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Pharmacology > Final Exam > Flashcards

Final Exam Flashcards

1
Q

By which method do antiplatelet medications, such as clopidogrel (Plavix), work to prevent thrombus?

A

They inhibit platelet aggregation.

Antiplatelets are used to prevent thrombosis in the arteries by suppressing platelet aggregation. Antiplatelets prolong bleeding time.

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2
Q

The nurse understands that which of the following are the main uses of antiplatelet drug therapy?

A

Prevention of repeat myocardial infarction or stroke

Prevention of myocardial infarction for patients with familial history

Prevention of stroke in patients having TIAs (transient ischemic attacks)

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3
Q

In developing a discharge teaching plan, the nurse will teach that the initial intervention for a patient taking an anticoagulant who cuts himself or herself is to

A

Apply direct pressure with a clean cloth to the cut for 5–10 minutes.

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4
Q

The nurse assesses the patient who is taking enoxaparin. Which signs and symptoms should prompt the nurse to take further action?

A

Petechiae
Bruising
Hematuria

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5
Q

The nurse prepares to administer enoxaparin to a patient who is post-operative total knee replacement. How should the nurse administer the medication?

A

Deep subQ injection

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6
Q

Which statement BEST describes how Heparin works as an anticoagulant?

A

It enhances the activation of antihrombin III, which prevents the activation of thrombin and the conversion of fibrinogen to fibrin.

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7
Q

A patient is receiving Heparin IV for treatment of pulmonary emboli. The nurse would monitor all of the following labs:

A

Platelets
aPPT
Hemoglobin & Hematocrit

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8
Q

Which medication is associated with a risk of heparin induced thrombocytopenia (HIT)?

A

Enoxaparin (Lovenox)

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9
Q

The nurse knows that clopidogrel should be discontinued in the preoperative patient at what point in time?

A

5 days (up to a week before)

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10
Q

A patient is to be discharged with a transdermal nitroglycerin patch. Which instruction should the nurse include in the patient’s teaching plan?

A

“Apply the patch to a non-hairy area of the upper torso or arm.”

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11
Q

A nurse is monitoring a patient with angina for therapeutic effects of nitroglycerin. Which assessment finding indicates that the nitroglycerin has been effective?

A

Patient stating that pain is 0 out of 10

The patient taking nitroglycerin should expect the therapeutic effect of absence of chest pain.

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12
Q

The nurse is monitoring a patient during IV nitroglycerin infusion. Which assessment finding warrants nursing action?

A

Chest pain

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13
Q

Which statement made by the patient demonstrates a need for additional instruction from the nurse regarding the use of nitroglycerin?

A

“I can take up to five tablets at 3-minute intervals for chest pain if necessary.”

Patients are taught to take up to three tablets every 5 min. If no relief from chest pain is obtained after one tablet, they should seek medical assistance and take up to two more tablets.

“If I get a headache, I should keep taking nitroglycerin and use Tylenol for pain relief.”
“I should change positions slowly to avoid getting dizzy.”
“I should keep my nitroglycerin in a cool, dry place.”

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14
Q

Which patient assessment would assist the nurse in evaluating therapeutic effects of a calcium channel blocker?

A

Absence of chest pain.

The workload in the heart should be decreased with the vasodilation from the calcium channel blocker. With less strain, the patient should have fewer incidences of angina as afterload is decreased.

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15
Q

Before the nurse administers isosorbide dinitrate, what is a priority nursing assessment?

A

Assess blood pressure

Isosorbide dinitrate is a vasodilator and thus can cause hypotension. It is important to assess blood pressure before administering.

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16
Q

The patient asks the nurse how nitroglycerin should be stored while traveling. What is the nurse’s best response?

A

“It’s best to keep it in its original container away from heat and light.”

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17
Q

Which statement indicates to the nurse that the patient understands sublingual nitroglycerin medication instructions?

A

“I should sit or lie down after I take a nitroglycerin tablet to prevent dizziness.”

