PHARMACOLOGY HESI PRACTICE TEST EXAM 2023/2024 A+ GRADED
PHARMACOLOGY HESI PRACTICE TEST EXAM 2023/2024 A+ GRADED Create a high risk of digoxin toxicity if taken long-term and daily - CORRECT ANSWERDigoxin and Furosemide (Lasix) Dangers associated with Lasix - CORRECT ANSWER-Hypokalemia leading to digoxin toxicity Normal Digoxin levels - CORRECT ANSWER-0.5 - 2 ng/ml Normal serum potassium levels - CORRECT ANSWER-3.5 to 5 mEq/L Low potassium or magnesium levels may increase risk for what toxicity? - CORRECT ANSWER-Digoxin toxicity Signs and symptoms of digoxin toxicity - CORRECT ANSWER-Anorexia, bradycardia, headache, dizziness, confusion, nausea and visual disturbances (blurred vision, yellow vision and/or halo vision) When should you hold the Labetolol and notify the prescriber? - CORRECT ANSWERWhen the pt's pulse rate too low Side effects of Labetolol - CORRECT ANSWER-Weight gain due to fluid retention How much weight should the patient be losing when taking Labetolol? - CORRECT ANSWER-1kg (2.2 lb.) = 1,000 mL fluid gain or loss in 24 hours. When should you remove the nitroglycerin transdermal patch? and why? - CORRECT ANSWER-At night; It can produce tolerance when worn for 24 hours How long should be without the nitroglycerin transdermal patch at night? - CORRECT ANSWER-8 hours Why wear gloves when applying nitroglycerin paste or patch? - CORRECT ANSWERBecause it can cause severe vasodilation, decrease blood pressure, intense headache to the administrator. What can you give to a patient who is taken the nitroglycerin paste/patch and is experiencing a headache? - CORRECT ANSWER-Acetaminophen What action should you take when the patient is experiencing angina and is prescribed nitro? - CORRECT ANSWER-If the vital signs are okay, leave the nitroglycerin patch and administer the PRN sublingual nitro. VS associated with nitro drip - CORRECT ANSWER-hypotension: decrease drip rate What is the common ending for calcium channel blockers? - CORRECT ANSWER-- dipine What are the other two names for calcium channel blockers that do not end in -dipine? - CORRECT ANSWER-Verapamil (Calan) and Diltiazem (Cardizem) "Dipines" affect only what? - CORRECT ANSWER-Vessels (vasodilation) Adverse of calcium channel blockers - CORRECT ANSWER-Dizziness, facial flushing, hypotension and edema. Verapamil (Calan) and Diltiazem (Cardizem) also affect what? - CORRECT ANSWERThe heart and vessels What should you monitor when the patient is taking calcium channel blocker? - CORRECT ANSWER-Blood pressure and decrease heart rate. What is another side effect in Verapamil (Calan) and Diltiazem (Cardizem)? - CORRECT ANSWER-Constipation What is a beverage that you should avoid when taking calcium channel blockers? - CORRECT ANSWER-Grapefruit juice What are some teaching interventions when taking Aliskiren (Tekturna)? - CORRECT ANSWER-Don't take if pregnant (stop the drug immediately when the patient is pregnant). Don't take with high fat meal. What does Aliskiren (Tekturna) increase and what should they avoid? - CORRECT ANSWER-They increase potassium levels so don't take medications that increase potassium. Furosemide (Lasix) is what kind of drug? - CORRECT ANSWER-Loop diuretic Is furosemide (Lasix) slow or rapid acting? - CORRECT ANSWER-Rapid What is the use for furosemide (Lasix)? - CORRECT ANSWER-Rapid diuresis in emergencies such as pulmonary edema. Furosemide (Lasix) may produce what kind of adverse effect? - CORRECT ANSWERHypokalemia What should you assess when you suspect patient of hypokalemia? - CORRECT ANSWER-Muscle cramps and muscle weakness. What also should you assess when patient is experiencing some adverse effects of furosemide (Lasix)? - CORRECT ANSWER-Hypotension, fluid and electrolyte abnormalities, and dehydration. What are the side effects of furosemide (Lasix)? - CORRECT ANSWER-Dizziness, headache, tinnitus, nausea, vomiting, diarrhea, low potassium levels, hyperglycemia, ototoxicity with aminoglycosides (drugs that end in -mycin). What is biggest side effect concern when patient taking furosemide (Lasix)? - CORRECT ANSWER-Low potassium levels When a patient needs potassium supplements what are some foods a patient can consume that contain potassium? - CORRECT ANSWER-Dried fruits, fish, leafy veggies, squash, beans, meats, nuts, bananas, potatoes, and