pharm_at_proc_review.docx

1. Introduction to Pharmacology 2. A patient asks you about the difference between a generic drug and a trade- or brand- name drug. You explain that a generic drug (Select all that apply.) -has the same chemical composition as the brand-name drug. -may have several brand names. -is usually less expensive than a brand-name drug. 3. Distribution is the movement of a drug by the circulatory system to its intended site of action. -Metabolism is the change that occurs in a drug into a more or less potent or more soluble form after it passes through the liver, kidneys, intestinal mucosa, or other body organ or part. -Excretion is the removal of the drug or its metabolites through the kidneys, gastrointestinal tract, skin, or lungs. -Absorption is the movement of a drug from the site of administration into the circulatory system. 4. A patient with glaucoma asks you about taking oxybutynin (Ditropan), a muscarinic antagonist, to manage an overactive bladder. You explain that glaucoma is a contraindication for taking oxybutynin. Patients should not take a drug that is contraindicated because of its potential for which of the following? Serious adverse reactions The peak drug level is the time it takes a drug to demonstrate its full therapeutic effect. -Duration of action is the length of time the drug's therapeutic effect lasts. -The trough drug level is the point in time when a drug is at its lowest level in the body. -The onset of action is the time it takes for a drug to demonstrate a therapeutic response. 5. You note that a primary care provider prescribed morphine sulfate, an opioid agonist, to relieve a patient's postoperative pain. Which of the following describes the action of an agonist on a receptor? Activates the receptor 6. A patient who has a peanut allergy comes to the emergency department with suspected anaphylactic shock. Which of the following actions should you anticipate taking? (Select all that apply.) -Initiate oxygen therapy to support respiratory function. -Administer epinephrine to increase blood pressure. -Give diphenhydramine to stop histamine release. -Establish and maintain an open airway to ensure oxygenation. 7. You are talking with a patient about taking tetracycline along with an antacid. You tell the patient not to take these two drugs at the same time because the antacid can reduce the absorption of tetracycline. When one drug reduces the effect of another drug, it is an antagonistic effect. 8. Primary care providers prescribe drug dosages for children using which of the following information? (Select all that apply.) -Body surface area -Age -Weight -Drug properties 9. An older adult patient may be at risk for drug toxicity due to which of the following physiologic changes associated with aging? Reduced hepatic blood flow 10. You are helping a client learn how to give himself an insulin injection. Which of the following is the best method for evaluating effective learning? Have the client demonstrate an insulin injection 11. A nurse is preparing to teach a client how to take care of a newly created colostomy. The nurse should identify that which of the following factors can decrease the client's ability to learn? (Select all that apply.) - impaired cognitive level -language barrier -discomfort -unreadiness to learn 12. A nurse is caring for a client who has a new prescription for a drug. After receiving the first dose of the drug, the client experiences anaphylaxis. The nurse should identify that anaphylaxis represents which of the following results of the drug? adverse effect 13. A nurse is preparing to administer a drug to a client. In which of the following sections of a drug handbook should the nurse look to determine if the drug has more than one use? indications 14. A nurse is caring for a client who was prescribed an antidepressant based on its ability to prevent the reuptake of neurotransmitters. The nurse should identify that which of the following terms describes why this drug was prescribed for the client? pharmacologic action 15. A nurse is caring for a client who is receiving nitroglycerin IV and is switching to the oral form of the drug. The nurse should identify that the oral dose will be hight than the IV dose for which of the following reasons? the oral form has decreased bioavilability because of the first-pass effect 16. A nurse is teaching a client who has a prescription for a drug that has a receptor agonist effect. Which of the following information should the nurse include in the teaching? "this will increase the effects of normal cellular functions." 17. A nurse is caring for a client who is postpartum and breastfeeding. The client asks the nurse about the effects that taking over-the-counter drugs will have on her newborn. Which of the following should the nurse consider when recommending a drug for the client? (Select all that apply.) -newborn's weight -how much breast milk the newborn consumes each day -whether or not the benefits tot he mother outweigh the risks to the newborn -properties of the drug 18. A nurse is caring for a client who arrived at an emergency department following a bee sting. Which of the following indicates an anaphylactic reaction? (Select all that apply.) low blood pressure -wheezing -difficulty swallowing 19. When reviewing a list of drugs in a drug handbook, a nurse can identify the generic names for a drug in which of the following ways? -it begins with a lower-case letter 20. A nurse is preparing to administer a drug to a client. In which of the following sections of a drug handbook should the nurse look to determine if the client can receive the drug? -contraindications 21. A nurse is caring for a client who is taking acetaminophen and codeine for pain relief. These analgesics drugs interact with one another to cause an additive effect. The nurse should identify that which of the following are characteristics of additive drug interactions? (Select all that apply.) clients can achieve desired effects with the use the lower dosages both drugs have similar actions 22. A nurse is obtaining a client's health history and discovers that the client takes loratadine, and over-the-counter drug. The nurse should identify that which of the following is correct regarding over-the-counter drugs? (Select all the apply.) -they do not require the supervision of the nurse -they can interact the other drugs -the should be included in the client's drug history assessment 23. A nurse is speaking to a client who is taking sertraline and reports drinking grapefruit juice. The nurse explains that grapefruit juice inhibits an enzyme in the liver that is used to metabolize sertraline. The nurse should recognize that client's risk for which of the following? drug toxicity 24. A nurse is caring for a client who has a history of renal insufficiency and is taking lithium. The nurse should monitor the client for which of the following? drug toxicity 25. A nurse is teaching a client about the adverse effects of digoxin. Which of the following statements should the nurse include in the teaching? contact your provider if an adverse effect occurs 26. A nurse is preparing to teach a client about a newly prescribed drug. Prior to providing teaching, the nurse should review the precautions section of a drug handbook for which of the following reasons? -to determine if dosage modification is indicated 27. A nurse is teaching a client about naproxen enteric-coated tablets. Which of the following statements should the nurse include in the teaching? -do not crush or chew the tablet 28. A nurse is caring for a client who is newly admitted to the facility for chest pain. At which of the following times should the nurse begin teaching about drugs and discharge planning? -as soon as possible 29. A nurse is providing teaching for a client who has a new prescription for a drug with a high potential for toxicity. Which of the following information should the nurse include? (Select all that apply.) periodic laboratory tests are essential to measure serum drug levels -monitoring for