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Pharmacology RN Nursing School Midterm Study Guide
A nurse has been assigned to care for a 52-year-old attorney who has hypertension and peptic ulcer disease. Before administering his medications, the nurse must complete an initial assessment. Core patient variables will be obtained from which of the following? (Select all that apply.)
A) The patient's interview
B) The patient's medical history
C) The patient's medical record
D) The patient's physical examination
E) The patient's current laboratory and other diagnostic findings
A 68-year-old female patient who was diagnosed with hypertension 2 weeks ago and was prescribed a new hypertension medication has returned to the clinic for a follow-up visit. The nurse notes that the patient's blood pressure is unchanged from her last clinic visit. When the patient was asked if she was taking the new medication on a regular basis, she stated, "I thought that I was supposed to take the new drug when I had a pounding headache or was in a stressful situation, not all the time." An appropriate nursing diagnosis for this patient would be:
A) Knowledge, Deficient due to the lack of understanding concerning diagnosis of hypertension
B) Coping, Ineffective due to forgetfulness
C) Confusion, Acute concerning drug administration
D) Anxiety due to diagnosis of hypertension
In order to promote therapeutic drug effects, the nurse should always encourage patients to:
A) Take their medication with meals
B) Take their medication at the prescribed times
C) Increase medication dosages if necessary
D) Use alternative therapy to increase the effects of their medications
A patient is treated with an antibiotic for an infection of the leg. After 2 days of taking the antibiotic, the patient calls the clinic and reports that he has a rash all over his body. The nurse is aware that a rash can be an adverse effect of an antibiotic and can be either a biologic, chemical, or physiologic action of the drug, which is an example of:
A nurse has been assigned the task of preparing educational materials for patients with diabetes. The nurse has included the drug name, the reason the drug was prescribed, the intended effect of the drug, along with important adverse effects that should be reported to the nurse or health care provider. Which of the following information is essential to include in the educational materials?
A) Drug administration method
B) Core drug knowledge
C) Vital signs of the patient
D) Diagnosis and outcome identification mechanism
A 56-year-old female patient has been admitted to the hospital with chronic muscle spasms and has been prescribed a new medication to treat the spasms. She has a poorly documented allergy to eggs, synthetic clothes, and perfumes. What is the priority action of the nurse to ensure that prescribed medication does not aggravate the patient's allergies?
A) Call the prescriber immediately regarding her allergic reactions.
B) Hold the medication for her muscle spasms until she can be treated for a possible allergic reaction.
C) Post an allergies notice on the front of the chart and document the allergies in the appropriate area of the patient's record.
D) Call the dietary staff and make sure that the patient is not served eggs for breakfast.
The nurse has been assigned a 49-year-old patient who has acute colitis, and the nurse just completed gathering data concerning core drug knowledge and core patient variables. To implement nursing management of drug therapy for this patient, the nurse will then:
A) Evaluate the outcome of the drug therapy.
B) Devise strategies to maximize the therapeutic effects of the drug.
C) Implement planned nursing actions.
D) Assess for data that will indicate interactions between core drug knowledge and core patient variables.
Which of the following activities would the nurse expect to complete during the evaluation phase of the nursing process in drug therapy?
A) Compare the outcome expected with the actual patient outcome.
B) Reconsider core drug knowledge and core patient variables.
C) Ask questions to prepare an effective patient education program.
D) Establish a baseline for the patient's treatment and care.
A nurse is caring for a post-surgical patient who has small tortuous veins and had a difficult IV insertion. The patient is now receiving IV medications on a regular basis. What is the best nursing intervention to minimize the adverse effects of this drug therapy?
A) Monitor the patient's bleeding time.
B) Check the patient's blood glucose levels.
C) Record baseline vital signs.
D) Monitor the IV site for redness, swelling, or pain.
A patient has been prescribed several drugs and fluids to be given intravenously. Before the nurse starts the intravenous administration, a priority assessment of the patient will be to note:
A) Heart rate
B) Body weight and height
C) Blood pressure
D) Skin surrounding the potential IV site
A physician has ordered intramuscular injections of morphine, a narcotic, every 4 hours as needed for pain for a motor vehicle accident victim. The nurse is aware that there is a high abuse potential for this drug and that it is categorized as a:
A) C-I drug
B) C-II drug
C) C-III drug
D) C-IV drug
A nurse working for a drug company is involved in phase III drug evaluation studies. Which of the following might the nurse be responsible for during this stage of drug development?
A) Working with animals who are given experimental drugs
B) Monitoring drug effects in patients who are selected to participate in a study, who have the disease that the drug is meant to treat
C) Administering investigational drugs to patients
D) Informing healthy, young volunteer participants of possible risks that could occur from taking an experimental drug
Which of the following would be the best source of drug information for a nurse?