diary products. What is another name for IV potassium? - CORRECT ANSWER-KCl What should you assess when the patient is on IV potassium? - CORRECT ANSWEROverall condition of the veins. Which vein should you use when administering IV potassium? - CORRECT ANSWERLarge vein, like the antecubital vein. Why is venous access important when administering IV potassium? - CORRECT ANSWER-Because it can irritate the skin. What should you do when the patient is burning at the site during the IV potassium? - CORRECT ANSWER-Notify the nurse immediately IV Potassium extravasation can cause what? - CORRECT ANSWER-Necrosis of the tissues What should you assess and confirm prior to administering IV potassium? - CORRECT ANSWER-Calculate and set the rate as ordered, know anticipated duration of therapy and know the restrictions imposed by patient's history. Do not give what kind of IV during IV potassium? - CORRECT ANSWER-IV push You should infuse the IV potassium rate no greater than what in peripheral IV? - CORRECT ANSWER-10 mEq/hr. You should infuse the IV potassium rate no greater than what in central line? - CORRECT ANSWER-20 mEq/hr. Always use what for IV potassium? - CORRECT ANSWER-Infusion pump How often should you assess the IV site when patient is on IV potassium? - CORRECT ANSWER-Every hour What is the treatment of hypokalemia adults IV? - CORRECT ANSWER-10-20 mEq/dose (maximum 40 mEq/dose) to infuse over 2-3 hours. Maximum infusion rate 40 mEq/hr. Antihypertensive effects are more pronounced in which age group? - CORRECT ANSWER-Elderly Which antihypertensive will raise potassium? - CORRECT ANSWER-ACE inhibitors, angiotensin II receptor blockers (ARBs) and renin inhibitors. How can you determine the effectiveness of Osmitrol (Mannitol)? - CORRECT ANSWER-Decrease intracranial pressure What is Osmitrol (Mannitol) NOT used for? - CORRECT ANSWER-Peripheral edema What does Osmitrol (Mannitol) treat? - CORRECT ANSWER-Patients with closed head injuries Spironolactone (Aldactone), amiloride (Midamor), triamterene (Dyrenium) are what kind of drugs? - CORRECT ANSWER-Potassium sparing diuretics What do potassium sparing diuretics cause? - CORRECT ANSWER-Increase in potassium What does potassium sparing diuretic block? - CORRECT ANSWER-Receptors of aldosterone What does potassium sparing diuretic inhibits? - CORRECT ANSWER-Sodium and water reabsorption Why should you take potassium sparing diuretic in the morning? - CORRECT ANSWER-Because you will urinate a lot What should you avoid when taking potassium sparing diuretics? - CORRECT ANSWER-Salt substitutes, ACE inhibitors, ARBs. Potassium sparing diuretics are often taken with other thiazide diuretics to treat what? - CORRECT ANSWER-Edema, hypertension, and heart failure. Can potassium sparing diuretics be taken with other meds that lower potassium? - CORRECT ANSWER-Yes What lab value should you look for in patients taking atorvastatin (Lipitor)? - CORRECT ANSWER-HDL should increase and LDL and total cholesterol decrease. What are some other "statin" drugs? - CORRECT ANSWER-Rosuvastatin (Crestor), fluvastatin, lovastatin, simvastatin, pravastatin What should be routinely checked when taking "statin" drugs? - CORRECT ANSWERLiver function tests and creatinine/kinase. Why should liver function tests and creatinine/kinase labs be checked in patients who are taking "statin" drugs? - CORRECT ANSWER-Because "statin" drugs can cause muscle pain also known as rhabdomyolysis Alpha-1 medication do what? - CORRECT ANSWER-Stimulate What happens when a patient takes alpha-1 medications? - CORRECT ANSWERVasoconstriction What does Beta-1 focus on? - CORRECT ANSWER-Heart What does Beta 2 focus on? - CORRECT ANSWER-Lungs, smooth muscle What are agents used to produce dilation of pupils for eye exams and ocular surgery? - CORRECT ANSWER-Mydriatics What does Tamsulosin (Flomax) treat? - CORRECT ANSWER-BPH What do alpha-1 blockers normally end in? - CORRECT ANSWER--zosin What do alpha-1 blockers normally treat? - CORRECT ANSWER-Hypertension Dopaminergic activation causes what of the renal vasculature? - CORRECT ANSWERDilation The dilation of the renal vasculature due to the dopaminergic activation is exploited in the treatment of what? - CORRECT ANSWER-Shock
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