Pharm ?s

Question 1

The patient is to begin taking atorvastatin (Lipitor) and the nurse is providing education about the drug. Which symptom related to this drug should be reported to the healthcare provider?

a. constipation
b. ↑ muscle/joint pain
c. hemorrhoids
d. flushing/”hot flash”

Answer 1

b. ↑ muscle/joint pain

Question 2

A patient is receiving cholestyramine (Questran) for elevated low-density lipoprotein (LDL) levels. As the nurse completes the nursing care plan, which adverse effects will be included for continued monitoring?

a. abd pain
b. orange-red urine and saliva
c. ↓ cap refill time
d. sore throat and fever

Answer 2

a. abd pain

Question 3

The nurse is instructing a patient on home use of niacin and will include important instructions on how to take the drug and about its possible adverse effects. Which of the following may be expected adverse effects of this drug? (SATA)

a. fever and chills
b. intense flushing and hot flashes
c. tingling of fingers and toes
d. hypoglycemia
e. dry mucous membranes

Answer 3

b, c

b. intense flushing and hot flashes
c. tingling of fingers and toes

Question 4

The community health nurse is working with a patient taking simvastatin (Zocor). Which patient statement may indicate the need for further teaching about this drug?

a. “I’m trying to reach my ideal body weight by increasing my exercise.”
b. “I didn’t have any symptoms even though I had high lipid levels. I hear that’s common.”
c. “I’ve been taking my pill before my dinner.”
d. “I take my pill with grapefruit juice. I’ve always taken my pill this way.”

Answer 4

d. “I take my pill with grapefruit juice. I’ve always taken my pill this way.”

Question 5

A patient has been on long-term therapy with colestipol (Colestid). To prevent adverse effects related to the length of therapy and lack of nutrients, which supplements may be required? (SATA)

a. folic acid
b. vitamins A, D, E, K
c. potassium, iodine, chloride
d. protein
e. B vitamins

Answer 5

a, b

a. folic acid
b. vitamins A, D, E, K

Question 6

A patient has been ordered gemfibrozil (Lopid) for hyperlipidemia. The nurse will first validate the order with the healthcare provider if the patient reports a history of what disorder?

a. HTN
b. angina
c. gallbladder disease
d. tuberculosis

Answer 6

c. gallbladder disease

Question 7

The patient has been given a prescription of hydrochlorothiazide (Microzide) as an adjunct to treatment of hypertension and returns for a follow-up check. Which is the most objective data for determining the therapeutic effectiveness of the furosemide?

a. absence of edema in lower extremities
b. weight loss of 13kg (6lb)
c. BP log notes BP 120/70 to 134/88 since discharge
d. frequency of voiding at least 6x/day

Answer 7

c. BP log notes BP 120/70 to 134/88 since discharge

Question 8

Nifedipine (Procardia XL) has been ordered for a patient with HTN. In the care plan, the nurse includes the need to monitor for which adverse effect?

a. rash and chills
b. reflex tachycardia
c. ↑ urinary output
d. weight loss

Answer 8

b. reflex tachycardia

Question 9

The patient is taking atenolol (Tenormin) and doxazosin (Cardura). What is the rationale for combining two antihypertensive drugs?

a. BP will ↓ faster
b. lower doses of both drugs may be given with fewer adverse effects
c. there is less daily medication dosing
d. combination therapy will treat the patient’s other medical conditions

Answer 9

b. lower doses of both drugs may be given with fewer adverse effects

Question 10

What health teaching should the nurse provide for the patient receiving nadolol (Corgard)?

a. ↑ fluids and fiber to prevent constipation
b. report a weight gain of 1kg per month or more
c. immediately stop taking the medication if sexual dysfunction occurs
d. rise slowly after prolonged periods of sitting or lying down

Answer 10

a. ↑ fluids and fiber to prevent constipation

Question 11

The nurse is caring for a patient with chronic HTN. The patient is receiving lorsartan (Cozaar) daily. Which patient manifestations would the nurse conclude is an adverse effect of this medication? (SATA)

a. tremors
b. dizziness
c. drowsiness
d. hypoglycemia
e. angioedema

Answer 11

b, d, e

b. dizziness
d. hypoglycemia
e. angioedema

Question 12

A patient with significant HTN unresponsive to other medications is given a prescription for hydralazine. An additional prescription of propranolol (Inderal) is also given to the patient. The patient inquires why two drugs are needed. What is the nurse’s best response?

a. giving the two drugs together will lower the BP even more than just one alone
b. the hydralazine may cause tachycardia and the propranolol will keep the HR within normal limits
c. the propranolol is to prevent lupus erythematous from developing
d. direct-acting vasodilators such as hydralazine cause fluid retention, and the propranolol will prevent excessive fluid buildup

Answer 12

b. the hydralazine may cause tachycardia and the propranolol will help keep the HR within normal limits

Question 13

The patient is prescribed digoxin (Lanoxin) for treatment of heart failure. Which statement by the patient indicates the need for further teaching?

a. “I may notice my HR decreases.”
b. “I may feel tired during early treatment.”
c. “This drug should cure my heart failure.”
d. “My energy level should gradually improve.”

