Pharmacology Final Exam (Questions from quizzes) with accurate answers 2024

A patient with which of the following disorders will need a lower dose of most drugs? a. Infection b. Cirrhosis c. Diabetes d. Colitis - answersb. cirrhosis You are administering a medication to a patient who is in pain. What is the best way to know if the medication worked? a. The patient will ask for the same medication again. b. The patient will tell you that his pain is gone. c. The doctor will tell you that you have given enough medication. d. The patient will no longer put on his call light. - answersb. The patient will tell you that his pain is gone. The nursing process is a way to solve problems. What step do you carry out to determine if the method you chose to solve the problem was helpful? a. Evaluation b. Assessment c. Diagnosis d. Implementation - answersa. Evaluation A current concern with elderly patients is the risk of increased adverse reactions and interactions when many different drugs are taken at once. This is called a. Synergism b. Tolerance c. Interdependence d. Polypharmacy - answersd. Polypharmacy A PRN medication order gives the nurse discretion regarding when to give the drug within the ordered parameters. Select one: True False - answersTrue What is the usual order of the nursing process? Select one: a. Assessment, Diagnosis, Planning, Implementation, Evaluation b. Diganosis, Evaluation, Assessment, Implementation, Planning c. Planning, Implementation, Diagnosis, Evaluation, Assessment d. Assessment, Evaluation, Diagnosis, Planning, Implementation - answersa. Assessment, Diagnosis, Planning, Implementation, Evaluation The patient's family has asked the doctor to make the patient comfortable but the patient wants to stay alert. The doctor has ordered Morphine 15 mg every 3 hours prn for pain. The patient is refusing to take the drug. How can you respond to the family and demonstrate support for the patient's autonomy? Select one: a. "I appreciate your concern but your father has told me that he does not want the drug." b. "I can see that your dad is having pain; I will prepare the drug." c. "I will tell your father that you are requesting that he take his drugs for pain." d. "Your father probably doesn't know what he is saying; I will get the drug for him." - answersa. "I appreciate your concern but your father has told me that he does not want the drug." The nurse is gathering assessment data for a patient's drug history. The patient states "I am not able to swallow pills." This is an example of which type of data? Select one: a. Objective b. Subjective - answersb. Subjective Creams and ointments used for skin lesions exert primarily a(an): Select one: a. local effect. b. systemic effect. - answersa. local effect Morphine has a high first pass effect. What are the implications of this for a patient receiving oral morphine for pain? Select one: a. The patient will need a lower dose of oral morphine than IV morphine. b. The patient will need the same amount of IV or oral morphine. c. The patient will need a higher dose of oral morphine than IV morphine. - answersc. The patient will need a higher dose of oral morphine than IV morphine Once a drug is administered, it is distributed throughout the body by the: Select one: a. blood. b. liver. c. kidneys. d. GI mucosa - answersa. blood The nurse is preparing to give a patient amlodipine/benazepril (Lotrel) an antihypertensive medication. The patient's blood pressure has been in the 110/70 range the last 3 days which is normal. Prior to administering this medication the nurse should do which of the following? Select one: a. Check the patient's heart rate. b. Check the patient's blood pressure. c. Call the physician and inquire why the medication is being given. d. Hold the medication for further clarification. - answersb. Check the patient's blood pressure. Which information is most important to collect when assessing for allergies? Select one: a. The date of the last reaction. b. Whether or not the physician was contacted after the reaction. c. If there is a supply of Benadryl in the home. d. What the allergy is to and what type of reaction was experienced. - answersd. What the allergy is to and what type of reaction was experienced. Most drugs are excreted by which route? Select one: a. Urinary b. Bowel c. Respiratory d. Oral - answersa. Urinary Older adult patients often need lower drug doses. Which of the following statements best explains why this occurs? Select one: a. Older people are at risk for drug tolerance. b. Older people may have altered GI function and an inability to absorb and distribute medications. c. Older people have diminished liver and