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Pharmacy NURS-6521 correctly answered latest 2023
Administer a tablet under his tongue and repeat the action in 5 and 10 minutes if the pain has not subsided A 62-year-old man is admitted to the hospital ... [Show More] with a diagnosis of chest pain. He has an order for 0.3 mg of sublingual nitroglycerin prn for chest pain. Which of the following actions should the nurse do first when he complains of chest pain? increased HR and decrease BP An expected outcome for a patient who has just taken sublingual nitroglycerin should be 10 mg A patient is to take nifedipine (Procardia) 10 mg PO tid. How many milligrams will he take per dose? Nitrate tolerance A nurse explains to a patient that nitroglycerin patches should be applied in the morning and removed in the evening. This medication schedule reduces the potential for ... Blood pressure A patient is admitted to the emergency department with severe chest pain. The emergency department physician orders intravenous nitroglycerin 5 mcg/min, titrate dose by 5 mcg/min every 3 to 5 minutes per infusion pump as needed. Before administering the nitroglycerin, the nurse should prioritize which of the following assessments? Dizziness A nurse is caring for a patient with chronic angina. The patient is receiving ranolazine (Ranexa) 500 mg PO bid. Which of the following signs or symptoms would the nurse attribute to being a common adverse effect of this medication? crush the capsule and ask the patient to inhale the vapors A 45-year-old man enters the emergency department complaining of chest pain. The nurse has an order to administer amyl nitrite. The nurse will... keep the tablets in the original dark bottle. A patient is being discharged home with a prescription for sublingual nitroglycerin. The nurse will instruct the patient and family to... don a pair of gloves A nurse has an order to apply nitroglycerin topically, twice a day. The nurse's initial action will be to... have the patient go into his house and sit or lie down A patient calls the clinic and reports that he is having chest pain. The patient states that ì'm scared that I am going to die and I've been pacing up and down my driveway.î After calming the patient, the initial instruction by the nurse would be to... The patient's angina may necessitate the use of a calcium channel blocker A recent episode of chest pain while doing yard work prompted a 70-year-old man to seek care and he has been subsequently diagnosed with chronic stable angina. The nurse should recognize what guiding principle in the treatment of this patient's angina? The woman will be more susceptible to hypotension than a young patient. Frequent episodes of exercise-related chest pain have caused a 79-year-old woman to use her prescribed nitroglycerin spray several times in recent weeks. This patient's age will have what effect on her use of nitroglycerin? Acute Pain, headache, related to adverse effects of drug therapy A nurse is creating a plan of care for a 68-year-old woman with a recent diagnosis of unstable angina and new prescription for nitroglycerin. Which of the following nursing diagnoses should the nurse prioritize in the planning of this patient's care? Put your patch on a part of your skin that doesn't have too much hair on it. A man has left his most recent visit to his primary care provider with a new prescription for a transdermal nitroglycerin patch. What patient education should the nurse provide to this patient? Mr. Penny requires concurrent treatment with a beta blocker, nitrate, or a calcium channel blocker. Mr. Penny, age 67, was diagnosed with chronic angina several months ago and has been unable to experience adequate relief of his symptoms. As a result, his physician has prescribed ranolazine (Ranexa). Which of the following statements is true regarding the use of ranolazine for the treatment of this patient's angina? Determine if the drug is going to make you drowsy before you drive. A patient is in the clinic for seasonal allergic rhinitis. Loratadine (Claritin) is prescribed. Which of the following statements will the nurse include when providing patient education concerning this drug? Taking too many laxatives can make your bowels dependent on them, making you more susceptible to constipation. A 73-year-old woman has scheduled an appointment with her nurse practitioner to discuss her recurrent constipation. The woman states that she experiences constipation despite the fact that she takes docusate on a daily basis and performs cleansing enemas several times weekly. How should the nurse best respond to this patient's statements? 15 to 30 minutes. A 68-year-old man complains of a chronic, nonproductive cough. He states that he has to have relief, that he has been coughing every 2 to 3 minutes, and he is worn out. Dextromethorphan is prescribed for him. Before he leaves the clinic he asks how long it will take for the medicine to work. The nurse will advise him that he should experience therapeutic effects in she must be prepared to show identification when buying a drug that contains pseudoephedrine. A patient with seasonal allergies is exasperated by her recent nasal congestion and has expressed her desire to treat it by using pseudoephedrine. The nurse should inform the patient that A 79-year-old male with cardiomegaly A normal maintenance dose for digoxin is 0.125 to 0.5 mg/day. In which of the following patients would the nurse most likely administer a lower-than-normal maintenance dose of digoxin? Monitor glucose levels closely A patient with diabetes has had a cough for 1 week and has been prescribed a cough syrup (an expectorant). What special instructions should the nurse include in the patient teaching for this situation? An oral antidepressant that the patient has been taking daily for several years An elderly postsurgical patient has developed postoperative pneumonia in the days following abdominal surgery and is being treated with a number of medications. Which of the following medications that the nurse will administer has the slowest absorption? Integrating the new drug into the patient's existing schedule promotes adherence. A 79-year-old woman who takes several medications for a variety of chronic health problems has been prescribed an oral antiplatelet aggregator that is to be taken once daily. The nurse has encouraged the woman to take the pill at the same time of day that she takes some of her other medications. What is the most likely rationale for the nurse's advice? [Show Less]
