Pharmacology Packet Flashcards

1
Q

Which statement is the scientific rationale for the combination drug carbidopa/levodopa prescribed to a client diagnosed with Parkinson’s disease?

a. The carbidopa delays the breakdown of the levodopa in the periphery so more dopamine gets to the brain

b. The medication is less expensive when combined, so it is more affordable to clients on a fixed income

c. The carbidopa breaks down in the periphery and causes vasoconstriction of the blood vessels

d. Carbidopa increases the action of levodopa on the renal arteries, increasing renal perfusion

A

a. The carbidopa delays the breakdown of the levodopa in the periphery so more dopamine gets to the brain

*** without the carbidopa, the levodopa would break down before reaching the blood-brain barrier leaving it ineffective for patients with Parkinson’s

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2
Q

The client with increased intracranial pressure is receiving mannitol. Which intervention should the nurse implement to evaluate the effectiveness of the medication?

a. Monitor the client’s vital signs

b. Maintain strict intake and output

c. Assess the client’s neurological status

d. Check the client’s serum osmolality level

A

c. Assess the client’s neurological status

*** neurological status is the gold standard in assessing changes in ICP

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3
Q

A patient is going to take their first dose of immediate-release gabapentin. What is the best way to take it?

a. Early in the morning before going to work

b. Right before going to bed

c. Must be taken with a full meal

d. Taken with an antacid to reduce adverse effects

A

b. Right before going to bed

*** gabapentin (Neurontin) is a CNS depressant and can cause dizziness and drowsiness

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4
Q

The client who has been prescribed phenytoin for epilepsy calls the clinic and reports a measles-like rash. Which intervention should the nurse implement?

a. Instruct the client to come to the clinic immediately

b. Determine if the client is drinking grapefruit juice

c. Encourage the client to apply hydrocortisone cream to the rash

d. Explain that this is a common side effect of this medication

A

a. Instruct the client to come to the clinic immediately

*** measles-like rash is indicative of Steven Johnson’s syndrome

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5
Q

The client with a seizure disorder who is taking carbamazepine tells the clinic nurse, “I am taking evening primrose oil for my premenstrual (PMS) cramps and it is really working.” Which statement is the nurse’s best response?

a. “You should inform your HCP about taking the herb.”

b. “It is very dangerous to take both the herb and the carbamazepine.”

c. “Herbs are natural substances and I am glad it is helping your PMS.”

d. “Are you sure you should be taking herbs along with carbamazepine?”

A

a. “You should inform your HCP about taking the herb.”

*** Many herbs can interfere with medications. Even if it doesn’t affect current meds, it should be in the patient’s chart in case the HCP decides to prescribe any other meds.

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6
Q

The nurse is teaching the client diagnosed with angina about sublingual nitroglycerin (NTG). Which statement indicates that the client needs more medication teaching?

a. “I will always carry my nitroglycerin in a dark-colored bottle.”

b. “If I have chest pain, I will put a tablet under my tongue.”

c. “If my pain is not relieved with one tablet, I will get medical help.”

d. “I should expect to get a headache after taking my nitroglycerin.”

A

c. “If my pain is not relieved with one tablet, I will get medical help.”

*** Pts can take up to three tablets of Nitro before they need to seek medical attention

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7
Q

The nurse is preparing to administer adenosine for the client diagnosed with supraventricular tachycardia (SVT). Which assessment finding would indicate the effectiveness of the medication?

a. The client’s ECG tracing shows normal sinus rhythm

b. The client’s apical pulse is within normal limits

c. The client’s blood pressure is above 100/60

d. The client’s serum adenosine level is 1.8 mg/dL

A

a. The client’s ECG tracing shows normal sinus rhythm

*** adenosine is an antiarrhythmic and the only way to know if it worked is by looking at the ECG

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8
Q

The client is scheduled for a bilateral adrenalectomy for Cushing’s disease. Which information regarding the prescribed prednisone should the nurse teach? Select all that apply.

a. When discontinuing this medication, it must be tapered.

b. Take the medication regularly; do not skip doses.

c. Stop taking the medication is you develop a round face.

d. Notify the HCP is you start feeling thirsty all the time.

e. Wear a Medical Alert bracelet in case of an emergency.

A

b. Take the medication regularly; do not skip doses.

d. Notify the HCP is you start feeling thirsty all the time.

e. Wear a Medical Alert bracelet in case of an emergency.

