Adult Health 324 Pharm exam Questions with Answers Tested and Verified Solutions RATED A+, Exams of Pharmacology

Download Adult Health 324 Pharm exam Questions with Answers Tested and Verified Solutions RATED A+ and more Exams Pharmacology in PDF only on Docsity! Adult Health 324 Pharm exam Questions with Answers Tested and Verified Solutions RATED A+ Chapter 1 The nurse is writing a nursing diagnosis for a plan of care for a patient who has been newly diagnosed with type 2 diabetes. Which statement reflects the correct format for a nursing diagnosis Anxiety related to new drug therapy, as evidenced by statements such as “I’m upset about having to test my blood sugars.” The patient is to receive oral guaifenesin (Mucinex) twice a day. Today, the nurse was busy and gave the medication 2 hours after the scheduled dose was due. What type of problem does this represent “Right time” The nurse has been monitoring the patient’s progress on a new drug regimen since the first dose and documenting the patient’s therapeutic response to the medication. Which phase of the nursing process do these actions illustrate Evaluation The nurse is assigned to a patient who is newly diagnosed with type 1 diabetes mellitus. Which statement best illustrates an outcome criterion for this patient The patient will demonstrate correct blood glucose testing technique. Which activity best reflects the implementation phase of the nursing process for the patient who is newly diagnosed with hypertension Providing education on keeping a journal of blood pressure readings The medication order reads, “Give ondansetron (Zofran) 4 mg, 30 minutes before beginning chemotherapy to prevent nausea.” The nurse notes that the route is missing from the order. What is the nurse’s best action Contact the prescriber to clarify the route of the medication ordered. When the nurse considers the timing of a drug dose, which factor is appropriate to consider when deciding when to give a drug The patient’s last meal The patient is complaining of a headache and asks the nurse which over-the- counter medication form would work the fastest to help reduce the pain. Which medication form will the nurse suggest A powder The nurse will be injecting a drug into the fatty tissue of the patient’s abdomen. Which route does this describe Subcutaneous Which drugs would be affected by the first-pass effect (Select all that apply.) Diphenhydramine (Benadryl) elixir Levothyroxine (Synthroid) tablets Esomeprazole (Nexium) capsules Chapter 3 Drug transfer to the fetus is more likely during the last trimester of pregnancy for which reason Enhanced blood flow to the fetus The nurse is monitoring a patient who is in the 26th week of pregnancy and has developed gestational diabetes and pneumonia. She is given medications that pose a possible fetal risk, but the potential benefits may warrant the use of the medications in her situation. The nurse recognizes that these medications are in which U.S. Food and Drug Administration pregnancy safety category Category D When discussing dosage calculation for pediatric patients with a clinical pharmacist, the nurse notes that which type of dosage calculation is used most commonly in pediatric calculations Milligram per kilogram of body weight formula The nurse is assessing a newly admitted 83-year-old patient and determines that the patient is experiencing polypharmacy. Which statement most accurately illustrates polypharmacy The patient uses multiple medications simultaneously. The nurse is aware that confusion, forgetfulness, and increased risk for falls are common responses in an elderly patient who is taking which type of drug Sedatives For accurate medication administration to pediatric patients, the nurse must take into account which criteria Organ maturity The nurse recognizes that it is not uncommon for an elderly patient to experience a reduction in the stomach’s ability to produce hydrochloric acid. This change may result in which effect Altered absorption of weakly acidic drugs The nurse is administering drugs to neonates and will consider which factor may contribute the most to drug toxicity The liver is not fully developed. An 83-year-old woman has been given a thiazide diuretic to treat mild heart failure. She and her daughter should be told to watch for which problems Fatigue, leg cramps, and dehydration An elderly patient with a new diagnosis of hypertension will be receiving a new prescription for an antihypertensive drug. The nurse expects which type of dosing to occur with this drug therapy The patient will receive the lowest possible dose at first, and then the dose will be increased as needed. The nurse is trying to give a liquid medication to a -year-old child and notes that the medication has a strong taste. Which technique is the best way for the nurse to give the medication to this child Give the medication with a spoonful of ice cream. The nurse is preparing to give an injection to a 4-year-old child. Which intervention is age appropriate for this child Offer a brief, concrete explanation of the procedure at the patient’s level and with the parent or caregiver present. Which statements are true regarding pediatric patients and pharmacokinetics (Select all that apply.) The levels of microsomal enzymes are decreased. Perfusion to the kidneys may be decreased and may result