Test 6 Pharmacology

PharmacologyStuvia.
com
for Canadian Health Care Practice 3rd Edition Lilley Test Bank
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Chapter 08: Over-the-Counter Drugs and Natural Health Products

Lilley: Pharmacology for Canadian Health Care Practice, 3rd Canadian Edition
MULTIPLE CHOICE
1. A 25-year-old woman is visiting the prenatal clinic and shares with the nurse her desire to go
―natural‖ with her pregnancy. She shows the nurse a list of natural health products that she
wishes to take so she can ―avoid taking any drugs.‖ Which statement represents the nurse‘s
best response?
a. Most natural health products are nontoxic and safe for use during pregnancy.
b. Please read the labels carefully before use, to check for cautionary warnings.
c. Products from different manufacturers are required to contain consistent amounts
of herbal constituents.
d. Natural health products are actually drugs of unproven safety and should not be
taken during pregnancy without medical supervision.
ANS: D
Natural health products are actually drugs of mostly unproven safety, especially for pregnant
women; many have not been tested for safety during pregnancy. Manufacturers are not
required to provide cautionary statements or guarantee the reliability of the contents. The
labels on natural health products may not provide enough information for use during
pregnancy. Manufacturers of natural health products are not required to guarantee the
reliability of the contents.
DIF: Cognitive Level: Analysis REF: p. 126| p. 128

N R I G B.C M
2. The role of the Natural Health U
ProS
ductNs DT
irectoraO
te (NPHD) is to see that
a. natural health products are regulated for safety and quality.
b. natural health products are held to the same standards as drugs.
c. producers of natural health products prove the therapeutic efficacy of their
products.
d. natural health products are protected by patent laws.
ANS: A
The NPHD ensures access to safe, effective, and quality natural health products.
DIF: Cognitive Level: Analysis REF: pp. 121-122
3. Which is a concern regarding the use of the natural health product kava?
a. Cancer risk
b. Liver toxicity
c. Cardiovascular incidents
d. Intestinal disorders
ANS: B
The herb kava is found in herbal and homeopathic preparations and sometimes in food. Kava
is promoted for the treatment of anxiety, nervousness, insomnia, pain, and muscle tension.
Health Canada has issued warnings about possible liver toxicity with the use of kava root. In
2012, after a 10-year ban, Health Canada regulated kava root as a new drug.
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DIF: Cognitive Level: Knowledge REF: p. 122
4. A patient tells the nurse that she wants to begin taking St. John‘s wort for treatment of
depression. The nurse should warn her about which substance that may cause an interaction
with St. John‘s wort?
a. digoxin
b. All caffeine-containing products
c. Alcoholic beverages
d. Selective serotonin reuptake inhibitors
ANS: D
Drug interactions may occur with the ingestion of other serotonergic drugs, such as selective
serotonin reuptake inhibitors; the drug interaction may lead to serotonin syndrome.
DIF: Cognitive Level: Comprehension REF: p. 123
5. A patient says that he eats large amounts of garlic for its cardiovascular benefits. Which drug,
if taken, could have a potential interaction with the garlic?
a. acetaminophen
b. warfarin
c. digoxin
d. phenytoin
ANS: B
When taking garlic, taking any drugs that may interfere with platelet and clotting functions
should be avoided. These drugs include antiplatelet drugs, anticoagulants (e.g., warfarin),
nonsteroidal anti-inflammatory drugs (NSAIDs), and acetylsalicylic acid (Aspirin).
Acetaminophen, digoxin, andNpUhRenSyI inGdT
toN oBno.t C
haOvM
e interactions with garlic.
DIF: Cognitive Level: Analysis REF: p. 123
6. When teaching patients about over-the-counter (OTC) and natural health products, the nurse
should teach the patients that
a. histamine-blocking agents should be taken with antacids to prevent gastrointestinal
upset.
b. drug interactions are rare with OTC products because OTC drugs are safer than
prescription drugs.
c. manufacturers of natural health products are required to provide evidence of safety
and effectiveness; therefore, check the labels carefully.
d. natural health products and OTC drugs cannot be safely administered to infants,
children, and pregnant or lactating women without first checking with the health
care provider.
ANS: D
Natural health products and OTC drugs are not necessarily safe for infants, children, and
pregnant or lactating women; the health care provider should be contacted before use.
―Histamine-blocking agents should be taken with antacids to prevent gastrointestinal upset,‖
―Drug interactions are rare with OTC products because OTC drugs are safer than prescription
drugs,‖ and ―Manufacturers of natural health products are required to provide evidence of
safety and effectiveness; therefore, check the labels carefully‖ are all false statements.

7. Patients from which culture will not report gastrointestinal symptoms caused by OTC drugs or
natural health products?
a. Chinese
b. Japanese
c. Hispanic
d. European
ANS: B
Japanese patients experiencing nausea, vomiting, or bowel changes as a result of OTC drugs
or natural health products often do not mention these symptoms. Because the Japanese culture
considers complaining about gastrointestinal symptoms to be unacceptable, these symptoms
may go unreported. The nurse needs to be aware of this implication for this ethnocultural
group.
MULTIPLE RESPONSE
1. Which statement is true regarding the use of OTC drugs? (Select all that apply.)
a. Use of OTC drugs may delay treatment of more serious ailments.
b. Drug interactions with OTC medications are rare.
c. OTC drugs may relieve symptoms without addressing the cause of the problem.
d. OTC drugs are indicated for long-term treatment of conditions.
e. Patients may misunderstand product labels and misuse the drugs.
ANS: A, C, E NURSINGTB.COM
―Use of OTC drugs may delay treatment of more serious ailments,‖ ―OTC drugs may relieve
symptoms without addressing the cause of the problem,‖ and ―Patients may misunderstand
product labels and misuse the drugs‖ are all true statements about the use of OTC drugs and
should be included when patients are being taught about their use. Drug interactions may
indeed occur with prescription medications and other OTC drugs. Normally, OTC drugs are
intended for short-term treatment of minor ailments.

