Pharmacology FINAL EXAM Review Revision 2024

The nurse is administering parenteral drugs. Which statement is true regarding parenteral drugs? a. Absorption of parenteral drugs is affected by reduced blood flow to the stomach. b. Parenteral drugs bypass the first-pass effect. c. Parenteral drugs exert their effects while circulating in the bloodstream. d. Absorption of parenteral drugs is faster when the stomach is empty. - ANSWERSb During a nursing assessment, which question by the nurse allows for greater clarification and additional discussion with the patient? a. "Are you taking this medication with meals?" b. "Are you allergic to penicillin?" c. "What medications do you take?" d. "Have you had a reaction to this drug?" - ANSWERSc A patient is taking the nonsteroidal anti-inflammatory drug indomethacin (Indocin) as treatment for pericarditis. The nurse will teach the patient to watch for which adverse effect? a. Tachycardia b. Nervousness c. Dizziness d. Nausea and vomiting - ANSWERSd A patient with a severe fungal infection has orders for voriconazole (Vfend). The nurse is reviewing the patient's medical record and would be concerned if which assessment finding is noted? a. Decreased breath sounds in the lower lobes b. Potassium level of 4.0 mEq/L c. History of type 2 diabetes d. History of cardiac dysrhythmias - ANSWERSd The patient is experiencing chest pain and needs to take a sublingual form of nitroglycerin. Where does the nurse instruct the patient to place the tablet? a. On top of the tongue b. At the back of the throat c. In the space between the cheek and the gum d. Under the tongue - ANSWERSd The nurse notes in a patient's medication history that the patient is taking allopurinol (Zyloprim). Based on this finding, the nurse interprets that the patient has which disorder? a. Osteoarthritis b. Gout c. Rheumatoid arthritis d. Systemic lupus erythematosus - ANSWERSb Which nursing diagnosis is appropriate for the patient who has just received a prescription for a new medication? a. Lack of knowledge regarding newly prescribed drug therapy b. Impaired memory related to new drug therapy c. Noncompliance related to new drug therapy d. Deficient knowledge related to newly prescribed drug therapy - ANSWERSd The nurse is monitoring for therapeutic results of antibiotic therapy in a patient with an infection. Which laboratory value would indicate therapeutic effectiveness of this therapy? a. Increased hemoglobin level b. Decreased platelet count c. Increased red blood cell count d. Decreased white blood cell count - ANSWERSd When given an intravenous medication, the patient says to the nurse, "I usually take pills. Why does this medication have to be given in the arm?" What is the nurse's best answer? a. "The intravenous medication will have delayed absorption into the body's tissues." b. "The action of the medication will begin sooner when given intravenously." c. "The medication will cause fewer adverse effects when given intravenously." d. "There is a lower chance of allergic reactions when drugs are given intravenously." - ANSWERSb A patient has a urinary tract infection. The nurse knows that which class of drugs is especially useful for such infections? a. Macrolides b. Sulfonamides c. Carbapenems d. Tetracyclines - ANSWERSb During a busy night shift, a new nurse administered an unfamiliar medication without checking it in a drug handbook. Later that day, the patient had a severe reaction because he has renal problems, which was a contraindication to that drug. The nurse may be liable for which of these? a. Autonomy b. Nonmaleficence c. Nursing negligence d. Medical negligence - ANSWERSc The nurse is providing counseling to a woman who is HIV positive and has just discovered that she is pregnant. Which anti-HIV drug is given to HIV-infected pregnant women to prevent transmission of the virus to the infant? a. Zidovudine (Retrovir) b. Acyclovir (Zovirax) c. Foscarnet (Foscavir) d. Ribavirin (Virazole) - ANSWERSa Which are appropriate considerations when the nurse is assessing the learning needs of a patient? (Select all that apply.) a. Health beliefs b. Level of education c. Family history d. Readiness to learn e. Cultural background - ANSWERSa, b, d, e A patient is receiving hydroxychloroquine therapy but tells the nurse that she has never traveled out of her city. The nurse knows that a possible reason for this drug therapy is which condition? a. Intestinal tapeworms b. Lyme disease c. Systemic lupus erythematosus d. Toxoplasmosis - ANSWERSc A patient who has been hospitalized for 2 weeks has developed a pressure ulcer that contains multidrug-resistant Staphylococcus aureus (MRSA). Which drug would the nurse expect to be chosen for therapy? a. Vancomycin (Vancocin) b. Metronidazole (Flagyl) c. Ciprofloxacin (Cipro) d. Tobramycin (Nebcin) - ANSWERSa A patient who has advanced cancer is receiving opioid medications around the clock to keep him comfortable as he nears the end of his life. Which term best describes this type of therapy? a. Supplemental therapy b. Maintenance therapy c. Palliative therapy d. Empiric therapy - ANSWERSc The nurse will be injecting a drug into the fatty tissue of the patient's abdomen. Which route does this describe? a. Subcutaneous b. Transdermal c. Intradermal d. Intramuscular - ANSWERSa The nurse is reviewing the applications of gene therapy. Which drug is manufactured as a result of indirect gene therapy? a. Human insulin b. Heparin c. Vitamin K d. Warfarin - ANSWERSa The nurse is assessing a newly admitted 83-year-old patient and determines that the patient is experiencing polypharmacy. Which statement most accurately illustrates polypharmacy? a. The patient uses over-the-counter drugs for an illness. b. The patient is experiencing multiple illnesses. c. The patient uses one medication for an illness several times per day. d. The patient uses multiple medications simultaneously. - ANSWERSd The nurse is administering an amphotericin B infusion. Which actions by the nurse are appropriate? (Select all that apply.) a. Using an infusion pump for IV therapy b. Knowing that muscle twitching may indicate hypokalemia c. Discontinuing the drug immediately if the patient develops tingling and numbness in the extremities d. If adverse effects occur, reducing the IV rate gradually until they subside e. Monitoring the IV site for signs of phlebitis and infiltration f. Administering premedication for fever and nausea g. Administering the medication by rapid IV infusion h. Knowing that the intravenous solution for amphotericin B will be cloudy - ANSWERSa,c,e,f When the