PHARMA Flashcards
An 86-year-old patient is being discharged to home on digitalis therapy and has very little information regarding the medication. Which statement best reflects a realistic outcome of patient teaching activities?
a. The patient and patient’s daughter will state the
proper way to take the drug.
b. The nurse will provide teaching about the drug’s
adverse effects.
c. The patient will state all the symptoms of digitalis
toxicity.
d. The patient will call the prescriber if adverse effects occur
A
A patient has a new prescription for a blood pressure medication that may cause him to feel dizzy during the first few days of therapy. Which is the best nursing diagnosis for this situation?
a. Activity intolerance
b. Risk for injury
c. Disturbed body image
d. Self-care deficit
B
A patient’s chart includes an order that reads as follows:
“Lanoxin 250 mcg once daily at 0900.” Which action by the nurse is correct?
a. The nurse gives the drug via the transdermal route.
b. The nurse gives the drug orally.
c. The nurse gives the drug intravenously.
d. The nurse contacts the prescriber to clarify the
dosage route
D
The nurse is compiling a drug history for a patient.
Which question from the nurse will obtain the most
information from the patient?
a. “Do you depend on sleeping pills to get to sleep?”
b. “Do you have a family history of heart disease?”
c. “When you have pain, what do you do to relieve it?
d. “What childhood diseases did you have?
c
A 77-year-old man who has been diagnosed with an
upper respiratory tract infection tells the nurse that he is allergic to penicillin. Which is the most appropriate response by the nurse?
a. “That’s to be expected—lots of people are allergic to penicillin.”
b. “This allergy is not of major concern because the drug is given so commonly.”
c. “What type of reaction did you have when you took penicillin?”
d. “Drug allergies don’t usually occur in older individuals because they have built up resistance.”
C
The nurse is preparing a care plan for a patient who has been diagnosed with type 2 diabetes mellitus. Put into correct order the steps of the nursing process with 1 being the first step and 5 being the last step.
- Implementation
- Nursing Diagnosis
- Assessment
- Evaluation
- Planning
a. 1,2,3,4,5
b. 2,3,4,1,5
c. 3,2,5,1,4
d. 4,3,2,1,5
C
The nurse is reviewing new medication orders that have
been written for a newly admitted patient. The nurse will
need to clarify which orders? Select all that apply
a. Metformin (Glucophage) 1000 mg PO twice a day
b. Sitagliptin (Januvia) 50 mg daily
c. Simvastatin (Zocor) 20 mg PO every evening
d. Irbesartan (Avapro) 300 mg PO once a day
e. Docusate (Colace) as needed for constipation
b and e
An elderly woman took a prescription medicine to help
her to sleep; however, she felt restless all night and did
not sleep at all. The nurse recognizes that this woman
has experienced which type of reaction or effect?
a. Allergic reaction
b. Idiosyncratic reaction
c. Mutagenic effect
d. Synergistic effect
b
While caring for a patient with cirrhosis or hepatitis, the
nurse knows that abnormalities in which phase of
pharmacokinetics may occur?
a. Absorption
b. Distribution
c. Metabolism
d. Excretion
c
A patient who has advanced cancer is receiving opioid
medications around the clock to “keep him comfortable”
as he nears the end of his life. Which term best
describes this type of therapy?
a. Palliative therapy
b. Maintenance therapy
c. Supportive therapy
d. Supplemental therapy
A
The nurse is giving medications to a patient in heart
failure. The intravenous route is chosen instead of
the intramuscular route. The nurse knows that the
factor that most influences the decision about which
route to use is the patient’s
a. altered biliary function
b. increased glomerular filtration
c. educed liver metabolism
d. diminished circulation
d
A patient has just received a prescription for an
enteric coated stool softener. When teaching the
patient, the nurse should include which statement?
a. “Take the tablet with 2 to 3 ounces of orange
juice.”
b. “Avoid taking all other medications with any
enteric coated tablet.”
c. “Crush the tablet before swallowing if you have
problems with swallowing.”
d. “Be sure to swallow the tablet whole without
chewing it.”A patient has just received a prescription for an
enteric coated stool softener. When teaching the
patient, the nurse should include which statement?
a. “Take the tablet with 2 to 3 ounces of orange
juice.”
b. “Avoid taking all other medications with any
enteric coated tablet.”
c. “Crush the tablet before swallowing if you have
problems with swallowing.”
d. “Be sure to swallow the tablet whole without
chewing it.”
d
A drug that delivers 500 mg has a half-life of 4 hours.
How many milligrams of drug will remain in the body
after 1 half-life?
a. 125 mg
b. 250 mg
c. 500 mg
d. 350 mg
b
The primary treatment for heart failure (HF) is
___________.
A. Increasing the heart rate so the heart can pump more
blood
B. Decreasing the heart rate so the heart can rest
C. Increasing contractility so the heart will be able to
pump more blood
D. Decreasing contractility to prevent muscle fatigue
c
Feedback
The complete answer would be to make the heart beat
efficiently, that is to increase its force of contraction
without increasing the heart rate. Through this, more
blood is pumped every beat without overwhelming the
heart because rate of contraction is not increased.
The most common cause of HF is ______________.