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18
Q

What instruction should the nurse provide to the patient who needs to apply nitroglycerin ointment?

A

Apply the ointment to a non-hairy part of the upper torso.

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19
Q

A patient receiving intravenous nitroglycerin at 20 mcg/min complains of dizziness. Nursing assessment reveals a blood pressure of 85/40 mm Hg, heart rate of 110 beats/min, and respiratory rate of 16 breaths/min. What is the nurse’s priority action?

A

Decrease the intravenous nitroglycerin by 10 mcg/min.

Nitroglycerin, as a vasodilator, causes a decrease in blood pressure. Because it is short-acting, decreasing the infusion rate will allow the blood pressure to rise. The patient should be monitored every 10 min while changing the rate of the intravenous nitroglycerin infusion

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20
Q

A patient’s serum digoxin level is noted to be 0.4 ng/mL. What is the nurse’s priority action?

A

Administer ordered dose of digoxin.

Therapeutic serum digoxin levels are 0.8–2 ng/mL. The patient should receive the next dose to bring the level into therapeutic range.

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21
Q

A patient is taking digoxin 0.25 mg and furosemide 40 mg. The patient tells the nurse, there are yellow halos around the lights. Which priority action will the nurse take?

A

Evaluate digoxin levels.

Seeing yellow or green halos around lights is a symptom of digoxin toxicity. The nurse should evaluate the patient’s digoxin levels.

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22
Q

Which assessment finding will alert the nurse to suspect early digitalis toxicity?

A

Loss of appetite with slight bradycardia

Early symptoms of digitalis toxicity include anorexia, nausea and vomiting, and bradycardia.

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23
Q

A patient is being treated for short-term management of heart failure with milrinone. What is the primary nursing action?

A

Monitor cardiac rhythm and blood pressure continuously.

Milrinone lactate is a phosphodiesterase inhibitor administered intravenously for short-term treatment in patients with heart failure not responding adequately to digoxin, diuretics, or other vasodilators. Blood pressure and heart rate should be closely monitored.

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24
Q

A nurse is caring for a patient who has been started on ibutilide. Which assessment is a priority for this patient?

A

ECG and palpitations

Ibutilide is specifically indicated for treatment of recent-onset atrial fibrillation and flutter. It is important for the nurse to obtain an ECG to see if the patient has converted to sinus rhythm and to watch for palpitations.

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25
Q

When titrating intravenous nitroglycerin for a patient, what is most important for the nurse to monitor?

A

Presence of chest pain
Continuous blood pressure

Intravenous nitroglycerin can cause hypotension and tachycardia.

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26
Q

An oral anticoagulant that antagonizes vitamin K to prevent synthesis of four coagulation factors.

A

Warfarin (Coumadin)

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27
Q

Which anticoagulant requires monitoring for PT and INR

A

Warfarin

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28
Q

Medications that attack and dissolve existing clots, typically end in “plase”, such as alteplase.

A

Thrombolytics

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29
Q

A selective Factor Xa inhibitor that prevents clot formation, used for DVT, PE, and atrial fibrillation.

A

Apixaban (Eliquis)

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30
Q

A parenteral anticoagulant that inactivates thrombin, affecting clotting cascade. Must be given subcutaneously or via IV.

A

Heparin

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31
Q

Which medication requires monitoring of aPTT?

A

Heparin

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32
Q

Medications that prevent platelet aggregation, such as clopidogrel and aspirin, used to prevent arterial thrombosis

A

Antiplatelets

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33
Q

INR therapeutic range

A

2-3 for patients on warfarin therapy

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34
Q

An antiplatelet agent that prevents platelet aggregation, may be prescribed with aspirin

A

Clopidogrel (Plavix)

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35
Q

A thrombolytic medication that converts plasminogen to plasmin, used within 3-4 hours of MI or 3 hours for thrombotic stroke.