in reduced renal function. First-pass elimination is reduced because of the immaturity of the liver. Gastric emptying is slowed because of slow or irregular peristalsis Which statements are true regarding the elderly and pharmacokinetics (Select all that apply.) The levels of microsomal enzymes are decreased. Fat content is increased because of decreased lean body mass. The number of intact nephrons is decreased. Gastric pH is less acidic. Chapter 4 During the development of a new drug, which would be included in the study by the researcher to prevent any bias or unrealistic expectations of the new drug’s usefulness A placebo A member of an investigational drug study team is working with healthy volunteers whose participation will help to determine the optimal dosage range and pharmacokinetics of the drug. The team member is participating in what type of study Phase I During discharge patient teaching, the nurse reviews prescriptions with a patient. Which statement is correct about refills for an analgesic that is classified as Schedule C-III The patient may have no more than five refills in a 6-month period. During a period of time when the computerized medication order system was down, the prescriber wrote admission orders, and the nurse is transcribing them. The nurse is having difficulty transcribing one order because of the prescriber’s handwriting. Which is the best action for the nurse to take at this time Contact the prescriber to clarify the order. When taking a telephone order for a medication, which action by the nurse is most appropriate Repeat the order to the prescriber before hanging up the telephone. The nurse can prevent medication errors by following which principles (Select all that apply.) Use two patient identifiers before giving medications. Do not give a medication that another nurse has drawn up in a syringe. Minimize the use of verbal and telephone orders. Chapter 6 Which nursing diagnosis is appropriate for the patient who has just received a prescription for a new medication Deficient knowledge related to newly prescribed drug therapy The nurse is developing a care plan for a patient who will be self- administering insulin injections. Which statement reflects a measurable outcome The patient will demonstrate the proper technique of self- administering insulin injections. During a nursing assessment, which question by the nurse allows for greater clarification and additional discussion with the patient “What medications do you take” The nurse is setting up a teaching session with an 85-year-old patient who will be going home on anticoagulant therapy. Which educational strategy would reflect consideration of the age-related changes that may exist with this patient Develop large-print handouts that reflect the verbal information presented. When the nurse teaches a skill such as self-injection of insulin to the patient, what is the best way to set up the teaching/learning session After demonstrating the procedure, allow the patient to do several return demonstrations. A patient with a new prescription for a diuretic has just reviewed with the nurse how to include more potassium in her diet. This reflects learning in which domain Cognitive During an admission assessment, the nurse discovers that the patient does not speak English. Which is considered the ideal resource for translation A translator who does not know the patient The nurse is teaching a 16-year-old patient who has a new diagnosis of type 1 diabetes about blood glucose monitoring and the importance of regulating glucose intake. When developing a teaching plan for this teenager, which of Erikson’s stages of development should the nurse consider Identity versus role confusion A 60-year-old patient is on several new medications and expresses worry that she will forget to take her pills. Which action by the nurse would be most helpful in this situation Assisting the patient with obtaining and learning to use a calendar or pill container Which are appropriate considerations when the nurse is assessing the learning needs of a patient (Select all that apply.) Cultural background Level of education Readiness to learn Health beliefs Chapter 7 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 herbal remedies that she wants to buy so that she can “avoid taking any drugs.” Which statement by the nurse is correct “It’s important to remember that herbal remedies do not have proven safety ratings for pregnant women.” “Drink a full glass of water with each dose.” The nurse is monitoring a patient who has been on antibiotic therapy for 2 weeks. Today the patient tells the nurse that he has had watery diarrhea since the day before and is having abdominal cramps. His oral temperature is 101° F (38.3° C). Based on these findings, which conclusion will the nurse draw The patient needs to be tested for Clostridium difficile infection. The nurse is monitoring for therapeutic results of antibiotic therapy in a patient with an infection. Which laboratory value would indicate therapeutic effectiveness of this therapy Decreased white blood cell count The nurse is reviewing the sputum culture results of a patient with pneumonia and notes that the patient has a gram-positive infection. Which generation of cephalosporin is most appropriate for this type of infection First generation A patient will be having