Pharm final review

An essential element for successful antibiotic therapy is: a functioning immune

system

When serious ad effects in pt treated w vanco are assessed, the nurse reports—
hearing for evidence of ototoxicity

Side effects of antibiotics—except joint pain

Cephalosporins are : similar to penicillin

A pt has been taking an antibiotic for an upper resp tract infection and has
completed the 1- day course. How much drug will be left after 2 half lives—25
percent

Therapeutic index of 20 and a drug with a therapeutic index of 2, considered less

safe

The nurse is planning to obtain serum for peak aminoglyucoside level—30 munites
after completeing infusion

Counsels a pt with a new prescription for a 10 day course pf penicillin. Importrant

instruction—take the entire presxcribed for 10 days

A pt on iv cephalosporin therapy complains of pain and irritation at the infusion site.

A nurse observes signs of thrombophlebitis—the nurse should select an alternate iv
site and administer infusion slowly

The ed50 indicates the does required to produce-- a therapeutic response in half the
population

A pt has been taking an antibiotic for an upper resp tract infection how much of the
drug will remain at the end of three half lives—12.5 percent

The ld 50 indicates the dose required to produce a –lethal response in half of the
population

The nurse is planning to obtain serum for a trough aminoglycoside level when
should blood be drawn—between one hour and immediately before giving the dose
The nurse is preparing to administer a drug to a patient with an infection. What is
the most imp characteristic of this drug—it will destroy the microorganism

A nurse is teaching a pt about a newly prescribed drug. Which is most important to

teach to improve the intesntiy of the response of the drug—take the prescribed
dose

A nurse has given morphine 2 mg iv to a pt after surgery and has observed the six
rights. What additional responsibiliy does the nurse have as a patient advocate—to
know the possible reactions to morphine

A nurse does not understand why a pt is to receive a prescribed med. What should
she do?—verify w the prescribing healthcare provder the reason

A nurse is administering a drug that is categorized as schedule 4. The nurse

understand that this means --the drug has acceptable medical application with low
potential for abuse

A nurse is preparing to administer epi to a pt who is having a severe allergic

reaction. Which route would provide the fastest and most complete absorption of
epi—IV

Digoxin has a half life of 36-48 hours. Bc of the half life, the nurse expects dosing
to be—once a day

A pt is prescribed cimetidine (tagmamet) to treat gastric ulcer. The nurse will teach
the pt-- inhibit the action of histamine at receptor sites and block gastric acid
secretion

Drug x has a therapeutic index of 10 and drug y has a therapeutic index of 2.

Which drug should be monitored according to measurements of the actual blood
levels achieved: drug y

A pt taking digioxin is prescribed a new med inderal. The two drugs combined may
cause a serious decrease in heart rate. This is an example of—an increased
therapeutic effect

A pt is prescribed a calcium channel blocker, cardiazem, to treat hypertension. The

nurse should instruct the patient to avoid: grapefruit juice

Which of the following pts would be at highest risk for an adverse drug reaction—an
84 yr old pt w diabetes, heart failure, and hypertension who takes 8 prescription
medications every day

A nurse receives a handwritten medication order in which the writing is not legible.
The nurse should: contact the prescriber to clarify the order
A patient is receiving amphotericin b for a systemic fungal infection. The nurse
should constantly monitor the pt for the development of: nephrotoxicity

A pt has been receiving amphotericin b for 4 weeks. The nurse can minimize
toxicity by administering it with—1 l of d5w IV

When a pt with recurrent herpes simplex genetalis infection is vared for, a n

important component of pt ed is – the patient will need to use condoms even when
there are no lesions evident

After receiving inactivated flu vaccine, an adult pt telephones a nurse and

complains of lethargy and a fever of 101 f. that has lasted for 5 hrs—advise the pt
to take acetaminophen and rest

A pt treated w weekly chloroquine for malaria prophylaxis complains of abdominal

discomfort and nausea after taking each dose. The nurse should—instruct the
patient to take the med with meals

An important component of education for a pt with a new prescription for flagyl is

that—the pt should not use it with etoh

A nurse manages care for a pt who has been on cyclosporine for 9 months for the
prevention of renal allograft rejection. The nurse reviews lab data and notes that
the pts blood bun and serum creatinne have risen sharply in the last two weeks –
organ rejection

A nurse should instruct a pt taking cyclosporine that toxic levels may be reached if
they drink—grapefruit juice

After an allograft liver transplant, a pt is prescribed cyclosporine oral solution.

