FOCUS ON NURSING PHARMACOLOGY

1. A patient comes to the clinic with symptoms as seen in a cold. What group of upper respiratory drugs causes local vasoconstriction, which decreases blood flow and shrinks swollen membranes to improve air flow? a. Antitussives b. Decongestants c. Expectorants d. Mucolytics Ans: B Feedback: Decongestants cause local vasoconstriction that decreases blood flow to irritated and dilated capillaries of the mucous membranes lining the nasal passages and sinus cavities. This vasoconstriction ...

1. The clinic nurse is admitting a 39-year-old woman who has come to the clinic complaining of left-sided tenderness, fever, chills, and flank pain. What does the nurse suspect the patient has? a. Cystitis b. Kidney stones c. Neurogenic bladder d. Pyelonephritis Ans: D Feedback: The fever and chills indicate an inflammatory process. Flank pain and left-sided tenderness indicate kidney swelling within the capsule. These symptoms indicate pyelonephritis. Kidney stones cause intense pain; ...

1. A nurse is discussing ways the body protects itself against infection. What are the microscopic, hair- like projections of the cell membrane found in the nasal cavity, which transport foreign substances toward the throat where it can be swallowed and kept away from the respiratory system? a. Goblet cells b. Cilia c. Alveolar sacs d. Sinuses Ans: B Feedback: Cilia are found in the epithelial cells of the lining of the nasal cavity and are constantly in motion directing mucus and trapp...

1. The class of diuretics that act to block the chloride pump in the distal convoluted tubules and leads to a loss of sodium and potassium and a minor loss of water is what? a. Carbonic anhydrase inhibitors b. Osmotic diuretics c. Potassium-sparing diuretics d. Thiazide diuretics Ans: D Feedback: Thiazide diuretics work to block the chloride pump, which leads to a loss of sodium, potassium, and some water. They are considered mild diuretics. Carbonic anhydrase inhibitors work to block t...

1. The nurse is caring for a patient in end-stage renal failure and anemia. What is the cause of this patient’s anemia? a. Low serum iron levels b. Low erythropoietin levels c. Inadequate oxygenation of tissue d. Lack of B12 and folic acid intake Ans: B Feedback: Anemia can occur if erythropoietin levels are low. This is seen in association with renal failure, when the kidneys are no longer able to produce erythropoietin. Low iron levels, hypoxia, and vitamin deficiency are not likely...

1. A patient is admitted to the hospital with deep vein thrombosis. A 10,000-unit dose of heparin is administered subcutaneously. What drug does the nurse keep on hand to reverse the effects of heparin if the patient begins to bleed? a. Antithrombin (Thrombate III) b. Desirudin (Iprivask) c. Protamine sulfate d. Vitamin K Ans: C Feedback: The antidote for heparin is protamine sulfate. This drug forms stable salts as soon as it comes in contact with heparin. The reaction immediately reve...

1. The nursing instructor is talking with students about the renal system. What would the instructor tell the students about the renal system, especially how it helps maintain calcium levels in the body by regulating the activation of what? a. Vitamin A b. Vitamin B c. Vitamin C d. Vitamin D Ans: D Feedback: The renal system has four major functions in the body. One is regulating vitamin D activation, which helps maintain and regulate calcium levels. Vitamins A, B, and C are not associa...

1. When planning patient care the nurse recognizes what patient is at greatest risk of developing coronary artery disease? a. A 32-year-old Asian American with total cholesterol of 120 mg/dL b. A 62-year-old white American with total cholesterol of 260 mg/dL c. A 48-year-old African American with total cholesterol of 198 mg/dL d. A 26-year-old Native American with total cholesterol of 150 mg/dL Ans: B Feedback: White Americans have the highest incidence of coronary artery disease (CAD)....

1. A patient presents to the emergency department with rales, wheezing, and blood-tinged sputum. What does the nurse recognize that these symptoms indicate? a. Cardiomyopathy b. Cardiomegaly c. Valvular heart disease d. Pulmonary edema Ans: D Feedback: In left-sided heart failure, the left ventricle pumps inefficiently resulting in a backup of blood into the lungs causing pulmonary vessel congestion and fluid leaks into the alveoli and lung tissue. As more fluid continues to collect in ...

1. A patient with a history of atrial fibrillation has had a worsening of his or her condition. The nurse knows that the drug of choice for long-term stabilization of atrial fibrillation following electrocardioversion is what? a. Disopyramide (Norpace) b. Moricizine (Ethmozine) c. Procainamide (Pronestyl) d. Quinidine (generic) Ans: D Feedback: Quinidine is often the drug of choice for long-term stabilization of atrial fibrillation after the rhythm is converted by electrocardioversion. ...

