Questions Verified Answers and Detailed Rationales for Nursing
Exam Success
1. Therapeutic Drug Levels: Digoxin: 0.8 to 2.0 ng/ml
Toxic Level: greater than 3.4 ng/ml
2. CLONIDINE: Adverse Effects/Nursing Considerations:
Drowsiness/sedation - will improve with time, careful to avoid driving and other activities
Dry mouth - will improve with time, suck on hard candy
Constipation - drink lots of water
Rebound hypertension - don't stop suddenly (can be given oral, and transdermal) - wean off
over 1-2 weeks
Administer patch on hairless, clean, dry skin and be sure to remove old patch
Other patient teaching - avoid taking with alcohol and other medications that cause
drowsiness!
3. Therapeutic Drug Levels: Gentamicin: 0.5 to 0.8 ng/ml A 58 year old who doesn't listen
4. sargramostim: increases WBC
5. Therapeutic Drug Levels: Lidocaine: 1.5 to 5.0 mcg/ml
Toxic Level: greater than 5 mcg/ml
6. Therapeutic Drug Levels: Lithium: 0.4 to 1.0 mEq/L
Toxic Level: greater than 1.5 mEq/L
7. Therapeutic Drug Levels: Magnesium Sulfate: 4 to 8 mg/dL
Toxic Level: greater than 9 mg/dL
8. Therapeutic Drug Levels: Phenobarbital: 10 to 30 mcg/ml
Toxic Level: greater than 40 mcg/ml
9. GENTAMYCIN: 58 year old with bad kidneys, who doesn't listen, and can't see because he fell
in a trough
and got a rash.
,Nephrotoxicity - monitor and report!
Hearing loss (ototoxicity) - ringing in ear, headache, dizziness, vertigo; stop and notify the
physician
Neurologic (numbness, tingling, weakness, optic nerve dysfunction (visual changes) - monitor
and report
Hypersensitivity - report rash, urticaria
Monitor peak and trough
Peak - 30 minutes AFTER administration
Trough - right BEFORE next dose
10. salmeterol AND teburtaline: Long-Acting to require less dosing
lasts 12 hours (MDI)
x
x
Peak effect in 2 hours, duration 12 hours
Onset 10-20 minutes - prevent!
11. -pril: ACE Inhibitor (Captopril, lisinopril)
Therapeutic Use: HTN, HF, MI, Diabetic Neuropathy
12. -pam, -lam: Benzodiazepine/DONT CONFUSE WITH PRAM
13. -statin: Antilipidemic (lovastatin, simvastatin)
Therapeutic Use: Hypercholesterolemia, Prevention of Coronary Events, Protection against MI
and stroke in clients
with disbetes
14. -asone, -solone: Corticosteroid (prednisone, prednisolone)
Therapeutic Use: status asthmaticus, acute asthma attack, asthma attack PPX
15. -olol: Beta Blocker (propranolol, metoprolol)
Therapeutic Use: HTN, Angina, Tachydysrhythmia, HF, MI
16. -cillin: Penicillin
,17. Dosing Administration Techniques (MDI) -: Shake inhaler - attach spacer
Exhale, press canister, inhale
Hold breath for 10 seconds (or as long as possible)
Exhale through pursed lips
Wait 1 minute before repeating
Clean and rinse case, cap
18. -ide: Oral Hypoglycemic (Biguanides, glipizide)
Therapeutic Use: Used in conjunction of diet and exercise to control blood glucose levels in type
2 diabetes mellitus
19. -prazole: Proton Pump Inhibitor (omeprazole, lansoprazole)
Therapeutic Use: gastric and peptic ulcer, GERD, Zollinger-Ellison syndrome
20. -ase: Thrombolytic
21. -mycin: Aminoglycoside
22. -tyline: Tricyclic Antidepressant (amitriptyline, imipramine, nortriptyline) Trips and IMI
23. -pram, -ine: SSRIs (fluoxetine, sertraline, paroxetine, citalopram, escitalopram)PRAM NOT
PAM!!!!
24. Antidote/Reversal Agent: Acetaminophen ACET for ACET: Acetylcysteine
25. Antidote/Reversal Agent: Benzodiazepine If you get a FLU from benzos: -
flumazenil (Romazicon - GABA receptor antagonist)
26. VIR: Nephrotoxicity - renal dysfunction - administer intravenous slowly over 1 hr; encourage
fluid intake during
and after therapy
x
x
Causes inflammation or phlebitis at injection sites! - infuse slowly over 1 hour
Wear gloves for topical application
Patient Teaching
, Wash area and keep dry
Take as directed
Avoid sexual activity
27. vincristine (Oncovin): NO PREGO for CANCER DRUGS
NOT bone marrow toxic!
Peripheral neuropathy effects - report weakness, paresthesia, tingling, ataxia
Alopecia - hair loss will occur after 7-10 days and last 2 months after therapy stopped
Tissue damage from extravasation - use central line for infusions
Give antiemetic for N/V = Good oral hygiene, avoid mouthwash with alcohol
28. Intravenous (Heparin) continuous drip on a pump:: Monitor VS, obtain baseline CBC,
platelet count, hematocrit levels
Double check dosages when preparing with another nurse!
Monitor infusion and bleeding every 30-60 minutes
Monitor aPTT every 4-6 hours until therapeutic range maintained, then daily
aPTT-28-35 but up to 87 on HEP
29. Antidote/Reversal Agent: Digitalis: digoxin immune FAB
30. SUBQ Heparin: Subcutaneous:
Withdraw med - 20-22 gauge
Change needles - 25-26 ½ to 5/8 inch
Inject deep subcutaneous; ABDOMEN best 2 inches from umbilicus; do not aspirate
Apply PRESSURE 1-2 minutes; don't massage
Record and rotate sites
Monitor bleeding 90 angle pinch the skin
31. CEPHLASPORINS: Cross-sensitivity with penicillins
Allergic reactions
x