Chapter 09: Vitamins and Minerals

MULTIPLE CHOICE
1. Conditions such as infantile rickets, tetany, and osteomalacia are caused by a deficiency in
which vitamin or mineral?
a. Vitamin D
b. Vitamin K
c. Magnesium
d. Cyanocobalamin
ANS: A
Conditions such as infantile rickets, tetany, and osteomalacia are all results of long-term
vitamin D deficiency.
2. Which nursing diagnosis is appropriate for the patient undergoing therapy with vitamin A?
a. Risk for impaired skin integrity due to vitamin deficiency
b. Disturbed sensory perception (visual) due to night blindness
c. Impaired physical mobility (muscle weakness) due to vitamin deficiency
d. Disturbed thought processes (confusion and psychosis) due to vitamin deficiency
ANS: B
Vitamin A deficiency causes night blindness.
NURSINGTB.COM
3. Which symptom may indicate toxicity during vitamin D therapy?

a. Urticaria
b. Anorexia
c. Diarrhea
d. Tinnitus
ANS: B
Anorexia may indicate vitamin D toxicity.
DIF: Cognitive Level: Comprehension REF: p. 136, Table 9-4
4. Which dietary information is important for the patient taking calcium supplements?
a. Oral calcium supplements should be taken before meals.
b. Calcium products bind with tetracyclines, making the antibiotic inactive.
c. Foods high in calcium include whole grain cereals, egg yolks, and liver.
d. Foods high in oxalate and zinc, such as spinach and legumes, increase the
absorption of oral calcium supplementation.
ANS: B
Calcium products chelate or bind with tetracyclines, resulting in decreased effects of
tetracyclines. Foods high in calcium include milk and other dairy products, shellfish, and dark
green leafy vegetables. Oral calcium supplements should be taken with meals.

5. What adverse effect may occur from calcium salt infusion?

a. Ototoxicity
b. Metabolic acidosis
c. Nephrotoxicity
d. Respiratory arrest
ANS: B
Adverse effects from calcium salts include metabolic acidosis, as well as hemorrhage,
hypertension, constipation, obstruction, nausea, vomiting, flatulence, kidney dysfunction, and
hypercalcemia.
DIF: Cognitive Level: Application REF: p. 147
6. Which vitamin is given to newborns shortly after delivery?

a. Vitamin B3
b. Vitamin D
c. Vitamin A
d. Vitamin K
ANS: D
Vitamin K deficiency in newborns is a result of malabsorption attributable to inadequate
amounts of bile. Thus, vitamin K is given in a single intramuscular dose to infants shortly
after delivery.
DIF: Cognitive Level: ApplicN

ationR REF: p. 138
U SINGTB.COM
7. A patient with a history of alcohol abuse has been admitted to hospital for severe weakness
and malnutrition. Which preparation will he receive to prevent Wernicke‘s encephalopathy?
a. Vitamin B3
b. Vitamin B1
c. Vitamin B2
d. Vitamin B6
ANS: B
Vitamin B1 (thiamine) is useful in the treatment of a variety of thiamine deficiencies,
including Wernicke‘s encephalopathy.
8. People who live in Canada‘s North often have a lack of which vitamin?
a. Vitamin A
b. Vitamin B
c. Vitamin C
d. Vitamin D
ANS: D
Vitamin D, the ―sunshine vitamin,‖ is naturally produced by the sun. People who live in
Canada‘s North, which lacks sunlight for much of the year, dress for intense cold, which
reduces their opportunity for taking in vitamin D.

MULTIPLE RESPONSE
1. Which statement is true in regard to vitamin C? (Select all that apply.)
(Your answer should appear as lowercase letters separated by a comma and a space as
follows: a, b, c, d)
a. Vitamin C is important in the maintenance of bones, teeth, and capillaries.

b. Vitamin C is important for erythropoiesis.
c. Glycogenolysis relies on the presence of vitamin C.
d. Vitamin C is important for tissue repair.
e. Vitamin C is essential for the synthesis of blood coagulation factors.
f. Vitamin C is found in animal sources, such as dairy products and meat.
g. Vitamin C is found in citrus fruits, tomatoes, cabbage, and strawberries.
h. Vitamin C is essential for night vision.
ANS: A, B, D, G
Vitamin C is important in the maintenance of bones, teeth, and capillaries; for erythropoiesis;
and for tissue repair. Vitamin C is found in citrus fruits, tomatoes, cabbage, and strawberries.
Vitamin C deficiency is known as scurvy.
DIF: Cognitive Level: Comprehension REF: p. 133| pp. 144-145
NURSINGTB.COM

Chapter 45: Antiviral Drugs

MULTIPLE CHOICE
1. A patient diagnosed with shingles is prescribed topical acyclovir (Zovirax ®). What important
adverse effects should the nurse warn this patient about?
a. Insomnia and nervousness
b. Temporary swelling and rash
c. Burning of the skin
d. No adverse effects
ANS: C
Burning of the skin may occur with the topical application of acyclovir.
DIF: Cognitive Level: Comprehension REF: p. 852, Table 45-2
2. A patient who has had a bone marrow transplant has contracted cytomegalovirus (CMV)
retinitis. Which drug is preferable for this patient?
a. acyclovir (Zovirax®)
b. foscarnet (Foscavir®)
c. ganciclovir (Cytovene®)
d. amantadine (Dom-Amantidine®)
ANS: B
Foscarnet is indicated for the treatment of CMV retinitis and is less toxic to the bone marrow
than ganciclovir is. NURSINGTB.COM
DIF: Cognitive Level: Knowledge REF: p. 854, Drug Profile
3. Which is a true statement about amantadine (Dom-Amantidine) therapy?