***(Answer A is not correct because with an adrenalectomy, the patient will be on prednisone forever and will not D/C the med)

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9
Q

The client diagnosed with diabetes insipidus is prescribed desmopressin. Which comorbid condition warrants a change in medication?

a. Renal calculi

b. Diabetes Mellitus Type II

c. Sinusitis

d. Hyperthyroidism

A

c. Sinusitis

*** Because desmopressin is an inhaled medication

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10
Q

The client diagnosed with hypothyroidism is prescribed levothyroxine. Which assessment data supports the client needs to take more medication? Select all that apply.

a. The client has a 2-kg weight loss

b. The client reports being too cold

c. the client has exophthalmos

d. the client’s radial pulse rate is 90 beats per minute

e. The client reports being constipated

A

b. The client reports being too cold

e. The client reports being constipated

*** both of these are symptoms of hypothyroidism and indicate that an increase in medication is needed

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11
Q

The client who received darbepoetin calls the clinic nurse and reports aching in the back and legs. Which statement is the nurse’s best response.

a. “This is unrelated to this medication. You may be getting the flu.”

b. “You should come to the clinic immediately to see the HCP.”

c. “This is an expected side effect of the medication and can be treated.”

d. “Have you taken your blood pressure medication today?”

A

c. “This is an expected side effect of the medication and can be treated.”

*** darbepoetin causes the hyperstimulation of the bone marrow to produce blood cells, so aching is expected. Can be treated with NSAIDs.

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12
Q

The 39-year-old client diagnosed with breast cancer is prescribed tamoxifen. Which information is most important for the nurse to teach the client?

a. The medication will cause menopause symptoms

b. Tamoxifen may cause vaginal discharge and nausea

c. Tamoxifen will slow the growth of estrogen-positive tumors

d. It is important to see a gynecologist regularly

A

d. It is important to see a gynecologist regularly

*** Due to increased risk of endometrial cancer

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13
Q

Which client should the nurse question receiving erythropoietin?

a. The client diagnosed with end-stage renal disease

b. The client diagnosed with essential hypertension

c. The client diagnosed with lung cancer and metastasis

d. The client diagnosed with anemia and leukopenia

A

b. The client diagnosed with essential hypertension

*** erythropoietin increases the production of red blood cells which increases blood pressure

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14
Q

The post menopausal client with breast cancer is placed on the aromatase inhibitor anastrozole (Arimidex). Which data indicated the medication is effective?

a. The client reports a positive body image

b. The client is able to discuss her feelings openly

c. The client’s bone and lung scans are negative

d. The client’s DNA and ploidy tests show diploid cells

A

c. The client’s bone and lung scans are negative

*** This med stops the growth of hormone induced tumors by blocking the conversion of androgen into estrogen in the body

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15
Q

The male client who is diagnosed with AIDS is prescribed megestrol. Which data indicates the medication is effective?

a. The Kaposi’s lesions have become light brown

b. The client ate 90% of the meal served to him

c. The client experiences a decrease in nausea

d. The client is able to complete activities of daily living

A

b. The client ate 90% of the meal served to him

*** megestrol is an appetite stimulant

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16
Q

Which medication should the nurse prepare to administer to the client exhibiting the following telemetry strip?

a. Adenosine

b. Amiodarone

c. Digoxin

d. Dopamine

A

b. Amiodarone

*** This med slows down overactive electrical signals that lead to arrhythmias such as PVCs

17
Q

The client diagnosed with CHF is prescribed enalapril. Which statement explains the scientific rationale for administering this medication?

a. Enalapril increases the levels of angiotensin II in the blood vessels

b. Enalapril dilates arteries, which reduced the workload of the heart

c. Enalapril decreases the effects of bradykinin in the body

d. Enalapril block the intervention of antidiuretic hormone in the kidney

A

b. Enalapril dilates arteries, which reduced the workload of the heart

***this drug is an ACE inhibitor (ends in -pril) which is a vasodilator to reduce workload of the heart

18
Q

The nurse in the ICU is caring for a client diagnosed with left cerebral artery thrombotic stroke who received a thrombolytic medication in the ED. Which intervention should be implemented?

a. Administer oral Ticlopidine

b. Place the client in Trendelenburg position

c. Keep the client turned to the right side in high Fowler’s position

d. Monitor heparin infusion

A

d. Monitor heparin infusion

*** Patient received TPA in the ED so the only thing needed is to monitor heparin infusion and titrate according to Q6 hour PTT

