood swings
A) Osteoporosis
B) Moon face
C) Glycosuria
E) Mood swings
A patient in the ICU requires intravenous insulin. The nurse is aware that
A) insulin aspart or glargine can be administered IV.
B) any form of insulin can be used IV at the same dose ordered for subcutaneous administration.
C) insulin should never be given IV, and this order should be questioned.
D) only regular insulin can be administered IV.
D) only regular insulin can be administered IV.
The nurse has admitted a patient to the unit. While asking about the health history, the nurse asks if the patient is taking any medications. The patient states that she has been taking adrenal corticosteroids for a long time. The nurse recognizes that ______ may result from the use of adrenal corticosteroids at high doses.
A) asthma
B) Cushing's syndrome
C) allergic reactions
D) severe inflammation
B) Cushing's syndrome
The nurse working on a high acuity medical-surgical unit is prioritizing care for four patients who were just admitted. Which patient should the nurse assess first?
A) The NPO patient with a blood glucose of 80 mg/dL who just received 20 units of 70/30 Novolin insulin
B) The patient with a pulse of 58 beats per minute who is about to receive digoxin (Lanoxin)
C) The patient with a blood pressure of 136/92 mm Hg with complaints of a headache
D) The patient with an allergy to penicillin who is receiving an infusion of vancomycin (Vancocin)
A) The NPO patient with a blood glucose of 80 mg/dL who just received 20 units of 70/30 Novolin insulin
The nurse is providing patient education about oral itraconazole (Sporanox) therapy. Which of the following statements by the patient best demonstrates understanding of the administration of this medication? "To enhance absorption, I should take the medication
A) with a glass of wine."
B) with an antacid."
C) with a soda."
D) on an empty stomach."
C) with a soda."
A patient presents to the emergency department with complaints of chills, severe flank pain, dysuria, and urinary frequency. Vital signs reveal: temperature 102.9° F, pulse 92/minute, respirations 24/minute, and blood pressure 119/58 mm Hg. The nurse would be correct to suspect that the patient shows signs and symptoms of
A) acute cystitis.
B) urinary tract infection.
C) pyelonephritis.
D) prostatitis.
C) pyelonephritis.
A nurse caring for a patient who has diabetic ketoacidosis recognizes which of these characteristics in the patient? (Select all that apply.)
A) Occurs mainly in type 2 diabetes patients
B) Altered fat metabolism leading to ketones
C) Arterial blood pH of 7.35 to 7.45
D) Sudden onset, triggered by acute illness
E) Plasma osmolality of 300 to 320 milliosmoles/L
B) Altered fat metabolism leading to ketones
D) Sudden onset, triggered by acute illness
E) Plasma osmolality of 300 to 320 milliosmoles/L
A patient in cardiac arrest receives vasopressin (Pitressin) during cardiopulmonary resuscitation (CPR). An increase in which of these findings would indicate to a nurse a desired effect of the medication?
A) Respiratory rate
B) Blood pH
C) Blood pressure
D) Body temperature
C) Blood pressure
A patient with renal impairment who has been taking nitrofurantoin (Macrodantin) for a urinary tract infection telephones a nurse and describes the recent onset of "numbness and tingling" in the fingers and toes. The nurse should instruct the patient to
A) discontinue the drug and come in for further evaluation.
B) continue the drug and keep the hands and feet elevated when possible.
C) check the color of the extremities every 4 hours.
D) collect a urine sample and bring it to the clinic.
A) discontinue the drug and come in for further evaluation.
Insulin glargine is prescribed for a hospitalized patient who is diabetic. When will the nurse administer this drug?
A) Approximately 15 to 30 minutes before each meal
B) In the morning and at 4 PM
C) Once daily at bedtime
D) After meals and at bedtime
C) Once daily at bedtime
The nurse receives an order to give 1 mg of dexamethasone at 2300. At 0800 the next morning, plasma cortisol levels are drawn and reveal higher than normal levels. The patient asks the nurse what the lab results indicate. The nurse would be correct to tell the patient that the overnight dexamethasone suppression test is used to diagnose
A) adrenal crisis.
B) secondary adrenal insufficiency.
C) primary adrenal insufficiency.
D) Cushing's syndrome.
D) Cushing's syndrome.
Which statement is accurate about the long-term complications of diabetes?
A) Long-term complications are almost always the result of hypoglycemia and ketoacidosis.
B) The complication rates for patients with tightly controlled type II diabetes are the same as for those whose disease is not tightly controlled.