indications of toxicity is important -taking the smallest effective dose is crucial 30. A nurse is reviewing a drug handbook prior to administering a drug to a client who has kidney disease. The handbook states that the drug can be administered but identifies certain risks. Which of the following terms describes these risks? precautions 31. A nurse is providing teaching to a pregnant client who is taking captopril, an ACE inhibitor, to treat hypertension. The nurse informs the client that captopril is a teratogenic drug. The nurse should explain that teratogenic drugs can cause which of the following? -fetal malformation 32. A nurse is caring for a client who is taking diphenhydramine for insomnia and reports drowsiness. The nurse should identify that drowsiness indicates which of the following? -therapeutic effect 33. A nurse is caring for a client who is having difficulty remembering to take their prescribed drug three times a day. The nurse should identify that which of the following alternate forms of the drug can help to promote adherence to the prescribed dosage? -extended-release tablet 34. A nurse is obtaining a client's health history. The client reports no allergies but has experienced mild itching while taking amoxicillin in the past. Which of the following responses should the nurse make? -"itching can indicate a hypersensitivity to amoxicillin." 35. A nurse is reviewing drugs in a drug reference. The nurse should identify that drugs in the same class share which of the following similarities? they have similar mechanisms of actions 36. A client is prescribed amoxicillin to treat an ear infection. The health care provider instructs the client to report the following? Rash 37. A client is prescribed gentamicin for treatment of a respiratory tract infection. The provider instructs the client to monitor and report which of the following adverse effects of gentamicin? Tinnitus 38. A client is prescribed oral tetracycline for treatment of acne vulgaris. When instructing the client about the tetracycline, which of the following information should the provider include? (select all that apply) Report mouth pain, Take 1 hr before meals, Wear sunscreen and protective clothing 39. Imipenem should be used with caution in which of the following clients? A client with: Seizure disorder 40. A client is prescribed trimethoprim/ sulfamethoxazole for treatment of a UTI. The health care provider should instruct the client to monitor and report which of the following, which may indicate a serious adverse effect of trimethoprim/ sulfamethoxazole? Sore throat 41. A client is prescribed rifampin for treatment of TB. The health care provider should instruct the client to monitor and report which of the following, which may indicate a serious adverse effect of the rifampin? Jaundice 42. A client is prescribed itraconazole for treatment of systemic mycoses. The provider should include which information when instructing the client about the administration of itraconazole? (select all that apply) Take w/ food to reduce gastric distress Take w/ 8oz of acidic liquid, like cola or OJ to increase absorption 43. Which of the following interventions may prevent a serious adverse reaction to acyclovir? Increase fluid intake 44. Because the client is allergic to PCN, which of the following antibiotics is appropriate to prescribe for the meningitis? Vancomycin 45. When receiving vancomycin;, the client becomes flushed and warm. Which of the following additional adverse reaction to vancomycin should be expected? Hypotension 46. A primary care provider is prescribing drug therapy for a patient whose sputum culture results indicate methicillin-resistant Staphylococcus aureus (MRSA). Which of the following drugs should be administered? Vancomycin 47. A health care professional is caring for a patient who is about to begin receiving acyclovir (Zovirax) IV to treat a viral infection. The health care professional should recognize that cautions use of the drug is essential if the patient also has which of the following? dehydration 48. A patient who is taking tetracycline orally to treat a chlamydia infection contacts the health care professional to report severe blood-tinged diarrhea. Recognizing the adverse effects of tetracycline, the health care professional should suspect which of the following? Clostridium difficile – associated diarrhea 49. A health care professional is caring for a patient who is about to begin take isoniazid (INH) to treat tuberculosis. The health care professional should tell the patient to report which of the following adverse effects of the drug? (Select all that apply.) Jaundice, numbness of the hands, dizziness 50. A patient who is taking imipenem to treat a bacterial infection contacts the health care professional to report inability to eat because of mouth pain. Recognizing the adverse effects of imipenem, the health care professional should suspect which of the following? Superinfection 51. A health care professional is caring for a patient who is about to begin gentamicin therapy to treat an infection. The health care professional should monitor the patient for which of the following? Urine output 52. A health care professional is caring for a patient who takes an oral contraceptive and is about to begin rifampin therapy to treat tuberculosis. The health care professional should include which of the following instructions? use a non- hormonal for of contraception 53. A patient who is taking amoxicillin to treat a respiratory infection contacts the health care professional to report a rash and wheezing. Which of the following instructions should the health care professional provide? call emergency services immediately Amoxicillin can cause a severe anaphylactic reaction 54. A health care professional is caring for a patient who is about to begin taking nitrofurantoin (Macrodantin) to treat a urinary tract infection. The health care professional should tell the patient to report which of the following adverse effects of the drugs? cough 55. A primary care provider is considering the various pharmacologic options for a patient who has a gynecologic infection and a history of alcohol use disorder. Which of the following medications can cause a reaction similar to disulfiram (Antabuse) if the patient drinks alcohol while taking it? (Select all that apply.) Cefotetan, metronidazole 56. A health care professional is caring for a patient who is taking warfarin (Coumadin) and is about to begin taking trimethoprim/sulfamethoxazole (Bactrim) to treat a urinary tract infection. The health care professional should question the drug regimen because taking these two drugs concurrently can increase the patient's risk for which of the following? Bleeding. 57. A primary care provider should prescribe a lower dose of aztreonam (Azactam) for a patient who has a respiratory tract infection and also has which of the following? renal impairment 58. Which of the following drugs should a provider prescribe for a patient who has streptococcal pharyngitis and is allergic to penicillin? Erythromycin 59. A health care professional is caring for a patient who is about to begin taking ketoconazole to treat a fungal infection. The health care professional should tell the patient to report which of the following adverse effects of the drug? gynecomastia 60. A health care professional is caring for a patient who is taking ciprofloxacin (Cipro) to treat a urinary tract infection and has rheumatoid arthritis, for which he takes prednisolone (Prelone). Recognizing the adverse effects of ciprofloxacin, the health care professional should tell the patient to report which of the following? Tendon pain 61. A health care professional is caring for a patient who is about to begin taking metronidazole (Flagyl) to treat an anaerobic intra-abdominal bacterial infection. The health care professional should recognize that cautious use of the drug is indicated if the patient also has which of the following? Seizure disorder 62. A health care professional is caring for a patient who is