kidney function, which will slow metabolism and excretion of medications. d. Older people are at risk for polypharmacy, which can lead to dependence and addiction. - answersc. Older people have diminished liver and kidney function, which will slow metabolism and excretion of medications. A patient has been on bronchodilator inhalers for 10 years. Over the years, he has had to increase the dose and frequency of the inhalers to achieve the same effect. This is an example of: Select one: a. drug dependence. b. drug tolerance. c. drug abuse. d. idiosyncratic action. - answersb. drug tolerance A patient is malnourished with an albumin level of 2.6 (normal is 3.2-4.5 g/dl). Low serum albumin may affect the patient's medication dosage needs because: Select one: a. low serum albumin will impair liver function, thereby reducing metabolism of the drug. b. low serum albumin will cause increased protein loss by the kidneys, thereby affecting excretion of the drugs. c. less serum protein will be available for medication binding, so less free drug will be available. d. less serum protein will be available for medication binding, and more free drug will be available. - answersd. less serum protein will be available for medication binding, and more free drug will be available It is important to know what the patient eats and drinks because certain foods, beverages, alcohol, caffeine and even cigarettes can interact with medicines. Select one: True False - answersTrue Controlled substances are described in five categories (schedules). A substance that is medically accepted but can lead to strong physical and psychologic dependence is in Schedule _______. Select one: a. I b. II c. III d. V - answersb. II The American Nurses Association (ANA) and the Canadian Nurses Association (CNA) have a Code of Ethics for Nurses. Which of the following statements is NOT reflected in the ANA code for nurses? Select one: a. The nurse practices with compassion and respect for the inherent dignity and worth of all patients. b. The nurse prescribes medications for clients and their families in health care. c. The nurse assumes responsibility and accountability for nursing judgments and actions. d. The nurse maintains competence in nursing. - answersb. The nurse prescribes medications for clients and their families in health care. Which of the following effects might result from a severe drug allergy? Select one: a. nausea and poor appetite b. anaphylaxis c. gastrointestinal bleeding d. teratogenic - answersb. anaphylaxis The serum half life is important in determining: Select one: a. renal function. b. presence of side effects. c. length of treatment. d. dosing interval. - answersd. dosing interval. The half-life of Coumadin (warfarin) is 2 days. The medication wil be cleared by the liver after how many days? Select one: a. 2 b. 4 c. 6 d. 8 - answersd. 8 You will be studying digoxin (Lanoxin) this term. Lanoxin is an example of a: Select one: a. generic name. b. trade name. c. chemical name - answersb. trade name The agency responsible for enforcement of laws pertaining to drugs is: Select one: a. The Federal Bureau of Drug Investigation b. The Federal Food and Cosmetic Bureau c. The Drug Enforcement Agency (DEA) d. The New Drug Application Agency - answersc. The Drug Enforcement Agency (DEA) When you establish goals for a client you are engaging in which step of the Nursing process? Select one: a. interventions b. assessment c. planning d. evaluation - answersc. planning A child is given a sedative before an invasive procedure. Instead of calming him, he becomes very excited. This an example of which effect? Select one: a. hypersensitive b. tolerant c. displaced d. idiosyncratic - answersd. idiosyncratic If a drug has a low therapeutic index, it is: Select one: a. a very safe drug. b. a potentially unsafe drug. c. a very effective drug. d. a minimally effective drug - answersb. a potentially unsafe drug In what order do drugs act in the body? Select one: a. excretion, absorption, distribution, metabolism b. absorption, distribution, metabolism, excretion c. absorption, metabolism, distribution, excretion d. distribution, absorption, metabolism, excretion - answersb. absorption, distribution, metabolism, excretion Most drugs are metabolized in the: Select one: a. kidneys. b. spleen. c. liver. d. intestines - answersc. liver Mr. Jones has drugs prescribed for pain relief. He asks you whether he can continue to drive heavy machinery while taking these drugs. A nursing diagnosis that you might consider would be: Select one: a. Health Seeking Behaviors b. Acute Pain c. Noncompliance d. Ineffective Management of Therapeutic Regimen. - answersa. Health