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Pharm Exam 2 Questions with Verified
Solution
1. A 50-year-old male patient reports having decreased libido and testicular
atrophy. The nurse will anticipate that the provider may order which medication to treat these symptoms?
a. Testosterone (Androderm)
b. Finasteride (Proscar)
c. Gonadotropin-releasing hormone (Gn-RH)
d. Sildenafil (Viagra): a. Testosterone (Androderm)
Testosterone is given to patients who have low testosterone, evidenced by decreased libido and testicular atrophy in adult men. Finasteride is given to treat benign prostatic hypertrophy. Gn-RH is used to inhibit testosterone production. Sildenafil is used to treat erectile dysfunction.
2. The nurse is teaching the parents of a boy who has inadequate pituitary
function and delayed puberty about testosterone enanthate injections. Which statement by the parents indicates a need for further teaching?
a. He will need x-rays of his hands every 6 months.
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b. Injections will be given deep into his gluteal muscles.
c. Sexual development will occur in 1 to 2 years.
d. We should report urinary tract problems immediately.: c. Sexual development will occur in
1 to 2 years. It takes 3 to 4 years for sexual development to occur with androgen therapy for hypogonadism, so parents should be reminded of this. X-rays are needed every 6 months to assess bone age. Injections are given deep intramuscularly into gluteal muscles. Urinary tract problems can occur and should be reported.
3. The nurse is instructing a patient about the buccal muco-adhesive testos-
terone system (Striant) to treat low testosterone. What information will the nurse include when teaching this patient about this drug?
a.If the product slides out of position more than 4 hours before the next dose, replace
it with a new system.
b. Place the flattened surface against the gum and hold it firmly in place for 30
seconds.
c.The product may be swallowed after it has been in place for at least 4 hours.
4 / 73 -The patient should apply two patches every day at 10PM. -The first day of use results in serum testosterone levels in the normal range, and serum levels do not accumulate with continued use.
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5. A man who has been using androgen therapy tells the nurse that he and his wife
wish to conceive a pregnancy. The nurse will tell this patient that:
a. androgen therapy will not harm the fetus.
b. he will need to increase his dose of testosterone to increase his sperm count.
c. It may take 3 months after cessation of androgen therapy to conceive.: c. It may take 3
months after cessation of androgen therapy to conceive. Androgens cause decreased sperm counts and usually takes 3 months after cessation of therapy to return sperm counts to normal. -During pregnancy, androgens can cross the placenta and cause masculinization of the fetus. -Virilization can occur in those secondarily exposed to testosterone gel and may cause teratogenic ettects in fetuses. -Increasing the testosterone will not increase the sperm count.
6. The nurse is teaching an adult male patient about the use of testosterone gel.
Which statement by the patient indicates understanding of the teaching?
a. A decreased urinary stream is an expected side effect.
b. I should apply the gel to my forearms every day
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b. 12 months
c. Indefinitely
d. Until symptoms resolve: c. Indefinitely
Continued treatment with finasteride is recommended in order to sustain results since reversal of ettect usually occurs within 1 year after cessation of the drug.
9. A 14-year-old male is being evaluated for delayed puberty. Which finding
indicates delayed puberty in this child?
a. Androgen deficiency
b. Growth hormone deficiency
c. Height of 2.5 standard deviations below the mean
d. Lack of epiphyseal closure: a. Androgen deficiency
Low androgen levels indicate delayed puberty. Patients who are short and who have not developed secondary sexual characteristics may have growth hormone deficiency, normal variations in development, or delayed puberty. Growth hormone deficiency may cause short stature.
10. A male patient wants to begin taking tadalifil (Cialis) to treat erectile
dys-function. Which aspect of this patients history would be of concern?
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a. Angina pectoris
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a. Sulfonamides are bactericidal.
b. Sulfonamides are derived from biologic substances.
c. Sulfonamides have antifungal and antiviral properties.
d. Sulfonamides increase bacterial synthesis of folic acid.: b. Sulfonamides are derived from
biologic substances. Sulfonamides are bacteriostatic, not bactericidal. They are not derived from biologic substances. They are not antifungals or antivirals. They act by decreasing bacterial synthesis of folic acid.
13. The nurse is counseling a patient who will begin taking a sulfonamide drug
to treat a urinary tract infection. What information will the nurse include in teaching?
a. Drink several quarts of water daily.
b. If stomach upset occurs, take an antacid.
c. Limit sun exposure to no more than 1 hour each day.: a. Drink several quarts of water daily.
Patients should drink several quarts of water daily while taking sulfonamides to prevent crystalluria. Patients should not take antacids with sulfonamides. Patients should not go out into the sun. Sore throat should be reported.
14. A female patient who is taking trimethoprim-sulfamethoxazole (TMP-SMZ)
(Bactrim, Septra) to treat a urinary tract infection reports vaginal itching and discharge. The nurse will perform
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a. Ask the patient if she might be pregnant.
b. Reassure the patient that this is a normal side effect.
c. Report a possible superinfection to the provider.
d. Suspect that the patient is having a hematologic reaction.: c. Report a possible
superinfection to the provider. Superinfection can occur with a secondary infection. Vaginal itching and discharge is a sign of superinfection. This is not symptomatic of pregnancy. These are not common side ettects and do not indicate a hematologic reaction.
15. A patient who will begin taking trimethoprim-sulfamethoxazole (TMP-SMX)
asks the nurse why the combination drug is necessary. The nurse will explain that the combination is used to
a. broaden the antibacterial spectrum.
b. decrease bacterial resistance
c. improve the taste
d. minimize toxic effects: The combination drug is used to decrease bacterial resistance to sulfonamides. It does not
broaden the spectrum, improve the taste, or decrease toxicity. DIF:
16. The nurse is preparing to administer trimethoprim-sulfamethoxazole
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c. an increased dose of warfarin
d. coagulation studies: d. coagulation studies
Sulfonamides can increase the anticoagulant ettects of warfarin. The nurse should request INR levels. An increased dose of warfarin would likely lead to toxicity and to undesirable anticoagulation.