about to begin taking chloroquine to prevent malaria. When talking with the patient about taking the drug, the health care professional should include which of the following instructions? (Select all that apply.) Wear sunglasses outdoors, avoid driving and take the drug with food. 63. A health care professional is caring for a patient who is about to begin taking nitrofurantoin (Macrodantin) to treat a urinary tract infection. The health care professional should tell the patient to report which of the following adverse effects of the drugs? cough 64. A primary care provider is prescribing drug therapy for a patient whose sputum culture results indicate methicillin-resistant Staphylococcus aureus (MRSA). Which of the following drugs should be administered? vancomycin 65. A health care professional is caring for a patient who is about to begin using nystatin to treat oral Candida albicans that resulted from tetracycline therapy. Which of the following instructions should the health care professional include about using the antifungal preparation? swish the suspension in the mouth before swallowing it 66. A health care professional is caring for a patient who is about to begin take isoniazid (INH) to treat tuberculosis. The health care professional should tell the patient to report which of the following adverse effects of the drug? (Select all that apply.) jaundice, numbness of hands, dizziness 67. A health care professional is preparing to administer amphotericin B IV to a patient who has a systemic fungal infection. Which of the following drugs should the health care professional administer prior to the infusion to prevent or minimize adverse reactions during amphotericin B administration? (Select all that apply.) acetaminophen, diphenhydramine 68. When administering erythromycin to a patient who has pneumococcal pneumonia, the health care professional should monitor for which of the following adverse effects of the drug? Cardiac dysrhythmias 69. A patient who is taking tetracycline orally to treat a chlamydia infection contacts the health care professional to report severe blood-tinged diarrhea. Recognizing the adverse effects of tetracycline, the health care professional should suspect which of the following? Pseudomembranous enterocolitis 70. While administering IV cefotetan to a patient to treat bacterial meningitis, the health care professional finds the IV insertion site warm and reddened. Which of the following actions should the health care professional take? Stop the cefotetan infusion 71. A patient who is taking amoxicillin to treat a respiratory infection contacts the health care professional to report a rash and wheezing. Which of the following instructions should the health care professional provide? Call emergency services immediately 72. A health care professional is caring for a patient who is about to begin taking cephalexin (Keflex) to treat bacterial meningitis. The health care professional should explain to the patient the need to monitor which of the following laboratory tests? creatinine 73. A patient who is taking imipenem to treat a bacterial infection contacts the health care professional to report inability to eat because of mouth pain. Recognizing the adverse effects of imipenem, the health care professional should suspect which of the following? suprainfection 74. A health care professional is caring for a patient who is about to receive gentamicin to treat a systemic infection. The health care professional should question the use of the drug for a patient who is also taking which of the following drugs? furosemide 75. A health care professional is caring for patient who takes an oral contraceptive and is about to begin rifampin therapy to treat tuberculosis. The health care professional should include which of the following instructions? Use additional contraception 76. A patient who is taking ciprofloxacin to treat a respiratory tract infection contacts the health care professional to report dyspepsia. The health care professional to report dyspepsia. The health care care professional should recommend which of the following instructions? take an antacid at least 2 hr after taking the drug 77. A health care professional is caring for a patient who is about to begin taken acyclovir (Zovirax) to treat a herpes simplex infection. The health care professional should monitor which of the following laboratory values for the patient BUN 78. A health care professional is caring for a patient who is about to begin gentamicin therapy to treat an infection. The health care professional should monitor the patient for which of the following? Urine output 79. A health care professional is caring for a patient who is about to begin receiving acyclovir (Zovirax) IV to treat a viral infection. The health care professional should recognize that cautions use of the drug is essential if the patient also has which of the following? dehydration 80. A patient is about to start taking aspirin to prevent cardiovascular events. You should instruct the patient to watch for and report which of the following adverse effects of aspirin? Petechiae 81. A patient is about to start taking oral morphine to treat acute pain from an injury. Which of the following instructions should you include when talking with the patient about taking morphine? (Select all that apply.) 82. A patient is about to start taking oral morphine to treat acute pain from an injury. Which of the following instructions should you include when talking with the patient about taking morphine? (Select all that apply.) Take it with food, rise slowly from sitting or reclining, increase fluid and fiber intake, do not take it before driving 83. A provider prescribes prednisone for a patient who has type 1 diabetes mellitus. Recognizing the risk for an adverse reaction to the prednisone, which of the following precautions should the provider take for this patient? Increase serum glucose monitoring 84. A patient is about to start taking tramadol (Ultram) to treat moderate pain. Which of the following instructions should you include when talking with the patient about taking this drug? Allow 1 hr for it to take effect 85. A patient who is receiving chemotherapy takes allopurinol (Zyloprim) prior to the chemotherapy to reduce the risk for which of the following? Hypericemia 86. A patient arrives at the emergency room immediately following an acetaminophen (Tylenol) overdose. Which of the following drugs should you prepare to administer? Acetylcysteine 87. A patient is about to begin celecoxib (Celebrex) therapy for osteoarthritis. You should instruct the patient to watch for and report which of the following possible indications of a serious reaction to this drug? Black, tarry stools 88. Because the patient is taking celecoxib (Celebrex) for osteoarthritis, he knows to watch for and report which of the following possible indications of an adverse reaction to celecoxib? Weight gain 89. In addition to celecoxib (Celebrex), the patient takes low-dose aspirin daily for which of the following purposes? Reduces the risk of a cardiovascular event 90. Which of the following instructions should the health care provider give the patient regarding the use of aspirin prior to the surgery? Stop taking it 1 week before surgery 91. The health care provider prepares to give the patient morphine IV for pain. Knowing the adverse effects of morphine, she should monitor the patient for which of the following? Respiratory depression 92. As the health care provider prepares to give the patient morphine IV for pain, she makes sure she has which of the following drugs available? Naloxone 93. A nurse is teaching a client who has a new prescription for allopurinol. Which of the following instructions should the nurse include? Avoid driving or activities that require mental alertness. 