a. It causes less central nervous system (CNS) toxicity than rimantadine.
b. It is commonly used to treat influenza A and influenza B.
c. It should not be given to women who are breastfeeding.
d. It has a longer half-life than rimantadine and may be dosed less frequently.
ANS: C
Amantadine is contraindicated in lactating women, in patients with a hypersensitivity to it, in
children younger than 12 months, and in patients with an eczematic rash. Amantadine is
active only against influenza A viruses. Compared with amantadine, rimantadine has a longer
half-life, may be dosed less frequently, and causes less CNS toxicity.
4. A patient with acquired immune deficiency syndrome (AIDS) has been taking zidovudine
(AZT) therapy for almost 1 year. The physician has decided to change the medication to
didanosine (Videx EC®). The patient is very concerned about this medication change. What is
the nurse‘s best explanation to the patient?
a. Didanosine has fewer toxic effects than zidovudine.
b. Didanosine has been shown to improve survival rates.

c. Taking the zidovudine with the didanosine might have led to serious toxicity.
d. The patient may have been experiencing bone marrow suppression due to the
zidovudine therapy.
ANS: D
Bone marrow suppression is often the reason why a patient with a human immunodeficiency
virus (HIV) infection needs to be switched to another anti-HIV drug, such as didanosine.
Zidovudine and didanosine can be taken together by cutting back on the doses of both, thus
decreasing the likelihood of toxicity.
DIF: Cognitive Level: Comprehension REF: p. 861, Drug Profile
5. The nurse is administering acyclovir (Zovirax).

Which statement is true?
a. Intravenous (IV) infusions should be administered slowly, over at least 1 hour.
b. IV infusions should be administered by rapid IV bolus.
c. IV acyclovir is compatible with many other IV solutions.
d. Oral fluids should be restricted while the client is taking IV acyclovir.
ANS: A
IV infusions of acyclovir should be given slowly, over at least 1 hour. Many IV agents and
solutions are incompatible with IV acyclovir. A fluid intake of at least 2 400 mL per day
should be encouraged for clients receiving acyclovir, unless contraindicated.
6. Whichis a therapeutic effect of antiviral drugs?

a. Elimination of the virus N R I G B.C M
U S N T O
b. Eradication of herpetic lesions
c. Delayed progression of HIV infection
d. Prevention of future infections with the same virus
ANS: C
One of the therapeutic effects of antiviral agents is delayed progression of HIV infection.
7. A patient who is taking a combination of antiretroviral drugs as treatment of early stages of

HIV infection asks the nurse whether the drugs will kill the virus. Which statement is the
nurse‘s best response to this patient?
a. Antiretroviral drugs are rarely beneficial and are given for palliative reasons only.
b. Antiretroviral drugs will be effective as long as the patient is not exposed to the
virus again.
c. Antiretroviral drugs can be given in large enough doses to eradicate the virus
without harming the body‘s healthy cells.
d. Antiretroviral drugs are effective only while the virus is replicating, and replication
is often finished by the time symptoms appear.
ANS: D

Antiretroviral drugs are effective only while the virus is replicating, and replication is often
finished by the time symptoms appear. Antiretroviral drugs are beneficial and treat patients
with active HIV infection. The body‘s healthy cells are often harmed during antiretroviral
therapy, resulting in the possible occurrence of toxic adverse effects.
8. A young adult calls the clinic to ask for a prescription for ―the flu drug.‖ He says he has had
―the flu‖ for almost 4 days and just heard about a drug that can reduce the symptoms. Which
statement about oseltamivir (Tamiflu®) and zanamivir (Relenza®) is true?
a. These drugs do not stop the spread of influenza.
b. These drugs have few adverse effects.
c. As long as this patient starts treatment within the next 24 hours, the drug should be
effective.
d. Treatment with these drugs should begin within 2 days of the onset of influenza
symptoms.
ANS: D
Treatment with these drugs should be started within 2 days of the onset of influenza
symptoms. These drugs may cause nausea or vomiting, and they do work to stop the spread of
influenza.
DIF: Cognitive Level: Analysis REF: p. 854, Drug Profile
9. Which drug belongs to the newer class of antiviral drugs called fusion inhibitors?
a. enfuvirtide (Fuzeon®)
b. tenofovir (Viread®)
c. nevirapine (Viramune®) NURSINGTB.COM
d. indinavir (Crixivan®)
ANS: A
Enfuvirtide is the drug that belongs to the newer class of antiviral drugs, which are called
fusion inhibitors.
10. A patient with late-stage AID) has developed Kaposi‘s sarcoma. What type of infection is
Kaposi‘s sarcoma?
a. A drug-resistant infection
b. An opportunistic infection
c. A co-infection
d. A superinfection
ANS: B
Kaposi‘s sarcoma is an example of an opportunistic situation; it is an HIV-associated
neoplasm.
11. Which is a common adverse effect of oseltamavir (Tamiflu)?

