Pharmacology final 2024

Pharmacology final 2024 What test would the nurse expect to have preformed for a client with a fever and sore throat? A. Throat culture B. Blood culture C. Assay for antibiotics D. Gram strain - ANS A. Throat culture The nurse knows the best time to obtain specimen culture is which of the following. A. 48 hours after antibiotics has been started B. 12 hours after antibiotics has been started C. 24 hours after antibiotics has been started D. Before antibiotics have been started - ANS D. Before antibiotics have been started The physician is explaining to a client that the results of a culture test revealed that the organism is resistant. The client later asks the nurse if this means the antibiotic is working against the organism. How should the nurse respond? A. The organisms growth is inhibited by the antibiotic because of its sensitivity to the antibiotic B. The organisms growth is not inhibited, because of its lack of sensitivity to the antibiotic C. Another culture will need to be done because the organism did not respond to the first test D. The antibiotic is at too toxic a drug level to be therapeutic - ANS B. The organisms growth is no inhibited, because of its sensitivity to the antibiotic Where are nosocomial infections acquired? A. Retirement communities B. In healthcare facilities C. In educational environments D. On airplanes and trains - ANS B. In Healthcare facilities A client taking an antibiotic reports that he has an extremely itchy rash all over his chest. The nurse suspects that the type of reaction occurring in the client is which of the following? A. Allergic hypersensitivity B. Direct toxicity C. Indirect toxicity D. Anaphylaxis - ANS A. Allergic hypersensitivity The nursing student is reviewing her pharmacology notes. She knows that the selection of an anti-infective agent is based in which of the following? A. Site of infection, respiratory and cardiac function, and pregnancy status B. Site of infection, allergies, weight, age, pregnancy status, and organism resistance C. Site of infection, renal and liver function, availability, and pregnancy status D. Site of infection, renal and liver function, age, pregnancy status, and organism resistance - ANS D. Site of infection, renal and liver function, age, pregnancy status, and organism resistance A 26-year-old client presents to the client with urinary frequency and burning. A urine specimen is taken, and white blood cells are present in the urine dip test. Another specimen is sent out for urine culture. The client is discharged with an antibiotic. What urinary anti-infective would the nurse anticipate that the client would be prescribed? A. Nitrofurantoin B. Tobramycin C. Isoniazid D. Acyclovir - ANS A. Nitrofurantoin The nurse knows that an example of an antibiotic is gentamycin. What is a characteristic of this drug class? A. It is a safe agent used for short bursts of treatment for gram-negative organisms only B. It is used for long term therapy C. It requires serum drug levels therapeutic response D. It is a safe agent used for short bursts of treatment for gram-positive organisms - ANS C. It requires serum drug levels therapeutic response The nurse stresses to the client the importance of reporting which of the following side effects of gentamycin? A. Nausea B. Decrease in white blood cell count C. Decrease in appetite D. Hearing loss - ANS D. Hearing loss The nurse knows that levaquin belongs to which of the following drug classification? A. Aminoglycoside B. Quinolone C. Cephalosporin D. Tetracycline - ANS B. Quinolone A pediatric client is being treated for otitis media. A common pathogen for this age group is streptococcus pneumonia. The pediatric client is allergic to penicillin. What antibiotic would the nurse anticipate the client receiving? A. Amoxicillin B. Ampicillin C. Zithromax D. Keflex - ANS C. Zithromax In the health clinic, the nurse is counseling a young adult client regarding the use of tetracycline for acne. What educational information should the nurse share with the client regarding this medication? A. Wear sunscreen B. It is acceptable to take with a multivitamin C. There are no precautions when taking it D. Take it on a full stomach - ANS A. Wear sunscreen 49-year-old female client with diabetes is being treated for a candidal infection with fluconazole, an antifungal agent. What education does the nurse need to share with the client? A. Stop the medication when symptoms improve, so as not to develop resistance to overuse B. The client can continue her oral anti diabetic treatment C. This medication is administered sublingually D. Take the medication until finished, even if symptoms resolve - ANS D. Take the medication until finished, even if symptoms resolve The nurse is demonstrating to the client how to install ophthalmic drops. She reviews proper hand washing and handling of the medication. What other instruction does the nurse need to explain regarding the procedure? A. Install the drops into the eye with your head tilted back B. Instill the drops into the lower conjunctival sac C. Install the drops into the eye sitting straight