Pharm Ch. 1, 4, 5, 33, 34 Flashcards
A patient has a new medication prescription and the nurse is providing education about the drug. Which statement made by the patient would indicate the need for further medication education?
a. “I can consult my healthcare provider if I experience adverse effects.”
b. “If I take more, I’ll have a better response.”
c. “Taking this drug with food will decrease how much drug gets into my system.”
d. “The liquid form of the drug will absorb faster than the tablets.”
b. “If I take more, I’ll have a better response.”
A combination of two different antihypertensive drugs in lower doses has been ordered for a patient whose hypertension has not been controlled by standard doses of either drug alone. The nursing student recognizes the interaction between these two drugs is known as what term?
a. addition
b. synergism
c. antagonism
d. displacement
b. synergism
A patient with cirrhosis of the liver has hepatic impairment. This will require what possible changes? (SATA)
a. a reduction in the dosage of the drugs
b. a change in the timing of medication admin
c. an increased dose of prescribed drugs
d. giving all prescribed drugs by IM injection
e. more frequent monitoring for adverse drug effects
a. a reduction in the dosage of the drugs
b. a change in the timing of medication admin
e. more frequent monitoring for adverse drug effects
The patient requires a drug that is known to be completely metabolized by the first-pass effect. What change will be needed when this drug is administered?
a. the drug must be given more frequently
b. the drug must be given in a higher dose
c. the drug must be given in a lipid-soluble form
d. the drug must be given by a non-oral route, such as parenterally
d. the drug must be given by a non-oral route, such as parenterally
A patient who has acute kidney injury (AKI) may have diminished capacity to excrete medications. The nurse must assess the patient more frequently for what development?
a. increased risk of allergy
b. decreased therapeutic drug effects
c. increased risk for drug toxicity
d. increased absorption of the drug from the intestines
c. increased risk for drug toxicity
What is the rationale for the administration of a loading dose of a drug?
a. it decreases the number of doses that must be given
b. it results in lower dosages being required to achieve therapeutic effect
c. it decreases the risk of drug toxicity
d. it more rapidly builds plasma drug levels to a plateau level
d. it more rapidly builds plasma drug levels to a plateau level
A patient experiences profound drowsiness when a stimulant drug is given. This is an unusual reaction fo this drug, a reaction that has not been associated with this type of drug. What is the term for this type of drug reaction?
a. allergic reaction
b. idiosyncratic reaction
c. enzyme-specific reaction
d. unaltered reaction
b. idiosyncratic reaction
The provider has ordered atropine, a drug that will prevent the patient’s own chemical, acetylcholine, from causing parasympathetic effects. What type of drug would atropine be considered?
a. antagonist
b. partial agonist
c. agonist
d. protagonist
a. antagonist
A nursing student reads in a pharmacology textbook that 10mg of morphine is considered to provide the same pain relief as 200mg of codeine. This indicates that the morphine would be considered more _____ than codeine.
potent
What is the term used to describe the magnitude of maximal response that can be produced from a particular drug?
a. efficacy
b. toxicity
c. potency
d. comparability
a. efficacy
The nurse looks up butorphanol (Stadol) in a drug reference guide prior to administering the drug and notes that it is a partial agonist. What does this term tell the nurse about the drug?
a. it is a drug that produces the same type of response as the endogenous substance
b. it is a drug that will occupy a receptor and precent the endogenous chemical from acting
c. it is a drug that causes unpredictable and unexplained drug reactions
d. it is a drug that produces a weaker, or less efficacious, response than an agonist drug
d. it is a drug that produces a weaker, or less efficacious, response than an agonist drug
The nurse reads that the drug to be given to the patient has a “narrow therapeutic index.” The nurse knows that this means that the drug has what properties?
a. it has a narrow range of effectiveness and may not given this patient the desired therapeutic results
b. it has a narrow safety margin and even a small increase in dose may produce adverse or toxic effects
c. it has a narrow range of conditions or diseases that the drug will be expected to treat successfully
d. it has a narrow segment of the population for whom the drug will work as desired
b. it has a narrow safety margin and even a small increase in dose may produce adverse or toxic effects
A patient with a history of hypertension is to start drug therapy for rheumatoid arthritis. Which drugs would be contraindicated, or used cautiously, for this patient? (SATA)
a. aspirin
b. ibuprofen (Advil, Motrin)
c. acetaminophen (Tylenol)
d. naproxen (Aleve)
e. methylprednisolone (Medrol)
b. ibuprofen (Advil, Motril)
d. naproxen (Aleve)
e. methylprednisolone (Medrol)
The patient has been taking aspirin for several days for headache. During the assessment, the nurse discovers that the patient is experiencing ringing in the ears and dizziness. What is the most appropriate action by the nurse?