A. Hypertension
B. Valvular heart diseases
C. Cardiomyopathy
D. Coronary artery disease (CAD)
d
Feedback
It accounts for 95% of HF cases. CAD results to
insufficient supply of blood in the heart. This leads to
hypoxia and loss of function of heart muscles
Digoxin was prescribed to a patient with ventricular
tachycardia. What should the nurse do?
A. Administer the drug as ordered.
B. Discuss the order with the doctor.
C. Discontinue other intravenous medications before
administering digoxin.
D. Count apical pulse for one full minute before
administering
b
Feedback
Digoxin is contraindicated in patients with ventricular
tachycardia and fibrillation because these are potentially
fatal arrhythmias and need to be treated with other
medications.
It is contraindicated in patients with ventricular
tachycardia and fibrillation because these are potentially
fatal arrhythmias and need to be treated with other
medications.
Digoxin
What is the antidote for digoxin intoxication?
A. Diphenhydramine
B. Atropine sulfate
C. Digoxin immune fab (Digibind, DigiFab).
D. Phosphodiesterase inhibitors
C
Feedback
Digoxin Immune Fab or DigiFab, DigiBind should be
administered for serum digoxin levels of >10 ng/mL and
serum potassium level of >5 mEq/mL.
An infant who is receiving cardiac glycosides has an
apical pulse of 80 beats per minute. Which is the best nursing intervention for this assessment
finding?
A. Administer drug as ordered.
B. Withdraw the drug and notify doctor.
C. Assess apical pulse every hour for the next five hours.
D. Decrease drug dose and administer.
b
What signals the novice nurse that intravenous
milrinone was combined to furosemide in
management of patients with heart failure?
A. Presence of bubbles
B. Pink discoloration of the solution
C. Formation of precipitates
D. No obvious sign. Solution is clear.
c
Feedback
Phosphodiesterase inhibitor-furosemide combination
should be avoided. Alternate lines should be used if both
of these drugs are given intravenously.
In severe cardiac glycoside toxicity, all of the
following should be in the bedside, except
_________.
A. Lidocaine
B. Phenytoin
C. Calcium channel blocker
D. A and B only
c
Feedback
Lidocaine and potassium salts are used to treat
arrhythmias. Phenytoin is for the treatment of seizures.
Other medications and equipment at the bedside include
atropine for treatment of increased heart rate, and a
cardiac monitor.
What is the therapeutic level for digoxin?
A. 0.5-2 ng/mL
B. 1.5-2 ng/mL
C. 0.5-1.5 mg/mL
D. 0.5-2 mg/mL
A (0.8-2 ng/mL)
Type of angina which involves spasm of the blood
vessels
A. Stable angina
B. Pre-infarction angina
C. Unstable angina
D. Prinzmetal angina
D
Feedback
It is an unusual type of angina that involves the spasm of
blood vessels and not just by narrowing of vessels.
Person with prinzmetal angina has angina at rest and
associated ECG changes.
Each statement describes a phase of pharmacokinetics. Put the statement in order, 1 as first 4 as last.
- Drug metabolites are secreted through passive glomerular filtration into the renal tubules.
2 Enzymes in the liver transform the drug into an inactive metabolite
3 A drug binds to the plasma protein albumin and circulates through the body
4 A drug moves from the intestinal lumen into the mesenteric blood system
a. 4.2.3.1
b. 4.3.2.1
c. 4.1.2.3
d. 4.3.1.2
d
Contraction and relaxation in each cardiac cycle is
controlled by
A. autonomic nervous system
B. the heart
C. cranial nerves
D. central nervous system
B
Feedback
Contraction and relaxation is controlled by impulses
arising spontaneously in the SA node and transmitted via
a specialized conducting system to activate all parts of
the muscle almost simultaneously. These rhythmic and
continuous contractions are controlled by the heart itself.
All of the following can cause arrhythmia, except:
A. acidosis
B. respiratory depression
C. hyperkalemia
D. none of the above
D
Feedback
Electrolyte disturbances, hypoxic conditions, acidosis or
accumulation of waste products, and structural damage
of the conduction system can lead to arrhythmia.
Verapamil and diltiazem belong to which class
of antiarrhythmics?
1/1
A. Class IV
B. Class III
C. Class Ia
D. Class II
A
Feedback
Verapamil and diltiazem are calcium-channel blockers and
belong to Class IV antiarrhythmics
The conduction system of the heart include the
following:
A. Sinoatrial node
B. Bundle of Purkinje
C. His Fibers
D. Atriomyocardial node
A
What is the correct sequence of path of conduction in the heart?
a. SA node -> AV node -> Bundle of His -> Purkinje fibers.
b. Bundle of His -> Purkinje fibers -> SA node -> AV node
c. SA node -> AV node -> Purkinje fibers -> Bundle of His
d. SA node -> Bundle of His ->Purkinje Fibers -> AV node
A
Feedback
Path of conduction is as follows: SA node -> AV node ->
Bundle of His -> Purkinje fibers.
The phase of cardiac muscle cell action potential
characterized by calcium entering the cell and
potassium leaving the cell.
A. Phase 1
B. Phase 2
C. Phase 3
D. Phase 4
b