A) Drug Facts and Comparisons book
B) A nurse's drug guide
C) A drug package insert
D) The Physician's Drug Reference (PDR)
A nurse works in a private hospital in Canada. She needs to administer some narcotic drugs to one of her patients. Which of the following should the nurse consider when administering narcotics to patients in a Canadian hospital?
A) Narcotics are banned in Canada and cannot be used.
B) Narcotics can be used in the hospital after obtaining written approval from the Joint Commission for Accreditation of Hospitals and Healthcare Organizations (JCAHO).
C) Narcotics to be used in the hospital are dispensed only with a written prescription and "N" on the label.
D) Narcotics can be used in the hospital after obtaining written approval from the Health Protection Branch of Canada.
A nurse who is responsible for administering medications should understand that the goals of the MedWatch program are to: (Select all that apply.)
A) Provide regular feedback about product safety issues
B) Accredit new medical facilities and hospitals
C) Facilitate the reporting of adverse reactions of drugs
D) Increase awareness of serious reactions caused by drugs or medical devices
E) Report medication errors that occur in hospitals
A nurse is a member of a research team that is exploring unique differences in responses to drugs that each individual possesses, based on genetic make-up. This area of study is called:
Which of the following statements best defines how a chemical becomes termed a drug?
A) A chemical must have a proven therapeutic value or efficacy without severe toxicity or damaging properties to become a drug.
B) A chemical becomes a drug when it is introduced into the body to cause a change.
C) A chemical is considered a drug when the Food and Drug Administration (FDA) approves its release to be marketed.
D) A chemical must have demonstrated therapeutic value to become a drug.
Which of the following serves to protect the public by ensuring the purity of a drug and its contents?
A) American Pharmaceutical Association
B) United States Adopted Names Council
C) United States Pharmacopeia
D) Federal legislation
A nurse is providing a patient with a list of drugs as a part of the patient's plan of care. Which of the following drug nomenclatures should the nurse use to list the drugs?
A) The drugs' chemical names
B) The drugs' generic names
C) The drugs' trade names
D) The drugs' biologic name
The medication nurse is in charge of transcribing drug orders and administering drugs to assigned patients. While preparing the drugs for administration, the nurse should always check:
A) For drug composition
B) The chemical, generic, and trade name of each drug
C) The drug name at least three times—before, during, and after obtaining each drug
D) The cost of each drug
A patient located on a medical-surgical unit has an order to receive ampicillin 500 mg PO tid ac. Which of the following medication administration schedules would be best for a medication ordered tid ac?
A) 4 AM, 12 noon, 8 PM
B) 7 AM, 11 AM, 6 PM
C) 7 AM., 1 PM, 8 PM
D) 8 AM, 12 noon, 4 PM., 8 PM
A mother brings her 4-year-old child, who is vomiting and has a temperature of 103°F into the emergency department (ED). The ED physician orders acetaminophen (Tylenol) for the fever. The best form of Tylenol to give the child, considering her presentation, would be:
A nurse has received an order to administer a drug intravenously over a 60-minute period in a patient with NS running at TKO. The nurse should gather supplies and prepare to administer the drug by:
A) Intravenous piggyback (IVPB)
B) Intravenous push (IVP)
C) Peripherally inserted central line (PIC)
D) Continuous IV infusion
A nurse has received an order to administer a TB skin test. The nurse will inform the patient that TB skin tests are most often given subcutaneously in the:
A) Left thigh
B) Medial forearm
An unconscious patient has been brought to the hospital, and the physician has prescribed a life-saving drug to be administered parenterally. Which of the following methods would be most appropriate for the nurse to use when administering the medication?
A) Intravenous infusion
B) Subcutaneous administration
C) Intrathecal administration
D) Intramuscular administration
A patient with diabetes has had a cough for 1 week and has been prescribed a cough syrup (an expectorant). What special instructions should the nurse include in the patient teaching for this situation?
A) Wash hands before and after taking the medicine.
B) Keep track of any gastrointestinal tract infections.
C) Monitor glucose levels closely.
D) Note the time the medicine is taken each day.
A patient is being treated for respiratory infection. He is a recovering alcoholic and has impaired liver function. The nurse will instruct the patient to be especially cautious when taking:
A) An elixir
B) A tablet
C) A syrup
D) A troche
A physician has ordered the use of an inhaler for a patient with a lung ailment, but the patient finds that taking deep breaths is very difficult. The nurse should:
A) Change the route of administration to liquid sprays.
B) Ask the patient to make a better effort to take deep breaths.
C) Use a spacer to facilitate easier inhalation of the drug.
D) Contact the prescriber for a recommendation.
What critical piece of information is missing from the following medication order: Amoxicillin 250 mg every 8 hours?