a. Diarrhea
b. Sinusitis

c. Nausea
d. Constipation
ANS: C
The most common adverse effects associated with oseltamavir are nausea and vomiting.
Sinusitis, diarrhea, and nausea are associated with zanamivir. Constipation is not an adverse
effect of oseltamavir.
MULTIPLE RESPONSE
1. A patient diagnosed with genital herpes is taking topical acyclovir (Zovirax). What should the
nurse say to the patient about this drug? (Select all that apply.) Express your answer with
small letters followed by a comma and a space (e.g., a, b, c, d).
a. ―Be sure to wash your hands thoroughly before and after applying this medicine.‖
b. ―Apply this ointment until the lesion stops hurting.‖
c. ―Sterile gloves are required when applying this ointment.‖
d. ―Use a clean glove or finger cot when applying this ointment.‖
e. ―If your partner develops these lesions, then he can also use the medication.‖
f. ―You need to avoid touching around your eyes.‖
g. ―You will need to practice abstinence when these lesions are active.‖
h. ―Ask your health care provider about getting a Pap smear every 6 months due to an
increased risk for cervical cancer.‖
ANS: A, D, F, G, H
Hands should be thoroughly N washed
should be used when applying U the S
Ibefore
RointNmen
and after
GTt,B.C
the pO
M applying this medicine, clean gloves
atient should avoid touching around the
eyes, abstinence must be practised while the lesions are active, and female patients should
have a Pap smear every 6 months due to an increased risk for cervical cancer. This medication
should be applied as long as prescribed, and sterile gloves are not needed. Prescriptions
should not be shared; if the partner develops these lesions, then the partner will need to be
evaluated before medication is prescribed if needed.
DIF: Cognitive Level: Application REF: p. 864| p. 866

Chapter 47: Antifungal Drugs

MULTIPLE CHOICE
1. A patient has been prescribed ketoconazole. What should the nurse tell the patient to do in
regard to this medication?
a. Have liver function tested.
b. Take antacids with the drug to minimize gastrointestinal upset.
c. Take the drug with a large glass of orange juice or water.
d. Take the drug 2 hours before a meal or 2 hours after a meal.
ANS: A
Patients receiving ketoconazole should have their liver function assessed. The patient should
not take alkaline products or antacids for at least 2 hours before or after dosing. Ketoconazole
should not be taken with coffee, tea, or acidic fruit juices. Taking ketoconazole with food
helps to minimize gastrointestinal upset.
2. Which is a contraindication to the use of griseofulvin?

a. Porphyria
b. Renal disease
c. Cardiac disease
d. Meningitis
ANS: A NURSINGTB.COM
Griseofulvin is contraindicated in patients with porphyria.
3. The nurse is administering an antifungal medication. What assessment finding may indicate
medication-induced renal damage?
a. Rash and chills
b. Increased urinary output
c. Decreased levels of blood urea nitrogen (BUN) and creatinine
d. A weight gain of 2.5 kg in 1 week
ANS: D
A weight gain of more than 1 kg in in a 24-hour period or 2.3 kg or more in 1 week may
indicate possible medication-induced kidney damage and the need for prompt medical
attention.
BUN and creatinine levels will increase, not decrease, if renal damage occurs. Urine output
would decrease if renal damage were indicated. Rash and chills are not symptoms of renal
damage.
4. Which antifungal drug causes increased effects of oral anticoagulants?

a. miconazole
b. fluconazole
c. ketoconazole
d. amphotericin B (Fungizone®)
ANS: B
Fluconazole causes increased effects of oral anticoagulants.
DIF: Cognitive Level: Knowledge REF: p. 885, Table 47-3
5. During administration of amphotericin B (Fungizone), the patient may experience severe

adverse effects, such as fever, chills, hypotension, tachycardia, malaise, nausea, and headache.
The correct action for the nurse to take is to
a. discontinue the infusion immediately.
b. reduce the infusion rate gradually until the adverse effects subside.
c. administer the medication by rapid intravenous (IV) infusion to reduce the
potential adverse effects.
d. Anticipating these effects, pretreat the patient with an antipyretic, such as
acetaminophen, an antihistamine, and an antiemetic drug.
ANS: D
Pretreatment with an antipyretic (acetaminophen), an antihistamine, and an antiemetic drug is
the appropriate action to reduce the adverse effects of amphotericin B therapy.
6. The nurse is administering Amphotec, one of the newer formulations of amphotericin B.

When giving this drug, what N URorta
imp SIntNiG TBm.aC
nfor OMdoes the nurse need to remember?
tion
a. The new formulation may be given in an oral form.
b. The newer doses are much lower than the older doses.
c. The newer doses are much higher than the older doses.
d. The newer and older forms have no differences in their doses.
ANS: C
The newer forms of amphotericin B use much higher doses, ranging from 3 to 6 mg/kg per
day. Doses of older forms of amphotericin B range from 0.25 to 1.5 mg/kg per day.
7. A patient has been prescribed a vaginal antifungal drug. What important information should
the nurse teach the patient about this drug?
a. The medication is to be continued even if menstruation begins.
b. The health care provider should be contacted if symptoms are not gone in 48
hours.
c. Daily douching is part of the treatment for vaginal fungal infections.
d. Consumption of alcohol is to be avoided.
ANS: A
The nurse should advise the patient to continue to take the medication even if menstruation
begins; the course of treatment must be completed. Daily douching is not part of the treatment
for vaginal fungal infections, and the patient does not need to avoid consumption of alcohol. It
may take up to 7 to 10 days for symptoms to disappear.

