nursing nurs Pharmacology Test 1 2024 UPDATE

nursing nurs Pharmacology Test 1 2024 UPDATE Which drugs will go through a pharmaceutic phase after it is administered? Subcutaneous antiglycemics Oral analgesics Intravenous vasopressors Intramuscular cephalosporins The nurse is preparing to administer an oral medication and wants to ensure a rapid drug action. Which form of the medication will the nurse administer? Tablet Liquid solution Enteric-coated pill Capsule The nurse is teaching a patient who will be discharged home with a prescription for an enteric-coated tablet. Which statement by the patient indicates understanding of the teaching? “I may crush the tablet and put it in applesauce to improve absorption.” “I should consume acidic foods to enhance absorption of this medication.” “I should expect a delay in onset of the drug’s effects after taking the tablet.” “I should take this medication with high-fat foods to improve its action.” Which nursing actions would be most appropriate for ensuring patient safety with a medication that has a low therapeutic index? Monitoring serum peak and trough levels Monitoring a patient’s urine output Assessing vital signs hourly Maintaining strict isolation precautions A patient about to receive his morning dose of digoxin has an apical pulse of 70 per minute. What should the nurse do? Withhold the dose, and notify the physician. Notify the physician, and monitor the patient’s vital signs. Recheck the pulse, making sure to count for 1 full minute Administer the dose. In assessing the patient before administration of a cardiac glycoside, the nurse knows that what condition can predispose a patient to digitalis toxicity? Heart failure Hypokalemia Hypocalcemia Hyperkalemia The nurse is reviewing medication information with a nursing student prior to administering an oral drug and notes that the drug has extensive first-pass effects. Which statement by the student indicates the student understands the concept of first-pass effect? “The first-pass effect reduces all the toxic effects of the drug" "The first-pass effect means the drug must make a second pass through the liver to make it a more active drug.” “A drug given via the oral route may be extensively metabolized by the liver before reaching the systemic circulation.” “The first-pass effect means the drug must circumvent the liver.” The nurse prepares to change a patient’s medication from an intravenous to an oral form and notes that the oral form is ordered in a higher dose. The nurse understands that this is due to differences in pinocytosis. protein binding. bioavailability. tachyphylaxis. A nurse with adequate knowledge about the administration of intravenous nitroglycerine will recognize that which statement is correct? The IV form is given by IV push injection. Because the IV form is short-lived, the dosing must be every hour. Intravenous nitroglycerine must be protected from exposure to light through a special tubing. Intravenous nitroglycerine can be given by gravity drip infusion. The nurse gives 800 mg of a drug that has a half-life of 8 hours. How much drug will be left in the body eight hours after the drug is given if no additional drug is given? None 50 mg 400 mg 200 mg While assessing a patient who is receiving digoxin, the nurse recognizes that the drug has a negative chronotropic effect. How would this drug effect be evident in the patient? No answer text provided. Decreased heart rate Decreased Q-wave Increased ectopic beats The nurse is preparing to administer a drug that is eliminated through the kidneys. The nurse reviews the patient’s chart and notes that the patient has increased serum creatinine and blood urea nitrogen (BUN). The nurse will perform which action? Administer the drug as ordered. Anticipate a shorter than usual half-life of the drug. Expect decreased drug effects when the drug is given. Notify the provider and discuss giving a lower dose. A patient at home has been taking digoxin at home but has taken an accidental overdose and has developed toxicity. He has been admitted to the telemetry unit where the physician has ordered digoxin immune Fab (Digibind). The patient asks the nurse why this medication was ordered. The nurse’s best response is: “It works faster than digoxin.” “It is safer than digoxin and can be taken orally.” “It helps to convert the irregular heart rhythm to a more normal rhythm.” “This drug is an antidote to digoxin and will help to lower the blood levels. The nurse is preparing to administer the first dose of digoxin (Lanoxin) to a patient and notes that the first dose ordered is much higher than the subsequent doses, this is called: Stacking. Testing tolerance. Tachyphylaxis. Digitalization. A nurse is preparing to administer digoxin (Lanoxin) to a patient. Which laboratory result is the nurse most concerned about? Sodium 138 mEq/L Potassium 3.0 mEq/L Digitalis level 1.8 ng/mL BNP 100 pg/mL A patient is admitted to the intensive care unit with increased intracranial pressure. The nurse would anticipate