Exam 1 Flashcards
During initial rounds, the nurse notes that a dopamine infusion has extravasated into the forearm of a patient. After stopping the infusion, the nurse follows standing orders and immediately injects phentolamine subcutaneously in a circular fashion around the extravasation site. What is the mechanism of action of the phentolamine in this situation?
It increases blood flow to the ischemic site by vasodilation to prevent tissue damage
Remelteon (Rozerem) is prescribed for a patient with insomnia. The nurse checks the patient’s medical history, knowing that this medication is contraindicated in which disorder?
Liver Disease
An elderly patient with a new diagnosis of hypertension will be receiving a new prescription for an antihypertensive drug. The nurse expects which type of dosing to occur with this drug therapy?
The patient will receive the lowest possible dose at first, and then the dose will be adjusted as needed.
A member of an investigational drug study team is working with healthy volunteers whose participation will help determine the optimal dosage range and pharmacokinetics od the drug. The team member is participating in what type of study?
Phase 1
During a teaching session about self monitoring while taking a beta blocker at home, the nurse has taught the patient to take his apical pulse daily for 1 minute. If the pulse rate decreases to less than 60 beats/min., the nurse will instruct the patient to:
Notify his prescriber
While the nurse is assisting a patient in taking his medications, the medication cup falls to the color, spilling the tablets. What is the nurses best action at this time?
Discarding the medications and repeating preparation
A patient has a new prescription for the transdermal form of scopolamine. The nurse knows that this form of scopolamine is used for which condition?
Motion sickness
A patient is suffering from tendonitis of the knee. The nurse is reviewing the patients medication administration record and recognizes that which adjuvant medication is most appropriate for this type of pain?
Corticosteroid
During the development of a nw drug, which would be included in the study by researcher to prevent any bias or unrealistic expectations of the new drugis usefulness?
A placebo
A patient has a new prescription for Tamsulosin (Flomax) as treatment for benign prostatic hyperplasia. The nurse is checking his current medication list and will contact the prescriber regarding a potential interaction if the patient is also taking which drug?
Sildenafil (Viagra), an erectile dysfunction medication
When teaching a patient about taking a newly prescribed antiepileptic drug (AED) at home, the nurse will include which instruction?
Regular, consistent dosing is important for successful treatment
When evaluating a patient who is taking orlistat (Xenical), which is an intended therapeutic effect?
Decreased weight
During discharge patient teaching, the nurse reviews prescriptions with a patient. Which statement is correct about refills for an analgesic that is classified as Schedule C-III?
The patient may have no more than five-refill in a 6-month period
The nurse is reviewing the food choices of a patient who is taking a monoamine oxidase inhibitor (MAOI). Which food choice would indicate the need for additional teaching?
Salami and swiss cheese sandwich
A patient has been treated with antiparkinson medications for 3 months. What therapeutic responses should the nurse look for when assessing this patient?
Improved ability to perform activities of daily living
The nurse is reviewing the mechanism of action of cholinergic drugs. The undesired effects of cholinergic drugs come from the stimulation of which receptors?
Nicotinic
In preparation for eye surgery, the nurse monitors for which desired drug effect in a patient who is receiving a cholinergic blocking eyedrop medication?
Mydriasis
Nurses have the ethical responsibility to tell the truth to their patients. What is this principle known as?
Veracity
After administering an intradermal (ID) injection for a skin test, the nurse notices a small bleb at the injection site. The best action for the nurse to take at this time is to:
Do nothing
The nurse is preparing the administer dopamine, which is the correct technique for administering dopamine?
Continuous IV infusion with an infusion pump
The nurse is teaching a 16-year-old patient who has a new diagnosis of type 1 diabetes about blood glucose monitoring and the importance of regulating glucose intake. When developing a teaching plan for this teenager, which of Erickson’s stages of development should the nurse consider?
Identity versus role confusion
A patient has been taking haloperidol (Haldol) for 3 months for a psychotic disorder, and the nurse is concerned about the development of extrapyramidal symptoms. The nurse will monitor the patient closely for which effects?
Tremors and muscle twitching
A patient who has received some traumatic news is panicking and asks for some medication to help settle down. The nurse anticipates giving which drug that is most appropriate for this situation?