nurse considers the timing of a drug dose, which factor is appropriate to consider when deciding when to give a drug? a. The patient's height b. The patient's ability to swallow c. The patient's last meal d. The patient's allergies - ANSWERSc The nurse is performing an assessment of a patient. Which assessment findings may indicate a higher risk for genetic disorders? (Select all that apply.) a. The patient's grandfather died of a cerebral vascular accident at 78 years of age. b. The patient's mother was diagnosed with breast cancer at 33 years of age. c. The patient has two uncles and a grandparent who have been diagnosed with Alzheimer's disease. d. The patient's father was diagnosed with heart disease at 60 years of age. e. The patient's sister has a history of both renal and lung cancer. - ANSWERSb,c,e When reviewing the allergy history of a patient, the nurse notes that the patient is allergic to penicillin. Based on this finding, the nurse would question an order for which class of antibiotics? a. Sulfonamides b. Quinolones c. Tetracyclines d. Cephalosporins - ANSWERSd The nurse is reviewing the medication history of a patient who will be taking a sulfonamide antibiotic. During sulfonamide therapy, a significant drug interaction may occur with which of these drugs or drug classes? (Select all that apply.) a. Warfarin (Coumadin) b. Sulfonylureas c. Oral contraceptives d. Antihistamines e. Phenytoin (Dilantin) f. Opioids - ANSWERSa,b,c,e A patient who has a history of coronary artery disease has been instructed to take one 81-mg aspirin tablet a day. The patient asks about the purpose of this aspirin. Which response by the nurse is correct? a. "It will help to prevent clot formation." b. "It helps to reduce inflammation." c. "Aspirin is given to relieve pain." d. "Aspirin is given reduce anxiety." - ANSWERSa A patient will be receiving nitrofurantoin (Macrodantin) treatment for a urinary tract infection. The nurse is reviewing the patient's history and will question the nitrofurantoin order if which disorder is present in the history? (Select all that apply.) a. Type 1 diabetes mellitus b. Hyperthyroidism c. Coronary artery disease d. Liver disease e. Chronic renal disease - ANSWERSd,e The nurse is providing teaching to a patient taking an oral tetracycline antibiotic. Which statement by the nurse is correct? a. "Avoid direct sunlight and tanning beds while on this medication." b. "Milk and cheese products result in increased levels of tetracycline." c. "Take the medication until you are feeling better." d. "Antacids taken with the medication help to reduce gastrointestinal distress." - ANSWERSa A patient with gout has been treated with allopurinol (Zyloprim) for 2 months. The nurse will monitor laboratory results for which therapeutic effect? a. Decreased white blood cell count b. Decreased uric acid levels c. Decreased prothrombin time d. Increased hemoglobin and hematocrit levels - ANSWERSb The patient has been taking an over-the-counter (OTC) acid-reducing drug because he has had "stomach problems" for several months. He tells the nurse that the medicine helps as long as he takes it, but once he stops it, the symptoms return. Which statement by the nurse is the best advice for this patient? a. "Using this drug may relieve your symptoms, but it does not address the cause. You should be seen by your health care provider." b. "The over-the-counter dosage may not be strong enough. You should be taking prescription-strength for best effects." c. "The over-the-counter drug has helped you, so you should continue to take it." d. "For best results, you need to watch what you eat in addition to taking this drug." - ANSWERSa The patient is to receive oral guaifenesin (Mucinex) twice a day. Today, the nurse was busy and gave the medication 2 hours after the scheduled dose was due. What type of problem does this represent? a. "Right time" b. "Right route" c. "Right dose" d. "Right medication" - ANSWERSa A patient has used enteric aspirin for several years as treatment for osteoarthritis. However, the symptoms are now worse and she is given a prescription for a nonsteroidal anti-inflammatory drug and misoprostol (Cytotec). The patient asks the nurse, "Why am I now taking two pills for arthritis?" What is the nurse's best response? a. "Cytotec will also reduce the symptoms of your arthritis." b. "Cytotec reduces the mucous secretions in the stomach, which reduces gastric irritation." c. "Cytotec helps the action of the NSAID so that it will work better." d. "Cytotec may help to prevent gastric ulcers that may occur in patients taking NSAIDs." - ANSWERSd A 6-year-old child who has chickenpox also has a fever of 102.9° F (39.4° C). The child's mother asks the nurse if she should use aspirin to reduce the fever. What is the best response by the nurse? a. "It's best to wait to see if the fever gets worse." b. "Acetaminophen (Tylenol) should be used to reduce his fever, not aspirin." c. "You can use the aspirin, but watch for worsening symptoms." d. "You can use aspirin, but be sure to follow the instructions on the bottle." - ANSWERSb During a period of time when the computerized medication order system was down, the prescriber wrote admission orders, and the nurse is transcribing them. The nurse is having difficulty transcribing one order because of the prescriber's handwriting. Which is the best action for the nurse to take at this time? a. Ask the patient what medications he takes at home. b. Wait until the prescriber makes rounds again to clarify the order. c. Contact the prescriber to clarify the order. d. Ask a colleague what the order says. - ANSWERSc The nurse is reviewing pharmacology terms for a group of newly graduated nurses. Which sentence defines a drug's half-life? a. The time it takes for one half of the original amount of a drug to be absorbed into the circulation b. The time it takes for one half of the original amount of a drug to reach the target cells c. The time it takes for the drug to cause half of its therapeutic response d. The time it takes for one half of the original amount of a drug to be removed from the body - ANSWERSd During drug therapy for pneumonia, a female patient develops a vaginal superinfection. The nurse explains that this infection is caused by: a. large doses of antibiotics that kill normal flora. b. an allergic reaction to the antibiotics. c. resistance of the pneumonia-causing bacteria to the drugs. d. the infection spreading from her lungs to the new site of infection. - ANSWERSa Hydroxychloroquine (Plaquenil) is prescribed as part of malaria prophylaxis