Pharm exam 2

The nurse is caring for a client with Parkinson disease. Which should the nurse understand is the action of the pharmacotherapy used to treat the condition?

-Increase the amount of dopamine and reduce the amount of acetylcholine

-Increase the amount of dopamine and acetylcholine

-Reduce the amount of dopamine and acetylcholine

-Reduce the amount of dopamine and increase the amount of acetylcholine

Increase the amount of dopamine and reduce the amount of acetylcholine.

A client with chronic back pain informs the nurse that he has been receiving therapeutic touch in addition to his medications. What is the nurse's best classification of the clients treatment.

-Pharmacotherapy

-Complementary therapy

-Biologic therapy

-Alternative therapy

complementary therapy

A client is receiving multiple antibiotics. Which assessment should the nurse make a priority for this client?

-Renal and liver function tests

-Blood cultures for the presence of bacteria

-Changes in stool , white patches int he mouth, and urogenital itching or rash

-Adequate food and fluid intake

Changes in stool, white patches in the mouth, and urogenital itching or rash

A client is prescribed an azole antifungal medication. In which way should the nurse explain the mechanism of action for this medication?

-Impairs fungal cellular growth

-Interferes with DNA replication

-Interferes with the synthesis of ergosterol

-Has a cytotoxic effect on the lungs

interfere with the synthesis of ergosterol.

A patient has been taking phenytoin (Dilantin) for control of generalized seizures, tonic-clonic type. The patient is admitted to the medical unit with symptoms of nystagmus, confusion, and ataxia. What change in the phenytoin dosage does the nurse anticipate will be made based on these symptoms.

-The dosage will remain unchanged but an additional antiseizure medication may be added

-The dosage will be decreased

-The dosage will remain unchanged; these are symptoms unrelated to the phenytoin

-The dosage will be increased

the dosage will be decreased

An older client is prescribed a nonsteroidal anti-inflammatory drug (NSAID). Which outcome should the nurse include in the plan of care for this client?

-The client will refrain from taking other medications with the NSAID

-The client will report any bleeding or bruising while taking the NSAID

-The client will avoid the use of caffeine while taking the medication

-The client will report any mood changes while taking the drug

The client will report any bleeding or bruising while taking the NSAID

A client is prescribed ondansetron (Zofran). Which current medication should the nurse concern?

-haloperidol (Haldol)

-warfarin (Coumadin)

-atenolol (Tenormin)

-metformin (Glucophage)

haloperidol (Haldol)

Which information should the nurse include in the education of a client prescribed an antacid?

-Antacids can be safely administered with antibiotics

-Administer antacids at least 2 hours before other oral medications

-Lie down for 30 minutes after taking antacids

-Antacids can be safely administered with H2-receptor medications

Administer antacids at least 2 hours before other oral medications.

A client is newly diagnosed with Alzheimer disease. Which medication should the nurse anticipate being prescribed for this client?

-Donepezil (Aricept)

-Haloperidol (Haldol)

-Benzotropine mesylate (Cogentin)

-Levodopa (Lardocopa)

Donepezil (Aricept)

A client taking amitriptyline (Elavil) (a TCA) for 2 weeks says the medication is not working. Which response should the nurse make?

-"This may not be the best prescription for you. I will notify your healthcare provider."

-"The prescription can take several weeks to have an effect."

-"You may need additional pharmacotherapy."

-"You might still feel depressed, but you are looking much better."

"The prescription can take several weeks to have an effect."

What are some of the adverse effects of gabapentin?

- somnolence

- drowsiness

- anxiety

- dizziness

- memory difficult

- somnolence

- drowsiness

- dizziness

- memory difficult

A patient asks the nurse when would be the best time to take an over-the counter (OTC) antacid for "heartburn." Which time frame would the nurse provide?

-1-3 hours after meals and at bedtime

-With meals and 1 hour after

-With meals and at bedtime

-1 hour before meals

1-3 hours after meals and at bedtime

A client is to be prescribed an antidepressant. Which question should the nurse prioritize when completing the initial assessment.

-"How much alcohol do you consume during the week?"

-"have you had any thoughts about killing yourself?"

-"How long have you been depressed?"

-"Are you allergic to any medications?"

"Have you had any thoughts about killing yourself?"

A client is taking dantrolene (Dantrium). Which laboratory result is a priority for the nurse to assess?