up D. Install the drops onto the upper lid and then close the eye - ANS B. Instill the drops into the lower conjunctival sac A client is evaluated on the emergency department with a chemical splash to the face and eyes. Following eye irritation and evaluation of visual acuity, the client is started on an anti inflammatory agent. How does the nurse explain the mode of action to the client? A. It is used to relieve irritation of the conjunctiva B. It is used to treat superficial infections C. It is used to block histamine receptors in the conjunctiva D. It increases tear production - ANS A. It is used to relieve irritation of the conjunctiva A 62-year-old female client is started on ketorolac (Acular), a nonsteroidal anti-inflammatory ophthalmic agent, for postoperative cataract surgery. What instructions would benefit this client? A. Avoid driving for 2 weeks. B. Apply pressure on the tear duct at the inner corner to reduce systemic absorption Avoid wearing contact lenses if eyes are red. C. Avoid rubbing the eyes. D. Avoid wearing eye makeup - ANS D. Avoid wearing eye makeup How can the nurse describe the symptoms of chronic (open-angle) glaucoma? A. Red eye with no pain B. A sudden onset of pain, blurred vision, and dilated pupils C. Constricted and nonreactive pupils and irregularly shaped eyes D. Progressive blurring and loss of peripheral vision, typically bilaterally - ANS D. Progressive blurring and loss of peripheral vision, typically bilaterally A 76-year-old male client with atrial fibrillation is on metoprolol, 50 mg PO three times a day. He is being treated for glaucoma and is started on Timolol Maleate eyedrops. What should the nurse be aware of when administering this medication? A. Hypotension B. Tachycardia C. Hypertension D. Atrial tachycardia - ANS A. Hypotension The client is being admitted to the ambulatory surgery unit for cataract surgery. Prior to surgery, a pilocarpine eye solution is ordered. What contraindication does the nurse know would prevent this client from receiving this medication? A. History of glaucoma B. History of cardiovascular disease C. History of retinal detachment D. History of sub conjunctival hemorrhage - ANS C. History of retinal detachment A client with glaucoma is placed on a miotic drug and asks the nurse how his medication will work. How does the nurse respond? A. It acts by decreasing the rate of aqueous humor production B. It acts by decreasing the formation of the aqueous humor. C. It acts by increasing aqueous humor outflow. D. It acts by increasing intraocular pressure. - ANS C. It acts by increasing aqueous humor outflow A client has been prescribed corticosteroid eyedrops and is fearful of taking any medications that will be absorbed into her body. How does the nurse respond? A. When administering eyedrops, gently apply pressure to the inner canthus. B. When administering eyedrops, gently apply pressure to the lower lid. C. When administering eyedrops, gently apply pressure to the upper lid. D. This drug is not absorbed systerically. - ANS A. When administering eyedrops, gently apply pressure to the inner canthus. A client is being evaluated at the eye clinic for a foreign body in the left eye. The nurse explains that prior to the eye exam, he will receive a local eye anesthetic to help relieve the pain. What important instruction should the nurse share with this client? A. Do not touch or rub your eye. B. After administration, irrigate your eye. C. This anesthetic can be used as frequently as needed to relieve pain. D. Discontinue use of contact lenses for at least 72 hours after administration. - ANS A. Do not touch or rub your eye The client tells the nurse that the pharmacist gave them an eye drop to use in the ear. How should the nurse respond? A. Report the pharmacy to the FDA B. Never use eye drops in the ear. C. It is acceptable to use eye drops in the ear, but not ear drops in the eye. D. I think you must have misunderstood the pharmacist. - ANS C. It is acceptable to use eye drops in the ear, but not ear drops in the eye. For which common disorder are ear drops alone prescribed? A. Otitis media B. Outer ear infections. C. Ear infection D. Bacterial infection - ANS B. Outer ear infections A pediatric client is being evaluated for an eye exam: The nurse is administering cyclopentolate (Cyclogyl) prior to the exam. What information can the nurse explain to the parent of the client? A. This medication is used to reduce client anxiety. B. This medication is used to constrict the pupil. C. This medication is used to relax the muscles in the eye. D. This medication is used to dilate the pupils - ANS D. This medication is used to dilate the put A client is being started on a serotonin receptor agonist for migraines. What information should the nurse share with the client prior to taking this medication? A. Do not take this if you are using another ergot alkaloid B. Do not take this is if you have renal disease C. Do not take this is you have diabetes D. Do not take this is you have anemia - ANS A. Do not take this if you are using another ergot alkaloid What is the purpose of lidocaine? A. Pain