Final Exam Review Flashcards
What are disadvantages of over-the-counter (OTC) medications? Select all that apply.
A.Inaccurate self-diagnosis
B.Development of adverse drug reactions and interactions
C.Few visits to the pharmacy to obtain the medication
D.Cost to consumers is not reimbursed by insurance companies
E.Earlier resumption of activities of daily living
Answer: A, B, D
DISADVANTAGES
E is an advantage of taking OTC meds
After teaching a student about the Food and Drug Administration (FDA) related to drugs, the nurse recognizes that the information was understood when the student identifies which responsibilities as being that of the FDA?
A.Regulating credentials for prescribers.
B.Setting standards for efficacy and safety.
C.Enforcing the control of substances with high abuse potential.
D.Determining national priorities for drug research and development.
Answer: B
C - DEA
What are the four processes involved in the pharmacokinetics of a medication? Select all that apply.
A.Excretion
B.Lipid solubility
C.Absorption
D.Metabolism
E.Distribution
F.Half-life
Answer: A, C, D, E
Which variables can affect drug absorption? Select all that apply.
A.Liver function
B.Blood flow to site of administration
C.Protein-binding of drugs
D.Route of administration
E.Presence of receptor agonists
Answer: B, D
Drug absorption - key; from outside to inside
Liver func - affects metabolism
Poor blood flow not absorped as well
Protein-binding - affects distribution
Route - affect drug absorption: oral v IV: think first pass effect
Presence of receptor agonists - affects distribution
The serum lithium levels of a client with bipolar disorder have risen to the minimum level required to have a therapeutic effect. What is the term used to indicate this client’s serum lithium levels have been achieved?
A.Critical concentration
B.Dynamic equilibrium
C.Half-life
D.Active transport
Answer: A
Critical concentration (MEC) - enough medication to have an effect; enough have therapeutic effect
Dynamic equilibrium - steady state of drug to have continued effect; consider processes of pharmacokinetics so stay in therapeutic window
The caregiver of client describes the client as having Alzheimer’s disease for 20 years and is currently in the late stage of the disease. The caregiver asks the nurse if the client can go back on the medication donepezil. Which response by the nurse is appropriate?
A.“Let me discuss your concerns with the prescriber.”
B.“A newer drug that has recently been developed is galantamine.”
C.“The drug is best used early as it slows the progression of AD.”
D.“Donepezil has had research studies findings suggestive of curing of AD.”
Answer: C
Most effective early on because more functioning neurons; target keeping more AcH in synaptic cleft so more functioning neurons the better
A client is prescribed levofloxacin. Which should be included in the client’s teaching? Select all that apply.
A.Report new fever to the prescriber
B.Report diarrhea to the prescriber
C.Report changes in heart rate to the prescriber
D.Report increased appetite to the prescriber
E.Report creamy white, lace like patches on the tongue, mouth, or throat to the prescriber.
Answer: A, B, C, E
Diarrhea is an AE - know about this because assess for potential for C.diff
E - manifestations of superinfection
A client is experiencing intense nausea while being treated with antineoplastic drugs. What action should the nurse perform?
A.Provide the client with a low-residue diet
B.Administer antacids as prescribed, 30 minutes before meals
C.Offer mouth rinses every 4 hours
D.Provide the client with small, frequent meals
Answer: D
Having lot nausea - not want overfill stomach to where cannot tolerate; give smaller meals to where can tolerate it better; keep smaller than larger
B - antacids after the fact; antiemetics - 30-60 mins before chemo then ATC after
Lot interventions for AE - stomatitis, mucositis: blood cells being effected
Which client would be most likely to benefit from the administration of epoetin alfa?
A.A client with anemia due to bone marrow suppression
B.A client with hemorrhage after abdominal surgery
C.A client diagnosed with iron deficient anemia
D.A client with a severe folic acid deficiency
Answer: A
EPO - stimulates RBC in bone marrow; time for bone marrow to stim
A nurse is providing education to a client prescribed lisinopril. Which statements should be included? Select all that apply.
A.“A decrease of blood pressure is expected.”
B.“If you develop a cough, call the prescriber.”
C.“You can be expected to urinate more frequently.”
D.“Decreased heart rate warrants a call to the prescriber.”
E.“Your diabetes medication will interfere with the effectiveness of lisinopril.”
Answer: A, B
ACE inhibitor for high blood pressure; get dry cough with it
Agioedemal, cough, elevated edema
C - not diuretic, HCTZ
D - ACE inhibitor not directly affect HR
E - no direct interaction between the two meds;
Which outcome is most important for a client recently diagnosed with hypertension?
A.verbalization of an understanding of medical regimen
B.compliance with antihypertensive medications
C.multiple diastolic blood pressure readings < 90 mm Hg
D.compliance with a low-sodium diet
Answer: C
PRIORITY; GOAL
A, B, D - should occur - help get to goal
C - most imp outcome and other 3 help get there
The use of a sympathomimetic would be contraindicated or used with great caution in clients with what disorders? Select all that apply.
A.Hypothyroidism
B.Cardiac disease
C.Kidney disease
D.Diabetes mellitus
E.Peripheral vascular disease
Answer: B, D, E
Increase HR, BP - increase strain on heart
Increase BG
Lower HR and BP with hypothyroidism - not sympathomimetic; not for hyperthyroidism
The nurse is reviewing a medication list for a client. What combination of medications should the nurse be most concerned about?
A.Metoprolol, lisinopril, hydrochlorothiazide
B.Lispro, glargine, prednisone
C.Polyethylene glycol, docusate, bisacodyl
D.Diazepam, oxycodone, baclofen
Answer: D
Benzo - CNS and resp depression; baclofen - cause CNS depression; oxy - CNS and resp depression
The nurse is caring for a client who has just been diagnosed with a deep vein thrombosis (DVT) of the lower extremity. Which medication should the nurse expect the primary care provider to prescribe?
A.Aspirin
B.Enoxaparin
C.Alteplase
D.Clopidogrel
Answer: B
LMWH - treatment for DVT - inhibits action of clotting cascade - clot not get bigger and not propagate
Alteplase - PE, CVA
The nurse is preparing to administer oral haloperidol to a client. The nurse should monitor for which adverse effects? Select all that apply.
A.Sedation
B.Dystonia
C.Vomiting
D.Hypertension
E.Insomnia
F.Dry mouth
Answer; A, B, F
GI effects not major for antipsychotics - cause EPS and anticholinergic and sedation
