PHARM 293 Evolve Pharmacology Questions & Answers

PHARM 293 Evolve Pharmacology Questions & Answers 1. Which response best supports the observations that the nurse identifies in a client who is experiencing a placebo effect?  Psychological response to inert medication 2. Methylphenidate HCl (Concerta) is prescribed for daily administration to a 10-year-old child with attention deficit-hyperactivity disorder (ADHD). In preparing a teaching plan for the parents of this child newly diagnosed with ADHD, which instruction is most important for the nurse to provide to the parents?  Administer the medication in the morning before the child goes to school. 3. Which physiologic mechanism explains a drug's increased metabolism that is triggered by a disease process?  Pharmacokinetics 4. The health care provider prescribes ipratropium (Atrovent) for a client. An allergic reaction to which other medication would cause the nurse to question the prescription for Atrovent?  Atropine sulfate (Atropine) 5. A 42-year-old client is admitted to the emergency department after taking an overdose of amitriptyline (Elavil) in a suicide attempt. Which drug should the nurse plan to administer to reverse the cardiac and central nervous system effects of amitriptyline (Elavil)?  Sodium bicarbonate 6. A client who is hypertensive receives a prescription for hydrochlorothiazide (HCTZ) – thiazide diuretic cause potassium wasting in the urine. When teaching about the side effects of this drug, which symptoms are most important for the nurse to instruct the client to report?  Fatigue and muscle weakness 7. The nurse is preparing to apply a surface anesthetic agent for a client. Which action should the nurse implement to reduce the risk of systemic absorption?  Avoid abraded skin areas when applying the anesthetic. – apply to the smallest surface of intact skin 8. The health care provider prescribes cisplatin (Platinol) to be administered in 5% dextrose and 0.45% normal saline with mannitol (Osmitrol) added. Which assessment parameters would be most helpful to the nurse in evaluating the effectiveness of the Osmitrol therapy?  Urine output 9. A 19-year-old male client who has sustained a severe head injury is intubated and placed on assisted mechanical ventilation. To facilitate optimal ventilation and prevent the client from "fighting" the ventilator, the health care provider administers pancuronium bromide (Pavulon) IV, with adjunctive opioid analgesia. What medication should the nurse maintain at the client's bedside?  Neostigmine bromide (Prostigmin) 10. The nurse is reviewing a client's laboratory results before a procedure in which a neuromuscular blocking agent is a standing order. Which finding should the nurse report to the health care provider?  Hypokalemia - Low potassium levels enhance the effects of neuromuscular blocking agents 11. A female client with myasthenia gravis is taking a cholinesterase inhibitor and asks the nurse what can be done to remedy her fatigue and difficulty swallowing. What action should the nurse implement?  Develop a teaching plan for the client to self-adjust the dose of medication in response to symptoms. - Clients should be taught to recognize signs of overmedication and undermedication so that they can modify the dosage themselves based on a prescribed sliding scale. 12. A client receives pancuronium (Pavulon), a long-acting, nondepolarizing neuromuscular blocker, during surgical anesthesia. Which client situation should alert the nurse to evaluate the client for a prolonged muscle relaxation response to this medication?  Renal insufficiency 13. A client is ordered 22 mg of gentamicin by IM injection. The drug is available in 20 mg/2 mL. How many mL should be administered?  2.2 mL - (22 mg/20 mg) × 2 mL = 2.2 mL 14. A client is receiving oral griseofulvin (Grisactin) for a persistent tinea corporis infection. Which response by the client indicates an accurate understanding of the drug teaching conducted by the nurse?  "I'll wear sunscreen whenever I mow the lawn." - Photosensitivity is a side effect of griseofulvin (Grisactin), so clients should be cautioned to wear protective sunscreen during sun exposure. 15. The nurse has completed diabetic teaching for a client who has been newly diagnosed with diabetes mellitus. Which statement by this client would indicate to the nurse that further teaching is needed?  "When I exercise, I should plan to increase my insulin dosage." - Exercise helps facilitate the entry of glucose into the cell, so increasing insulin doses with exercise would place the client at high risk for a hypoglycemic reaction. 16. The nurse is evaluating a client's understanding of the prescribed antilipemic drug lovastatin (Mevacor). Which client statement indicates that further teaching is needed?  "I will take the medication every day before breakfast." - The enzyme that helps metabolize cholesterol is activated at night, so this medication should be taken with the evening meal. 17. A client with acute lymphocytic leukemia is to begin chemotherapy today. The health care provider's prescription specifies that ondansetron (Zofran) is to be administered IV 30 minutes prior to the infusion of cisplatin (Platinol). What is the rationale for administering Zofran prior to the chemotherapy induction?  Reduction or elimination of nausea and vomiting 18. A client who arrives in the postanesthesia care unit (PACU) after surgery is not awake from general anesthesia. Which action should the nurse implement first?  