for a patient who will be traveling. The nurse will discuss which potential adverse effects with the patient? (Select all that apply.) a. Headache b. Rash c. Constipation d. Diarrhea e. Dizziness f. Insomnia - ANSWERSa,b,d,e When taking a telephone order for a medication, which action by the nurse is most appropriate? a. Repeat the order to the prescriber before hanging up the telephone. b. Ask the pharmacist to double-check the order. c. Call back the prescriber to review the order. d. Verify the order with the charge nurse. - ANSWERSa The nurse is preparing an infusion of amphotericin B for a patient who has a severe fungal infection. Which intervention is appropriate regarding the potential adverse effects of amphotericin B? a. Discontinuing the infusion immediately if fever, chills, or nausea occur b. Before beginning the infusion, administering an antipyretic and an antiemetic drug c. Gradually increasing the infusion rate until the expected adverse effects occur d. If fever, chills, or nausea occur during the infusion, administering medications to treat the symptoms - ANSWERSb The nurse is asking a patient about his family history as part of an assessment. Which component is included in an effective family history? a. Asking the patient about the current and past health status of the patient's children b. Obtaining a family history of the patient's spouse c. Covering at least three generations of family history d. Asking about the family history for the patient's siblings and parents only - ANSWERSc During assessment of a patient with osteoarthritis pain, the nurse knows that which condition is a contraindication to the use of nonsteroidal anti-inflammatory drugs (NSAIDs)? a. Headaches b. Diabetes mellitus c. Renal disease d. Rheumatoid arthritis - ANSWERSc The nurse is reviewing medication errors. Which situation is an example of a medication error? a. A patient receives a double dose of a medication because the nurse did not cut the pill in half. b. A patient complains of severe pain still present 60 minutes after a pain medication was given. c. A patient develops hives after having started an IV antibiotic 24 hours earlier. d. A patient refuses her morning medications. - ANSWERSa If a patient is taking fluconazole (Diflucan) with an oral anticoagulant, the nurse will monitor for which possible interaction? a. Reduced action of oral anticoagulants b. Decreased effectiveness of the antifungal drug c. Increased effects of oral anticoagulants d. Hypokalemia - ANSWERSc A drug dose that delivers 250 mg has a half-life of 5 hours. Identify how much drug will remain in the body after one half-life. _______ - ANSWERS125 mg The nurse is about to give a rectal suppository to a patient. Which technique would facilitate the administration and absorption of the rectal suppository? a. Encouraging the patient to lie on his or her left side for 15 to 20 minutes after insertion b. Having the patient lie on his or her right side, unless contraindicated c. Having the patient hold his or her breath during insertion of the medication d. Lubricating the suppository with a small amount of petroleum-based lubricant before insertion - ANSWERSa A patient has been selected as a potential recipient of an experimental drug for heart failure. The nurse knows that when informed consent has been obtained, it indicates which of these? a. The patient has had the study's purpose, procedures, and the risks involved explained to him. b. The patient will receive the actual drug during the experiment. c. The patient will be informed of the details of the study as the research continues. d. The patient has been informed of the possible benefits of the new therapy. - ANSWERSa The nurse is conducting a class for senior citizens about the use of over-the-counter (OTC) drugs. Which statements are true regarding the use of OTC drugs? (Select all that apply.) a. Use of OTC drugs may delay treatment of serious ailments. b. OTC drugs may relieve symptoms without addressing the cause of the problem. c. Drug interactions with OTC medications are rare. d. Patients may misunderstand product labels and use the drugs improperly. e. OTC drugs are indicated for long-term treatment of conditions. - ANSWERSa,b,d The nurse is assessing an elderly Hispanic woman who is being treated for hypertension. During the assessment, what is important for the nurse to remember about cultural aspects? a. The nurse will expect the patient to value protective bracelets and "root workers" as healers. b. The nurse will remember that the balance among body, mind, and environment is important for this patient's health beliefs. c. The nurse's assessment needs to include gathering information regarding religious practices and beliefs regarding medication, treatment, and healing. d. The patient should be discouraged from using folk remedies and rituals. - ANSWERSc When reviewing the mechanism of action of a specific drug, the nurse reads that the drug works by selective enzyme interaction. Which of these processes describes selective enzyme interaction? a. The drug is attracted to a receptor on the cell wall, preventing an enzyme from binding to that receptor. b. The drug's effectiveness within the cell walls of the target tissue is enhanced. c. The drug alters cell membrane permeability. d. The drug binds to an enzyme molecule and inhibits or enhances the enzyme's action with the normal target cell. - ANSWERSd The nurse is assigned to a patient who is newly diagnosed with type 1 diabetes mellitus. Which statement best illustrates an outcome criterion for this patient? a. The patient will adhere to the new insulin treatment regimen. b. The patient will not experience complications. c. The patient will follow instructions. d. The patient will demonstrate correct blood glucose testing technique. - ANSWERSd When reviewing the medication orders for a patient who is taking penicillin, the nurse notes that the patient is also taking the oral anticoagulant warfarin (Coumadin). What possible effect may occur as the result of an interaction between these drugs? a. The warfarin will increase the effectiveness of the penicillin. b. The penicillin will cause an enhanced anticoagulant effect of the warfarin. c. The warfarin will reduce the anti-infective action of the penicillin. d. The penicillin will cause the anticoagulant effect of the warfarin to decrease. - ANSWERSb A 6-year-old boy has been started on an extended-release form of methylphenidate hydrochloride (Ritalin) for the treatment of attention deficit hyperactivity disorder (ADHD). During a follow-up visit, his mother