1. A nurse is providing patient teaching to a patient who has been experiencing unstable angina. What will the nurse’s explanation of this condition include? a. A coronary vessel has become completely occluded and is unable to deliver blood to your heart. b. The pain is caused by a spasm of a blood vessel, not just from the vessel narrowing. c. There is serious narrowing of a coronary artery that is causing a reduction in oxygen to the heart. d. Your body’s response to a lack of oxygen i...

1. Several nursing students are creating a poster on the mechanism of the heart. What structure would they label as separating the right half of the heart from the left? a. Auricle b. Bundle of His c. Syncytia d. Septum Ans: D Feedback: The septum is a partition that separates the right and left halves of the heart. The right half receives deoxygenated blood from everywhere in the body and the left half receives oxygenated blood from the lungs. The auricle is an appendage attached to ea...

1. What does the clinic nurse anticipate as initial drug therapy for a 39-year-old African American man who is 25 pounds overweight and newly diagnosed with hypertension? a. An angiotensin-converting enzyme (ACE) inhibitor b. A beta-blocker c. A calcium channel blocker d. A diuretic Ans: D Feedback: African Americans are at highest risk for developing hypertension with men more likely than women to develop the disease. African Americans have documented differences in response to antihyp...

1. A nurse is caring for an adolescent with hypogonadism who has been prescribed fluoxymesterone (Androxy) for replacement. What adverse effect of this drug will the nurse alert the patient to that could result in self-esteem concerns? a. Acne b. Dizziness c. Insomnia d. Fatigue Ans: A Feedback: All these options are possible adverse effects of the drug. However, for the adolescent, acne is the only one that could cause image concerns, which could lead to low self-esteem. Dizziness, ins...

1. What hormone stimulates the release of the follicle-stimulating hormone (FSH) from both male and female glands? a. Growth hormone-releasing hormone (GHRH) b. Thyrotropin-releasing hormone (TRH) c. Gonadotropin-releasing hormone (GnRH) d. Prolactin-releasing hormone (PRH) Ans: C Feedback: The male and female glands respond to luteinizing hormone (LH) and FSH, which are released from the anterior pituitary in response to stimulation from GnRH that is released from the hypothalamus. GHR...

1. The nurse is caring for a female patient who would like to start taking oral contraceptives. What assessment finding may indicate the patient is not a good candidate for these drugs? a. Decreased appetite b. Dehydration c. Occasional headaches d. History of deep vein thrombosis Ans: D Feedback: Estrogens are contraindicated in the presence of a history of thromboembolic disorders because of the increased risk of thrombus and embolus development. A loss of appetite would not contraind...

1. The nurse is teaching the patient, newly diagnosed with Graves’s disease, about the normal functioning of the thyroid gland. What hormone will the nurse tell the patient controls production and release of thyroid hormones? a. Thyrotropin-releasing hormone (TRH) b. Thyroid-stimulating hormone (TSH) c. Tetraiodothyronine d. Triiodothyronine Ans: B Feedback: Thyroid hormone production and release are regulated by the anterior pituitary hormone called thyroid- stimulating hormone (TSH)...

1. The nurse administers fludrocortisone (Florinef) to a patient diagnosed with salt-losing adrenogenital syndrome and then assesses for what therapeutic action? a. Development of hypokalemia and elevated serum glucose level b. An increase in sodium and water reabsorption and potassium excretion c. Headache, edema, weakness, arrhythmias, and hypertension d. Sodium and water depletion along with potassium retention Ans: B Feedback: Fludrocortisone’s therapeutic effects include an incre...

1. The nurse is discussing the endocrine system with a class of nursing students. What substance would the nurse label as a hormone? a. Acetylcholine b. Norepinephrine c. Nucleic acid d. Serotonin Ans: B Feedback: A hormone is secreted directly into the bloodstream and travels from the site of production to react with specific receptor sites to cause an action. Norepinephrine, which is a neurotransmitter, is a hormone when it is produced in the adrenal medulla, secreted into circulation...

1. A patient suspected of having Cushing’s disease comes to the clinic. What drug might the nurse administer to test for adrenal function and responsiveness? a. Corticotropin b. Menotropins c. Thyrotropin alfa d. Chorionic gonadotropin Ans: A Feedback: Corticotropin (ACTH) and cosyntropin are used for diagnostic purposes to test adrenal function and responsiveness. Menotropin is a purified preparation of gonadotropins and is used as a fertility drug. Thyrotropin alfa is used as adjunc...