3rd exam Flashcards
1
Q
When preparing an IV solution that contains potassium, which of these conditions must a nurse recognize as a contraindication to the potassium infusion?
A
serum potassium level of 5.6mEq/L
2
Q
during a counseling session for a group of teenage athletes, the use of androgenic steroids is discussed. the nurse will explain that which problem is rare but devastating effect of androgenic steroid use
A
kidney failure
3
Q
a patient who has a history of asthma is experiencing an acute episode of shortness of breath and needs to take a medication for immediate relief. the nurse will choose which medication that is appropriate for the situation
A
a leukotriene receptor antagonist, such as montelukast
4
Q
After a nebulizer treatment with the beta agonist
albuterol, the patient complains of feeling a little
“shaky,” with slight tremors of the hands. The patient’s
heart rate is 98 beats/min, increased from the
pretreatment rate of 88 beats/min. The nurse knows
that this reaction is an
A
An expected adverse effect of the
medication
5
Q
A patient is receiving ipratropium via inhaler. The
nurse will assess the patient for which of these
adverse effects? Select all that apply:
A
-
Dry mouth or throat, nasal congestion,
headache
-
B,d,e
6
Q
A patient is receiving ipratropium via inhaler. The
nurse will assess the patient for which of these
adverse effects? Select all that apply:
A
-
Dry mouth or throat, nasal congestion,
headache
-
B,d,e
7
Q
During a teaching session for a patient who will be
receiving a new prescription for the LTRA montelukast
(Singulair), the nurse will tell the patient that the drug
has which therapeutic effect?
A
Reduces inflammation in the airway
8
Q
A patient who is taking a xanthine derivative for
chronic bronchitis asks the nurse, “I miss my morning
coffee. I can’t wait to go home and have some.” What
is the nurse’s best response?
A
It’s important not to take coffee or other
caffeinated products with this medicine
as it may cause an increased heart rate
as well as other problems
9
Q
A client has been taking Iansoprazole (proton-pump
inhibitor) the nurse should monitor the client for the
relief of which symptom?
A
Heartburn
10
Q
A client is taking amiloride hydrochloride daily. The
nurse should tell the client to take the dose at what
time?
A
In the morning with breakfast
11
Q
Theophylline is prescribes for a client with bronchial
asthma. The nurse provides dietary instructions to the
client and should tell the client to avoid consuming
which item?
A
Iced tea
12
Q
The nurse is preparing to administer medications to a
hospitalized client and notes that the client takes
levothyroxine daily. The nurse suspects that the client
has a history of which condition?
A
Hypothyroidism
13
Q
Which of the following classes of antihypertensive
drugs is not recommended for initial treatment?
A
Potassium sparing diuretics
14
Q
A 55-yr-old woman, who is devoted to singing in her
church chorus, has hypertension which has been well
controlled with enalapril for the past month. She calls
to report a new, intolerable side effect, and she
requests to be switched to a different drug. Which of
the following adverse effects is most likely to be
intolerable to this patient
A
Dry cough
15
Q
During her annual physical examination, a 45-yr-old
patient with a history of asthma is found to have an
elevated blood pressure. Elevated pressures are
confirmed on 2 additional readings in the physician’s
office. In evaluating therapies for this patient, which
class of antihypertensive drugs is contraindicated?
A
Beta blockers
16
Q
A digitalis preparation is effective for treating which of
the following health conditions?
A
Heart failure (HF)
17
Q
What is lidocaine primarily used to treat?
A
Ventricular dysrhythmias
18
Q
Which of the following medication is the most potent
calcium channel blocker?
A
Nifedipine (Procardia)
19
Q
When testing a metered-dose inhaler (MDI) canister to
estimate whether it is empty, the inhaler canister (not
the mouthpiece) is dropped into a container that is
wider and longer that the inhaler and filed up to threequarters fill with water. Which of the following indicates
that the inhaler canister is nearly empty?