medicaton B. Local anesthetic C. Antibiotic D. Clotting agent - ANS B. Local anesthetic The nurse is discussing acetaminophen use with a client. What is a rare but dangerous side effect of acetaminophen? A. Orthostatic hypotension B. Hepatotoxicity C. Tachyarrhythmia D. Tinnitus - ANS B. Hepatotoxicity An older adult client with arthritis is prescribed NSAID medications. What information can the nurse share with the client about taking this medication? A. Take with food to decrease Gl upset. B. Take the dose at night. C. Take half the prescribed dose to decrease the side effects. D. You can take the medication with your anticoagulant. - ANS A. Take with food to decrease Gl upset A client is currently taking over-the-counter ibuprofen and Tylenol for pain relief. After an outpatient procedure, the physician discharges him with a prescription for Vicodan ES. What client education does the nurse need to share with this client? A. Take both pain medications as needed. B. Continue to take over-the-counter Tylenol along with Vicodan ES to help relieve your pain. c. Take the Vicodan during the day and Tylenol at night. D. Stop taking over-the-counter Tylenol while taking Vicodan ES - ANS D. Stop taking over-the-counter Tylenol while taking Vicodan ES The nurse sees an order for a salicylate and knows that this type of drug is most commonly used for its analgesic and antipyretic properties. What property does an antipyretic contain? A. Anti-anxiety B. Anti-inflammatory C. Fever-reducing D. Anti-cancerous - ANS C. Fever reducing A client asks the nurse what the strongest painkiller is, morphine or hydromorphone. How does the nurse respond? A. Morphine is much stronger than hydromorphone. B. They both have the same potency but are designated by different trade names. C. Hydromorphone is much stronger than morphine. D. They are two completely different drugs and cannot be compared, - ANS C. Hydromorphone is much stronger than morphine A nurse is assisting the RN with monitoring a client who has received IV morphine for a procedure to reduce a dislocated shoulder. What should the nurse watch for and inform the physician if it occurs? A. Decreased respiratory rate to 8 B. Decreased heart rate to 69 C. Decreased diuresis of 30 cc per hour D. Decreased blood pressure to 110/50 - ANS A. Decreased respiratory rate to 8 A nurse is giving a presentation on analgesics. How can she explain the role of an endorphin? A. An endogenous compound that produces a sense of well-being B. A chemical receptor that works peripherally at the site of pain C. An exogenous compound that produces a sense of well-being D. An enzyme that is produced in the body and activates the inflammatory cascade - ANS A. An endogenous compound that produces a sense of well-being A 22-year-old male client is treated in the emergency room for a sprained right ankle. Knowing that the client has no medical history of allergies, what might the nurse recommend for an over-the-counter anti-inflammatory medication to take at home? A. Acetaminophen (Tylenol) B. Ibuprofen (Motrin) C. Codeine #2 D. Codeine #3 - ANS B. Ibuprofen (Motrin) A client asks the nurse why he is being put on an antidepressant for back pain when he does not suffer from depression. How does the nurse respond? A. Antidepressants are used as pain medications. B. You may get depressed because of your back pain, which will hinder your progress C. Antidepressants can be used as adjunct medications to enhance the effect of the pain medication D. Antidepressants have no effect on pain but should make you fecl better. - ANS C. Antidepressants can be used as adjunct medications to enhance the effect of the pain medication A nurse is educating a client about opiates. Which of the following is the MOST serious side effect associated with opiate use? A. Respiratory depression B. Hypertension and tachycardia C. Inability to sleep D. Nausea and vomiting - ANS A. Respiratory depression A client is prescribed an opiate for acute pain. Why is short-term use of this drug for acute pain typically NOT associated with addiction or psychological dependence? A. Clients are usually less tolerant of short-term opiates. B. It is not as potent as drugs taken for chronic usage. C. It is not given around the clock. D. The majority of clients stop taking it when the pain is gone. - ANS D. The majority of clients stop taking it when the pain is gone The nurse knows that opioids work on what system? A. The peripheral nervous system B. Central nervous system C. Autonomic nervous system D. Somatic nervous system - ANS B. Central nervous system The nurse knows that analgesics are prescribed for which of the following conditions? A. To relieve pain B. To sedate C. To calm or soothe D. To produce sleep - ANS A. To relieve pain What antidote should be considered or kept on hand to treat opioid overdose in a patient who begins to exhibit signs of respiratory arrest? A. Flumazenil B. Administer oxygen C. The opioid antagonist [e.g., Narcan or naloxone] D. Vitamin K - ANS C. The opioid antagonist [e.g., Narcan or naloxone] Terminally ill patients who require large doses of opioids