C) Tightly controlling type I diabetes produces excessive episodes of life-threatening hypoglycemia.
D) Tightly controlling both types of diabetes reduces the risk of eye, kidney, and nerve damage.
D) Tightly controlling both types of diabetes reduces the risk of eye, kidney, and nerve damage.
The nurse is preparing to administer a dose of growth hormone and reconstitutes the medication. After adding the diluent, the nurse notices that the preparation is cloudy. What action should the nurse take?
A) The drug should be administered as ordered.
B) The drug should be discarded and another dose prepared.
C) The drug should be shaken to help dissipate the particles.
D) The prescriber should be notified.
B) The drug should be discarded and another dose prepared.
The nurse is caring for a patient on a medical-surgical unit who has been experiencing fever of unknown origin. The prescriber has ordered a broad-spectrum antibiotic. Which intervention is the priority?
A) Administer the antibiotic immediately.
B) Administer antipyretics as soon as possible.
C) Obtain all cultures before the antibiotic is administered.
D) Delay administration of the antibiotic until the culture results are available.
C) Obtain all cultures before the antibiotic is administered.
The nurse is planning to implement an order to desensitize a patient to an antibiotic to which the patient previously had experienced a severe reaction. Which of the following implementations would be most appropriate prior to administration of the drug?
A) Stay with the patient for the duration of the medication administration.
B) Have a heart monitor accessible in the patient's room.
C) Clarify the order and recommend a different antibiotic.
D) Have epinephrine readily accessible in the patient's room.
D) Have epinephrine readily accessible in the patient's room.
A patient is receiving desmopressin (DDAVP) for the treatment of diabetes insipidus. Which of these instructions is the priority for a nurse to give the patient?
A) "Decrease water intake to prevent intoxication."
B) "Rotate nostrils daily to prevent irritation."
C) "You must weigh yourself several times each week."
D) "You'll quickly see results of a lower urine amount."
A) "Decrease water intake to prevent intoxication."
A newly admitted patient is going to be started on a course of antibiotic therapy with penicillin. The nurse understands that, while taking the patient's health history, a priority assessment is questioning the patient about
A) a history of seizure activity.
B) the cardiac history.
C) any previous allergy to penicillin.
D) any recent urinary tract infections (UTIs).
C) any previous allergy to penicillin.
A patient who has type 2 diabetes has a glycated hemoglobin (HbA1c) result of 10%. A nurse should make which of these changes to the nursing care plan?
A) Refer to a diabetic educator, there is poor glycemic control.
B) Glycemic control is adequate, no changes are needed.
C) Hypoglycemia is a risk, teach the patient the symptoms.
D) Instruct the patient to limit activity and weekly exercise.
A) Refer to a diabetic educator, there is poor glycemic control.
A nurse transcribes a new prescription for potassium penicillin G given intravenously (IV) q 8 hours and gentamicin IV q 12 hours. Which plan is the best schedule for administering these drugs?
A) Give the penicillin at 0800, 1600, and 2400; give the gentamicin (Garamycin) at 1800 and 0600.
B) Give the penicillin at 0800, 1600, and 2400; give the gentamicin (Garamycin) at 1200 and 2400.
C) Give the penicillin at 0600, 1400, and 2200; give the gentamicin (Garamycin) at 0600 and 1800.
D) Give the penicillin every 8 hours; give the gentamicin (Garamycin) simultaneously with two of the penicillin doses.
A) Give the penicillin at 0800, 1600, and 2400; give the gentamicin (Garamycin) at 1800 and 0600.
For which of the following patients would nitrofurantoin (Macrodantin) be contraindicated?
A) A patient with hypoglycemia
B) A patient with hyperkalemia
C) A patient with bacteria in the urine
D) A patient with a creatinine clearance of 38 mL/minute
D) A patient with a creatinine clearance of 38 mL/minute
Which patient has the highest risk for type II diabetes?
A) A 20-year-old man who drinks a can of beer every evening
B) A 35-year-old man with a family history of pancreatic cancer
C) A 50-year-old woman with a stressful lifestyle
D) A 55-year-old woman who is 5'3" tall and weighs 194 pounds
D) A 55-year-old woman who is 5'3" tall and weighs 194 pounds
Before administering metformin (Glucophage), which of these laboratory values would require a nurse to notify the prescriber?
A) Creatinine (Cr) of 2.1 mg/dL
B) Hemoglobin (Hgb) of 9.5 gm/dL
C) Sodium (Na) of 131 mEq/dL
D) Platelets of 120,000/mm3
A) Creatinine (Cr) of 2.1 mg/dL
Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are products of which of these structures?
