Focus on Nursing Pharmacology Chapters 47, 48, 49, & 51 Exam Questions With 100% Correct Answers (Wolters Kluwer Amy M. Karch)

Focus on Nursing Pharmacology Chapters 47, 48, 49, & 51 Exam Questions With 100% Correct Answers (Wolters Kluwer Amy M. Karch) The client has been prescribed nicotinic acid for treatment of hyperlipidemia. The nurse should teach about which common side effects with the medication? - Fever - Facial tics - Drowsiness - Flushing of the skin - answerFlushing of the skin A health care provider has prescribed triamterene to a male client with renal disease. The client informs the nurse that he is taking potassium supplements to address some heart problems. The nurse would be alert for: (Ch 51) - Decreased diuretic effects. - Increased risk of hyperkalemia. - Increased risk of arrhythmias. - Increased risk of bleeding. - answerIncreased risk of hyperkalemia. Rationale: Potassium-sparing diuretics are not as powerful as loop diuretics, but they retain potassium instead of wasting it. They cause a loss of sodium while promoting the retention of potassium. The most common adverse effect of these drugs is hyperkalemia. Patients taking these drugs need to be evaluated regularly for signals of increased potassium and informed about the signs and symptoms to watch out for. Patients should be advised to avoid foods that are high in potassium. (Box 51.6) (pg 901-902) The nursing instructor is talking with a student about erythropoietin drug therapy. What is an adverse effect of erythropoietin drug therapy that the instructor would tell the student about? - Constipation - Hypotension - Depression - Edema - answerEdema The clinic nurse has been assigned to a 43-year-old client who is obese and loves to eat. The client has been diagnosed with hyperlipidemia and has been prescribed lovastatin. Which dietary instruction would be a priority for the nurse to discuss with the client? (Ch 47) - Increase intake of fatty acids. - Avoid drinking grapefruit juice. - Decrease intake of plant stanols. - Increase intake of milk and dairy products. - answerAvoid drinking grapefruit juice. Rationale: HMG-CoA reductase inhibitors block HMG-CoA reductase from completing the synthesis of cholesterol. This blocks the early rate-limiting step in the synthesis of cellular cholesterol that involves the enzyme HMG-CoA. Thus, serum cholesterol and LDL levels decrease because more LDLs are absorbed by the cells for processing into cholesterol. In contrast, HDL levels increase slightly with this alteration in fat metabolism. (pg 821) Patients who are taking HMG-CoA inhibitors need to be cautioned to avoid drinking grapefruit juice while taking these drugs. Grapefruit juice alters the metabolism of the drugs, leading to an increased risk for adverse effects, such as the potentially fatal rhabdomyolysis with renal failure. The metabolism of the components of grapefruit juice takes about 48 hours . Since the effects may last for several days, just drinking grapefruit juice at a different time of the day does not protect the patient from risk. (pg 823, Box 47.7) A 22-year-old female who has severe dysmenorrhea has been prescribed ferrous gluconate (Fergon) to treat iron deficiency anemia. What is important for the nurse to instruct the client to avoid when taking the drug? - Eggs - Pork - Chocolate - Whole wheat - answerEggs A 22-year-old female client is seen in the primary care provider's office for a follow-up visit. Six weeks ago she was diagnosed with iron deficiency anemia and has been taking the prescribed iron supplement. She noticed that her stool has turned black. She tells the nurse she fears that she is bleeding to death inside her belly. The nurse teaches the client about which expected outcome? (Ch 49) - "Iron supplements cannot cause bleeding." - "Black stool is not a sign of internal bleeding." - "Iron supplements may cause bleeding, but this is nothing to worry about." - "Iron supplements can cause black or dark stools because of the iron composition." - answer"Iron supplements can cause black or dark stools because of the iron composition." Rationale: The iron preparations stain the stools; the color remains as long as you are taking the drug and should not cause concern. The most common adverse effects associated with oral iron are related to direct GI irritation. (pg 871) The nurse is teaching a male client who has just been prescribed a bile acid sequestrate. The nurse teaches the client that he may mix his lipid-lowering agent with a carbonated beverage. What bile acid sequestrant is the client taking? - Cholestyramine (Questrant) - Colesevelam (Colestid) - Colestipol (Colestid) - Ezetimibe (Zetia) - answerColestipol (Colestid) What is an example of a loop diuretic? (Ch 51) - Furosemide (Lasik) - Chlorothiazide (Diuril) - Acetazolamide (Diamox) - Spironolactone (Aldactone) - answerFurosemide (Lasik) Rationale: Furosemide is a loop diuretic. Chlorothiazide is a thiazide diuretic. Acetazolamide is a carbonic anhydrase inhibitor. Spironolactone is a potassium-sparing diuretic. (pg 890) A client has been diagnosed with chronic renal failure. Which medication will assist in raising the client's hemoglobin levels? - Estazolam - Epoetin alfa