Diazepam (Valium)
The nurse is discussing gene therapy in a continuing education class. Which is the best definition of eugenics?
Intentional selection, before birth, of genotypes that considered more desirable than others
A 2-year-old child is to receive eardrops. The nurse is teaching the parent about giving the eardrops. Which statement reflects the proper technique for administering eardrops to this child?
Straighten the ear canal by pulling the pinna down and back
The nurse is explaining the Human Genome Project to colleagues. Which os these is the main purpose of the Human Genome Project?
To describe the entire genome of a human being
The nurse recognizes that adrenergic drugs cause relaxation of the bronchi and bronchodilation by stimulating which type of receptors?
Beta-2 adrenergic
A patient is taking an alpha blocker as treatment for benign prostatic hyperplasia, the nurse will monitor for which potential drug effect?
Orthostatic hypotension
A patient has been taking tolterodine (Detrol), but today her prescriber changed her to a newer drug, darifenacin (Enablex). What advantage does darifenacin have over the tolterodine?
The incidence of dry mouth is much lower with darifenacin
The nurse is performing an assessment of a newly admitted patient. Which is an example of subjective data?
The patient reports that he uses the herbal product gingko
A patient has had an overdose of an intravenous cholinergic drug. The nurse expects to administer which drug as an antidote?
Atropine sulfate
A patient arrives at the urgent care center complaining of leg pain after a fall when rock climbing, the x-rays show no broken bones, but he has a large bruise on his thigh. The patient says he drives a truck and does not want to take anything strong because he needs to stay awake. Which statement by the nurse is most appropriate?
You can take acetaminophen, also known as Tylenol, for pain, but no more than 3000mg per day
The nurse is aware that confusion, forgetfulness, and increased risk for falls are common responses in an elderly patient who is taking which type of drug?
Sedatives
A patient has been taking temazepam (Restoril) for intermittent insomnia. She calls the nurse to say that when she takes it, she sleeps well, but the next day she feels so tired. Which explanation by the nurse is correct?
These drugs affect the sleep cycle, resulting in daytime sleepiness
A patient says he prefers to chew rather than swallow his pills. One of the pills has the abbreviation SR behind the name of the medication. The nurse needs to remember which correct instruction regarding how to give the medication?
Do not crush or break the tablet before administration
A patient is undergoing abdominal surgery and has been anesthetized for 3 hours. Which nursing diagnosis would be appropriate of this patient?
Impaired gas exchange related to central nervous system depression produced by general anesthesia
A patient who has advanced cancer is receiving opioid medications around the clock to keep him comfortable as he nears the end of his life. Which term best describes the type of therapy?
Palliative therapy
The nurse is assessing the medication history of a patient with a new diagnosis of Parkinson’s disease. Which condition is a contraindication for the patient, who will be taking tolcapone (Tasmar)?
Liver failure
The nurse is monitoring a patient who is in the 26th week of pregnancy and has developed gestational diabetes and pneumonia. She is given medications that pose a possible fetal risk, but the potential benefits may warrant the use of the medications in her situation.
Category D
When the nurse considerds the timing of a drug dose, which factor is appropriate to consider when deciding when to give a drug?
The patient’s last meal
During a period of time when the computerized medication order system was down, the prescriber wrote admission orders, and the nurse is transcribing them. The nurse is having difficulty transcribing one order because of the prescriber’s handwriting, which is the best action for the nurse to take at this time?
Contact the prescriber to clarify the order
The nurse is giving medications through a percutaneous endoscopic gastrostomy (PEG) tube, which technique is correct
Using the barrel of the syringe, allowing the medication to flow via gravity into the tube
When reviewing the various schedules of controlled drugs, the nurse knows that which description correctly describes Schedule II drugs?
Drugs with high potential for abuse that have accepted medical use
When given a scheduled morning medication, the patient states, “I haven’t seen that pill before. Are you sure its correct?” the nurse checks the medication administration record and verifies that it is listed. Which is the nurses best response?
Let me check on the order first before you take it
An 83-year-old woman has been given a thiazide diuretic to treat mild heart failure. She and her daughter should be told to watching for which problems?