DIF: Cognitive Level: Analysis REF: p. 889, Pt Teaching
8. Which drug may be used for invasive aspergillosis in patients who cannot tolerate other
antifungal drugs?
a. fluconazole (Diflucan®)
b. flucytosine (5-FC)
c. caspofungin (Cancidas®)
d. nystatin
ANS: C
Caspofungin is used for treating a severe Aspergillus infection (invasive aspergillosis) in
patients who are intolerant of or refractory to other drugs.
9. The nurse is reviewing the history of a patient who will be taking an antifungal drug. Which
condition is a contraindication to this treatment therapy?
a. Diabetes
b. Kidney failure
c. Hyperthyroidism
d. Meningitis
ANS: B
Liver failure and kidney failure are the most common contraindications to antifungal drugs.
The other conditions listed are not contraindications to the use of antifungal drugs.
DIF: Cognitive Level: ComprN

ehenRsionI REF: p. 884
U S NGTB.COM
®
10. A patient with a severe fungal infection has been prescribed voriconazole (Vfend ). Which
assessment finding should the nurse be concerned about before the medication is started?
a. Decreased breath sounds in the lower lobes
b. History of cardiac dysrhythmias
c. History of type 2 diabetes
d. Potassium level of 3.8 mmol/L
ANS: B
Voriconazole is contraindicated when coadministered with certain other drugs metabolized by
the cytochrome P-450 enzyme CYP3A4 (e.g., quinidine) because of the risk for inducing
serious cardiac dysrhythmias.
DIF: Cognitive Level: Application REF: p. 886, Drug Profile
11. A patient is receiving therapy with amphotericin B (Fungizone). The nurse will monitor for
known adverse effects that are reflected by which laboratory result?
a. A serum potassium level of 2.9 mmol/L
b. A serum potassium level of 5.6 mmol/L
c. A white blood cell count of 6 500 mm3
d. A platelet count of 300 000 per microlitre
ANS: A
The nurse should monitor for hypokalemia, a possible adverse effect of amphotericin B.

DIF: Cognitive Level: Analysis REF: p. 884, Table 47-2
MULTIPLE RESPONSE
1. The nurse is administering amphotericin B (Fungizone). Which actions by the nurse are
appropriate? (Select all that apply.) Express your answer by using small letters followed by a
comma and a space (e.g., a, b, c, d).
a. Administering the medication by rapid IV infusion
b. Discontinuing the drug immediately if the patient develops tingling and numbness
in the extremities
c. If adverse effects occur, reducing the IV rate gradually until the adverse effects
subside
d. Using an infusion pump with IV therapy
e. Monitoring the IV site for signs of phlebitis and infiltration
f. Administering premedication for fever and nausea as ordered
g. Ensuring that the IV solution for amphotericin B is cloudy
h. Monitoring for muscle twitching, which may indicate hypokalemia
ANS: B, D, E, F
When administering amphotericin B, the nurse should discontinue the drug immediately if the
patient develops tingling and numbness in the extremities An infusion pump should be used
with IV therapy. The nurse should monitor the IV site for signs of phlebitis and infiltration
and note that premedication for fever and nausea may be ordered. The medication should be
administered at the recommended rate and stopped, not slowed, if adverse reactions occur.
The IV solution should be clear and without precipitates, and muscle weakness, not twitching,
may indicate hypokalemia. NURSINGTB.COM

Chapter 50: Immunosuppressant Drugs

MULTIPLE CHOICE
1. How is cyclosporine (Neoral®) usually given intravenously?

a. In a single intravenous (IV) injectable form to minimize adverse effects
b. Initiated by an oral test dose, then an IV infusion started after 2 hours
c. Diluted and infused with an infusion pump
d. Given as an IV bolus for the first dose, then with an infusion pump for following
doses
ANS: C
With intravenously administered cyclosporine, the dose must be diluted as recommended by
the manufacturer and given according to the standards of care and institutional policy. Always
infuse using an infusion pump and over the recommended period. Monitor the patient closely
during the infusion, especially during the first 30 minutes, for any allergic reactions.
Cyclosporine is not given by using an IV bolus or with an oral test dose.

®
2. A patient about to undergo kidney transplantation will be given azathioprine (Imuran ) to
minimize organ rejection. What important preoperative information should the nurse give the
patient about this drug?
a. Before the surgery, the medication will be administered orally.
b. The oral doses should be taken 1 hour before meals, to maximize absorption.
NUoni
c. Blood pressure should be m
RStore
INdGfoTrB.C M
the deOvelopment of moderate
hypertension.
d. For several days before surgery, the patient will need to visit the office daily for
intramuscular (IM) injections.
ANS: A
Several days before transplant surgery, immunosuppressant drugs should be taken by the oral
route, if possible, to avoid IM injections and the risk of infections caused by them.
3. A female patient has started azathioprine (Imuran®) therapy in preparation for her kidney
transplant surgery. Which expected adverse effect of azathioprine therapy should the nurse tell
the patient about?
a. Tremors
b. Diarrhea
c. Leukopenia
d. Fluid retention
ANS: C
Leukopenia is an expected adverse effect of azathioprine therapy.

4. Which drug may increase the action of azathioprine (Imuran)?

a. nafcillin
b. rifampin
c. allopurinol
d. phenobarbital
ANS: C
Allopurinol may increase the action of azathioprine.
5. When providing patient education related to immunosuppressive therapy, which items of

information will the nurse include?
a. If a dose is missed, double the next scheduled dose.
b. Take the medication with any type of juice or water.
c. It is important to have a 1-week supply of medication.
d. If the blister-pack pills have an odour, discard them.
ANS: C
Tell the patient about the complexity of dosing and about the need to always have a 1-week
supply of medication available so that there is never a risk of running out. If a dose is missed,
the patient is to contact the health care provider. The medication cannot be taken with
grapefruit juice. Pills in blister-packs normally have a characteristic odour.
6. Which immunosuppressant is the only one currently indicated for the treatment of relapsing
forms of multiple sclerosis? NURSINGTB.COM
a. azathioprine (Imuran)
b. fingolimod hydrochloride (Gilenya®)
c. mycophenolate mofetil (CellCept®)
d. sirolimus (Rapamune®)
ANS: B
Fingolimod hydrochloride (Gilenya), a new sphingosine 1-phosphate receptor modulator,
failed as an antirejection drug but was approved for treating multiple sclerosis. It is the only
oral drug for relapsing forms of multiple sclerosis.
7. The nurse will monitor which laboratory result when the patient is receiving an infusion of
cyclosporine?
a. Hemoglobin
b. Hematocrit
c. Alanine aminotransferase (ALT)
d. Bilirubin
ANS: C
The nurse needs to closely monitor the patient‘s blood urea nitrogen, L-lactate dehydrogenase
(LDH), aspartate aminotransferase (AST), and ALT during therapy, as ordered, to detect
possible kidney and liver impairment.