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NURS 6521 Midterm CORRECTLY ANSWERED 2023
In order to promote therapeutic drug effects, the Nurse Practitioner should always encourage patients to take their medication at the prescribed times. ... [Show More] A female patient with a diagnosis of type 1 diabetes mellitus has been experiencing increasing neuropathic pain in recent months, a symptom that has not responded appreciably to conventional analgesics. The patient's care provider has begun treatment with gabapentin (Neurontin). How is the addition of this drug likely to influence the management of the patient's existing drug regimen? It is unlikely to influence the patient's other medications because gabapentin does not interact with other drugs. of the following assessment findings should an assisted living facility has begun taking daily oral Following an assessment by her primary care provider, a 70-year-old resident of doses of levothyroxine. Which prompt the nurse to withhold a scheduled dose of levothyroxine? The resident's apical heart rate is 112 beats/minute with a regular rhythm processes protects the lower respiratory system? Cilia sweep foreign material and mucus upward toward the trachea and larynx where they can then be swallowed. A 62-year-old man has been prescribed lovastatin. The Nurse Practitioner will instruct the patient to take the medication at bedtime. A Nurse Practitioner who provides care for older adults is aware of the high incidence of drug interactions in this population. When educating a group of seniors about the prevention of drug interactions, the Nurse Practitioner should encourage them to consult their care provider before taking new over-the-counter medications. A Nurse Practitioner is teaching an older adult patient about polypharmacy. Which of the following statements best describe this term? Taking several drugs simultaneously A diabetic patient being treated for obesity tells the Nurse Practitioner that he is having adverse effects from his drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which of the following adverse effects would need the Nurse Practitioner's immediate attention? Increased blood glucose A 22 year old patient is transitioning from oral agents to insulin. He will be taking 20 units of lantus at bedtime and regular insulin before meals. What instructions should the NP provide about the timing and dose of regular insulin? Take 1 unit of regular insulin for each 10 grams of carbohydrate to be consumed 15 minutes before each meal decongestants should not be used chronically (>5 days) because they can cause rebound rhinitis/congestion The parents of a 7-year-old boy who has just been diagnosed with allergic asthma are being taught about their son's medication regimen by the nurse. The nurse is currently teaching the parent's about the appropriate use of a "rescue drug" for acute exacerbations of their son's asthma. What drug should the nurse suggests the parents to use in these situations? Albuterol A 70-year-old woman with a history of atrial fibrillation takes digoxin and verapamil to control her health problem. Verapamil achieves a therapeutic effect by blocking adrenergic receptors and producing antisympathetic effects. A patient receives 25 units of NPH insulin at 7.AM. At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction? Late afternoon A child with sinusitis has been on antibiotics for seven days and his symptoms are not improving., All of the following are options to prescribe for the patient now EXCEPT: Amoxicillin/clavulanic acid The Nurse Practitioner's assessment of a community-dwelling adult suggests that the client may have drug allergies that have not been previously documented. What statement by the client would confirm this? "I broke out in hives and got terribly itchy when I started a new prescription last year." A homeless man who is well known to care providers at the local hospital has been admitted to the emergency department after having a seizure outside a mall. The man is known to be a heavy alcohol user and is malnourished with a very low body mass index. How are this patient's characteristics likely to influence possible treatment with phenytoin? The patient's protein deficit will likely increase the levels of the free drug in his blood. A patient has been prescribed a histamine-2 (H2) receptor antagonist for the treatment of GERD. Why are H2RAS more effective than H1 receptor antagonists in the treatment of diseases of the upper GI tract? The parietal cells of the stomach have H2 receptors but not H1 receptors. A 24-year-old factory worker has been prescribed guaifenesin for the first time. Which of the following will be a priority assessment by the nurse before the patient's first dose? The amount of alcohol consumption In light of her recent high blood pressure readings, a patient has been started on a thiazide diuretic and metoprolol (Lopressor), which is a beta-adrenergic blocker. What is the most likely rationale for using two medications to address the patient's hypertension? Using the two drugs to treat a health problem may create a synergistic effect. A woman with numerous chronic health problems has been diagnosed with a benign gastric ulcer has begun treatment with ranitidine (Zantac). Which of the following teaching points should the nurse provide to this patient? "Quitting smoking will significantly increase the chance that this drug will heal your ulcer." The APRN should educate a diabetic patient that beta blockers may mask the signs and symptoms of hypoglycemia A patient has been prescribed a drug that can be self-administered at home. Which of the following would be the most important information for the nurse to relate to the patient concerning self-administration of a drug? The therapeutic effects and possible adverse effects Advanced practice nurse prescribing of scheduled medications is affected most by: Combined state medical / pharmacy /nursing prescribing board regulations The APRN is treating a patient with type 2 diabetes. The patient is on the maximum dose of metformin and glucotrol. Current weight 212 pounds. Labs from this morning indicate a fasting blood sugar of 312 and HBA1C of 9. The APRN wants to start the patient on Lantus 0.2 unit/kg. What dose and instructions should the APRN provide? Give 19 units of Lantus subcutaneously prior