tells the nurse that she has been giving the medication at bedtime so that it will be "in his system" when he goes to school the next morning. What is the nurse's appropriate evaluation of the mother's actions? a. The medication should not be taken until he is at school. b. She is giving him the medication dosage appropriately. c. The medication should be given 4 to 6 hours before bedtime to diminish insomnia. d. The medication should be taken with meals for optimal absorption. - ANSWERSc The nurse is administering insulin lispro (Humalog) and will keep in mind that this insulin will start to have an effect within which time frame? a. 80 minutes b. 3 to 5 hours c. 15 minutes d. 1 to 2 hours - ANSWERSc The nurse is preparing to administer a barbiturate. Which conditions or disorders would be a contraindication to the use of these drugs? (Select all that apply.) a. Severe liver disease b. Diabetes mellitus c. Epilepsy d. Gout e. Severe chronic obstructive pulmonary disease f. Pregnancy - ANSWERSa,e,f A patient was diagnosed with pancreatic cancer last month, and has complained of a dull ache in the abdomen for the past 4 months. This pain has been gradually increasing, and the pain relievers taken at home are no longer effective. What type of pain is the patient experiencing? a. Neuropathic pain b. Acute pain c. Chronic pain d. Somatic pain - ANSWERSc The nurse is teaching a class about the various chemotherapy drugs. Which of these statements explains why alkylating drugs are also called "cell cycle-nonspecific drugs"? a. They are more highly differentiated than cell cycle-specific drugs. b. They are effective against several types of neoplasms. c. They are cytotoxic in any phase of the cell cycle. d. They are cytotoxic during a specific cell cycle. - ANSWERSc Phenytoin (Dilantin) has a narrow therapeutic index. The nurse recognizes that this characteristic indicates which of these? a. There is no difference between safe and toxic plasma levels. b. The phenytoin has a low chance of being effective. c. A very small dosage can result in the desired therapeutic effect. d. The safe and the toxic plasma levels of the drug are very close to each other. - ANSWERSd A patient is concerned about the body changes that have resulted from long-term prednisone therapy for the treatment of asthma. Which effect of this drug therapy would be present to support the nursing diagnosis of disturbed body image? a. Weight loss b. Hair loss c. Weight gain d. Pale skin color - ANSWERSc The nurse is reviewing therapy with glucocorticoid drugs. Which conditions are indications for glucocorticoid drugs? (Select all that apply.) a. Cerebral edema b. Organ transplantation c. Chronic obstructive pulmonary disease and asthma d. Septicemia e. Glaucoma f. Varicella - ANSWERSa, b, c Abatacept (Orencia) is prescribed for a patient with severe rheumatoid arthritis. The nurse checks the patient's medical history, knowing that this medication would need to be used cautiously if which condition is present? a. Chronic obstructive pulmonary disease b. Diabetes mellitus c. Coronary artery disease d. Hypertension - ANSWERSa What is the nurse's priority action if extravasation of an antineoplastic drug occurs during intravenous (IV) administration? a. Stop the infusion immediately, but leave the IV catheter in place. b. Change the infusion to normal saline, and inject the area with hydrocortisone. c. Reduce the infusion rate. d. Discontinue the IV, and apply warm compresses. - ANSWERSa A 10-year-old patient will be started on methylphenidate hydrochloride (Ritalin) therapy. The nurse will perform which essential baseline assessment before this drug is started? a. Liver function studies b. Hearing test c. Height and weight d. Eye examination - ANSWERSc Cyclosporine is prescribed for a patient who had an organ transplant. The nurse will monitor the patient for which common adverse effect? a. Agitation b. Hypertension c. Fever and tremors d. Nausea and vomiting - ANSWERSb A patient has a diagnosis of primary hypothyroidism. Which statement accurately describes this problem? a. The abnormality is caused by an insufficient intake of iodine. b. The abnormality is in the thyroid gland itself. c. The pituitary gland is dysfunctional and is not secreting TSH. d. The hypothalamus is not secreting thyrotropin-releasing hormone (TRH); therefore, thyroid-stimulating hormone (TSH) is not released from the pituitary gland. - ANSWERSb A patient has experienced insomnia for months, and the physician has prescribed a medication to help with this problem. The nurse expects which drug to be used for long-term treatment of insomnia? a. Secobarbital (Seconal), a barbiturate b. Eszopiclone (Lunesta), a nonbenzodiazepine sleep aid c. Diazepam (Valium), a benzodiazepine d. Midazolam (Versed), a benzodiazepine - ANSWERSb When a patient is receiving vasopressin (Pitressin), the nurse will monitor for which therapeutic response? a. Increased serum potassium levels b. Improved appetite c. Decreased urinary output d. Increased serum albumin levels - ANSWERSc Before beginning a patient's therapy with selective serotonin reuptake inhibitor (SSRI) antidepressants, the nurse will assess for concurrent use of which medications or medication class? a. Aspirin b. Nonsteroidal anti-inflammatory drugs c. Diuretics d. Anticoagulants - ANSWERSd A patient's medication order indicates that he is to receive a dose of cosyntropin (Cortrosyn). The nurse is aware that this drug is used to diagnose which condition? a. Pituitary dwarfism b. Myasthenia gravis c. Adrenocortical insufficiency d. Diabetes insipidus - ANSWERSc A patient arrives at the urgent care center complaining of leg pain after a fall when rock climbing. The x-rays show no broken bones, but he has a large bruise on his thigh. The patient says he drives a truck and does not want to take anything strong because he needs to stay awake. Which statement by the nurse is most appropriate? a. "It would be best for you not to take anything if you are planning to drive your truck." b. "You can take acetaminophen, also known as Tylenol, for pain, but no more than 1000 mg per day." c. "You can take acetaminophen, also known as Tylenol, for pain, but no more than 3000 mg per day." d. "We will discuss with your doctor about taking an opioid because that would work best for your pain. - ANSWERSc After starting treatment for type 2 diabetes mellitus 6 months earlier, a patient is in the office for a follow-up examination. The nurse will monitor which laboratory test to The nurse is administering parenteral drugs. Which statement is