95. A nurse is reviewing the drug list for a client who has a new prescription for allopurinol. The nurse should identify that which of the following drug interacts with allopurinol? Warfarin 96. A nurse is caring for a client who has a new prescription for butorphanol. The nurse should monitor the client for which of the following adverse drug reactions? Nausea, dizziness, headache 97. A nurse is caring for a child who has a viral infection. The nurse should identify that which of the following drugs can increase the risk of Reye syndrome in children who have viral infections? Aspirin 98. A nurse is teaching a client who has a new prescription for prednisone. Which of the following instructions should the nurse include? 99. A nurse is caring for a client who has a prescription for aspirin to treat an ankle sprain. The nurse should instruct the client to report which of the following adverse drug reactions? Weight gain 100. A nurse is teaching a client who has a new prescription for allopurinol. The nurse should instruct the client to report which of the following adverse drug reactions? Sore throat, vertigo, bruising, vision changes 101. A nurse is caring for a client who currently takes furosemide and has a new prescription for prednisone. The nurse should monitor the client for which of the following manifestations during concurrent use of the two drugs? hypokalemia 102. A nurse is reviewing the medical record of a client who has a new prescription for tramadol. The nurse should identify that which of the following conditions is a contraindication for tramadol? Seizure disorder 103. A nurse is caring for a client who has a new prescription for celecoxib. The nurse should tell the client to report which of the following adverse drug reactions? Chest pain 104. A nurse is reviewing the medical record of a client who has a new prescription for celecoxib. The nurse should identify that which of the following conditions is a contraindication to celecoxib? Sulfonamide allergy 105. A nurse is caring for a client who is taking acetaminophen at regular intervals for mild discomfort. The nurse should tell the client to report which of the following early indications of acetaminophen toxicity? Diaphoresis, nausea, diarrhea 106. A nurse is teaching a client who is taking allopurinol about minimizing adverse effects. Which of the following instructions should the nurse include? Eat a small meal before taking the drug 107. A nurse is teaching a client who has a new prescription for tramadol. Which of the following instructions should the nurse include? Increase fiber and fluid intake, take the drug with food, avoid driving after taking the drug, change positions gradually 108. A nurse is caring for a client who is opioid dependant and has a new prescription for butorphanol. The nurse should monitor the client for which of the following manifestations of ab syndrome? Vomiting, abdominal cramps, hypertension 109. A nurse is caring for a client who is receiving morphine to relieve severe pain. The nurse should monitor the client for which of the following adverse drug reactions? Urinary retention, respiratory depression, sedation, orthostatic hypotension 110. A nurse is caring for a client who has a new prescription for prednisone for long- term treatment of rheumatoid arthritis. The nurse should monitor the client for which of the following adverse drug reactions? Bone less 111. A nurse is caring for a client who is taking allopurinol to treat gout. The nurse should monitor the client for which of the following manifestations of hypersensitivity syndrome? fever 112. A nurse is caring for a client who is taking naloxone to treat acute morphine toxicity. The nurse should monitor the client for which of the following adverse drug reactions? Increased respiratory rate, increased pain, ventricular arrhythmias, hypertension 113. A nurse is planning care for a client who has stared taking prednisone. Which of the following interventions should the nurse include? Monitor the client’s glucose 114. A nurse is caring for a client who asks about taking acetaminophen. The nurse should identify that acetaminophen is indicated for which of the following conditions? To reduce fever and to relieve mild pain 115. A nurse is caring for a client who is about to begin taking aspirin. The nurse should instruct the client to report which of the following manifestations of salicylism? Fever, tinnitus, diaphoresis, dizziness 116. A nurse is caring for a client who takes low-dose aspirin to prevent cardiovascular events. The client asks the nurse about taking ibuprofen to treat rheumatoid arthritis. Which of the following responses should the nurse make? Ibuprofen will reduce the cardioprotective effects of low-dose aspirin 117. A nurse is reviewing the medical record of a client who reports taking acetaminophen at home. The nurse should identify that which of the following client conditions is a contraindication for acetaminophen? Alcohol use disorder 118. You are about to administer cisplatin to a patient who has ovarian cancer. Before beginning the infusion, you should take which of the following actions? (Select all that apply.) Infuse 1 to 2 L of IV fluid, administer an antiemetic, evaluate the patient’s hearing, determine the patient’s weight 119. A patient is about to start taking mercaptopurine (Purinethol) to treat acute lymphocytic leukemia. You should instruct the patient to watch for and report which of the following indications of an adverse effect of this drug? bruising 120. A patient is about to start therapy with topotecan (Hycamtin) to treat metastatic ovarian cancer. To minimize neutropenia, an adverse effect of topotecan, you should administer filgrastim (Neupogen) at which of the following times? 24 hr after the topotecan infusion 121. You are assessing a patient who is receiving imatinib (Gleevec) to treat chronic myeloid leukemia. Which of the following findings may indicate an adverse reaction to this drug? Crackles at lung bases 122. While administering trastuzumab (Herceptin) IV to a patient who has breast cancer, you should ensure that you have which of the following drugs available to treat an adverse reaction to this drug? Epinephrine 123. You're caring for a patient who is pregnant and is HIV-positive. Which of the following drugs helps prevent the transfer of HIV to the fetus? Zidovudine (Retrovir) 124. A patient is about to start taking ritonavir (Norvir) to treat HIV-1 infection. Which of the following instructions should you include when talking with the patient about taking this drug? (Select all that apply.) expect periodic blood glucose testing, watch for and report jaundice, increase weight-bearing activity, expect periodic cholesterol testing. 125. You should instruct a patient who is taking tamoxifen (Soltamox) to treat breast cancer to watch for and report which of the following serious adverse effects of this drug? Abnormal menstrual bleeding 126. You're administering cyclophosphamide and mesna (Mesnex) to a patient. Mesna, a chemoprotective agent, helps prevent which of the following adverse reactions to cyclophosphamide? Hemorrhagic cystitis 127. You should monitor this patient for which of the following indications of an adverse reaction to cyclophosphamide? fever 128. When talking with the patient about chemotherapy with doxorubicin (Adriamycin), you explain the need for periodic diagnostic tests. The result of which of the following diagnostic tests or procedures requires monitoring? ecg 129. You should give the patient which of the following instructions about chemotherapy with doxorubicin (Adriamycin)? (Select all that apply.) report vaginal itching, expect red-tinged tears, use effective contraception, expect regrowth after hair loss 130. During IV administration of doxorubicin (Adriamycin), the infusion site becomes swollen, red, and painful. Which of the following actions should you take? Stop the IV infusion 131. Unless there are any specific contraindications, which of the following immunizations should adults receive once each year? Influenza 132. A health care professional is caring for a patient who is about to start ritonavir (Norvir) and zidovudine (Retrovir) therapy to treat HIV-1. The health care professional should explain that the patient will receive