to bedtime. A 75-year-old woman is prescribed magnesium hydroxide for constipation. The nurse's assessment reveals that the patient is being treated for rheumatoid arthritis and hypertension. The patient lives in assisted living and is on a low- sodium diet. Before the magnesium hydroxide therapy begins, it will be most important for the nurse to assess the patient's medication history. A female patient is taking 0.125 mg of digoxin daily for heart failure. At a recent clinic visit she reports that since she has been on the drug, she can breathe better and her heart rate has been around 74 beats per minute. nurse weighs the patient and notices that she has gained 10 pounds since the digoxin therapy was started. The patient is concerned that the additional weight will necessitate an increase in the medication. Which of the following is an appropriate response by the nurse? "No, the drug dosage will likely stay the same." A 72-year-old man is prescribed theophylline for symptomatic relief of bronchial asthma. Which of the following findings would alert the nurse to the need for close monitoring? Need for additional bronchodilation A patient has a history of tonic-clonic seizures that have been successfully treated with phenytoin (Dilantin) for several years. Phenytoin achieves a therapeutic effect by decreasing the influx of sodium into neurons. A man who smokes one pack of cigarettes daily has been diagnosed with chronic bronchitis. He has been prescribed theophylline by his family doctor. What effect will the patient's smoking status have on the therapeutic use of theophylline? The patient may require higher doses of theophylline than a nonsmoker A 56-year-old female patient has been admitted to the hospital with chronic muscle spasms and has been prescribed a new medication to treat the spasms. She has a poorly documented allergy to eggs, synthetic clothes, and perfumes. What is the priority action of the nurse to ensure that prescribed medication does not experience an allergic reaction? Post an allergies notice on the front of the chart and document the allergies in the appropriate area of the patient's record A Nurse Practitioner is instructing a patient concerning a newly prescribed drug. Which of the following should be included to help improve patient compliance and safety? Measures to alleviate any discomfort associated with adverse effects A home health Nurse Practitioner is performing a home visit to an elderly client who has early-stage dementia. The Nurse Practitioner observes that some of the client's pill bottles are empty, even though the client is not due for refills for 2 weeks. What nursing diagnosis should the Nurse Practitioner prioritize when planning this client's care? Impaired Home Maintenance Management Mr. Nguyen, age 71, will soon be discharged home from the hospital after a successful coronary artery bypass graft (CABG). During patient education about his drug regimen, Mr. Nguyen's nurse should prioritize teach about potential adverse effects of the drugs that Mr. Nguyen will be taking. A woman has a long history of seasonal allergies that are typically accompanied by rhinorrhea, red eyes, and frequent sneezing. Sneezes are a result of a CNS reflex that is initiated by receptors in the nasal cavities. A 34-year-old male patient is prescribed methimazole (MMI). The Nurse Practitioner will advise him to report which of the following immediately? Intolerance to cold A patient with a long history of alcohol abuse has been admitted to an acute medical unit with signs and symptoms of hepatic encephalopathy. His current medication orders include QID doses of oral lactulose. What desired outcomes should the nurse associate with this drug order? Patient will have three to four loose bowel movements each day. The Nurse Practitioner is treating a patient that takes frequent doses of antacids for his heartburn and is also taking an enteric coded aspirin. What instructions should be provided to the patient? The medications should be taken at least 2 hours apart. To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic patient, as the patient regains consciousness, the nurse should administer carbohydrates. An expected outcome for a patient who has just taken sublingual nitroglycerin should be increased heart rate and decreased bloo [Show Less]
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NURS 6521 Adv. Pharmacology Final Exam correctly answered latest 2023
Question 1: A 59-year-old man with a recent history of erectile dysfunction has been assessed and prescribed sildenafil (Viagra). When providing patient ed... [Show More] ucation to this man, the nurse should tell him which of the following? ... Answer: "You might find that your face becomes flushed, or you get a headache after taking Viagra." ... Question 2: A patient takes etoposide for a testicular tumor refractory treatment. The nursing assessment reveals that he is also taking warfarin. The nurse must carefully monitor which of the following? ... Answer: Elevated prothrombin time ... Question 3: A man is prescribed ciprofloxacin to treat a sexually transmitted infection. The nurse will instruct the patient ... Answer: to complete the entire course of drug therapy. ... Question 4: Drugs have a valid medical use but a high potential for psychological and physiologic abuse. In an emergency, a Schedule II drug may be prescribed by telephone if a written prescription cannot be provided at the time. However, a written prescription must be provided within 72 hours with the words authorization for emergency dispensing written on the prescription. These prescriptions cannot be refilled. A new prescription must be written each time. Examples include certain amphetamines and barbiturates. These are scheduled drugs ... Answer: Schedule II ... Question 5: A 16-year-old boy has been prescribed cromolyn sodium nasal spray to treat a nasal allergy. To maximize the drug's therapeutic effects, which of the following will the nurse include in instructions to the patient? ... Answer: Take the drug for one whole week before coming in contact with allergens. ... Question 6: A woman is receiving magnesium sulfate for intrapartum eclampsia. The patient is sweating, and her BP is 88/50. The serum magnesium level is 10 mg/dL. The nurse will interpret these manifestations as ... Answer: Magnesium Sulfate toxicity. ... Question 7: A patient with a recent diagnosis of chronic myelogenous leukemia (CML) discusses