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Pharm 2 > Practice Questions/TBL Exam 3 > Flashcards

Practice Questions/TBL Exam 3 Flashcards

1
Q

Drugs used to treat Parkinson’s disease work on which neurotransmitters? SATA

  • Epinephrine
  • Dopamine
  • Acetylcholine
  • Norepinephrine
A

Dopamine

Acetylcholine

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2
Q

Why is carbidopa combined with levodopa?

  • To enhance the effects of levodopa
  • When the two drugs are combined, more levodopa is metabolized by the intestines and peripheral tissues
  • To prolong the action of the drug and reduce drug dosing to every other day
  • To increase the taste of the medication and improve compliance
A

To enhance the effects of levodopa

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3
Q

What is meant by the “wearing off” effect?

  • Increasing doses of the drug are required to get the same effect
  • Loss of effect of the dose occurs as the end of the dosing interval when the next dose is due
  • The patient becomes tolerant to the medication and the drug is no longer effective
  • The dose is too great for the patient and needs to be reduced
A

Loss of effect of the dose occurs as the end of the dosing interval when the next dose is due

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4
Q

Anti cholinesterase drugs are effective for treatment of Alzheimer’s disease? T or F

A

False

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5
Q

Anti cholinesterase drugs for Alzheimer’s disease work by

  • Preventing the destruction of acetylcholine by receptors and therefore increasing the amount available at the synapse
  • Increasing the amount of acetylcholine produced in neurons
  • Preventing the re-uptake of acetylcholine by acetylcholinesterase and therefore increasing the amount of AcH available at the synapse
  • Preventing the breakdown of ACH thereby increasing the amount of ACH at cholinergic synapses
A

Preventing the breakdown of ACH thereby increasing the amount of ACH at cholinergic synapses

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6
Q

Which of the following is true about memantine (Namenda) for ALZ disease?

  • Memantine is used in moderate or severe ALZ
  • Memantine is poorly tolerated that few patients on the medication
  • Memantine works better than anti cholinesterase inhibitors
  • Memantine has been proven to slow the progression of AD
A

Memantine is used in moderate or severe AS

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7
Q

A patient is starting on levodopa/carbidopa and doesn’t want to take the medication because it makes him nauseous. What is the most appropriate response from the nurse?

  • Take the medication before bedtime
  • The nausea will get better after about 6 weeks
  • Take the medication with food to help decrease nausea
  • Nausea is an AE and may indicate toxicity
A

Take the med with food to help decrease nausea

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8
Q

What potential side effect does the nurse monitor for a patient taking meds for PD that impacts safety?

  • Shuffling gait
  • Orthostatic hypotension
  • Frequent urination
  • HA
A

Orthostatic hypotension

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9
Q

The nurse anticipates what outcome from a patient taking donepezil for AD?

  • Improved attention
  • Recall of previously forgotten information
  • Improved sleep
  • Slowing or maintaining cognitive function
A

Slowing or maintaining cognitive function

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10
Q

What time of the day should the nurse schedule donepezil for a newly admitted patient?

  • 9 AM
  • 10 AM
  • 12 NOON
  • 6 PM
A

6 PM

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11
Q

What is a common side effect of many of the anti-epileptic medications?

  • CNS side effects
  • Hepatotoxicity
  • Bone marrow suppression
  • Hair loss
A

CNS side effects

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12
Q

A nurse providing teaching for a patient with a newly diagnosed partial complex seizure disorder who is about to begin therapy with AEDS. Which statement by the patient indicates understanding of the teaching?

  • Even with an accurate diagnosis of my seizures, it may be difficult to find an effective drug
  • I will soon know that the drugs are effective by being seizure free for several months
  • Serious side effects may occur, and if they do, I should stop taking the medication
  • When drug levels are maintained at therapeutic levels, I can expect to be seizure free
A

Even with an accurate diagnosis of my seizures, it may be difficult to find an effective drug

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13
Q

Most anti-epileptic drugs are pregnancy category A or B? T or F

A

False

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14
Q

A nurse is caring for a patient who has been taking an AED for several months. The nurse asks the patient if the therapy is effective. The patient reports there has been no change in frequency of seizures, despite taking the medication as it was prescribed. What action should the nurse take?

