***Practice Midterm*** Flashcards
1st generation antihistamines, like diphenydramine, are associated with \_\_?\_\_ A. Dry eyes, mouth and throat B. Urinary retention C. Sedation D. Inability to sweat E. All the above
All the above
A 30 year-old client with depression has attempted suicide by overdosing on acetaminophen. The nurse in the emergency department anticipates the use of which agent in an attempt to limit liver damage due to the acetaminophen? A. Flumazenil B. Neostigmine C. Dantrolene D. Naltrexone E. Acetylcysteine
Acetylcysteine
A 65-year-old client is taking high doses of aspirin for pain related to osteoarthritis of the knee. Which of these is a toxic effect caused by aspirin that this patient should be made aware of during patient teaching as an immediate signal of overdose? A. Tinnitus or other changes in hearing B. Changes in taste (dysgeusia) C. Sedation D. Photosensitivity E. Increased gestation time
Tinnitus or other changes in hearing
A client is prescribed an Advair Diskus for symptoms related to chronic obstructive pulmonary disease. The education provided by the nurse regarding the use of this inhaler will include:
A. Rinse your mouth out well after each use
B. It may make you sleepy
C. Stay out of the sun
D. All of the above
E. None of the above
Rinse your mouth out well after each use
A client with asthma asks which of these prescribed medications should be used in the event of an acute episode of bronchospasm. The nurse replies, that for a typical acute asthma attack, use: A. Epinephrine B. Albuterol C. Salmeterol D. Advair Diskus E. Montelukast
Albuterol
A drug name ends in "pril," what is the drug class? A. ACEI B. NSAID C. LOX inhibitor D. LT Receptor blocker E. ARB
ACEI
A high fat meal can substantially reduce the absorption of the DRI drug called \_\_?\_\_. A. Promethazine B. Aliskiren C. Benazepril D. Ibuprofen E. Diphenhydramine
Aliskiren
A trade name like "Benadryl" or "Diovan" is: A. Never on the label B. Not trade marked C. Proprietary D. Always the same as the chemical name E. Nonproprietary
Proprietary
ACEI work better in Caucasians than in \_\_?\_\_ A. Polynesians B. African Americans C. Europeans D. Hispanics E. Asians
African Americans
Acetylation is a type of Phase II conjugation reaction. There are people who genetically, are fast acetylators and others whose enzymes work slowly. In a fast acetylator, given a normal amount of a drug metabolized by this route, you would expect (assumes drug is NOT a prodrug):
A. Treatment failure
B. Not enough information to answer
C. Toxicity or overdose
D. The drug will be metabolized slower than normal
E. No effect
Treatment failure
ALL sedative hypnotics cause \_\_?\_\_, some more so than others. Think alcohol intoxication. A. Bad breath B. Steven-Johnson's syndrome C. Drug-induced amnestic state D. Renal failure E. Blindness
Drug-induced amnestic state
An anti-inflammatory agent is ordered to be given IV to a client for pain. Which of these anti inflammatories is available as an IV? A. Acetaminophen B. Etanercept C. Aspirin D. Ibuprofen E. Celecoxib
Ibuprofen
Angiotensin Converting Enzyme Inhibitors (ACEI), Angiotensin Receptor Blockers (ARBs) and Direct Renin Inhibitors (DRIs) all have a boxed warning regarding __?__
A. Severe tissue injury regardless of administration route
B. 1st dose anaphylaxis
C. Fatal respiratory depression in kids
D. Fetotoxicity in the 2nd and 3rd trimester
E. Suicide
Fetotoxicity in the 2nd and 3rd trimester
Aspirin is associated with \_\_?\_\_ in kids with viral infections (influenza or chicken pox). A. Respiratory distress syndrome B. Reye's syndrome C. Urticaria D. Constipation E. GIT ulcers
Reye’s syndrome
Benzodiazepines, non-benzodiazepine sedative hypnotics and barbiturates all cause \_\_?\_\_. A. Tolerance B. Dependence C. Withdrawal syndrome D. Some degree of amnesia E. All the above
All the above
Catecholamines are hormones produced by the adrenal medulla. They include NE, EPI and \_\_?\_\_. A. Dopamine B. Serotonin C. Histamine D. Acetylcholine E. Melatonin
Dopamine
Corticosteroids are associated with causing drug-induced \_\_?\_\_ A. Angioedema B. Antimuscarinic effects C. Cataracts D. Sedation E. Gastric ulcers
Cataracts
H1 antagonists are known as \_\_?\_\_ A. Antihyupertensive agents B. Antihistamines C. Antidepressants D. Gastric acid reducers E. Anti migraine drugs
Antihistamines
Having the HLA-B 1502 allele (a variant of the HLA-B gene) predisposes patients on carbamazepine to \_\_?\_\_ A. Epilepsy B. Steven Johnson's Syndrome C. Heart disease D. Psychosis E. Blood dyscrasias
Steven Johnson’s Syndrome
Isoflurane is a lung irritant and will cause laryngospasm and bronchospasm. It is contraindicated in \_\_\_?\_\_ A. Diabetes mellitus type 2 patients B. Minor surgical procedures C. Dentists D. Asthmatics E. The elderly
Asthmatics
