Prophecy/Relias RN Pharmacology A

Prophecy/Relias RN Pharmacology A What medication is a leukotriene receptor antagonist? - ANS Montelukast Which statement made by a person regarding hydrochlorothiazide (HCTZ) is correct? - ANS I should take extra care when standing up or changing positions. A 250mg dose of an oral medication has been ordered. The medication is supplied only in 100mg tablets. How many tablets would you administer? - ANS 2.5 What medication is considered a potassium-sparing diuretic? - ANS spironolactione (Aldactone) You receive report from the off-going nurse that the person being cared for just received their fourth dose of IV vancomycin that was administered over 30 minutes. Upon assessment of them, you notice their face and neck are red and they are itching all over. What would you suspect? - ANS Red man syndrome due to a rapid infusion rate. Sildenafil (Viagra) is prescribed to treat a patient with erectile dysfunction. A nurse reviews the patient's medical record and would question the prescription if which of the following is noted in the history? - ANS nitroglycerin You are caring for a person with a capillary blood glucose of 33 mg/dL and they are unable to tolerate oral intake. Which of the following would you administer? - ANS dextrose 50% IV push A physician's written order for the person you are caring for is as follows: Insulin glargine (Lantus), 10 U, subQ QD. What changes would you suggest for safety and to avoid the use of "do not use" abbreviations? - ANS Spell out units and daily Which statement, if made by the person you are caring for, reflects the need for further education regarding a new prescriptions of warfarin (Coumadin)? - ANS If I get headaches, aspirin is my best options for pain A person is noted to have a penicillin allergy. What medication would you question of ordered by a physician? - ANS ceftriaxone You receive and order to start a Heparin drip at 18 units/kg/hr for a person weighing 75 kg. The heparin comes in a 500 mL bag with 25,000 units. what is the starting rate of the infusion? - ANS 27 mL/hr The physician orders 0.5 mg/kg of a medications. The medication is supplied in a 10 mg/mL solution. The person you are caring for weighs 40 kg. How many mL of the drug would you administer?f - ANS 2 mL A person with a hypothyroidism has a serum calcium level of 13 mg/dL. What medication would you expect to administer? - ANS Calcitonin A person you are caring for has a known GI bleed. What drug is contraindicated? - ANS enoxaparin (Lovenox) A person has been prescribed nitrofurantoin (Furadantin) for a UTI. What education would you provide for them? - ANS wash your mouth out after taking this medication to avoid staining of the teeth What is appropriate education to provide to a person who has received a new prescription for a PPI? - ANS You should not take this medicine at the same time as other medicines. Your patient presents with CHF and has a Potassium level of 5.8. Which diuretic do you anticipate being ordered by the provider? - ANS bumetanide (Bumex) Your patient has been diagnosed with. chronic CHF and will be taking Lasix 80mg PO twice a day. When teaching about high Potassium foods in the diet, which group of foods would you recommend to the patient? - ANS Bananas, spinach, raisins Which medication would you question if ordered by the provider to treat a person that is complaining of nausea and vomiting? - ANS Famotidine (Pepcid) Shortly after administering an IV med, the person you are caring for starts to complain of itching and feeling flushed. On assessment, you notice hives begun to form on their chest. What is the best intervention? - ANS Administer PRN IV diphenhydramine (Benadryl) and notify provider Patient refuses a dose of IV medication. What is the MOST approriate action? - ANS Document the refusal and notify the MD You receive an order to administer 1 tsp of an elixir. What amount of elixir will you prepare? - ANS 5ml When caring for a patient with a central line who is receiving TPN, what is the MOST important action on the part of the nurse to prevent CLABSI? - ANS Perform correct sterile technique for dressing change at the CVC site An order has been placed for sublingual medication. Pt has NG. what is the most appropriate action? - ANS administer the med A person was recently prescribed a corticosteroid inhaler. What would you include when educating them on the medication? - ANS It is important that you wash out your mask after every dose to help prevent fungal infection of your mouth What medication is incompatible for administration with Lactated Ringers solution? - ANS Diazepam (Valium) A person has a new onset dysrhythmia. What medication might be prescribed for this condition? - ANS diltiazem (Cardizem) You are educating your patient for cyclosporine and a new diet with a potassium intake restriction. What food would you tell them to avoid? - ANS raisins A person is being treated for mild to moderate pain following an orthopedic procedure. Which order would you question? - ANS eplerenone You have an order for 4 mg of dexamethasone (Decadron) IV push. The med is supplied in 10mg/mL vial. How many mL do you give? - ANS 0.4 mL A person on a morphine PCA without a basal infusion rate and is afraid of overdosing. What would you say to educate them? - ANS A small dose is delivered only when you push the trigger button and only if it has been long enough since your last dose A person has been diagnosed with diabetes and prescribed an oral antihyperglycemic agent . What statement made by them indicates that they adequately understand the symptoms of hypoglycemia? - ANS If I have sweating, shakes, nervousness, increased heart rate, or headache, my sugar might be low because of my new medicine What class of med would you expect ordered for a person with acid reflux? - ANS Proton pump inhibitor Your patient has an epidural infusing hydromorphone with bupivacaine at 6ml/hr continuously. The patient's blood pressure at the beginning of your shift was 92/58 with a heart rate of 68. You noticed the patient's blood pressures have been around 130/70. What should you do FIRST? - ANS Check infusion rate to confirm 