oral surgery and has received an antibiotic to take for 1 week before the surgery. The nurse knows that this is an example of which type of therapy Prophylactic A patient has a urinary tract infection. The nurse knows that which class of drugs is especially useful for such infections Sulfonamides During drug therapy for pneumonia, a female patient develops a vaginal superinfection. The nurse explains that this infection is caused by: large doses of antibiotics that kill normal flora. The nurse is preparing to use an antiseptic. Which statement is correct regarding how antiseptics differ from disinfectants Disinfectants are used only on nonliving objects to destroy organisms. A patient with a long-term intravenous catheter is going home. The nurse knows that if he is allergic to seafood, which antiseptic agent is contraindicated Povidone-iodine (Betadine) During antibiotic therapy, the nurse will monitor closely for signs and symptoms of a hypersensitivity reaction. Which of these assessment findings may be an indication of a hypersensitivity reaction (Select all that apply.) Wheezing Shortness of breath Swelling of the tongue Itching The nurse is reviewing the medication history of a patient who will be taking a sulfonamide antibiotic. During sulfonamide therapy, a significant drug interaction may occur with which of these drugs or drug classes (Select all that apply.) Oral contraceptives Sulfonylureas Phenytoin (Dilantin) Warfarin (Coumadin) Chapter 39 When a patient is on aminoglycoside therapy, the nurse will monitor the patient for which indicators of potential toxicity Tinnitus and dizziness The nurse is administering a vancomycin (Vancocin) infusion. Which measure is appropriate for the nurse to implement in order to reduce complications that may occur with this drug’s administration Infusing the drug over at least 1 hour Which nursing diagnosis is appropriate for a patient who has started aminoglycoside therapy Risk for injury (renal damage) A patient who has been hospitalized for 2 weeks has developed a pressure ulcer that contains multidrug-resistant Staphylococcus aureus (MRSA). Which drug would the nurse expect to be chosen for therapy Vancomycin (Vancocin) A patient is receiving aminoglycoside therapy and will be receiving a beta- lactam antibiotic as well. The patient asks why two antibiotics have been ordered. What is the nurse’s best response “The combined effect of both antibiotics is greater than each of them alone.” The nurse is reviewing the medication orders for a patient who will be receiving gentamicin therapy. Which other medication or medication class, if ordered, would be a potential interaction concern Loop diuretics The nurse checks the patient’s laboratory work prior to administering a dose of vancomycin (Vancocin) and finds that the trough vancomycin level is 24 mcg/mL. What will the nurse do next Hold the drug, and notify the prescriber. A patient has been diagnosed with carbapenemase-resistant Enterobacteriaceae (CRE). The nurse expects to see orders for which drug Colistimethate sodium (Coly-Mycin), a polypeptide antibiotic A 79-year-old patient is receiving a quinolone as treatment for a complicated incision infection. The nurse will monitor for which adverse effect that is associated with these drugs Tendonitis and tendon rupture The nurse is administering intravenous vancomycin (Vancocin) to a patient who has had gastrointestinal surgery. Which nursing measures are appropriate (Select all that apply.) Monitoring serum creatinine levels Warning the patient that a flushed feeling or facial itching may occur Instructing the patient to report dizziness or a feeling of fullness in the ears Reporting a trough drug level of 24 mcg/mL and holding the drug The nurse is discussing adverse effects of antitubercular drugs with a patient who has active tuberculosis. Which potential adverse effect of antitubercular drug therapy should the patient report to the prescriber Numbness and tingling of extremities A patient who has been taking isoniazid (INH) has a new prescription for pyridoxine. She is wondering why she needs this medication. The nurse explains that pyridoxine is often given concurrently with the isoniazid to prevent which condition Peripheral neuropathy The nurse will assess the patient for which potential contraindication to antitubercular therapy Hepatic impairment When monitoring patients on antitubercular drug therapy, the nurse knows that which drug may cause a decrease in visual acuity Ethambutol (Myambutol) A patient has been taking antitubercular therapy for 3 months. The nurse will assess for what findings that indicate a therapeutic response to the drug therapy There is a decrease in symptoms of tuberculosis along with improved chest x-rays and sputum cultures. The nurse is counseling a woman who will be starting rifampin (Rifadin) as part of antitubercular therapy. The patient is currently taking oral contraceptives. Which statement is true regarding rifampin therapy for this patient Oral contraceptives are less effective while the patient is taking rifampin. The nurse is reviewing the medication administration record of a patient who is taking isoniazid (INH). Which drug or drug class has a significant drug interaction with isoniazid Phenytoin (Dilantin) A patient who has started drug therapy for tuberculosis wants