treatment options with his care team. What aspect of the patient's condition would contraindicate the use of cyclophosphamide to treat leukemia? ... Answer: The patient's bone marrow function is significantly depressed. ... Question 8: After six months of unsuccessfully trying to conceive, a 31-year-old woman and her husband have sought a referral to a fertility specialist to explore their options. A nurse at the clinic should recognize that the woman may benefit from ... Answer: clomiphene. ... Question 9: A 34-year-old male has been diagnosed with TB and will be started on INH therapy. The medication history reveals that he currently takes antacids regularly. The nurse will instruct the patient: ... Answer: to take antacids not less than 1 hour before or 2 hours after taking INH. ... Question 10: A Nurse Practitioner working in a cancer center is preparing to administer medication to a 5-year-old child. The nurse will calculate the drug dosage by using ... Answer: Body Surface Area ... Question 11: An older adult woman has been diagnosed with acute lymphoblastic leukemia (ALL), and her care team has identified potential benefits of imatinib. Which of the following characteristics of this patient's current health status may preclude the use of imatinib? ... [Show Less]
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Nurs 6521 Advanced Pharmacology Final with complete solutions 2023
A nurse is caring for an infant after a surgical procedure. After ensuring that the ordered dose is appropriate for the infant's age and weight, the nurse ... [Show More] administers a narcotic analgesic intravenously. When assessing the infant 15 minutes later, the nurse notes respirations of 22 breaths/minute and a heart rate of 110 beats/minute. The infant is asleep in the parent's arms and does not awaken when vital signs are assessed. The nurse understands that these findings are the result of: immaturity of the blood-brain barrier in the infant. A child will receive 750 mg of an antibiotic for 10 days. The child attends day care. The drug may be dosed in several ways and is available in two concentrations. Which dosing regimen will the nurse discuss with the child's provider? 500 mg/5 mL to 375 mg PO twice daily Parents ask the nurse why an over-the-counter cough suppressant with sedative side effects is not recommended for infants. Which response by the nurse is correct? "Infants are more susceptible to central nervous system effects than are adults." A nurse caring for a 5-year-old child notes that the child has discoloration of several teeth. When taking a medication history, the nurse will ask about which group of medications? Tetracyclines An infant has allergies and often develops a pruritic rash when exposed to allergens. The infant's parents ask the nurse about using a topical antihistamine. What should the nurse tell them? Applying an antihistamine to the skin can cause toxicity in this age group. An infant is receiving a medication that has a narrow therapeutic range. The nurse reviews the medication information and learns that the drug is excreted by the kidneys. When giving the medication, the nurse will assess the infant for: signs of drug toxicity. A pediatric nurse is teaching nursing students to calculate medication doses for children using a formula based on body surface area. Which statement by a nursing student indicates understanding of the teaching? "This formula helps approximate the first dose; other doses should be based on clinical observations." A pediatric nurse is teaching nursing students about medication administration in children. Which statement by a student indicates an understanding of the teaching? "Drugs effective in adults may not work in children, even if the dose is proportional for weight and size." A nurse is teaching nursing students about pediatric medication administration. What will the nurse include when discussing pediatric drug research? Studies showed a significant percentage of unanticipated and potentially lethal side effects in children. A prescriber has ordered medication for a newborn. The medication is eliminated primarily by hepatic metabolism. The nurse expects the prescriber to: order a dose that is lower than an adult dose. The parents of a child with asthma ask the nurse why their child can not use oral corticosteroids more often, because they are so effective. The nurse will offer which information that is true for children? Chronic steroid use can inhibit growth. A patient with schizophrenia receives a dose of risperidone [Risperdal Consta] IM. The nurse teaching this patient about this medication will make which statement? "You will need to take an oral antipsychotic drug for 3 weeks." A patient with schizophrenia shows suicidal behaviors, and the provider orders clozapine [Clozaril]. The nurse teaches the family about the medication and its side effects. Which statement by a family member indicates a need for further teaching about this drug? "If the ANC is less than 3000, the drug will be discontinued permanently." A patient in whom drug therapy has failed several times in the past is readmitted to a hospital to begin therapy for schizophrenia. What will the nurse do to help improve adherence? Teach the patient about drug side effects and how to manage them. A nurse provides teaching for a patient about to begin taking an FGA drug for schizophrenia. Which statement by the patient indicates a need for further teaching about side effects of these drugs? "Dry mouth and constipation are uncommon with this medication." A patient taking an FGA medication develops severe parkinsonism and is treated with amantadine [Symmetrel]. The amantadine is withdrawn 2 months later, and the parkinsonism returns. The nurse will expect the provider to: try a second-generation antipsychotic (SGA). What are negative symptoms of schizophrenia? Select all that apply. Poor judgment Poor self-care Poverty of speech A patient is taking an FGA for schizophrenia. The nurse notes that the patient has trouble speaking and chewing and observes slow, wormlike-movements of the patient's tongue. The nurse recognizes which adverse effect in this patient? Tardive dyskinesia A nurse and a nursing student are discussing the plan of care for a patient with schizophrenia. The patient, who has been taking a high-potency FGA for 2 months, has become restless and constantly needs to be in motion. Which statement by the student indicates a