A) Hypothalamus
B) Anterior pituitary gland
C) Posterior pituitary gland
D) Ovaries
B) Anterior pituitary gland
A nurse should teach a patient to observe for which of these side effects when taking ampicillin (Polycillin)?
A) Skin rash and loose stool
B) Reddened tongue and gums
C) Digit numbness and tingling
D) Bruising and petechiae
A) Skin rash and loose stool
The nursing instructor asks the students to demonstrate proper hand-washing techniques, as established by the guidelines of the Centers for Disease Control and Prevention (CDC). Which technique, used by one of the students, indicates a need for further teaching?
A) The student cleanses the hands with warm water and antimicrobial soap after cleaning a bed pan.
B) The student cleanses the hands with hand gel after giving a patient a glass of water.
C) The student cleanses visibly dirty hands with an alcohol-based hand rub.
D) The student cleanses the hands with an alcohol-based hand rub prior to obtaining a blood pressure.
C) The student cleanses visibly dirty hands with an alcohol-based hand rub
A patient complains of mouth sores. Upon assessment, the nurse notes white, patchy spots and redness of the tongue and throat. The nurse expects the prescriber to order
A) miconazole (Micatin).
B) itraconazole (Sporanox).
C) fluconazole (Diflucan).
D) nystatin (Mycostatin).
D) nystatin (Mycostatin).
The nurse manages care for a patient with diabetes who takes metformin. Which laboratory result would cause the greatest concern?
A) Elevated creatinine
B) Decreased hemoglobin
C) Decreased platelets
D) Increased iron
A) Elevated creatinine
What is the most reliable measure for assessing diabetes control over the preceding 3-month period?
A) Self-monitoring blood glucose (SMBG) graph report
B) Patient's report
C) Fasting blood glucose level
D) Glycosylated hemoglobin level
D) Glycosylated hemoglobin level
A patient with type I diabetes reports mixing NPH and regular insulin to allow for one injection. The nurse should inform the patient that
A) this is an acceptable practice.
B) these two forms of insulin are not compatible and cannot be mixed.
C) mixing these two forms of insulin may increase the overall potency of the products.
D) NPH insulin should only be mixed with insulin glargine.
A) this is an acceptable practice.
The nurse is serving as a preceptor for a graduate nurse on a medical-surgical unit. The nurse, who is discussing the mechanisms of action of antibiotics, currently is talking about the mechanism of action of penicillins (PCNs). Which statement by the graduate nurse best demonstrates understanding? "Penicillin works by
A) weakening the bacterial cell wall, which then ruptures and dies."
B) inhibiting protein synthesis and suppressing bacterial growth."
C) disrupting bacterial protein synthesis, destroying the bacterial wall."
D) disrupting biochemical reactions, which results in cellular lysis."
A) weakening the bacterial cell wall, which then ruptures and dies."
Amphotercin B is used to treat:
a) Bacterial infections
b) Fungal and parasitic infections
c) Viral infections
d) Preventative bacterial infections
b) Fungal and parasitic infections
A patient with Graves' disease is treated with iodine-131 (Iodope) therapy. Which of these statements, if made by the patient, would indicate that the patient has the correct understanding of the treatment's effects?
A) "I'll have to isolate myself from my family so I don't expose them to radiation."
B) "I'm looking forward to feeling better immediately after this treatment."
C) "I'll tell my doctor if I have fatigue, hair loss, or cold intolerance."
D) "I'll need to take this drug on a daily basis for at least 1 year."
C) "I'll tell my doctor if I have fatigue, hair loss, or cold intolerance."
A nurse is providing education for a patient recently started on levothyroxine (Levothroid). To evaluate the patient's knowledge of the drug-to-drug interactions explained in the patient's educational session, the nurse asks the patient which drugs should not be taken concurrently with levothyroxine. Which statement made by the patient best demonstrates the need for further teaching?
A) "I should avoid taking iron supplements."
B) "I should take only Maalox and Mylanta for indigestion."
C) "I should anticipate an increase in the dose of levothyroxine if I start taking sertraline (Zoloft) again."
D) "I should anticipate a decrease in my dose of warfarin (Coumadin)."
B) "I should take only Maalox and Mylanta for indigestion."
A student has just performed a physical assessment on a patient who has an infection with Clostridium difficile, a microorganism that produces spores. As the student prepares to leave the room, the nurse notices that she uses an alcohol rub to cleanse her hands. What immediate action should the nurse take?