to know how long he will be on the medications. Which response by the nurse is correct “You should expect to take these drugs for as long as 24 months.” The nurse is preparing to administer morning medications to a patient who has been newly diagnosed with tuberculosis. The patient asks, “Why do I have to take so many different drugs” Which response by the nurse is correct “Taking multiple drugs reduces the chance that the tuberculosis will become drug resistant.” A patient newly diagnosed with tuberculosis (TB) has been taking antitubercular drugs for 1 week calls the clinic and is very upset. He says, “My urine is dark orange! What’s wrong with me” Which response by the nurse is correct “This is an expected side effect of the medicine. Let’s review what to expect.” The nurse is providing patient teaching for a patient who is starting antitubercular drug therapy. Which of these statements should be included (Select all that apply.) “Take the medications at the same time every day.” “Avoid alcoholic beverages while on this therapy.” Chapter 42 During an intravenous (IV) infusion of amphotericin B, a patient develops tingling and numbness in his toes and fingers. What will the nurse do first Discontinue the infusion immediately. If a patient is taking fluconazole (Diflucan) with an oral anticoagulant, the nurse will monitor for which possible interaction Increased effects of oral anticoagulants The nurse is preparing an infusion of amphotericin B for a patient who has a severe fungal infection. Which intervention is appropriate regarding the potential adverse effects of amphotericin B Before beginning the infusion, administering an antipyretic and an antiemetic drug The nurse is administering one of the lipid formulations of amphotericin B. When giving this drug, which concept is important to remember The lipid formulations are associated with fewer adverse effects than the older drugs. The nurse is reviewing instructions for vaginal antifungal drugs with a patient. Which statement by the nurse is an appropriate instruction regarding these drugs “Abstain from sexual intercourse until the treatment has been completed and the infection has resolved.” A patient is infected by invasive aspergillosis, and the medical history reveals that the patient has not been able to tolerate several antifungal drugs. The nurse anticipates an order for which medication to treat this infection Caspofungin (Cancidas) A patient with a severe fungal infection has orders for voriconazole (Vfend). The nurse is reviewing the patient’s medical record and would be concerned if which assessment finding is noted History of cardiac dysrhythmias During therapy with amphotericin B, the nurse will monitor the patient for known adverse effects that would be reflected by which laboratory result Serum potassium level of 2.7 mEq/L A patient has received a prescription for a 2-week course of antifungal suppositories for a vaginal yeast infection. She asks the nurse if there is an alternative to this medication, saying, “I don’t want to do this for 2 weeks!” Which is a possibility in this situation A single dose of a fluconazole (Diflucan) oral tablet. A patient is taking nystatin (Mycostatin) oral lozenges to treat an oral candidiasis infection resulting from inhaled corticosteroid therapy for asthma. Which instruction by the nurse is appropriate “Let the lozenge dissolve slowly and completely in your mouth without chewing it.” orally. A patient has an order for cyclosporine (Sandimmune). The nurse finds that cyclosporine-modified (Neoral) is available in the automated medication cabinet. Which action by the nurse is correct Notify the pharmacy to obtain the Sandimmune form of the drug. The nurse is preparing to administer an injection of monoclonal antibodies. Which additional drug will the nurse administer to minimize adverse reactions to the monoclonal antibodies A corticosteroid When administering cyclosporine, the nurse notes that allopurinol is also ordered for the patient. What is a potential result of this drug interaction Increased levels of cyclosporine and toxicity The nurse is monitoring a patient who is receiving muromonab- CD3 (Orthoclone OKT3) after an organ transplant. Which effect is possible with muromonab-CD3 therapy Chest pain When monitoring a patient who is on immunosuppressant therapy with azathioprine (Imuran), the nurse will monitor which laboratory results White blood cell (leukocyte) count A patient with multiple sclerosis will be starting therapy with an immunosuppressant drug. The nurse expects that which drug will be used Glatiramer acetate (Copaxone) Cyclosporine is prescribed for a patient who had an organ transplant. The nurse will monitor the patient for which common adverse effect Hypertension The nurse follows which procedures when giving intravenous (IV) cyclosporine (Select all that apply.) Using an infusion pump to administer this medication Monitoring the patient closely for the first 30 minutes for severe adverse effects Checking blood levels periodically during cyclosporine therapy Performing frequent oral care during therapy A patient has started azathioprine (Imuran) therapy as part of renal transplant surgery. The nurse will monitor for which expected adverse effect of azathioprine therapy (Select all that apply.) Leukopenia Thrombocytopeni a Hepatotoxicity