-Creatinine clearance

-Serum amylase

-Hemoglobin and hematocrit

-Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT)

Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT)

A client has a fever of 104. Which laboratory test should the nurse anticipate being prescribed to

-Liver function tests

-Complete blood count (CBC)

-Urinalysis

-Blood for culture and sensitivity

Blood for culture and sensitivity.

The patient is experiencing diarrhea. Which food would the nurse advise the patient to avoid? (Select all that apply)

-Fried foods

-Clear liquids

-Bottled water

-Milk products

-Gelatin

*Fried foods

*Milk products

A client is receiving hydrocortisone therapy. For which electrolyte disturbance should the nurse assess the client?

-Hypercalcemia and hyperkalemia

-Hypoglycemia and hyponatremia

-Hypernatremia and hyperglycemia

-Hypernatremia and hyperkalemia

Hypernatremia and hyperglycemia

A client who takes phenytoin (Dilantin) for epilepsy and has been seizure free asks why blood testing is till needed. Which response should the nurse make to the client?

-"Phenytoin (Dilantin) can cause blood-thinning in some clients."

-"Phenytoin (Dilantin) can deplete your system of potassium."

-"Phenytoin (Dilantin) has a very narrow range between a therapeutic dose and a lethal dose."

-"Phenytoin (Dilantin) can cause Stevens-Johnson symptoms, which can be detected through blood testing."

Phenytoin (Dilantin) has a very narrow range between a therapeutic dose and a lethal dose.

Select the drug that best matches with each statement

1. Selectively inhibits serotonin reuptake and has weight gain and sexual dysfunction as two common Ses/AEs

2. Drug of choice for absence seizures

3. SE/AEs include orthostatic hypotension, anticholinergic effects, and drowsiness with AE of cardiotoxicity

4. If concurrently eat salami, overripened fruit, red wine, and beer will have a hypertensive crisis type reaction

5. No antidote available and tolerance does not develop to the respiratory depression

6. flumazenil is the antidote and increases GABA effects

1. SSRIs

2. succinimides

3. TCAs

4. MAOIs

5. Barbituates

6. benzodiapezines

The nurse instructs a client about a topical antifungal. Which client statement indicates further teaching is needed?

-"I will make sure my clothing is loose over the area."

-"I will allow the area to dry after applying the prescription."

-"I will not scrub the are where the prescription will be applied."

-"I will protect the area with an occlusive dressing."

"I will protect the area with an occlusive dressing."

A client asks if liquid acetaminophen (Tylenol) used for an older child can be used for a 4-month-old baby with a fever. Which response should the nurse make?"

-"Infants should not be given acetaminophen (Tylenol) because it damages the liver."

-"Infant drops should be used because they are a different concentration from liquid medicine."

-"You can use the same medication, just use half the recommended dosage."

-"You can use the same prescription for both children."

"Infant drops should be used because they are a different concentration from liquid medicine."

Twenty minutes after receiving a dose of antibiotic, a client develops a red, itchy rash. Which action should the nurse take first?

-Document the presence of the rash in the medical record.

-Withhold the next dose of the medication.

-Report the finding to the healthcare provider.

-Place an allergy bracelet on the client.

Report the finding to the healthcare provider.

Which herbal supplements have the potential to increase a patient's bleeding risk?

-ginger

-ginkgo

-feverfew

-ginseng

-garlic

-St. John's wort

-ginger

-ginkgo

-feverfew

-ginseng

-garlic

Which drug class may be used to prevent ulcers (SATA)

-Proton pump inhibitors

-antacids

-anticholinergics

-histamine 2 blockers

-antibiotics

-proton pump inhibitors

-antacids

-anticholinergics

-histamine 2 blockers

A client taking lorazepam (Ativan) for 2 years reports stopping the medication 3 days ago. Which assessment finding should the nurse anticipate?

-A sense of calmness and lack of anxiety

-Increased heart rate, fever, and muscle cramps

-Nothing different; it is safe to abruptly stop lorazepam (Ativan)

-Pinpoint pupils, constipation, and urinary retention

Increased heart rate, fever, and muscle cramps

A patient is prescribed acetaminophen for fever and/or headache. The nurse includes in the patient teaching the maximum daily amount of acetaminophen. How many grams/day is the maximum?

-2700 mg/day

-5 grams/day

-4000 mg/day

-4 grams/day

-4 grams/day

The nurse notes that a client is prescribed zolpidem (Ambien) for insomnia. Which information should the nurse recall about this medication?

