RN VATI Pharmacology 2019 Exam with Answers

RN VATI Pharmacology 2019 Exam with Answers 3 months, the provider can increase the estrogen dosage in the contraceptive or prescribe a different progestin medication. If the client is to start a new dosage of the medication, the nurse should instruct the client to start the new prescription at the beginning of a menstrual cycle. Combination oral contraceptives can cause glucose tolerance, changes in appetite, and edema, which can result in weight gain. Combination oral contraceptives can cause several cardiovascular adverse effects, including hypertension, thrombosis, pulmonary embolism, and myocardial infarction; however, increased bruising is not an adverse effect of combination oral contraceptives. Combination oral contracep- tives can cause hypertension due to the increase in blood levels of angiotensin and aldosterone. Clients taking this type of contraceptive therapy should have regular blood-pressure checks. 58. A nurse is providing teaching to a client who has new prescriptions for beclomethasone and albuterol inhalers. Which of the following instructions should the nurse include in the teaching? O "Gargle with water after using beclomethasone." Q "It is not necessary to shake beclomethasone prior to use." 0 "Use beclomethasone for an acute asthma attack." 0 "Use beclomethasone before using albuterol to increase absorption.": "Gar- gle with water after using beclomethasone." Beclomethasone is an inhaled corticosteroid that prevents bronchial inflammation. Because it can cause oral candida infections, the nurse should instruct the client to gargle with water after using beclomethasone. The beclomethasone inhaler is an aerosolized medication that requires the client to shake the canister prior to use to distribute the medication particles in order to deliver a measured dose of the medication. Beclomethasone is an inhaled corticosteroid that prevents bronchial inflammation and is intended for long-term control of airway inflammation. It is not effective during an acute attack. The client should use beclomethasone on a regular basis for asthma control, and should use albuterol to stop acute asthma attacks. The client should use albuterol first, which is a short-acting beta2-agonist, to promote bronchodilation and increase the absorption of beclomethasone. 59. A nurse is assessing a client who has Parkinson's disease and is taking levodopalcarbidopa. The nurse observes that the client has tremors and twitching. Which of the following medications should the nurse anticipate administering? O Metoprolol O Bethanechol O Amantadine O Gabapentin: Amantadine A client who is taking levodopa/carbidopa for Parkinson's disease is at risk for developing dyskinesias, which are involuntary movements. Amantadine can help alleviate this adverse effect by increasing the release of dopamine. Metoprolol is a beta blocker that decreases heart rate and blood pressure and is used for the treatment of hypertension, heart failure, and angina pectoris. The nurse should administer bethanechol, a muscarinic agonist, to a client who has urinary retention. Bethanechol contracts the bladder's detrusor muscle, as well as relaxes the trigone and bladder sphincter, allowing for urination. The nurse should administer gabapentin, an anticonvulsant, to a client who has a seizure disorder or neuropathy. 60. A nurse is providing teaching to a client about proper administration of a medication with regard to meals. The nurse should instruct the client that the presence of food will alter the rate of which of the following pharma- cokinetic processes? 0 Distribution 0 Metabolism O Excretion 0 Absorption: Absorption. Absorption is the movement of the medication into the bloodstream. Food in the stomach alters gastric emptying and can delay the transport of the medication to the intestines, where it will be absorbed. However, certain medications, such as griseofulvin, have increased absorption when taken with foods that are high in fat. Distribution is the movement of a medication from the bloodstream into the tissues and fluids of the body. The presence of food in the stomach does not directly affect this process. Blood flow and the ability of a medication to leave the vascular system and to enter the cell can affect this process. Metabolism is the enzymatic alteration of the medication that occurs primarily in the liver. The presence of food in the stomach does not directly affect this process. Liver disease or dysfunction can slow the metabolism of medications and can result in toxicities. Excretion is the elimination of the metabolized medication from the body. The presence of food in the stomach does not directly affect this process. Excretion can occur through the kidneys, bile, sweat, saliva, breast milk, or through exhalation. 61. A nurse is caring for a client who has a prescription for penicillin V. Which of the following adverse effects is the priority for the nurse to monitor after the administration of the medication? O Laryngeal edema O Urticaria O Epigastric distress O Maculopapular rash: Laryngeal edema. When using the airway, breathing, and circulation (ABC) approach to client care, the nurse should determine that the priority adverse effect to monitor the client for is laryngeal edema, which indicates an anaphylactic reaction. This is a life-threatening reaction that compromises the client's airway and requires treatment with epineph- rine. Urticaria can result from penicillin administration and cause the client discomfort. However, this is not the priority adverse effect for which the nurse should monitor. Epigastric distress is a common effect of penicillin administration that can cause the client discomfort. However, this is not the priority adverse effect for which the nurse should monitor. Penicillin administration can cause a maculopapular rash that can cause the client discomfort. However, this is not the priority adverse effect for which the nurse should monitor. 62. A nurse is caring for a client who is receiving meperidine. Which of the following is the nurse's priority assessment before administering the medication? O Urinaryretention O Vomiting O Respiratoryrate O Level ofconsciousness: Respiratoryrate 63. A nurse is caring for a client who has hydromorphone toxicity. The nurse should anticipate a prescription for which of the following medications? O Disulfiram O Epinephrine O Naloxone O Flumazenil: Naloxone The nurse should expect to administer naloxone to reverse the effects of opiates, such as hydromorphone. Naloxone reverses the respiratory and CNS depression caused by opioids. Naloxone requires careful titration to reduce the risk of complete opioid reversal, which might result in the return of the client's pain. The nurse should continue to monitor the client's respiratory status following the administration of naloxone, as additional doses of naloxone might be necessary for the length of time the opioid remains in the client's system. Disulfiram helps maintain abstinence from alcohol use by aversion therapy. A client who consumes alcohol while taking this medication will develop acetaldehyde syn- drome, a potentially life-threatening condition that results in manifestations such as seizures, hypotension, cardiac dysrhythmias, nausea, vomiting, and respiratory depression. The nurse should instruct a client who has a new prescription for disulfiram to avoid all forms of alcohol, including cough syrups, colognes, and aftershaves. The nurse should administer epinephrine to a client who is having an anaphylactic reaction or cardiac arrest. The nurse should monitor a client receiving epinephrine closely for the development of tachydysrhythmias and hypertension. Flumazenil is a benzodiazepine receptor antagonist that specifically reverses acute benzodiazepines toxicity. Clients who are physically dependent on benzodiazepines or have a history of seizures should not receive this medication because flumazenil can precipitate seizure activity in these clients.