A
The canister floats on top of the water
20
Q
The following medications are example of Histamine H2 antagonist
A
Nifedipine (adalat)
21
Q
Action: decrease secretion of gastric acid and formation of pepsin by blocking histamine 2 receptor sites
A
Histamine 2 antagonist
22
Q
Action: reduce stomach acid by working on secretory surface receptors to stop the last phase of acid production
A
Proton pump inhibitors
23
Q
Mix with hydrochloric acid to neutralize stomach secretions and prevent transformation of pepsinogen to pepsin
A
Antacids
24
Q
Stops secretion of gastric acid and elevates production of mucus and bicarbonate to preserve stomach lining
A
Misoprostol (Cytotec)
25
Action: forms a protective coveting of ulcer sites and guards against pepsin, bile salts, and acid, which stops further breakdown of the sites
Sucralfate (Carafate)
26
Uses:
GERD
Heartburn
Zollinger Ellison Syndrome
Stress ulcer
GI bleeding
Gastric and duodenal ulcer
Histamine 2 antagonist
27
USE:
short term treatment for gastric and duodenal ulcers, GERD, esophagitis
Long term treatment of hypersecretory diseases
H. pylori infection
Proton pump inhibitors
28
Use:
Treat and prevent gastritis, GI bleeding, stress ulcers, heartburn, GERD, PUD, esophagitis
Antacids
29
USE:
Prevention of gastric ulcers from the use of NSAIDs
Misoprostol (Cytotec)
30
Use:
Duodenal ulcer
Sucralfate (Carafate)
31
Side/Adverse effect of histamine 2 antagonist (CNS)
Confusion
Hallucinations
Drowsiness
Headache
Dizziness
32
Side/Adverse effect of histamine 2 antagonist (CV)
hypotension
Arrhythmias
33
Side/Adverse effect of Histamine 2 antagonist (derm)
Reversible alopecia
Rash
Steven johnson syndrome
34
Side/Adverse effect of histamine 2 antagonist
F&E
Elevated creatinine
BUN
Serum uric acir
35
Side/Adverse effect of histamine 2 antagonist
GI
Constipation
Diarrhea
36
Side/Adverse effect of histamine 2 antagonist
GU
Reversible impotence
Gynecomastia
Galactorrhea
37
Side/Adverse effect of histamine 2 antagonist
Hematologic
Elevated prothrombin time
38
Side/Adverse effect of histamine 2 antagonist
Other
Fever
Joint pain in clients with arthritis
39
Side/Adverse effect of proton pump inhibitors
Cns
Tiredness
Dizziness
Headache
Insomnia
40
Side/Adverse effect of proton pump inhibitors
Derm
Pruritus
Alopecia
Rash
Dry skin
41
Side/Adverse effect of proton pump inhibitors
GI
Dry mouth
Nausea
Diarrhea
Abdominal pain
42
Side/Adverse effect of proton pump inhibitors
GU
Blood/protein in urine
43
Side/Adverse effect of proton pump inhibitors
Resp
Nasal stuffiness
Hoarseness
Cough
Nosebleed
44
Side/Adverse effect of proton pump inhibitors
Other
Fever
Back pain
45
Side/Adverse effect of antacids
F&E
Hypophosphatemia
Hypermanesemia in clients with renal disease
46
Side/Adverse effect of antacid
GI
Magnesium antacids cause diarrhea
Aluminum antacids cause constipation
Acid rebound
47
Side/Adverse effect of antacid
Other
Encephalopathy
Osteomalacia
48
Side/Adverse effect of Misoprostol
Cns
Headache
49
Side/Adverse effect of Misoprostol
Gi
Constipation
Diarrhea
Nausea
Vomiting
Abdominal pain
Flatulence
50
Side/Adverse effect of Misoprostol
GU
Menstrual irregularities
Uterine contractions
51
Side/Adverse effect of Sucralfate
CNS
Insomnia
Dizziness
52
Side/Adverse effect of Sucralfate
Derm
Rash
53
Side/Adverse effect of Sucralfate
GI
Constipation
Diarrhea
Nausea
54
Side/Adverse effect of Sucralfate
Other
Back pain
55
Antidiarrheals
Action: act directly on the areas of the CNS that control movement of the GI tract
Lomotil
Motofen
Camphorated Opium tincture
56
Antidiarrheals
Action: works directly on the GI tract lining to slow movement and reduce inflammation
Bismuth subsalicylate (pepto bismol)
57
Antidiarrheals
Action: acts on GI tract muscle to decrease peristalsis
Loperamide (Imodium)
58
Antidiarrheals
Action: represses the action of a number of GI enzymes
Octreotide (sandostatin)
59
Indications of loperamide hcl. (Imodium)
acute nonspecific diarrhea and of chronic diarrhea associated with inflammatory bowel disease
60
Precautions
in
administering
metoclopramide (Reglan)
should not be used in
patients with a history of seizures or those who
are prone to developing them.