D) Trade name of the drug
A child is admitted to the burn unit with second and third degree burns on both arms and part of his face. When administering topical medications to the burned areas, the nurse should:
A) Cool the medication prior to administration.
B) Use sterile technique when applying the medication.
C) Allow the child to apply the medication if possible.
D) Use clean technique only when applying the medication.
In which of the following patients would a nurse expect to experience alterations in drug metabolism?
A) A 35-year-old woman with cervical cancer
B) A 41-year-old man with kidney stones
C) A 50-year-old man with cirrhosis of the liver
D) A 62-year-old woman in acute renal failure
A patient has a blood serum drug level of 50 units/mL. The drug's half-life is 1 hour. If concentrations above 25 units/mL are toxic and no more of the drug is given, how long will it take for the blood level to reach the non-toxic range?
A) 30 minutes
B) 1 hour
C) 3 hours
A nurse has been administering a drug to a patient intramuscularly (IM). The physician discontinued the IM dose and wrote an order for the drug to be given orally. The nurse notices that the oral dosage is considerably higher than the parenteral dose and understands that this due to:
A) Passive diffusion
B) Active transport
C) Glomerular filtration
D) First-pass effect
A nurse receives an order to administer a critically ill patient two drugs immediately (stat). The nurse begins the process by:
A) Washing her hands before handling the medications
B) Consulting a drug guide for compatibility
C) Questioning the patient concerning allergies
D) Identifying the patient by checking the armband and asking the patient to state his name
A 38-year-old patient is obese and has abscesses around his inner thigh muscles. He is receiving IV antibiotics, but no improvement has been seen. The patient questions the nurse about the most likely cause for the drug therapy failure. The nurse explains to the patient that the:
A) Surface area of the abscesses is not large enough for the drug to have the desired therapeutic effect
B) Route of administering the medication should not have been IV
C) Distribution of the drug to the area of the abscesses is impaired
D) Distribution of the drug to the thigh muscles is generally impaired, even in healthy individuals
A patient has been receiving regular doses of an agonist for 2 weeks. Which of the following should the nurse anticipate?
A) The drug will decrease in effectiveness.
B) The drug will increase in effectiveness.
C) There will be a steady state with no anticipated changes.
D) The drug will cause excessive therapeutic effects even when administered in small doses.
A nurse is discussing with a patient the efficacy of a drug that his physician has suggested he begin taking. Efficacy of a drug means which of the following?
A) The amount of the drug that must be given to produce a particular response
B) How well a drug produces its desired effect
C) A drug's strength of attraction for a receptor site
D) A drug's ability to stimulate its receptor
A patient has been admitted to the intensive care unit following a myocardial infarction. His nurse is preparing to administer his ordered medications when she notices that one drug ordered is used for treating seizure disorders. The nurse does not find a history of seizures in the patient's record. The most appropriate action for the nurse is to:
A) Ask the charge nurse if she knows why the drug has been ordered.
B) Look up the drug to see if there are other conditions that the drug could be prescribed for.
C) Question the physician about the prescribed medication.
D) Call the pharmacist and inquire about therapeutic uses of the drug.
A nurse notes new drug orders for her patient who is already getting several medications. Which of the following is the most important consideration when she is preparing to administer the new drugs?
A) How the patient will feel about new medications added to her drug therapy
B) Possible drug-drug interactions that might occur
C) Any special nursing considerations that the nurse must be aware of
D) If generic preparations of the drugs can be used
A nurse is caring for a patient who has had part of her small intestine removed due to cancer. She has also now developed hypertension and has been prescribed a new medication to decrease her blood pressure. While planning her care, the nurse should consider a possible alteration in which of the following aspects of pharmacokinetics?
Talwin given in combination with Vistaril diminishes the adverse effects of nausea caused by the Talwin. This drug interaction affecting the pharmacodynamics of the Talwin is:
A) An additive effect
B) A synergistic effect
C) A potentiated effect
D) An antagonistic effect
On the 1 AM rounds, the nurse finds a patient awake and frustrated that she cannot go to sleep. The nurse administers an ordered hypnotic to help the patient sleep. Two hours later, the nurse finds the patient out of bed, full of energy, cleaning her room, and singing. The nurse evaluates the patient's response to the hypnotic as:
A) An allergic reaction
B) An idiosyncratic response
C) A synergistic effect
D) A teratogenic effect
The nurse is caring for a patient receiving an aminoglycoside (antibiotic) which can be nephrotoxic. Which of the following will alert the nurse that the patient may be experiencing nephrotoxicity?
