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Pharm FINAL (lecture example questions)
Terms in this set (80)
A patient is recovering from an appendectomy. She also has asthma and allergies to shellfish and iodine. To manage her postoperative pain, the physician has prescribed patient-controlled analgesia (PCA) with hydromorphone (Dilaudid). Which vital sign is of greatest concern?
b. Blood pressure
A patient who has metastasized bone cancer has been on transdermal fentanyl patches for pain management for 3 months. He has been hospitalized for tests and has told the nurse that his pain is becoming "unbearable." The nurse is reluctant to give him the ordered pain medication because the nurse does not want the patient to get addicted to the medication. What do the nurse's actions reflect?
a. Appropriate concern for the patient's best welfare
b. Appropriate caution for a patient who is already on a long-term opioid
c. An uncaring attitude toward the patient
d. A failure to manage the patient's pain properly
a failure to manage the patients pain properly
A patient with a history of heavy alcohol use needs a medication for pain. The recommended maximum daily dose of acetaminophen for this patient would be
a. 1000 mg.
b. 2000 mg.
c. 3000 mg.
d. 4000 mg.
The nurse is administering medications. One patient has an order for aspirin 325 mg by mouth daily and another patient has an order for aspirin 650 mg 4 to 6 times daily (maximum 4 g/day). What indication for the 325 mg should the nurse recognize?
a. Pain management
b. Fever reduction
c. Treatment of OA
A patient is admitted with salicylate toxicity. When assessing the patient, the nurse anticipates which manifestation associated with salicylate toxicity?
A hospitalized patient has an order for ketorolac (Toradol). The nurse notes that the order is only for 5 days. What is the rationale for this?
a. The patient's pain should subside by that time.
b. There are concerns about addiction to the drug.
c. The drug can cause severe renal and GI effects.
d. The drug loses its effectiveness over time.
the drug can cause sever renal and GI effects
An 82-year-old woman is taking ibuprofen (Motrin) 3200 mg divided three times daily as treatment for arthritis. She has had no other health problems. What is the most important assessment for the nurse to monitor while the patient is on this therapy?
a. Blood sugar
b. Liver function studies
c. Assessment of hearing
d. Renal function studies
renal function studies
Which drug does the nurse associate with the development of potentially life-threatening skin adverse effects of exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis?
c. Febuxostat (Uloric)
d. Allopurinol (Zyloprim)
A patient is taking ibuprofen 800 mg three times a day by mouth as treatment for OA. While taking a health history, the nurse finds out that the patient has a few beers on weekends. What concern would there be with the interaction of the alcohol and ibuprofen?
a. Increased bleeding tendencies
b. Increased chance for GI bleeding
c. Increased nephrotoxic effects
d. Reduced antiinflammatory effects of the NSAID
increased chance for GI bleeding
Which effect does the nurse expect to see in a patient receiving hydrocortisone (Solu-Cortef)?
a. Increase in inflammatory leukocyte function
b. Reduction of scar tissue formation
c. Renal excretion of sodium
reduction of scar tissue formation
When administering octreotide (Sandostatin) to a patient, it is most important for the nurse to assess which parameter?
a. Urine output
b. Blood sugar
c. Liver function tests
A patient will be receiving somatropin. The nurse expects that the patient has which disorder?
a. Adrenocortical insufficiency
b. Hypopituitary dwarfism
c. Esophageal varices
d. Septic shock
A patient who is taking a thyroid replacement medication tells the nurse that she is starting to experience cold intolerance, depression, constipation, and dry skin. What potential cause does the nurse
a. inadequate doses of the medication.
b. possible overdose of the medication.
c. worsening of the underlying disease.
d. drug interactions with another medication.
inadequate doses of the medication
Which information will the nurse include when teaching a patient about thyroid replacement therapy?
a. "Take the medication before bed."
b. "You will experience beneficial effects of the drug after 1 week of treatment."
c. "Stop taking the drug if you experience insomnia."
d. "Take the medication on an empty stomach."