should be used with
caution in patients with Parkinson's disease
61
involves
selectively targeting and inhibiting proton
pumps in order to reduce gastric acid
production. This medication has proven to be
highly
effective
in
managing
various
gastrointestinal
conditions
and
providing
much-needed relief for patients suffering from
these ailments.
omeprazole
(Prilosec)
62
Side effects of Sulfasalazine (Azulfidine)
gastrointestinal distress. This
can manifest as nausea, vomiting, diarrhea,and
abdominal pain.
allergic reactions
63
Best time to administer sucralfate (Carafate)
one hour before breakfast and two tablets
at bedtime.
64
Cause water to be retained in the stool, which causes distention of the bowel and result in defecation
Bulk forming laxatives
65
work by absorbing water
and swelling up in order to increase stool
volume and softness.
Bulk forming laxatives
66
an
effective
treatment
for
constipation
Lactulose
67
Mechanism action of lactulose
Constipation
-used to treat
hepatic encephalopathy, a condition that occurs
when the liver is unable to remove toxins from
the blood
-helps reduce ammonia
levels in the blood by promoting its excretion
through the stool.
68
is a laxative that works by increasing the
amount of water in the stool, making it easier to
pass.
polyethylene glycol (PEG
69
is a natural fiber that absorbs water in
the intestines, making the stool softer and
easier
to
pass. It is often
found in
over-the-counter laxatives and can be taken in
powder or capsule form
Psyllium
70
on the other
hand, works by increasing the amount of water
in the stool, making it softer and easier to pass.
It is available as a liquid or tablet
Docusate
71
is a stimulant laxative that works by
irritating the lining of the intestines, causing
them to contract and move stool along more
quickly. It is available as tablets or liquid
extracts.
Senna
72
is a saline
laxative that draws water into the intestines to soften
the
stool
and
stimulate
bowel
movements.
magnesium citrate
73
works is by reducing hepatic
glucose production. It inhibits the enzyme gluconeogenesis, which is responsible for the
synthesis of glucose in the liver. By
suppressing this process
Metformin
74
is enhancing
insulin sensitivity in peripheral tissues such as
muscle and adipose tissue
Metformin
75
an enzyme called AMP-activated protein kinase
(AMPK), which plays a crucial role in cellular energy homeostasis. Activation of AMPK leads
to increased glucose uptake by muscle cells and
improved insulin sensitivity.
Metformin
76
affects intestinal
absorption of glucose, leading to decreased
postprandial blood sugar levels. It delays the
absorption
of
carbohydrates
from
the
gastrointestinal tract, resulting in reduced
glucose spikes after meals.
Metformin
77
is the first-line therapy for Type 2
DM. It works by reducing glucose production
in the liver and improving insulin sensitivity in
peripheral tissues.
Metformin
78
stimulate
insulin secretion from pancreatic beta cells,
thereby
lowering
blood
sugar
levels.
Thiazolidinediones enhance insulin sensitivity
in muscle and adipose tissue.
Sulfonylureas
79
increase incretin hormone
levels, which stimulate insulin release and
inhibit glucagon secretion. These drugs also
slow down gastric emptying, leading to
decreased appetite and weight loss.
DPP-4 inhibitors
80
generally
well-tolerated but can cause gastrointestinal
upset
Metformin
81
may cause hypoglycemia
and weight gain.
Sulfonylureas
82
have been
associated with fluid retention and an increased
risk of heart failure.
Thiazolidinediones
83
are
generally well-tolerated but may increase the
risk of pancreatitis.
DPP-4 inhibitors
84
is to delay the absorption of glucose
from the small intestine.
alpha-glucosidase
inhibitors
85
Best time to take prednisone
with breakfast so it does not upset your
stomach. Taking prednisolone in the morning
86
One of the primary symptoms of Diabetes
Insipidus is
polydipsia, or excessive thirst.
