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Pharm II > Final > Flashcards

Final Flashcards

1
Q

The nurse is assessing a patient who is complaining of hearing voices. What is this patient experiencing?

A

Hallucinations

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2
Q

What occurs with mania associated with bipolar disorder?

A

Distinct episodes of elation

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3
Q

Which type of adverse effects is present when a patient displays prolonged tonic contractions of the tongue, oculogyric crisis, and torticollis?

A

Dystonic reaction

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4
Q

A patient taking phenytoin (Dilantin) and isoniazid reports feeling lethargic. Nystagmus is noted on physical examination. Which problem does this information suggest to the nurse?

A

Phenytoin toxicity

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5
Q

Which drug used in the treatment of seizures requires careful monitoring of renal function?

A

Carbamazepine (Tegretol)

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6
Q

A patient admitted to the hospital is exhibiting psychotic behavior. Which sign(s) and/or symptom(s) would support the diagnosis of psychosis? (Select all that apply.)

A

b. Deterioration of social functioning
c. Reporting that the FBI has solicited important secret information from his phone conversations
d. Confirmation of hearing voices in his head
e. Changing the topic of conversation inappropriately

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7
Q

A newly admitted psychiatric patient repetitively states, “I wish I were dead. I just want to kill myself.” The priority nursing at this time is to

A

Provide for patient safety

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8
Q

A patient taking an MAOI reports a severe occipital headache, stiff neck, sweating, nausea, and vomiting. Which is the nurse’s priority assessment?

A

Blood pressure

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9
Q

The outcome statement for a patient suffering from anxiety disorder reads, “After 1 week on alprazolam (Xanax) therapy, patient will exhibit a manageable level of anxiety.” Which assessment finding validates that this outcome is met?

A

Patient reports sleeping better and increased interest in activities

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10
Q

What instruction is most important for the nurse to teach the patient who has recently been prescribed alprazolam (Xanax)?

A

You may feel dizzy or unsteady when rising to a standing position

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11
Q

which of the following would be used in trigeminal neuralgia?

A

Carbamazepine (tegretol)

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12
Q

The nurse is preparing to begin administration of apomorphine to a patient. Before administering, the nurse will perform a baseline assessment of the patients: (Select all that apply.)

A

a. mobility.
b.orientation.
d.alertness.
e.vital signs.

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13
Q

What is the pharmacologic action of entacapone, a potent catechol O methyl transferase (COMT) inhibitor?

A

Reduces the destruction of dopamine in peripheral tissues.

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14
Q

What is the primary response to alpha-1-receptor stimulation?

A

Vasoconstriction

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15
Q

A patient who has been prescribed the antiparkinsonian medication carbidopa/levodopa, asks the healthcare provider, “Why am I getting these two medications?” How should the healthcare provider respond?

A

“The carbidopa prevents the breakdown of the levodopa.”

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16
Q

For what conditions are benzodiazepines prescribed?

A

Preoperative sedation

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17
Q

A patient has been prescribed lorazepam (Ativan), a benzodiazepine used to treat insomnia. Which action will the nurse take?

A

Assess the patient’s blood pressure in sitting and lying positions.

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18
Q

Why are benzodiazepines often preferred over barbiturates? (Select all that apply.)

A

a. They have selective action at specific receptor sites.
b. There is a wide range of safety between therapeutic and lethal levels.
c. REM sleep is decreased to a lesser extent.
d. Accidental overdoses are well tolerated.

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19
Q

An older adult patient received a hypnotic agent at 9:00 PM. At 2:00 AM, the nurse discovers that the patient has removed her gown and is attempting to get out of bed without assistance. What type of medication effect is the patient exhibiting?

A

Paradoxical

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20
Q

The nurse is providing education to a patient recently placed on selegiline disintegrating tablets. Which statement by the patient indicates a need for further teaching?

A

“I will place the tablet on my tongue before breakfast.”

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21
Q

Which condition would alert the nurse of the need to use beta-adrenergic blockers cautiously?

A

Emphysema

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22
Q

A patient with Parkinson’s disease asks the nurse why anticholinergics are used in the treatment. Which response by the nurse is most accurate?

A

“These drugs inhibit the action of acetylcholine.”

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23
Q

Before the initiation of anticholinergic medications, it is important for the nurse to screen patients for which condition?