"take the medication on an empty stomach"
A woman who has type 2 DM is now pregnant. She wants to know whether to take her oral antidiabetic medication. What instructions will she receive?
a. She should continue the antidiabetic medication at the same dosage.
b. The antidiabetic medication dosage will be increased gradually throughout her pregnancy.
c. She will be switched to insulin therapy while she is pregnant.
d. She will not receive any antidiabetic medication while pregnant and will need to monitor her dietary intake closely.
she will be switched to insulin therapy while she is pregnant
The nurse has just administered the morning dose of a patient's lispro (Humalog) insulin. Just after the injection, the dietary department calls to inform the patient care unit that breakfast trays will be 45 minutes late. What will the nurse do next?
a. Inform the patient of the delay.
b. Check the patient's blood glucose levels.
c. Call the dietary department to send a tray immediately.
d. Give the patient food, such as cereal and skim milk, and juice.
give the pt food, such as cereal and skim milk, and juice
A patient with type 1 DM is admitted to the medical unit with an acute exacerbation of chronic obstructive pulmonary disease. He is placed on IV piggyback antibiotics, nebulizer treatments with albuterol, and an IV corticosteroid, and he is also taking a proton pump inhibitor for gastroesophageal reflux disease. He takes a dose of glargine insulin every evening. This evening the nurse notes that his blood glucose level is 170 mg/dL. The next morning, his fasting glucose level is 202 mg/dL. What is the most likely cause of his elevated glucose levels?
a. The albuterol
b. The antibiotics
c. The proton pump inhibitor
d. The corticosteroid
A male patient who has a history of type 2 DM is admitted to the medical unit with a diagnosis of pneumonia. The patient has many questions regarding his care and asks the nurse why everyone keeps telling him about HbA1C.
1. What can the nurse inform the patient about the use of HbA1C in diabetes mellitus?
a. Helps to identify which type of DM the patient has
b. Will identify if he has an infection
c. Will aid in monitoring patient compliance with treatment regimen for several months previously
d. Represents current fasting blood glucose level
will aid in monitoring pt compliance with treatment regimen for several months previously
The patient was taking metformin before this hospitalization. To facilitate better glucose control, the patient has been switched to insulin therapy while hospitalized. The patient asks the nurse why it is so important to time meals with the insulin injection and to give him an example of a long-acting insulin.
2. Which drug will the nurse tell the patient is a long-acting insulin?
a. Insulin glulisine (Apidra)
b. Insulin isophane suspension (NPH)
c. Insulin detemir (Levemir)
d. Regular insulin (Humulin R)
insulin detemir (Levemir)
The patient is being discharged home with insulin aspart (NovoLog) and insulin isophane suspension (NPH).
1. Which information does the nurse include when providing discharge teaching to the patient?
a. Store the insulins in the refrigerator.
b. Shake the insulins for 1 full minute before use.
c. Administer the injection at a 30-degree angle to your skin.
d. Draw up the insulin aspart (NovoLog) first and then draw up the insulin isophane suspension (NPH) into the same syringe.
draw up the insulin aspart (NovoLog) first and then draw up the insulin isophane suspension (NPH) into the same syringe
The nurse enters the patient's room to complete the discharge process and finds the patient to be lying in bed unresponsive and breathing. The patient has a blood glucose reading of 48 mg/dL.
1. What is the most appropriate response by the nurse?
a. Place a packet of table sugar in the patient's mouth.
b. Start cardiopulmonary resuscitation (CPR).
c. Roll the patient to the side and administer the ordered glucagon.
d. Have the patient drink orange juice.
roll the pt to the side and administer the ordered glucagon
A patient who has chronic renal failure wants to self-treat with an antacid for occasional heartburn. Which medication is the best choice for this patient?
a. A magnesium-containing antacid
b. A calcium-containing antacid
c. An aluminum-containing antacid
d. Because of renal problems, the patient should not take antacids for this problem.
an aluminum-containing antacid
When working with an older patient who has been admitted for a possible GI bleed, the nurse identifies which drug as having the potential to cause confusion and disorientation?
a. An antacid
b. A PPI
c. An H2 antagonist
d. A mucosal protectant
an H2 antagonist
When teaching a patient about sucralfate (Carafate) therapy, which of the following statements will the nurse include?
a. "Take sucralfate 1 hour before your other medications."
b. "Sucralfate is administered once daily upon waking up."
c. "Sucralfate acts systemically to heal gastric ulcers."
d. "Sucralfate binds and concentrates epidermal growth factor to promote ulcer healing."