  • Contact the provider to request an order for serum drug levels
  • Ask the patient to complete a seizure frequency chart for the past few weeks
  • Reinforce the need to take the med as prescribed
  • Request an order to increase the dose of the AED
A

Contact the provider to request an order for serum drug levels

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15
Q

A nurse counsels a patient who is to begin taking phenytoin (Dilantin) for epilepsy. Which statement by the patient indicates understanding of the teaching?

  • I should brush and floss my teeth regularly
  • Once therapeutic blood levels are reached, it is east to keep the levels steady
  • I can consume alcohol in moderation while taking this drug
  • Rashes are a common SE but are not serious
A

I should brush and floss my teeth regularly

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16
Q

Which two classes of drugs are used most for anxiety disorders?

  • Benzodiazepines
  • Barbituates
  • SSRI
  • Tricyclic antidepressants
A

Benzos and SSRI

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17
Q

Which of the following drug classes include the most commonly prescribed treatment choices for insomnia? SATA

  • SSRI
  • Benzo
  • Benzo- like drugs
  • Antihistamines
A

Benzo and Benzo-like drugs

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18
Q

The home health nurse is working with a patient who takes zolpidem for sleep. What statement by a family member indicates a side effect from this medication?

  • Waking with a dry mouth
  • Feeling hungover in the morning
  • Difficulty falling asleep
  • Restless leg syndrome
A

Feeling hungover in the morning

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19
Q

A patient on a medsurg unit is admitted because of new onset seizure disorder. Which medication does the nurse expect to be ordered PRN with the indication of use if the patient has a seizure?

  • Carbamazepine IV
  • Zolpidem oral
  • Lorazepam IV
  • Diazepam oral
A

Lorazepam IV

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20
Q

A 23-year old patient is prescribed oral triazolam for sleep. What is the priority concern of the nurse for this patient with the first dosing?

  • Falls
  • Respiratory depression
  • Paradoxical anxiety
  • Needed for a repeat dose
A

Falls

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21
Q

A patient presents to the ED unresponsive with known use of benzodiazepines. What drug should be administered?

  • Lorazepam
  • Flumazenil
  • Phenytoin
  • Naloxone
A

Flumazenil

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22
Q

All of the following medications are available on the medication administration record of a patient. Which of the following is routinely used solely for insomnia?

  • Lorazepam
  • Midazolam
  • Diazepam
  • Triazolam
A

Triazolam

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23
Q

A patient reports to the nurse that his spouse is telling him he is doing strange things, like doing laundry and cleaning the house when sleeping. The nurse recognizes this as a potential AE with which medication?

  • Flumazenil
  • Zolpidem
  • Buspirone
  • Triazolam
A

Zolpidem (Ambien)

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24
Q

A nurse is working with a patient who is using hydroxyzine for management of anxiety. What AE is the nurse concerned may be made worse by use of this medication?

  • Insomnia
  • Low BP
  • Urinary retention
  • Itching
A

Urinary retention

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25
Q

A patient is starting the drug buspirone for management of anxiety. What concern does the nurse have about this medication?

  • Discussion with the patient about returning to the office for any refill needs
  • Instructing the patient that there may be an increased risk of suicide with this med, so alert the provider of any mood changes
  • The patient will need to stop having a glass of wine with dinner
  • The patient enjoys drinking grapefruit juice for breakfast
A

The patient enjoys drinking grapefruit juice for breakfast `

26
Q

The nurse notices that a patient has gingival hypertrophy from seizure medication use. What teaching should the nurse provide the patient?

  • Good oral hygiene will help; brushing teeth, flossing and massaging gums
  • Gingival hypertrophy can be a sign of toxicity
  • A dentist is essential to help you manage this SE
  • If you also have a skin rash, that could mean you are having a serious reaction to this drug
A

Good oral hygiene will help; brushing teeth, flossing and massaging gums

27
Q

What initial medication is given for someone actively having a seizure?

  • Phenytoin
  • Lorazepam
  • Valproic acid
  • Carbamezepine
A

Lorazepam

28
Q

A nurse is monitoring the blood work for a patient taking phenytoin for management of seizures. Which laboratory result indicates normal serum levels?

