Pharm ?s

Question 1

Which action by the nurse is most important when caring for a patient with CKD who has an order for furosemide (Lasix)?

a. assess urine output and renal lab values for signs of nephrotoxicity
b. check the spec gravity of urine daily
c. eliminate potassium rich foods from the diet
d. encourage patient to void q4hrs

Answer 1

a. assess urine output and renal lab values for signs of nephrotoxicity

Question 2

The patient admitted for heart failure has been receiving hydrochlorothiazide (Microzide). Which lab values should the nurse carefully monitor? (SATA)

a. platelet count
b. WBC
c. potassium
d. sodium
e. uric acid

Answer 2

c, d, e

c. potassium
d. sodium
e. uric acid

Question 3

Which of the following clinical manifestations may indicate that the patient taking metolazone (Zaroxolyn) is experiencing hypokalemia?

a. HTN
b. polydipsia
c. cardiac dysrhythmias
d. skin rash

Answer 3

c. cardiac dysrhythmias

Question 4

The nurse is providing teaching to a patient who has been prescribe furosemide (Lasix). Which of the following should the nurse teach the patient?

a. avoid consuming lg amounts of kale, cauliflower, or cabbage
b. rise slowly from a lying/sitting position to standing
c. count the pulse for one full minute before taking this medication
d. restrict fluid intake to no more than 1L per 24hr period

Answer 4

b. rise slowly from a lying/sitting position to standing

Question 5

While planning for a patient’s discharge from the hospital, which teaching points would be included for a patient going home with a prescription for chlorothiazide (Diuril)?

a. ↑ fluid/salt intake to make up for the loss caused by the drug
b. ↑ intake of vitamin C rich foods, such as grapefruit/oranges
c. report muscle cramping or weakness to the healthcare provider
d. take the drug at night bc it may cause drowsiness

Answer 5

c. report muscle cramping or weakness to the healthcare provider

Question 6

A patient with a history of heart failure will be started on spironolactone (Aldactone). Which drug group should not be used, or used with extreme caution in patients taking potassium-sparing diuretics?

a. NSAIDs
b. corticosteroids
c. loop diuretics
d. ACE inhibitors or ARBs

Answer 6

d. ACE inhibitors or ARBs

Question 7

A women reports using OTC aluminum hydroxide (AlternaGEL) for relief of gastric upset. She is on renal dialysis three times a week. What should the nurse teach this patient?

a. continue using the antacids but if she needs to continue them beyond a few months, she should consult the healthcare provider about different therapies
b. take the antacid no longer than for 2wks, if it has not worked by then, it will not be effective
c. consult with the healthcare provider about the appropriate amount and type of antacid
d. continue to take the antacid, it is OTC and safe

Answer 7

c. consult with the healthcare provider about the appropriate amount and type of antacid

Question 8

The nurse is assisting the older adult diagnosed with a gastric ulcer to schedule her medication admin. What would be the most appropriate time for this patient to take her lansoprazole (Prevacid)?

a. about 30min before her morning meal
b. at night before bed
c. after fasting at least 2hrs
d. 30min after each meal

Answer 8

a. about 30min before her morning meal

Question 9

Simethicone (Gas-X, Mylicon) may be added to some medications or given plan for what therapeutic effect?

a. ↓ amount of gas associated with GI disorders
b. ↑ the acid-fighting ability of some medications
c. prevent constipation associated with GI drugs
d. prevent diarrhea associated with GI drugs

Answer 9

a. ↓ amount of gas associated with GI disorders

Question 10

The nurse is caring for a patient with GERD and would question an order for which of the following?

a. amoxicillin (Amoxil)
b. ranitidine (Zantac)
c. pantoprazole (Protonix)
d. calcium carbonate (Tums)

Answer 10

a. amoxicillin (Amoxil)

Question 11

A 35yo M has been prescribed omeprazole (Prilosec) for treatment of GERD. Which assessment findings would assist the nurse to determine whether drug therapy has been effective? (SATA)

a. ↓ ‘gnawing’ upper abdominal pain on an empty stomach
b. ↓ belching
c. ↓ appetite
d. ↓ nausea
e. ↓ dysphagia

Answer 11

b, d, e

b. ↓ belching
d. ↓ nausea
e. ↓ dysphagia

Question 12

In taking a new patient’s history, the nurse notices that he has been taking omeprazole (Prilosec) consistently over the past 6 months for treatment of epigastric pain. Which recommendation would be the best for the nurse to give this patient?