"Sucralfate binds and concentrates epidermal growth factor to promote ulcer healing"
Simethicone (Mylicon) is often combined with calcium carbonate antacids because of what effect?
a. An increased antacid effect will result when these drugs are given in combination.
b. Simethicone helps to reduce the gas that is caused by the calcium antacids.
c. Simethicone reduces the diarrhea that is caused by the calcium.
d. Simethicone improves the taste of the calcium tablets, which must be chewed.
Simethicone helps to reduce the gas that is caused by the calcium antacids
When providing education regarding the use of PPIs, which statement will the nurse include?
a. "Take the medication along with the first meal of the day."
b. "Take the medication on an empty stomach, 30 to 60 minutes before eating."
c. "Take the medication when you have symptoms of heartburn."
d. "Take the medication at bedtime with a snack."
"Take the medication on an empty stomach, 30-60 minutes before eating"
The antidiarrheal drug Lomotil contains both diphenoxylate, a synthetic opiate agonist, and atropine, an anticholinergic. What is the purpose of the additive, atropine?
a. Enhance the effects of the diphenoxylate.
b. Discourage recreational use of the opiate diphenoxylate.
c. Counteract the adverse effects of the diphenoxylate.
d. Act as an adsorbent for bacteria in the bowel.
discourage recreational use of the opiate diphenoxylate
A patient is experiencing diarrhea while completing a course of antibiotic therapy. Which of the following agents does the nurse anticipate administering to the patient?
a. L. acidophilus (Bacid)
b. Bismuth subsalicylate (Pepto-Bismol)
c. Diphenoxylate with atropine (Lomotil)
d. Loperamide (Imodium A-D)
L. acidophilus (Bacid)
A patient who takes Coumadin has been prescribed an adsorbent for diarrhea. It is important for the nurse to assess the patient for bruising because use of Coumadin with adsorbents interferes with the absorption of which vitamin?
Before administering belladonna alkaloids, it is most important for the nurse to assess the patient for a history of which condition?
b. Diabetes mellitus
c. Myasthenia gravis
Which antidiarrheal does the nurse associate with the development of adverse effects of urinary retention, headache, confusion, dry skin, rash, and blurred vision?
patient is taking lactulose four times a day but does not have a history of constipation. In fact, he has had bowel movements every day. What is the probable reason for the lactulose?
a. Cleansing the bowel before a procedure
b. Removal of helminths
c. Reduction of high ammonia levels associated with liver failure
d. Daily maintenance to prevent constipation
reduction of high ammonia levels associated with liver failure
A hospitalized patient is experiencing diarrhea. Which of the following does the nurse identify as adverse side effects of diphenoxylate with atropine therapy? (Select all that apply.)
a. Increased salivation
b. Abdominal pain
d. Blurred vision
A 48-year-old patient has been admitted with abdominal pain, and states that she has not had a bowel movement for 4 days. Her abdomen is distended and slightly tender. Which laxative would be appropriate for this patient?
a. Milk of Magnesia
b. A bulk-forming laxative
c. Mineral oil
d. No laxative should be given at this time.
no laxative should be given at this time
The nurse is preparing to administer scopolamine to a patient. It is most important for the nurse to determine if the patient has a history of which condition?
b. Narrow-angle glaucoma
d. Detached retina
A patient is receiving a continuous tube feeding via a percutaneous endoscopic gastrostomy tube. Which drug would most likely be prescribed for this patient?
a. Metoclopramide (Reglan)
b. Meclizine (Antivert)
c. Aprepitant (Emend)
Phosphorated carbohydrate solution (Emetrol
A patient with terminal cancer has not had chemotherapy for a few weeks and has had no nausea or vomiting since then. However, he is taking dronabinol twice a day. What rationale should be considered by the nurse?