®
8. What does the nurse tell a patient who is to take sirolimus (Rapamune ) orally?
a. ―Take the medication on an empty stomach.‖
b. ―It is all right to dilute the medication in a Styrofoam cup.‖
c. ―Change the time that you take the medication each day by 1 hour.‖
d. ―This drug has a prolonged onset of action, so it is important to take it with your
midday meal.‖
ANS: A
Oral dosages of tacrolimus are given on an empty stomach. As with cyclosporine, oral doses
of tacrolimus are not to be put in Styrofoam cups or containers. Inform the patient to avoid the
consumption of grapefruit within 2 hours of taking the drug. Both sirolimus and tacrolimus
have long half-lives, so toxicity is an added concern because of possible cumulative effects.
9. Which statement is true in regard to cyclosporine?

a. Any leftover solution should be refrigerated.
b. It should be mixed with water only.
c. The use of Styrofoam containers should be avoided.
d. It can be given only intravenously.
ANS: C
Styrofoam containers should be avoided because the drug has been found to adhere to the
inside of the container. Oral solutions may be mixed with chocolate milk, regular milk, or
orange juice and served at room temperature. After the solution is mixed, the patient must
drink it immediately. Oral soN URnsSI
lutio ofNcG TBsp.oCrine
yclo OMshould not be refrigerated. Cyclosporine
can be given orally or intravenously.

Chapter 51: Immunizing Drugs and Pandemic Preparedness

MULTIPLE CHOICE
1. Two patients arrive at the clinic: a young boy with sickle-cell anemia and a 57-year-old
woman with early-stage Hodgkin‘s disease. Both patients require the same vaccine. What
vaccine do they require?
a. Bacillus Calmette-Guérin (BCG) vaccine
b. Tetanus, diphtheria, and pertussis vaccine
c. Hepatitis B virus vaccine, inactivated
d. Haemophilus influenzae type b conjugate vaccine
ANS: D
H. influenzae type b conjugate vaccine is usually given to patients with sickle-cell anemia (an
immunodeficiency syndrome) and with Hodgkin‘s disease.
DIF: Cognitive Level: Analysis REF: pp. 946-947
2. Which type of immunity occurs when the body is exposed to a relatively harmless form of an
antigen that imprints this information on the body‘s memory bank and stimulates the body‘s
defences to resist any subsequent exposures?
a. Active immunity
b. Attenuating immunity
c. Naturally acquired passive immunity
d. Artificially acquired passive immunity B.C M
N R I G
U S N T O
ANS: A
Active immunity causes an antigen–antibody response and stimulates the body‘s defences to
resist any subsequent exposures.
3. A 45-year-old male has had a series of equine-derived immunizing drugs in preparation for a
trip to an undeveloped country. His wife brings him to the emergency department because he
has developed edema of the face, tongue, and throat and is having trouble breathing. What is
he experiencing?
a. Serum sickness
b. Cross-sensitivity
c. An adverse effect
d. An anaphylactic reaction
ANS: A
Serum sickness sometimes occurs after repeated injections of equine-derived immunizing
agents and is characterized by edema of the face, tongue, and throat; rash; urticaria; fever;
flushing; dyspnea; and other conditions.

4. A 12-month-old infant has received measles, mumps, and rubella virus (MMR) vaccine. Her
mother calls the clinic to ask how she can help her infant to ―feel better.‖ What is the nurse‘s
best suggestion to the mother?
a. Apply an ice pack to the injection site.
b. Give the infant pediatric Aspirin for the pain.
c. Apply warm compresses to the injection site.
d. Observe the site for further swelling and redness.
ANS: C
Applying warm compresses to the injection site and using acetaminophen (not Aspirin, which
carries the risk of Reye‘s syndrome) should help to relieve the infant‘s discomfort.
Contraindications to the administration of immunizing agents include active infections,
pregnancy, febrile illnesses, and a history of reactions to or serious adverse effects of the
drugs. Patients who are already immunosuppressed should not be given these agents.
DIF: Cognitive Level: Application | Cognitive Level: Comprehension

REF: p. 953
5. A health care employee has had a needle-stick injury from a contaminated needle. Which drug
is used to provide passive immunity to hepatitis B infection?
a. Haemophilus influenzae type b (HIB) vaccine
b. Varicella zoster immune globulin (VariZIG®)
c. Hepatitis B immunoglobulin (H-BIG)
d. HB vaccine inactivated (Recombivax HB®)
ANS: C
H-BIG provides passive immunity in the prophylaxis and post exposure treatment of people
exposed to hepatitis B virus oNrU
heRpS
atI sG
itiN suBr.
BT faC
ceOaM
ntigen–positive materials, such as blood,
plasma, or serum. Recombivax HB promotes active immunity to hepatitis B infection in
people considered at high risk for potential exposure to the virus. HIB vaccine is given to
infants to prevent Haemophilus influenzae type B, and varicella zoster immune globulin is
given for exposure to chicken pox.
6. At what age is the first dose of DTaP-IPV (diphtheria, tetanus, and acellular pertussis [DTaP]
and inactivated polio vaccine [IPV]) given?
a. 1 month
b. 2 months
c. 4 months
d. 6 months
ANS: B
The first dose of this series is given at the age of 2 months.
7. A 14-month-old patient is to be vaccinated with measles, mumps, rubella, and varicella