a. question the patient about history of sinus infections
b. determine whether the patient has mixed the aspirin with other medications
c. tell the patient not to take any more aspirin
d. tell the patient to take the aspirin with food or milk
c. tell the patient not to take any more aspirin
While educating the patient about hydrocortisone (Cortef), the nurse would instruct the patient to contact the healthcare provider immediately if which of the following occurs?
a. there is a decrease of 1kg (2lb) in weight
b. there is an increase in appetite
c. there is tearing of the eyes
d. there is any difficulty breathing
d. there is any difficulty breathing
The nurse is admitting a patient with rheumatoid arthritis. The patient has been taking prednisone for an extended time. During the assessment, the nurse observes that the patient has a very round moon-shaped face, bruising, and an abnormal contour of the shoulders. What does the nurse conclude based on these findings?
a. these are normal reactions with the illness
b. these are probably birth defects
c. these are symptoms of myasthenia graves
d. these are symptoms of adverse drug effects from the prednisone
d. these are symptoms of adverse drug effects from the prednisone
A 24yo patient reports taking acetaminophen (Tylenol) fairly regularly for headaches. The nurse knows that a patient who consumes excessive acetaminophen per day or regularly consumes alcoholic beverages should be observed for what adverse effect?
a. hepatoxicity
b. renal damage
c. thrombotic effect
d. pulmonary damage
a. hepatoxicity
The nurse is counseling a mother regarding antipyretic choices for her 8yo daughter. When asked why aspirin is not a good drug to use, what should the nurse tell the mother?
a. it is not as good an antipyretic as is acetaminophen
b. it may increase fever in children under age 10
c. it may produce nausea and vomiting
d. it increases the risk of Reye’s syndrome in children under 19 with viral infections
d. it increase the risk of Reye’s syndrome in children under 19 with viral infections
A 55yo female patient is receiving cyclosporine (Neoral, Sandimmune) after a heart transplant. The patient exhibits a WBC count of 12,000cells/mm^3, a sore throat, fatigue, and a low-grade fever. Which condition does the nurse suspect?
a. transplant rejection
b. heart failure
c. dehydration
d. infection
d. infection
Which statement by a patient who is taking cyclosporine (Neural, Sandimmune) would indicate the need for more teaching by the nurse?
a. “I will report any reduction in urine output to my healthcare provider.”
b. “I will wash my hands frequently.”
c. “I will take my blood pressure at home everyday.”
d. “I will take my cyclosporine at breakfast with a glass of grapefruit juice.”
d. “I will take my cyclosporine at breakfast with a glass of grapefruit juice.”
The nurse is evaluating drug effects in a patient who has been given interferon alfa-2b (Intron A) for hepatitis B and C. Which of the following is a common adverse effect?
a. depression and thoughts of suicide
b. flulike symptoms of fever, chills, or fatigue
c. edema hypotension, and tachycardia
d. hypertension, renal or hepatic insufficiency
b. flulike symptoms of fever, chills, or fatigue
The nurse would question an order for peginterferon alfa-2a (Pegasys) if the patient has which of the following conditions? (SATA)
a. pregnancy
b. kidney disease
c. hepatitis
d. liver disease
e. malignant melanoma
a. pregnancy
b. kidney disease
d. liver disease
A nurse is preparing to administer a hepatitis B vaccination to a patient. Which condition would cause the nurse to withhold the vaccination and check with the healthcare provider?
a. the patient smokes cigarettes, one pack a day
b. the patient is frightened by needles and injections
c. the patient is allergic to yeast and yeast products
d. the patient has hypertension
c. the patient is allergic to yeast and yeast products
A 5yo child is due for pre-kindergarten immunizations. After interviewing her mother, which response may indicate a possible contraindications for giving this preschooler a live vaccine at this visit and would require further exploration by the nurse?
a. her cousin has the flu
b. the mother has just finished her series of hep B vaccines
c. her arm became very sore after her last tetanus shot
d. they are caring for her grandmother who has just finished her second chemo treatment for breast cancer
d. they care caring for her grandmother who has just finished her second chemo treatment for breast cancer
