HESI PHARMACOLOGY EXIT-STUDY GUIDE

HESI PHARMACOLOGY EXIT-STUDY GUIDE The nurse should observe most closely for drug toxicity when a client receives a medication that has which characteristic? Nurse is conducting DC teaching about anti-anxiety drug diazepam (valium) Nursing instruction most important for patient on Zyloprim Client getting Tofranil (Imipramine) Magnesium antidote Patient with hyperthyroidism taking inderal (propanalol) A client with hyperthyroidism is receiving propranolol (Inderal). Which finding indicates that the medication is having the desired effect? - A client experiencing withdrawal from the benzodiazepines alprazolam (Xanax) is demonstrating severe agitation and tremors. What is the best initial nursing action? - A client with bipolar disorder began taking valproic acid (Depakote) 250 mg PO three times daily two months ago. Which finding provides the best indication that the medication regimen is effective? Patient on Heparin going for surgery in a.m.,-priority 1. A female client receives a prescription for alendronate sodium (Fosamax) to treat her newly diagnose osteoporosis. W /hat instruction should the nurse include in the client’s teaching plan? - A peak and trough level must be drawn for a client receiving antibiotic therapy. What is the optimum time for the nurse to obtain the trough level? Know the insulins and their peak/onset (there are several Qs about this in different formats) Chlamidia treatment RN is teaching a pt about a new drug… what’s most important to teach the pt to improve the intensity of the response to the drug A nurse is giving morphine 2 mg IV to a pt after surgery and she has followed the “six rights of administration”… RN doesn’t understand why a pt is to receive a prescribed med A nurse is administering a drug that is categorized as Schedule IV. The nurse understands that this means the drug: Where would a RN direct a pt to obtain more info about prescribed medications RN is prepared to administer Epinephrine to pt that has a severe allergic reaction Digoxin has 36-48 hr half life – because of the length of half life, the RN expects to be dosing this medication When teaching a patient who has a gastric ulcer about cimetidine (a histamine H2 antagonist) therapy, the nurse should include which information about antagonists A pt taking Digoxin is also prescribed Propanolol. The 2 drugs combined may cause a serious decrease in HR The nurse cares for a patient taking a calcium channel blocker for hypertension. The nurse is most concerned if the patient makes which statement? Which of the pts would be at highest risk for an adverse reaction RN receives a handwritten medication order – can’t read A breast-feeding pt is prescribed an antimicrobial medication The RN is evaluating the kidney fx of an 82 yo pt before administration of medications – The most important factor in an adverse drug reaction in the elderly population is A pt is prescribed Bethanocol (Muscarinic Agonist) for urinary retention – if pt exhibits signs of overdose such as: increased salivation, sweating, bradycardia, hypotention, the RN would administer The pt takes Oxybutinin (anticholenergic) for OOB takes an OTC antihistamine (anticholenergic) for hay fever After IM injection of penicillin the pt develops severe difficulty breathing and swollen tongue (Anaphylaxis) Pt receives a drug that blocks adrenergic receptors Orthostatic hypotension (no BP to the brain) A pt with diabetes gets a beta blocker (mask the signs of hypoglycemia and blocks beta receptors – inhibits glycogenolysis) A pt with depression is prescribed an antidepressant – the medication will reach full therapeutic effect A pt taking Levadopa/Carbadopa (dopaminergic) and experiences a frequent “on – off” episodes - A patient with mild symptoms of Alzheimer's disease is prescribed donepezil (Aricept). Which statement made by the patient indicates a need for further teaching? Which assessment best determines the effectiveness of Sumatriptan (triptans are used for treatment of Migraines so… - A patient with schizophrenia is prescribed chlorpromazine (Thorazine) oral concentrate. Which of the following discharge instructions should the nurse complete? Which assessment best determines the pt is developing tardive dyskinesia Pt is on Marplan (MAOIs – have the most food interactions) for depression Pt on Lithium A pt is prescribed Venlafaxine and the pt asks what the purpose of medication is, you should state A pt with OCD is prescribed Zoloft – which is not a true statement about the medication Pt states that he’s on Oxycodone and the dose that he currently receives does not provide the same pain relief A pt with HF is getting Furosemide (Lasix) (loop diuretic is K+ wasting) A client in renal failure asks why he is being given antacids - A client is receiving digoxin for the onset of supraventricular tachycardia (SVT). Which laboratory findings should the nurse identify that places this client at risk? - The healthcare provider prescribes naloxone (Narcan) for a client in the emergency room. Which assessment data would indicate that the naloxone has been effective? The client's... A client who has been taking levadopa PO Tid to control the symptoms of Parkinson’s disease has a new prescription for sustained-release levadopa/carbidopa (Simemet 25/100) PO Bid and took his levadopa at 0800 Which action is most important for the nurse to implement during the administration of the antiarrhythmic drug adenosine (Adenocard) Nurse is teaching a client with cancer about opioid management for intractable pain and tolerance related side effects. The nurse should prepare the client for which side effect that is most likely to persist during long-term use of opioids? - The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with congestive heart failure. Which intervention should the nurse implement prior to administering the digoxin? Which method of medication administration provides the client with the greatest first pass effect Rheumatoid arthritis takes ibuprophin (Motrin) 600 mg PO 4 times a day. To prevent gastrointestinal bleeding, misoprostol (Cytotec) 100 mcg PO is prescribed Which information is most important for the nurse to include in client teaching? - A client is receiving methylprednisolone (Solu-Medrol) 40 mg IV daily. The nurse anticipates an increase in which laboratory value as the result of this medication? - The nurse is preparing the 0900 dose of losartan (Cozaar), an angiotensin II receptor blocker (ARB), for a client with hypertension and heart failure. The nurse reviews the client's laboratory results and notes that the client's serum potassium level is 5.9 mEq/L. What action should the nurse take first? Taking hydromorphone (Dilaudid) PO q4h at home. Following surgery Dilaudid IV q4h PRN and butorphanol tartrate (Stadol) IV q4h PRN are prescribed for pain. The pt received a dose of dilaudid IV 4 hours ago and isagain requesting pain medication. What intervention should the nurse implement? Dobutamine (Dobutrex) is an emergency drug most commonly prescribed for which condition - A client with giardiasis is taking metronidazole (Flagyl) 2 grams PO. Which information should the nurse include in the client's instruction? - The nitrate isosorbide dinitrate (Isordil) is prescribed for a client with angina. Which instruction should the nurse include in this client's discharge teaching plan? - The nurse is reviewing the use of the patient-controlled analgesia (PCA) pump with a client in the immediate postoperative period. The client will receive morphine 1 mg IV per hour basal rate with 1 mg IV every 15 minutes per PCA to total 5 mg IV maximally per hour. What assessment has the highest priority before initiating the PCA pump? When assessing an adolescent who recently overdosed on acetaminophen (Tylenol), it is most important for the nurse to assess for pain in which area of the body