true regarding parenteral drugs? a. Absorption of parenteral drugs is affected by reduced blood flow to the stomach. b. Parenteral drugs bypass the first-pass effect. c. Parenteral drugs exert their effects while circulating in the bloodstream. d. Absorption of parenteral drugs is faster when the stomach is empty. - ANSWERSb During a nursing assessment, which question by the nurse allows for greater clarification and additional discussion with the patient? a. "Are you taking this medication with meals?" b. "Are you allergic to penicillin?" c. "What medications do you take?" d. "Have you had a reaction to this drug?" - ANSWERSc A patient is taking the nonsteroidal anti-inflammatory drug indomethacin (Indocin) as treatment for pericarditis. The nurse will teach the patient to watch for which adverse effect? a. Tachycardia b. Nervousness c. Dizziness d. Nausea and vomiting - ANSWERSd A patient with a severe fungal infection has orders for voriconazole (Vfend). The nurse is reviewing the patient's medical record and would be concerned if which assessment finding is noted? a. Decreased breath sounds in the lower lobes b. Potassium level of 4.0 mEq/L c. History of type 2 diabetes d. History of cardiac dysrhythmias - ANSWERSd The patient is experiencing chest pain and needs to take a sublingual form of nitroglycerin. Where does the nurse instruct the patient to place the tablet? a. On top of the tongue b. At the back of the throat c. In the space between the cheek and the gum d. Under the tongue - ANSWERSd The nurse notes in a patient's medication history that the patient is taking allopurinol (Zyloprim). Based on this finding, the nurse interprets that the patient has which disorder? a. Osteoarthritis b. Gout c. Rheumatoid arthritis d. Systemic lupus erythematosus - ANSWERSb Which nursing diagnosis is appropriate for the patient who has just received a prescription for a new medication? a. Lack of knowledge regarding newly prescribed drug therapy b. Impaired memory related to new drug therapy c. Noncompliance related to new drug therapy d. Deficient knowledge related to newly prescribed drug therapy - ANSWERSd The nurse is monitoring for therapeutic results of antibiotic therapy in a patient with an infection. Which laboratory value would indicate therapeutic effectiveness of this therapy? a. Increased hemoglobin level b. Decreased platelet count c. Increased red blood cell count d. Decreased white blood cell count - ANSWERSd When given an intravenous medication, the patient says to the nurse, "I usually take pills. Why does this medication have to be given in the arm?" What is the nurse's best answer? a. "The intravenous medication will have delayed absorption into the body's tissues." b. "The action of the medication will begin sooner when given intravenously." c. "The medication will cause fewer adverse effects when given intravenously." d. "There is a lower chance of allergic reactions when drugs are given intravenously." - ANSWERSb A patient has a urinary tract infection. The nurse knows that which class of drugs is especially useful for such infections? a. Macrolides b. Sulfonamides c. Carbapenems d. Tetracyclines - ANSWERSb During a busy night shift, a new nurse administered an unfamiliar medication without checking it in a drug handbook. Later that day, the patient had a severe reaction because he has renal problems, which was a contraindication to that drug. The nurse may be liable for which of these? a. Autonomy b. Nonmaleficence c. Nursing negligence d. Medical negligence - ANSWERSc The nurse is providing counseling to a woman who is HIV positive and has just discovered that she is pregnant. Which anti-HIV drug is given to HIV-infected pregnant women to prevent transmission of the virus to the infant? a. Zidovudine (Retrovir) b. Acyclovir (Zovirax) c. Foscarnet (Foscavir) d. Ribavirin (Virazole) - ANSWERSa Which are appropriate considerations when the nurse is assessing the learning needs of a patient? (Select all that apply.) a. Health beliefs b. Level of education c. Family history d. Readiness to learn e. Cultural background - ANSWERSa, b, d, e A patient is receiving hydroxychloroquine therapy but tells the nurse that she has never traveled out of her city. The nurse knows that a possible reason for this drug therapy is which condition? a. Intestinal tapeworms b. Lyme disease c. Systemic lupus erythematosus d. Toxoplasmosis - ANSWERSc A patient who has been hospitalized for 2 weeks has developed a pressure ulcer that contains multidrug-resistant Staphylococcus aureus (MRSA). Which drug would the nurse expect to be chosen for therapy? a. Vancomycin (Vancocin) b. Metronidazole (Flagyl) c. Ciprofloxacin (Cipro) d. Tobramycin (Nebcin) - ANSWERSa A patient who has advanced cancer is receiving opioid medications around the clock to keep him comfortable as he nears the end of his life. Which term best describes this type of therapy? a. Supplemental therapy b. Maintenance therapy c. Palliative therapy d. Empiric therapy - ANSWERSc The nurse will be injecting a drug into the fatty tissue of the patient's abdomen. Which route does this describe? a. Subcutaneous b. Transdermal c. Intradermal d. Intramuscular - ANSWERSa The nurse is reviewing the applications of gene therapy. Which drug is manufactured as a result of indirect gene therapy? a. Human insulin b. Heparin c. Vitamin K d. Warfarin - ANSWERSa The nurse is assessing a newly admitted 83-year-old patient and determines that the patient is experiencing polypharmacy. Which statement most accurately illustrates polypharmacy? a. The patient uses over-the-counter drugs for an illness. b. The patient is experiencing multiple illnesses. c. The patient uses one medication for an illness several times per day. d. The patient uses multiple medications simultaneously. - ANSWERSd The nurse is administering an amphotericin B infusion. Which actions by the nurse are appropriate? (Select all that apply.) a. Using an infusion pump for IV therapy b. Knowing that muscle twitching may indicate hypokalemia c. Discontinuing the drug immediately if the patient develops tingling and numbness in the extremities d. If adverse effects occur, reducing the IV rate gradually until they subside e. Monitoring the IV site for signs of phlebitis and infiltration f. Administering premedication for fever and nausea g. Administering the medication by rapid IV infusion h. Knowing that the intravenous solution for amphotericin B will be cloudy - ANSWERSa,c,e,f When the nurse considers the timing of a drug dose, which factor is appropriate to consider when deciding when to give