Answer 13

c. “This drug should cure my heart failure.”

Question 14

The patient is receiving hydralazine with isosorbide (BiDil) for heart failure. The nurse should monitor this patient for:

a. dizziness and rapid HR
b. bleeding
c. tingling or cramping in the legs
d. confusion and agitation

Answer 14

a. dizziness and rapid HR

Question 15

A patient with heart failure has an order for lisinopril (Prinivil, Zestril). Which condition in the patient’s history would lead the nurse to confirm the order with the provider?

a. a history of HTN previously treated with diuretic therapy
b. a history of seasonal allergies currently treated with antihistamines
c. a history of angioedema after taking enalapril (Vasotec)
d. a history alcoholism, currently abstaining

Answer 15

c. a history of angioedema after enalapril (Vasotec)

Question 16

The teaching plan for a patient receiving hydralazine (Apresoline) should include which point?

a. returning for monthly urinalysis testing
b. including citrus fruits, melons, and vegetables in the diet
c. decreasing potassium-rich food in the diet
d. rising slowly to standing from a lying or sitting position

Answer 16

d. rising slowly to standing from a lying or sitting position

Question 17

Lisinopril (Prinivil) is part of the treatment regimen for a patient with heart failure. The nurse monitors the patient for the development of which adverse effects of this drug? (SATA)

a. hyperkalemia
b. hypocalcemia
c. cough
d. dizziness
e. heartburn

Answer 17

a, c, d

a. hyperkalemia
c. cough
d. dizziness

Question 18

The patient who has not responded well to other therapies has been prescribed milrinone (Primacor) for treatment of his heart failure. What essential assessment must the nurse make before starting this drug?

a. weight and presence of edema
b. dietary intake of sodium
c. electrolytes, especially potassium
d. history of sleep patterns and presence of sleep apnea

Answer 18

c. electrolytes, especially potassium

Question 19

The patient is being discharged with nitroglycerin (Nitrostat) for sublingual use. While planning patient education, what instruction will the nurse include?

a. “Swallow 3 tablets immediately for pain and call 911.”
b. “Put one tablet under your tongue for chest pain. If pain does not subside, call 911.”
c. “Call your healthcare provider when you have chest pain. She will tell you how many tablets to take.”
d. “Place 3 tablets under your tongue and call 911.”

Answer 19

b. “Put one tablet under your tongue for chest pain. If pain does not subside, call 911.”

Question 20

Nitroglycerin patches have been ordered for a patient with a history of angina. What teaching will the nurse give to this patient?

a. keep the patches in the fridge
b. use the patches only if the chest pain is severe
c. remove the old patch and wait 6-12hrs before applying the new one
d. apply the patch only to the upper arm or thigh areas

Answer 20

c. remove the old patch and wait 6-12hrs before applying the new one

Question 21

Which assessment findings in a patient who is receiving atenolol (Tenormin) for angina would be cause for the nurse to hold the drug and contact the provider? (SATA)

a. HR of 50 BPM
b. HR of 124 BPM
c. BP of 86/56
d. BP 156/88
e. tinnitus and vertigo

Answer 21

a, c

a. HR of 50 BPM
c. BP of 86/56

Question 22

The nurse is caring for a patient with chronic stable angina who is receiving isosorbide dinitrate (Isordil). Which of the following are common adverse effects of isosorbide?

a. flushing and headache
b. tremors and anxiety
c. sleepiness and lethargy
d. light-headedness and dizziness

Answer 22

d. light-headedness and dizziness

Question 23

What health teaching should the nurse provide for a patient receiving diltiazem (Cardizem)? (SATA)

a. avoid driving or performing other activities requiring mental alertness until the effects of the drug are known
b. maintain adequate fluid and fiber intake to facilitate stool passage
c. report weight gain of 2kg (5lb) per week
d. rise slowly from prolonged periods of sitting or lying down
e. immediately stop taking medication if sexual dysfunction is noted

Answer 23

a, b, c, d

a. avoid driving or performing other activities requiring mental alertness until the effects of the drug are known
b. maintain adequate fluid and fiber intake to facilitate stool passage
c. report weight gain of 2kg (5lb) per week
d. rise slowly from prolonged periods of sitting or lying down

