A patient has liver and kidney disease. He is given a medication with a half-life of 30 hours. What is the expected duration of this
... [Show More] medication?
A.increase.
B.decrease.
C.remain unchanged.
D.dissipate.
A
A nurse is to administer a dose of furosemide (Lasix). The nurse is aware that Lasix is the ________ for the drug.
•
A.generic name
B.chemical name
C.nonproprietary name
D.brand name
D
When assessing older adults and those with renal dysfunction, the nurse would expect the creatinine clearance to be which of the following?
A. substantially increased.
B. slightly increased.
C. decreased.
D. in the normal range.
C
A patient sustains significant burns to the skin and is experiencing fluid shift associated with edema in the fluid overload phase. The nurse would anticipate that this will interfere most with which phase of pharmacodynamics?
•
A. Absorption
B. Distribution
C. Metabolism
Excretion
B
Which nursing actions would be most appropriate for ensuring patient safety with a medication that has a low therapeutic index?
A.Monitoring a patient's urine output
B.Assessing vital signs hourly
C.Maintaining strict isolation precautions
D.Monitoring serum peak and trough levels
D
What is the primary site of metabolism for most drugs?
A. kidney.
B. small intestine.
C. liver.
D. brain.
C
Children have higher metabolic rates than adults. The nurse realizes that this affects administration of medication for pain in children in all of the following ways except
A.higher requirement for medication.
B.increased dosage.
C.decreased frequency.
D.increased frequency.
D
A toddler requires an oral medication. It is most appropriate for the nurse to administer the oral medication
A.in a nipple.
B.dipped in a pacifier.
C.via an oral syringe.
D.mixed with formula in a bottle.
C
Older adults are at risk for taking many medications together. This is known as
•
A.tachyphylaxis.
B.drug interaction.
C.polypharmacy.
tolerance.
C
Which is a physiologic change seen in the older adult that has an effect on drug administration?
•
A.Lower (acidic) gastric secretions
B.Increased first-pass effect through the liver
C.Increased glomerular filtration rate
D.Lower cardiac output
D
When assessing older adults' renal function, which laboratory value will the nurse monitor?
•
A.Liver enzymes
B.Serum electrolytes
C.Complete blood count
D.Blood urea nitrogen and creatinine
D
The nurse caring for a patient who is taking an adrenergic agent will expect which side effects?
(Select all that apply)
A. Dilated pupils
B. Increased heart rate
C. Increase gastrointestinal motility
D. Vasodilation
E. Bronchospasm
F. Relaxed uterine muscles
A, B, F
Stimulation of which adrenergic receptor results in dilation of vessels and decrease in blood pressure?
•
A.Alpha1
B.Alpha2
C.Beta1
D.Beta2
B
The nurse is teaching the patient about the side effects of atenolol. These include
•
A.pupillary constriction.
B.blood vessel dilation.
C.bronchospasm.
D.tachycardia.
B
A nurse has just administered atropine to a patient. It is most important for the nurse to assess the patient for the development of which effect?
A.Nausea
B.Tachycardia
C.Rales
D.Hypotension
B
A patient is ordered to receive bethanechol chloride for urinary retention. Which health condition would serve as a contraindication for this medication?
•
A.Asthma
B.Hypertension
C.Diabetes mellitus
D.Chronic allergies
A
A patient is prescribed scopolamine. It is most important for the nurse to assess the patient for a history of which condition?
●
A.Diabetes mellitus
B.Glaucoma
C.Allergy to penicillin
D.Gastric ulcer
B
•A patient has an allergy to sulfa drugs but she receives sulfamethoxazole accidentally. She becomes flushed and short of breath. Her heart rate is normal but her blood pressure is dropping. You first administer:
•
A.Epinephrine
B.Diphenhydramine
C.Albuterol
D.Atropine
A
•The patient who has nasal congestion asks the nurse to recommend a decongestant medication.
• Which drug the nurse can recommend to patients?