A

Alteplase (aPA)

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36
Q

An aspirin toxicity that is a medical emergency requiring activated charcoal, IV fluids, and possible gastric lavage.

A

Salicylism

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37
Q

The reversal agent for factor Xa inhibitors like apixabian.

A

Andexxa

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38
Q

A low molecular weight heparin that inactivates Xa factor, used for prophylaxis of AMI, thrombosis, and treatment of PE and DVT

A

Enoxaparin (Lovenox)

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39
Q

What is a clot formation in the blood vessel called?

A

Thrombus

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40
Q

What is PE?

A

Pulmonary embolism, a condition where a blood clot travels to the lungs, requires anticoagulant treatment.

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41
Q

What is the antidote for warfarin?

A

Vitamin K, takes 24-48 hours to be effective.

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42
Q

What is the antidote used for heparin and enoxaparin overdose?

A

Protamine sulfate

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43
Q

What are the EGGGOS?

A

Supplements to avoid with anticoagulants:
Vitamin E, Gingko biloba, Ginseng, Garlic, Omega 3, St. John’s wort

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44
Q

Antiplatelet medication that inhibits COX-1 & 2, prostaglandin synthesis, and platelet aggregation.

A

Aspirin

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45
Q

Medications that prevent clot formation, such as heparin, enoxaparin, warfarin, and apixaban.

A

Anticoagulants

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46
Q

What are NOACs/DOACs?

A

Novel/Direct-acting oral anticoagulants that do not require routine coagulation monitoring and have a wide therapeutic window.

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47
Q

A dislodged clot that moves through the bloodstream.

A

Embolus

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48
Q

When should heparin therapy be stopped based on platelet count?

A

Below 100,000

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49
Q

What is the recommended time window for administering alteplase (tPA) following a thrombolytic stroke?

A

Within 3 hours

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50
Q

What is the mechanism of action for heparin?

A

Inactivates thrombin, affecting clotting cascade, preventing clot formation.

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51
Q

Which medication is selective Factor Xa inhibitor?

A

Apixaban

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52
Q

Which anticoagulant is contraindicated during pregnancy?

A

Warfarin

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53
Q

What is the primary difference between a thrombus and an embolus?

A

An embolus of a dislodged clot moving through the bloodstream

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54
Q

What is the antidote for heparin?

A

Protamine sulfate

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55
Q

Any deviation from the normal rate or pattern of heartbeat, including rhythms that are too slow, too fast, or irregular.

A

Dysrhythmias

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56
Q

Medications that block the conversion of angiotensin I to angiotensin II and decrease levels of bradykinin, used to teat hypertension and heart failure.

A

ACE inhibitors

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57
Q

A type of lipoprotein that can contribute to plaque build up in arteries, often referred to as bad cholesterol.

A

LDL (low density lipoprotein)

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58
Q

Drugs that increases the force of heart muscle contraction

A

Positive Inotropic Agents

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59
Q

A medication that slows impulse conduction through AV nodes to restore normal sinus rhythm, primarily used to paroxysmal supraventricular tachycardia.

A

Adenosine

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60
Q

Medications that block beta receptors in the myocardium and electrical conduction system of the heart, used to treat hypertension, heart attack, and angina.

A

Beta Blockers

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61
Q

Consistent elevation of systemic arterial blood pressure that requires early intervention to reduce cardiovascular mortality.

A

Hypertension

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62
Q

An HMG-CoA reductase inhibitor used to treat hypercholesterolemia and atherosclerosis by inhibiting cholesterol production.

A

Atorvastatin (Lipitor)

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63
Q

A condition characterized by elevated levels of lipids in the blood, including cholesterol, triglycerides, phospholipids, and steroids.

A

Hyperlipidemia

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64
Q

Medications that inhibit calcium influx across myocardial and vascular smooth muscle cell membranes, used to treat hypertension and angina.