need for further education? "Because this may be an exacerbation of psychosis, the provider may increase the dose of the FGA." A patient who is taking a first-generation antipsychotic (FGA) drug for schizophrenia comes to the clinic for evaluation. The nurse observes that the patient has a shuffling gait and mild tremors. The nurse will ask the patient's provider about which course of action? Giving an anticholinergic medication A patient with schizophrenia has been taking an oral FGA for 1 week. The patient has been taking the drug daily in two divided doses. The individual complains of daytime drowsiness. The patient's family reports a decrease in the person's hostility and anxiety but states that the patient remains antisocial with disordered thinking. What will the nurse tell the patient and the family? Some symptoms take months to improve. A patient with schizophrenia has been taking an antipsychotic drug for several days. The nurse enters the patient's room to administer a dose of haloperidol [Haldol] and finds the patient having facial spasms. The patient's head is thrust back, and the patient is unable to speak. What will the nurse do? Request an order to give diphenhydramine. A parent reports being afraid that a child may have schizophrenia because of disorganized speech and asocial behaviors. The nurse will tell this parent that which of the following must also be present to make a diagnosis? Select all that apply. A decrease in self-care, job, or school function A 1-month duration of active phase symptoms Continuous signs of disturbance for longer than 6 months Which side effects are more common in second-generation antipsychotic medications than in first-generation antipsychotic medications? Select all that apply. Agranulocytosis Anticholinergic effects Metabolism by CYP3A4 [Show Less]
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Nurs 6521 Midterm 2 correct answers latest 2023
A Nurse Practitioner explains to a patient that nitroglycerin patches should be applied in the morning and removed in the evening. This medication schedule... [Show More] reduces the potential for nitrate tolerance. Mr. Nguyen, age 71, will soon be discharged home from the hospital after a successful coronary artery bypass graft (CABG). During patient education about his drug regimen, Mr. Nguyen's nurse should prioritize teach about potential adverse effects of the drugs that Mr. Nguyen will be taking. The most effective therapy for a patient who is H. pylori positive with a gastric ulcer is: Bismuth, Metronidazole, Omeprazole, and Tetracycline A 60-year-old African-American man lives with a number of chronic health problems. Genetic factors are likely to influence his etiology and/or treatment of hypertension. A female patient has been taking prednisone for her asthma for 1 month. The nurse will teach her to gradually decrease her dose of prednisone to avoid adrenal insufficiency. A Nurse Practitioner is caring for a 70-year-old patient who is taking desmopressin (DDAVP). The patient has a history of cardiovascular disease. The nurse will prioritize the assessment of which of the following? Electrolyte levels Which of the following will a Nurse Practitioner inform the patient is one of the most common adverse effects of guaifenesin (Robitussin)? Gastrointestinal distress Which of the following is TRUE about long acting beta agonist use in asthma patients? It can be combined with an inhaled corticosteroid to improve asthma control A patient with a variety of chronic health problems is being seen by her nurse practitioner, who is currently reviewing the patient's medication regimen. Which patient's medications should prompt the nurse to teach her to avoid drinking grapefruit juice? Atorvastatin (Lipitor) A Nurse Practitioner is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which of the following instructions? Wear appropriate clothing and sunscreen whenever he is in direct sunlight A 66-year-old type 1 diabetes, woman has a complex renal failure as a poorly-controlled failure (CHF). Her care provider woman's medication regimen. The nurse should medical history that includes result of diabetic nephropathy and chronic heart has recently added spironolactone (Aldactone) to the consequently assess for signs and symptoms of hyperkalemia. A Nurse Practitioner is providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The Nurse Practitioner will question the patient about her intake of which of the following? Coffee A patient has been prescribed lovastatin for a high cholesterol level. The nurse's teaching plan will include a basic explanation of how the drug produces its therapeutic effect. The nurse will explain that lovastatin lowers cholesterol levels because it inhibits cholesterol syntheses. A patient with bronchial asthma is prescribed a sustained-release preparation of theophylline. To help minimize the adverse effects of the drug, which of the following should the nurse suggest? Take it on an empty stomach, 1 hour before or 2 hours after meals A patient with bronchial asthma is prescribed a sustained-release preparation of theophylline. To help minimize the adverse effects of the drug, which of the following should the nurse suggest? Take it on an empty stomach, 1 hour before or 2 hours after meals A Nurse Practitioner is caring for a 78-year-old patient with renal insufficiency and chronic heart failure who is receiving rapid infusions of high-dose furosemide. It will be a priority for the Nurse Practitioner to monitor for ototoxicity. A 39-year-old African-American male is 25 pounds overweight and has been diagnosed with hypertension after three consecutive above-normal blood pressure readings. The most likely initial drug therapy for this patient will be a diuretic. A homeless man who is well known to care providers at the local hospital has been admitted to the emergency department after having a seizure outside a mall. The man is known to be a heavy alcohol user and is malnourished with a very low body mass index. How are this patient's characteristics likely to influence possible treatment with phenytoin? The patient's protein deficit will likely increase the levels of the free drug in his blood. A 70-year-old man with diabetes mellitus is taking metoprolol (Lopressor) to manage his hypertension. The nurse would be sure to instruct the patient to understand the signs and symptoms of hypoglycemia. A normal maintenance dose for digoxin is 0.125 to 0.5 