for pain management should be frequently assessed for signs and symptoms of addiction or dependence. A. True b. false - ANS B. False A client is prescribed morphine after back surgery. Which conditions would be a contraindication for the administration of morphine? (Select all that apply.) A. Perforated duodenum secondary to ulcer disease B. Closed-head injury of a trauma victim C. Respiratory distress secondary to long-standing COPD D. Septic shock with no urine output E. Hypertension - ANS B. Closed-head injury of a trauma victim C. Respiratory distress secondary to long-standing COPD D. Septic shock with no urine output The nurse is educating her client regarding the use of Tylenol, an over-the-counter analgesic. What precaution should you tell the client regarding this medication? A. Take it with food as it enhances the absorption and decreases Gl upset. B. Be aware of the danger of overdose. C. Be aware of the danger of poisoning D. Avoid consuming alcohol while taking Tylenol - ANS B. Be aware of the danger of overdose. C. Be aware of the danger of poisoning D. Avoid consuming alcohol while taking Tylenol Contraindications to the use of opinion medications include A. Head injury with increased intracranial pressure B. Undiagnosed gastrointestinal disease C. Pregnancy D. All of the above - ANS D. All of the above A client is started on a serotonin receptor agonist for migraines. What information should the nurse share with the client prior to taking this medication? A. Do not take this if you are using another ergot alkaloid. B. Do not take this if you have renal disease. C. Do not take this if you have diabetes. D. Do not take this if you have anemia. - ANS A. Do not take this if you are using another ergot alkaloid Which statement BEST indicates the rationale for the importance of taking and documenting a detailed history about the type of seizure? A. Treatment failure can be the result of inappropriate selection of an anticonvulsant for the specific type of seizure. B. The client is most likely exhibiting malingering behavior. C. The nurse needs to rule out urinary frequency. D. The adult home staff may be liable if false information has been given. - ANS A. Treatment failure can be the result of inappropriate selection of an anticonvulsant for the specific type of seizure The paramedics have brought a client to the emergency room reporting that the client was in status epileptics. The paramedics initiated IV lorazepam (Ativan) simultaneously loading with IV phenytoin (Dilantin), anticonvulsants with efficacy. Which of the following statements BEST describes the rationale behind this pharmaceutical intervention? A. This is an alternative method of treatment if the drug of choice, ethosuximide (Zarontin), is not available. B. Simultaneous administration of lorazepam and phenytoin are contraindicated. C. The treatment of choice in status epileptics is IV lorazepam. Simultaneous loading with IV phenytoin or fosphenytoin is also recommended. D. The paramedics are not licensed to administer IV solutions. - ANS C. The treatment of choice in status epileptics is IV lorazepam. Simultaneous loading with IV phenytoin or fosphenytoin is also recommended. A client recently diagnosed with generalized seizure disorder was started on phenytoin (Dilantin), an anticonvulsant. What possible side effects would be important to mention while educating the client about this medication? A. Renal failure, panic attacks, and cough B. Fine hand tremors, pericarditis, and diarrhea C. Hypercalcemia, catatonia, and osteopenia D. Gingival hyperplasia, Stevens-Johnson syndrome, and toxic epidermal necrolysis - ANS D. Gingival hyperplasia, Stevens-Johnson syndrome, and toxic epidermal necrolysis The FDA advises health care professionals to closely monitor clients taking anticonvulsants because of what psychiatric concern? A. Emerging or worsening suicidal thoughts and behavior or depression B. Grandiose or manic behavior C. Anorexia or bulimia nervosa D. Narcissistic personality disorder - ANS A. Emerging or worsening suicidal thoughts and behavior or depression Which of the following statements about taking phenytoin and pregnancy are TRUE? A. There is no harm in breast-feeding while taking phenytoin. B. There are no known contraindications with taking phenytoin while pregnant. C. Phenytoin needs to be increased for maximum benefit while client is pregnant. D. Pregnancy and lactation are considered contraindications of phenytoin. - ANS D. Pregnancy and lactation are considered contraindications of phenytoin. A client has recently been prescribed carbamazepine (Tegretol), an anticonvulsant, for the management of a seizure disorder. What foods should the nurse advise the client to avoid? A. Peanuts B. Grapefruit C. Red meats D. Cheese products - ANS B. Grapefruit A client who is currently on valproic acid (Depakote), an anticonvulsant for seizure disorder, has come to the neurologist for routine blood work. He asks the nurse why he has to have his blood drawn. Which statement below BEST answers this question? A. Only a certified physician can answer that question. B. The