a drug? a. The patient's height b. The patient's ability to swallow c. The patient's last meal d. The patient's allergies - ANSWERSc The nurse is performing an assessment of a patient. Which assessment findings may indicate a higher risk for genetic disorders? (Select all that apply.) a. The patient's grandfather died of a cerebral vascular accident at 78 years of age. b. The patient's mother was diagnosed with breast cancer at 33 years of age. c. The patient has two uncles and a grandparent who have been diagnosed with Alzheimer's disease. d. The patient's father was diagnosed with heart disease at 60 years of age. e. The patient's sister has a history of both renal and lung cancer. - ANSWERSb,c,e When reviewing the allergy history of a patient, the nurse notes that the patient is allergic to penicillin. Based on this finding, the nurse would question an order for which class of antibiotics? a. Sulfonamides b. Quinolones c. Tetracyclines d. Cephalosporins - ANSWERSd The nurse is reviewing the medication history of a patient who will be taking a sulfonamide antibiotic. During sulfonamide therapy, a significant drug interaction may occur with which of these drugs or drug classes? (Select all that apply.) a. Warfarin (Coumadin) b. Sulfonylureas c. Oral contraceptives d. Antihistamines e. Phenytoin (Dilantin) f. Opioids - ANSWERSa,b,c,e A patient who has a history of coronary artery disease has been instructed to take one 81-mg aspirin tablet a day. The patient asks about the purpose of this aspirin. Which response by the nurse is correct? a. "It will help to prevent clot formation." b. "It helps to reduce inflammation." c. "Aspirin is given to relieve pain." d. "Aspirin is given reduce anxiety." - ANSWERSa A patient will be receiving nitrofurantoin (Macrodantin) treatment for a urinary tract infection. The nurse is reviewing the patient's history and will question the nitrofurantoin order if which disorder is present in the history? (Select all that apply.) a. Type 1 diabetes mellitus b. Hyperthyroidism c. Coronary artery disease d. Liver disease e. Chronic renal disease - ANSWERSd,e The nurse is providing teaching to a patient taking an oral tetracycline antibiotic. Which statement by the nurse is correct? a. "Avoid direct sunlight and tanning beds while on this medication." b. "Milk and cheese products result in increased levels of tetracycline." c. "Take the medication until you are feeling better." d. "Antacids taken with the medication help to reduce gastrointestinal distress." - ANSWERSa A patient with gout has been treated with allopurinol (Zyloprim) for 2 months. The nurse will monitor laboratory results for which therapeutic effect? a. Decreased white blood cell count b. Decreased uric acid levels c. Decreased prothrombin time d. Increased hemoglobin and hematocrit levels - ANSWERSb The patient has been taking an over-the-counter (OTC) acid-reducing drug because he has had "stomach problems" for several months. He tells the nurse that the medicine helps as long as he takes it, but once he stops it, the symptoms return. Which statement by the nurse is the best advice for this patient? a. "Using this drug may relieve your symptoms, but it does not address the cause. You should be seen by your health care provider." b. "The over-the-counter dosage may not be strong enough. You should be taking prescription-strength for best effects." c. "The over-the-counter drug has helped you, so you should continue to take it." d. "For best results, you need to watch what you eat in addition to taking this drug." - ANSWERSa The patient is to receive oral guaifenesin (Mucinex) twice a day. Today, the nurse was busy and gave the medication 2 hours after the scheduled dose was due. What type of problem does this represent? a. "Right time" b. "Right route" c. "Right dose" d. "Right medication" - ANSWERSa A patient has used enteric aspirin for several years as treatment for osteoarthritis. However, the symptoms are now worse and she is given a prescription for a nonsteroidal anti-inflammatory drug and misoprostol (Cytotec). The patient asks the nurse, "Why am I now taking two pills for arthritis?" What is the nurse's best response? a. "Cytotec will also reduce the symptoms of your arthritis." b. "Cytotec reduces the mucous secretions in the stomach, which reduces gastric irritation." c. "Cytotec helps the action of the NSAID so that it will work better." d. "Cytotec may help to prevent gastric ulcers that may occur in patients taking NSAIDs." - ANSWERSd A 6-year-old child who has chickenpox also has a fever of 102.9° F (39.4° C). The child's mother asks the nurse if she should use aspirin to reduce the fever. What is the best response by the nurse? a. "It's best to wait to see if the fever gets worse." b. "Acetaminophen (Tylenol) should be used to reduce his fever, not aspirin." c. "You can use the aspirin, but watch for worsening symptoms." d. "You can use aspirin, but be sure to follow the instructions on the bottle." - ANSWERSb During a period of time when the computerized medication order system was down, the prescriber wrote admission orders, and the nurse is transcribing them. The nurse is having difficulty transcribing one order because of the prescriber's handwriting. Which is the best action for the nurse to take at this time? a. Ask the patient what medications he takes at home. b. Wait until the prescriber makes rounds again to clarify the order. c. Contact the prescriber to clarify the order. d. Ask a colleague what the order says. - ANSWERSc The nurse is reviewing pharmacology terms for a group of newly graduated nurses. Which sentence defines a drug's half-life? a. The time it takes for one half of the original amount of a drug to be absorbed into the circulation b. The time it takes for one half of the original amount of a drug to reach the target cells c. The time it takes for the drug to cause half of its therapeutic response d. The time it takes for one half of the original amount of a drug to be removed from the body - ANSWERSd During drug therapy for pneumonia, a female patient develops a vaginal superinfection. The nurse explains that this infection is caused by: a. large doses of antibiotics that kill normal flora. b. an allergic reaction to the antibiotics. c. resistance of the pneumonia-causing bacteria to the drugs. d. the infection spreading from her lungs to the new site of infection. - ANSWERSa Hydroxychloroquine (Plaquenil) is prescribed as part of malaria prophylaxis for a patient who will be traveling. The nurse will discuss which potential adverse effects with the patient? (Select