A

Calcium Channel Blockers

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65
Q

A condition where ventricles cannot pump enough blood for bodys needs, caused by weakening of the heart muscle due to aging or disease.

A

Heart Failure

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66
Q

A class III antiarrhythmic that increases the refractory period and prolongs action potential duration, used for life-threatening ventricular tachycardia and fibrillation.

A

Amiodarone

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67
Q

A nitrate medication that dilates veins and decreases preload to reduce cardiac oxygen demand and prevent/reduce coronary artery spasms.

A

Nitroglycerin

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68
Q

A type of protein that helps remove cholesterol from the bloodstream, often referred to as good cholesterol.

A

HDL (high density lipoprotein)

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69
Q

Chest pain caused by inadequate blood flow to the myocardium due to either plaque build up or spasms of the coronary arteries.

A

Angina Pectoris

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70
Q

A cardiac glycoside that increases force and efficiency of myocardial contraction and decreases heart rate, used as a second-line treatment for heart failure.

A

Digoxin (Lanoxin)

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71
Q

A serious condition with symptoms including anorexia, nausea, vomiting, vision changes, and bradycardia, occurring when digoxin levels exceed therapeutic range of 0.8-2 ng/mL

A

Digoxin Toxicity

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72
Q

An ACE inhibitor that treats hypertension and heart failure by blocking the conversion of angiotensin I to angiotensin II.

A

Lisinopril

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73
Q

A form of angina that occurs more frequently with progressive severity unrelated to activity and is unpredictable, often indicating an impending MI

A

Unstable angina

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74
Q

Mechanism that facilitate or impair the circulation of blood, ranging from optimal ro no perfusion (tissue/cellular ischemia)

A

Perfusion

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75
Q

Which population may not respond well to beta blockers alone for hypertension?

A

African American patients

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76
Q

Which population may not respond well to beta blockers alone for hypertension?

A

African American patients

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77
Q

What is the therapeutic level range for digoxin?

A

0.8-2 ng/mL

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78
Q

What is the half-life of andenosine?

A

Less than 5 seconds

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79
Q

What is the maximum number of sublingual nitroglycerin tablets that should be taken during an angina attack?

A

3 tablets

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80
Q

Which medication requires protection from light during administration?

A

Nitroprusside

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81
Q

What is the primary MOA of ACE inhibitors like lisinopril?

A

Blocks conversion of angiotensin I to II

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82
Q

Which drug class does atorvastatin (Lipitor) belong to?

A

HMG-CoA reductase inhibitors

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83
Q

What is one of the side effects of digoxin?

A

Yellow-green halos around objects.

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84
Q

What is a contraindication for calcium channel blockers?

A

Heart block

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85
Q

How should amiodarone be used due to its toxicity risk?

A

Only for life-threatening arrhythmias

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86
Q

Which potassium level should be maintained for patients on digoxin?

A

3.5-5.0 mEq/L

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87
Q

What is a characteristic of unstable angina?

A

Progressive severity unrelated to activity

88
Q

Which condition is a contraindication for beta blockers?

A

Asthma

89
Q

What should be monitored when administering lidocaine?

A

EKG

90
Q

What is the MOA of nitroprusside?

A

Stimulates smooth muscle of veins and arteries

91
Q

Which medication should be avoided with grapefruit juice?

A

Diltiazem

92
Q

What type of angina occurs during rest?

A

Variant angina

93
Q

What is the primary use of sacubitril/valsartan (Entresto)?

A

Heart failure

94
Q

What is a side effect of atropine?

A

Dry mouth

95
Q

How long should a patient wait between sublingual nitroglycerin doses?

A

5 minutes

96
Q

A medical emergency characterized by continuous seizure activity or repeated seizures without recovery of consciousness between episodes.

A

Status epilepticus

97
Q

Condition characterized by dizziness, headache, sweating, agitation, fever, requiring removal of offending agent and symptomatic treatment.