a. Prevents recurrence of the chemotherapy-induced nausea and vomiting
b. Prevents stress ulcers
c. Improves his mood
d. Stimulate his appetite
stimulate his appetite
A patient is 2 months pregnant. She comes to the clinic complaining of severe morning sickness. She has tried numerous nonpharmacologic measures to relieve the morning sickness, but they have not worked. The nurse anticipates the use of which antinausea drug?
a. Phosphorated carbohydrate solution (Emetrol)
b. Aprepitant (Emend)
c. Palonosetron (Aloxi)
d. Dolasetron (Anzemet)
phosprated carbohydrate solution (Emetrol)
Which group of drugs used to treat nausea does the nurse identify as most likely to cause a prolonged QTc interval?
d. Serotonin blockers
A patient tells the nurse that he takes ginger almost every day for nausea. It is most important for the nurse to determine if the patient is taking which medication?
a. Furosemide (Lasix)
b. Acetaminophen (Tylenol)
c. Warfarin (Coumadin)
d. Calcium supplements
While taking a history of a 68-year-old female patient who is receiving estrogen therapy as part of palliative treatment for advanced breast cancer, which assessment finding would be of most concern to the nurse?
a. The patient is on transdermal opioids for cancer pain.
b. The patient smokes 1 pack of cigarettes a day.
c. The patient drinks a glass of wine one evening a week.
d. The patient has a history of osteoporosis.
the patient smokes 1 pack of cigarettes a day
A 60-year-old woman is taking a bisphosphonate. She calls the clinic and tells the nurse that her stomach has been bothering her and wants to know what she should do. Which instruction is most appropriate for the nurse to provide?
a. Take the medication with milk.
b. Take the medication with breakfast.
c. Remain upright in a sitting position for at least 10 minutes after taking the medication.
d. Stop the medication and come in for an evaluation.
stop the medication and come in for an evaluation
1. A woman at 39 weeks' gestation sees her obstetrician in the office. The baby is in perfect position for delivery, and the physician decides to have the patient go to the hospital in the morning for induction.
a. If bleeding occurs after delivery, what medication will the nurse expect to be ordered?
Oxytocin or methylergonovine (Methergine)
A woman in labor is on an oxytocin infusion. The nurse notes that her contractions are close to 1 minute apart and are lasting 1.5 minutes. The mother's blood pressure has increased to 130/98 mm Hg, and the fetal heart rate decreases during the contractions. The woman states, "Wow, this medicine is sure hurrying things along!" What is the nurse's priority action?
a. Continue to monitor the labor, which is progressing nicely.
b. Offer comfort measures during the contractions.
c. Stop the infusion, administer oxygen, have her lie on her left side, and notify the physician immediately.
d. Take the patient to the delivery area because delivery is imminent.
stop the infusion, administer oxygen, have her lie on her left side, and notify the physician
A woman has not taken her oral contraceptive since Monday. It is now Wednesday morning. What should she do now to prevent pregnancy?
a. Take the two missing doses as soon as possible.
b. Continue the drug as if no doses were missed.
c. Start over with a new monthly pack of oral contraceptives.
d. Resume the drug but also use a second form of birth control.
resume the drug but also use a second from of birth control
A 48-year-old man asks the nurse practitioner for a prescription for sildenafil (Viagra). He is currently taking transdermal nitroglycerin, hydrochlorothiazide, and potassium supplements for cardiac problems, as well as a multivitamin with iron. Which medication would be a cause for concern if taken with the sildenafil?
a. Transdermal nitroglycerin
d. Multivitamin with iron
A patient has been prescribed Testoderm transdermal patches for hypogonadism. What is an important teaching point the nurse should include?
a. Apply the patch to the upper arm.
b. Apply the patch to clean, dry scrotal skin that has been shaved for optimal skin contact.
c. Shave the skin of the calf and apply the patch.
d. Discontinue use of the patch if the skin is uncomfortable.
apply the patch to clean, dry scrotal skin that has been shaved for optimal skin contact
Before administering lithium to a patient, it is important for the nurse to assess which laboratory value?
When patients are taking selective SSRIs for the first time for depression, which is most important to monitor for during the first few weeks of therapy?
A patient has two inhalers that are due to be taken at the same time. One is a bronchodilator; the other is a corticosteroid. Which inhaler should the patient take first?
