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Pharm exam 4 questions with complete solution
1. Patient with Hypothyroidism clinical presentation r/t psychosocial: Depression
2. Budesonide is what class of medication?: Corticosteroid
3. A nurse is caring for a client undergoing a cosyntropin stimulation test. Thirty minutes after
administration, the client's cortisol level remains low. How should the nurse interpret this finding? A. The client likely has secondary adrenal insufficiency due to pituitary dys-function.B. The client likely has primary adrenal insufficiency due to adrenal gland failure.C. The client has a normal response and does not have adrenal insufficiency.D. The client is experiencing an Addisonian crisis and needs immediate IV steroids.: B. The client likely has primary adrenal insuflciency due to adrenal gland failure
4. Does Levothyroxine require bloodwork?: Yes, TSH Every few weeks until pt
reaches therapeutic level
5. Pharmacotherapy of type 2 DM is initiated with what first line Med?: Metformin
6. A major advantage of Metformin is that it does not cause
But it can cause lactic acidosis and a metallic taste.: Hypoglycemia
7. What medication is contraindicated for 2 days prior to and 2 days after receiving IV radiographic
contrast.: Metformin
8. Tx for Diabetes Insipidus: Desmopressin
9. Patient with Hyperthyroidism clinical presentation r/t psychosocial: Bipolar/Ma-nia
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10. Hyperthyroidism concerns:: Weight loss Diarrhea
Risk of overheating (Heat Intolerance)
11. What is the priority intervention for a diabetic patient in HHS?: Fluid Replacement
- Start with 0.9% normal saline (NS) Then regular insulin
12. Graves Disease =: Hyperthyroidism
13. What medication is used to lower thyroid hormone secretion by destroying part of the gland (ablation)?:
Radioactive iodine
14. Tx for Hypothyroidism: Levothyroxine
15. Examples of Rapid acting insulins are:: All of the above
16. Tx for Hyperthyroidism (Most often d/t adverse effects of Methimazole): -
thyroidectomy
17. Pharmacological Tx for hyperthyroidism:
Rationale: Methimazole - less frequent dosing and fewer adverse effects. Propylthiouracil - preferred during pregnancy or Pt unable to tolerate methi-mazole.: Methimazole (First line) Propylthiouracil
18. Methimazole side effects: Fetal Harm (Pregnancy test!) Liver toxicity
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25. Thyroid Replacement Drug:: Levothyroxine
26. Use of in the treatment of obesity or weight loss is
contraindicated.: Levothyroxine (thyroid hormone)
27. Corticosteroid use carries the following risks:: PUD Hyperglycemia
Infection Weight gain Hypokalemia, Hypernatremia Osteoporosis HTN Audio/visual hallucinations
28. Corticosteroids are contraindicated for patients with what condition?: Glau-coma
29. Best indicator for long-term glucose control:: A1C
30. Can you combine long acting insulin with a short acting insulin in the same syringe?: No!
31. Should a patient be eating during or shortly after a rapid insulin is admin-istered?
Rational: 5-10 min before a meal: YES!
32. What is the most common complaint with Antidiabetic drugs?: Nausea, diarrhea, gas (Gas)
33. What is the biggest concern with metformin?: Lactic Acidosis (Liver impairment)
34. Is DKA most often associated with type 1 or type 2?: Type 1
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35. Excessive dosing of Erythropoietin may lead to which of the following complications, and what
treatment is used to manage it?: Polycythemia treated with Phlebotomy Or Dialysis
36. What are the adverse effects of EPO therapy due to Polycythemia ?: 1. MI
2. HTN and Tachy
3. DVT
37. What is the Black Box Warning for EPO?: Cardiovascular and Thromboembolic Events (DVT, PE, MI, Stroke)
Tumor Progression
38. Spleen rupture is associated with which Hematopoietic growth factor med-ication?: Filgrastim and
Eltrombopag
39. Flulike symptoms, and thrombocytopenia (which increase bleeding risk) Are associated with what
medication?: Filgrastim
40. What are the three colony-stimulating factor medications that are indicated to increase WBC count?: All of
the above
41. What lab values does the nurse anticipate checking for anyone taking Filgrastim?: Leukocytes
Neutrophils (ANC) Target range is 1,500-10,
42. A patient taking ferrous sulfate (Iron) develops dark stool, is this a cause for concern?: NO
43. Bone pain occurs in a significant number of people taking
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52. What medication carries a black box warning of potential Anaphylaxis with parenteral (IM, IV)
administration?: Ferrous Sulfate
53. What is the antidote for ferrous sulfate?: Deferoxamine
54. What increases absorption of iron supplements like ferrous sulfate?: Orange juice and Strawberries (Any foods high in
Vit. C)
55. T or F: B12 deficiency (Pernicious anemia) can present with nervous system symptoms like memory
loss, confusion, unsteadiness, tingling or numbness in the limbs, delusions, mood disturbances, and even hallucinations in severe deficiencies.: True
56. T or F: Folate deficiency signs are the same as those for B12 deficiency; however, no neurologic
signs are present.: True
57. iron deficiency most commonly occurs in women of
childbearing age due to blood losses during and .: Menses; Pregnancy
58. Folic acid supplementation decreases the occurrence of neural tube defects (NTDs) like:: anencephaly
spina bifida.