physician maintains records for The Joint Commission. C. Blood work has been ordered to monitor for the potential development of blood dyscrasias, hepatotoxicity, and therapeutic levels. D. It is necessary to know the client's blood type before prescribing this medication. - ANS C. Blood work has been ordered to monitor for the potential development of blood dyscrasias, hepatotoxicity, and therapeutic levels. A client has been prescribed a first-generation anticonvulsant for treatment of partial seizure disorder. Upon visiting the clinic, she revealed to the nurse that she has not been compliant with the medication because she has experienced uncomfortable cognitive side effects. After discussing this with the team, a decision was made to start the client on a second-generation anticonvulsant. What is the rationale behind this? A. First-generation anticonvulsants have fewer side effects and usually do not require drug level monitoring. B. Second-generation anticonvulsants have fewer side effects and usually do not require drug level monitoring. C. Third-generation anticonvulsants are too expensive. D. Fourth-generation anticonvulsants are saved for use as a last resort. - ANS B. Second-generation anticonvulsants have fewer side effects and usually do not require drug level monitoring Which of the following are instructions the nurse should share with the client regarding antiseizure medication? Select all that apply A. Take the medication at different times of day as needed. B. Wear a medical alert bracelet. C. Practice careful oral hygiene. D. Take the medication on an empty stomach E. You may skip doses as needed to fit your lifestyle. - ANS B. Wear a medical alert bracelet. C. Practice careful oral hygiene. A client with Parkinson's disease was started on carbidopa-levodopa (Sinemet), an antiparkinsonian drug used for dopamine replacement. The client asks the nurse if this medication will cure her disease. Which of the following would be the nurse's BEST response? A. The treatment goal is to relieve symptoms and maintain mobility. B. Sinemet has been known to repair nerve ending damage. C. A herbologist can best answer this question D. Sinemet will reduce your dopamine level and thereby lessen symptoms - ANS A. The treatment goal is to relieve symptoms and maintain mobility. C A client has been prescribed carbidopa-levodopa (Sinemet), an antiparkinsonian drug for Parkinson's disease. When providing client education for this medication, what should the nurse include as a frequent side effect? A. Left sided hemiparesis B. Rectal bleeding C. Alopecia D. Hypotension - ANS D. Hypotension A client has been taking carbidopa-levodopa (Sinemet), an antiparkinsonian drug, for many years and informs the nurse that symptoms are increasing and the medication does not seem to work anymore. The nurse knows this may be attributed to which of the following? A. The client may be experiencing a tolerance to this drug. B. The client may have a urinary tract infection. C. The client may be gaining weight. D. The client may be experiencing hypertensive crisis. - ANS A. The client may be experiencing a tolerance to this drug A client with Parkinson's disease has been prescribed bromocriptine (Parlodel), a dopamine agonist, used to delay the onset of motor complications. The nurse is educating the client regarding this medication. Which of the following are side effects of bromocriptine? Select all that apply. A. Hyperthyroidism B. Syncope C. Confusion D. Hypotension E. Sleep walking - ANS B. Syncope C. Confusion D. Hypotension E. Sleep walking A client with Parkinson's disease (PD) is prescribed a selective MAO type-B inhibitor as monotherapy for early PD. Which category of medications does the nurse know is contraindicated while taking MAO-B inhibitors? A. Antiemetics B. Anticholinergics C. Anticoagulants D. Selective serotonin reuptake inhibitors (SSRIs) - ANS D. Selective serotonin reuptake inhibitors (SSRIs) A female client is prescribed amantadine (Symmetrel), an antiviral agent, to treat extrapyramidal reactions associated with carbon monoxide poisoning. She complains of GI distress, constipation, and urinary retention. What should the nurse know about these side effects? A. They are dose-related and irreversible. B. They are dose-related and reversible C. They are related to route of administration. D. They are related to the time of day when medication is taken. - ANS B. They are dose-related and reversible A psychiatric client is prescribed anticholinergic medication to reduce symptoms of Parkinson's-like tremors associated with long-term antipsychotic pharmacotherapy. Which of the following are common side effects of anticholinergic medication? (Select all that apply.) A. Urinary frequency B. Dry mouth C. Blurred vision D. Dizziness E. Hypertension - ANS B. Dry mouth C. Blurred vision D. Dizziness A client was administered a neuromuscular blocking agent (NMBA) as a muscle relaxant during a procedure. Upon recovery, what should the nurse watch for in terms of possible serious side effects? A. Respiratory arrest B. Periorbital edema C. Fluid third spacing