mg/day. In which of the following patients would the nurse most likely administer a lower-than-normal maintenance dose of digoxin? A 79-year-old male with cardiomegaly A 72-year-old man is prescribed theophylline for symptomatic relief of bronchial asthma. Which of the following findings would alert the nurse to the need for close monitoring? Enlarged prostate gland A patient with unstable angina pectoris who is NOT controlled with a nitrate would likely benefit most from the addition of: 2. Beta blocker A 58-year-old man is admitted to the emergency department. A diagnosis of severe digoxin toxicity is made. Bradycardia is present, and an electrocardiogram (ECG) confirms toxicity. The nurse will administer which of the following drugs? Digoxin immune fab A patient is admitted to the emergency department with severe chest pain. The emergency department physician orders intravenous nitroglycerin 5 mcg/min, titrate dose by 5 mcg/min every 3 to 5 minutes per infusion pump as needed. Before administering the nitroglycerin, the nurse should prioritize which of the following assessments? Blood pressure An elderly postsurgical patient has developed postoperative pneumonia in the days following abdominal surgery and is being treated with a number of medications. Which of the following medications that the nurse will administer has the slowest absorption? An oral antidepressant that the patient has been taking daily for several years The lower respiratory system utilizes a number of different mechanisms that confer protection and maintain homeostasis. Which of the following physiological processes protects the lower respiratory system? Cilia sweep foreign material and mucus upward toward the trachea and larynx where they can then be swallowed. A Nurse Practitioner has administered a medication to a patient with hypertension. The prescribed drug is supposed to decrease cardiac output. A decrease in cardiac output would most likely decrease the amount of circulating blood sent through the kidneys. A 76-year-old woman has a complex medical history that includes emphysema, osteoporosis, malnutrition, and hypothyroidism. Recently, the woman fell outside her home as a result of weakness and suffered a fracture to her femoral head. The woman's subsequent hip-replacement surgery has been scheduled and the care team recognizes that the use of isoflurane will be most significantly influenced by her history of emphysema. [Show Less]
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Adv. Pharmacology Final 6521 correctly answered rated A+ 2023
antipsychotic medications Prescription drugs that are used to reduce psychotic symptoms; frequently used in the treatment of schizophrenia; also called ne... [Show More] uroleptics. Block dopamine, acetylcholine, histamine, and norepinephrine receptors in the brain and periphery. Acute and chronic psychosis, schizophrenia, manic phase of bipolar disorders, Tourette's syndrome, delusional and schizoaffective disorders, dementia. Conventional (typical) or atypical. Patient education: s/s of orthostatic hypotension - move slowly when standing up. Sedation - avoid hazardous activities such as driving until sedation wears off. Impaires libido and erection / ejaculation *avoid anticholinergic drugs, barbiturates, benzos and alcohol. first generation antipsychotics a group of medications originally developed to combat psychotic symptoms by reducing dopamine levels in the brain; also called conventional or typical antipsychotics block receptors for dopamine, acetylcholine, histamine, and norepinephrine Ex. (low potency): Chlorpromazine, Thioridazine s/e orthostatic hyposension, long Q-T syndrome, high sedation (medium potency): loxapine, perhenazine, s/e moderate sedation (high potency):fluphenazine, haloperidol, pimozide, thiothoxene, frifluoperizine s/e movement problems second generation antipsychotics drugs that alleviate schizophrenia with less likelihood of movement problems S/E: are associated with metabolic adverse effects (eg. weight gain, dyslipidemia, hyperglycemia, and increased risk of diabetes). As such they should be monitored for changes. Olanzapine and clozapine carry the greatest risk. Ex. apripiprazole, asenapine, brexpiprazole, cariprazine, clozapine, iloperidone, lurasidone, olanzapine (Zyprexa), Quetiapine (Seroquel), Risperidone, Potency the size of the dose needed to elicit a given response Neuroleptic Malignant Syndrome (NMS) A rare and sometimes fatal reaction to high-potency neuroleptic drugs. Symptoms include muscle rigidity, fever, and elevated white blood cell count. It is thought to result from dopamine blockage at the basal ganglia and hypothalamus. Treatment: support body through withdrawal. Chlorpromazine (Thorazine) - Chlorpromazine is used to treat psychotic disorders such as schizophrenia or manic-depression, and severe behavioral problems in children ages 1 through 12. Chlorpromazine is also used to treat nausea and vomiting, anxiety before surgery, chronic hiccups, acute intermittent porphyria, and symptoms of tetanus. S/E: - This medication can cause photophobic skin reactions and damage to the retina of the eye if exposed to direct sunlight. PTs taking this should be reminded to wear protective clothing, apply sunscreen and wear sunglasses when they are outside. sedation, orthostatic hypotension, anticholinergic effects. Clozapine (Clozaril) Second Generation (Atypical) Antipsychotic low affinity to D2 dopamine receptors treats schizophrenia and suicidal behavior. Not many EPSs. S/E weight gain, orthostatic hypotension, sedation, cholinergic, urinary retention, constipation, tachycardia. extrapyramidal symptoms side effects of antipsychotic medications that affect a person's gait, movement, or posture Usually caused by high potency first gen. antipsychotics Also referred to as EPS Acute Dystonia: occurs within first few days of therapy. Severe spasm of the muscles of tongue, face, neck and back. Parkinsonism: bradykinesia, mask-like facies, drooling, tremor, rigidity, shuffling gait, stooped posture. Akathisia: pacing and squirming, need to move uncontrollably. develops in first 2 months of treatment. Tardive Dyskinesia: occurs with long-term therapy. Involuntary choreoathetoid movements of the tongue and face. Haloperidol (Haldol) An antipsychotic drug thought to block receptor sites for dopamine, making it effective in treating the delusional thinking, hallucinations and agitation commonly associated