A

Serotonin syndrome

98
Q

Progressive loss of brain function characterized by decline in ADLs, cognitive abilities, & behavior changes; associated with plaques & tangles in hippocampus and acetylcholine deficiency.

A

Alzheimer’s disease

99
Q

Conventional antipsychotics that only treat positive symptoms, have more side effects but less expensive. Can be divided into phenothiazines and non-phenothiazines

A

First generation (typical) Antipsychotics

100
Q

Mood stabilizer that works by alteration of ion transport in muscle & nerve cells; used for bipolar disorder and maniac episodes; requires careful monitoring of blood levels.

A

Lithium Carbonate

101
Q

Usually first line treatment, more effective with fewer side effects. Treat both, positive and negative symptoms and help with cognitive symptoms.

A

Second generation (atypical) antipsychotics

102
Q

Chronic, recurring illness characterized by unusual shifts from mania to depression; includes bipolar I & II and cyclothymic disorder

A

Bipolar disorder

103
Q

Hydrantoin anticonvulsant that delays sodium influx into neurons; used for tonic-clonic/partial seizures and status epilepticus; requires careful monitoring of therapeutic levels

A

Phenytoin (Dilantin)

104
Q

Involuntary muscle movement caused by blockage of D2 receptors; includes acute dystonia, akathisia, pseudoparkinsonism, and tardive dyskinesia

A

Extrapyramidal Symptoms (EPS)

105
Q

Antidepressants that selectively block reuptake of serotonin; first-line treatment for depression with fewer side effects than older medications

A

SSRIs (Selective Serotonin Reuptake Inhibitors)

106
Q

Altered cognition, perception, and/or impaired ability to determine what is/isn’t real; may be seen in various psychiatric disorders including schizophrenia and bipolar I mania.

A

Psychosis

107
Q

CNS stimulants that stimulate release and block reuptake of norepinephrine & dopamine; used for ADHD and narcolepsy.

A

Methylphenidate/amphetamines

108
Q

Second generation antipsychotic that blocks mainly serotonin and dopamine; used for schizophrenia, bipolar disorders, and impulse control disorders.

A

Risperidone (Risperdal)

109
Q

First gen. Antipsychotic that alters effect of dopamine on the CNS; used for psychotic disorders and agitation; takes 2-6 weeks to become effective.

A

Haloperidol (Haldol)

110
Q

Most common mental illness characterized by mood changes and loss of interest; symptoms include anhedonia, anergia, SI, weight changes, sleep disturbances, inability to think/concentrate.

A

Depression

111
Q

Abnormal uncontrolled electric discharges from neurons in the brain characterized by loss or disturbance of consciousness and unusually involuntary, uncontrolled movement.

A

Seizures

112
Q

Sudden high grade fever, BP fluctuations, disrhythmias, muscle rigidity, diaphoresis, tachycardia, change in LOC developing to coma; considered an emergency.

A

Neuroleptic Malignant syndrome

113
Q

Characterized by inappropriate degree of inattention, impulsiveness, & hyperactivity; symptoms present before age 7 but may go unnoticed until adulthood.

A

ADHD

114
Q

Treatment dependent on type of seizure, patient’s history/diagnostic studies, and associated pathogens; usually starts with low initial dose and gradually increases.

A

Antiepileptic drug therapy

115
Q

Antidepressants that block MAO enzymes in the brain increasing the amount of NE, dopamine, serotonin, & tyramine; last choice drug due to many interactions.

A

MAOIs (Monoamine Oxidase Inhibitors)

116
Q

What is the primary MOA for second generation (atypical) antipsychotics?

A

Block mainly serotonin and less dopamine than 1st generation

117
Q

What is a sign of tardive dyskinesia?

A

Involuntary movements of tongue and face

118
Q

What is a nursing consideration for patients on antipsychotics?

A

Monitor EPS and NMS

119
Q

How long does it typically take to see initial effects of antidepressants?

A

1-3 weeks

120
Q

Which antidepressant class should not be administered within 14 days of an MAOI?