A

Closed-angle glaucoma

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24
Q

A long-term care resident is taking an anticholinergic agent. The nurse observes the resident to be disoriented and hallucinating. The priority nursing action is to:

A

provide for resident’s safety.

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25
Q

Which instruction(s) given by the nurse will assist a patient to cope with the common adverse effects of anticholinergic medications? (Select all that apply.)

A

b. “Increase fluids daily.”
d. “Suck on candy or ice chips.”

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26
Q

Which instruction by the nurse will be included when teaching an adult patient about digoxin (Lanoxin) for management of heart failure?

A

A. “Report nausea and vomiting to your health care provider.”

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27
Q

A trauma patient arrives in the emergency department via EMS. He is bleeding profusely. A medical alert bracelet indicates that he is on heparin therapy. The nurse will most likely administer which medication that counteracts the action of heparin?

A

C. Protamine sulfate

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28
Q

What will the nurse advise the patient to do to avoid the development of tolerance to nitroglycerin?

A

C. Allow for a daily 8- to 12-hour nitrate free period

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29
Q

How frequently are nitroglycerin tablets discarded and prescriptions refilled?

A

C. every 6 months

30
Q

Which assessment verifies increased blood perfusion to the lower extremities?

A

C. Increased amplitude of pedal pulses

31
Q

A patient is admitted to the acute care telemetry unit with a diagnosis of atrial fibrillation. The physician orders dofetilide (Tikosyn). Before initiating this medication, the nurse will

A

C. assess potassium level.

32
Q

A patient has recently been prescribed cilostazol (Pletal). Which statement by the patient indicates that this medication is effective?

A

A. I have less leg cramping when I walk.”

33
Q

Which is an accurate nursing action when administering subcutaneous enoxaparin, a low-molecular-weight heparin product?

A

B. Leave the needle in place for 10 seconds after injection.

34
Q

The nurse is preparing discharge education for a patient who will be receiving warfarin (Coumadin) at home. Which important point(s) will the nurse include? (Select all that apply.)

A

A. “Do not make any major changes to your diet without discussing it with your healthcare provider.”
B. “Keep outpatient laboratory appointments for monitoring of therapy.”
D. “Report signs of bleeding to your health care provider, including observing skin for bruising; petechiae; blood in emesis, urine, or stools; bleeding gums; cold, clammy skin; faintness; or altered sensorium.”
E. “Avoid aspirin products.”

35
Q

The nurse transcribes a new order for a daily diuretic on a patient diagnosed with congestive heart failure. The nurse will schedule this medication

A

in the morning.

36
Q

Which instruction will the nurse include when teaching a patient about the administration of translingual nitroglycerin spray?

A

C. Administer the medication under the tongue.

37
Q

Patients who are on neuromuscular blocking agents and lidocaine must be closely observed for which complication?

A

B. respiratory depression

38
Q

Which is the most potent of the natural estrogenic hormones produced in the ovaries?

A

Estradiol

39
Q

Which condition can occur if congenital hypothyroidism is not treated?

A

Cretinism

40
Q

The nurse is assessing a patient for adverse effects of long-term glucocorticoid therapy. Which condition would most likely be present?

A

Osteoporosis

41
Q

When preparing a female patient for the endocrine changes that may occur as a result of androgen changes, the nurse will include information regarding:

A

Voice changes

42
Q

Which fluid replacement method will the nurse identify for a patient on a fluid restriction?

A

Half the volume with meals and the remainder divided among shifts

43
Q

Which medication is used to treat hyperthyroidism?

A

Propylthiouracil (Propacil)

44
Q

What is the mechanism of action of propylthiouracil?

A

Blocks synthesis of hormone in the thyroid gland

45
Q

Which clinical symptom(s) would the nurse observe in a patient with thyrotoxicosis? (Select all that apply.)

A

d. Muscle tremors
e. Restlessness
f. Anxiety
g. Sweating

46
Q

Which patient on oral contraceptive therapy will be at greatest risk for heart attack?

A

A 36-year-old woman who smokes half a pack per day

47
Q

Medications ordered on a patient with hypothyroidism include liotrix and cholestyramine. The nurse administers the dose of liotrix at 08:00. When is the best time for the nurse to administer cholestyramine?

A

12:00

48
Q

The nurse is instructing a patient about adverse effects associated with corticosteroid therapy. What information would be important to include? (Select all that apply.)