Question 24

Erectile dysfunction drugs such as sildenafil (Viagra) are contraindicated in patients taking nitrates for angina. What is the primary concern with concurrent administration of these drugs?

a. they contain nitrates, resulting in an overdose
b. they also ↓ BP through vasodilation and may result in prolonged and severe hypotension when combined with nitrates
c. they will adequately treat the patient’s angina as well as erectile dysfunction
d. they will ↑ thee possibility of nitrate tolerance developing and should be avoided unless other drugs an be used

Answer 24

b. they also ↓ BP through vasodilation and may result in prolonged and severe hypotension when combined with nitrates

Question 25

A patient with deep vein thrombosis is receiving in infusion of heparin and will be sorted on warfarin (Coumadin) soon. While the patient is receiving heparin, what alb test will provide the nurse with information about its therapeutic effects?

a. antithrombin II
b. international normalized ration (INR)
c. activated partial thromboplastin time (aPTT)
d. platelet count

Answer 25

c. activated partial thromboplastin time (aPTT)

Question 26

The patient receiving heparin therapy asks how the “blood thinner” works. What is the best response by the nurse?

a. “Heparin makes the blood less thick.”
b. “Heparin does not thin the blood but prevents clots from forming as easily in the blood vessels.”
c. “Heparin decreases the number of platelets so that blood clots more slowly.”
d. “Heparin dissolves the clot.”

Answer 26

b. “Heparin does not thin the blood but prevents clots from forming as easily in the blood vessels.”

Question 27

What patient education should be included for a patient receiving enoxaparin (Lovenox)? (SATA)

a. teach the patient/caregiver to give SubQ injections at home
b. teach the patient/caregiver not to take any OTCs without first consulting with the health care provider
c. teach the patient to observe for unexplained bleeding, such as pink, red, or dark brown urine or bloody gums
d. teach the patient to monitor for the development of deep vein thrombosis
e. teach the patient about the importance of drinking grapefruit juice daily

Answer 27

a, b, c, d

a. teach the patient/caregiver to give SubQ injections at home
b. teach the patient/caregiver not to take any OTCs without first consulting with the health care provider
c. teach the patient to observe for unexplained bleeding, such as pink, red, or dark brown urine or bloody gums
d. teach the patient to monitor for the development of deep vein thrombosis

Question 28

A patient with a congenital coagulation disorder is given aminocaproic acid (Amicar) to stop bleeding following surgery. The nurse will carefully monitor this patient for development of which adverse effects? (SATA)

a. anaphylaxis
b. HTN
c. hemorrhage
d. headache
e. hypotension

Answer 28

a, d, e

a. anaphylaxis
d. headache
e. hypotension

Question 29

A patient is receiving a thrombolytic drug, alteplase (Activate), following an acute MI. Which effect is most likely attributed to this drug?

a. skin rash with uticaria
b. wheezing with labored respirations
c. bruising and epistaxis
d. temp elevation of 38.2 C (100.8 F)

Answer 29

c. bruising and epistaxis

Question 30

A patient has started clopidogrel (Plavix) after experiencing a TIA. What is the desired therapeutic effect of this drug?

a. anti-inflammatory and antipyretic effects
b. reduce risk of a stroke from a blood clot
c. analgesic as well as clot-dissolving effects
d. stop clots from becoming emboli

Answer 30

b. reduce risk of stroke from a blood clot

Question 31

The patient has been prescribed oxymetazoline (Afrin) nasal spray for seasonal rhinitis. Which instructions will the nurse provide?

a. limit use of spray to 5 days or less
b. the drug may be sedating so be cautious with activities requiring alertness
c. this drug should not be used in conjunction with antihistamines
d. it is an OTC and may be used as needed for congestion

Answer 31

a. limit use of this spray to 5 days or less

Question 32

A patient has a prescription for fluticasone (Flonase) for allergic rhinitis. Place the following instructions in the order in which the nurse will instruct the patient to use this drug.

a. instill one spray direct high into the nasal cavity
b. clear the nose by blowing
c. prime the inhaler prior to first use
d. spit out any excess liquid that drains into the mouth

Answer 32

c, b, a, d,

c. prime the inhaler prior to first use
b. clear the nose by blowing
a. instill one spray direct high into the nasal cavity
d. spit out any excess liquid that drains into the mouth

Question 33

A man, age 67, reports taking diphenhydramine (Benadryl) for hay fever. Considering this patient’s age, the nurse assesses for which findings?

a. history of prostatic or urinary conditions
b. any recent weight gain
c. history of allergic reactions
d. history of peptic ulcer disease