administering: furosemide (Lasix). mannitol (Osmitrol). triamterene (Dyrenium). spironolactone (Aldactone). The first-line drug of choice to treat PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA (PSVT) is Digoxin Verapamil Calcium channel blockers Adenosine The nurse is preparing to administer digoxin to a patient who has heart failure. The patient reports nausea, vomiting, headache, and yellow vision. The nurse notes a respiratory rate of 18 breaths per minute, a heart rate of 58 beats per minute, and a blood pressure of 120/78 mm Hg. What will the nurse do next? Administer the next dose as ordered since these are mild side effects. Hold the dose and notify the provider of possible digoxin toxicity. Reassure the patient that these are common, self-limiting side effects. Request an order for an antiemetic and an analgesic medication. The nurse performs a medication history and learns that the patient takes a thiazide diuretic and digoxin (Lanoxin). The nurse will question the patient to ensure that the patient is also taking which medication? Cortisone Lidocaine Nitroglycerin Potassium The nurse administers a dose of digoxin (Lanoxin) to a patient who has heart failure and returns to the room later to reassess the patient. Which finding indicates that the medication is effective? Decreased urine output Decreased dyspnea Increased blood pressure Increased heart rate A patient with angina has been given a prescription for a calcium channel blocker. The nurse knows that this class of drugs is used to treat which type of angina? Stable angina Unstable angina Vasospastic (Prinzmetal) angina Crescendo angina The nurse is teaching a patient about the use of a transdermal nitroglycerin patch. Which statement by the patient indicates understanding of the teaching? “I will apply the patch as needed when I experience anginal pain.” “I will remove the old patch and replace it with a new one at bedtime each day.” “I should rotate sites when changing the patch to prevent skin irritation.” “When I am symptom-free, I may stop using the patch on a regular basis.” The nurse is teaching a patient about sublingual nitroglycerin administration. What information will the nurse include when teaching this patient? Call 911 immediately. Continue current activity. Swallow the tablet with small sips of water. Take the first tablet while sitting or lying down. A patient is ordered to receive a nitrate to relieve stable angina. What side effect(s) will the nurse anticipate in a patient receiving this medication? Nausea and vomiting Increased blood pressure Pruritus and skin rash Pounding headache A patient asks the nurse why nitroglycerin is given sublingually. The nurse will explain that nitroglycerin is administered by this route for which reason. To avoid hypotension To avoid first pass effect To minimize gastrointestinal upset To prevent hepatotoxicity A patient who has been taking nitroglycerin for angina has developed variant angina (Prinzmetal angina), and the provider has added A calcium channel blocker (verapamil -Calan) to the patient’s regimen. The nurse will explain that verapamil is given for which purpose? To facilitate oxygen use by the heart To improve renal perfusion To increase cardiac contractility To relax coronary arteries Which statement need to be included when the nurse provides patient education for a patient with heart failure who is taking daily doses of spironolactone (Aldactone)? "Be sure to eat foods high in potassium." "Avoid foods high in potassium." "Avoid read meats while taking this medication." " A low fiber diet will prevent adverse effects of this drug." The nurse is administering lidocaine and considers which condition , if present in the patient, a caution for the use of this drug ? Tachycardia Hypertension Ventricular dysrhythmias Renal dysfunction Prinzmetal angina occurs as a result of electrolyte imbalance a spasm of a coronary artery decreased venous return to the heart a ventricular arrhythmia The nurse is caring for a patient who develops marked edema and a low urine output as a result of heart failure. Which medication will the nurse expect the provider to order for this patient? Digoxin (Lanoxin) Furosemide (Lasix) Hydrochlorothiazide (HydroDIURIL) Spironolactone (Aldactone) Angina causes death of heart muscle cells. is pain due to lack of oxygen to myocardial cells. cannot occur at rest. is not treatable Question 32 The nurse is caring for a patient who is taking hydrochlorothiazide (HydroDIURIL) and digoxin (Lanoxin). Which potential electrolyte imbalance will the nurse monitor for in this patient? Hypomagnesemia Hypernatremia Hypocalcemia Hypokalemia A patient with heart failure will be started on a beta blocker metroprolol (Toprol). The nurse will monitor for which expected cardiovascular effect. Increased heart rate Increased myocardial contractility Defective automaticity Reduced heart rate When monitoring laboratory test results for patients receiving loop and thiazide diuretics, the nurse knows to look for? decreased