87
One of the key actions of thyroid hormones is
their ability to
increase basal metabolic rate.
They stimulate oxygen consumption and heat
production in almost all tissues, thereby
promoting energy expenditure. Additionally,
they enhance protein synthesis and degradation,
regulate
carbohydrate
metabolism,
and
influence lipid metabolism.
88
One of the most common side effects of
intranasal vasopressin is
nasal discomfort. This
can manifest as irritation, dryness, or even
nosebleeds.
Headache
allergic reactions such as
hives, difficulty breathing, or swelling of the
face, lips, tongue, or throat.
89
is a valuable
medication used in managing hyperthyroidism
caused by Graves' disease. Its ability to inhibit
thyroid hormone synthesis makes it an effective
tool in normalizing thyroid function and
alleviating associated symptoms.
propylthiouracil (PTU
90
aids in
managing conditions related to water balance
and bleeding disorders,
Desmopressin acetate
91
been widely studied and proven
to be effective in managing these conditions. In
patients with diabetes insipidus, it helps
regulate water balance in the body by
increasing water reabsorption in the kidneys.
This results in decreased urine output and
prevents dehydration.
Desmopressin
Acetate
(DDAVP)
92
has shown promising
results
in
treating
nocturnal
enuresis,
commonly known as bedwetting, particularly in
children.
By reducing
nighttime
urine
production, it helps individuals achieve dry
nights and improves their quality of sleep.
Desmopressin
Acetate
(DDAVP)
93
has revolutionized the treatment of
erectile dysfunction since its discovery. Its
accidental finding during clinical trials for
angina paved the way for an effective oral
therapy that has improved countless lives.
However, it is crucial to use this medication
responsibly and seek medical advice before
starting or changing any treatment regimen
involving sildenafil or any other medications.
Sildenafil (Viagra)
94
Foods and drinks to avoid for patient taking
Glipizide (Glucotrol)
sugary foods and beverages.
high-carbohydrate meals or snacks
95
is an
intermediate-acting insulin that provides a
longer duration of action compared to regular insulin
Humulin NPH insulin
96
work by blocking
the action of aldosterone in the distal tubules of
the kidneys. They are indicated for patients
with hypertension or heart failure who are at
risk for hypokalemia
Potassium-sparing diuretics
97
act on the ascending loop of
Henle to inhibit sodium reabsorption. They are
used to treat edema associated with heart
failure or renal disease.
Loop diuretics
98
inhibiting sodium
reabsorption in the distal convoluted tubules.
They are prescribed for hypertension or edema
caused by heart failure or renal disease.
Thiazide diuretics
99
increase osmotic pressure in
the glomerular filtrate to promote water
excretion. They are used to reduce intracranial
pressure or intraocular pressure in conditions
such as cerebral edema or glaucoma.
Osmotic diuretics
100
may increase the
risk of losing sodium and water.
Potassium-sparing diuretics
101
can cause significant losses of potassium,
calcium, magnesium, and sodium.
Loop diuretics
102
may result in the loss of potassium,
magnesium, and sodium.
Thiazide
diuretics
103
can
lead to the loss of water and electrolytes.
Osmotic diuretics
104
by inhibiting the
reabsorption of sodium and chloride in the
distal convoluted tubules of the kidneys. This
leads to increased excretion of water and
electrolytes in urine.
Thiazide diuretics
105
examples of loop diuretics.
Furosemide and bumetanide
106
Potassium-sparing
diuretics
such
as
spironolactone
and
amiloride
107
osmotic diuretics like
mannitol
108
gets released by postganglionic
neurons of the sympathetic nervous system,
which binds to and activates adrenergic
receptors.
Norepinephrine
109
found in both the
central nervous system (CNS) and peripheral
nervous system (PNS).
Nicotinic receptors
110
are responsible
for mediating the effects of acetylcholine, a
neurotransmitter involved in muscle movement
and cognitive function.
Nicotinic receptors
111
receptors are
only found in PNS
muscarinic
112
receptors regulate various bodily
functions such as heart rate, smooth muscle
contraction, glandular secretions, and cognitive
processes.
Muscarinic
113
receptors
respond
to
norepinephrine and epinephrine (adrenaline).
These receptors are mainly located on smooth
muscles lining blood vessels. Activation of
alpha-adrenergic
receptors
causes
vasoconstriction leading to increased blood
pressure.