A) Visual disturbances
B) Yellowing of the skin
C) A decrease in urine output
D) Ringing noise in the ears
A nurse is caring for a patient who has recently moved from Vermont to south Florida. The patient has been on the same antihypertensive drug for 6 years and has had stable blood pressures and no adverse effects. Since her move, however, she reports "dizzy spells and weakness" and feels that the drug is no longer effective. The nurse suspects that the change in the effectiveness of the drug is related to:
A) The impact of the placebo effect on the patient's response
B) The accumulative effect of the drug if it has been taken for many years
C) The impact of the warmer climate on the patient's physical state
D) Problems with patient compliance with the drug regimen due to the move
A nurse is instructing a patient concerning a newly prescribed drug. Which of the following should be included to help improve patient compliance and safety?
A) A list of pharmacies where the drug can be obtained
B) Measures to alleviate any discomfort associated with adverse effects
C) The cost of the brand drug compared with the generic form
D) Statistics related to phase III of testing for the prescribed drug
A nurse is caring for a patient who is experiencing nausea and vomiting from chemotherapy. Which of the following would be an appropriate nursing diagnosis for this patient?
A) Infection, Risk for related to drug-induced bone marrow suppression
B) Nutrition, Imbalanced: Less Than Body Requirement related to adverse effects of drug
C) Poisoning, Risk for related to use of a drug with a narrow therapeutic index
D) Nutrition, Imbalanced: More Than Body Requirement related to adverse effects of drug
A nurse has administered a medication to a patient with hypertension. The prescribed drug is supposed to decrease cardiac output. A decrease in cardiac output would most likely:
A) Increase the serum creatinine level
B) Decrease drug absorption in the blood
C) Decrease the amount of circulating blood sent through the kidneys
D) Increase the synergistic effect of the drug
A home health nurse notes that there have been changes to a patient's oral drug regimen. The nurse will closely monitor the new drug regimen to:
A) Track the exact route of metabolism as a research project
B) Identify any changes in drug absorption that would change the drug effect
C) Monitor only for the adverse effect of immunotoxicity
D) Determine the speed of chelation
Which of the following affects drug distribution throughout the body?
A) Presence of food in the gastrointestinal tract
B) Increase in hepatic enzymes
C) Protein binding
D) High blood levels
A patient is being seen in the emergency department for a sprained ankle and is given a drug to relieve pain. When a second dose of the pain medication is given, the patient develops redness of the skin, itching, and swelling at the site of injection of the drug. The most likely cause of this response is:
A) A hepatotoxic response
B) An idiosyncratic response
C) A paradoxical response
D) An allergic response
Recently a 40-year-old woman has become interested in alternative therapy as a means to maintain and enhance her state of health. However, she has developed hypertension and will be prescribed an antihypertensive agent. The nurse's health history reveals that the patient eats a balanced diet, swims regularly, and occasionally takes an over-the-counter medication for allergies. A priority assessment for the nurse will be to determine:
A) The amount of dietary fiber in the patient's diet
B) How much exercise the patient gets daily
C) If the patient is taking any nutritional supplements
D) If the patient is taking herbal or botanical medications regularly
A 70-year-old woman is starting on an acidic drug. The nurse is aware that food and nutrient intake can affect drug excretion by changing the urinary pH. About which of the following will the nurse question the patient concerning her diet?
A) The intake of sodium
B) The amount of meat and vegetables
C) The use of grapefruit
D) The intake of foods high in protein
During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The nurse's assessment reveals that the patient has been taking over-the-counter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives:
A) May cause nutrient deficiencies
B) May counter the therapeutic effect of other drugs
C) Causes acidic urine and urinary tract infections
D) Inhibits biotransformation of drugs
A patient is in the advanced stages of atherosclerotic vascular disease and has diabetes mellitus. The nurse will advise him to include which of the following in his diet?
A) Amino acids
C) Complex carbohydrates
D) Trace elements
A 36-year-old man is frail and emaciated and often faints due to weakness. He has a history of movement disorder and has been prescribed appropriate drugs to treat it. A priority nursing assessment will be to question him concerning his:
A) Professional life
B) Marriage and sex life
C) Nutritional intake
D) Mental and emotional well-being
A nurse is evaluating a patient who is receiving the antituberculosis drug, isoniazid. The nurse should be careful to assess for:
A) A vitamin B6 deficiency
B) A folic acid deficiency
C) The use of bulk-producing laxatives
D) Changes in serum potassium levels
A nurse is talking to an 18-year-old patient who has had a seizure disorder since she was 10 years old and is taking phenytoin (Dilantin). The nurse suggests that she take which of the following?
A) A potassium supplement
B) An iron supplement
C) Folic acid
D) Vitamin C
A 79-year-old patient in a long-term care facility is to receive an intravenous fat emulsion. Which of the following lab values would be a priority for the nurse to assess before administration?