D. Hyperreflexia - ANS A. Respiratory arrest A client is being treated for neck strain with a skeletal muscle relaxant. When providing medication education, what would be an appropriate instruction from the nurse? A. If you skip one dose, it is best to double the next dose to maintain a therapeutic blood level B. This medication does not interact with alcoholic beverages or pain medication. C. This medication may cause insomnia. D. Use caution while driving. - ANS D. Use caution while driving. A client taking NSAIDs long term developed a Gl ulcer, and the medication was stopped until the ulcer had healed. Together with the health care practitioner, it was decided that the client could resume the NSAID along with lansoprazole (Prevacid), a proton pump inhibitor. How can the nurse BEST explain to the client the rationale of adding the proton pump inhibitor with NSAIDs? A. The proton pump inhibitor will potentate the effects of the NSAID. B. The proton pump inhibitor is being prescribed to protect the gastric mucosa. C. The proton pump inhibitor will help alleviate the client's anxiety D. The proton pump inhibitor will act as a placebo. - ANS B. The proton pump inhibitor is being prescribed to protect the gastric mucosa. A client in need of long-term anti-inflammatory medication has been tried on NSAID and NSAID combination therapy with anti-ulcer medications, but continues to have recurring Gl ulcerations. The treating physician discusses the possibility of switching to a different NSAID known as celecoxib (Celebrex), a cyclooxygenase-2 (COX-2) inhibitor. What is the nurse aware of when educating the client about the rationale for switching medications? A. COX-2 inhibitors inhibit platelet aggregation (clotting). B. The COX-2 inhibitors have the potential to cause fewer gastric problems and pose less risk of GI bleeding. C. Clients taking NSAIDS are not at risk for developing GI ulcers. D. When taking COX-2 inhibitors, there is a potential for abuse or addiction. - ANS B. The COX-2 inhibitors have the potential to cause fewer gastric problems and pose less risk of GI bleeding. A client asks the nurse where to find more information about NSAID medications. What is the nurse's best response? A. The nurse can redirect the client to read the packet insert first and then ask questions. B. The nurse can tell the client that the FDA has posted extensive NSAID medication information on the Internet. C. The client should be told that only a licensed pharmacologist can answer that question. D. The client should be instructed to go to the local library for information. - ANS B. The nurse can tell the client that the FDA has posted extensive NSAID medication information on the Internet. What are some potential side effects of NSAIDs that the nurse can share with her client? A. Alopecia and hair thinning B. Diarrhea and urinary frequency C. Tinnitus and hearing loss D. Hypotension and bradycardia - ANS C. Tinnitus and hearing loss A client recently diagnosed with gout has been prescribed colchicine to relieve the inflammation in his big toe. What information should the nurse share with the client when educating him about this medication? A. Increase fluid intake B. Increase exercise C. Increase foods high in purine D. Continue to take the medication even after relief of symptoms - ANS A. Increase fluid intake A postmenopausal female client who has a family history of osteoporosis has decided to start estrogen as a hormone replacement therapy (HRT). The client asks the nurse about HRT. What is the nurse's BEST response? A. Estrogen is most effective when started at the highest possible dose. B. Estrogen should be taken in high doses over a long period of time. C. Estrogen is not recommended for postmenopausal osteoporosis prevention. D. If started soon after menopause, estrogen prevents the accelerated phase of bone loss that occurs in the first S years after the onset of menopause. - ANS D. If started soon after menopause, estrogen prevents the accelerated phase of bone loss that occurs in the first S years after the onset of menopause. A postmenopausal woman is placed on raloxifene (Evista), a selective estrogen receptor modifier for osteoporosis therapy. What possible side effects should the nurse discuss when educating the client about taking this medication? A. Fine hand tremors B. Anorexia C. Somnolence D. Hot flashes and muscle cramps in the legs - ANS D. Hot flashes and muscle cramps in the legs A client with recently diagnosed osteoporosis is prescribed a bisphosphonate agent, How should the nurse instruct the client regarding the administration of bisphosphonate? A. The client must stay upright for at least 30 to 60 minutes after taking this medication. B. The client must stay in a prone position for at least 30 to 60 minutes after taking this medication. C. The client must stay in a supine position for at least 30 to 60 minutes after taking this medication. D. The client must stay in a lying position on his left side for at least 30 to 60 minutes after taking this medication. - ANS A. The client must stay upright for at least 30 to 60 minutes after taking this