ritonavir along with at least one reverse transcriptase inhibitor to: prevent drug resistance 133. A health care professional is caring for a patient who is about to being taking tamoxifen (Soltamox) to treat breast cancer. The health care professional should recognize the need for cautious use of the drug if the patient also has which of the following? cataracts 134. When considering drug therapy options for a patient who has metastatic breast cancer that is positive for human epidermal growth factor receptor 2 (HER2), the health care professional should choose which of the following drugs? Tratuzumab (Herceptin) 135. While assessing a patient who is receiving interferon alfa-2a (Roferon-A) to treat Kaposi's sarcoma, the health care professional should check for which of the following possible indication of an adverse reaction? fever 136. When caring for a patient who is taking flutamide to treat prostate cancer, the health care professional should monitor the patient for which of the following adverse effects of the drug? gynecomastia 137. A health care professional is about to administer enfuvirtide (Fuzeon) to a patient. The health care professional should perform which of the following actions? (select all that apply) administer the drug subcutaneously, roll the vital gently to reconstitute the solution, inject the solution at room temperature 138. A health care professional is caring for a patient who is about to begin receiving cisplatin to treat testicular cancer. The health care professional should tell the patient to report which of the following adverse effects? (select all that apply) paresthesia, sore throat, flank pain, tinnitus 139. A health care professional is caring for a patient who is about to begin maraviroc (Selzentry) therapy. The health care professional should tell the patient to report which of the following adverse effects of the drug? (select all that apply). Paresthesias, cough, jaundice and fever 140. A health care professional should question the use of maraviroc (Selzentry) for a patient who has which of the following? Non-chemokine receptor 5 (ccr5) tropic hiv-1 141. A health care professional is about to administer IV paclitaxel (Taxol) to a patient who has ovarian cancer. Which of the following actions should the health care professional take? (select all that apply) Give the patient an antihistamine Administer the drug through non-PVC tubing Use an in-line filter 142. A health care professional should under that raltegarvir (Isenstress) treats patients who have which of the following? Resistant HIV disease 143. When talking to a patient who is about to begin vincristine therapy to treat lymphoma, the health care professional should include which of the following instructions? Increase fiber intake 144. A health care professional is caring for a patient who is about to begin taking imatinib (Gleevec) to treat chronic myeloid leukemia. Which of the following instructions should the health care professional include when talking to the patient about taking the drug? (select all that apply) Clean fruits and vegetables thoroughly Weigh yourself daily Perform hand hygiene frequently Avoid herbal supplements 145. A health care professional should under that efuvirtide (Fuzeon) is an appropriate choice for patietns who have which of the following? Advanced HIV disease 146. A health care professional is caring for a patient who is about to begin topotecan (Hycamtin) therapy to treat resistant, small-cell lung cancer. The health care professional should caution the patient about taking which of the following types of over-the-counter drugs while receiving the therapy? Ibuprofen (Advil): A health care professional should question the use of anastrozole (Arimidex) for a patient who is Allergic to salicylates Premenopausal 147. A health care professional is assessing a patient following a trastuzumab (Herceptin) infusion to treat metastatic breast cancer. Which of the following findings indicates an adverse reaction to the drug? (select all that apply) wheezing, dysrhythmias, hypotension, fever 148. A health care professional should question the use of cyclophosphamide for a patient who has which of the following? dehydration 149. A health care professional is caring for a patient who is about to begin delavirdine (Rescriptor) therapy to treat HIV-1. The health care professional should tell the patient to report which of the following adverse reactions to the drug? rash 150. A health care professional is caring for a patient who is about to begin intrathecal cytarabine (DepoCyt) therapy to treat meningeal leukemia. The health care professional should explain that the patient should also receive which of the following drugs to reduce the risk of neurotoxicity? dexamethasone 151. A health care professional is caring for a patient who is receiving IV carmustine (BiCNU) to treat multiple myeloma. The health care professional should recognize that the patient is at the greatest risk for infection for which of the following lengths of time after the infusion? 4 to 6 weeks 152. When talking with a patient who is about to begin methotrexate (Trexall) therapy to treat non-Hodgkin lymophoma, the health care professional should include which of the following instructions? Use a soft-bristled toothbrush 153. A health care professional is caring for a patient who is about to begin taking mercaptopurine (Purinethol) to treat leukemia. Which of the following instructions should the health care professional include when talking with the patient about the drug? (Select that all apply) Use contraception if pregnancy is a risk Perform oral hygiene frequently Perform hand hygiene frequently Avoid activities that can cause serious injury 154. When caring for a patient who is receiving vincristine to treat lung cancer, the health care professional should monitor for which of the following findings that indicate an adverse effect? Weak hand grasps 155. You are caring for a patient who is taking exenatide (Byetta) to treat type 2 diabetes mellitus. The patient reports severe abdominal pain. You suspect which of the following adverse reactions to the drug? Pancretitis 156. You are caring for a patient who takes acarbose (Precose) and a sulfonylurea to treat type 2 diabetes mellitus. Which of the following is an indication of an adverse reaction to this drug combination? tremors 157. A patient is about to start taking sustained release glipizide (Glucotrol) to treat type 2 diabetes mellitus. Which of the following instructions should you include when talking with the patient about taking this drug? Take it once a day, 30 mins before selected meals. 158. You are caring for a patient who is taking levothyroxine (Synthroid) to treat hypothyroidism. The patient report palpitations, weight loss, and diarrhea. You suspect which of the following adverse effects of this drug? hyperthyroidism 159. A patient is about to start taking somaptropin (Genotropin). You plan to evaluate the effectiveness of this drug therapy with which of the following assessments? height and weight 160. A patient is about to start taking hydrocortisone (Cortef) to treat adrenocortical insufficiency. You should instruct the patient to do which of the following to help reduce her risk for adverse effects of this drug? Expect lifelong therapy, carry extra doses of the drug, expect periodic blood sampling, report increased stress. 