(MMRV) vaccine. Which is a true statement about this vaccine?
a. It is given yearly to provide ongoing immunization.
b. It is given by deep intramuscular injection.

c. It is given by subcutaneous injection.

d. The patient will need a total of three injections by 18 months of age.
ANS: C
Measles vaccine is available as measles, mumps, and rubella (MMR) vaccine or as MMRV
vaccine. Children receive a single dose subcutaneously at 12 to 15 months of age and a second
dose at 18 months of age or at 4 to 6 years of age.
8. The human papilloma virus (HPV) vaccine can be given to males and females beginning at
what age?
a. 3 years
b. 6 years
c. 9 years
d. 12 years
ANS: C
The HPV vaccine is recommended to be given to females and males beginning at 9 years of
age and before the onset of sexual intercourse.
MULTIPLE RESPONSE
1. Active immunizations are usually contraindicated in which patients? (Select all that apply.)
Express your answer with small letters followed by a comma and a space (e.g., a, b, c, d).
a. Pregnant women NURSINGTB.COM
b. Patients with active infections
c. Infants under the age of 1 year
d. Older adults
e. Patients who are immunosuppressed
f. Patients receiving cancer chemotherapy
g. Patients with acquired immunodeficiency syndrome (AIDS)
ANS: A, B, E, F, G
Contraindications to the administration of immunizing drugs include pregnancy, active
infections, febrile illnesses, and a history of reactions to or serious adverse effects from the
drugs. Those who are already immunosuppressed (patients with AIDS and patients receiving
chemotherapy) should not be given these drugs. Infants under the age of 1 year and older
adults may receive immunizing drugs.
2. Active immunizations are usually contraindicated in which patients? (Select all that apply.)
Express your answer with small letters followed by a comma and a space (e.g., a, b, c, d).
a. Pregnant women
b. Patients with active infections
c. Infants under the age of 1 year
d. Older adults
e. Patients who are immunosuppressed

f. Patients receiving cancer chemotherapy

g. Patients with acquired immunodeficiency syndrome (AIDS)
ANS: A, B, E, F, G
Contraindications to the administration of immunizing drugs include pregnancy, active
infections, febrile illnesses, and a history of reactions to or serious adverse effects from the
drugs. Those who are already immunosuppressed (patients with AIDS and patients receiving
chemotherapy) should not be given these drugs. Infants under the age of 1 year and older
adults may receive immunizing drugs.
NURSINGTB.COM

Chapter 55: Anemia Drugs

MULTIPLE CHOICE
1. A patient is to receive iron dextran (Dexiron®) injections. What should the nurse use to
administer this medication?
a. Intravenous (IV) injection mixed with 5% dextrose
b. Intramuscular (IM) injection in the upper arm
c. IM injection using the Z-track method
d. Subcutaneous injection with a half-inch, 29-gauge needle
ANS: C
With the Z-track method, IM iron should be given deep into a large muscle mass.
2. A patient is prescribed oral iron supplementation. What should the nurse tell the patient to do
while on this treatment?
a. Take the iron tablets with milk or antacids.
b. Crush the pills as needed to help swallowing.
c. Avoid reclining positions for up to 30 minutes after taking the drug.
d. You do not need to eat foods that are high in iron, such as meat, dark green leafy
vegetables, and dried beans.
ANS: C
To prevent esophageal irritatN nR
ioU orScI roG
orN onB, .
siT paCtiO
enMts on an iron supplement should avoid
reclining positions for 15 to 30 minutes after taking the drug. Antacids and milk may cause
decreased iron absorption; iron tablets should be taken whole and not crushed; and clients
should continue to eat foods high in iron.
3. What may occur as a result of therapy with iron preparations?

a. Palpitations
b. Dizziness and syncope
c. Black and red tarry stools
d. Yellow discoloration of the urine
ANS: C
Black and red tarry stools and other gastrointestinal disturbances may occur as a result of
taking iron preparations.
4. A patient has been taking iron supplements for anemia for 4 weeks. Which therapeutic
response should the patient be taught to watch for?
a. Decreased weight
b. Absence of fatigue
c. Decreased palpitations

d. Decreased visual disturbances

ANS: B
Absence of fatigue, increased activity tolerance and well-being, and increased nutritional
status are therapeutic responses to iron supplementation.
5. Before administering iron supplements, the nurse should assess for which contraindication?
a. Poor nutrition
b. Hemolytic anemia
c. Weakness and fatigue
d. Decreased hemoglobin
ANS: B
Hemolytic anemia is a contraindication to the use of iron supplements. Poor nutrition,
weakness and fatigue, and decreased hemoglobin are related to iron deficiency anemia.

®
6. When ferrous fumarate (Palafer ) is given to infants, what is the onset of action time period?
a. 10 to 12 hours
b. 24 to 48 hours
c. 3 to 10 days
d. 14 to 21 days
ANS: C
The onset of action for ferrous fumarate is 3 to 10 days.
NURSINGTB.COM
7. The nurse is teaching a patient about the oral administration of iron preparations. What will
increase the absorption of iron?
a. Milk
b. Yogourt
c. Antacids
d. Ascorbic acid
ANS: D
Ascorbic acid enhances the absorption of oral iron. Antacids, milk, and yogourt may interfere
with absorption.
8. A patient is taking a liquid form of an iron product. What should the nurse tell the patient to
do when taking this product?
a. Follow the dose with milk.
b. Take the medication through a plastic straw.
c. Mix the dose with juice and sip slowly.
d. Drink the medication undiluted from a measured medicine cup.
ANS: B