A) Blood glucose levels
B) Serum potassium levels
C) Serum sodium levels
D) Triglyceride levels
A nurse is counseling a 55-year-old woman who is going through menopause. When discussing the prevention of osteoporosis, the nurse will encourage the patient to consume:
A) 200 mg of potassium daily
B) 400 mg of magnesium daily
C) 1,000 mg of sodium daily
D) 1,500 mg of calcium daily
A patient has taken an overdose of vitamin/mineral supplement containing magnesium. The nurse will be sure to assess:
A) Blood pressure
B) Body temperature
C) Fluid intake
D) Skin changes
A male patient is receiving heparin by continuous intravenous infusion. The nurse will instruct the patient and family members to report which of the following should it occur?
A) A skin rash
B) Sudden occurrence of sleepiness and drowsiness
D) Presence of blood in urine or stools
A nurse will use extreme caution when administering heparin to which of the following patients?
A) A 56-year-old male who smokes and drinks alcohol occasionally
B) A 22-year-old female with urticaria
C) A 38-year-old male with peptic ulcer disease
D) A 54-year-old female with accelerated heart rate
A nurse is caring for a 64-year-old female patient who is receiving IV heparin and reports bleeding from her gums. The nurse checks the patient's laboratory test results and finds that she has a very high aPTT. The nurse anticipates that which of the following drugs may be ordered?
D) Protamine sulfate
A 59-year-old patient is on warfarin therapy. On follow-up visits to the clinic, the nurse will assess the patient for which of the following?
A) Blood glucose level
B) Intake of vitamin K
C) Presence of skin-related disorders
D) Presence of breathing disorders
A nurse has an order to administer heparin. Before administration, a priority nursing assessment will be the patient's:
A) Heart rate and pulse
B) Sodium and potassium levels
D) Blood glucose level
A 51-year-old man is being discharged from the hospital following treatment on anticoagulant therapy for a deep vein thrombosis. The nurse will instruct the patient to:
A) Alternate between the types of anticoagulant drugs in the therapy.
B) Consider safety measures to prevent bleeding and be alert for signs of bleeding.
C) Change the route of administration to intravenous if oral proves ineffective.
D) Eat small amounts of food during drug administration.
The nurse is explaining the importance of tests such as Coombs, thromboplastin generation, and prothrombin generation to a patient who is taking antihemophilic factor (AHF). The nurse will emphasize that these tests provide information about which of the following?
A) Blood count
B) Amount of protein and platelets in the blood
C) Blood pressure
D) Clotting times
Which of the following patients would be the best candidate to receive alteplase recombinant therapy?
A) An 18-year-old male who has had an ischemic stroke with clinically meaningful neurologic deficit
B) An 18-year-old female who has intracranial bleeding
C) A 12 year-old female with ischemic stroke
D) A 16-year-old male who has a massive pulmonary embolism
A 61-year-old man is prescribed alteplase for an acute myocardial infarction. A priority nursing intervention will be to monitor for which of the following during and after drug therapy?
A) Gastrointestinal distress
B) Liver failure
C) A drop in blood pressure
A patient in the cardiac care unit is given streptokinase for a suspected acute myocardial infarction. During the administration of this drug, the nurse will monitor the patient for which of the following?
B) Fever and chills
C) Dry mouth
D) Increased blood pressure
A 70-year-old man is being treated for herpes zoster virus. He has been prescribed acyclovir (Zovirax). The clinic nurse will monitor which of the following?
A) Neurologic function
B) Renal function
C) Cardiac function
D) Respiratory function
A nurse is instructing a 30-year-old female patient in the use of acyclovir at home for her active lesions. The nurse will instruct the patient to:
A) Refrigerate the drug solution.
B) Protect the drug from moisture only.
C) Store the drug in a heated environment.
D) Protect the drug from light and moisture.
A nurse is explaining the use of acyclovir therapy to a 72-year-old man. Nephrotoxicity is discussed as a major adverse effect in older patients. To minimize the risk of the patient developing this adverse effect, the nurse will advise him to:
A) Take the tablets on an empty stomach.
B) Decrease the drug dosage if initial symptoms of nephrotoxicity appear.
C) Stay well hydrated by drinking at least eight 8-oz glasses of water daily.
D) Eat light meals every day.
A 20-year-old man has been diagnosed with herpes genitalis and has been prescribed acyclovir. A priority assessment by the nurse for this patient would be which of the following?
A) The amount of water he drinks daily
B) The type of food he eats
C) His use of nicotine
D) His use of alcohol
A nurse is caring for a stroke victim in the intensive care unit. The nurse notices a cold sore and requests medication; docosanol (Abreva) is ordered. Before applying the medication, the nurse would first:
A) Clean the area to be treated and then pat it dry.
B) Assess the area and make sure that there are no open lesions or abrasions.
C) Put gloves on to protect herself.
D) Prepare the applicator for drug administration.
A patient has been taking adefovir (Hepsera) to treat hepatitis B. Which medication would the nurse question if it were ordered for this patient?