A

Any antidepressant

121
Q

What is a characteristic of 1st generation (typical) antipsychotic?

A

They only treat positive symptoms

122
Q

What is the MOA for lithium?

A

Alteration of ion transport in muscle and nerve cells

123
Q

What is the main slide effect concern with MAOIs?

A

Hypertensive crisis

124
Q

What is a potentially serious complication of antipsychotic medication?

A

Neuroleptic malignant syndrome

125
Q

What is the therapeutic blood level range for lithium?

A

0.8-1.2 mEq/L

126
Q

How should lithium levels be monitored initially?

A

Every 2-3 days until therapeutic level obtained

127
Q

What is a characteristic of 2nd generation antipsychotic?

A

They treat both positive and negative symptoms

128
Q

How long should antidepressant therapy typically continue after resolution of symptoms?

A

6 months

129
Q

What is the primary use of benztropine (Congentin)?

A

Relief of Parkinson’s symptoms and drug-induced Parkinsonism

130
Q

What is the primary mechanism for antiseizure medications?

A

Suppress neuronal activity

131
Q

What is the MOA for CNS stimulants used in ADHD?

A

Stimulate release and block reuptake for norepinephrine and dopamine

132
Q

What is the main concern with using antidepressants in patients under 25 years?

A

Increased risk of suicide.

133
Q

What is a common side effect of risperidone?

A

Metabolic effects

134
Q

What is a sign of serotonin syndrome?

A

Agitation and fever

135
Q

What is the therapeutic use of donepezil (Aricept)?

A

Alzheimer’s disease

136
Q

What is a side effect of clopidogrel (Plavix)?

A

Thrombocytopenia

137
Q

What should patients avoid while taking anticoagulants?

A

Foods high in vitamin K

138
Q

What is the reversal agent for apixaban?

A

Andexxa

139
Q

What type of monitoring is required for apixaban?

A

No routine coagulation monitoring

140
Q

What is a characteristic of low molecular weight Heparin?

A

More stable and requires less lab testing.

141
Q

How long does it take for warfarin to take full effect?

A

3-5 days

142
Q

What is the maximum recommended dose for alteplase?

A

90 mg

143
Q

Which medication class is typically used to prevent arterial thrombosis?

A

Antiplatelets

144
Q

What is an advantage of enoxaparin over standard heparin?

A

Decrease incidence of thrombocytopenia

145
Q

What is a contraindication of alteplase?

A

Active bleeding
Recent surgery within 2 weeks
Head trauma
Uncontrolled hypertension

146
Q

What are the 6 rights of medication?

A

Right reason/indication
Right time
Right route
Right patient
Right medication
Right dose

147
Q

What is the nursing process?

A

Concept
Assessment (recognize cues)
Analysis (Analyze cues and prioritize hypothesis)
Planning (generate solutions)
Interventions (take action)
Evaluation

148
Q

What is the first pass effect?

A

Drugs are absorbed from the GI tract and carried to the liver through the portal circulation

149
Q

What is half-life?

A

The time it takes for the amount of the drug in the body to be reduced by half

150
Q

For pharmacodynamics what does agonist/antagonist drugs do?

A

Agonist drugs activate an action
Antagonist drugs blocks an action

151
Q

What is a trough/peak?

A

A trough is a lab level drawn prior to a dose of a medication.
A peak is a lab level drawn after the medication is administered.

152
Q

What is a loading dose?

A

A loading dose is an initial dose of medication administered to rapidly achieve therapeutic levels

153
Q

What is true about polypharmacy?

A

Older adults are at a higher risk
Having multiple physicians is a risk factor
Is a common cause of medication interactions

154
Q

what is the reversal agent for acetaminophen?

A

Acetylcysteine

155
Q

What does tolerance mean?

A

Is a person’s response to a drug, which occurs when the drug is used repeatedly and the body adapts to the continued presence of the drug.