Seeking Behaviors The nurse is preparing to administer a schduled dose of morphine 5 mg IM. The client reports having an allergy to codeine and refuses the medication. Select one: a. The nurse does not give the medication. b. The nurse reviews the medication record, noting the client has received morphine before, and reassures the client that there has not been an allergy to morphine. The nurse then administers the medication after the client consents to receive it. c. The nurse holds the medication and calls the physician. d. The nurse informs the client that this is not true and gives the medication - answersb. The nurse reviews the medication record, noting the client has received morphine before, and reassures the client that there has not been an allergy to morphine. The nurse then administers the medication after the client consents to receive it. The concept of informed consent is important in drug testing. Which statement explaining informed consent is best? Select one: a. Patients must be told whether they are receiving an experimental drug or a placebo in a new drug study. b. Detailed information about human responses to a drug being studied must be presented to a patient before informed consent may be given. c. Patients must be informed of the consent of their physician before participating in a drug study. d. Patients must be clearly told of any risks involved in a drug study before consenting to participate. - answersd. Patients must be clearly told of any risks involved in a drug study before consenting to participate. You just gave Mr. John Jones' medications to Mr. Tom Jones. You are new at the job and are still in orientation, and are concerned that if you report your error that you will lose your job. It is safe and acceptable not to tell anyone of the error as long as you monitor the patient carefully and report any adverse effects. Select one: True False - answersFalse Pegaspargase, an antineoplastic agent, is in pregnancy category C. What does this mean? Select one: a. There is no risk to the fetus. b. No risk has been shown in humans. c. There is insufficient data to determine safety in women. d. Human fetal risk has been clearly documented. - answersc. There is insufficient data to determine safety in women. Sometimes two drugs are given together, and the total effect is greater than the expected effect of the two drugs given separately. This is called: Select one: a. tolerance. b. antagonism. c. synergism. d. additive effect. - answersc. synergism. Janis has a history of myasthenia gravis, and takes pyridostigmine (Mestinon) 60 mg po q 3 hours. Pyridostigmine is a cholinergic drug that reduces symptoms of myasthenia gravis by: Select one: a. breaking down acetylcholine in the sympathetic synapses. b. enhancing dopamine production in the CNS. c. inhibiting acetylcholinesterase at the neuromuscular junction. Good, if AChE is inhibited, then more ACh will be available to help the muscles contract! d. enhancing norepinephrine production in the adrenal medulla. - answersc. inhibiting acetylcholinesterase at the neuromuscular junction. An example of an alpha blocker is: Select one: a. metoprolol (Lopressor) b. glycopyrrolate (Robinul) c. chromolyn sodium (Intal) d. prazosin (Minipress) - answersd. prazosin (Minipress) How should the nurse evaluate the patient's response to pyridostigmine administered to treat myasthenia gravis? Select one: a. Monitor heart rate. b. Test muscle strength. c. Listen to bowel sounds. d. Assess mental status. - answersb. Test muscle strength. What teaching should the nurse provide for Mr. Ford related to his use of a beta blocker? Select one: a. Teach him to monitor his pulse and blood pressure. b. Explain the importance of avoiding foods high in fiber. c. Encourage him to monitor his intake of sugar. d. Teach him the importance of regular lab work to monitor his potassium level - answersa. Teach him to monitor his pulse and blood pressure. Intravenous atropine may also be given in some emergency situations to: Select one: a. reduce blood pressure. b. treat narcotic overdose. c. raise the heart rate. d. induce vomiting - answersc. raise the heart rate. Miss M is being prepared for abdominal surgery. Her nurse administers atropine IM. Atropine is useful before surgery for which of the following actions? Select one: a. It relaxes muscles to make incising easier. b. It constricts blood vessels and reduces risk of hemorrhage. c. It produces amnesia and clouds memory of surgery. d. It decreases GI secretions and reduces risk of aspiration. - answersd. It decreases GI secretions and reduces risk of aspiration. Epinephrine and related drugs should be