Pharmocology Exam #4 Study Prep

Chapters 41, 42, 43, 44, 45, 47, 48, 53, 15, 18, 19, 20, 21, 22, 23, 24, 25

A nurse is caring for a patient newly diagnosed with active tuberculosis who is prescribed rifampin, pyrazinamide, and ethambutol. Which statement by the patient requires immediate follow-up?

A. “My urine looks orange since starting the medication.”
B. “I plan to stop taking the medication once I feel better.”
C. “I sometimes have difficulty seeing at night.”
D. “I will avoid alcohol while taking these medications.”

C

A 68 year old patient with early-stage dementia is admitted to the ER by his daughter for a severe burn on his hand. the patient's daughter explains that "I normally help take care of my Mom normally, and she gets super confused after dark. But its been getting worse, she keeps insisting on using the backroom and then she dosed go, and earlier tonight she grabbed the pan I was using to cook. That's why his hand is all burned." Based on the daughters report, what do suspect is wrong with the patient?

A) Progression of his dementia

B) He may be experiencing sundowning syndrome

C) Possible Urinary tract Infect

D) Case of Elder Abuse by daughter.

C

A 52 year old patient is diagnosed with active tuberculosis and presents to the emergency department with cough with bloody sputum, fever of 100.8 degrees fever and weight loss. He has been prescribed rifampin, pyrazinamide, and ethambutamol. Which statement made by the patient is the most alarming?

A. “When I stop coughing, I’ll stop the medicine.”

B. “I don’t have trouble seeing at night.”

C. “I drink several beers most evenings.”

D. “My wife uses birth control pills, so we don’t need to worry about anything.”

A

A 24‑year‑old patient returns to the clinic 3 days after starting trimethoprim‑sulfamethoxazole (TMP‑SMX) for a urinary tract infection. She reports a new rash on her trunk, severe sunburn after running outdoors, and persistent dysuria. She states, “I took the medication with milk because it upset my stomach.” Which nursing action is the priority?

A. Educate the patient to avoid taking antibiotics with dairy products

B. Notify the provider immediately of a possible sulfonamide hypersensitivity reaction

C. Reinforce the importance of completing the full course of antibiotics

D. Advise the patient to increase fluid intake to prevent crystalluria

B

A nurse is teaching a patient about tetracycline. Which statement shows a need for further teaching?
A. “I’ll take it with water.”
B. “I’ll avoid sunlight.”
C. “I can take it with milk.”
D. “I’ll finish the prescription.”

C

A nurse is caring for a patient with HIV who reports missing several doses of antiretroviral therapy. Which of the following is the priority concern?

A. Increased risk of mild side effects
B. Development of drug-resistant virus
C. Weight gain
D. Improved immune response

B

NCLEX Question- A patient is prescribed permethrin cream for scabies. What would indicate the patient needs further teaching?

A. “My roommates should be treated even if they don’t have symptoms.”

B. “I will wash my bedding and clothes in hot water.”

C- "I will clean my entire environment, including my roommates' rooms, so our whole apartment is treated."

D. “If I still itch after treatment, it means the medication did not work and I should tell my provider.”

D

A nurse is caring for a patient receiving IV piperacillin-tazobactam for sepsis. Which finding requires immediate follow-up?

A. Mild nausea

B. Loose stool x1

C. Watery diarrhea with abdominal cramping

D. Decreased appetite

C

True or False: Beta blockers block hypoglycemia symptoms

True

An 8-year-old child is brought to the clinic by their teacher. The teacher reports the child has been having frequent “staring spells” during class. These episodes last about 10–15 seconds. During the episodes, the child stops speaking, stares blankly, and then resumes activity without confusion. No jerking movements are observed

A. Tonic-clonic seizure, B. Absence seizure, C. Focal seizure, D. Myoclonic seizure

What is the best medication?

A. Phenytoin, B. Lorazepam, C. Ethosuximide, D. Phenobarbital

What should the nurse monitor?

A. Liver function, B. Respiratory depression, C. GI upset, D. Blood pressure

B, C, C

FIRST-LINE medication uses to stop active seizures quickly? IV

Lorazepam (Ativan)

A 60-year-old patient has been taking phenytoin for seizure control. During a follow-up visit, the nurse notes swollen, bleeding gums. The patient also reports mild dizziness and unsteady gait.

