Exam 4 Pharmacology and Nursing

A patient is receiving heparin therapy for a pulmonary embolism. Which laboratory test should the nurse monitor to assess the effectiveness of the therapy?

aPTT

A patient with severe anemia is receiving a blood transfusion. Baseline vital signs: HR 100, BP 115/72, RR 18, Temp 100.4°F. What is the most appropriate nursing action?

Stop the infusion

A patient receiving IV heparin is also started on warfarin. The patient asks why both medications are needed. What is the best response?

"Warfarin takes 3-5 days to develop anticoagulant effects, so you will need heparin until it becomes effective."

A patient receiving magnesium sulfate develops signs of toxicity. Which medication should the nurse anticipate administering?

Calcium gluconate

A patient on warfarin has an INR of 5.2 and no signs of bleeding. What is the most appropriate nursing action?

Hold the dose and notify the provider

Chemotherapy will result in bone marrow depression. Which teaching conversation should be a priority for the nurse with the patient?

Encourage the patient to avoid people with colds, flu, and other infections

What is the nurse's priority education for a female patient prescribed misoprostol?

Use multiple forms of birth control

The patient is taking diazepam (Valium) for treatment of epilepsy. The nurse should teach the patient which of the following?

Avoid alcohol while taking this medication

Heparin is administered as part of the treatment for a pulmonary embolism. The nurse should monitor the results of which laboratory test to check for the drug's effect?

aPTT

A 13-year-old girl receiving chemotherapy asks why she is losing her hair. What is the best response?

"Chemotherapy affects rapidly dividing cells, including hair."

The patient has a deep vein thrombosis in her lower legs and has been started on warfarin. She asks how warfarin works. What is the nurse's best answer?

"Warfarin prevents new clots from forming."

What is the mechanism of action of famotidine (Pepcid)?

Decreases gastric acid secretion by blocking H2 receptors

Which drug should be ordered for a patient who develops active bleeding as an adverse effect of heparin therapy?

Protamine sulfate

The nurse is preparing to administer potassium chloride IV to a client who has hypokalemia. Which action should the nurse take?

Implement cardiac monitoring

A patient who has taken alprazolam (Xanax) for an extended period presents to the hospital not feeling well after running out of their prescription. Which serious effect should the nurse monitor for?

Withdrawal and seizures

A patient receiving heparin develops heparin-induced thrombocytopenia (HIT) type 2. What is the appropriate nursing action?

Stop the heparin infusion and notify the provider

A patient with myasthenia gravis missed multiple doses of their medication. What are they at risk for?

Myasthenic crisis

A patient who takes warfarin is brought to the ED after accidentally taking too much. There are no signs of active bleeding. Which laboratory test should the nurse monitor?

PT/INR

Which of the following are important nursing considerations for antiepileptic drug therapy? (Select all that apply)

Instruct patient to wear a medical alert bracelet; Check serum drug levels; Initiate fall precautions

A patient is taking donepezil (Aricept) for Alzheimer's disease. The nurse should instruct the patient and caregiver that the appropriate time to take this medication is:

At bedtime

Which drug should the nurse keep available for the patient receiving drug therapy for myasthenia gravis?

Atropine

A nurse is teaching a student nurse about the general use of antiepileptic drugs (AEDs). Which statement is correct?

AEDs should not be stopped abruptly

A patient with diabetic ketoacidosis (DKA) is also 24 weeks pregnant. The nurse reviews the provider's orders and questions which of the following?

Begin warfarin therapy

A patient is diagnosed with H. pylori. Which medication is expected?

Antibiotic

Proton pump inhibitors like omeprazole (Prilosec) are the most effective drug class to suppress gastric acid secretion. Long-term use (more than 1 year) is associated with which adverse effect?

Increased risk of fractures

What is a concern for patients taking high doses of antacids?

Electrolyte imbalance

A patient undergoing chemotherapy is at risk for which hematologic complication?