used with caution in patients with a history which of the following? Select one: a. hypertension b. depression c. recent surgery d. asthma - answersa. hypertension Which of the following drugs is an example of a beta blocking agent? Select one: a. bethanechol (Urecholine) b. propranolol (Inderal) c. enalapril (Vasotec) d. atropine - answersb. propranolol (Inderal) What effects will albuterol have on Lucy? Select one: a. bronchoconstriction, vasodilation, lipolysis b. bronchodilation, tachycardia, increased blood sugar c. bronchodilation, hypoglycemia, diarrhea d. bronchoconstriction, elevated blood sugar, slowed heart rate - answersb. bronchodilation, tachycardia, increased blood sugar Mabel is transferred to the intensive care unit for acute congestive heart failure. The physician orders a dopamine IV drip. The nurse knows that dopamine is in which class of drugs? Select one: a. adrenergic b. adrenergic blocker c. cholinergic d. cholinergic blocker - answersa. adrenergic When taking a beta blocker it is also important for Mr. Ford to understand the importance of: Select one: a. taking his medication with an antacid. b. having monthly kidney function tests. c. not stopping his drug abruptly. d. avoid taking his medication with food - answersc. not stopping his drug abruptly Mr. Ford has essential hypertension and is started on a beta blocking agent. Beta blockers reduce blood pressure by: Select one: a. inhibiting parasympathetic innervation to the vessels b. inhibiting release of beta hormone c. blocking acetylcholine release from the adrenal medulla d. blocking sympathetic action at beta receptors - answersd. blocking sympathetic action at beta receptors Alpha blockers may also be used for hypertension. They act primarily on: Select one: a. kidneys b. heart contractility c. bronchi d. blood vessels - answersd. blood vessels Lucy is admitted to the emergency room with an acute asthma attack. The physician orders a nebulized mist treatment (NMT) with albuterol (Ventolin). To which of the following drug classes does albuterol belong? Select one: a. cholinergic agonists b. cholinergic blockers c. adrenergic agonists d. adrenergic blockers - answersc. adrenergic agonists Atropine and other anticholinergics should NEVER be given to patients with a history of which disorder? Select one: a. bradycardia b. prostatic hypertrophy Good, atropine can further aggravate urinary retention, not good for someone with prostate problems! c. atherosclerosis d. asthma - answersb. prostatic hypertrophy The nurse would assess for which of these side effects that are common to barbituates and benzodiazepines? Select one: a. Abdominal cramping and constipation b. Sedation and some respiratory depression c. Manic behavior and psychosis d. Tachycardia and hypertension - answersb. Sedation and some respiratory depression A patient remains stable while taking Thorazine for several years. Then the patient is admitted to the hospital with unusual involuntary movements of the face, mouth and tongue. The nurse would expect that this is due to which of these? Select one: a. Tardive dyskinesia b. Anticholinergic side effects c. Antiadrenergic effects - answersa. Tardive dyskinesia A patient who has been receiving Morphine is now confused and has shallow respirations. Which of these is the narcotic antagonist for treating narcotic overdose that the nurse would anticipate would be ordered for the patient? Select one: a. naloxone (Narcan) b. methadone (Dolophine) c. Atropine d. Epinephrine - answersa. naloxone (Narcan) A patient, who is taking an antiparkinson drug, experiences dizziness when getting up in the morning. Which of these patient instructions will be most helpful in preventing this dizziness when rising to a standing position? Select one: a. "You should lie back down if you feel dizzy." b. "Rise slowly and dangle your feet over the side of the bed before getting up." c. "Discontinue the medication immediately and call your physician." d. "Talk to your doctor about taking medication to raise your blood pressure." - answersb. "Rise slowly and dangle your feet over the side of the bed before getting up." For which of the following is ondansetron (Zofran) used effectively? Select one: a. Post-anesthesia nausesa and vomiting b. Irritable bowel syndrome c. Mild Alzheimer's disease d. Local anesthesia - answersa. Post-anesthesia nausesa and vomiting Phenytoin (Dilantin) controls seizures by which of these actions? Select one: a. Suppressing potassium movement in muscle fibers b. Promoting prostaglandin activity c. Stabilizing nerve cells in the motor cortex d. Inhibiting acetylcholine in the periphery - answersc. Stabilizing nerve cells in the motor cortex Due to potent side effects, ketorolac (Toradol) cannot be given for a longer time period than which of these? Select one: a. 24 hours b. 5 days c. 2 weeks d. 6 months - answersb. 