Alpha-adrenergic
114
receptors also respond
to norepinephrine and epinephrine but have
different effects compared to alpha-adrenergic
receptors.
beta-adrenergic receptors
115
are
a class of drugs commonly used in the
treatment of Alzheimer's disease (AD).
Acetylcholinesterase inhibitors (AChEIs)
116
is a
neurodegenerative disorder characterized by
the progressive decline of cognitive function,
memory loss, and behavioral changes
Alzheimer's disease
117
ability
to
inhibit
the
enzyme
acetylcholinesterase, which breaks down the
neurotransmitter acetylcholine.
Acetylcholinesterase inhibitors
118
helps improve focus, reduce
impulsivity, and control hyperactivity
Methylphenidate
119
methylphenidate, which is sold under
brand names like
Ritalin and Concerta.
120
These drugs also
enhance attention span, decrease restlessness,
and promote self-control.
amphetamine-based medications
like Adderall and Vyvanse
121
The most commonly prescribed CNS
stimulant
for
narcolepsy
is
modafinil
122
works by increasing dopamine levels
in the brain, which helps to promote
wakefulness
Modafinil
123
has been
shown to improve
excessive daytime sleepiness and reduce the
frequency of cataplexy episodes in individuals
with narcolepsy. It is generally well-tolerated
with minimal side effects such as headache,
nausea, or insomnia.
Modafinil
124
achieve
this by entering nerve terminals through
specific transporters, where they displace
stored neurotransmitters from vesicles into the
cytoplasm. This leads to an increased release of
dopamine and norepinephrine into the synaptic
cleft.
Amphetamines
125
blocks the
reuptake transporters responsible for removing
dopamine
and
norepinephrine
from
the
synapse.
By
inhibiting
reuptake,
more
neurotransmitters remain in the synaptic cleft
for a longer duration, thereby enhancing their
effects on target neurons.
Methylphenidate
126
CNS stimulant is commonly used to treat
Attention Deficit Hyperactivity Disorder
(ADHD)
127
is to alleviate the symptoms associated
with ADHD. It helps individuals with ADHD
to improve their focus, reduce impulsivity, and
control
hyperactivity.
By
enhancing
neurotransmitter activity in specific areas of the
brain responsible for attention and impulse
control, methylphenidate enables individuals
with ADHD to better manage their symptoms
and function more effectively in various
settings such as school or work.
methylphenidate
(ritalin)
128
are widely prescribed due to their
effectiveness in reducing anxiety symptoms.
They act quickly, providing immediate relief
from symptoms such as excessive worry,
restlessness, and irritability
- Benzodiazepines, such as diazepam and
alprazolam
129
class of drugs that act as
central nervous system depressants, primarily
used for their sedative and hypnotic effects.
The
primary
mechanism
of
action
of
barbiturates involves enhancing the inhibitory
effects
of
the
neurotransmitter
gamma-aminobutyric acid (GABA) in the
brain.
Barbiturates
130
is an inhibitory neurotransmitter that
reduces neuronal activity by binding to specific
receptors on nerve cells
GABA
131
have
been widely used for many years due to their
rapid onset and short duration of action. They
work by enhancing the inhibitory effects of
gamma-aminobutyric
acid
(GABA),
a
neurotransmitter that reduces neuronal activity
in the brain. However, their use has declined in
recent years due to potential side effects and the
availability of safer alternatives.
Barbiturates, such as thiopental sodium
132
commonly used as anesthetics due to their
sedative and amnesic properties. They work by
binding to specific receptors in the brain that
enhance
GABA's
inhibitory
effects.
Benzodiazepines like midazolam
133
are
potent analgesics that can be used alone or in combination with other anesthetics. They act on
opioid receptors in the central nervous system
to produce pain relief and sedation
Opioids, such as fentanyl and morphine
134
advanced agents such as nitrous oxide and
chloroform.
Anesthetic agent
135
commonly used today due to
their rapid onset and quick recovery times.
These agents are delivered through a mask or
endotracheal tube, allowing for precise control
over the depth of anesthesia.
Inhalational anesthetics like sevoflurane and
desflurane
136
are also widely used in surgical
settings. These drugs act quickly and provide
profound sedation, making them ideal for
induction of anesthesia.
