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Pharmcology Final

Question	Answer
Initial assessment of the child with ADHD includes ______________.	obtaining a summary of the child’s behavior pattern
When assessing the patient receiving doxapram for chronic pulmonary disease, the nurse observes the patient for adverse reactions, which may include _______________.	headache, dizziness, variations in heart rate
When teaching a patient with narcolepsy who is receiving an amphetamine, the nurse instructs the patient to _________________.	keep a record of how often periods of sleepiness occur keep a record of how often periods of sleepiness occur
When administering an amephetamine, the nurse first checks to see if the patient is taking or has taken a monoamine oxidase inhibitor (MAOI) because _______________.	the amphetamine is not given within 14 days of the MAOI
A child with ADHD is admitted to the pediatric unit for a fractured tibia. Dexmethylphenidate is prescribed 7.5 mg BID; when should those doses be given?	7 AM and 11 AM
Alprazolam (Xanax) is contraindicated in patients with ______________.	a psychotic disorder
Which of the following drugs is a schedule IV controlled substance?	chlordiazepoxide (Librium)
Which of the following is a sign of drug withdrawal and not an adverse reaction?	metallic taste
The benzodiazepines are pregnancy category D drugs that should not be taken while lactating because the newborn may become _______________.	lethargic and lose weight
A family member calls the nurse to report that the patient taking an antianxiety medication is hypotensive. The nurse instructs the family member to:	have the patient rise slower from a lying or sitting position
Which of these of these assessment should the nurse report immediately to the primary health provider?	respiration rate of 8 breaths/min
When giving a hypnotic to an elderly patient, the nurse is aware that ________________.	smaller doses of the drug are usually given to older patients
Which of the following points should be included in a teaching plan for a patient taking a sedative or hypnotic?	do not use any over the counter cold, cough, or allergy medications while taking a sedative or hypnotic
Which of the following sedatives/hypnotics is a pregnancy category X drug?	temazepam (Restoril)
An elderly women has arthritis in her lower back, and the pain keeps her awake at night. She asks if she can have a “sleeping pill.” In considering her request, the nurse must take into account that hypnotic medications might ______________.	not be the drug of choice when pain causes insomnia
When administering an antidepressant to a patient contemplating suicide, it is most important for the nurse to _________.	inspect the patient’s oral cavity to be sure the drug was swallowed
Which of the following adverse reactions would the nurse expect to find in a patient taking amitriptyline?	sedation and dry mouth
Clinical depression is suspected in which of the following patients?	line worker who lost his job in a manufacturing plant 3 months ago
Which of the following antidepressants would be most likely to cause the paitent to have a seizure?	bupropion
The nurse instructs the patient taking a MAOI not to eat foods containing _____________.	tyramine
Which of the following behaviors would the nurse expect to see in a patient experiencing TD?	rhythmic, involuntary movements of the tongue, face, mouth, or jaw
Which of the following symptoms would indicate to the nurse that a patient taking lithium is experiencing toxicity?	nausea, vomiting, diarrhea
Which of the following drugs is least likely to produce extrapyramidal effects?	risperidone
In giving discharge instructions to a patient taking lithium, the nurse stresses that the patient should.	increase oral fluid intake to approximately 3000 mL/day
The physician prescribes norepinephrine, a potent vasopressor, to be administered to a patient in shock. The rate of the administration of the IV fluid containing the norepinephrine is:	adjusted per protocol to maintain the patient’s blood pressure
At what intervals would the nurse monitor the blood pressure of a patient administered norepinephrine?	every 5 to 15 minutes
Which of the following are the common adverse reactions the nurse would expect with the administration of the adrenergic drugs?	headache, nervousness, nausea
When dobutamine is administered with the b-adrenergic blocking drugs, the nurse is aware of an increased risk for ___________.	hypertension
A patient is to receive a b-adrenergic drug for hypertension. Before the drug is administered, the most important assessment the nurse performs is _______________.	taking the blood pressure on both arms
When an adrenergic blocking drug is given for a life-threatening cardiac arrhythmia, which of the following activities would the nurse expect to be a part of patient care?	cardiac monitoring
To prevent complications when administering a b-adrenergic blocking drug to an elderly patient, the nurse would be particularly alert for ___________.	vascular insufficiency (e.g., weak peripheral pulses and cold extremities)
The patient with glaucoma will likely receive a(n) _____________.	a-adrenergic blocking drug
The primary health care provider prescribes 60 mg propranolol to be given via the GI tube. The oral solution with strength of 5 mg/mL. The nurse uses 30 mL of warm water to flush before and after administering the drug. The total volume	72 mL of water and drug solution
A patient with glaucoma is prescribed pilocarpine eye drops. One adverse reaction that the nurse will expect with the use of this drug is ___________.	temporary loss of visual acuity
The primary care provider allows the patient to keep pilocarpine eye drops at the bedside and to self-administer the eye drops four times daily. The nurse _____________.	must check the patient to be sure the medication is used properly and at the right time
A patient has received a diagnosis of myasthenia gravis and begins a regimen of ambenonium. The nursing assessment is important because the dose of the drug ____________.	frequently is increased or decreased early in therapy
A patient taking solifenacin (Vesicare) for an overactive bladder complains of dry mouth. The nurse should ___________.	encourage the patient to take frequent sips of water
Which of the following adverse reactions would the nurse expect after the administration of atropine as part of a patient’s preoperative medication regimen?	reduced secretions of the upper respiratory tract
Because of the effect of cholinergic blocking drugs on intestinal motility, the nurse must monitor the patient taking these drugs for the development of _____________.	constipation
Cholinergic blocking drugs are contraindicated in patients with __________.	glaucoma
Adverse reactions that the nurse would assess for in a patient taking rivastigmine (Exelon) include ___________.	vomiting