** Ticlopidine is an antiplatelet drug which is usually helpful but is not to be administered within 24 hours of TPA

19
Q

Which male client should the nurse consider at risk for complications when taking sildenafil

a. A 56-year-old client diagnosed with unstable angina

b. An 87-year-old client diagnosed with glaucoma

c. A 44-year-old client diagnosed with type 2 diabetes

d. a 32-year-old client diagnosed with L1 spinal cord injury

A

a. A 56-year-old client diagnosed with unstable angina

*** Sildenafil (Viagra) is a vasodilator and may increase symptoms of angina or lead to an MI

20
Q

The elderly male client is prescribed tolterodine for urge incontinence. Which statement warrants notifying the HCP?

a. “I have to suck on sugarless candy because my mouth is so dry.”

b. “I am so glad I can go all day without having to go to the bathroom.”

c. “i really have a problem swallowing the pills whole with water.”

d. “I hate that i had to give up my grapefruit juice, but I know that it is best.”

A

b. “I am so glad I can go all day without having to go to the bathroom.”

*** urine retention is bad

21
Q

A client taking nitrofurantoin for a UTI calls the clinic and tells the nurse that their urine has turned dark. What should the nurse tell the client?

a. “This is a standard side effect of the medication and is not usually indicative of a harmful reaction.”

b. “This means you have cystitis and should come in to see the HCP.”

c. “Stop taking the medication with food. That is what’s causing this reaction.”

d. “Your medication didn’t cause that; it must be some other issue.”

A

a. “This is a standard side effect of the medication and is not usually indicative of a harmful reaction.”

*** nitrofurantoin (Macrobid) turns urine dark
** Pyridium turns urine bright orange (also used for UTIs)

22
Q

The nurse is administering hydrochlorothiazide to a client diagnosed with CKD. Which assessment data should cause the nurse to question the administration of this medication? Select all that apply.

a. The client’s skin turgor on the upper chest is tented

b. The urine output was 90 mL for the last 8 hours

c. The client’s oral mucosa is moist and pink

d. The client has 3+ sacral and peripheral edema

e. The client’s blood pressure is 90/60 in the left arm

A

a. The client’s skin turgor on the upper chest is tented

*** do not give a diuretic when the pt is dehydrated

b. The urine output was 90 mL for the last 8 hours

*** This amount of kidney damage indicates that the diuretic will not be effective

e. The client’s blood pressure is 90/60 in the left arm

*** do not give a diuretic when the pt has a low bp

23
Q

Which statement best describes the scientific rationale for prescribing metformin?

a. This medication decreases insulin resistance, improving blood glucose control.

b. This medication allows the carbohydrates to pass slowly through the large intestine

c. This medication will decrease the hepatic production of glucose from stored glycogen.

d. This medication stimulates the beta cells to release more insulin into the bloodstream.

A

c. This medication will decrease the hepatic production of glucose from stored glycogen.

*** used for type 2 diabetics. Causes the liver to stop producing glucose from glycogen

24
Q

The nurse is preparing to administer spironolactone (Aldactone), potassium sparing diuretic. Which priority intervention should the nurse implement?

a. Check the patient’s potassium level

b. Monitor the patient’s urinary output

c. Encourage consumption of potassium rich foods

d. Give the medication with food

A

a. Check the patient’s potassium level

*** duh… self explanatory. potassium sparing = increased potassium

25
Q

The home health nurse is visiting a patient diagnosed with a DVT who is taking warfarin (Coumadin) an oral anticoagulant. The nurse assesses a large hematoma on the abdomen and multiple small ecchymotic areas scattered over the body. Which intervention should the nurse implement?

a. Send the patient to the emergency department immediately

b. Encourage the patient to apply ice to the area

c. Inform the patient that this is expected when taking this medication

d. Instruct the patient to wear a Medical Alert bracelet at all times

A

a. Send the patient to the emergency department immediately

*** bleeding on warfarin can be life threatening

26
Q

The patient is being prepared for a cardiac catheterization. Which statement by the patient warrants immediate intervention by the nurse?

a. “I took my blood pressure medication yesterday.”

b. “I broke out in an awful rash after eating oysters.”

c. “I have not had my daily aspirin in more than a week.”

d. “I am highly allergic to poison ivy or oak.”