Injectable
anesthetics
like propofol and
thiopental
137
often associated with pleasure
and reward. It is involved in motivation,
learning, and movement control
Dopamine
138
acts as both a neurotransmitter
and a hormone. It helps regulate attention,
alertness,
and
mood.
Norepinephrine
139
known as the "feel-good"
neurotransmitter. It plays a vital role in
regulating mood, sleep patterns, appetite, and
social behavior.
Serotonin
140
is an inhibitory neurotransmitter that
helps calm down brain activity by reducing
neuronal excitability. It plays a crucial role in
promoting relaxation and reducing anxiety.
GABA
141
collects
blood draining from the stomach, s.
Intestine,and most of the large intestine
Hepatic portal system
142
hepatic impairment is common;
usually transientof asymptomatic;
can be severe, permanent, or fatal
Drug-induced adverse effects:
143
Antiemetics
dopamine antagonist (metoclopramide), anticholinergic
(dimenhydrinate and/or diphenhydramine)
144
Anticholinergics
dimenhydrinate
145
Laxatives
stimulant (bisacodyl), saline (magnesium hydroxide), lubricant (mineraloil),
stool softeners (docusate
sodium), bulk-forming (psyllium)
146
reflux of gastric
acid into esophagus with inflammation, corrosion & scarring of
esophageal wall
Gastro-Esophageal Reflux Disease (GERD)
147
ulceration in wall of stomach or
duodenum
Peptic Ulcer Disease (PUD)
148
Action – buffers gastric acid from
pH 1 - 2 to pH 3 – 4 → ↓ damage to
tissues
Antacids
149
Uses – symptomatic relief by reducing gastric acidity for treatment of
GERD,PUD, gastritis, hiatus hernia
Antacids
150
Adverse Effects – constipation
(aluminum & calcium based), diarrhea(magnesium based)
Antacids
151
Medications Examples
Antacids
aluminum hydroxide (Amphojel, Maalox, Mylanta)
magnesium hydroxide/oxide
(Milk of Magnesia)
calcium carbonate (Tums)
152
Action – ↓s hydrochloric acid secretion
Histamine (H2) Receptor Antagonists
153
Uses – GERD, PUD, stress induced ulcers
Histamine (H2) Receptor Antagonists
154
Adverse Effects –
diarrhea, constipation
Histamine (H2) Receptor Antagonists
155
Meds Sample
Histamine (H2) Receptor Antagonist
ranitidine (Zantac)
156
Why is cimetidine no longer a drug
of choice in GERD & PUD?
Nicotiana species herbs
(tobacco) affect the acid blocking
effects of ranitidine.
157
Action – inhibits gastric acid &
pepsin secretion
GI Prostaglandins
158
Uses – prevention & treatment
of gastric ulcers caused by NSAIDs
and salicylates
GI Prostaglandins
159
a reflex originating in the
medulla (stimulated by cholinergic & dopaminergic fibres)
Antiemetics
160
Action – block dopamine receptors
along vomit center pathways (but
also at other CNS sites)
Dopamine Antagonist Antiemetics
161
Uses – antineoplastic therapy,
post-op
Dopamine Antagonist Antiemetics
162
Adverse Effects – extrapyramidal
effects in larger doses (dystonia,
parkinsonism,tardive dyskinesia)
Dopamine Antagonist Antiemetics
163
Dopamine Antagonist Antiemetics Meds example
metoclopramide (Maxeran), prochlorperazine
(Stemetil)
164
decrease of ADH
production, diuresis, something is
not happening in thebrain
Neurogenic DI
165
ephrons and
renal system are not functioning
properly so there is an increase in
urine up to 15L per day
Nephrogenic DI
166
Deficiency in glucocorticoids and
mineralocorticoids
Addison’s disease
167
improves beta cell responsiveness and enhances insulin secretionin proper amounts
Incretin mimetic
168
Used to treat DMT2
Action: iNcrease insulin secretion,
decrease glucagon secretion to
reduce glucose production
Incretin Modifier
169
Action: stimulate beta cells to secrete insulin
Glipizide,glyburide
170
Action: decrease hepatic glucose
production in liverstored from glycogen
Nonsulfonylureas