59. **What are the parenteral iron supplements for a patient unable to take PO preparations?: Iron sucrose
Iron dextran
60. Ferrous sulfate IM injections: Z-track method
61. An older adult patient diagnosed with iron-deficiency anemia will be taking ferrous sulfate (Feosol).
The nurse will teach which of the required adminis-tration guidelines to the patient?: All of the above
62. A nurse is caring for a patient with a severe viral illness who is experiencing thrombocytopenia.
8 / 16 Which of the following statements regarding treatment options is true? Rationale: Corticosteroids such as prednisone decrease the production of antiplatelet antibodies and increase the platelet count; therapy is recommended for only 6 weeks because of the potential for significant adverse effects with extended use.: Therapy with corticosteroids is recommended for a maximum of 6 weeks.
63. To best monitor for therapeutic effects from filgrastim (Granix, Neupogen), the nurse will assess which
laboratory finding?: White blood cell or absolute neutrophil counts
64. Darbepoetin (Aranesp) is ordered for each of the following patients. The nurse would question the
order for which condition?: A patient with HTN
65. When planning to teach the patient about the use of epoetin alfa (Epogen, Procrit), which instructions
would the nurse give?: Frequent rest periods should be taken to avoid excessive fatigue.
66. A patient diagnosed with pernicious anemia is to start cyanocobalamin injections. Which patient
statements demonstrates an understanding of the nurse's teaching?: All of the above
67. A nurse is caring for a client receiving filgrastim. Which of the following assessments is the
highest priority? Rationale: Clients receiving filgrastim are at risk for infection due to low WBC counts. Monitoring for fever (temperature) and increased heart rate (pulse) helps detect early signs of infection.: Assessing pulse and temperature every 4 hours
68. Which of the following instructions should the nurse include when teaching a client how to
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72. Side effects of corticosteroids: adrenal suppression (> 2 week treatment)
Iatrogenic Cushing's syndrome hyperglycemia impaired wound healing osteoporosis peptic ulcers myopathy
73. Cancer Meds antineoplastics share what common side effect?: Myelosuppression
(Bone marrow suppression) Anemic, Risk for infection, Risk for Bleeding Requires Neutropenic Precautions
74. Neutropenic precautions: Reverse isolation ’private room,
Fever ’Requires antibiotics immunocompromised ’No walking barefoot, strict hygiene, no raw veggies/fruits, avoid crowds, avoid children, cook food thoroughly
75. Is cyclophosphamide ok during pregnancy?: No
76. The antineoplastic Cyclophosphamide cause what Adverse effects?: Bone Marrow Suppression (Neutropenia,
Anemia, Thrombocytopenia)
77. When you hear bone marrow suppression what should come to mind?: Pan-cytopenia (“All Blood Cells)
Anemia ’fatigue, pallor, SOB Leukopenia (esp. neutropenia) ’‘infection risk Thrombocytopenia ’bruising, petechiae, bleeding risk
78. When you hear Polycythemia what should come to mind?: Too Many Red Blood
11 / 16 Cells ‘RBCs ’‘hematocrit (Hct) and hemoglobin (Hgb) ‘Blood viscosity ’thicker, slower-moving blood Polycythemia increases the risk of clots, strokes, and MI. TX= Phlebotomy or Dialysis
79. A patient is diagnosed with neutropenia when the neutrophil count is less
than cells/mL.: 1500
80. Before administering intravenous (IV) antineoplastic drugs, nurses should:-
: know the emergency treatment for extravasation.
81. Antineoplastics with strong vesicant activity include the following:: daunoru-bicin
vincristine vinblastine
82. Should you get pregnant while on Methotrexate?: NO!
83. Should you take concurrent NSAIDs with Methotrexate?: NO - leads to fatal myelo-suppression
84. What are the associated toxicities of Methotrexate?: Pulmonary Neuro
Nephro Hepatotoxicity
85. What is a critical nursing intervention for a patient receiving methotrexate
therapy?: 1. monitoring for signs of myelosuppression, such as infection or anemia
2. ensuring proper dosing and administration of leucovorin to mitigate toxicity
3. No NSAIDs
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94. "The most serious complication of desmopressin is
Rationale: Nurses must restrict fluids, monitor serum sodium, and assess for neurologic symptoms.": water intoxication leading to Hyponatremia
95. Cardiotoxic =: Doxorubicin
mitomycin mitoxantrone
96. Which drug reduces the degree of cardiac damage caused by antineoplastic drugs like Doxorubicin:
Dexrazoxane
97. Mucositis; Define: The epithelial lining of the digestive tract becomes inflamed
98. pharmacotherapy for Acromegaly: Octreotide Bromocriptine
99. Levothyroxine; indication: Hypothyroidism
100. Levothyroxine (T4) requires what lab work?
Rationale: High TSH levels usually indicate that the dosage of T4 needs to be increased.- : Serum therapeutic levels are used to assess the ettectiveness of a drug.
101. Left off at 10:00: Left ott at 10:
102. **Chronic corticosteroid use may lead to:: Audio/visual hallucinations
o
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103. Should Steroids ever be given to a patient with Glaucoma?: N
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115. What insulins should never be mixed with other insulins?: Long Action insulins like: Degludec
Detemir Glargine