A) Cimetidine (Tagamet)
B) Diltiazem (Cardizem)
C) Diphenhydramine (Benadryl)
D) Tobramycin (Nebcin)
A female patient comes to the clinic with complaints of visual disturbances. A drug history taken by the nurse indicates that the patient is on the medications listed below. Which medication does the nurse suspect could be causing the patient's visual disturbances?
A) Amantadine (Symmetrel)
C) Hydrochlorothiazide (HydroDIURIL)
D) Escitalopram oxalate (Lexapro)
A 49-year-old woman comes to the emergency department complaining of flu-like symptoms. A diagnosis of influenza A is made, and the physician prescribes amantadine (Symmetrel). Before the nurse gives the prescription to the patient, she should assess for which of the following?
A) Diabetes mellitus
B) Parkinson disease
D) Rheumatoid arthritis
A nurse is teaching a patient how to administer trifluridine (Viroptic) for keratoconjunctivitis. She will instruct the patient to apply the drops:
A) Once a day
B) Twice a day
C) Every 4 hours around the clock
D) Every 2 hours during waking hours
A patient is prescribed ganciclovir (CHPG) to treat a CMV infection. An oral dosage is prescribed. To help increase bioavailability of the drug, the nurse will encourage the patient to take the medication:
A) With high-fat meals
B) With orange juice
C) On an empty stomach
D) With high-protein meals
A 22-year-old patient is HIV-positive. She is 8 months' pregnant and did not receive antiretroviral therapy during her pregnancy. The nurse explains to the women that the best way to reduce the risk of transmitting the HIV virus to her baby is by receiving:
A) Intravenous zidovudine during delivery
B) Zidovudine the last 4 weeks of pregnancy
C) Intravenous zidovudine during labor
D) Zidovudine 1 week before the baby is born
A nurse is assessing a 66-year-old man who is HIV-positive. The patient has been prescribed didanosine (Videx). It would be most important to question the patient about which of the following?
A) High-calorie diet
B) Alcohol use
C) Activity level
D) Fluid intake
A 38-year-old man is being treated for HIV-1 with nevirapine (Viramune). Signs of liver dysfunction are noted by the physician, and a change in the drug therapy is necessary. The nurse explains to the patient that:
A) The therapy will be discontinued permanently.
B) The drug will be administered three times daily in divided doses.
C) The therapy should be reinitiated at half the previous dosage.
D) The dose should be escalated over a 2-week period.
A nurse provides medication teaching related to the importance of adhering to the saquinavir drug regimen. In order to best minimize the risk of increased fatty-like tissue, the nurse will instruct the patient to:
A) Take the drug within 2 hours after a high-fat meal.
B) Engage in regular exercise.
C) Take the drug within 2 hours after a low-fat meal.
D) Follow a low-fat diet.
A female patient is prescribed ritonavir (RTV) in oral capsule form as part of polytherapy for HIV. She will self-administer the drug. The nurse will instruct her to:
A) Keep the capsules in the refrigerator.
B) Store the capsules in a container other than the bottle they came in.
C) Store the capsules at room temperature.
D) Keep the capsules away from light.
A male patient is taking indinavir (Crixivan) for HIV. To decrease the risk of kidney stones, the nurse's teaching plan will include which of the following?
A) Increase physical activity.
B) Drink 1 to 2 L of water a day.
C) Avoid taking acetaminophen.
D) Decrease fatty foods in his diet.
The nurse is to administer enfuvirtide (Fuzeon) to a 27-year-old man. After the medication has been reconstituted with sterile water, the nurse will:
A) Allow the solution to sit for 10 minutes.
B) Discard any remaining solution.
C) Refrigerate the remaining dose in a syringe.
D) Administer the drug at 8-hour intervals.
A female patient is experiencing diarrhea as an adverse effect of nelfinavir (Viracept). The nurse will instruct the patient to do which of the following?
A) Eat small, frequent meals.
B) Eat large snacks or meals.
C) Take soluble fiber supplements.
D) Exercise regularly.
It will be most important for the nurse to monitor nevirapine therapy for a male patient during the first 12 to 16 weeks of therapy in order to:
A) Determine CD4+ T-cell counts
B) Assess for potentially life-threatening hepatotoxicity or skin reactions
C) Assess the drug serum level
D) Evaluate for thrombocytopenia
A male patient has been prescribed nevirapine as monotherapy for HIV. On follow-up visits to the clinic, it will be most important for the nurse to assess for which of the following?
A) Cutaneous eruptions
C) Cholestatic hepatitis
D) Antimicrobial resistance
Which of the following patients should be advised by the nurse to avoid over-the-counter cold and allergy preparations that contain phenylephrine?