A) No action is required.
B) Report the student's action to the instructor.
C) Ask the student to wash her hands with soap and water before she leaves.
D) Discuss the matter with the student later in a quiet area.
C) Ask the student to wash her hands with soap and water before she leaves.
Eight hours after administering a sulfonamide, the nurse notes that a patient has a temperature of 104° F, pulse of 112/minute, BP of 104/52 mm Hg, respirations of 20/minute, malaise, and widespread lesions of the skin and mucous membranes. The nurse would be correct to suspect
A) suprainfection.
B) systemic mycoses.
C) "red man" syndrome.
D) Stevens-Johnson syndrome.
D) Stevens-Johnson syndrome.
A patient calls from home, concerned about the appearance of a vial of insulin lispro. The patient reports that the solution appears cloudy. What would be the nurse's best response?
A) "Agitate the solution, and the granules should disperse."
B) "Discard the vial. The solution should be clear."
C) "Proceed with the injection. Drawing the solution into the syringe will mix the particles."
D) "Lispro is always cloudy. Proceed with the injection."
B) "Discard the vial. The solution should be clear."
A patient with type I diabetes who takes insulin reports taking propranolol for hypertension. The nurse is concerned because
A) the beta blocker can cause insulin resistance.
B) using the two agents together increases the risk of ketoacidosis.
C) propranolol increases insulin requirements because of receptor blocking.
D) the beta blocker can mask the symptoms of hypoglycemia.
D) the beta blocker can mask the symptoms of hypoglycemia.
A burn patient is admitted to a medical-surgical unit, and 2 days later develops a urinary tract infection (UTI). The prescriber orders mafenide (Sulfamylon). The nurse should monitor the laboratory test results for the development of
A) anemia.
B) uremia.
C) hepatitis.
D) acidosis.
D) acidosis.
A nurse assesses a patient who has all the following manifestations. Which of these does the nurse most clearly associate with a tumor of the hypothalamus?
A) Mood swings
B) Unstable body temperature
C) Irregular respirations
D) Increased heart rate
B) Unstable body temperature
Which of these manifestations should a nurse investigate first when monitoring a patient who is taking levothyroxine (Synthroid)?
A) Tachycardia
B) Tremors
C) Insomnia
D) Irritability
A) Tachycardia
A nurse is developing a plan of care for a patient who has Addison's disease and is taking hydrocortisone (Cortef). Which of these outcomes should receive priority in the plan?
A) At times of stress, increases glucocorticoid dose
B) A Medic Alert bracelet worn at all times
C) Carries an injectable plus oral form of glucocorticoid
D) Divides daily dose, two thirds in AM and one third in PM
A) At times of stress, increases glucocorticoid dose
A patient comes to the clinic with weakness, emaciation, and hyperpigmentation. Lab tests reveal a potassium level of 6 mEq/L, a sodium level of 129 mEq/L, and a blood glucose of 60 mg/dL; the patient's blood pressure is 94/66 mm Hg. The nurse recognizes these symptoms as ________________ and anticipates that the prescriber will order _______________.
A) Addison's disease; hydrocortisone
B) Cushing's disease; fludrocortisone (Florinef)
C) congenital adrenal hyperplasia; ketoconazole (Nizoral)
D) primary hyperaldosteronism; spironolactone (Aldactone)
A) Addison's disease; hydrocortisone
The nurse is caring for a patient who has a fungal infection and has been prescribed fluconazole (Diflucan). The patient is also taking tolbutamide (Orinase), an oral hypoglycemic agent. The nurse would especially monitor the patient for which effects?
A) Hypoglycemia
B) Hyperkalemia
C) Hyperglycemia
D) Bleeding
A) Hypoglycemia
A teaching plan for a patient who is taking lispro (Humalog) should include which of these instructions by the nurse?
A) "Inject this insulin with your first bite of food because it is very fast acting."
B) "The duration of action for this insulin is about 8 to 10 hours, so you'll need a snack."
C) "This insulin needs to be mixed with regular insulin to enhance the effects."
D) "To achieve tight glycemic control, this is the only type of insulin you'll need."
A) "Inject this insulin with your first bite of food because it is very fast acting."
A 44-year-old patient with type I diabetes is brought to the emergency department with ketoacidosis. The nurse should immediately prepare to administer
A) subcutaneous insulin.
B) intravenous normal saline in large quantities.
C) dextrose 50% plus thiamine.
D) glucagon.
B) intravenous normal saline in large quantities.
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