Liquid oral forms of iron should be taken through a plastic straw to avoid discoloration of
tooth enamel. Milk may decrease absorption. Because liquid iron can stain the teeth, the
patient should not sip or drink it directly.
9. A woman is planning to become pregnant in the next year. To reduce the risk for fetal neural
tube defects, she should ensure that she receives adequate levels of what?
a. Vitamin B12
b. Vitamin C
c. Iron
d. Folic acid
ANS: D
To reduce the risk for fetal neural tube defects, administration of folic acid is recommended to
begin at least 1 month before pregnancy and to continue through early pregnancy.
10. The nurse is administering medications to a patient with a new diagnosis of anemia. Which is
a true statement about treatment with folic acid?
a. Folic acid is used to treat any type of anemia.
b. The cause of the anemia should be determined before treatment with folic acid.
c. Folic acid is used to treat pernicious anemia.
d. Folic acid is used to treat iron deficiency anemia.
ANS: B
Folic acid should not be usedNtoUR SI
trea NGmia
t ane TBu.nCtilOtM
he underlying cause and type of anemia are
identified. Administering folic acid to a patient with pernicious anemia may correct the
hematological changes of anemia, but the symptoms of pernicious anemia (which is due to a
vitamin B12 deficiency, not a folic acid deficiency) may be deceptively masked.
MULTIPLE RESPONSE
1. A patient will be taking oral iron supplements. Which statements should the nurse include
when teaching this patient? (Select all that apply.) Give your answer with small letters
followed by a comma and a space (e.g., a, b, c, d).
a. Take the iron tablets with an antacid.
b. Take the iron on an empty stomach 1 hour before meals.
c. Take the iron with meals.
d. Drink 250 mL of milk with each iron dose.
e. Taking iron supplements with orange juice enhances iron absorption.
f. Stools may become loose and light-coloured.
g. Stools may become black and tarry.
h. Iron tablets may be crushed to enhance iron absorption.
ANS: C, E, G

Iron tablets should be taken with meals in order to reduce gastrointestinal distress, but
antacids and milk interfere with absorption. Stools may become black and tarry in patients
who are on iron supplements. Tablets should be taken whole, not crushed, and the patient
should be encouraged to eat foods high in iron. There is no evidence that taking iron
supplements with orange juice enhances absorption.
NURSINGTB.COM


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PharmacologyStuvia.

Chapter 08: Over-the-Counter Drugs and Natural Health Products

DIF: Cognitive Level: Analysis REF: p. 126| p. 128

DIF: Cognitive Level: Analysis REF: pp. 121-122

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DIF: Cognitive Level: Knowledge REF: p. 122

DIF: Cognitive Level: Comprehension REF: p. 123

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DIF: Cognitive Level: Comprehension REF: p. 126

DIF: Cognitive Level: Comprehension REF: p. 125

DIF: Cognitive Level: Analysis REF: p. 118

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Chapter 09: Vitamins and Minerals

DIF: Cognitive Level: Comprehension REF: p. 136

3. Which symptom may indicate toxicity during vitamin D therapy?

DIF: Cognitive Level: Comprehension REF: p. 136, Table 9-4

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DIF: Cognitive Level: Analysis REF: p. 150

5. What adverse effect may occur from calcium salt infusion?

DIF: Cognitive Level: Application REF: p. 147

6. Which vitamin is given to newborns shortly after delivery?

DIF: Cognitive Level: ApplicN

DIF: Cognitive Level: Comprehension REF: p. 140

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DIF: Cognitive Level: Knowledge REF: p. 136

1. Which statement is true in regard to vitamin C? (Select all that apply.)

a. Vitamin C is important in the maintenance of bones, teeth, and capillaries.

DIF: Cognitive Level: Comprehension REF: p. 133| pp. 144-145

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Chapter 45: Antiviral Drugs

DIF: Cognitive Level: Comprehension REF: p. 852, Table 45-2

3. Which is a true statement about amantadine (Dom-Amantidine) therapy?

DIF: Cognitive Level: Comprehension REF: p. 851

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DIF: Cognitive Level: Comprehension REF: p. 861, Drug Profile

5. The nurse is administering acyclovir (Zovirax).

DIF: Cognitive Level: Analysis REF: p. 864

6. Whichis a therapeutic effect of antiviral drugs?

DIF: Cognitive Level: Comprehension REF: p. 865

7. A patient who is taking a combination of antiretroviral drugs as treatment of early stages of

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DIF: Cognitive Level: Analysis REF: p. 849

DIF: Cognitive Level: Analysis REF: p. 854, Drug Profile

DIF: Cognitive Level: Knowledge REF: p. 858

DIF: Cognitive Level: Comprehension REF: p. 857

11. Which is a common adverse effect of oseltamavir (Tamiflu)?

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DIF: Cognitive Level: Comprehension REF: p. 854, Drug Profile

DIF: Cognitive Level: Application REF: p. 864| p. 866

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Chapter 47: Antifungal Drugs

DIF: Cognitive Level: Comprehension REF: p. 888

2. Which is a contraindication to the use of griseofulvin?

DIF: Cognitive Level: Knowledge REF: p. 884

DIF: Cognitive Level: Comprehension REF: p. 889

4. Which antifungal drug causes increased effects of oral anticoagulants?

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DIF: Cognitive Level: Knowledge REF: p. 885, Table 47-3

5. During administration of amphotericin B (Fungizone), the patient may experience severe

DIF: Cognitive Level: Analysis REF: p. 886, Drug Profile

6. The nurse is administering Amphotec, one of the newer formulations of amphotericin B.

DIF: Cognitive Level: Comprehension REF: p. 887

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DIF: Cognitive Level: Analysis REF: p. 889, Pt Teaching