all that apply.) a. Headache b. Rash c. Constipation d. Diarrhea e. Dizziness f. Insomnia - ANSWERSa,b,d,e When taking a telephone order for a medication, which action by the nurse is most appropriate? a. Repeat the order to the prescriber before hanging up the telephone. b. Ask the pharmacist to double-check the order. c. Call back the prescriber to review the order. d. Verify the order with the charge nurse. - ANSWERSa The nurse is preparing an infusion of amphotericin B for a patient who has a severe fungal infection. Which intervention is appropriate regarding the potential adverse effects of amphotericin B? a. Discontinuing the infusion immediately if fever, chills, or nausea occur b. Before beginning the infusion, administering an antipyretic and an antiemetic drug c. Gradually increasing the infusion rate until the expected adverse effects occur d. If fever, chills, or nausea occur during the infusion, administering medications to treat the symptoms - ANSWERSb The nurse is asking a patient about his family history as part of an assessment. Which component is included in an effective family history? a. Asking the patient about the current and past health status of the patient's children b. Obtaining a family history of the patient's spouse c. Covering at least three generations of family history d. Asking about the family history for the patient's siblings and parents only - ANSWERSc During assessment of a patient with osteoarthritis pain, the nurse knows that which condition is a contraindication to the use of nonsteroidal anti-inflammatory drugs (NSAIDs)? a. Headaches b. Diabetes mellitus c. Renal disease d. Rheumatoid arthritis - ANSWERSc The nurse is reviewing medication errors. Which situation is an example of a medication error? a. A patient receives a double dose of a medication because the nurse did not cut the pill in half. b. A patient complains of severe pain still present 60 minutes after a pain medication was given. c. A patient develops hives after having started an IV antibiotic 24 hours earlier. d. A patient refuses her morning medications. - ANSWERSa If a patient is taking fluconazole (Diflucan) with an oral anticoagulant, the nurse will monitor for which possible interaction? a. Reduced action of oral anticoagulants b. Decreased effectiveness of the antifungal drug c. Increased effects of oral anticoagulants d. Hypokalemia - ANSWERSc A drug dose that delivers 250 mg has a half-life of 5 hours. Identify how much drug will remain in the body after one half-life. _______ - ANSWERS125 mg The nurse is about to give a rectal suppository to a patient. Which technique would facilitate the administration and absorption of the rectal suppository? a. Encouraging the patient to lie on his or her left side for 15 to 20 minutes after insertion b. Having the patient lie on his or her right side, unless contraindicated c. Having the patient hold his or her breath during insertion of the medication d. Lubricating the suppository with a small amount of petroleum-based lubricant before insertion - ANSWERSa A patient has been selected as a potential recipient of an experimental drug for heart failure. The nurse knows that when informed consent has been obtained, it indicates which of these? a. The patient has had the study's purpose, procedures, and the risks involved explained to him. b. The patient will receive the actual drug during the experiment. c. The patient will be informed of the details of the study as the research continues. d. The patient has been informed of the possible benefits of the new therapy. - ANSWERSa The nurse is conducting a class for senior citizens about the use of over-the-counter (OTC) drugs. Which statements are true regarding the use of OTC drugs? (Select all that apply.) a. Use of OTC drugs may delay treatment of serious ailments. b. OTC drugs may relieve symptoms without addressing the cause of the problem. c. Drug interactions with OTC medications are rare. d. Patients may misunderstand product labels and use the drugs improperly. e. OTC drugs are indicated for long-term treatment of conditions. - ANSWERSa,b,d The nurse is assessing an elderly Hispanic woman who is being treated for hypertension. During the assessment, what is important for the nurse to remember about cultural aspects? a. The nurse will expect the patient to value protective bracelets and "root workers" as healers. b. The nurse will remember that the balance among body, mind, and environment is important for this patient's health beliefs. c. The nurse's assessment needs to include gathering information regarding religious practices and beliefs regarding medication, treatment, and healing. d. The patient should be discouraged from using folk remedies and rituals. - ANSWERSc When reviewing the mechanism of action of a specific drug, the nurse reads that the drug works by selective enzyme interaction. Which of these processes describes selective enzyme interaction? a. The drug is attracted to a receptor on the cell wall, preventing an enzyme from binding to that receptor. b. The drug's effectiveness within the cell walls of the target tissue is enhanced. c. The drug alters cell membrane permeability. d. The drug binds to an enzyme molecule and inhibits or enhances the enzyme's action with the normal target cell. - ANSWERSd The nurse is assigned to a patient who is newly diagnosed with type 1 diabetes mellitus. Which statement best illustrates an outcome criterion for this patient? a. The patient will adhere to the new insulin treatment regimen. b. The patient will not experience complications. c. The patient will follow instructions. d. The patient will demonstrate correct blood glucose testing technique. - ANSWERSd When reviewing the medication orders for a patient who is taking penicillin, the nurse notes that the patient is also taking the oral anticoagulant warfarin (Coumadin). What possible effect may occur as the result of an interaction between these drugs? a. The warfarin will increase the effectiveness of the penicillin. b. The penicillin will cause an enhanced anticoagulant effect of the warfarin. c. The warfarin will reduce the anti-infective action of the penicillin. d. The penicillin will cause the anticoagulant effect of the warfarin to decrease. - ANSWERSb A 6-year-old boy has been started on an extended-release form of methylphenidate hydrochloride (Ritalin) for the treatment of attention deficit hyperactivity disorder (ADHD). During a follow-up visit, his mother tells the nurse that she has been giving the medication at bedtime so that it will be "in his system" when