161. when talking with a patient about self-administering regular insulin, you should include which of the following instructions? Inject insulin subcutaneously 162. When talking with a 30 year old woman who will receive radioactive iodine-131 to treat graves disease, you should include which of the following instructions? Report weight gain and edema, use effective contraception, allow 2-3 months for full effects, expect periodic sampling 163. A nurse at a providers office is assessing a client who has been taking HydroCortisone for adrenal insufficiency. The client reports fatigue and feeling overwhelmed by personal responsibilities. Which of the following findings should the nurse identify as an indication the provider might need to increase the clients dosage? hypotension 164. A nurse is providing teaching to a client who is about to begin exentide therapy to treat type two diabetes mellitus. Which of the following instruction should the nurse include? (Select all that apply.) Inject the drug subcutaneously, expect the peak effect in 2 hours, use to drug as supplement to an oral hypoglycemic 165. A nurse is caring for a client who is about to begin taking pioglitazond to treat type two diabetes mellitus. The nurse should explain to the client about the need to monitor which of the following laboratory values? (Select all that apply.) Alanine aminotransferase (ALT), LDL 166. A nurse is caring for a client who is about to begin taking propylthiouracil (PTU) to treat hyperthyroidism. The nurse should instruct the client to import which of the following adverse effects? (Select all that apply) sore throat, joint pain, bradycardia, rash 167. A nurse is teaching a client about self administering regular insulin. The nurse should instruct the client to rotate injection sites to prevent which of the following? lipohypertrophy 168. A nurse is caring for a client who is taking metformin and is scheduled to undergo angiograpy using iodine containing contrast dye. The nurse should identify that in in direction between metformin and the IV contrast dye increases the clients risk for which of the following conditions? Acute renal failure 169. A nurse is providing teaching to a client about taking fludrocortisone to treat adrenocortical insufficiency. Which of the following instruction should the nurse include? (Select all that apply.) obtain weight measurement daily, report weakness or palpitations, have blood pressure checked regularly 170. A nurse should recognize that a provider will prescribe a lower dose of sitagliptin for a client who has type two diabetes mellitus and who always has which of the following? Renal impairement 171. A nurse is providing teaching to a client who is about to begin levothyroxine therapy to help hypothyroidism. Which of the following instruction should the nurse include? Expect life-long therapy with the drug 172. A nurse is caring for a client who is taking propylthiouracil (PTU) and reports weight gain, drowsiness, and depression. The nurse should identify that the client is experiencing which of the following adverse reactions to the drug? hypothyroidism 173. A nurse is speaking with a client who is taking glipizide to treat Type two diabetes mellitus and has called to report feeling shaky, hungry, and fatigue. Which of the following actions should the nurse instruct the client to take? Perform a fingerstick blood glucose check 174. A nurse is assessing a client who has a new prescription for levothyroxine. The nurse should identify which of the following findings as a contraindication for this drug? Recent myocardial infarction 175. A nurse is educating the parents of a child who has a new diagnosis of Prader- Willi Syndrome (PWS) and has been prescribed somatotropin. Which of the following statements by a parent indicates understanding of the teaching? We will use a different spot for injection each time to give medication 176. A nurse is teaching a client who has a prescription for glipizide therapy to treat type two diabetes mellitus. Which of the following instructions should the nurse include? Avoid drinking alcohol 177. A nurse is teaching a client about acarbose therapy to treat type two diabetes mellitus. Which of the following instruction should the nurse include? Eat more iron- iron rich foods 178. A nurse is caring for a client who is about to begin insulin glargine therapy. The nurse should identify the need for additional precautions because the client also takes which of the following types of drugs? Beta blockers 179. A nurse is caring for a client who is about to begin taking somatropin. The nurse should explain the need to monitor which of the following laboratory values? (Select all that apply.) urine calcium, blood glucose 180. A nurse is caring for a client who takes repaglinide 15 to 30 min before each meal to treat type two diabetes mellitus. The client asks, "If i skip a meal, what should i do?" Which of the following responses should the nurse make? Skip the dose 181. A nurse is teaching a client who has a prescription for pranlintide therapy to treat type 1 diabetes mellitus. Which of the following instructions should the nurse include? Administer pramlintide before meals 182. Which of the following drugs should be a nurse have available for a client who is experiencing insulin toxicity? glucagon 183. A nurse is caring for a client who is taking metformin to treat type 2 diabetes mellitus and resorts muscle pain. Which of the following adverse reactions should the nurse suspect? Lactic acidosis 184. A nurse is caring for a client who is taking desmopressin. The nurse should make which of the following assessments to evaluate the drug's effectiveness? Urine output 185. When considering replacement therapy options for a client who has chronic adrenocortical insufficiency, a nurse should recognize that the provider will choose which of the following drugs? hydrocotisone 186. A nurse administers pramlintide at 0800 to a client who had type 1 diabetes mellitus. At which of the following times should the nurse expect the drug to exert its peak action? 0820 187. A nurse is caring for a client who is taking pioglitazone to treat type 2 diabetes mellitus. The nurse should monitor for which of the following findings? Weight gain 188. The Neurological System Drills and Post-test Which of the following laboratory tests should you monitor for a patient who is taking interferon beta-1b (Betaseron) to treat multiple sclerosis? (Select all that apply.) Liver function tests E. CBC While obtaining a patient's medical history, you find that the patient is taking levodopa/carbidopa (Sinemet) for Parkinson's disease. Which of the following information in the patient's health history alerts you to take further action? Glaucoma At a visit to the provider's office, an older adult patient's partner reports that the patient has nausea, diarrhea, and a loss of appetite. He has a history of Alzheimer's disease and is taking donepezil (Aricept). The provider should advise which of the following?Take the drug with food. You are instructing a patient who has multiple sclerosis about how dantrolene (Dantrium) will help control spasticity. Through which of the following pharmacologic actions is this drug effective in treating this manifestation?Alters intracellular calcium exchange at the muscles You are caring for a patient who is preoperative and is NPO. The patient takes carbamazepine (Tegretol), 200 mg PO BID for a seizure disorder. Which of the following actions should you take? Give the oral dose of carbamazepine with a sip of water. You are instructing a school-age child and his parent about the use of amphetamine- dextroamphetamine (Adderall) to manage the child's attention-deficit hyperactivity disorder. You should tell the child and parent to watch for which of the following? (Select all that apply.) Weight loss, Insomnia, Hallucinations Controls tonic-clonic seizures as well as partial seizures by decreasing the neuronal activity of seizure-generating cells in the brain by inhibiting the influx of sodium channels.: Hydantoin Immunomoulators help reduce the symptoms of multiple sclerosis. They seem to inhibit the movement of leukocytes, which are produced as a part of the body's defective autoimmune response, and thus protect the myelin sheath of neurons from their damaging effects.: . Cholinesterase inhibitors help improve cognitive function in patients with mild to moderate Alzheimer's disease, thus minimizing symptoms. They increase the amount of acetylcholine available and thus counteract the acetylcholine depletion that characterizes Alzheimer's disease Dopamine receptor agonist, also known as monoamine oxidase or MAO inhibitors, are one of the types of