A) A 47-year-old female with hypertension
B) A 52-year-old male with adult-onset diabetes
C) A 17-year-old female with symptoms of an upper respiratory infection
D) A 62-year-old male with gout
A nurse receives an order for clonidine (Catapres) for a child. Which of the following would be the most appropriate action by the nurse?
A) Weigh the child to get the correct body surface area.
B) Have a second nurse check the dose before administering the drug.
C) Question the order because the drug is for use in only adults.
D) Make sure the child is on a cardiac monitor.
A nurse is caring for a patient who is taking propranolol (Inderal). Which of the following statements would indicate that teaching by the nurse concerning the beta-adrenergic antagonist has been effective?
A) "I may have a very dry mouth while taking this drug."
B) "I should never stop taking this drug abruptly but will taper the dose gradually."
C) "I can stop walking a mile a day."
D) "Since I am taking this drug, I no longer need to worry about my diet."
A priority nursing assessment for a patient who is to receive an alpha- or beta-adrenergic antagonist would be to:
A) Assess heart rate
B) Check blood glucose level
C) Measure urine output
D) Monitor respiratory rate
A 70-year-old man with diabetes mellitus is taking metipranolol (OptiPranolol) to manage ocular hypertension. The nurse would be sure to instruct the patient to:
A) Take his pulse at least four times a day
B) Weigh himself once a week at the same time of day
C) Avoid smoke-filled rooms
D) Understand the signs and symptoms of hypoglycemia
A patient experiencing a serious allergic reaction to a bee sting is brought to the emergency department. The patient's right hand is swollen, red, and painful. She is extremely upset, short of breath, and the nurse detects wheezing and stridor. The nurse is ordered to administer epinephrine to relieve the patient's:
A) Pain and swelling around the sting site
B) Discoloration in her hand
C) Acute anxiety
D) Acute bronchospasm
A nurse in the emergency department has started IV administration of dopamine (Intropin) and has been steadily titrating the dosage upward. For a patient in shock, dopamine helps to:
A) Decrease heart rate
B) Decrease blood pressure
C) Increase blood pressure
D) Increase body temperature
A patient is prescribed epinephrine via a nebulizer, 1 to 3 inhalations 4 to 6 times a day. Which of the following nursing diagnoses would be most appropriate for this patient related to comfort?
A) Imbalanced Nutrition: Less Than Body Requirements
B) Disturbed Sleep Pattern, Insomnia related to CNS excitation
C) Disturbed Sensory Perception
D) Ineffective Tissue Perfusion
A man with a history of cardiac arrhythmias is taking propranolol 30 mg three times a day. He calls the clinic at 11 AM and reports that he failed to take his 8 AM dose and his next dose is at 2 PM. What should the nurse instruct him to do?
A) Take two doses when the next dose is due at 2 PM.
B) Take two doses as soon as possible.
C) Take the missed dose as soon as possible.
D) Skip the missed dose and return to the regular dose at 2 PM.
A nurse is caring for a patient in the critical care unit. Phentolamine (Rogitine) has been ordered for the management of tissue necrosis caused by extravasation of parenterally administered drugs. Before administering this drug, the nurse will check the patient's chart for indications of:
A) Peptic ulcer disease
B) History of acute myocardial infarction
C) Diabetes mellitus
A 47-year-old woman has been diagnosed with open-angle glaucoma. Pilocarpine drops are prescribed. The nurse's assessment reveals that the patient has worn soft contact lenses for 15 years. The nurse will instruct the patient to:
A) Apply the contact lenses and wait 5 minutes before applying the drops.
B) Remove the contact lenses before applying the drops.
C) Apply the drops directly on the contact lenses.
D) Stop wearing the contact lenses during the pilocarpine therapy.
A patient is being discharged from the hospital and will be taking dicyclomine (Bentyl) for irritable bowel syndrome. The nurse will instruct the patient to take the medication:
A) Once in the morning and once at night
B) Before bedtime
C) Thirty minutes before meals and at bedtime
D) At noon only
A patient is taking flavoxate hydrochloride (Urispas) to help control an overactive bladder. On a follow-up visit to the clinic, the nurse will question the patient about which of the following?
A) Chronic diarrhea
B) Dental hygiene practices
A nurse is working in a women's hospital where she is caring for a new mother who is experiencing postpartum urinary retention. Bethanechol (Urecholine) has been ordered. The nurse will observe for which of the following?
D) Decreased salivation
A patient who is going on a cruise is concerned about motion sickness and sees his physician, who prescribes scopolamine. The nurse informs the patient that using scopolamine may cause him to experience:
A) Pupil constriction
D) Urinary incontinence
An anticholinergic drug is given to a 73-year-old man to treat his Parkinson disease. The man also has benign prostatic hyperplasia (BPH). The most important instruction the nurse can give to the patient with regard to his medication and medical diagnosis is to:
A) Avoid a warm environment
B) Avoid driving his car while taking the drug
C) Call his doctor if he cannot urinate
D) Take the drug with food to avoid gastrointestinal (GI) upset
Which of the following would be an expected outcome in a patient who has been given atropine to cause mydriasis and cycloplegia?