Step 1: What is the priority problem?

A. Infection, B. Gingival hyperplasia, C. Stroke, D. Dehydration

Step 2: What is the priority nursing intervention?

A. Stop medication immediately, B. Encourage good oral hygiene, C. Restrict fluids, D. Increase dose

What additional concern should the nurse monitor?

A. Hypoglycemia, B. Liver failure, C. Ataxia/toxicity, D. Hypertension

B, B, C

A 35-year-old patient reports episodes of repetitive lip smacking and hand movements. During the episodes, the patient appears confused and does not respond appropriately. Episodes last 1–2 minutes.

Step 1: What type of seizure is this?

A. Absence, B. Tonic-clonic, C. Focal (complex partial), D. Myoclonic

Step 2: What is the best medication?

A. Ethosuximide, B. Carbamazepine, C. Magnesium sulfate, D. Diazepam

Step 3: What lab must be monitored?

A. Blood glucose, B. CBC, C. Potassium, D. Calcium

C, B, B

Type 1 diabetes is caused by ________ destruction of beta cells

Autoimmune

Type 2 diabetes is caused by ______ resistance

Insulin

The only insulin that can be given IV is ______

regular

Rapid-acting insulin should be given _______ meals

Before

The most common side effect of insulin is _______

Hypoglycemia

Metformin works by decreasing _______ glucose production

Liver

A serious adverse effect of metformin is _______

Lactic acidosis

Sulfonylureas increase _______ secretion

Insulin

SGLT2 inhibitors work by increasing glucose excretion through the __________

Kidneys

A major risk of SGLT2 inhibitors is __________

Dehydration

Thyroid hormone regulates

Metabolism

Hyperthyroidism results in _________ metabolism

Increased

Hypothyroidism results in __________ metabolism

Decreased

The prototype antithyroid drug is _________

Propylthiouracil

Antithyroid drugs work by ______ thyroid hormone production

Decreasing

A beta blocker is used to control _______ in hyperthyroidism

Heart rate

The prototype thyroid replacement drug is ____________

Levothyroxine

Levothyroxine should be taken on an __________ stomach

Empty

A major sign of too much levothyroxine is __________

Tachycardia/palpitations

Radioactive iodine is contraindicated in ___________

Pregnancy

Growth hormone deficiency results in decreased ________

Growth

The prototype GH medications is ________

Somatropin

Somatropin stimulates ________ growth

Linear

Diabetes insipidus results from deficiency of _________

ADH

The prototype drug for DI is ________

Desmopressin

Desmopressin works by increasing _______ reabsorption

Water

A major risk of desmopressin is ____ ________

Water intoxication

Precocious puberty is treated with __________

Leuprolide

Acromegaly results from excess _______

Growth hormone

The drug used to treat acromegaly is _________

Octreotide

PTH ______ calcium levels

Increases

Calcitonin _________ calcium levels

Decreases

Vitamin D increases ________ absorption

Calcium

Bisphosphonates decrease ____ breakdown

Bone

Prototype bisphosphonate is ___________

Alendronate

Hypercalcemia is a _______ _________

Medical emergency

First treatment for hypercalcemia is __ _____ _____

IV normal saline

Calcium supplements should be taken with _______ _

Vitamin D

A major adverse effect of bisphosphonates is _______ irritation

Esophageal

Patients must remain ______ after taking alendronate

Upright

Addison disease results in _____ cortisol

Low

Cushing disease results in _____ cortisol

High

The prototype drug for Addison disease is ___________

Hydrocortisone

Hydrocortisone replaces ______

Cortisol

Fludrocortisone increases ______ retention

Sodium

The ACTH test uses ___________

Cosyntropin

Cushing disease is diagnosed with the _________ ________ test

Dexamethasone suppression

Ketoconazole works by ________ cortisol production

Inhibiting

Addisonian crisis is treated with _________ and __ ______ (__ _______ _____)

Hydrocortisone and IV fluids (or isotonic saline)

Cushing disease causes _________ blood glucose

Increased