medication. A client is being treated by a sports medicine doctor for a sports-related injury. He is temporarily placed on a skeletal muscle relaxant until the pain subsides and given instructions for complementary treatment. What is the acronym for this treatment? A. REST (rest, elevate, support, traction) B. RISE (resist, ice, support hose, elevate) C. RICE (rest, ice, compression, elevation) D. RACE (relax, apply heat, cold compress, elevate) - ANS C. RICE (rest, ice, compression, elevation) The health care practitioner prescribes naproxen (Naprosyn), an NSAID for inflammation of the sciatic nerve. What instructions should a nurse give to a client receiving NSAIDs? A. This medication should be taken 1 hour before or 2 hours after meals. B. This medication should be taken with meals or milk. C. This medication should only be taken for short periods as it can lead to physical dependence. D. This medication is an over-the-counter (OTC) drug and does not require a prescription. - ANS B. This medication should be taken with meals or milk. When working with clients receiving oxygen, the nurse knows that which of the following may be an initial sign of delivering too high a concentration? A. Tinnitus B. Hyperventilation C. Confusion D. Hypoventilation - ANS C. Confusion A 2-week-old infant client in the neonatal unit has apnea. What respiratory stimulant does the nurse know may be used to treat this condition? A. Pseudoephedrine B. Ritalin C. Benzodiazepines D. Caffeine citrate - ANS D. Caffeine citrate A client has come to the pulmonologist with complaints of dyspnea and wheezing. He is diagnosed with bronchial asthma and is prescribed a bronchodilator via inhaler. What should the nurse instruct the client about using inhalers? A. Demonstrate the proper technique for inhaler use. B. Instruct the client to avoid fluids using C. Encourage the client to use the inhaler as often as needed. D. Inform the client that it is safe to use OTC drugs without consulting the physician. - ANS A. Demonstrate the proper technique for inhaler use. The nurse is caring for a client who has been prescribed synthetic corticosteroids to relieve inflammation during treatment of persistent asthma. Which of the following statements is TRUE about corticosteroid therapy? A. Inhaled corticosteroids have no systemic side effects. B. Inhaled corticosteroids have less systemic side effects than oral or injectable administration C. Inhaled corticosteroids have an equal risk of systemic side effects as oral or injectable administration. D. Inhaled corticosteroids have more systemic side effects than oral or injectable administration. - ANS B. Inhaled corticosteroids have less systemic side effects than oral or injectable administration The nurse is educating clients who are being treated with inhaled corticosteroids. Which of the following is an appropriate instruction for the clients? A. This medication may cause joint swelling and pain. B. There are no side effects related to this medication. C. Do not shake the inhaler prior to use. D. Rinse your mouth with water or mouthwash after administration. - ANS D. Rinse your mouth with water or mouthwash after administration. A client at the allergy clinic has been prescribed a first-generation antihistamine for symptom relief. What common anticholinergic side effect might a client taking a first-generation antihistamine experience? A. Drying of secretions B. Urinary frequency C. Diarrhea D. Hypertension - ANS A. Drying of secretions What medication was once commonly used in OTC cold remedies, but was targeted by the Combat Methamphetamine Act of 2005 and is now only sold under special conditions by pharmacies? A. Diphenhydramine B. Dextromethorphan C. Pseudoephedrine D. Chlorpheniramine - ANS C. Pseudoephedrine A client with nasal congestion has been prescribed pseudoephedrine extended release (Sudafed ER) for symptom relief. What instructions could the nurse share with the client about taking this form of Sudafed? A. Do not take within 2 hours of meals. B. Take PO every 4 to 6 hours as needed. C.Dissolve in 8 ounces of water before taking. D. Do not crush, chew, or break extended-release preparations. - ANS D. Do not crush, chew, or break extended-release preparations. A client with a psychiatric history of mild depression has decided to quit smoking. After discussing options with the health care practitioner, he decides to try varenicline (Chantix), a partial nicotine receptor agonist-antagonist used as an aid in smoking cessation. What symptoms should the nurse educate the client and his caregivers to monitor while taking Chantix? A. Monitor for neuropsychiatric symptoms. B. Monitor for signs and symptoms of anorexia. C. Monitor for signs of metabolic acidosis. D. Monitor for delirium tremens. - ANS A. Monitor for neuropsychiatric symptoms. An older adult client is on digoxin (Lanoxin), a cardiac glycoside, for treatment of heart failure. What is important for the nurse to assess prior to administering this medication? A. Respiratory rate B. Intravenous therapy C. Temperature D. Heart rate - ANS D. Heart rate What is the MAJOR function of