A

a. Avoid crowds or people with an infection.
b. Monitor and care for your skin daily; change positions frequently.
d. During periods of physical or psychological stress, higher doses of corticosteroids are necessary. Contact your health care provider.
e. Follow a diet low in sodium

49
Q

Which symptoms will be most important for the nurse to assess for early signs of respiratory distress in the patient who has been given a neuromuscular-blocking agent?

A

Dyspnea, increased respiratory rate, and cyanosis

50
Q

A patient is complaining of moderate bladder pain and spasms secondary to a UTI. Which drug would assist in relieving symptoms?

A

Phenazopyridine hydrochloride (Pyridium)

51
Q

The nurse is obtaining a history on a patient who is seeking oral contraceptives. Which condition would contraindicate the use of oral contraceptives?

A

Thromboembolic disease

52
Q

Which medication will be prescribed for a patient complaining of muscle spasms resulting from a back injury?

A

Cyclobenzaprine (Flexeril)

53
Q

An employee at a factory has not been to work because of low back muscle spasms. His wife contacts the occupational health nurse to report that her spouse is on a centrally acting skeletal muscle relaxant and is having problems with sleepiness. Based on the medication action, what will the nurse tell her? (Select all that apply.)

A

b. “Your husband should avoid activities requiring alertness, such as driving or operating power equipment.”
c. “I need additional and specific information regarding the amount of your husband’s sedation.”
d. “I will review baseline laboratory studies, discuss your husband’s status with the health care provider, and call you back.”
e. “Sedation is an adverse effect of these medications and tends to resolve with continued therapy.”

54
Q

Which type of drug is most effective in the treatment of erectile dysfunction (ED)?

A

Phosphodiesterase inhibitors

55
Q

What is the action of timolol maleate (Timoptic), a beta-adrenergic blocking agent?

A

d. Decreases the production of aqueous humor.

56
Q

How often is fosfomycin (Monurol) usually administered when used in the treatment of UTIs?

A

In a one-time dose

57
Q

The nurse is preparing a patient for an ophthalmic examination. Which action occurs when the nurse instills eyedrops to produce mydriasis?

A

Extreme dilation of the pupil

58
Q

Which assessment is most important for the nurse to obtain when a patient is being treated with a neuromuscular-blocking agent?

A

Respiratory assessment for patent airway

59
Q

Which are important teaching points for the nurse to review with a patient recently diagnosed with open-angle glaucoma? (Select all that apply.)

A

a. The disease will cause damage to the optic disk if left untreated.
c. Loss of peripheral vision is a common trigger for diagnosis.
d. Total blindness may result if the glaucoma is not treated.

60
Q

A patient is receiving total parenteral nutrition. Which action(s) will the nurse perform? (Select all that apply.)

A

a. Assess for electrolyte imbalance.
d. Monitor blood glucose levels.
e. Discard the solution every 24 hours.

61
Q

What is black cohosh used for?

A

Reducing symptoms of premenstrual syndrome

62
Q

What is the purpose of administering filgrastim (Neupogen) to a patient who is post-bowel resection resulting from cancer?

A

d. Increase the white blood cell (WBC) counts

63
Q

The use of which medication would alert the nurse to educate the patient about using Ginkgo biloba cautiously?

A

c. Anticoagulants

64
Q

Patient is on continuous feed at 100mL/hr. Patient as 175mL residual volume. what should the nurse do?

A

stop the feed and notify the physician

65
Q

What is the intended outcome of the chemoprotective drug amifostine (Ethyol)?

A

d. Decreased renal toxicity

66
Q

Why are bone marrow stimulants used in the treatment of cancer?

A

c. To enhance the patient’s immune system during treatment

67
Q

The nurse is assisting with the development of care plan for a patient withdrawing from cocaine. What would be the first nursing diagnosis priority for this patient?

A

d. High risk for self-directed violence

68
Q

What does a urinalysis that is positive for the drug tested indicate?

A

d. It verifies whether the drug is present in the specimen.

69
Q

Which herbal medicine may improve a patient’s short-term memory loss and cognitive function?

A

d. Ginkgo biloba extract

70
Q

Which protects individuals who have been successfully rehabilitated from substance abuse from discrimination related to past addiction?

A

a. Americans with Disabilities Act (ADA)

Pharm II (4 decks)

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