Fatigue, leg cramps, and dehydration
Before beginning a patients therapy with selective serotonin reuptake inhibitor (SSRI) antidepressants, the nurse will assess for concurrent use of which medications or medication class?
Anticoagulants
When the nurse teaches a skill such as self-injection of insulin to the patient, what is the best way to set up the teaching/learning session?
After demonstrating the procedure, allow the patient to do several return demonstrations
A patient has been admitted to the emergency department with a suspected overdose of a tricyclic antidepressant. The nurse will prepare for what immediate concern?
Cardiac dysthymias
Carbidopa-levodopa (Sinemet) is prescribed for a patient with Parkinson’s disease. The nurse informs the patient that which common adverse effects can occur with this medication?
Hearth palpitations, hypotension, urinary retention
A patient with asthma is to begin medication therapy using a metered-dose inhaler. What is an important reminder to include during teaching sessions with the patient?
Inhale slowly while pressing down to release the medication
The nurse will be injecting a drug into the fatty tissue of the patient’s abdomen. Which route does this describe?
Subcutaneous
A 60-year-old patient is on several new medications and expresses worry that she will forget to take her pills. Which action by the nurse would be most helpful in this situation?
Assisting the patient with obtaining and learning to use a calendar or pill container
When monitoring the patient receiving an intravenous infusion to reduce blood pressure, the nurse notes that the patient’s blood pressure is extremely low, and the patient is lethargic and difficult to awaken, this would be classified as which type of adverse drug reaction?
Pharmacologic reaction
A patient is taking flurazepam (Dalmane) three to four nights a week for sleeplessness. She is concerned that she cannot get to sleep without taking the medication. What nonpharmacologic measure should the nurse suggest to promote sleep for this patient?
Providing a quiet environment
The patient is to receive oral guaifenesin (Mucinex) twice a day. Today, the nurse was busy and gave the medication 2 hours after the scheduled dose was due. What type of problem does this represent?
“Right time”
When giving medications, the nurse will use Standard Precautions, which include what action?
Discarding all syringes and needles in a puncture-resistant container
Drug transfer to the fetus is more likely during the last trimester of pregnancy for which reason?
Enhanced blood flow to the fetus
The nurse is reviewing herbal therapies. Which is a common use of the herb feverfew?
Migraine headaches
A patient is recovering from a minor automobile accident that occurred 1 week ago. He is taking cyclobenzaprine (Flexeril) for muscular pain and goes to physical therapy three times a week. Which nursing diagnosis would be appropriate for him?
Risk for injury related to decreased sensorium
A patient has been taking phenobarbital for 2 weeks as part of his therapy for epilepsy. He tells the nurse that he feels tense and that “the least little thing” bothers him now. Which is the correct explanation for this problem?
This drug causes deprivation of REM sleep and may cause the inability to deal with normal stress
A 6-year-old boy has been started on an extended-release form of methylphenidate hydrochloride (Ritalin) for the treatment of attention deficit hyperactivity disorder (ADHD). During a follow-up visit, his mother tells the nurse that she has been giving the medication at bedtime so that it will be “in his system” when he goes to school the next morning. What is the nurses appropriate evaluation of the mother’s actions?
The medication should be given 4 to 6 hours before bedtime to diminish insomnia
A patient is brought to the emergency department for treatment of a suspected overdose. The patient was found with an empty prescription bottle of a barbiturate by his bedside. He is lethargic and barely breathing, the nurse would expect which immediate intervention?
Implementing measures to maintain the airway and support respirations
The nurse is monitoring a patient who has been taking carbamazepine (Tegretol) for 2 months. Which effects would indicate that autoinduction has started to occur?
The drug levels for carbamazepine are lower than expected
The nurse is developing a care plan for a patient who will be self-administering insulin injections. Which statement reflects a measurable outcome?
The patient will demonstrate the proper technique of self-administering insulin injections
A patient is on a low-dose dobutamine drop for hearth failure. She had been feeling better but now has a sense of tightness in her chest, palpitations, and a bit of anxiety. Her hearth rate is up to 110 per minute, and her blood pressure is 150/98 mm Hg (increased from previous readings of 86 per minute and 120/80 mm Hg). What is the nurses immediate concern for this patient?