cardiac glycosides? A. They act directly on the myocardium to increase the force of myocardial contractions. B. They speed up the heart rate to reduce cardiac output. C. They improve glucose in the myocardial cells. D. They assist with vasodilation of the cardiac vessels. - ANS A. They act directly on the myocardium to increase the force of myocardial contractions. What might occur if metoprolol (Lopressor) were administered to a client with asthma? A. Headache B. Bronchospasm C. Hyperglycemia D. Hypertension - ANS B. Bronchospasm A client has been prescribed a calcium channel blocker. What food should the nurse educate a client to avoid while taking calcium channel blocker medication? A. Grapefruit juice B. Apple juice C. Carrot juice D. Prune juice - ANS A. Grapefruit juice A client has been diagnosed with hypertension and asks the nurse if the prescribed antihypertensive medication will cure her hypertension. Which statement is the BEST response? A. Studies have shown that herbal remedies may work better than antihypertensives. B. Yes. If you take the medication for at least 6 months, you should be cured. C. Perhaps you should seek another opinion if you are seeking a cure. D. Antihypertensives do not cure hypertension; they only control it. - ANS D. Antihypertensives do not cure hypertension; they only control it. A client is receiving a thrombolytic agent for the onset of an acute ST elevation myocardial infarction (MI). What is the MOST serious complication of thrombolytic therapy A. Intracranial hemorrhage B. Thrombus formation C. Thrombocytopenia D. Methemoglobinemia - ANS A. Intracranial hemorrhage What is the MOST common side effect of antihypertensives? A. Insomnia B. Alopecia C. Hypotension D. Sexual dysfunction - ANS C. Hypotension A client was recently prescribed losartan (Cozaar), an angiotensin receptor blocker (ARB), for treatment of hypertension. When compared to ACEls, ARBs are associated with a lower risk of which of the following? A. Drug-induced cough B. Hypotension C. Hyperkalemia D. Hypokalemia - ANS A. Drug-induced cough A client has been prescribed an HMG-CoA reductase inhibitor (statin), an antilipemic agent for monotherapy to manage high cholesterol. What condition is a rare but serious side effect of statins? A. Somnolence B. Diplopia C. Nystagmus D. Rhabdomyolysis - ANS D. Rhabdomyolysis A client, status post recurrent transient ischemic attacks (TIAs), has been prescribed acetylsalicylic acid (aspirin) therapy and a platelet aggregate inhibitor to reduce the risk of recurrence and to prevent thrombosis. What instructions should the nurse provide to this client about taking aspirin? A. Aspirin should be administered with food or milk. B. Aspirin should be administered on an empty stomach. C. Aspirin should not be administered within 2 hours of meals. D. Enteric-coated aspirin can be crushed or chewed to reduce gastric - ANS A. Aspirin should be administered with food or milk. Medications used to dilate blood vessels supplying the heart muscle are referred to as A. antiarrhythmic agents B. antilipemic agents C. coronary vasodilators D. vasoconstrictors - ANS C. coronary vasodilators Angiotensin-converting enzyme (ACE) inhibitors lower blood pressure by A. decreasing vasoconstriction B. blocking the hormone that causes vasoconstriction C. a central-acting alpha-adrenergic agent D. peripheral vasodilation - ANS A. decreasing vasoconstriction Bile acid sequestrants achieve efficacy by which mechanism of action? A. Inhibiting the enzyme needed for cholesterol syntheses B. Binding with bile acids in the intestine, which reduces the total body cholesterol C. Inhibiting the mobilization of free fatty acids from the peripheral tissues D. Inhibiting intestinal absorption of both dietary and biliary cholesterol, blocking its transport in the small intestine - ANS B. Binding with bile acids in the intestine, which reduces the total body cholesterol Nicotinic acid (niacin) is effective through which action? A. Inhibiting the enzyme needed for cholesterol syntheses B. Binding with bile acids in the intestine, which reduces the total body cholesterol C. Inhibiting the mobilization of free fatty acids from the peripheral tissues D. Inhibiting intestinal absorption of both dietary and biliary cholesterol, blocking its transport in the small intestine - ANS C. Inhibiting the mobilization of free fatty acids from the peripheral tissues Which of the following statements is true of coumadin? A. Its antidote is vitamin K. B. The lab test to measure action is activated partial thromboplastin time (aPTT). C. The medication may only be administered parenterally. D. Its onset of action is immediate. - ANS A. Its antidote is vitamin K Which comment made by a patient taking anticoagulants indicates the need for additional teaching? A. "I will report any sign of bleeding immediately." B. "I will take special care with shaving and brushing my teeth." C . "Once my INR is stable, no additional follow-up lab studies will be necessary." D. "I will wear a medical alert." - ANS C . "Once my INR is stable, no additional follow-up lab studies will be necessary."