6ml/hr, then notify anesthesia provider You are ordered to give digoxin. Your patient's vital signs are as follows: Blood Pressure 130/75, Temp 97.9 oral, HR 52, O2 Sat 100% room air. What should you do next? - ANS Hold digoxin and call the provider "Red Man" Syndrome may occur during the administration of vancomycin (Vancocin), primarily due to - ANS An increase in histamine production Why would NS be the solution of choice when preparing to administer a blood transfusion? - ANS NS is isotonic pt with no known risk factors to TB would need further diagnostic testing to rule out TB if the mantoux test showed an induration of what size? - ANS >15 Which statement is CORRECT for determining you have the correct person before administering a drug? - ANS You should ask them to say their name and DOB and compare it to the MAR and wrist band Your patient is on a Morphine PCA. While doing your rounds, you notice that your patient is slumped over, unresponsive, with delayed and slow respirations. You suspect narcotic overdose. Which reversal medication would you administer? - ANS naloxone (Narcan) You are educating a person about their new prescription for levothyroxine (Synthroid®). Which statement made by them requires correction? - ANS I should take this on a full stomach so I don't get nauseous MD orders 1000 mL of NS over 6 hrs. whats the rate? - ANS 166.67 125 mcg is how many mg? - ANS 0.125 mg A person is to receive 5mg/kg of medication. Patient weighs 80kg. What amount would you administer? - ANS 400 mg pt has new order for dig. What would be assessed immediately before administering? - ANS Apical HR Which of the following is the antidote for Heparin? - ANS protamine sulfate lasix ordered at 50 mg IV push. On hand is 20 mg/mL. How many mL to give? - ANS 2.5 .The person you are caring for is reviewing written instructions from their physician and see that they have 4 new medicines prescribed. They are primarily concerned with their migraine headaches and want to know which of the medicines will help with that. What medication might be used to treat their migraine headaches? - ANS Rizatriptan A person you are caring for tells you that they frequently take acetaminophen (Tylenol)at home. Which statement made by them is correct? - ANS I should pay close attention to OTC drug label so I don't take to much of Which of the following is considered an antiplatelet medication? - ANS clopidogrel (Plavix) The physician ordered atropine sulfate 0.6 mg IM before surgery. The medication is supplied in 0.8 mg/mL. How many mL would you administer? - ANS 0.75 mL Which of the following medications is known to cause orange-colored urine? - ANS phenazopyridine (Pyridium) Your patient taking digoxin (Lanoxin) has an AM Potassium level of 3.0. This level may: - ANS Increase risk of digoxin toxicity The patient is diagnosed with multiple myeloma. The physician has ordered cyclophosphamide (Cytoxan). Which instruction should be given to the patient? - ANS Increase daily water intake Which of the following anticoagulant is MOST commonly administered for DVT prophylaxis in a patient who has undergone a hip replacement? - ANS A)*WRONG* heparin B) enoxaparin C) aspirin D) warfarin Normal Saline (NS) is the solution of choice over D5W when preparing to administer a blood transfusion because: - ANS Normal Saline is an isotonic solution and prevents cell hemolysis Which of the following medications will crystalize when mixed with D5NS? - ANS phenytoin (Dilantin) While delivering the lunch tray of a patient who is taking warfarin (Coumadin), the nurse notices diversity of food items. Which of the following foods would be a concern? - ANS Spinach Your patient is to receive 2 G vancomycin over 2 hours. The medication comes in from the pharmacy as 2 G Vancomycin in 250ml normal saline. At what rate will the IV medication run? - ANS 125ml/hr A nurse is caring for a patient with hyperparathyroidism and notes that the patient's serum calcium level is 13mg/dl. Which medication should the nurse prepare to administer as prescribed to the patient? - ANS calcintonin (Miacalcin) The dosage of which drug must be tapered off slowly to prevent acute adrenal insufficiency? - ANS prednisone (Deltasone) When teaching a new nurse on how to administer IV push furosemide (Lasix), you emphasize that it should be given over two minutes to avoid: - ANS tinnitus A patient has a prescription to take Guaifenesin (Mucinex) every 4 hours, as needed. The nurse determines that the patient understands the MOST effective use of the medication if the patient states that he or she will: - ANS take the medication with a full glass of water Your patient is receiving vancomycin (Vancocin) 500mg IV every 12 hours. As a nurse, you understand that the PRIMARY rationale for monitoring serum levels of vancomycin is that: - ANS It can cause nephrotoxicity Convert 1.2 milligrams to micrograms - ANS 1200 mcg You are caring for a patient with diabetes. Humalog insulin is ordered via sliding scale AC and HS. When is the best time to administer Humalog insulin? - ANS 15 minutes before meal arrives A provider orders one liter of NS to be infused over four hours. At what rate would you set the IV pump? - ANS 250ml/hr When a patient has pernicious anemia, the nurse would expect to give them: - ANS Vitamin B12 Which of the following medications should be held today considering that your patient received IV contract two hours ago fir a CT scan? - ANS Metformin (Glucophage) Your patient, a Type 1 diabetic with a history of schizophrenia is exhibiting signs and symptoms of tardive dyskinesia, Which of the following long-term medications is more likely the etiology of the problem? - ANS chlorpromazine (Thorazine) Which medication is used to treat iron toxicity? - ANS A) digoxin immune fab (Digibind) B) Naloxone (Narcan) C) Mephyton (Vitamin K) D) *WRONG* deferoxamine (Digibind) There is an order to give Digoxin now. You note that the person you are caring for has a heart rate of 52. What would you do NEXT? - ANS Hold digoxin and call the provider The person you are caring for has a known gastrointestinal bleed. What drug is contraindicated? - ANS Enoxaparin (Lovenox)