The nurse knows that the adverse effects of a nonselective beta blocker are likely to be the most immediately life threatening in which patient?
patient with asthma
drug to reverse effects of an overdose of a cholinergic drug
Which finding would the nurse anticipate when assessing a patient with an atropine overdose?
A patient is prescribed two different types of inhaled medications for treatment of COPD. After administering the first medication, how long should the nurse wait to administer the second medication?
positive inotropic effect
increased force of myocardial contraction
positive chronotropic effect
increase heart rate
positive dromotropic effect
increased electrical pulses/conduction to heart
A patient with a known history of angina was walking his dog and developed chest pain. The patient immediately stops walking and sits down. He continues to experience chest pain when sitting down. When should he call 911?
If one sublingual tablet does not relive the pain after 5 minutes
When administering a loop diuretic, its most important for the nurse to determine if the pt is also taking which drug?
A pregnant woman has been diagnosed with cancer and is meeting with her oncologist to plan treatment. Which statement about chemotherapy and pregnancy is true?
a. Chemotherapy treatment during the second or third trimester poses less risk to the fetus
b. She will have to wait until the baby is born before starting chemotherapy.
c. The greatest risk of fetal harm from chemotherapy is during the third trimester.
d. Chemotherapy is unsafe during pregnancy, but radiation therapy is safe in low doses.
Chemotherapy treatment during the second or third trimester poses less risk to the fetus
The nurse is caring for a patient who received chemotherapy 24 hours ago. The patient's white blood cell count is 4,400 mcL. Which symptom, if experienced by the patient, should the nurse report to the prescriber immediately?
d. Nausea and vomiting
When working with a patient who is neutropenic, the nurse identifies which as the most effective measure to prevent the patient from developing an infection?
a. Perform hand hygiene
b. Administer prophylactic antibiotics.
c. Stop administration of the chemotherapeutic drug.
d. Vaccinate the patient to prevent bacterial infection.
perform hand hygiene
The nurse notes an order for the patient to receive an IV dose of methylprednisolone prior to administration of basiliximab. What is the rationale for this drug regime?
a. Prevention of cytokine release syndrome
b. Decreases pain at infusion site
c. Enhanced suppression of immune system
d. Prevention of fluid retention
prevention of cytokine release syndrome
A patient who had a kidney transplant is receiving cyclosporine orally in maintenance doses. What action would decrease the potency of this drug?
a. Using a Styrofoam container to administer the drug
b. Taking it with orange juice
c. Taking it with milk
d. Mixing it with chocolate milk
using a styrofoam container to administer the drug
Which potential problem is of most concern for a patient receiving immunosuppressant drugs?
a. Increased susceptibility to infections
b. Orthostatic hypotension
d. Peripheral edema
increased susceptibility to infections
Which oral fluid the patient requests with med administration would be most concerning to the nurse for a patient taking cyclosporine?
a. Grapefruit juice
d. Apple juice
A male patient who received a kidney transplant 6 months ago is taking cyclosporine. The patient tells the nurse that he has started to take several herbal preparations. Which does not pose a possible problem for the patient?
b. St. John's wort
c. Cat's claw
A patient with AIDS was cut by a rusty piece of metal while walking outside. He recalls that his last tetanus booster was more than 20 years ago. Which immunization therapy will he receive at this time?
a. Teatanus iummunoglobulin
b. He cannot receive any type of immunization therapy.
c. Tetanus toxoid, adsorbed
d. Tetanus and diphtheria toxoid (Td) booster
The zoster vaccine (Zostavax) is used in which situation?
a. To prevent chickenpox in children
b. To prevent chickenpox in children who have been exposed to herpes zoster
c. To prevent postherpetic neuralgia in patients who have shingles
d. To prevent reactivation of the zoster virus that causes shingles in patients age 60 years and older
to prevent reactivation of the zoster virus that causes shingles in patients age 60 years and older
Nursing considerations for conversion of IV heparin to oral warfarin (Coumadin) therapy will include
a. Overlapping therapy of IV heparin and warfarin are for at least 5 days
b. immediate discontinuation of IV heparin and administration of oral warfarin (Coumadin) therapy only.