18. 7. A patient who is taking trimethoprim-sulfamethoxazole (TMP-SMX) calls
to report developing an all-over rash. The nurse will instruct the patient to perform which action?
a. Increase fluid intake.
b. Take diphenhydramine.
c. Stop taking TMP-SMX immediately.: c. Stop taking TMP-SMX immediately.
A rash can indicate a serious drug reaction. Patients should stop taking the drug immediately and notify the provider.
19. The nurse is caring for a patient who is receiving sulfadiazine. The nurse
knows that this patients daily fluid intake should be at least which amount?
a. 1000 mL/day
b. 1200 mL/day
c. 2000 mL/day: c. 2000 mL/day
14 / 73 To prevent crystalluria, patients should consume at least 2000 mL/day.
20. A patient taking trimethoprim-sulfamethoxazole (TMP-SMX) to treat a
uri-nary tract infection complains of a sore throat. The nurse will contact the provider to request an order for which laboratory test(s)?
a. Complete blood count with differential
b. Throat culture
c. Urinalysis
d. Coagulation studies: a. Complete blood count with ditterential
A sore throat can indicate a life-threatening anemia, so a complete blood count with ditterential should be ordered.
21. 10. The nurse is caring for a patient who is ordered to receive PO trimetho-
prim-sulfamethoxazole (TMP-SMX) 160/800 QID to treat a urinary tract infection caused by E. coli. The nurse will contact the provider to clarify the correct
a. dose.
b. drug.
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c. Electrolytes: c. Electrolytes
TMP-SMX can result in hyperkalemia when taken with an ACE inhibitor.
24. A child who weighs 10 kg will begin taking oral trimethoprim-sulfamethox-
azole (TMP-SMX). The liquid preparation contains 40 mg of TMP and 200 mg of SMX per 5 mL. The nurse determines that the childs dose should be 8 mg of TMP and 40 mg of SMX/kg/day divided into two doses. Which order for this child is correct?
a. 5 mL PO BID
b. 5 mL PO daily
c. 10 mL PO BID
d. 10 mL PO daily: a. 5 mL PO BID
This child should receive (10 kg 8 mg) 80 mg of TMP and (10 kg 40 mg) 400 mL of SMX per day. When divided into two doses, the correct dose is 40 mg TMP and 200 mg SMX, or 5 mL per dose.
25. The nurse is caring for a patient who is receiving an intravenous antibiotic.
The nurse notes that the provider has ordered serum drug peak and trough levels. The nurse under-stands that these tests are necessary
17 / 73 for which type of drugs?
a. Drugs with a broad spectrum
b. Drugs with a narrow spectrum
c. Drugs with a broad therapeutic index
d. Drugs with a narrow therapeutic index: d. Drugs with a narrow therapeutic index
Medications with a narrow therapeutic index have a limited range between the therapeutic dose and a toxic dose. It is important to monitor these medications closely by evaluating regular serum peak and trough levels.
26. The nurse is caring for a patient who is receiving an intravenous antibiotic.
The patient has a serum drug trough of 1.5 mcg/mL. The normal trough for this drug is 1.7 mcg/mL to 2.2 mcg/mL. What will the nurse expect the patient to experience?
a. Inadequate drug effects
b. Increased risk for superinfection
c. Minimal adverse effects
d. Slowed onset of action: a. Inadequate drug ettects
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b. cross-resistance.
c. inherent bacterial resistance.
d. transferred resistance.: a. acquired bacterial resistance.
Acquired resistance occurs when an organism has been exposed to the antibacterial drug. Cross-resistance occurs when an organism that is resistant to one drug is also resistant to another. Inherent resistance occurs without previous exposure to the drug. Transferred resistance occurs when the resistant genes of one organism are passed to another organism.
29. 17. The nurse is preparing to administer amoxicillin (Amoxil) to a patient
and learns that the patient previously experienced a rash when taking penicillin. Which action will the nurse take?
a. Administer the amoxicillin and have epinephrine available.
b. Ask the provider to order an antihistamine.
c. Contact the provider to discuss using a different antibiotic.
d. Request an order for a beta-lactamase resistant drug.: c. Contact the provider to discuss
using a ditterent antibiotic. Patients who have previously experienced manifestations of allergy to a penicillin should not use penicillins again unless necessary. The nurse should contact the provider to discuss using another antibiotic from a
20 / 73 ditterent class. Epinephrine and antihistamines are useful when patients are experiencing allergic reactions, depend-ing on severity
30. 18. The nurse is preparing to administer an antibiotic to a patient who has
been receiving the antibiotic for 2 days after a culture was obtained. The nurse notes increased erythema and swelling, and the patient has a persistent high fever of 39 C. What is the nurses next action?
a. Administer the antibiotic as ordered.
b. Contact the provider to request another culture.
c. Discuss the need to add a second antibiotic with the provider.
d. Review the sensitivity results from the patients culture.: d. Review the sensitivity results from
the patients culture. The sensitivity results from the patients culture will reveal whether the organism is sensitive or resistant to a particular antibiotic. The patient is not responding to the antibiotic being given, so the antibiotic should be held and the provider notified. Another culture is not indicated. Antibiotics should be added only when indicated by the sensitivity.
31. The nurse is preparing to administer the first dose of an antibiotic to a
patient admitted for a urinary tract infection. Which action is most important prior to administering the antibiot-ic?