Which pt teaching –the medication will be taken every day for life

A pt is prescribed oral acyclovir. Which of the following symptoms may occur—

nausea, vomiting, diarrhea

A pt inquires about the best method to prevent flu—instruct the pt to obtain a flu
vaccine

A pt is prescribed flagyl to treat giardiasis. While taking this med, the pt will be
taught to avoid: alcoholic beverages

A pt who takes Benadryl for seasonal allergy symptoms complains of drowsiness.

The nurse should—tell the pt to take zyrtec instead of diphenhydramine

A pt is prescribed celecoxib (celebrex) and warfarin. The nurse should monitor for—
bleeding
A pt drinks 5-6 alcoholic beverages per day and takes Tylenol for pain relief. The
nurse should caution the pt to—limit the intake of acetaminophen to less than 2000
mg/day

After surgery, a pt has morphine prescribed for post op pain. Which is the priority
assessment—respiratory rate (hold if below 12)

A post op pt who has an iv infusion of morphine has a respiratory rate of 8 per

minute and is lethargic. --narcan

All the following are signs of opium overdose except—pinpoint pupils

Which of the following is true about Demerol—it should not be given to elderly
patients

A pt is receiving an iv infusion of heparin to tat a pulmonary embolism. What lab

will the nurse monitor to evaluate treatment—aPTT or PTT same thing

Which of the following patients may need a decreased dose of warfarin to avoid
toxicity—a pt taking an nsaid for back pain, a pt taking OC to prevent pregnancy, a
pt taking tagamet (inhibits liver enzymes) to prevent gastric ulcers

A pt with rheumatoid arthritis is prescribed methotrexate (rheumatrex). The nurse

will expect to observe therapeutic effects—3-6 weeks (anti-depressants, ssris, elavil
—1-2 months)

Which of the following pts would be a candidate for both lifestyle changes and
druyg therapy with an antyphypertensive med—a 32 yr old pt with a bp of
142/94mm Hg who is overweight and sedentary

A pt was hypertension, type 2 diabetes, and renal insufficiency. The nurse should
set the bp target goal for—less thnan 130/80

A pt is to receive prescribed doses of digoxin and lasix. Before tehse drugs are
administerd the nurse should check—serum potassium levels

A nurse is teaching a pt about the symptoms associated with digoxin toxicity. Then
nurse will teach a pt to report—nausea, bradychardia, and visual changes

A nurse administers quinidine to a pt with a fib. The nurse will observe the ecg
tracing for—prolongation of the qt interval

The nurse is preparing to administer digoxin to a pt in paroxysmal supraventricular

tacychardia. The most important intervention before giving the dig is—assess
apical pulse for rate over one minute and rhythm
The patient is prescribed lovastatin. The nurse will teach the pt to stop the drug
and call the provider for—muscle pain in various areas (rhabdomyolysis—check ck
levels)

The nurse will teach the pt who is prescribed niacin to prevent flushing of the face
by—taking 325 mg of asprin 30 minutes before each dose

A pt with angina is prescribed sl nitroglycerin. Which of the following statements

made by the pt indicates understanding of the med teaching—I may experience
headache as a side effect

A pt is prescribed nitroglycerin transdermal patch. The nurse will teach pt to—

remove patch at night

Which pt would the nurse be most concerned about taking potassium supplements
—a pt who is prescribed enalapril (ace inhibitors increase potassium levels)

A pt who is taking lasix is newly prescribed verapimil. The nurse should: administer
the medications as scheduled

A pt is to receive a scheduled dose of diltiazem (cardiazem) (calcium channel

blocker—slows conduction and hr). The nurse should hold the med and contact the
prescriber if—the patient is in second degree heart block

A pt with asthma is prescribed albuterol 2 puffs 3 times a day. Teach patient to—
wait 1 minute between puffs from the inhaler

A pt with asthma is prescribed beclomethasone inhaler. The nurse should—teach

the pt to use a spacer to prevent a fungal infection

A pt asks what med would be the most effective in treatment of seasonal hay fever.
The nurse will teach the pt about the use of—flucticasone (flonase) (inhaled
glucocorticoid)

A pt has codeine prescribed as an anti-tussive. Which of the following symptoms

will the nurse observe for as an adverse effect of this medication—respiratory
depression

A pt is prescribed synthroid for treatment of hypothyroidism. Which statement

made bny the patient indicates understanding of the medication teaching—“I will
call my doctor if I experience sweating, trouble sleeping, or chest pain.”