c. monitoring the INR and stopping the IV heparin when the INR is 1.0.
overlapping therapy of IV heparin and warfarin are for at least 5 days
When converting from IV heparin to oral warfarin (Coumadin) therapy, the prescriber monitors which of the following to determine the next appropriate dose of warfarin?
a. Platelet levels
c. Red blood cell count
Which of the following should the nurse include when providing dietary teaching for the patient receiving warfarin (Coumadin) therapy?
a. Avoid drinking large amounts of green tea.
b. Cranberry juice will provide you with needed nutrients while taking Coumadin.
c. You must never eat spinach.
d. You can only eat lettuce once a month.
avoid drinking large amount of green tea
The patient accidentally takes too much of the prescribed warfarin (Coumadin) and is readmitted to the hospital with bleeding. Which drug can the nurse anticipates administrating?
a. Protamine sulfate
b. Alteplase (Activase, Cathflo Activase)
c. Reteplase (Retavase)
d. Vitamin K
A patient is receiving Augmentin (amoxicillin and clavulanic acid) liquid solution through a percutaneous endoscopic gastrostomy (PEG) tube. What is the purpose of the clavulanic acid?
a. It works synergistically with the antibiotic to improve potency.
b. It inhibits the action of the enzymes produced by beta-lactamase-producing bacteria.
c. It protects the antibiotic from the harmful gastric acid secretions in the stomach.
d. It enhances the absorption of the antibiotic in the small intestine.
it inhibits the action of the enzyme produced by beta-lactamase-producing bacteria
Which of the following does the nurse identify as being a concern for patients receiving tetracycline?
a. Tetracycline should not be administered to anyone older than age 65 years.
b. Tetracycline has no impact on the effectiveness of oral contraceptives.
c. Tetracycline used with warfarin decreases its effectiveness and enhances clot formation.
d. Tetracyclines should not be administered with dairy products.
tetracyclines should not be administered with dairy products
A 58-year-old man is receiving vancomycin as part of the treatment for a severe bone infection. After the infusion, he begins to experience some itching and flushing of the neck, face, and upper body. He reports no chills or difficulty breathing. What should the nurse suspect?
a. An allergic reaction has occurred.
b. An anaphylactic reaction is about to occur.
c. The medication will not be effective for the bone infection.
d. The IV dose may have infused too quickly.
The IV dose may have infused too quickly
(RED MAN SYNDROME)
A group of office workers is concerned because a package was opened that contained a white powder substance. There is a concern that the white powder is anthrax. Which drug does the nurse anticipate being prescribed for the office workers?
a. Daptomycin (Cubicin)
b. Colistimethate (Coly-Mycin)
c. Ciprofloxacin (Cipro)
d. Quinupristin-dalfopristin (Synercid)
When teaching patients about treatment of viral infection with acyclovir (Zovirax), which of the following statements will the nurse include?
a. The drug is used mainly to suppress the replication of HSV-1, HSV-2, and VZV.
b. Acyclovir (Zovirax) is only effective for initial viral infections.
c. Acyclovir (Zovirax) is available in topical form only.
d. Acyclovir (Zovirax) is taken once daily.
The drug is used mainly to suppress the replication of HSV-1, HSV-2, and VZV.
A patient has been instructed to use an over-the-counter form of the bulk-forming laxative methylcellylose (Citrucel) to prevent constipation. The nurse will advise the patient of potential adverse effects, including which of these? (select all that apply)
a. electrolyte imbalance
b. decreased absorption of vitamins
c. gas formation
d. darkened stools
e. discolored urine
a. electrolyte imbalance
c. gas formation
When the nurse is administering a proton pump inhibitor (PPI), which actions by the nurse are correct? (select all that apply)
a. Giving the PPI on an empty stomach
b. Giving the PPI with meals
c. Making sure the patient does not crush or chew the capsules
d. Instructing the patient to open the capsule and chew the contents for best absorption
e. Administering the PPI only when the patient complains of heartburn
a. Giving the PPI on an empty stomach
c. Making sure the patient does not crush or chew the capsules
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