Answer 33

a. history of prostatic or urinary conditions

Question 34

The nurse is teaching a patient about the use of dextromethorphan with guaifenesin (Robitussin-DM) syrup for a cough accompanied by thick mucus. Which instruction should be included in the patient’s teaching?

a. lie supine for 30min after taking the liquid
b. drink minimal fluids to avoid stimulating the cough reflex
c. take the drug with food for best results
d. avoid drinking fluids immediately after the syrup but ↑ overall fluid intake throughout the day

Answer 34

d. avoid drinking fluids immediately after the syrup but ↑ overall fluid intake throughout the day

Question 35

A patient has been prescribe fluticasone (Flonase) to use with oxymetazoline (Afrin). How should the patient be taught how to use these drugs?

a. use the fluticasone first, then the oxymetazoline after waiting 5min
b. use the oxymetazoline first, then the fluticasone after waiting 5min
c. the drugs may be used in either order
d. the fluticasone should be used only if the oxymetazoline fails to relieve the nasal congestion

Answer 35

b. use the oxymetazoline first, then the fluticasone after waiting 5min

Question 36

Which of the following is the best advice that the nurse can give a patient with viral rhinitis who intends to purchase an OTC combination cold remedy?

a. dosages in these remedies provide precise dosing for each symptom that you are experiencing
b. these drugs are best used in conjunction with an antibiotic
c. it is safer to use a single-drug preparation if you are experiencing only one symptom
d. since these drugs are available OTC, it is safe to use any of them as long as needed

Answer 36

c. it is safer to use a single-drug preparation if you are experiencing only one symptom

Question 37

A patient is receiving treatment for asthma with albuterol (Proventil). The nurse teaches the patient that while serious adverse effects are uncommon, the following may occur. (SATA)

a. tachycardia
b. sedation
c. temporary dyspnea
d. nervousness
e. headache

Answer 37

a, d, e

a. tachycardia
d. nervousness
e. headache

Question 38

A patient with asthma has a prescription for two inhalers, albuterol (Proventil) and beclomethasone (Qvar). How should the nurse instruct this patient on the proper use of the inhalers?

a. use the albuterol inhaler, and use the beclomethasone only if symptoms are not relieved.
b. use the beclomethasone inhaler, and use the albuterol only if symptoms are not received.
c. use the albuterol inhaler, wait 5-10min, then use the beclomethasone inhaler
d. use the beclomethasone inhaler, wait 5-10min, then use the albuterol inhaler

Answer 38

c. use the albuterol inhaler, wait 5-10min, then use the beclomethasone inhaler

Question 39

A patient has been using a fluticasone (Flovent) inhaler as a component of his asthma therapy. He returns to his healthcare provider’s office complaining of a sore mouth. On inspection, the nurse notices white patches in the patient’s mouth. What is a possible explanation for these findings?

a. the patient has been consuming hot beverages after the use of the inhaler
b. the patient has limit his fluid intake, resulting in dry mouth
c. the residue of the inhaler propellant is coating the inside of the mouth
d. the patient has developed thrush as a result of the fluticasone

Answer 39

d. the patient has developed thrush as a result of the fluticasone

Question 40

A 65yo patient is prescribed ipratropium (Atrovent) for the treatment of asthma. Which condition should be reported to the healthcare provider before given this patient the ipratropium?

a. reported allergy to peanuts
b. history of intolerance to albuterol (Proventil)
c. history of bronchospasms
d. reported allergy to chocolate

Answer 40

a. reported allergy to peanuts

Question 41

A patient who received a prescription for montelukast (Singulair) returns to his provider’s office after 3 days, complaining that “the drug is not working.” She reports mild but continued dyspnea and has had to maintain consistent use of her bronchodilator inhaler, albuterol (Proventil). What does the nurse suspect is the cause of the failure of the montelukast?

a. the patient is not taking the drug correctly
b. the patient is not responding to the drug and will need to be switched to another formulation
c. the drug has not had sufficient time of use to have full effects
d. the albuterol inhaler is interacting with the montelukast

Answer 41

c. the drug has not had sufficient time of use to have full effects

Question 42

Vilanterol and fluticasone (Breo Ellipta) has been ordered for a patient with COPD. Because of the combination of drugs, what adverse effects may be expected? (SATA)

a. sedation and drowsiness
b. tremor and nervousness
c. hypotension
d. dry mouth and hoarseness
e. oropharyngeal candidiasis and ↑ risk of infections

Answer 42

b, d, e

b. tremor and nervousness
d. dry mouth and hoarseness
e. oropharyngeal candidiasis and ↑ risk of infections