  • 5 - 10 mcg/nL
  • 5 - 20 mcg/ nL
  • 10 - 20 mcg/nL
  • 10 - 15 mcg/nL
A

10 - 20 mcg/nL

29
Q

A patient is newly diagnosed with epilepsy and doesn’t like the new medication because of the sedation SE. What response is most appropriate by the nurse?

  • Some medications are more sedating than others. Talk to your provider about switching to a different medication
  • Try taking the medication at bedtime only
  • Make sure that you aren’t taking this medication with other medications
  • The sedation will improve after a couple of weeks. It is always worse when you first start a medication
A

The sedation will improve after a couple of weeks. It is always worse when you first start a medication

30
Q

A patient is taking valproic acid for management of epilepsy. Which of the following clinical symptoms is of highest concern and should be reported to the provider?

  • Right upper quadrant pain, N/V, and lack of appetitie
  • Heartburn and belching
  • Rash and tremor
  • Weight gain and hair loss
A

Right upper quadrant pain, N/V, and lack of appetite

31
Q

Which of the following gout medications is used for an acute attack and may cause gastric upset?

  • Colchicine
  • Allopurinol (zyloprim)
  • Penicillamine (Cuprimine)
  • Sulfasalazine (azulfidine)
A

Colchicine

32
Q

These drugs used to be reserved for advanced RA but are now being used within 3 months of RA diagnosis because they can delay joint degeneration

  • Biphosphonates
  • Calcitonin therapy
  • Disease modifying drugs (DMARDs)
  • NSAIDS
A

Disease modifying drugs

DMARDs

33
Q

Calcium carbonate

A

Calcium supplement

34
Q

Calcitrol

A

Vitamin D therapy

35
Q

Alendronate (Fosamax)

A

Biphosphonate

36
Q

Evista (Ralocifene)

A

SERM

37
Q

Methotrexate (Rheumatrex)

A

DMARD

38
Q

Allopurinol (Zyloprim)

A

Decreases uric acid levels

39
Q

Colchicine

A

Anti-inflammatory gout agent

40
Q

Methotrexate can be used to treat RA. What other condition is it used for?

  • Cancer
  • Pernicious anemia
  • Cardiac dysrhythmias
  • Renal failure
A

Cancer

41
Q

A patient has top from gout that is causing a great degree of pain when ambulating. Which drug do you expect the provider to prescribe that will help to reduce the size of the tophi?

  • Probenecid
  • Naproxen sodium
  • Allopurinol
  • Colchicine
A

Allopurinol

42
Q

A patient is taking colchicine for a gout attack. Which of the following complains should the nurse report to the provider as the drug therapy should be stopped?

  • The patient reports four episodes of loose stool in the last 24 hours
  • The patient complains of increased pain in the joint with gout
  • The patient reports he is unable to tolerate NSAIDS drug therapy due to a history of CKD stage 3
  • The patients BP is 178/78 and his pulse is 52
A

The patient reports four episodes of loose stool in the last 24 hours

43
Q

A long-term resident with osteoporosis is prescribed 1200mg/day calcium carbonate supplementation. How should the nurse schedule the medication?

  • Schedule 1200 mg at bedtime to manage associated nausea
  • Schedule one dose at breakfast and one at dinner
  • Schedule twice a day at 10 am and 10 pm to avoid food interactions
  • Administer calcium at the same time as vit D to ensure absorption
A

Schedule BID at 10 am and 10 pm to avoid food interactions

44
Q

A patient is scheduled for alendronate administration. Which of the following situations would alert the nurse to reschedule the administration of this medication.

  • Patient with new complains of oral candidiasis infeciton
  • The patient reports new diagnosis of HTN
  • The patients lab report reveals an elevated WBC count
  • The patient has just finished eating breakfast
A

The patient has just finished eating breakfast

45
Q

A patient is on estrogen replacement therapy for menopausal symptom management. Which admitting diagnosis would signal the nurse to hold the scheduled estrogen dose and contact the provider

  • Hip fracture
  • Suspected MI
  • Osteomyelitis
  • Hysterectomy
A

Suspected MI

46
Q

An individual is taking raloxifene drug therapy. The nurse understands that this medication has which effect on bone health

  • increases the activity of osteoclasts
  • Interferes with the effect on calcium and vitamin D supplementation
  • Increases the risk of bone fractures in postmenopausal individuals
  • improves bone density
A

Improves bone density

47
Q

A patient has RA. Which medication is best used for short term treatment but not long-term management of symptoms?