drugs used to control the symptoms of Parkinson's disease. These drugs are another drug classification that that comprises pharmacologic therapy for Parkinson's disease. These drugs either mimic the action of dopamine or make more of it available and thus counteract the dopamine depletion that characterizes Parkinson's disease.: A primary care provider prescribes sumatriptan (Imitrex) to treat a patient's migraine headaches. Which of the following instructions should you include when telling the patient how to take sumatriptan?Take the drug after onset of the migraine. Repeat the dose once if the headache is not relieved. A patient receives spinal anesthesia with lidocaine (Xylocaine) and epinephrine (Adrenalin). You explain that epinephrine is used with lidocaine for which of the following reasons?Prolongs the anesthetic effects Dantrolene (Dantrium) is a peripherally acting muscle relaxant that, in its IV form, helps reverse malignant hypertension, which is a dangerous complication of general anesthesia.: The amphetamine mixture that comprises the brand-name drug Adderall_helps patients with attention-deficit/hyperactivity disorder focus and lengthen their attention span: Zolpidem (Ambien)acts similarly to benzodiazepines in promoting sedation and thus helps patients fall asleep and stay asleep.: Sodium thiopental (Pentothal)_ is a barbiturate that helps provide rapid induction of anesthesia and hypnosis for brief procedures.: (Patient had a seizure)Which of the following assessments of this patient is most important immediately following the administration of intravenous diazepam (Valium)?Respiratory rate (Patient had a seizure)The health care professional is about to administer a loading dose of phenytoin (Dilantin) IV. Which of the following is essential for the health care professional to do before administering phenytoin IV?Infuse phenytoin slowly. (Patient had a seizure)The health care professional is now assessing the patient. Which of the following findings can be an early indication of phenytoin (Dilantin) toxicity?Nystagmus (Patient had a seizure)The health care professional is talking with the patient, who is soon to be discharged to home, about the adverse effects of phenytoin (Dilantin). Which of the following instructions may help minimize the adverse effects of phenytoin?Use good oral hygiene. (Patient had a seizure)The patient is taking oral contraceptives for birth control. Which of the following instructions should the health care professional include?Additional birth control methods may be needed. A health care professional is caring for a patient who is about to begin taking pramipexole (Mirapex) to treat Parkinson's disease. The health care professional should recognize that which of the following laboratory tests require monitoring?Creatine phosphokinase (CPK) For which of the following should a health care professional monitor a patient who is taking donepezil (Aricept) for Alzheimer's disease?Nausea A health care professional is talking to a patient who is newly diagnosed with Parkinson's disease about how levodopa/carbidopa (Sinemet) will help control her symptoms. With which of the following mechanisms is the drug effective in treating the disorder?Increases available dopamine in the brain A health care professional is talking to a patient who is about to begin taking valproic acid (Depakote) for a newly diagnosed seizure disorder. He should tell the patient to watch for which of the following adverse effects? (Select all that apply.)Drowsiness, Rash Which of the following findings should alert a health care professional that a patient is developing a potentially serious adverse reaction to interferon beta-1b (Betaseron)? Fatigue While talking with a patient and his family about taking memantine (Namenda) for Alzheimer's disease, the health care professional should include which of the following instructions?Notify the health care professional before taking over-the-counter antacids. When talking to a patient about taking modafinil (Provigil) to treat narcolepsy, which of the following instructions should the health care professional include?Take the drug in the morning. A health care professional is caring for a patient who is about to begin taking dantrolene (Dantrium) for skeletal muscle spasms. The health care professional should tell the patient to report which of the following adverse effects?Diarrhea Anesthetists often administer midazolam (Versed) during induction of anesthesia because of which of the following pharmacological actions?Causes amnesia A health care professional is caring for a patient who is about to begin taking dantrolene (Dantrium) for skeletal muscle spasms. The health care professional should recognize that which of the following laboratory tests requires monitoring?Liver function A health care professional is caring for a patient who is receiving thiopental (Pentothal). For which of the following should the health care professional monitor?Respiratory depression A health care professional should include which of the following instructions when talking with a patient about taking levodopa/carbidopa (Sinemet) to treat Parkinson's disease? Change position slowly to prevent orthostatic hypotension. A patient is taking selegiline (Eldepryl) to treat Parkinson's disease. The provider is considering the use of analgesics for the patient but should be aware that a drug interaction between selegiline and meperidine (Demerol) can result in which of the following?Muscle rigidity A health care professional is reviewing the medical record of a patient who has a newly diagnosed seizure disorder. The patient is to begin taking both valproic acid (Depakote) and phenytoin (Dilantin). The health care professional should recognize that which of the following can occur as a result of a drug interaction between valproic acid and phenytoin?Phenytoin toxicity Which of the following information should a health care professional include when talking to a patient about taking baclofen (Lioresal)?Avoid driving until the drug's effects are evident. A health care professional is talking with a patient who is to begin taking valproic acid (Depakote) to treat a seizure disorder. He should advise the patient to monitor for which of the following adverse effects?Jaundice When talking with a patient about taking temazepam (Restoril), which of the following instructions should the health care professional include? (Select all that apply.)Avoid alcohol and other depressants, Take the drug 30 minutes before bedtime,Taper the drug slowly to prevent withdrawal symptoms A health care professional is caring for a patient who is taking zolpidem (Ambien). The patient has a history of benzodiazepine abuse and reports insomnia. The health care professional should caution the patient that the drug can cause memory impairment. A health care professional is caring for a patient who is about to begin taking amphetamine sulfate (Adderall).The health care professional should monitor the patient for which of the Tachycardia A health care professional administers fentanyl (Sublimaze) to a patient to reduce pain. Which of the following drugs should she have available to reverse the effects of fentanyl?Naloxone A health care professional is talking to a patient about the adverse effects of interferon beta-1a (Avonex). To help minimize these effects, she should tell the patient to premedicate with acetaminophen (Tylenol). A health care professional is talking to a patient about beginning sumatriptan (Imitrex) therapy to treat migraine headaches. The health care professional should advise the patient to watch for which of the following adverse effects?Chest pain A health care professional is talking to a patient and her family about how methylphenidate (Ritalin) will help manage attention- deficit hyperactivity disorder (ADHD). Which of the following therapeutic effects should they expect?Increased focus Because of the potential for adverse effects, which of the following should a health care Begin taking the drug at a low dosage. An anesthetist