with schizophrenia. -Preferred treatment for Tourette syndrome. -Hepatic metabolism, excreted in urine. -early extrapyramidal reactions occur frequently. Long Q-T . Risperidone (Risperdal) Antipsychotic (Atypical) rapid-acting used for schizophrenia and acute bipolar mania. Absorbed rapidly, not effected by food, peaks 1 hour after dosing. Excreted through urine. S/E: increases prolactin levels but symptoms uncommon. Metabolic effects. Sedation in large doses. Olanzapine (Zyprexa) antipsychotic (atypical), mood stabilizer, thienobenzodiazepine antagonizes dopamine and seratonin type 2 in the CNSalso has antocholinergic, antihistiminic, and anti alpha1 adernergic effects decreases manifestations of psychoses Metabolized by the liver. Peaks in 6 hours 21-54 hour half-life contraindicated in lactation S/D metabolic. can cause leukopenia and neutropenia increasing risk for infection. Somnolence. Quetiapine (Seroquel) Antipsychotic (Atypical). Treats: Schizophrenia, major depression, bipolar Improves positive symptoms and lowers negative symptoms by blocking 5-HT2 receptors and D2 receptors. CYP3A4 - hepatic metabolism and excreted in urine and feces. S/E: metabolic effect, cataracts, long Q-T CYP3A4 most common metabolic enzyme involved in drug interactions Inducers: phenytoin, rifampin, barbituates, carbamazepine Inhibitors: ketoconazole, itraconazole, fluconazole, erythromycin. if using these and taking drugs metabolized by this enzyme, levels will increase which may cause toxicity. Aripiprazole (Abilify) atypical antipsychotic dopamine system stabilizers. Treats schizophrenia, acute bipolar mania, major depressive disorder, agitation associated with psychosis and irritability associated with autism spectrum disorder. Does not have metabolic s/e or EPSs. Food does not effect, protein bound, metabolized by liver, long elimination. S/E headache, agitation, nervousness, anxiety, insomnia, nausea, vomiting, dizziness, somnolence. High suicidality Cariprazine (Vraylar) atypical antipsychotic Mechanism unknown. Similar to aripiprazole. SSRIs (selective serotonin reuptake inhibitors) selectively inhibits serotonin reuptake from synaptic gap and results in potentiation of serotonergic neurotransmissions. Examples: Luvox, Paxil, Prozac, Zoloft end in [pram], [ine] citalopram [Celexa]; escitalopram [Lexapro]; fluoxetine [Prozac]; paroxetine [Paxil] initial responses are seen approx. 1-3 weeks. Max responses can take up to 12 weeks. Take for at least 1 month before changing or increasing dose. Do NOT use with MAOIs Fluoxetine (Prozac) Antidepressant, SSRI Treats: Depression (also bipolar, ocd, panic disorder, bulimia, pmdd). S/E: sexual dysfunction in 70% of adults. Treatment for this would involve decreasing dose, drug holiday on weekends, add a drug to treat this such as bupropion, nefazodone, mirtazapine. Weight gain and serotonin syndrome can be other side effects. Abrupt withdrawal can cause dizziness, headaches, nauea, sensory issues, tremors, anxiety and dysphoria - should be tapered down. Do not use in 3rd trimester Serotonin Syndrome With any drug that increases 5-HT (e.g., MAO inhibitors, SNRIs, TCAs) hyperthermia, confusion, myoclonus, cardiovascular instability, flushing, diarrhea, seizures. -Treatment: cyproheptadine (5-HT2 receptor antagonist). Can resolve on it's own by discontinuing the drug. SSNRIs (selective serotonin and norepinephrine reuptake inhibitors) Block 5-HT reuptake and thereby increase 5-HT in the synapse. Examples: Desvenlafaxine (Pristiq), Duloxetine (Cymbalta), Venlafaxine (Effexor XR), LEvomilnacipran (Fetzima). TCAs (tricyclic antidepressants) Inhibit serotonin and NE re-uptake (Amitrptyline, Desipramine, exepin, imipramine, and Clomipramine-OCD) MAOIs (monoamine oxidase inhibitors) -antidepressants that inhibit the action of an enzyme (monoamine oxidase) that is responsible for breakdown of NE and 5-HT Ex: isocarboxizid (marplan), phenelzine (nardil), selegiline (emsam). -can have fatal side effects (hypertensive crisis) if foods rich in amino acid TYRAMINE are consumed -thus, not used unless other classes of medication have failed -Depression with ATYPICAL features respond well to MAOIs Aripiprazole (Abilify) Antipsychotic Aripiprazole is used to treat certain mental/mood disorders. It may also be used in combination with other medication to treat depression. Dizziness, Lightheadedness, Drowsiness, Nausea, Vomiting, Tiredness, Excess saliva/drooling, Blurred, vision, Weight gain [Show Less]
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NURS 6521N Advanced Pharmacology Week 1 CORRCT ANSWERS 2023
The culture and sensitivity testing of a patient's wound exudate indicates that a specific antibiotic is necessary for treatment. The Untied States Pharmac... [Show More] opedia-National Formulary indicates that the drug in question is 96% protein bound. What are the implications of this fact? Dosages of the drug must be large in order to be effective. The nurses assessment of a community-dwelling adult suggests that the client may have drug allergies that have not been previously documented. What statement by the client would confirm this? I broke out in hives and got terribly itchy when I started a new prescription last year. Tylenol 325mg/tab, patient needs 650mg; how many tablets should the patient take? 2 A nurse is discussing with a patient the efficacy of a drug that his physician has suggested, and he begin taking. Efficacy of a drug means which of the following? How well a drug produces its desired effect A patient with a variety of chronic health problems is being seen by her nurse practitioner, who is currently reviewing the patients medication regimen. Which of the patient's medications should prompt the patient to teach to avoid drinking grapefruit juice? Atorvastatin (Lipitor) In order to promote therapeutic drug effects, the nurse should always encourage the patients to... take their medications at the prescribed times. A home health nurse notes that there have been changes to a patients oral drug regimen. The nurse will closely monitor the new drug regimen to... identify any changes in drug absorption that would change the drug effect. on 1 am rounds the nurse finds a patient awake and frustrated that she cannot sleep. The nurse administers an ordered hypnotic to help the patient sleep. Two hours later the nurse finds the patient out of bed, full of energy, cleaning her room. The nurse evaluates the patients response to a hypnotic as... An idiosyncratic effect In light of her recent high blood pressure readings a patient has been started on a thiazide diuretic and metoprolol (Lopressor), which is a beta-adrenergenic blocker. What is the most likely rationale for using two medications to address the patients hypertension? Using the two drugs to treat a health problem may create a synergistic effect. A patient has a blood serum drug level of 50 units/ml. The drugs half life is 1 hour. If concentrations above 25 units/ml are toxic and no more of the drug is given, how long will it take for the blood level reach the nontoxic range? 