-Ambien is classified as a benzodiazepine.

-Ambien will take longer to produce an effect when taken with food.

-Ambien is contraindicated during pregnancy but can be taken by breastfeeding mothers.

-Clients using Ambien should avoid foods that contain tyramine.

Ambien will take longer to produce an effect when taken with food.

A client prescribed sertraline (Zoloft) (SSRI) reports a problem with delayed ejaculation. Which response should the nurse make to the client?

-"This is a side effect of the prescription, but treating your depression is the priority."

-"Continue to take the prescription, as this usually goes away after a few months."

-"I will let your healthcare provider know and most likely your prescription will be changed."

-"I am concerned that you may become suicidal if you stop the prescription."

"I will let your healthcare provider know and most likely your prescription will be changed."

The nurse is caring for a client newly diagnosed with depression. Which drug classification should the nurse recall that is often used as a first-line treatment for depression due to the safety profile?

-SSRIs

-Beta-adrenergic blockers

-TCAs

-MAOIs

SSRIs

The nurse has completed the education for a client prescribed psyllium (Metamucil). Which statement made by the client indicates further teaching is required?

-"My cholesterol level will be reduced somewhat with this prescription."

-"This prescription takes several days to work."

-"This prescription is a lot more natural than other laxatives."

-"I don't need to drink extra fluids while I take this prescription."

"I don't need to drink extra fluids while I take this prescription."

A client with symptoms of hyperthermia and diaphoresis reports taking sertraline, St. John's wort, and escitalopram (an SSRI). Which condition should the nurse suspect in this client?

-a virus

-thyroid toxicosis

-withdrawal

-serotonin syndrome

serotonin syndrome

A client prescribed ibuprofen (Advil) asks how the medication works. Which response should the nurse make?

-Acts directly on the hypothalamus

-Blocks pain impulses sent to the brain

-Decreases stimulation of sensory nerve fibers

-Inhibits prostaglandin synthesis

Inhibits prostaglandin synthesis

A client is receiving amphotericin B (Fungizone). Which laboratory value(s) should the nurse monitor in this client?

-serum amylase

-serum glucose

-serum sodium

-serum creatinine

-blood urea nitrogen (BUN)

-serum creatinine

-blood urea nitrogen (BUN)

A client receiving an oral mystatin suspension for a candida infection cannot continue to "swish and swallow" because of nausea. Which response should the nurse make?

-"You can swish the prescription around and then spit it out."

-"Try having a carbonated drink after you swallow the prescription."

-"I will ask your healthcare provider if a pull form can be substituted."

-"I will request an antiemetic to be prescribed for you."

"I will request an antiemetic to be prescribed for you."

The nurse is preparing teaching for a client prescribed carbidopa (Sinemet). Which information should the nurse include?

-Avoid drinking caffeinated beverages

-Take the medication with meals

-Take the medication with a protein food

-Take the medication on an empty stomach

Take the medication on an empty stomach

A client is prescribed an antibiotic. Which information should the nurse provide when teaching the client actions to reduce antibiotic resistance?

-Take the full amount of any prescribed medication

-Antibiotic prescriptions are not used for the treatment of cold and influenza

-The best way to prevent antibiotic resistance is to prevent infections from occurring

-See a healthcare provider when feeling ill

-Use good infection control measures

-Take the full amount of any prescribed medication

-Antibiotic prescriptions are not used for the treatment of cold and influenza

-The best way to prevent antibiotic resistance is to prevent infections from occurring

-Use good infection control measures

The nurse is preparing teaching for a client prescribed a selective serotonin reuptake inhibitors. Which adverse effects should the nurse include in the teaching?

-drowsiness and coma

-weight gain and sexual dysfunction

-headache and nausea

-dry mouth and urine retention

weight gain and sexual dysfunction

Which patient would a laxative be contraindicated?

-a patient with cirrhosis

-a patient with a bowel obstruction

-a patient with Parkinsonisms

-a patient with stable angina

a patient with a bowel obstruction

Select the drug that matches each description

1. H2 antagonist with multiple drug interactions

2. Binds with protein to form a protective viscous coat covering the ulcer

3. Prostaglandin analogue for prevention of NSAID-induced ulcer

4. Drug that neutralizes gastric acid

5. Proton pump inhibitor

1. Cimetidine

2. Sucralfate

3. Misoprostol

4. Antacid

5. Omeprazole

A patient has been taking sertraline (SSRI) 20mg/mL oral concentrate, 2 mL/daily for several months and reports being unable to sleep well. The patient's depressive symptoms are well managed on the current dose. What will the nurse do next?

