140 Must Know NCLEX Meds questions
and answers
Alteplase (t-PA) - Answer *class*: thrombolytics
*Indication*: MI, acute ischemic stroke, occluded central lines
*Action*: converts plasminogen to plasmin which degrades the fibrin found
*Nursing Considerations*:
- contraindicated in active bleeding
-monitor for anaphylaxis
- use caution with uncontrolled hypertension
Atorvastatin (Lipitor) - Answer *class*: lipid-lowering agent
*Indication*: management of high cholesterol (hypercholesterolemia), primary prevention of
cardiovascular disease
*Action*: lowers total cholesterol as well as LDL while slightly increasing HDL. Inhibits HMG-CoA
reductase which plays a role in the liver in cholesterol formation
*Nursing Considerations*
- contraindicated in active liver disease
- may cause rhabdomyolysis
- monitor serum cholesterol
- monitor liver function tests, renal function
Acetaminophen (Tylenol) - Answer *class*: antipyretic, non-opioid analgesic
*Indication*: pain, fever
*Action*: inhibit the synthesis of prostaglandins which play a role in transmission of pain signals and
fever response
*Nursing Considerations*:
- do not exceed 4g of acetaminophen per day
- overdose will lead to hepatotoxicity
- **Acetadote**is the antidote for overdose
,- may increase risk for bleed with warfarin therapy
Acyclovir (Zovirax) - Answer *class*: antiviral, purine analogues
*Indication*:genital herpes, herpes zoster, chicken pox
*Action*: interferes with viral DNA synthesis
*Nursing Considerations*:
- may cause seizures, renal failure, Stevens-Johnson syndrome, thrombotic thrombocytopenic purpura
syndrome, diarrhea, dizziness, nausea
- monitor renal function
- assess lesions
- instruct patient to use proper protection during sexual intercourse
Albuterol (Proventil) - Answer *class*: bronchodilator ,adrenergic
*Indication*:bronchodilator used to prevent airway obstruction in asthma and COPD
*Action*: binds to Beta2 adrenergic receptors in the airway leading to relaxation of the smooth muscles
in the airways
*Nursing Considerations*:
- may decrease the effectiveness of Beta Blockers
-use caution with: heart disease, diabetes, glaucoma, seizure disorder
- overuse of inhalers can lead to bronchospasm
- monitor for chest pain and palpitations
- can decrease digoxin levels
Alendronate (Fosamax) - Answer *class*: bone resorption inhibitor, biphosphnates
*Indication*: osteoporosis (aging, menopause, corticosteroid induced)
*Action*: inhibits osteoclast activity leading to inhibition of resorption of bone
*Nursing Considerations*:
- take first thing in the morning with full glass of water 30 min prior to eating
- assess serum calcium and vitamin D
,- may lead to muscle pain
Alprazolam (Xanax) - Answer *class*: benzodiazepine, anti-anxiety agent
*Indication*:anxiety, panic disorder, manage symptoms of PMS, insomnia, mania, psychosis
*Action*: works in CNS to produce anxiolytic effect causing CNS depression.
*Nursing Considerations*:
- may cause CNS depression, drowsiness, lethargy
- may lead to physical dependence
- assess anxiety and mental status
- *Flumazenil* is the antidote for overdose
- Grapefruit juice may increase blood levels
Amiodarone (Cordarone) - Answer *class*: Antiarrhythmic class III, Potassium channel blocker
*Indication*: ventricular arrhythmias, SVT, ACLS protocol for v-fib and vTACH
*Action*: prolongs action potential, inhibits adrenergic stimulation, slows rate, decreases peripheral
vascular resistance causing vasodilation
*Nursing Considerations*:
- may lead to ARDS, pulmonary toxicity, CHF, bradycardia, hypotension
- increases risk for QT prolongation
- increases digoxin levels
- increases activity of warfarin
- monitor EKG
- assess for signs and symptoms of ARDS
- monitor liver function test
- check dosage with another RN
- avoid drinking grapefruit juice
Amitryptiline (Elavil) - Answer *class*: tricyclic antidepressant
*Indication*: depression, anxiety, insomnia
, *Action*: increases effect of serotonin and norepinephrine in the CNS, exhibits anticholinergic effects
*Nursing Considerations*:
- contraindicated in MI, heart failure, QT prolongation, glaucoma
- may increase risk for suicidal ideation
- may cause arrhythmias, hypotension, EKG changes
- may cause alterations in blood glucose levels
- may lead to general sedation and lethargy
- do not use within 2 weeks of MAOIs
- monitor for orthostatic hypotension
- may lead to photosensitivity, instruct patient to use sunscreen
- may turn urine blue/green color
Amlodipine (Norvasc) - Answer *class*: Ca channel blocker, antihypertensive
*Indication*: hypertension, angina
*Action*: blocks transport of calcium into muscle cells inhibiting excitation and contraction
*Nursing Considerations*:
- may cause gingival hyperplasia
- grapefruit juice may increase drug level
- monitor blood pressure and pulse
- monitor intake and output
- assess for signs of CHF
- assess characteristics of angina
- instruct patient of interventions for hypertension and how to take BP
Amoxicillin (Moxatag) - Answer *class*: anti-infectives, antiulcer agent, aminopenicillins
*Indication*: skin infections, respiratory infections, sinusitis, endocarditis prophylaxis, lime disease
*Action*: Inhibits synthesis of bacterial cell wall leading to cell death.
