Pharmacology Exam 3
Which potential problem is of most concern for a patient receiving immunosuppressant
drugs?
A. Orthostatic hypotension
B. Increased susceptibility to infections
C. Neurotoxicity
D. Peripheral edema correct answers B. Increased susceptibility to infections
Rationale: Neurotoxicity and edema may be a problem with some immunosuppressants
(not orthostatic hypotension), but a heightened susceptibility to opportunistic infections
is a major risk factor in immunosuppressed patients.
A patient is being discharged on cyclosporine therapy. Which statement by the patient
indicates that more teaching is needed? "I will take the cyclosporine tablet with:
A. water."
B. milk."
C. grapefruit juice."
D. apple juice." correct answers C. grapefruit juice
Rationale: Common drug interactions to assess for when patients take cyclosporin
include estrogens, protease inhibitors, HMG-CoA reductase inhibitors, clarithromycin,
phenytoin, phenobarbital, St. John's wort, nonsteroidal antiinflammatory drugs, and
grapefruit juice.
The nurse is administering medications. One patient has an order for aspirin 325 mg by
mouth daily and another patient has an order for aspirin 650 mg 4 to 6 times daily
(maximum 4 g/day). The nurse understands that the indication for the 325 mg of aspirin
once daily is:
A. pain management.
B. fever reduction.
C. treatment of OA.
D. thromboprevention. correct answers D. thromboprevention
Rationale: "Low-dose" aspirin, such as 81 or 325 mg once daily, is given for
thromboprevention. Dosages for pain, fever, or arthritis are much higher usually.
An 82-year-old woman is taking ibuprofen (Motrin) 3200 mg divided three times daily as
treatment for arthritis. She has had no other health problems. What is the most
important assessment for the nurse to monitor while the patient is on this therapy?
A. Blood sugar
B. Liver function studies
C. Assessment of hearing
D. Renal function studies correct answers D. Renal function studies
, Rationale: NSAIDs disrupt the prostaglandins, which stimulate vasodilation and
increase renal blood flow. This disruption may precipitate chronic or acute renal failure
in some patients, and older patients are at greater risk for this adverse drug reaction.
A patient is taking ibuprofen 800 mg three times a day by mouth as treatment for
Osteoarthritis. While taking a health history, the nurse finds out that the patient has a
few beers on weekends. What concern would there be with the interaction of the alcohol
and ibuprofen?
A. Increased bleeding tendencies
B. Increased chance for GI bleeding
C. Increased nephrotoxic effects
D. Reduced anti-inflammatory effects of the NSAID correct answers B. Increased
chance for GI bleeding
Rationale: NSAIDs taken with alcohol may result in increased risk of GI bleeding.
A 40-year-old female patient is seen in the clinic. She has been newly diagnosed with
RA. Which medication does the nurse anticipate being ordered for the patient?
A. methotrexate
B. adalimumab
C. infliximab
D. etanercept correct answers A. methotrexate
Rationale: For the treatment of RA, the recommend therapy with nonbiologic DMARDs
usually begins with methotrexate or leflunomide for most patients. Biologic DMARDs are
generally reserved for patients whose disease does not respond to methotrexate or
leflunomide. The biologic DMARDs include etanercept, infliximab, adalimumab,
abatacept, and rituximab.
Before administering methotrexate, it is most important for the nurse to assess the
patient for:
A. allergy to eggs.
B. congestive heart failure.
C. latent tuberculosis.
D. hypothyroidism. correct answers C. latent tuberculosis.
Rationale: Before administering DMARDs, it is important for the nurse to assess the
patient for contraindications to the use of DMARDs such as active bacterial infections,
active herpes, active or latent tuberculosis, and acute or chronic hepatitis B or C.
A patient who has a history of coronary artery disease has been instructed to take one
81-mg aspirin tablet a day. The patient asks about the purpose of this aspirin. Which
response by the nurse is correct?
a.
"Aspirin is given reduce anxiety."
b.
"It will help to prevent clot formation."