-Recommend asking the provider about weekly dosing.

-Counsel the patient to take the medication at bedtime

-Suggest that the patient request a lower dose

-Ask the patient what time of the day the medication is taken

Ask the patient what time of the day the medication is taken

Which condition should the nurse identify as a complication for long-term use of proton-pump inhibitors (PPIs)

-osteoporosis

-intestinal irritation

-hypertension

-anemia

osteoporosis

The nurse is caring for a patient with anxiety and insomnia. Which explanation best explains why barbituates would be avoided for these conditions?

-They have a high risk of producing an allergic response

-They are seldom effective

-They produce many serious adverse effects

-They have a greater associated cost

They produce many serious adverse effects

A client is prescribed a MAOI. Which food items should the nurse instruct the client to avoid?

-Spinach, rice, and venison

-Spring water, ice cream, and salmon

-Orange juice, cottage cheese, and turkey

-Chocolate, wine, and fava beans

Chocolate, wine, and fava beans

A client is receiving amphotericin B (Fungizone). Which symptom(s) should the nurse instruct the client to report?

-constipation

-fever

-hearing loss

-heart palpitations

-dizziness

-fever

-hearing loss

-heart palpitations

-dizziness

A client is prescribed a salicylate (aspirin). For which condition should the nurse monitor this client (SATA)

-nephrotoxicity

-cardiotoxicity

-ototoxicity

-pulmonary toxicity

-neurotoxicity

-nephrotoxicity

-ototoxicity

A client is prescribed corticosteroids. Which information should the nurse expect to be in the treatment plan to limit serious adverse effects from this medication?

-Administer steroids every other day

-Administer large doses for acute conditions then discontinue the medication

-Administer oral doses of the prescription whenever possible

-Administer small doses over a period of several weeks

Administer steroids every other day

The nurse is providing a medication to a client that affects the sympathetic nervous system. Which response should the nurse expect to asses?

-stimulated sex organs

-constricted bronchi

-increased salvation

-dilated pupils

dilated pupils

The nursing instructor teaches about the autonomic nervous system. Which student statement includes that teaching was effective? (SATA)

-"Sympathetic stimulation causes dilation of arterioles."

-"The parasympathetic nervous system causes bronchial constriction."

-"The sympathetic nervous system is activated under stress."

-"The parasympathetic nervous system is the 'flight or flight' response."

-"The sympathetic and parasympathetic systems are not always opposite in their effects."

-"The parasympathetic nervous system causes bronchial constriction."

-"The sympathetic nervous system is activated under stress."

-"The sympathetic and parasympathetic systems are not always opposite in their effects."

A client wants to take prednisone (glucocorticoid/corticosteroid) indefinitely as a treatment for an inflammatory condition. Which response should the nurse make to the client?

-"This is not recommended due to the serious side effects."

-"That is a common treatment plan, let's call your provider to change their orders."

-"The medication will lose its effect after your body builds up a tolerance to it."

-"The best treatment for your condition is to alternate medications."

"This is not recommended due to the serious side effects."

The nurse is caring for a client taking levodopa (Stalevol). Which assessment finding should cause the nurse the most concern?

-diarrhea

-muscle twitching

-hypertension

-dark urine

muscle twitching

A client is prescribed ibuprofen for chronic pain. Which client statement indicates an understanding of the maximum daily amount of ibuprofen (Motril)?

-"I cannot take over 3200 mg/day"

-"I cannot take over 4000 mg/day"

-"I cannot take over 3000 mg/day"

-"I cannot take over 3600 mg/day"

"I cannot take over 3200 mg/day"

Select the drug that goes best with each statement.

1. Used to increase ROM and decrease muscle spasm/spasticity

2. An opioid with a long-half life used in drug treatment centers

3. Protamine sulfate is the antidote

4. Low Na+ levels are dangerous while taking this drug for bipolar disorder

5. An immunosuppressant used to treat Rheumatoid Arthritis

6. used to reduce uric acid for treatment of gout

7. vitamin K is the antidote

8. used to treat migraine headache

1. baclofen

2. methadone

3. heparin

4. lithium

5. methotrexate

6. allopurinol

7. warfarin

8. sumatriptan

The nurse is caring for a client taking prednisone (glucocorticoid/corticosterold). For which finding should the nurse notify the healthcare provider?