  • NSAIDS
  • Steroid therapy
  • DMARD
  • Biologic agents
A

Steroid therapy such as prednisone

48
Q

The patient is asking the nurse how soon they will start seeing the improvement in RA symptoms with methotrexate. Which of the following is the best response by the nurse?

  • Quick effect such as within 24 hours
  • Approximately one week
  • Typically 3-6 weeks
  • At least one month
A

Typically 3-6 weeks

49
Q

Prior to starting a patient on entanjrcept, what screening needs to occur to ensure safety?

  • testing for TB
  • Screening for malaria
  • approval by insurance
  • presence of another autoimmune disorder
A

Testing for TB

50
Q

A patient with RA is starting a tumor necrosis factor antagonist drug therapy. Which vaccine would the nurse be concerned about the patient reciting while on this drug therapy?

  • Hepatitis B
  • COVID 19
  • Influenza injection
  • Varicella (chickenpox)
A

Varicella (chicken pox) - live vaccine

51
Q

Which of the following statements is true about antidepressants and suicide risk?

  • Suicide risk decreases when patients are placed on antidepressants
  • Elderly patients are at greatest risk of suicide when placed on antidepressants
  • Suicide is a risk only for patients taking MAOI antidepressants
  • Suicide risk is greatest for younger patients (under age 25) taking antidepressants
A

Suicide risk is greatest for younger patients (under age 25) taking antidepressants

52
Q

The most common AE of tricyclic antidepressants include:

  • Orthostatic hypotension, sedation, and anticholinergic side effects
  • Sedation, sexual dysfunction, and weight gain
  • Diaphoresis, dysrhythmias, mania
  • Hypertension, palpitations, and tachycardia
A

Orthostatic hypotension, sedation and anticholinergic side effects

53
Q

Patients who are taking MAOI for depression will experience ____ when they eat tyramine rich foods

  • Paranoia and hallucinations
  • Hypertensive crisis
  • Severe hypotension and cardiovascular collapse
  • Sedation and respiratory depression
A

Hypertensive crisis

54
Q

Bupriopion, an atypical antidepressant is used not only for depression but is also effective as ____

  • Treatment of PTSD
  • Anorexia treatment
  • An aid to quit smoking
  • Treatment for bed-wetting
A

An aid to quit smoking

55
Q

Which signs and symptoms are a part of serotonin syndrome? SATA

  • Fever and sweats
  • Altered mental status
  • Tremors
  • Hypertensive crisis
A

Fever and sweats
Altered mental state
Tremors

56
Q

A patient with bipolar disorder calls the primary care office with concerns of a GI bug. What information is crucial to report to the provider about this patient as the patient is at highest risk of complication?

  • The patient takes lithium carbonate and has a 2-day history of nausea, vomiting and diarrhea up to 12 stools a day
  • The patient takes lithium carbonate and the last drug levels were checked 10 days ago
  • A patient with a GI bug reports not being able to take his medication for the last 2 days
  • A patient with bipolar disorder, on lithium reports nausea since starting the medication 3 days ago
A

The patient takes lithium carbonate and has a 2-day history of nausea, vomiting, and diarrhea up to 12 stools a day

57
Q

The ER nurse is questioning a patient admitted in a hypertensive crisis who takes phenelzine (Nardil). Intake of which food may have precipitated the hypertensive crisis?

  • Avocado toast with sea salt
  • Diet Coke and a burger
  • Ice cream with caramel sauce
  • Eggs and ham omelet
A

Avocado toast with sea salt

58
Q

The nurse is scheduling the medications for a new patient admitted to LTC. What time should the nurse schedule the medication imipramine?

  • with dinner
  • early AM
  • at HS
  • PRN
A

@ HS –> bedtime

59
Q

Which antidepressant medication should not cause sexual dysfunction?

  • Bupropion
  • Isocarboxiazide (Marlin)
  • Fluoxetine
  • Imipramine
A

Bupropion

60
Q

The nurse makes a point of monitoring the BP more frequently in a LTC patient started on which antidepressant medication?

  • Venlafaxine
  • Fluoxetine
  • Imipramine
  • Tranylcypromine (Partite)
A

Venlafaxine

Pharm 2 (2 decks)

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