*Nursing Considerations*:
- Contraindicated with penicillin allergy
and answers
Alteplase (t-PA) - Answer *class*: thrombolytics
*Indication*: MI, acute ischemic stroke, occluded central lines
*Action*: converts plasminogen to plasmin which degrades the fibrin found
*Nursing Considerations*:
- contraindicated in active bleeding
-monitor for anaphylaxis
- use caution with uncontrolled hypertension
Atorvastatin (Lipitor) - Answer *class*: lipid-lowering agent
*Indication*: management of high cholesterol (hypercholesterolemia), primary prevention of
cardiovascular disease
*Action*: lowers total cholesterol as well as LDL while slightly increasing HDL. Inhibits HMG-CoA
reductase which plays a role in the liver in cholesterol formation
*Nursing Considerations*
- contraindicated in active liver disease
- may cause rhabdomyolysis
- monitor serum cholesterol
- monitor liver function tests, renal function
Acetaminophen (Tylenol) - Answer *class*: antipyretic, non-opioid analgesic
*Indication*: pain, fever
*Action*: inhibit the synthesis of prostaglandins which play a role in transmission of pain signals and
fever response
*Nursing Considerations*:
- do not exceed 4g of acetaminophen per day
- overdose will lead to hepatotoxicity
- **Acetadote**is the antidote for overdose
,- may increase risk for bleed with warfarin therapy
Acyclovir (Zovirax) - Answer *class*: antiviral, purine analogues
*Indication*:genital herpes, herpes zoster, chicken pox
*Action*: interferes with viral DNA synthesis
*Nursing Considerations*:
- may cause seizures, renal failure, Stevens-Johnson syndrome, thrombotic thrombocytopenic purpura
syndrome, diarrhea, dizziness, nausea
- monitor renal function
- assess lesions
- instruct patient to use proper protection during sexual intercourse
Albuterol (Proventil) - Answer *class*: bronchodilator ,adrenergic
*Indication*:bronchodilator used to prevent airway obstruction in asthma and COPD
*Action*: binds to Beta2 adrenergic receptors in the airway leading to relaxation of the smooth muscles
in the airways
*Nursing Considerations*:
- may decrease the effectiveness of Beta Blockers
-use caution with: heart disease, diabetes, glaucoma, seizure disorder
- overuse of inhalers can lead to bronchospasm
- monitor for chest pain and palpitations
- can decrease digoxin levels
Alendronate (Fosamax) - Answer *class*: bone resorption inhibitor, biphosphnates
*Indication*: osteoporosis (aging, menopause, corticosteroid induced)
*Action*: inhibits osteoclast activity leading to inhibition of resorption of bone
*Nursing Considerations*:
- take first thing in the morning with full glass of water 30 min prior to eating
- assess serum calcium and vitamin D
,- may lead to muscle pain
Alprazolam (Xanax) - Answer *class*: benzodiazepine, anti-anxiety agent
*Indication*:anxiety, panic disorder, manage symptoms of PMS, insomnia, mania, psychosis
*Action*: works in CNS to produce anxiolytic effect causing CNS depression.
*Nursing Considerations*:
- may cause CNS depression, drowsiness, lethargy
- may lead to physical dependence
- assess anxiety and mental status
- *Flumazenil* is the antidote for overdose
- Grapefruit juice may increase blood levels
Amiodarone (Cordarone) - Answer *class*: Antiarrhythmic class III, Potassium channel blocker
*Indication*: ventricular arrhythmias, SVT, ACLS protocol for v-fib and vTACH
*Action*: prolongs action potential, inhibits adrenergic stimulation, slows rate, decreases peripheral
vascular resistance causing vasodilation
*Nursing Considerations*:
- may lead to ARDS, pulmonary toxicity, CHF, bradycardia, hypotension
- increases risk for QT prolongation
- increases digoxin levels
- increases activity of warfarin
- monitor EKG
- assess for signs and symptoms of ARDS
- monitor liver function test
- check dosage with another RN
- avoid drinking grapefruit juice
Amitryptiline (Elavil) - Answer *class*: tricyclic antidepressant
*Indication*: depression, anxiety, insomnia
, *Action*: increases effect of serotonin and norepinephrine in the CNS, exhibits anticholinergic effects
*Nursing Considerations*:
- contraindicated in MI, heart failure, QT prolongation, glaucoma
- may increase risk for suicidal ideation
- may cause arrhythmias, hypotension, EKG changes
- may cause alterations in blood glucose levels
- may lead to general sedation and lethargy
- do not use within 2 weeks of MAOIs
- monitor for orthostatic hypotension
- may lead to photosensitivity, instruct patient to use sunscreen
- may turn urine blue/green color
Amlodipine (Norvasc) - Answer *class*: Ca channel blocker, antihypertensive
*Indication*: hypertension, angina
*Action*: blocks transport of calcium into muscle cells inhibiting excitation and contraction
*Nursing Considerations*:
- may cause gingival hyperplasia
- grapefruit juice may increase drug level
- monitor blood pressure and pulse
- monitor intake and output
- assess for signs of CHF
- assess characteristics of angina
- instruct patient of interventions for hypertension and how to take BP
Amoxicillin (Moxatag) - Answer *class*: anti-infectives, antiulcer agent, aminopenicillins
*Indication*: skin infections, respiratory infections, sinusitis, endocarditis prophylaxis, lime disease
*Action*: Inhibits synthesis of bacterial cell wall leading to cell death.
*Nursing Considerations*:
- Contraindicated with penicillin allergy