is about to administer lidocaine (Xylocaine) as part of the protocol for spinal anesthesia for a patient who is undergoing a surgical procedure. The health care professional should be aware that the patient could develop which of the following potentially serious effects? Hypotension ATI Pharm Neuro A patient is to start taking amitriptyline. For which of the following should the health care provider instruct the patient to monitor and report? (Select all that apply.)Blurred vision, Urinary hesitancy, Diarrhea. Early clinical manifestations of lithium (Lithobid) toxicity include which of the following? (Select all that apply.)Nausea,Muscle weakness During an assessment of a patient taking chlorpromazine, the provider notes a slow shuffling gait, rigid facial expression, and fine tremors. The provider recognizes this as which of the following?Parkinsonism Which of the following drugs used to treat glaucoma by lowering intraocular pressure is a beta- adrenergic receptor blocker?Betaxolol (Betoptic) You are instructing a patient about taking phenelzine (Nardil) to treat depression. Which of the following foods should you tell the patient avoid?Aged cheese A patient is taking risperidone (Risperdal) for schizophrenia. Recognizing the adverse effects of risperidone, you advise the patient to monitor for and report which of the following?Tremor . A patient is taking venlafaxine to treat major depression. Which of the following information should you include when instructing the patient and family about the use of venlafaxine? (Select all that apply.) Take it with food to reduce gastric disturbances,Monitor and report insomnia, Have blood pressure checked regularly, Check with the provider before taking any herbal supplements. You are instructing a patient about taking buspirone. You inform the patient to monitor and report a paradoxical reaction to buspirone. Which of the following is a paradoxical effect of buspirone?Insomnia A patient is admitted to the emergency department with spasms of his face and back. He has recently begun taking chlorpromazine to treat schizophrenia. Which of the following adverse reactions should the health care professional suspect?Acute dystonia A health care professional is caring for a patient who is taking venlafaxine to treat major depression. The health care professional should recognize that which of the following drugs can cause serotonin syndrome when patients take it concurrently with venlafaxine?Phenelzine (Nardil) A health care professional is caring for a patient who is about to begin amitriptyline therapy to treat major depression. The health care professional should include which of the following instructions when talking with the patient about taking the drug? (Select all that apply.)Change position slowly from sitting or lying to standing, Do not stop taking the drug abruptly, Take the drug at bedtime to prevent daytime drowsiness, Increase fiber and fluid intake. A health care professional should advise a patient who is taking phenelzine (Nardil) to avoid tyramine-enriched foods because of an increased risk for which of the following adverse reactions?Hypertensive crisis A health care professional is collecting data from a patient who is taking bupropion hydrochloride (Wellbutrin) to treat depression. The health care professional notes that the patient has a recent history of a head injury. She should recognize that the drug is inappropriate for the patient because of the increased risk for which of the following?Seizure activity A health care professional should monitor an older adult patient who is taking alprazolam (Xanax) for which of the following adverse effects? (Select all that apply.)Tolerance,Anxiety,Sedation, Respiratory depression A health care professional is caring for a patient who is taking lithium carbonate (Lithobid) to treat bipolar disorder. Which of the following diagnostic tests should the health care professional recommend periodically for the patient?Thyroid function tests When reviewing the indications for various antidepressants, a health care professional should understand that bupropion hydrochloride (Wellbutrin) is an appropriate choice for patients who have which of the following? (Select all that apply.) Seasonal affective disorder, Nicotine addiction, Depression A health care professional is obtaining a patient's drug history when he finds that the patient is taking lithium carbonate (Lithobid) for bipolar disorder. Which of the following findings in the patient's drug history should alert the health care professional to monitor for lithium toxicity? Furosemide (Lasix) for hypertension A health care professional is caring for a patient who is about to begin taking echothiophate (Phospholine Iodide) to treat glaucoma. The health care professional should monitor the patient for the development of which of the following adverse effects?Cataracts A health care professional is caring for a patient who is about to begin using betaxolol (Betoptic) eye drops to treat open-angle glaucoma. The health care professional should advise the patient to expect which of the following reactions?Ocular stinging A health care professional should question the use of timolol (Timoptic) for a patient who has which of the following disorders?Asthma During and immediately following IV administration of chlorpromazine to a patient who has schizoaffective disorder, the health care professional should monitor which of the following Blood pressure? Which of the following instructions should a health care professional include when advising a patient about instilling pilocarpine (Isopto Carpine) for managing open-angle glaucoma? (Select all that apply.)Apply gentle pressure to the nasolacrimal duct for 1 min after instilling the drops.Do not touch the tip of the dropper.Remove contact lenses prior to instilling the drops. A health care professional is talking to a patient who is taking lithium carbonate (Lithobid). Which of the following instructions should be included to reduce the risk of lithium toxicity? Avoid taking NSAIDs. A health care professional is caring for a patient who has been taking alprazolam (Xanax) for an extended period of time to treat anxiety. The health care professional should recognize that stopping alprazolam therapy suddenly can result in which of the following?Withdrawal symptoms A health care professional should expect which of the following adverse effects for a patient who is taking betaxolol (Betoptic) eye drops to treat glaucoma? Bradycardia A health care professional should question the use of alprazolam (Xanax) for a patient who drinks two 8-oz glasses of wine each evening. A health care professional is caring for a young adult patient who is taking fluoxetine (Prozac) to treat depression. The health care professional should tell the patient and the patient's family to report which of the following?Suicidal thoughts When talking to a patient about taking buspirone, the health care professional should include which of the following instructions?Allow 2 to 4 weeks before expecting to feel better Soon after beginning fluoxetine (Prozac), a patient is admitted to the emergency department with agitation and confusion. The health care professional should suspect which of the following?Serotonin syndrome A health care professional is caring for a patient who is about to begin taking lithium carbonate (Lithobid) to treat bipolar disorder. The health care professional should caution the patient to watch for which of the following indications of lithium toxicity? (Select all that apply.)Tremors, Confusion,Nausea,Muscle weakness When caring for a patient who is taking risperidone (Risperdal) for schizophrenia, the health care professional should monitor for which of the following adverse effects of the drug?Polyuria While talking with a patient about taking chlorpromazine, which of the following instructions should the health care professional include? Wear sunscreen when exposed to sunlight. When reviewing the adverse effects of drug therapy with a patient, a health care p