5 days When should rivastigmine (Exelon) be administered to a patient? Select one: a. In the morning prior to eating b. With meals c. Two hours after meals d. At bedtime - answersb. With meals Multiple Response Item In which of these situations should aspirin be avoided to prevent complications? (Select all answers that apply). Select one or more: a. For a person who is experiencing the symptoms of a heart attack. b. A four year old who has the flu c. For headache relief in a patient with asthma d. Every 4 hours continuously for arthritis in a 79 year old person - answersb. A four year old who has the flu c. For headache relief in a patient with asthma d. Every 4 hours continuously for arthritis in a 79 year old person Larodopa (Levodopa) helps relieve symptoms of Parkinson's disease by which of these actions? Select one: a. Blocking cholinergic activity in the brain. b. Inhibiting a virus causing Parkinson's disease. c. Stimulating uptake of serotonin in the central nervous system. d. Increasing the amount of dopamine in the brain. - answersd. Increasing the amount of dopamine in the brain. Which of the following is an example of a tricyclic antidepressant? Select one: a. phenelzine (Nardil) b. amitriptyline (Elavil) c. sertraline (Zoloft) d. bupropion (Wellbutrin) - answersb. amitriptyline (Elavil) Morphine sulfate acts to reduce pain by which of these actions? Select one: a. Producing adrenergic blockade b. Depressing peripheral nerve perception c. Binding to opiate receptors in CNS d. Reducing prostaglandin activity - answersc. Binding to opiate receptors in CNS Fluoxetine (Prozac) does not affect epinephrine levels, so which effects would be expected as a result? Select one: a. Less sedating side effects b. Increased insomnia c. Increased hepatotoxicity d. Fewer cardiovascular side effects - answersd. Fewer cardiovascular side effects The nurse would evaluate a patient as understanding instructions about taking lorazepam (Ativan) if the patient makes which of these statements? Select one: a. "I know I should avoid sunlight while I'm on Ativan." b. "I should avoid drinking alcohol while I'm taking Ativan." c. "I will stop the Ativan completely the minute I am feeling better." d. "I'm going to take my first dose of Ativan tomorrow morning, just before I drive to work." - answersb. "I should avoid drinking alcohol while I'm taking Ativan." When teaching a patient about NSAIDs which of these should the patient be taught as part of the teaching plan? Select one: a. Arthritic pain relief is immediate. b. Avoid taking NSAIDs with food. c. Monitor stools for gastrointestinal bleeding. d. Few drug interactions occur with NSAIDs. - answersc. Monitor stools for gastrointestinal bleeding. When teaching a patient how to take an antipsychotic medication, which of these statements would indicate patient understanding to the nurse? Select one: a. "I will stop taking the medication when I have had continued relief of symptoms for one month." b. "I will take the medication exactly as prescribed, even if my symptoms are gone." c. "I will take the medication with an antacid if gastric distress occurs." d. "I will increase the dosage by one half if my symptoms worsen." - answersb. "I will take the medication exactly as prescribed, even if my symptoms are gone." Which of these assessments is most essential for the nurse to make for a patient receiving a narcotic? Select one: a. Pupil and corneal reflex checks b. Blood pressure and respirations c. Gag reflex and appetite level d. Gait and muscle strength - answersb. Blood pressure and respirations Which of these can occur with high doses of acetaminophen (Tylenol)? Select one: a. Hepatotoxicity b. Spleenomegaly c. Fever d. Polyuria - answersa. Hepatotoxicity Which of these instructions should be included in the teaching plan of a patient who is taking phenytoin (dilantin)? Select one: a. "Brush and floss your teeth daily." b. "Your blood sugar may decrease so you will always feel hungry." c. "Check your pulse before each dose." d. "Eat a banana or an orange daily." - answersa. "Brush and floss your teeth daily." Which of these is a possible side effect of spinal anesthesia? Select one: a. Lethargy b. Hypertension c. Headache d. Increased respiratory rate - answersc. Headache Which of these side effects would a patient likely experience while taking cyclobenzaprine (Flexeril)? Select one: a. Dry mouth b. Diarrhea c. Cold intolerance d. Urinary frequency - answersa. Dry mouth