a. try switching to a different form of the drug
b. try a drug like cimetidine (Tagamet) or famotidine (Pepcid)
c. try taking the drug after meals instead of before meals
d. check with his healthcare provider about his continued discomfort

Answer 12

d. check with his healthcare provider about his continued discomfort

Question 13

A patient with constipation is prescribed psyllium (Metamucil) by his healthcare provider. What essential teaching will the nurse give to the patient?

a. take the drug with meals and at bedtime
b. take the drug with minimal water so that it will not be diluted in the GI tract
c. avoid caffeine and chocolate while taking this drug
d. mix the product in a full glass of water and drink another glassful after taking the drug

Answer 13

d. mix the product in a full glass of water and drink another glassful after taking the drug

Question 14

A patient with severe diarrhea has an order for diphenoxylate with atropine (Lomotil). When assessing for therapeutic effects, what will the nurse expect to find?

a. ↑ bowel sounds
b. ↓ belching and flatus
c. ↓ in loose, watery stools
d. ↓ abdominal cramping

Answer 14

c. ↓ in loose, watery stools

Question 15

A 24yo patient has been taking sulfasalazine (Azulfidine) for IBS and complains to the nurse that he wants to stop taking the drug because of nausea, headaches, and abdominal pain it causes. What would the nurse’s best recommendation be for this patient?

a. the drug is absolutely necessary, even with the adverse effects
b. talk to the healthcare provider about dividing the doses throughout the day
c. stop taking the drug and are if the symptoms of IBS have resolved
d. take an antidiarrheal drug such as loperamide (Imodium) along with the sulfasalazine

Answer 15

b. talk to the healthcare provider about dividing the doses throughout the day

Question 16

The nurse is preparing to administer chemotherapy to an oncology patient who also has an order for ondansetron (Zofran). When should the nurse administer the ondansetron?

a. every time the patient complains of nausea
b. just prior to starting the chemotherapy
c. only if the patient complains of nausea
d. when the patient begins to experience vomiting during the chemotherapy

Answer 16

b. just prior to starting the chemotherapy

Question 17

Pancrelipase (Pancreaze) granules are ordered for a patient. Which action will the nurse complete before administering the drug? (SATA)

a. sprinkle the granules on a nonacidic food
b. give the granules with or just before a meal
c. mix the granules with orange or grapefruit juice
d. ask the patient about an allergy to pork or pork products
e. administer the granules followed by an antacid

Answer 17

a, b, d

a. sprinkle the granules on a nonacidic food
b. give the granules with or just before a meal
d. ask the patient about an allergy to pork or pork products

Question 18

A patient with terminal cancer is receiving naloxegol (Movantik) for control of opioid-indued constipation. Because this drug is an opioid-antagonist, what effects on the patient’s pain should the nurse anticipate?

a. pain may worsen and additional adjunctive drugs may be required
b. there should be no effects on the patient’s level of pain
c. the pain may ↓, requiring less of the opioid drug
d. the patient’s pain level may ↓, but respiratory depression may occur

Answer 18

b. there should be no effects on the patient’s level of pain

Question 19

A nurse is preparing the teaching plan for a patient who will be discharged on methylprednisolone (Medrol Dosepak) after a significant response to poison ivy. The nurse will include instruction on reporting which adverse effects to the healthcare provider? (SATA)

a. tinnitus
b. edema
c. eye pain/visual changes
d. abdominal pain
e. dizziness upon standing

Answer 19

b, c, d

b. edema
c. eye pain/visual changes
d. abdominal pain

Question 20

The nurse is assisting a patient with chronic adrenal insufficiency to pain for medication consistency while on a family vacation. He is taking hydrocortisone (Cortef) and fludrocortisones (Florinef) as replacement therapy. What essential detail does this patient need to remember to do?

a. take his BP once or twice daily
b. avoid crowded indoor areas to avoid infections
c. have his vision checked before he leaves
d. carry an oral and injectable form of both drugs with him on his trip

Answer 20

d. carry an oral and injectable form or both drugs with him on his trip

Question 21

Which assessment findings would cause the nurse to withhold the patient’s regularly scheduled dose of levothyroxine (Synthroid)?

a. a 1kg (2lb) weight gain
b. BP reading of 90/62mmHg
c. HR of 110bpm
d. temp of 37.9 C (100.2 F)