The medication may be causing a worsening of a pre-existing cardiac disorder
When a patient is taking an anticholinergic such as benztropine (Cogentin) as part of the treatment for Parkinson’s disease, the nurse should include which information in the teaching plan?
Use artificial saliva, sugarless gum, or hard candy to counteract dry mouth
The nurse is administering an IV push medication through an IV lock. After injecting the medication, which action will be taken next?
Flushing the lock
The patient has been taking an over-the-counter (OTC) acid-reducing drug because he has had “stomach problems for several months. He tells the nurse that the medicine helps as long as he takes it, but once he stops it, the symptoms return. Which statement by the nurse is the best advice for this patient?
“Using this drug may relieve your symptoms, but it does not address the cause. You should be seen by your health care provider”
A 14-year-old patient has been treated for asthma for almost 4 months. Two weeks ago, she was given salmeterol as part of her medication regimen. However, her mother has called the clinic to report that it does not seem to work when her daughter is having an asthma attack., which response by the nurse is appropriate?
“This medication if indicated for prevention of bronchospasm, not for relief of acute symptoms”
When administering medication for IV bolus (push), the nurse will occlude the IV line by which method?
Pinching the tubing just above the injection port
Which nursing diagnosis is appropriate for the patient who has just received a prescription for a new medication?
Deficient knowledge related to newly prescribed drug therapy
The patient is complaining if a headache and asks the nurse which over-the-counter medication form would work the fastest to help reduce the pain. Which medication form will the nurse suggest?
A powder
The nurse is assigned to a patient who is newly diagnosed with type 1 diabetes mellitus. Which statement best illustrates an outcome criterion for this patient>
The patient will demonstrate correct blood glucose testing technique
A 29-year-old male patient is admitted to the intensive care unit with the following symptoms: restlessness, hyperactive reflexes, talkativeness, confusion and periods of panic and euphoria, tachycardia, and fever. Th nurse suspects that he may be experiencing the effects of taking which substance?
Stimulants
The nurse reads in the patients medication history that the patient is taking buspirone (BuSpar). The nurse interprets that the patient may have which disorder?
Anxiety disorder
A patient with a new prescription for a diuretic has just reviewed with the nurse how to include more potassium in her diet. This reflects learning in which domain?
Cognitive
The nurse is reviewing the dosage schedule for several different antiepileptic drugs (AEDs). Which antiepileptic drug allows for once-a-day dosing?
Phenobarbital
The nurse is reviewing the applications of gene therapy. Which drug is manufactured as a result of indirect gene therapy?
Human insulin
A patient who has had abdominal surgery has been discharged on a cholinergic drug to assist in increasing gastrointestinal peristalsis. The nurse will teach this patient to look for which therapeutic effect?
Passage of flatus
The nurse is administering parenteral drugs. Which stamen is true regarding parenteral drugs?
Parenteral drugs bypass the first-pass effect
A patient with the diagnosis of schizophrenia is hospitalized and is taking a phenothiazine drug. Which statement by this patient indicated that he is experiencing a common adverse effect of phenothiazines?
“My mouth has been so dry lately”
When giving a buccal mediation to a patient, which action by the nurse is appropriate?
Placing the medication between the upper or lower molar teeth and the cheek
When admitting a patient with a suspected diagnosis of chronic alcohol use, the nurse will keep in mind that chronic use of alcohol might result in which condition?
Korsakoff’s psychosis
The nurse is presenting a substance-abuse lecture for teenage girls and is asked about “roofies”. The nurse recognizes that this is the slang term for which substance?
Flunitrazepam
When reviewing the mechanism of action of a specific drug, the nurse reads that the drug works by selective enzyme interaction. Which of these processes describes selective enzyme interaction?
The drug binds to an enzyme molecule and inhibits or enhances the enzymes action with the normal target cell
The nurse has given medication instructions to a patient receiving phenytoin (Dilantin). Which statement by the patient indicated that the patient has an adequate understanding of the instructions?
“I will need to take extra care of my teeth and gums while on this medication”
The nurse is assessing a newly admitted 83-year-old patient and determines that the patient is experiencing polypharmacy. Which statement most accurately illustrates polypharmacy?
The patient uses multiple medications simultaneously