•The nurse performs a medication history and learns that the patient takes a beta blocker to treat hypertension. Which of the over-the-counter products below would be most appropriate to recommend?
-Adrenergic Agonist- Alpha 1
- Nasal spray antihistamine (do not increase HR & BP)
•An adult patient is brought to the emergency department for treatment of an asthma exacerbation. The patient uses inhaled albuterol as needed to control wheezing. The nurse notes expiratory wheezing, tremors, restlessness, and a heart rate of 120 beats per minute. The nurse suspects that the patient has:
•
A. overused the albuterol.
B. not been using albuterol.
C. taken a beta-adrenergic blocker.
D. taken a monoamine oxidase (MAO) inhibitor.
A
•The nurse is caring a patient who is experiencing urinary retention. Which type of drug to treat this condition?
A.Anticholinergic
B.Cholinergic agonist
•The nurse is preparing to administer Bethanechol (Urecholine). The nurse notes that the patient has blood pressure of 90/60 mm Hg. What action the nurse will perform ?
•Why?
-B
- Hold med and contact physician
- Side effect of
cholinergic agonist is hypotension
A patient is ordered to receive bethanechol chloride for urinary retention. Which health condition would serve as a contraindication for this medication?
•
A.Asthma
B.Hypertension
C.Diabetes mellitus
D.Chronic allergies
A
A patient is prescribed scopolamine. It is most important for the nurse to assess the patient for a history of which condition?
●
A.Diabetes mellitus
B.Glaucoma
C.Allergy to penicillin
D.Gastric ulcer
B
•Outside of hypnotics, we can see respiratory depression can be seen in the following______________________.
1.
2.
3.
4.
Alcohol use
Opioid use
chronic aspiration
CO2 retention
•What if you wake up before your hypnotic is eliminated?
1.
2.
3.
mentation impaired
motor skills impaired
Benzodiazepine antidote?
Flumazenil (Romazicon)
•A 65 year old patient is being discharged on temazepam (Restoril). This is a brand new medication for him.
Provide at least 5 counseling points before you send him home.....
1.
2.
3.
4.
5.
1. don't consume with alcohol
2. don't drive
3. take right before bed
4. Monitor Blood pressure & resp rate
5. Avoid other CNS depressants
•Inhaled anesthetics are easy to identify and used commonly during OR procedures. What is the most concerning adverse effect with these agents? How is this managed?
-Malignant Hyperthermia
-Treated with Dantrolene (muscle relaxer)
Which anorexiant is not mediated through the CNS?
Orlistat- Lipase inhibitor
Why is Myasthenia gravis bad?
•Ocular muscles, bulbar muscles, limb muscles and respiratory muscles are all involved
What neurotransmitter do we need to increase in Myasthenia Gravis?
Acetylcholine recptors
What are the adverse effects of increasing acetylcholine?
Salivation
Lactation
Urination
Deification
Bradycardia
What would indicate to the nurse that the child taking methylphenidate requires more teaching?
A.The child is seen drinking a cola product.
B.The child checks his weight twice a week.
C.The child takes the drug 45 minutes before a meal.
D.The child takes the drug before breakfast and lunch.
A
What would indicate to the nurse that a patient taking a sedative-hypnotic requires more teaching?
A.The patient wants to listen to music on the radio.
B.The patient has saved her urine to be measured.
C.The patient says she has taken 1800 mL of fluid today.
D.The patient requests a cup of kava kava tea to help her get to sleep faster.
D
An older adult complains of insomnia. Which suggestion would be most appropriate for the nurse to provide as an initial method to deal with this issue?
A."Take Benadryl pills each evening before bedtime."
B."Drink warm milk or chamomile tea before bedtime."
C."Develop an exercise regimen for the evening hours."
D."Take naps during the day whenever you feel drowsy."
B
A patient is experiencing status epilepticus. The nurse anticipates immediate administration of which drug?