-arthritis

-unexplained fever

-asthma

-latex allergy

-unexplained fever

A client is prescribed a proton-pump inhibitor. Which information should the nurse include when describing the mechanism of action of this medication?

-Neutralizes the acid in the stomach.

-Blocks the enzyme that secretes acid in the stomach

-Decreases the amount of H. pylori

-Blocks H2 receptors in the stomach

Blocks the enzyme that secretes acid in the stomach

The nursing instructor is planning to discuss the Dietary Supplement Health and Education Act (DSHEA) of 1994 with a group of nursing students. Which information should the instructor include?

-It mandates that herbal product labels state that the products are not intended to diagnose, treat, cure, or prevent disease.

-It ensures that herbal products provide proof of their intended effects.

-It mandates that herbal product labels contain accurate information

-It requires that herbal products undergo the same rigorous testing as drugs do under the FDA

It mandates that herbal product labels state that the products are not intended to diagnose, treat, cure, or prevent disease.

A client overdoses on lorazepam (Ativan). Which prescription should the nurse prepare to administer?

-acetylsysteine

-flumazenil

-naloxone

-physostigmine

flumazenil

Select the herbal supplement that best matches the primary uses listed.

1. use as an antiemetic

2. reduces stress, improve sleep quality

3. prevent urinary tract infection

4. improve memory, reduce dizziness

5. reduce depression, reduce anxiety, use as anti-inflammatory

1. ginger

2. ashwagandha

3. cranberry

4. ginkgo

5. St. John's wort

The nurse is caring for a client suspected of overdosing on donepezil (Aricept). Which medication should the nurse prepare to administer?

-physostigmine

-atropine

-gastric lavage with charcoal

-epinephrine

atropine

A client prescribed haloperidol (Haldol) is observed making wormlike movements with the tongue. In which way should the nurse categorize this behavior?

-an adverse effect likely caused by the medication

-a symptom of the underlying psychosis

-an indication that the patient the patient has not taken the prescription

-a normal reaction to the medication that will resolved within a few weeks

an adverse effect likely caused by the medication

A client is suspected of overdosing on amitriptyline (TCA). Which assessment should the nurse make a priority?

-neurological function

-liver function

-renal function

-cardiac function

cardiac function

Select the drug that belongs to each drug class

1. Histamine2 blocker

2. anticholinergic

3. pepsin inhibitor

4. antacid

5. proton pump inhibitor

1. famotidine

2. glycopyrrolate

3. sucralfate

4. calcium carbonate

5. pantoprazole

A patient who has been taking, a monoamine oxidase (MAO) inhibitor for several months will begin taking a tricyclic antidepressant (TCA) instead of the MAO inhibitors. The nurse will counsel the patient to begin taking the TCA:

-the day after the last dose of the MAOI

-along with the MAOI for several months

-at least 14 days after discontinuing the MAOI

-while withdrawing the MAOI over several weeks

at least 14 days after discontinuing the MAOI

A child is prescribed acetaminophen (Tylenol) for a minor health problem. Which statement should the nurse include when teaching the parent about this medication?

-"Baby aspirin can be substituted for acetaminophen (Tylenol)"

-"Acetaminophen (Tylenol) should be administered with a high-carbohydrate meal."

-"Due to the lasting effects, acetaminophen (Tylenol) should only be given to children once a day."

-"Read the labels of all over-the-counter medications for the amount of acetaminophen (Tylenol).

"Read the labels of all over-the-counter medications for the amount of acetaminophen (Tylenol).

Which statement is FALSE regarding COX-2 inhibitors?

-This drug class has a reduced risk of gastrointestinal bleeding than non-selective NSAIDS.

-These drugs do not block COX-1

-They are safer alternative to non-selective NSAIDs (non-steroidal anti-inflammatory drugs)

-They were found to have increased incidence of cardiovascular events

They are safer alternative to non-selective NSAIDs (non-steroidal anti-inflammatory drugs)

A patient who is taking amitriptyline (tricyclic antidepressant (TCA)), reports constipation and dry mouth. The patient notes that these side effects are a nuisance, but not. The nurse will give the patient which instruction?

-Stop taking the medication immediately

-Request another antidepressant

-Increase fluid intake

-Notify the provider

Increase fluid intake