A) Constricted pupils and blurred vision
B) Dilated pupils and improved vision
C) Dilated pupils and blurred vision
D) Dry eyes and constricted pupils
A 4-year-old child is brought to the emergency department by her mother. The mother reports that the child has been vomiting, and the nurse notes that the child's face is flushed and she is diaphoretic. The mother thinks that the child may have swallowed carbachol drops. A diagnosis of cholinergic poisoning is made. Which of the following drugs would be administered?
A 29-year-old man comes to the clinic requesting a scopolamine patch. His company is sponsoring a deep-sea fishing trip in 2 weeks and he is afraid that he will get sick. The medication is prescribed for him, and the nurse's instructions concerning use of the patch will include which of the following?
A) Do not clean the application area before applying the patch.
B) When replacing the patch apply the new patch in the same area.
C) The onset of action is 30 minutes.
D) Shave the area before applying the patch.
A 63-year-old patient has a confirmed diagnosis of Alzheimer disease. Memantine hydrochloride (Namenda) has been prescribed. Which of the following would be the appropriate dose for this patient?
A) 5 to 20 mg/day in divided doses
B) 25 mg once a day
C) 25 to 50 mg/day in divided doses
D) 100 mg once a day
A clinic nurse has been assigned to follow up with a group of patients on hydrochlorothiazide therapy. Which patient will the nurse closely monitor for hyponatremia?
A) A 23-year-old male who has diabetes
B) A 36-year-old female who has diabetes
C) A 42-year-old male who has advanced arteriosclerosis
D) A 71-year-old female who has advanced arteriosclerosis
A female patient reports that she has frequent muscle cramps while on hydrochlorothiazide therapy. The nurse will advise her to:
A) Drink plenty of fluids.
B) Take potassium supplements.
C) Take calcium supplements.
D) Include high-sodium foods in her diet.
Which of the following would be most important for the nurse to assess before initiating furosemide therapy in a patient with chronic heart failure or pulmonary edema?
A) Measuring fluid intake and urinary output
B) Assessing skin turgor and mucous membranes
C) Auscultating breath sounds
D) Measuring blood pressure
A nurse is caring for a 78-year-old patient with renal insufficiency and chronic heart failure who is receiving rapid infusions of high-dose furosemide. It will be a priority for the nurse to monitor for:
A) Hepatic encephalopathy
C) Vascular thrombosis
A nurse is providing patient teaching for a 62-year-old woman who is taking triamterene. The nurse will teach the patient to avoid which of the following in her diet?
B) Bell peppers
D) Fresh pineapple
A nurse is caring for a patient who is receiving mannitol. The nurse will inform the prescriber that the ongoing mannitol administration should be withheld if:
A) The urine output is less than 30 mL/hour after the test dose.
B) The urine output is less than 60 mL/hour after the test dose.
C) The patient experiences dry mouth or extreme thirst.
D) The patient develops a slight headache.
A nurse is assigned to a male patient in the critical care unit who is receiving mannitol. The patient complains of nausea accompanied by chest pain and shortness of breath. The nurse is aware that these manifestations may be symptoms of:
A) Osmotic nephrosis
C) Serum osmolarity
D) Water intoxication
Which of the following special precautions should the nurse take when administering urea to an older patient?
A) Mix the drug with 5% or 10% dextrose solution.
B) Avoid using veins in the lower extremities.
C) Infuse the urea slowly.
D) Monitor the infusion site carefully for tissue necrosis.
The nurse will monitor closely which of the following patients during acetazolamide therapy?
A) A 49-year-old male with cirrhosis
B) A 28-year-old female with liver disease
C) A 51-year-old male with decreased serum sodium levels
D) A 35-year-old female with adrenocortical insufficiency
A nurse is planning care for a patient who is taking tolterodine. Which of the following is an appropriate nursing diagnosis for a patient taking this drug?
A) Risk for Injury related to multiple drug therapies and drug interactions
B) Risk for Injury related to hyperkalemia secondary to use of the drug
C) Altered Urinary Elimination related to overactive bladder
D) Risk for Deficient Fluid Volume related to the action of the drug
A nurse works in a cardiology clinic and is following an 82-year-old woman who is prescribed lovastatin to reduce her high cholesterol level. The patient lives with her daughter and is very thin and frail. Which of the following serious adverse effects is it most important for the nurse to monitor?
A patient has been prescribed lovastatin for a high cholesterol level. The nurse's teaching plan will include an explanation of how the drug produces its therapeutic effect. The nurse will explain that l
[Solved] Pharmacology RN Nursing School Midterm Study Guide
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