Which potential problem is of most concern for a patient receiving immunosuppressant
drugs?
A. Orthostatic hypotension
B. Increased susceptibility to infections
C. Neurotoxicity
D. Peripheral edema correct answers B. Increased susceptibility to infections
Rationale: Neurotoxicity and edema may be a problem with some immunosuppressants
(not orthostatic hypotension), but a heightened susceptibility to opportunistic infections
is a major risk factor in immunosuppressed patients.
A patient is being discharged on cyclosporine therapy. Which statement by the patient
indicates that more teaching is needed? "I will take the cyclosporine tablet with:
A. water."
B. milk."
C. grapefruit juice."
D. apple juice." correct answers C. grapefruit juice
Rationale: Common drug interactions to assess for when patients take cyclosporin
include estrogens, protease inhibitors, HMG-CoA reductase inhibitors, clarithromycin,
phenytoin, phenobarbital, St. John's wort, nonsteroidal antiinflammatory drugs, and
grapefruit juice.
The nurse is administering medications. One patient has an order for aspirin 325 mg by
mouth daily and another patient has an order for aspirin 650 mg 4 to 6 times daily
(maximum 4 g/day). The nurse understands that the indication for the 325 mg of aspirin
once daily is:
A. pain management.
B. fever reduction.
C. treatment of OA.
D. thromboprevention. correct answers D. thromboprevention
Rationale: "Low-dose" aspirin, such as 81 or 325 mg once daily, is given for
thromboprevention. Dosages for pain, fever, or arthritis are much higher usually.
An 82-year-old woman is taking ibuprofen (Motrin) 3200 mg divided three times daily as
treatment for arthritis. She has had no other health problems. What is the most
important assessment for the nurse to monitor while the patient is on this therapy?
A. Blood sugar
B. Liver function studies
C. Assessment of hearing
D. Renal function studies correct answers D. Renal function studies
, Rationale: NSAIDs disrupt the prostaglandins, which stimulate vasodilation and
increase renal blood flow. This disruption may precipitate chronic or acute renal failure
in some patients, and older patients are at greater risk for this adverse drug reaction.
A patient is taking ibuprofen 800 mg three times a day by mouth as treatment for
Osteoarthritis. While taking a health history, the nurse finds out that the patient has a
few beers on weekends. What concern would there be with the interaction of the alcohol
and ibuprofen?
A. Increased bleeding tendencies
B. Increased chance for GI bleeding
C. Increased nephrotoxic effects
D. Reduced anti-inflammatory effects of the NSAID correct answers B. Increased
chance for GI bleeding
Rationale: NSAIDs taken with alcohol may result in increased risk of GI bleeding.
A 40-year-old female patient is seen in the clinic. She has been newly diagnosed with
RA. Which medication does the nurse anticipate being ordered for the patient?
A. methotrexate
B. adalimumab
C. infliximab
D. etanercept correct answers A. methotrexate
Rationale: For the treatment of RA, the recommend therapy with nonbiologic DMARDs
usually begins with methotrexate or leflunomide for most patients. Biologic DMARDs are
generally reserved for patients whose disease does not respond to methotrexate or
leflunomide. The biologic DMARDs include etanercept, infliximab, adalimumab,
abatacept, and rituximab.
Before administering methotrexate, it is most important for the nurse to assess the
patient for:
A. allergy to eggs.
B. congestive heart failure.
C. latent tuberculosis.
D. hypothyroidism. correct answers C. latent tuberculosis.
Rationale: Before administering DMARDs, it is important for the nurse to assess the
patient for contraindications to the use of DMARDs such as active bacterial infections,
active herpes, active or latent tuberculosis, and acute or chronic hepatitis B or C.
A patient who has a history of coronary artery disease has been instructed to take one
81-mg aspirin tablet a day. The patient asks about the purpose of this aspirin. Which
response by the nurse is correct?
a.
"Aspirin is given reduce anxiety."
b.
"It will help to prevent clot formation."