•
A.Phenobarbital
B.Phenytoin
C.Valproic acid
D.Diazepam
D
Which side effect/adverse effect of carbidopa/levodopa does the nurse realize is most important to monitor?
A.Dysphagia
B.Increased libido
C.Agranulocytosis
D.Urinary retention
C
Before administering benztropine (Cogentin) for the treatment of Parkinson's disease, it is most important for the nurse to assess the patient for a history of
•
A.pulmonary disease.
B.diabetes mellitus.
C.allergy to penicillin.
D.glaucoma.
D
A patient with Parkinson's disease is being treated with carbidopa-levodopa. The daughter asks the nurse why he needs both agents. The nurse responds,
•
A."The two medicines together are doubly effective."
B."This combination has fewer side effects."
C."You'll tolerate this better than a single-agent medication."
D."The carbidopa helps the levodopa reach the brain."
D
A patient with myasthenia gravis comes to the emergency department in respiratory distress. He has been diagnosed with myasthenic crisis. The nurse anticipates administration of which drug?
A.Diazepam
B.Baclofen
C.Edrophonium
D.Neostigmine
D
The patient is admitted to the emergency department with cholinergic crisis. The nurse anticipates administration of
A.atropine.
B.baclofen.
C.edrophonium.
D.neostigmine.
A
A child with cerebral palsy is ordered to receive baclofen. The nurse is aware that this medication is prescribed to
A.induce sleep and rest.
B.increase appetite.
C.reduce muscle spasticity.
D.increase bowel function.
C
A patient has been advised to take ibuprofen. When teaching the patient about ibuprofen, which instruction should the nurse include? (Select all that apply.)
A.Avoid taking aspirin with ibuprofen.
B.Take with food to reduce GI upset.
C.Monitor for bleeding gums, nosebleeds, black tarry stools.
D.Take herbs, ginkgo and garlic, with ibuprofen.
E.Take NSAIDs 2 days before menstruation to decrease discomfort.
A, B, C
An older adult patient takes tolmetin for arthritis pain. Which statement made by the patient is of most concern to the nurse?
A."I feel like I am coming down with a cold."
B."My stomach aches and burns."
C."I have a bad headache."
D."I feel dizzy when I get up fast."
B
The nurse is caring for a client who is taking naproxen, a nonsteroidal anti-inflammatory (NSAID) drug for rheumatoid arthritis. During a clinic visit, the client appears pale and reports increasing fatigue. Which of the client serum laboratory value is most important for the nurse to review?
A.Glucose
B.Total protein
C.Sodium
D.Hemoglobin
D
A 65-year-old man has been diagnosed with chronic gout. The nurse anticipates that the patient will be treated with
•
A.allopurinol.
B.colchicine.
C.adalimumab.
D.infliximab.
A
A 35-year-old woman diagnosed with rheumatoid arthritis has been prescribed infliximab. The nurse identifies infliximab as which type of medication?
A.Immunosuppressive
B.Immunomodulator
C.Antimalarial
D.Steroid
B
The nurse identifies Infliximab as useful in the treatment of rheumatoid arthritis as well as
A.Crohn disease.
B.asthma.
C.peptic ulcer disease.
D.multiple sclerosis.
A
The patient asks the nurse how the infliximab will be administered. The nurse should respond that this medication is administered
A.orally.
B.subcutaneously.
C.intramuscularly.
D.intravenously.
D
The next day, the patient's pain medication is changed from morphine sulfate to hydromorphone. Which statement regarding hydromorphone does the nurse identify as being true?
A.Hydromorphone must be administered intravenously.
B.Hypertension is a common side effect.
C.Physical dependence does not occur with hydromorphone therapy.
D.Hydromorphone is more potent than morphine.
D
The nurse assesses a patient receiving morphine via a PCA pump. The patient has a respiratory rate of 6 breaths/min. The nurse anticipates administration of which of the following drugs?
A.Naloxone
B.Sumatriptan
C.Nalbuphine
D.Hydromorphone
A [Show Less]