A

b. “I broke out in an awful rash after eating oysters.”

*** an allergy to shellfish indicates a probably allergy to IV contrast dye

27
Q

The 28-year-old patient who is obese is complaining of nervousness, irritability, insomnia, and heart palpitations. Which question should the clinic nurse ask the patient first?

a. “How much weight have you gained or lost within the last 12 months?”

b. “Do you make yourself vomit after eating large meals?”

c. “Is there any history of you taking illegal drugs such as amphetamines?”

d. “Have you been taking any over the counter appetite suppressants?”

A

d. “Have you been taking any over the counter appetite suppressants?”

*** these are common side effects of appetite suppressants

28
Q

The daughter of a client diagnosed with Alzheimer’s disease tells the home health nurse that she has been giving her mother ginkgo biloba, an herbal medication. Which intervention should the nurse implement?

a. Tell her to stop giving her mother the herb because it will not help.

b. Teach her that herbs have many life threatening adverse effects

c. Explain that the effects may only last for 6-12 months

d. Ask the HCP to prescribe tacrine (Cognex) instead of the herb

A

c. Explain that the effects may only last for 6-12 months

*** ginkgo can help with brain function but will not stop the progression of Alzheimer’s disease

29
Q

The charge nurse notices that the primary nurse is preparing to administer the antacid Maalox to the patient receiving his routine morning medications. Which intervention should the charge nurse take first?

a. Take no action because this is acceptable standard of practice

b. Discuss changing the administration time with the pharmacist

c. Inform the primary nurse to not administer the Maalox

d. Instruct the primary nurse to shake the Maalox container

A

c. Inform the primary nurse to not administer the Maalox

*** antacids have a chelation effect on other medications which makes them inactive. You should change the time that this med is given

** nurses can change the administration time of medications without talking to the pharmacist

30
Q

The patient diagnosed with end-stage liver failure is taking lactulose, a laxative. Which assessment data indicates the medication is effective?

a. The patient reports and decrease in pruritus

b. The patient’s abdominal girth has decreased

c. The patient is experiencing diarrhea

d. The patient’s ammonia level is decreased

A

d. The patient’s ammonia level is decreased

*** lactulose binds to ammonia and then carries it out with it in the bowels. That’s why their BMs smell like a litter box…. yuck

31
Q

The patient diagnosed with COPD is prescribed Solu-medrol (methylprednisolone) a glucocorticoid IVP. Which laboratory test should the nurse monitor?

a. WBC count

b. Hemoglobin and hematocrit

c. Blood glucose levels

d. BUN and creatinine

A

c. Blood glucose levels

*** glucocorticoids (steroids) can increase the blood glucose level causing a patient without diabetes to need PRN insulin

32
Q

The patient diagnosed with a PE is receiving intravenous heparin, and the HCP prescribes 5 mg of warfarin (Coumadin) orally once a day. Which statement best explains the scientific rationale for prescribing these two anticoagulants?

a. Coumadin interferes with production of prothrombin

b. It takes 3-5 days to achieve a therapeutic level with Coumadin

c. Heparin is more effective when administered with warfarin

d. Coumadin potentiates the therapeutic action of heparin

A

b. It takes 3-5 days to achieve a therapeutic level with Coumadin

*** It is standard procedure to bridge oral anticoagulants with IV heparin for a few days before discontinuing the heparin

33
Q

The patient is 2 days postoperative right total hip replacement and is receiving Lovenox subcutaneously. Which laboratory data should the nurse monitor?

a. PT

b. INR

c. There is no laboratory data to monitor

d. PTT

A

c. There is no laboratory data to monitor

***enoxaparin (Lovenox) is a factor Xa inhibitor which does not affect PT, PTT, or INR

34
Q

The nurse is preparing to administer medications to patients on an orthopedic floor. Which medication should the nurse question administering?

a. An NSAID to a patient with tendonitis that has a history of a duodenal ulcer

b. A PRN narcotic to a patient with an open reduction and internal fixation of the left tibia

c. A COX-2 inhibitor to a client who is diagnosed with osteoarthritis and has joint stiffness

d. A cephalosporin antibiotic to a client with osteomyelitis and as allergy to sulfa drugs

A

a. An NSAID to a patient with tendonitis that has a history of a duodenal ulcer

*** NSAIDS can cause duodenal ulcers and other GI problems