NR 293 - Final Exam Review Questions and answers + rationales

What is a normal aPTT time for someone on continuous heparin infusion?

60-100 seconds

What are serious side effects of propranolol (Inderal)?

Hypotension

Bradycardia

Hypoglycemia

Expiratory wheezing

Shortness of breath

What foods should be limited with Spironolactone (Aldactone) therapy?

Foods high in potassium

What medications can be used for C. diff related diarrhea?

Fidaxomicin

Florastor

Vancomycyn

Patients taking cholesterol medications such as Atorvastatin (Lipitor) should get which lab frequently checked?

Live enzymes/liver tests.

Can cause hepatotoxicity.

Patients on diuretics therapy should report...?

Signs and symptoms of dehydration (dizziness, weakness, etc), weight gain, difficulty breathing, crackles, etc.

Patients can exhibit symptoms of dehydration but also symptoms of fluid overload if diuretic isn't working.

What are some things that decrease patients compliance with medication in general?

Lack of education

Side effects

Large/difficult to swallow pills

Long duration/course of medication

ACE inhibitors such as Lisinopril and captopril are safe for liver dysfunction patients, but other ACE inhibitors are not. Why?

Lisinopril and captopril are not pro drug and are not metabolized by the liver..

What do you need to know about sublingual nitroglycerin?

Used for angina.

You can take up to three doses, five minutes apart. If chest pain persists, go to the hospital

Can not be taken with Viagra.

Frequently causes headaches.

What drug is used as the first line treatment for a newly diagnosed diabetic type 2 patient?

Metformin

Which foods should patients on Warfarin (coumadin) avoid?

Foods high in Vitamin K.

Ex - Kale, spinach, Brussel sprouts, collards, mustard greens, chard, broccoli, asparagus

Which lab value is most important with diuretic therapy?

Potassium.

Sodium is also important, but potassium is the most important.

Which lab value is most important with digoxin therapy?

Digoxin Lab Value - 0.5-2

Potassium. (Digoxin can cause dysrhythmias, and digoxin toxicity causes potassium deficiency. Cardiac drugs in general, potassium lab values are important)

What lab values should the nurse watch for a patient on gentamicin (garamycin) therapy?

Kidney related labs.

BUN and creatinine.

Gentamicin (garamycin) can cause nephrotoxicity

What medication would be the first choice to treat genital Herpes?

Acyclovir (Zovirax)

Dobutamine for heart failure is an adrenergic agonist. What does adrenergic agonist mean?

Positive ionotropic

Positive chronotropic

Positive dromotropic.

Stimulates heartbeat, maintains electrical conduction, improves pumping.

List four symptoms of hypoglycemia.

Dizziness

Shaking

Sweating

Heart Palpitations

List four symptoms of hyperglycemia.

Fruity smelling breath

Shortness of breath

Dry mouth

Confusion

What is a side effect of high doses of steroids?

Masculization - Weigh gain (puffy, like a balloon), moon face, etc.

Can also cause hyperglycemia and thyroid storm.

The nurse is preparing to administer eyedrops. Which interventions should the nurse be careful about?

1. Wash Hands

2. Put gloves on

3. Place drop in the conjunctival sac

4. Pull the lower lid down against the cheekbone

5. Instruct the client to squeeze the eyes shut after instilling the eye drop

6. Instruct the client to tilt the head forward, open the eyes and look down

What is the antidote for acetaminophen?

Acetylcsteine

What is the vomiting center in the brain?

Medulla

What can be used to treat a barbiturate overdose?

Narcan

What is Dantrolene (Dantrium) primarily used for?

Antidote for anesthesia

Does Ergot alkaloid cause vasoconstriction or vasodilation?

Vasoconstriction

List drugs that can be used to treat ADHD.

Amphatamines - Methylphenidate, amphetamine aspartate, dextroamphetamine sulfate

Nonamphetamines - Atomexetine

What is glargine?

Long acting insulin

Which other insulins can glargine be mixed with?

None. It has to be given individually and can not be mixed with other insulins.

What is the antidote for heparin?

Protamine sulfate

What medication would be the best choice for bipolar disorder?

Lithium carbonate

List all the symptoms of extrapyramidal side effects.

Pseudoparkinsonism - akathisia, restless muscle

Acute dystonia - painful muscle spasms

Tardive dyskinesia - Twitching face and mouth muscles

When can buspirone (buspar) be used?

When patient has anxiety.

Should be used at the same time every day.

What can cause a thyroid storm?

Injury

Stress

Surgery

Myocardial Infarction

Infection

Abruptly stopping thyroid medication

What are side effects of hydrochlorothiazide?

Photosensitivity

Hypokalemia

Hyperglycemia

Hyperuricemia

Hypochloremia

Alkalosis

Can a patient with high sodium and high potassium levels use a salt substitute to control his sodium level?

No, salt substitutes are made from potassium chloride.

What side effect is seen in patients withdrawing from clonidine?

Rebound hypertension

When using a steroid and a bronchodilator, which one should be administered forst?

Bronchodilator first.

The airway needs to be open for the steroid to be able to get in and work.

What is the action of Sinemet (carbidopa levodopa)?

Direct dopamine replacement. Works presynaptically to increase brain levels of dopamine.

What is a very common side effeect of a bronchodilator?

Cardiac stimulation/tachycardia

What should a nurse be careful about before administering magnesium-based medications?

Kidney function.

Perform kidney function tests.

How does Carafate (sucralfate) work to prevent gastric ulcers?

It's a mucosal protectant.

Forms a thick, protective barrier in the stomach lining (which is why it affects the absorption of other medications and it should be given after other medications)

Are baseline vitals needed prior to diuretic therapy? If so, which vital is the most important?

Yes.

Blood pressure is the most important.

What should be your action for patient complaining of headache after taking nitroglycerin?

Give them Tylenol.

Name several proton pump inhibitors.

Esomeprazole (Nexium)

Omeprazole (Prilosec)

Pantoprazole (Protonix)

End in -zole

What is the best medication for gastric ulcers related to long term use of NSAIDs?

Esomeprazole (Nexium)

What is Nesiritide used for?

Used as a final effort to treat severe, life-threatening heart failure

What are four symptoms of Addison's disease?

Weight loss

Dizziness

Hypotension

Hypoglycemia

What are four symptoms of Cushing's syndrome?

Moon face

Hunch back

Hirsutism

Weight gain (especially in abdomen and trunk)

What is the relation between metformin and iodine-based contrast media?

If they are given together, it may result in lactic acidosis.

Stop metformin 48 hours before imaging with iodine-based contrast.

The use of Viagra is contraindicated to a patient taking which drug?

Nitroglycerin

What are the normal lab values of sodium, potassium, creatinine, BUN, and hemoglobin?

Sodium - 135 - 145

Potassium - 3.5 - 5.0

BUN - 6 - 25 (?)

Creatinine - 0.6 - 1.2

Hemoglobin - Appx. 13 - 17

What is gonadotrophin hormone responsible for?

Sex hormone

Stimulates production of sperm or ova

What is somatotropin hormone responsible for?

Growth hormone

Stimulates skeletal growth