Thrombocytopenia

A client is undergoing cytotoxic chemotherapy for stage 3 lung cancer. Which effect is most likely to occur as a result of this treatment?

The client's platelet count will decline

A 36-year-old male with abdominal trauma recently received 2 units of packed red blood cells. Which finding indicates therapeutic effectiveness of the transfusion?

Increased hemoglobin and hematocrit levels (pick the option with the value in the therapeutic range)

A patient becomes confused 3 days after gastric surgery. Which medication could be the cause?

Cimetidine

A patient is receiving alteplase following an acute ischemic stroke. Which adverse effects are most commonly associated with this medication?

Bruising and hematuria

Which blood type is considered the universal recipient?

Type AB

The nurse should include which of the following in a discharge teaching plan for a patient prescribed phenytoin (Dilantin)?

Maintain a regular schedule for tooth brushing and flossing

The use of misoprostol is contraindicated in which patient?

A pregnant woman

A patient has been having tonic-clonic seizures for 10 minutes en route to the hospital. Which medication should the nurse anticipate administering?

Lorazepam

Levodopa-carbidopa is used to treat which condition?

Parkinson's disease

A patient is receiving chemotherapy with a drug known to have a high potential for causing nausea and vomiting. Which medication should the nurse anticipate administering to prevent this?

Serotonin blockers such as ondansetron (Zofran)

Which patient education point should be the nurse's priority when administering misoprostol to a female patient of childbearing age?

Ensure multiple methods of birth control to avoid pregnancy while on this medication

Which medication may be prescribed to a patient with anemia to help stimulate red blood cell production in the bone marrow?

Epoetin alfa (Epogen)

A patient with stomach cancer has undergone a total gastrectomy. Which vitamin supplement should the nurse expect to administer?

Vitamin B12

A patient on chemotherapy is at risk for thrombocytopenia due to bone marrow suppression. Which finding should the nurse report immediately?

Bloody urine

How does warfarin work to prevent blood clots?

Prevents new clots from forming

A client with anemia has a new prescription for a liquid iron supplement. Which statement indicates a need for further teaching?

"I will take the iron with milk to reduce stomach upset."

The nurse is reviewing infection-prevention measures with a patient receiving antineoplastic drug therapy. Which statement indicates a need for further teaching?

"I will keep fresh flowers in my room."

A patient asks why he is taking aluminum hydroxide (Maalox) for indigestion. Which is the correct explanation of how antacids work?

They neutralize hydrochloric acid in the stomach

A nursing instructor is reviewing ondansetron with a student nurse. Which statement by the student indicates a need for further teaching?

"It's safe to give ondansetron to a client with a known prolonged QT interval."

Which lab findings are most consistent with tumor lysis syndrome in a patient undergoing chemotherapy?

Hyperkalemia, hyperuricemia, hyperphosphatemia

A patient is receiving lactulose three times a day and is not constipated. For which reason is the patient receiving this drug?

To decrease ammonia levels in hepatic encephalopathy

A client has chronic renal failure. Which agent is used to raise the client's hemoglobin levels?

Epoetin alfa (Epogen)

A patient with peptic ulcer disease asks why sucralfate was prescribed. How should the nurse respond?

"It forms a protective barrier over the ulcer to promote healing."

A patient taking warfarin begins vomiting blood. Labs show a PT of 42 seconds and an INR of 5.5. Which medication should the nurse anticipate administering?

Vitamin K (phytonadione)

Anticoagulants treat embolisms and clots. True or False?

False

Should the nurse monitor lab tests like aPTT when administering therapeutic doses of heparin? True or False?

True

A patient with an artificial heart valve should receive which anticoagulant?

Warfarin (Coumadin)

A patient recently underwent a gastrectomy. How long will they need vitamin B12 injections?

Life-long

When should folic acid supplementation be given to women of childbearing age?

Before pregnancy and during the first three months

Why is folic acid given to women of reproductive age or during pregnancy?

To prevent neural tube defects