156
Q

What is a contradiction for the use of NSAIDs?

A

Gastric ulcers

157
Q

Levodopa/carbidopa is the cure for Parkinson’s Disease

A

False
It is a treatment, PD has no cure.

158
Q

What is true regarding benzodiazepines?

A

The reversal agent is flumazenil
It is a schedule IV drug
They can cause anticholinergic effects

159
Q

What is a side effect of timolol (Timoptic)?

A

eye stinging
bronchoconstriction
bradycardia

160
Q

Atropine can cause anticholinergic effects

A

True

161
Q

Which medication does not interact with omeprazole (Prilosec)?

A

Amoxicillin

The following medications interact with it:
Warfarin
Sucralfate
Phenytoin

162
Q

Which medications are used to treat constipation?

A

Psylium mucilloid
lactulose (Cephulac)
docusate (Colace)

163
Q

When mixing insulin, clear should be drawn up before cloudy.

A

True

164
Q

Which lab values are expected in hyperthyroidism?

A

High T3 & T4, Low TSH

165
Q

Which lab values are expected in hypothyroidism?

A

Low T3 & T4, high TSH

166
Q

What is the onset of regular insulin?

A

30 min

167
Q

Electrolyte imbalances that can be caused by furosemide & HTZ?

A

Hypokalemia
hyponatremia
Hyperglycemia

168
Q

Potassium chloride should be administered IV push/bolus.

A

False

169
Q

Which medication is used to abort an acute asthma exacerbation?

A

Abluterol

170
Q

What is true about fluticasone (Flonase)?

A

The medications takes 7-21 days to reach therapeutic effects

171
Q

At what age can a patient begin to receive the intranasal influenza vaccine?

A

2 years to 49 years

172
Q

Which is true about amoxicillin?

A

This medication can cause diarrhea

173
Q

Which drugs can cause a disulfiram-like reaction?

A

cephazolin
trimethoprim-sulfamethoxazole
glyburide

174
Q

What is true is isoniazid (INH)?

A

It can cause GI distress

175
Q

What is true about aspirin?

A

It should be taken with food
Monitor BUN/Creatinine
Tinnitus, dizziness, and sweating may indicate overdose

176
Q

What are DMARDs used for?

A

inflammatory diseases

177
Q

What does Epoetin alfa increase?

A

Red blood cells

178
Q

Which medication increases uterine contraction frequency and strength?

A

oxytocin

179
Q

Missing one dose of a combined hormonal contraception pill makes it ineffective.

A

False

180
Q

PT and INR is measured when taking warfarin

A

True

181
Q

Pregnancy is contraindicated in which drug

A

Warfarin

182
Q

Bleeding precautions include all the following

A

No aspirin
Protecting from injury
Using elecric razor to shave
Decreasing needle sticks

183
Q

How long before surgery should a client stop taking an anticoagulant?

A

5-7 days

184
Q

Which VS is priority for a patient receiving digoxin?

A

HR

185
Q

Which class of drugs is contraindicated in asthma patients?

A

Beta blockers

186
Q

Atorvastatin breaks down existing cholesterol

A

False

187
Q

Clients using a transdermal nitroglycerin should be medication-free for how long?

A

12-14 hours

188
Q

The risk of digoxin toxicity increases as potassium

A

Decreases

189
Q

Which two dose-related complications are associated with atorvastatin?

A

hepatotoxicity
muscle breakdown

190
Q

Which medication is most likely to cause cough?

A

Lisinopril

191
Q

Which medication is most likely to cause bradycardia?

A

propranolol

192
Q

What are signs of serotonin syndrome?

A

Agitation
Tachycardia
fever
diaphoresis

193
Q

Which labs should be monitored for long term use of lithium?

A

TSH, T3, T4
BUN/Cr

194
Q

Clients on MAOIs should avoid:

A

tyramine

195
Q

Second/third generation antipsychotics are most likely to cause:

A

Metabolic syndrome

196
Q

AEDs should be given at the same time everyday.