A pt with hyperthyroidism is taking PTU. The nurse will monitor the pt for—fever
and sore throat (bc of agranulocytosis)

A pediatric pt is prescribed humatrope for growth hormone deficiency. Before the

drug is administed, the nurses will—obtain weight and height
A pt with hypothalamic diabetes insipidus is prescribed desmopressin. Which
statements made by the pt indicates understanding of the made—“I will take this
medication by sniffing through my nose twice a day.” (This med will be taken
lifelong. Urine volume will decrease. Fluid intake will be reduced to prevent water
intoxication)

A pt is prescribed insulin glargine (lantus). Which of the following should the nurse
include in the discharge instructions—the patient will have less risk of hypoglycemic
reactions with this insulin

Which of the following pts would be taking a glucocrticoid in low doses for
replacement therapy—a patient with Addison’s disease (cushings is too much
glucocoritcoid; addisons is a deficiency of it)

A pt with systemic lupus erythematosus is prescribed prednisone. The nurse will

monitor the patient for—hyperglycemia

A pt taking pharmacologic doses of glucocorticoids should be instructed to—never

abruptly withdrawal therapy

A pt is prescribed tagamet and aluminum hydroxide (mallox) for the treatment of

peptic ulcer disease. The nurse should teach the pt to—wait at least one hour
between the administrations of the two medications

A pt is prescribed bismuth, amoxicillin and tetracycline to treat peptic ulcer disease.

The nurse will instruct the pt that this medication regimen will (treatment for
h.pylori)—destroy the bacteria in the stomach that are causing ulceration

A nurse is teaching a class on laxative use to an elderly group of patients with renal
impairment. Which type of laxative will the nurse teac the group to avoid—
magnesium hydroxide (milk of magnesia)

A pt is prescribed long-acting morphine to treat severe pain. The nurse should

anticipate the need for—laxative

A pt with heart failure is prescribed lasix. The nurse should instruct the patient to
consume—oranges, spinach, and potatoes

A pt is prescribed spironolactone (aldactone) for treatment of hypertension. Which

foods should the patient avoid—salt substitutes

A pt is admitted to the hospital for treatment of symptomatic bradycardia and av

heart block. The pt also has open angle glaucoma. Which topical med for the eye
should the nurse withhold and discuss with the healthcare provider before
administration—timolol (beta-blocker)

The nurse is teaching a class about HRT to a group of premenopausal women.

Teach pts there is a risk for --stroke
A pt is taking estrogen 0.3 mg per day. Which of the following would best reduce
the risk for cardiovascular event such as stroke or MI—stop smoking

Which of the following pts who are prescribed OC would be the most at risk for
developing a thrombosis---a 22 yr old patient who smokes two packs of cigarettes a
day

A female pt contacts a clinic nurse to determine the action to take after she forgot
to take her OC for the past 2 days. The nurse should—

A nurse is providing medication teaching to a 12 yr old male pt with hypogonadism.

Which statement made by the pt indicates an understanding of the prescribed med,
testosterone enanthate (delasteryl)-- “I will come to the clinic every 4 weeks for
shots of testosterone”

A male pt is prescribed transdermal testosterone gel (androgel). The nurse will

teach the patient to—keep the treated area covered

A pt has been prescribed sildenafil (Viagra) for erectile dysfunction. What should
the nurse teach the pt—avoid taking nitroglycerin with this drug

A patient with closed angle glaucoma should not use this drug topically to decrease
AH— Epinephrine (it will cause blindness)