1 hour For which of the following patients would a nasogastric tube most likely be considered to aid in the administration of medications? A 78 year old man who is unable to swallow following an ischemic stroke A 56 year old female patient has been admitted to the hospital with chronic muscle spasms and has been prescribed a new medication to treat spasms. She has a poorly documented allergy to eggs, synthetic clothing, and perfumes. What is the priority action of the nurse to ensure that prescribed medication does not experience an allergic reaction? Post an allergies notice on the front of the chart and document the allergies in the appropriate area of the patients record. 5ml=____tsp 1 A nurse who is responsible for administering medications should understand that the goals of the MedWatch program are to (select all) b. facilitate reporting of adverse reactions of drugs d. increase awareness of serious reactions caused by drugs or medical devices e. provide regular feedback about product safety A patient who has ongoing pain issues has been prescribed Demerol (meperidine) IM. How should the nurse administer this medication? Into the patients gleuteal using a large gauge needle The nurse is caring for a patient receiving aminoglycoside (antibiotic) that can be nephrotoxic. Which of the following will alert the nurse that the patient may be experiencing nephrotoxicity? A decrease in urinary output In which of the following patients would a nurse expect to experience alterations in drug metabolism? A 50 year old man with cirrhosis of the liver A nurse is instructing a patient on a newly prescribed drug. Which of the following should be included to help improve patient compliance and safety? Measures to alleviate discomfort associated with adverse effects Which of the following statements best defines how a chemical becomes termed a drug? A chemical must have a proven therapeutic value or efficacy without severe toxicity or damaging properties to become a drug. 30ml=____tbsp 2 A nurse has been administering a drug to a patient IM. The physician discontinues the IM dose and wrote an order for the drug to be given orally. The nurse notices that the oral dosage is considerably higher that the parenteral dose and understands that this is due to the... first pass effect. A patient with a recent diagnosis of acute renal failure has a long standing seizure disorder which has been successfully controlled for several years with antiseizure medications. The nurse should recognize that the patients compromised renal function will likely... Increase the half life of medications that are metabolized by the kidney. An older patient with a history of Alzheimer's disease and numerous chronic health problems has been prescribed several medications during his current admission to hospital and recent declines in the patients cognition have impaired his ability to swallow pills. Which of the following medications may the nurse crush before administering them to this patient? An immediate release opioid analgesic tablet An 80 year old patient has been taking lorazepam since his wife died a year ago. He has been staying with his son, but will now move into an assisted living facility. Before admission to the assisted living facility, the patients physician has determined that the drug is no longer needed. The nurse at the facility will plan to.... withdraw the drug gradually over a 2 to 3 week period. A 79 year old patient in a long term care facility is to receive an intravenous fat emulsion. Which of the following lab values would be a priority for the nurse to assess before administration? Triglyceride level Medication reconciliation for an 82 year old man who has recently moved to a long term care facility reveals that the man takes 1 to 2 mg of lorazepam bid prn. The nurse should recognize what consequence of this aspect of the residents drug regimen? Increased risk for falls A 77 year old woman who is 5 feet 3 inches tall and weighs 89 lbs has been admitted to the hospital with a diagnosis of failure to thrive. What should the nurse prioritize when addressing the woman's apparent lack of nutrition? Assess the reasons behind the patients poor nutritional status. A patient who has been admitted to the hospital for a mastectomy has stated that she has experienced an adverse drug effects at various times during her life. Which of the following strategies should the nurse prioritize in order to minimize the potential of adverse drug effects during the patients stay in the hospital? Monitor the patient vigilantly for signs and symptoms of potentially adverse drug effects. A patient is treated with an antibiotic for an infection in his leg. After 2 days of taking the antibiotic, the patient calls the clinic and reports that he has a rash all over his body. The nurse is aware that a rash can be an adverse effect of an antibiotic and can be either a biologic, chemical, or physiologic action of the drug which is an example of pharmacodynamics A nurse is caring for a 92 year old patient who is taking multiple drugs and displaying increased cognitive impairment and memory loss. The initial action of the nurse would be to... try to distinguish between normal signs of aging and the adverse drug effects. A nurse notes new drug orders for a patient who is already getting several medications. Which of the following is the most important consideration when preparing to administer the new drugs? Possible drug-drug interactions that might occur An older adult who lives in a long term care facility has recently begun taking losartan (Cozaar) for the treatment of hypertension. The nurse who provides care for this resident should recognize that this change in the residents medication regimen might create a risk for... falls [Show Less]
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