Isoflurane is associated with \_\_?\_\_. A. Post-op nausea and vomiting (PONV) B. Laryngospasm and apnea C. Changes in mood D. Shivering E. All the above
All the above
Lithium causes goiter because it \_\_?\_\_. A. Inhibits the release of thyroid hormone B. Has antimuscarinic symptoms C. Has a narrow therapeutic margin D. Has a withdrawal syndrome E. Causes weight gain
Inhibits the release of thyroid hormone
Loratadine has a long half-life, therefore it is administered less frequently than 1st generation antihistamines like \_\_?\_\_ A. Diphenhydramine B. Buspirone C. Fexofenadine D. Valsartan E. Fluoxetine
Diphenhydramine
Medications are primarily regulated by:
A. The EPA (Environmental Protection Agency)
B. The OSHA (Occupational Safety and Health Administration)
C. The DHS (Department of Health Services)
D. The DEA (Drug Enforcement Administration)
E. The FDA (Food and Drug Administration)
The FDA
Metabolism may produce metabolites (daughters) that (are): A. More or less toxic than the parent B. Have a new action or effect C. More or less active than the parent D. Similar to the parent E. All the above
All the above
Mirtazapine (Remeron) is an antidepressant that affects a number of CNS receptors including the 5-HT3 receptor. Mirtazapine inhibits the 5-HT3 receptors found on the CTZ, so you would expect Mirtazapine to be \_\_\_ ? \_\_\_\_. A. Antiemetic like haloperidol B. Antimigraine like sumatriptan C. Antiemetic like scopolamine D. Antiemetic like ondansetron E. Anxiolytic like buspirone
Antiemetic like ondansetron
Misoprostol has a boxed warning regarding __?__
A. 1st dose anaphylaxis
B. Suicide
C. Fetoxiticy in the 2nd and 3rd trimester
D. Severe tissue injury regardless of administration route
E. Risk of abortion in pregnant women
Risk of abortion in pregnant women
Monoamine Oxidase Inhibitors (MAOIs) are associated with \_\_?\_\_. A. Dependence B. Neuroleptic Malignant Syndrome C. Serotonin syndrome D. Tolerance E. Malignant hyperthermia
Serotonin syndrome
Morphine, an opioid analgesic, is an example of a drug derived from \_\_?\_\_ A. Plants B. Bacteria or yeast C. Animals D. Minerals E. Synthetic chemistry
Plants
NSAIDs are assoicated with \_\_?\_\_ A. Myalgia B. Sedation C. Dry mouth, dry eyes D. Gastric ulcers E. Cataracts
Gastric ulcars
Part of educating a client about the effects of using an orally inhaled drug such as albuterol should include a warning about:
A. Photophobia
B. Sedation
C. Immediate increase in heart rate which may include palpitations
D. A predisposition to infections
E. Fetotoxicity
Immediate increase in heart rate which may include palpitations
Patients who are already taking a diuretic, who are then given an ACEI, may experience severe: A. Hypotension B. Neutropenia C. Dysgeusia D. Hyperkalemia E. Hepatotoxicity
Hypotension
Patients with a genetic predisposition to developing \_\_\_?\_\_\_ are at particular risk when given the halogenated volatile liquid general anesthetics and inorganic gas general anesthetics. A. Serotonin syndrome B. Megaloblastic anemia C. Malignant hyperthermia D. Steven Johnson's syndrome E. Neuroleptic malignant syndrome
Malignant Hyperthermia
Patients with a ___?___ should not use Ester local anesthetics like benzocaine.
A. Risk factor for malignant hyperthermia
B. G6PD deficiency
C. Cold
D. HIstory of heart disease
E. PABA allergy
PABA Allergy
Phenobarbital is a potent \_\_?\_\_ A. TCA B. SSRI C. Benzodiazepine D. SNRI E. P450 inducer
P450 Inducer
Renin-Angiotensin-Aldosterone pathways control blood pressure. Renin is an enzyme released from kidney juxtaglomerular epithelial cells in response to __?__
A. Decreased NaCl detected in the kidney
B. Sympathetic (beta 1) stimulation
C. Decreased intra renal pressure
D. Decreased blood pressure
E. All the listed answers are correct
All
Selective Serotonin Reuptake Inhibitors (SSRIs) have \_\_?\_\_. A. Control schedule I (CI) listing B. A narrrow therapeutic margin C. A risk of EPS D. Analgesic effects E. A withdrawal syndrome
A withdrawal syndrome
Sufentanil is a potent opioid analgesic indicated for use as part of balanced general anesthesia. Which of the following products contains an opioid similar to sufentanil? A. Sublimaze B. Versed C. Ketaset D. Ultane E. Diprivan
Sublimaze
The elderly generally require lower doses or more careful monitoring because:
A. Their livers are no longer synthesizing normal amounts or proteins including plasma proteins and metabolic enzymes
B. The kidney function is significantly reduced due to age
C. Their cardiac function is significantly reduced due to age
D. They have experienced alterations in body water and lean body mass
E. All the above
All
The most commonly prescribed antidepressants, including SNRIs and SSRIs, are associated with \_\_?\_\_ A. Potential effects on clotting B. Weight gain C. Delayed onset (often times weeks) D. Sexual dysfunction E. All the above
All