A pt is prescribed bethanechol for urinary retention. What would be the signs of an

overdose (toxic dose) with this drug—increased salivation, sweating, bradycardia,
and hypotension

a pt is prescribed bethanechol for urinary retnention. If the pt exhibits signs of an

overdose, the nurse will administer—atropine

which antibiotic category has the potential for tendon rupture as a serious adverse
effect—fluroquinolone

this drug is the antidote for heparin—protamine sulfate

this drug should be dc upon epipheseal closure—hgh (sometrem)

when observing the effects of antydysrhythmic drugs administered iv, it is essential

to monitor this—monitor ekg

this component of combination ocs, cause an increase in HDL and decrease in LDL
cholesterol—estrogen

monitoring for therapeutioc effects is an example of this phase of the nursing

process—evaultion

a drug posess possible fetal risk; but the benefits may outweight he risks in this
category—cat d
a high byut noprmal dose of wa ter soluble drug is given to a 75 yr old pt. the blood
serum levels may be this—toxix (bc the y have less water)

when used with this category of drugs ____, spironolactone may cause this
electrolyte abnormality__ -- ace inhibitors, and hyperkalemia

this H2 blocker interacts with many drugs causing increased and or decreased
blood levels of concurrently taken drugs—tagamet

this serum drug lev el of a drug taken by this route—oral

this is the only monamine that increases renal blood flow—dopamine

when taken with etoh this drug may cause antabuse type reaction—flagyl

these are the two main reasons why a neonate may develop drug toxicicty—
undervelepoped liver and kidney

regarding animal fetus’ this is the main difference bw a pregnancy category b and c
—c causes fetal harm, b does not cause fetal harm according to research

asking a pt if he she has any drug allergies is an example of—assessment

the only purpose for this ratio is to indicate a drug’s safety—therapeutic index

protein binding—distribution

this antibiotic category is associated with potential hearing loss and kidney
impairment—aminoglycosides

approximately half of the most frequently

in peds patients redcuce number of livers mi c—toxicyt

this is the most severe adverse effect of nsaids—gi bleeding

this antiulcer drug acts like prstonalndins in the stomach—cytotec

dissociation is a possible afvverse effect of this antiemetic---cannabinoid

(dronabinal)

this is the reason some drugs are given bid and some are given qid—half life

sympathmimetic drugs have this effect on blood sugar—increases

an alpha blocker mied has this effect on bp=-decreases

this is the antidote for neostigmeine poisoning—atropine

when cogentin is ordered prn along with an anti[psuchotic med the nurse would
adminster it for this adverse effect—EPS

heparin dosage is adjusted –aptt

if a beta blocker such as inderal is taken at the same time with a cholinergic, this is
the effect on the bronchi—severe bronchoconstriciton (for asthma—albuterol)

antichoinergics have this effect on iop in acute close angle glaucoma—increased iop

dopamine in the brain may have this effect if levodopla and thorazine were taken
together—unchanged. These drugs would negatye each other

this substance breaks down endogenous epinephrine, norepi and dopamine—MAOI

when taken within 2 hours of another dfug, Mylanta may effect –absorption

for a pt taking urecholine (bethanochol), this physical exam assessment is essential

—abdominal exam, assessing for distended bladder

testosterone has this effect on lipids—increase ldl, decrease hdl

setting goals for pt care of pt edi ios an example of nursing process—planning

most all of drug is metablozed and excreted—four half lives

a drug that should be administerd on an empty stomach should be taken when in

regards to meals—to hours before or after a meal

thses are signs of cholinergic crisis—vomiting diarrhea

a pt calls and reports that a v

placebo effect is reduced by

the most accurate method to administer a dose—bsa

maoi taken with food

this is the most reliable test to determine levels fo bloodc glucose over the last
several weeks –hg

period of greatest fetal harm—embryonic

between water soluble and lipid soluble which passes-lipid

this insulin peaks 8-10 houurs after administration—nph

when giving lasix iv push to a pt in chf, this is how long it should be administered—
over 2 minutes at least
when giving regular insulin, a meal should be available within 30 minutes

metformin—lactic acidosis

this eps is characterized by shuffling gait, masked facies, resting tremor—

parkinsons

this common analgesic that should be taken with glucocorticoids—tylenol

taper

pts who take too much glucocoricoids—cushins syndrome

when dehydrated—adh

people on glucocritcoids need to do this to their dose during times of stress—

increase dose

people who take desmopressin is at risk—water intoxication