NUR 2474 Pharmacology
Final Exam The nurse working on a high-acuity medical-surgical unit is prioritizing care for four patients who were just admitted. Which patient should the nurse assess first?
a.The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30 Novolin insulin
b.The patient with a pulse of 58 beats per minute who is about to receive digoxin (Lanoxin)
c.The patient with a blood pressure of 136/92 mm Hg who complains of having a headache
d.The patient with an allergy to penicillin who is receiving an infusion of vancomycin (Vancocin) - CORRECT ANSWER a.The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30 Novolin insulin
A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on a sliding scale and are ordered before a meal and at bedtime. The patient's blood sugar level is 317 mg/dL. Which formulation of insulin should the nurse prepare to
administer?
a.No insulin should be administered.
b.NPH
c.70/30 mix
d.Lispro (Humalog) - CORRECT ANSWER d.Lispro (Humalog) A patient with type 1 diabetes recently became pregnant. The nurse plans a blood
glucose testing schedule for her. What is the recommended monitoring schedule?
a.Before each meal and before bed
b.In the morning for a fasting level and at 4 PM for the peak level
c.Six or seven times a day
d.Three times a day, along with urine glucose testing - CORRECT ANSWER c.Six or seven times a day
An adolescent patient recently attended a health fair and had a serum glucose test. The patient telephones the nurse and says, "My level was 125 mg/dL. Does that mean I have diabetes?" What is the nurse's most accurate response?
a."Unless you were fasting for longer than 8 hours, this does not necessarily mean
you have diabetes."
b."At this level, you probably have diabetes. You will need an oral glucose tolerance test this week."
c."This level is conclusive evidence that you have diabetes."
d."This level is conclusive evidence that you do not have diabetes." - CORRECT ANSWER a."Unless you were fasting for longer than 8 hours, this does not necessarily mean you have diabetes."
Insulin glargine is prescribed for a hospitalized patient who is diabetic. When will the nurse administer this drug?
a.Approximately 15 to 30 minutes before each meal
b.In the morning and at 4 PM
c.Once daily at bedtime
d.After meals and at bedtime - CORRECT ANSWER c.Once daily at bedtime A patient with type 1 diabetes who takes insulin reports taking propranolol for hypertension. Why is the nurse concerned?
a.The beta blocker can cause insulin resistance.
b.Using the two agents together increases the risk of ketoacidosis.
c.Propranolol increases insulin requirements because of receptor blocking.
d.The beta blocker can mask the symptoms of hypoglycemia. - CORRECT ANSWER d.The beta blocker can mask the symptoms of hypoglycemia.
Which statement is correct about the contrast between acarbose and miglitol?
a.Miglitol has not been associated with hepatic dysfunction.
b.With miglitol, sucrose can be used to treat hypoglycemia.
c.Miglitol is less effective in African Americans.
d.Miglitol has no gastrointestinal side effects. - CORRECT ANSWER a.Miglitol has not been associated with hepatic dysfunction.
A nurse counsels a patient with diabetes who is starting therapy with an alpha-
glucosidase inhibitor. The patient should be educated about the potential for which adverse reactions? (Select all that apply.)
a.Hypoglycemia
b.Flatulence
c.Elevated iron levels in the blood
d.Fluid retention
e.Diarrhea - CORRECT ANSWER b.Flatulence
e.Diarrhea The nurse is caring for a pregnant patient recently diagnosed with hypothyroidism. The patient tells the nurse she does not want to take medications while she is pregnant. What will the nurse explain to this patient?
a.Hypothyroidism is a normal effect of pregnancy and usually is of no consequence.
b.Neuropsychologic deficits in the fetus can occur if the condition is not treated.
c.No danger to the fetus exists until the third trimester.
d.Treatment is required only if the patient is experiencing symptoms. - CORRECT ANSWER b.Neuropsychologic deficits in the fetus can occur if the condition is not treated.
A nurse is teaching a patient who has been diagnosed with hypothyroidism about levothyroxine (Synthroid). Which statement by the patient indicates a need for further teaching?
a."I should not take heartburn medication without consulting my provider."
b."I should report insomnia, tremors, and an increased heart rate to my provider."
c."If I take a multivitamin with iron, I should take it 4 hours after the Synthroid."
d."If I take calcium supplements, I may need to decrease my dose of Synthroid." - CORRECT ANSWER d."If I take calcium supplements, I may need to decrease
my dose of Synthroid."
A patient with hypothyroidism begins taking PO levothyroxine (Synthroid). The nurse assesses the patient at the beginning of the shift and notes a heart rate of 62 beats per minute and a temperature of 97.2° F. The patient is lethargic and difficult to arouse. The nurse will contact the provider to request an order for which drug?