Answer 21

c. HR of 110pbm

Question 22

A patient will be started on desmopressin (DDAVP) for treatment of DI (diabetes insipidus). Which instruction should the nurse include in the teaching plan?

a. drink plenty of fluids, especially those high in calcium
b. avoid close contact with children or pregnant women for 1 week after admin of the drug
c. obtain and record daily weights
d. wear a mask if around children and pregnant women

Answer 22

c. obtain and record daily weights

Question 23

A patient is being treated with methimazole (Tapazole) for hyperthyroidism, pending thyroidectomy. While the patient is taking this drug, what symptoms will the nurse teach the patient to report to the healthcare provider?

a. tinnitus, altered taste, thickened saliva
b. insomnia, nightmares, night sweats
c. general weakness, muscle cramps, dry skin
d. dry eyes, ↓ blinking, reddened conjunctiva

Answer 23

c. generalized weakness, muscle cramping, dry skin

Question 24

The nurse is taking with the parents of a child who will receive somatropin (Nutropin) about the drug therapy. Which important detail will the nurse include in the teaching for these parents?

a. the drug must be given by injection
b. the drug must be given regularly throughout adolescence and young adulthood to achieve desired effects
c. if the drug therapy is given throughout adolescence, it could add 6-8in to the child’s height
d. daily lab monitoring will be required during the first weeks of therapy

Answer 24

a. the drug must be given by injection

Question 25

A patient receives NPH and regular insulin every morning. The nurse is verifying that the patient understands that there are 2 different peak times to be aware of for this insulin regimen. Why is this an important concept for the nurse to stress?

a. the patient needs to plan the next insulin injection around the peak times
b. additional insulin may be needed at peak times to avoid hyperglycemia
c. it is best to plan exercise or other activities around peak insulin activity
d. the risk for hypoglycemia is greatest around the peak of insulin activity

Answer 25

d. the risk for hypoglycemia is greatest around the peak of insulin activity

Question 26

The patient is scheduled to receive 5 units of Humalog and 25 units of NPH (Isoprene) insulin prior to breakfast. Which nursing intervention is most appropriate for this patient?

a. make sure the patient’s breakfast is available to eat before administering insulin
b. offer the patient a high carbohydrate snack in 6 hours
c. hold the insulin if the blood glucose level is greater than 110 mg/dL
d. administer the medications in two separate syringes

Answer 26

a. make sure the patient’s breakfast is available to eat before administering insulin

Question 27

The nurse is initiating discharge teaching with the newly diagnosed patient with diabetes. Which statement indicates that the patient needs additional teaching?

a. “If I am experiencing hypoglycemia, I should drink 1/2 a cup of apple juice.”
b. “My insulin needs may increase when I have an infection.”
c. “I must draw the NPH insulin first if I am mixing it with regular insulin.”
d. “If my blood glucose levels are less than 60 mg/dL, I should notify my healthcare provider.”

Answer 27

c. “I must draw the NPH insulin first if I am mixing it with regular insulin.”

Question 28

What patient education should the nurse provide to the patient with diabetes who is planning an exercise program? (SATA)

a. monitor blood glucose levels before and after exercise
b. eat a complex carb prior to strenuous exercise
c. exercise may increase insulin needs
d. withhold insulin prior to engaging in strenuous exercise
e. take extra insulin prior to exercise

Answer 28

a, b

a. monitor blood glucose levels before and after exercise
b. eat a complex carb prior to strenuous exercise

Question 29

A patient with type 2 diabetes has been nothing by mouth (NPO) since midnight for surgery in the morning. He has been on a combination of oral type 2 anti diabetic drugs. What would be the best action for the nurse to take concerning the admin of his medications?

a. holed all medications as per the NPO order
b. give him the medications with a sip of water
c. give him half the original dose
d. contact the healthcare provider for further orders

Answer 29

d. contact the healthcare provider for further orders

Question 30

A 63yo patient with type 2 diabetes is admitted to the nursing unit with an infected foot ulcer. Despite previous good control on glyburide (DiaBeta), his blood glucose has been elevated the past several days and he requires sliding-scale insulin. What is the most likely reason for the elevated glucose levels?

a. it is a temporary condition related to the stress response with ↑ glucose release
b. he is converting to a type 1 diabetic
c. the oral anti diabetic drug is no longer working for him
d. patients with diabetes who are admitted to the hospital are switched to insulin for safety and tighter control

Answer 30

a. it is a temporary condition related to the stress response with ↑ glucose release