ATI PN Pharmacology Proctored Exam Review questions and Answers,A+

Patient identifiers - Correct Answers -Medical record number -home telephone number What lab values should a nurse monitor for a patient with chronic renal failure? - Correct Answers ■ Urinalysis Hematuria, proteinuria, and alterations in specific gravity Serum creatinine - Gradual increase of 1 to 2 mg/dL per every 24 to 48 hr for acute renal failure (ARF) - Gradual increase over months to years for chronic renal failure (CRF) exceeding 4 mg/dL ■ Blood urea nitrogen (BUN) - 80 to 100 mg/dL within 1 week with ARF - Gradual increase with elevated serum creatinine over months to years for CRF - 180-200 mg/dL with (CRF) ■ Serum electrolytes - Decreased sodium (dilutional) and calcium, increased potassium, phosphorus, and magnesium ■ Complete blood count (CBC) - Decreased hemoglobin What food should you increase when taking Lasix? - Correct Answers -increased amounts of potassium-rich foods (e.g., bananas, prunes, raisins, and orange juice) Patient reports IV discomfort, what is your first action? - Correct Answers color and temperature Sumatriptan (treats migraine headaches) adverse effect - Correct Answers pain, tightness, pressure, or heaviness in the chest, throat, neck, and/or jaw slow or difficult speech Know about Transdermal patch - Correct Answers -• Apply at the same time once each day, preferably in the morning. Keep patch on for 12 to 14 hr each day. • Remove the patch at night to reduce the risk of developing tolerance to nitroglycerin. Be medication-free a minimum of 10 to 12 hr each day (usually at night). • Do not cut patches to ensure appropriate dosage. • Place the patch on a hairless area of skin (chest, back, or abdomen) and rotate sites to prevent skin irritation. • Wash skin with soap and water and dry thoroughly before applying new patch. RBC Blood transfusion - Correct Answers What to understand about Parkinson's Meds? - Correct Answers -they don't cure disease, they slow the process. NEUPOGEN (filgrastim)-what is the appropriate route of this med? - Correct Answers administered by subcutaneous injection or IV infusion Lisinopril therapeutic effect - Correct Answers blood pressure answer (e.g. 120/80) Medication for Schizophrenia - Correct Answers risperidone, Risperdal Macrodantin medication - Correct Answers used to treat or prevent certain urinary tract infections Haldol-inform if you are taking ____________ medication. - Correct Answers -benzodiazepine class of anti-anxiety drugs (all ending with "pam") and even, Xanax. Fosomax - Correct Answers same as-Alendronate is used for treating osteoporosis in men and postmenopausal women. Lipitor - Correct Answers -lowers cholesterol in blood, "statins". Reduce LDL and total cholesterol. Raise HDL. Garamycin- - Correct Answers Antibiotic that is toxic to the kidney, injected for radiology studies. Digoxin side effects - Correct Answers -Fatigue -Bradycardia -Anorexia -Nausea/Vomiting Singulair - Correct Answers used before exercise to prevent breathing problems during exercise (bronchospasm). What medication to administer with Tylenol overdose? - Correct Answers acetylcysteine (Mucomyst) must be given IV HPV vaccine - Correct Answers Human Papilloma Virus (HPV2, HPV4) - -Three doses should be given over a 6 month -interval for females at 11 to 12 years of age (minimum age is 9 years). -The second dose should be administered 2 months after the first dose, and the third dose should be administered 6 months after the first dose. -HPV4 may be given to males starting at age 9 years of age. Opioid toxicity-what to check first - Correct Answers oxygen saturation Valporic Acid lab - Correct Answers liver Lithium report immediately - Correct Answers slurred speech Prednisone report - Correct Answers sore throat Food to avoid when taking Lithium - Correct Answers -salty foods -alcoholic beverages Labs for patients taking hydrothiazide - Correct Answers Periodic determination of serum electrolytes to detect possible electrolyte imbalance should be done at appropriate intervals. 1) A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium level is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the client? 1. Calcium chloride 2. Calcium gluconate 3. Calcitonin (Miacalcin) 4. Large doses of vitamin D - Correct Answers 3. Calcitonin (Miacalcin) Rationale: The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia. Calcium gluconate and calcium chloride are medications used for the treatment of tetany, which occurs as a result of acute hypocalcemia. In hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroid hormone, decreases the plasma calcium level by inhibiting bone resorption and lowering the serum calcium concentration. 2.) Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The nurse instructs the mother to administer the iron with which best food item? 1. Milk 2. Water 3. Apple juice 4. Orange juice - Correct Answers 4. Orange juice Rationale: Vitamin C increases the absorption of iron by the body. The mother should be instructed to administer the medication with a citrus fruit or a juice that is high in vitamin C. Milk may affect absorption of the iron. Water will not assist in absorption. Orange juice contains a greater amount of vitamin C than apple juice. 3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which of the following would indicate the presence of systemic toxicity from this medication? 1. Tinnitus 2. Diarrhea 3. Constipation 4. Decreased respirations - Correct Answers 1. Tinnitus Rationale: Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can result. Symptoms include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation and diarrhea are not associated with salicylism. 4.) The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse reminds the children that chemical sunscreens are most effective when applied: 1. Immediately before swimming 2. 15 minutes before exposure to the sun 3. Immediately before exposure to the sun 4. At least 30 minutes before exposure to the sun - Correct Answers 4. At least 30 minutes before exposure to the sun Rationale: Sunscreens are most effective when applied at least 30 minutes before exposure to the sun so that they can penetrate the skin. All sunscreens should be reapplied after swimming or sweating. 5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury. When applying the medication, the client complains of local discomfort and burning. Which of the following is the most appropriate nursing action? 1. Notifying the registered nurse 2. Discontinuing the medication 3. Informing the client that this is normal 4. Applying a thinner film than prescribed to the burn site - Correct Answers 3. Informing the client that this is normal Rationale: Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms and is used to treat burns to reduce bacteria present in avascular tissues. The client should be informed that the medication will cause local discomfort and burning and that this is a normal reaction; therefore options 1, 2, and 4 are incorrect 6.) The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site of injury. The nurse monitors the client, knowing that which of the following indicates that a systemic effect has occurred? 1.Hyperventilation 2.Elevated blood pressure 3.Local pain at the burn site 4.Local rash at the burn site - Correct Answers 1.Hyperventilation Rationale: Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion of acid, thereby causing acidosis. Clients receiving this treatment should be monitored for signs of an acid-base imbalance (hyperventilation). If this occurs, the medication should be discontinued for 1 to 2 days. Options 3 and 4 describe local rather than systemic effects. An elevated blood pressure may be expected from the pain that occurs with a burn injury. 7.) Isotretinoin is prescribed for a client with severe acne. Before the administration of this medication, the nurse anticipates that which laboratory test will be prescribed? 1. Platelet count 2. Triglyceride level 3. Complete blood count 4. White blood cell count - Correct Answers 2. Triglyceride level Rationale: Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be measured before treatment and periodically thereafter until the effect on the triglycerides has been evaluated. Options 1, 3, and 4 do not need to be monitored specifically during this treatment. 8.) A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes isotretinoin. The nurse reviews the client's medication record and would contact the (HCP) if the client is taking which medication? 1. Vitamin A 2. Digoxin (Lanoxin) 3. Furosemide (Lasix) 4. Phenytoin (Dilantin) - Correct Answers 1. Vitamin A Rationale: Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A supplements should be discontinued before isotretinoin therapy. Options 2, 3, and 4 are not contraindicated with the use of isotretinoin. 9.) The nurse is applying a topical corticosteroid to a client with eczema. The nurse would monitor for the potential for increased systemic absorption of the medication if the medication were being applied to which of the following body areas? 1. Back 2. Axilla 3. Soles of the feet 4. Palms of the hands - Correct Answers 2. Axilla Rationale: Topical corticosteroids can be absorbed into the systemic circulation. Absorption is higher from regions where the skin is especially permeable (scalp, axilla, face, eyelids, neck, perineum, genitalia), and lower from regions in which permeability is poor (back, palms, soles).