Final Exam The nurse working on a high-acuity medical-surgical unit is prioritizing care for four patients who were just admitted. Which patient should the nurse assess first?
a.The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30 Novolin insulin
b.The patient with a pulse of 58 beats per minute who is about to receive digoxin (Lanoxin)
c.The patient with a blood pressure of 136/92 mm Hg who complains of having a headache
d.The patient with an allergy to penicillin who is receiving an infusion of vancomycin (Vancocin) - CORRECT ANSWER a.The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30 Novolin insulin
A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on a sliding scale and are ordered before a meal and at bedtime. The patient's blood sugar level is 317 mg/dL. Which formulation of insulin should the nurse prepare to
administer?
a.No insulin should be administered.
b.NPH
c.70/30 mix
d.Lispro (Humalog) - CORRECT ANSWER d.Lispro (Humalog) A patient with type 1 diabetes recently became pregnant. The nurse plans a blood
glucose testing schedule for her. What is the recommended monitoring schedule?
a.Before each meal and before bed
b.In the morning for a fasting level and at 4 PM for the peak level
c.Six or seven times a day
d.Three times a day, along with urine glucose testing - CORRECT ANSWER c.Six or seven times a day
An adolescent patient recently attended a health fair and had a serum glucose test. The patient telephones the nurse and says, "My level was 125 mg/dL. Does that mean I have diabetes?" What is the nurse's most accurate response?
a."Unless you were fasting for longer than 8 hours, this does not necessarily mean
you have diabetes."
b."At this level, you probably have diabetes. You will need an oral glucose tolerance test this week."
c."This level is conclusive evidence that you have diabetes."
d."This level is conclusive evidence that you do not have diabetes." - CORRECT ANSWER a."Unless you were fasting for longer than 8 hours, this does not necessarily mean you have diabetes."
Insulin glargine is prescribed for a hospitalized patient who is diabetic. When will the nurse administer this drug?
a.Approximately 15 to 30 minutes before each meal
b.In the morning and at 4 PM
c.Once daily at bedtime
d.After meals and at bedtime - CORRECT ANSWER c.Once daily at bedtime A patient with type 1 diabetes who takes insulin reports taking propranolol for hypertension. Why is the nurse concerned?
a.The beta blocker can cause insulin resistance.
b.Using the two agents together increases the risk of ketoacidosis.
c.Propranolol increases insulin requirements because of receptor blocking.
d.The beta blocker can mask the symptoms of hypoglycemia. - CORRECT ANSWER d.The beta blocker can mask the symptoms of hypoglycemia.
Which statement is correct about the contrast between acarbose and miglitol?
a.Miglitol has not been associated with hepatic dysfunction.
b.With miglitol, sucrose can be used to treat hypoglycemia.
c.Miglitol is less effective in African Americans.
d.Miglitol has no gastrointestinal side effects. - CORRECT ANSWER a.Miglitol has not been associated with hepatic dysfunction.
A nurse counsels a patient with diabetes who is starting therapy with an alpha-
glucosidase inhibitor. The patient should be educated about the potential for which adverse reactions? (Select all that apply.)
a.Hypoglycemia
b.Flatulence
c.Elevated iron levels in the blood
d.Fluid retention
e.Diarrhea - CORRECT ANSWER b.Flatulence
e.Diarrhea The nurse is caring for a pregnant patient recently diagnosed with hypothyroidism. The patient tells the nurse she does not want to take medications while she is pregnant. What will the nurse explain to this patient?
a.Hypothyroidism is a normal effect of pregnancy and usually is of no consequence.
b.Neuropsychologic deficits in the fetus can occur if the condition is not treated.
c.No danger to the fetus exists until the third trimester.
d.Treatment is required only if the patient is experiencing symptoms. - CORRECT ANSWER b.Neuropsychologic deficits in the fetus can occur if the condition is not treated.
A nurse is teaching a patient who has been diagnosed with hypothyroidism about levothyroxine (Synthroid). Which statement by the patient indicates a need for further teaching?
a."I should not take heartburn medication without consulting my provider."
b."I should report insomnia, tremors, and an increased heart rate to my provider."
c."If I take a multivitamin with iron, I should take it 4 hours after the Synthroid."
d."If I take calcium supplements, I may need to decrease my dose of Synthroid." - CORRECT ANSWER d."If I take calcium supplements, I may need to decrease
my dose of Synthroid."
A patient with hypothyroidism begins taking PO levothyroxine (Synthroid). The nurse assesses the patient at the beginning of the shift and notes a heart rate of 62 beats per minute and a temperature of 97.2° F. The patient is lethargic and difficult to arouse. The nurse will contact the provider to request an order for which drug?