serum levels of potassium increased serum levels of calcium decreased serum levels of glucose increased serum levels of sodium. Antiarrhythmic drugs alter the action potential of the cardiac cells. Because they alter the action potential, antiarrhythmic drugs often cause heart failure. alter blood flow to the kidneys. cause new arrhythmias. cause electrolytes disturbances. When a nurse is checking the laboratory data for a patient taking spironolactone (Aldactone), which results would be a potential concern? Serum sodium level of 140mEq/L Serum calcium level of 10.2 mg/dL Serum potassium level of 6.8mEq/L Serum magnesium levels of 2.0 mg/dL The nurse should instruct a patient to not suddenly stop taking Beta Blockers in order to avoid rebound bradycardia. rebound tachycardia. rebound hypertension. rebound hypotension. A patient is recovering from surgery to replace her right hip. In the early postoperative phase, the nurse anticipates administration of which drug to prevent deep vein thrombosis? Dipyridamole (Persantine) Low-molecular-weight heparin (Lovenox) Abciximab (ReoPro) Anagrelide HCl (Agrylin) Which information will the nurse include when teaching a patient about warfarin (Coumadin) therapy? Increase the amount of green, leafy vegetables in your diet. Rinse your mouth instead of brushing your teeth. Follow up with laboratory tests such as PT or INR to regulate warfarin (Coumadin) dose. Use a new razor blade each time you shave. During thrombolytic therapy, the nurse monitors the patient for adverse effects. What is the most frequent undesirable effect of thrombolytic therapy? Dysrhythmias Nausea and vomiting Anaphylactic reactions Internal and superficial bleeding A patient has received too much warfarin. The nurse would expect to give which antidote for warfarin toxicity? Vitamin E Vitamin K Protamine sulfate Potassium phosphate A patient visits an outpatient clinic. The patient has been noncompliant with anticoagulation therapy and states, “I don’t like having to have blood work all of the time.” The nurse anticipates prescription of which medication? Abciximab (ReoPro) Tirofiban (Aggrastat) Eptifibatide (Integrilin) Dabigatran (Pradaxa) A patient will be receiving a thrombolytic drug as part of the treatment for acute myocardial infarction. The nurse explains to him that this drug is used to: Relieve chest pain. Prevent further clot formation. Dissolve the clot in his coronary artery. Control bleeding in the coronary microcirculation. A patient who is beginning anticoagulant therapy (Heparin) would be told that the primary goal of drug therapy is to: Prevent further clotting. Dissolve an existing thrombus. Stabilize an existing thrombus. Prevent the thrombus from becoming an embolus. A patient who is taking warfarin (Coumadin) therapy has a headache and wants to take a pain reliever. Which of the following is recommended? aspirin tablets ibuprofen (Advil), an NSAID acetaminophen (Tylenol) Calling the office for an opioid order The nurse is caring for a patient who received alteplase tPA (Activase) for treatment of acute cerebral stroke. The patient starts to bleed. The nurse anticipates administration of which medication? Protamine sulfate (protamine) Vitamin K (Mephyton) Warfarin (Coumadin) Aminocaproic acid (Amicar) A patient with diabetes has a new prescription for a thiazide diuretic. Which statement will the nurse include when teaching the patient about the thiazide drug? "There is nothing for you to be concerned about when you are taking the thiazide diuretic." "Be sure to avoid foods high in potassium." "You need to take the thiazide at night to avoid interaction with the diabetic drug." "Monitor your blood sugar level closely, thiazide diuretics may affect your blood sugar levels.” A patient has liver and kidney disease. He is given a medication with a half- life of 30 hours. The nurse expects the duration of this medication to increase decrease remain unchanged dissipate Most drugs are metabolized in the: kidney. small intestine. liver. brain. A patient with a rapid, irregular heart rhythm is being treated in the ER with adenosine. During administration of this drug, the nurse be prepared to monitor the patient for what effect? Nausea and vomiting Asystole for a few seconds Muscle tetany Hypertension A patient’s serum lipids are cholesterol 197 mg/dL, low-density lipoprotein (LDL) 110 mg/dL, and high-density lipoprotein (HDL) 35 mg/dL. The nurse knows what about these values? Serum lipids are within desirable values. Cholesterol is within desirable value, but LDL and HDL are not. Cholesterol is not within desirable value, though LDL and HDL are. Cholesterol, LDL, and HDL are not within desirable values. A patient is receiving medication therapy for peripheral vascular disease. Which medication does the nurse identify as an antiplatelet drug? Cilostazol (Pletal) Papaverine (Para-Time) Prazosin (Minipress) Nifedipine (Procardia) A major side effect of a "Statin" drug is? Nausea and vomiting Blood Dyscrasias Hepatotoxicity Kidney failure