A

True

197
Q

What is the therapeutic range for phenytoin?

A

10-20 mcg/mL

198
Q

Which medication can cause gingival hyperplasia?

A

Phenytoin

199
Q

If a client gets a rash while taking lamotrigine (Lamictal) we should suspect Steven Johnson’s Syndrome

A

True

200
Q

How long must a patient be seizure-free before the HCP may consider discontinuing AEDs?

A

3-5 years

201
Q

Anti-epileptic drugs cause CNS depression

A

True

202
Q

Donepezil causes which symptoms?

A

Rest and digest

203
Q

Which statement best describes clopidogrel?

A

It can be used together with aspirin after myocardial infarction (MI) or cerebrovascular accident (CVA) to prevent platelet aggregation

204
Q

A patient on warfarin has an international normalized ratio (INR) of 10.3 seconds. Which drug would the nurse prepare to administer?

A

Vitamin K (phytonadione) is the antidote for warfarin

205
Q

Which patient would be a candidate for anticoagulant?

A

A patient with deep vein thrombosis (DVT)
A patient with an artificial heart valve
A patient with cerebrovascular accident (CVA)

206
Q

The nurse has several patients receiving warfarin. Which international normalized ratio (INR) would concern the nurse?

A

1.2, 1.4, & 1,8.

The normal range levels are 2-3

207
Q

A nurse is caring for a client who has a new prescription for lisinopril (Zestril) for hypertension. The nurse should monitor the client for which of the following as an adverse effect of this medication?

A

Hyperkalemia

Other SE
Cough
Angioedema

208
Q

Angiotensin II-receptor blockers (ARBs) may be prescribed for patients with hypertension instead of an angiotensin-converting enzyme (ACE) inhibitor. Which factor is the most limiting in the use of ACE inhibitors?

A

Coughing

209
Q

A nurse in a provider’s office is monitoring blood electrolytes for four clients who take digoxin. Which of the following electrolyte values increases a client’s risk for digoxin toxicity?

A

Potassium 3.4 mEq/mL

The risk for digoxin toxicity increases as the potassium decreases.

210
Q

A nurse is teaching a client who has angina pectoris and is learning how to treat acute anginal attacks. The clients asks, “What is my next step if I take one tablet, wait 5 minutes, but still have anginal pain?” Which of the following responses should the nurse make?

A

“Call 911”

211
Q

A nurse is assessing a client who is currently taking perphenazine. Which of the following findings should the nurse identify as an extrapyramidal symptom (EPS)?

A

Facial grimacing
Involuntary arm movements
Continual pacing

212
Q

A nurse is providing discharge teaching for a client who has schizophrenia and a new prescription for risperidone (Risperdal). Which of the following client statements indicates an understanding of the teaching?

A

“I will be careful not to gain too much weight while taking this medication.”

213
Q

A nurse is providing teaching to a client who has a new prescription for amitriptyline (Elavil).
Which of the following statements by the client indicates an understanding of the teaching?

A

“I may feel drowsy for a few weeks after starting this medication.”

214
Q

A nurse is caring for a client who is to begin taking sertraline (Zoloft) for treatment of panic disorder. Which of the following statements indicates the client understands the use of this medication?

A

“I will need to discontinue this medication slowly.”

215
Q

A nurse is admitting a client who has a new diagnosis of bipolar disorder and is scheduled to begin lithium therapy. When collecting a medical history from the client’s caregiver, which of the following statements is the priority to report to the provider?

A

“Current medications include furosemide for congestive heart failure.”

Due to the sodium

216
Q

A nurse is caring for a school-age child who has conduct disorder and a new prescription for methylphenidate (Ritalin). Which of the following information should the nurse provide about the medication?

A

Caffeine should be avoided while on this drug
Nervousness and tremors may occur
The medication should be taken before meals

Pharmacology (7 decks)

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