he goes to school the next morning. What is the nurse's appropriate evaluation of the mother's actions? a. The medication should not be taken until he is at school. b. She is giving him the medication dosage appropriately. c. The medication should be given 4 to 6 hours before bedtime to diminish insomnia. d. The medication should be taken with meals for optimal absorption. - ANSWERSc The nurse is administering insulin lispro (Humalog) and will keep in mind that this insulin will start to have an effect within which time frame? a. 80 minutes b. 3 to 5 hours c. 15 minutes d. 1 to 2 hours - ANSWERSc The nurse is preparing to administer a barbiturate. Which conditions or disorders would be a contraindication to the use of these drugs? (Select all that apply.) a. Severe liver disease b. Diabetes mellitus c. Epilepsy d. Gout e. Severe chronic obstructive pulmonary disease f. Pregnancy - ANSWERSa,e,f A patient was diagnosed with pancreatic cancer last month, and has complained of a dull ache in the abdomen for the past 4 months. This pain has been gradually increasing, and the pain relievers taken at home are no longer effective. What type of pain is the patient experiencing? a. Neuropathic pain b. Acute pain c. Chronic pain d. Somatic pain - ANSWERSc The nurse is teaching a class about the various chemotherapy drugs. Which of these statements explains why alkylating drugs are also called "cell cycle-nonspecific drugs"? a. They are more highly differentiated than cell cycle-specific drugs. b. They are effective against several types of neoplasms. c. They are cytotoxic in any phase of the cell cycle. d. They are cytotoxic during a specific cell cycle. - ANSWERSc Phenytoin (Dilantin) has a narrow therapeutic index. The nurse recognizes that this characteristic indicates which of these? a. There is no difference between safe and toxic plasma levels. b. The phenytoin has a low chance of being effective. c. A very small dosage can result in the desired therapeutic effect. d. The safe and the toxic plasma levels of the drug are very close to each other. - ANSWERSd A patient is concerned about the body changes that have resulted from long-term prednisone therapy for the treatment of asthma. Which effect of this drug therapy would be present to support the nursing diagnosis of disturbed body image? a. Weight loss b. Hair loss c. Weight gain d. Pale skin color - ANSWERSc The nurse is reviewing therapy with glucocorticoid drugs. Which conditions are indications for glucocorticoid drugs? (Select all that apply.) a. Cerebral edema b. Organ transplantation c. Chronic obstructive pulmonary disease and asthma d. Septicemia e. Glaucoma f. Varicella - ANSWERSa, b, c Abatacept (Orencia) is prescribed for a patient with severe rheumatoid arthritis. The nurse checks the patient's medical history, knowing that this medication would need to be used cautiously if which condition is present? a. Chronic obstructive pulmonary disease b. Diabetes mellitus c. Coronary artery disease d. Hypertension - ANSWERSa What is the nurse's priority action if extravasation of an antineoplastic drug occurs during intravenous (IV) administration? a. Stop the infusion immediately, but leave the IV catheter in place. b. Change the infusion to normal saline, and inject the area with hydrocortisone. c. Reduce the infusion rate. d. Discontinue the IV, and apply warm compresses. - ANSWERSa A 10-year-old patient will be started on methylphenidate hydrochloride (Ritalin) therapy. The nurse will perform which essential baseline assessment before this drug is started? a. Liver function studies b. Hearing test c. Height and weight d. Eye examination - ANSWERSc Cyclosporine is prescribed for a patient who had an organ transplant. The nurse will monitor the patient for which common adverse effect? a. Agitation b. Hypertension c. Fever and tremors d. Nausea and vomiting - ANSWERSb A patient has a diagnosis of primary hypothyroidism. Which statement accurately describes this problem? a. The abnormality is caused by an insufficient intake of iodine. b. The abnormality is in the thyroid gland itself. c. The pituitary gland is dysfunctional and is not secreting TSH. d. The hypothalamus is not secreting thyrotropin-releasing hormone (TRH); therefore, thyroid-stimulating hormone (TSH) is not released from the pituitary gland. - ANSWERSb A patient has experienced insomnia for months, and the physician has prescribed a medication to help with this problem. The nurse expects which drug to be used for long-term treatment of insomnia? a. Secobarbital (Seconal), a barbiturate b. Eszopiclone (Lunesta), a nonbenzodiazepine sleep aid c. Diazepam (Valium), a benzodiazepine d. Midazolam (Versed), a benzodiazepine - ANSWERSb When a patient is receiving vasopressin (Pitressin), the nurse will monitor for which therapeutic response? a. Increased serum potassium levels b. Improved appetite c. Decreased urinary output d. Increased serum albumin levels - ANSWERSc Before beginning a patient's therapy with selective serotonin reuptake inhibitor (SSRI) antidepressants, the nurse will assess for concurrent use of which medications or medication class? a. Aspirin b. Nonsteroidal anti-inflammatory drugs c. Diuretics d. Anticoagulants - ANSWERSd A patient's medication order indicates that he is to receive a dose of cosyntropin (Cortrosyn). The nurse is aware that this drug is used to diagnose which condition? a. Pituitary dwarfism b. Myasthenia gravis c. Adrenocortical insufficiency d. Diabetes insipidus - ANSWERSc A patient arrives at the urgent care center complaining of leg pain after a fall when rock climbing. The x-rays show no broken bones, but he has a large bruise on his thigh. The patient says he drives a truck and does not want to take anything strong because he needs to stay awake. Which statement by the nurse is most appropriate? a. "It would be best for you not to take anything if you are planning to drive your truck." b. "You can take acetaminophen, also known as Tylenol, for pain, but no more than 1000 mg per day." c. "You can take acetaminophen, also known as Tylenol, for pain, but no more than 3000 mg per day." d. "We will discuss with your doctor about taking an opioid because that would work best for your pain. - ANSWERSc After starting treatment for type 2 diabetes mellitus 6 months earlier, a patient is in the office for a follow-up examination. The nurse will monitor which laboratory test to evaluate the patient's adherence to the antidiabetic therapy over the past few months? evaluate the patient's adherence to the antidiabetic therapy over the past few months?