Review the medication administration record (MAR). - Most general anesthetics produce cardiovascular and respiratory depression, so a review of the client's MAR identifies all the medications received during surgery and helps the nurse anticipate the client's response and emergence from anesthesia. 19. Which class of antineoplastic chemotherapy agents resembles the essential elements required for DNA and RNA synthesis and inhibits enzymes necessary for cellular function and replication?  Antimetabolites 20. A client who is HIV-positive is receiving combination therapy with the antiviral medication zidovudine (Retrovir). Which instruction should the nurse include in this client's teaching plan?  Return to the clinic every 2 weeks for blood counts. - Bone marrow depression with granulocytopenia is a severe but common adverse effect of zidovudine (Retrovir). Careful monitoring of CBCs is indicated. 21. During administration of theophylline (Theo-Dur), the nurse should monitor for signs of toxicity. Which symptom would cause the nurse to suspect Theo-Dur toxicity?  Restlessness - Other signs of toxicity are anorexia, nausea, vomiting, insomnia, tachycardia, arrhythmias, and seizures. 22. Amoxicillin, 500 mg PO every 8 hours, is prescribed for a client with an infection. The drug is available in a suspension of 125 mg/5 mL. How many milliliters should the nurse administer with each dose?  20 mL 23. A 45-year-old female client is receiving alprazolam (Xanax) for anxiety. Which client behaviors would indicate that the drug is effective?  The staff observes the client sitting in the day room reading a book. 24. Which parameter is most important for the nurse to check prior to administering a subcutaneous injection of heparin?  Activated partial thromboplastin time (aPTT) 25. A client is receiving antiinfective drug therapy for a postoperative infection. Which complaint should alert the nurse to the possibility that the client has contracted a superinfection?  "My mouth feels sore." - Stomatitis caused by a thrush infection, which can cause mouth pain, is a sign of superinfection. 26. A client is taking famotidine (Pepcid). Which client statement should the nurse further assess because it may indicate that the client is experiencing a side effect of this drug?  "I seem to be having difficulty thinking clearly." - A common side effect of Pepcid is confusion. 27. A 2-month-old infant is scheduled to receive the first DPT immunization. What is the preferred injection site to administer this immunization?  Vastus lateralis 28. Prior to administering a scheduled dose of digoxin (Lanoxin), the nurse reviews the client's current serum digoxin level, which is 1.3 ng/dL. Which action should the nurse implement?  Give the dose of digoxin if the client's heart rate is within a safe range. 29. The nurse is preparing to administer a secondary infusion of a dobutamine solution to a client. The nurse notes that the solution is brown in color. Which action should the nurse implement?  Administer the drug if the solution's reconstitution time is less than 24 hours. 30. A client is being discharged with a prescription for sulfasalazine (Azulfidine) to treat ulcerative colitis. Which instruction should the nurse provide to this client prior to discharge?  Drink eight glasses of fluid a day. - Adequate hydration is important for all sulfa drugs because they can crystallize in the urine. If possible, the drug should be taken after eating to provide longer intestinal transit time. 31. A psychiatric client is discharged from the hospital with a prescription for haloperidol (Haldol). Which instruction should the nurse include in the discharge teaching plan for this client?  Use sunglasses and sunscreen when outdoors. - Photosensitivity is a common adverse effect of haloperidol (Haldol). 32. In addition to nitrate therapy, a client is receiving nifedipine (Procardia), 10 mg PO every 6 hours. The nurse should plan to observe for which common side effect of this treatment regimen?  Hypotension - Nifedipine (Procardia) reduces peripheral vascular resistance and nitrates produce vasodilation, so concurrent use of nitrates with nifedipine can cause hypotension with the initial administration of these agents. 33. A client is receiving pyridostigmine bromide (Mestinon) to control the symptoms of myasthenia gravis. Which client behavior would indicate that the drug therapy is effective?  Clear speech - Clear speech is the result of increased muscle strength. Muscle weakness characteristic of myasthenia gravis often first appears in the muscles of the neck and face. 34. An older client who had a colon resection yesterday is receiving a constant dose of hydromorphone (Dilaudid) via a patient-controlled analgesia (PCA) pump. Which assessment finding is most significant and requires that the nurse intervene?  Respirations decrease to 14 breaths/min. - Hydromorphone (Dilaudid) is an opioid agonist-analgesic of opiate receptors that inhibits ascending pathways and can cause respiratory depression. Older adults are more sensitive to opioids so the "start low and go slow" approach should be taken. 35. The nurse is preparing to administer amphotericin B (Fungizone) IV to a client. What laboratory data is most important for the nurse to assess before initiating an IV infusion of this medication?  Serum potassium level 36. Methenamine mandelate (Mandelamine)