When administering tacrine (Cognex) to a patient with AD, the nurse would most likely expect which laboratory tests to be prescribed?	liver function studies
Which of the following nursing diagnoses would the nurse most likely place on the care plan of a patient with AD that is related to adverse reactions of the cholinesterase inhibitors?	imblanced nutrition
The nurse correctly administers donepezil (Aricept) ___________.	once daily at bedtime
The nurse correctly disposes of the rivastigmine transdermal patch by:	folding it over so the adhesive side sticks together
The most serious adverse reactions seen with levodopa include ___________.	choreiform and dystonic movements
Elderly patients prescribed one of the dopamine receptor agonists are monitored closely for which of the following adverse reactions?	hallucinations
When taking a cholinergic blocking drug for parkinsonism, the patient would mostly experience which of the following adverse reactions?	dry mouth, dizziness
The patient taking tolcapone for Parkinson’s disease is monitored closely for ______________.	liver dysfunction
The nurse reports which of the following as a diminished response to antiparkinson drug treatment rather than an adverse reaction:	increased hand tremor
A patient is prescribed phenytoin for a recurrent convulsive disorder. The nurse informs the patient that the most common adverse reactions are ____________.	related to the CNS
When administering pehnobarbital to an elderly patient, the nurse should monitor the patient for unusual effects of the drug such as __________.	marked excitement
When caring for a patient taking a succinimide for seizure control, the nurse monitors the patient for blood dyscrasias. Which of the following symptoms would indicate that the patient may be developing a blood dyscrasia?	sore throat, general malaise
Which statement would be included when educating the patient taking trimethadione for seizures?	wear a sunscreen and protective blothing when exposed to sunlight
Which of the following adverse reactions, if observed in a patient prescribed phenytoin, would indicate that the patient may be developing phenytoin toxicity?	ataxia
When administering a skeletal muscle relaxant, the nurse observes the patient for the most common adverse reaction, which is ___________.	drowsiness
When a patient is prescribed alendronate (Fosamax) for osteoporosis, the nurse administers the drug _____.	30 minutes before breakfast
When allopurinol (Zyloprim) is used for treating gout, the nurse _________.	encourages liberal fluid intake
What teaching points would the nurse include when educating the patient who will begin taking risedronate?	after taking the drug, remain upright for at least 30 minutes
When administering a DMARD drug subcutaneously, the nurse should:	rotate sites to minimize tissue irritation
At a team conference, the nurse explains that the anti-inflammatory actions of the salicylates are most likely due to:	the inhibition of prostaglandins
Which of the following symptoms would the nurse expect in a patient experiencing salicylism?	Dizziness, tinnitus, mental confusion
When administering a salicylate, the nurse correctly administers the drug:	with food or milk
While taking acetaminophen, patients who consume alcohol habitually are monitored by the nurse for symptoms of toxicity, which include:	liver tenderness
Which of the following drugs would the nurse most likely administer to a child with an elevated temperature?	Acetaminophen
A nurse instructs the patient taken aspirin to avoid foods containing salicylates because this increases the risk of adverse reactions. Which foods should the patient avoid?	Prunes, tea
The nurse monitors for which of the common adverse reactions when administering naproxen to a patient?	Headache, dyspepsia
An elderly patient is receiving sulindac. The nurse is aware that older adults taking NSAIDs are at increased risk for _______________.	ulcer disease
When a patient is receiving an NSAID, the nurse must monitor the patient for ______________.	GI symptoms, which can be serious and sometimes fatal
Which of the following statements would the nurse be certain to include in a teaching plan for the patient taking an NSAID?	Avoid the use of aspirin or other salicylates when taking these drugs
The nurse teaches a patient to self administer sumatriptan; when is this injection contraindicated?	weekly prophylactic use
The nurse explains to the patient that some opioids may be used as part of the preoperative medication regimen to _______________.	lessen anxiety and sedate the patient
Each time the patient requests an opioid analgesic, the nurse must ___________. check the patient’s diagnosis	determine the exact location and intensity of the pain
When administering opioid analgesics to an elderly patient, the nurse monitors the patient closely for __________.	confusion
When administering a timed-release medication to a patient, the nurse must be aware that _____.	it should not to crushed
Which of the following findings requires that the nurse immediately contact the primary health care provider?	Compliant of breakthrough pain
Which opioid antagonist would most likely be prescribed for treatment of a patient who is experiencing an opioid overdose?	naloxone
Which patient, given an opioid analgesic for acute pain, should the nurse monitor most closely for respiratory distress?	Man who has never used an opioid pain medication
When planning preoperative care, the nurse expects that a preanesthetic medication is given ____________ before the patient is transported to surgery.	30 minutes
Which of the following drugs is the most commonly used gas for general anesthesia?	Nitrous oxide
Neuroleptanalgesia is used to promote general quietness, reduce motor activity, and induce profound analgesia. Which of the following two drugs are used in combination to accomplish neuroleptanalgesia?	Fentanyl and droperidol
One use of skeletal muscle relaxants as part of general anesthesia is to:	facilitate insertion of the endotracheal tube
Which of the following would the nurse mostly likely choose to treat a hypoglycemic reaction?	orange juice
Which of the following would be the correct method of administering insulin glargine?	at bedtime
Which of the following symptoms would alert the nurse to a possible hyperglycemic reaction?	thirst, abdominal pain, nausea
A patient with diabetes received a glycosylated hemoglobin test result of 10%. This indicates?	poor blood glucose control
List in order the following steps in drawing up two types of insulin.	1.cleaning both vials, inject air into the Humulin N insulin vial 2.remove the needle from vial w/o fluid (insulin) on the needle 3.inject air into regular insulin vial, invert withdraw prescr. amount.4.remove air bodies the syringe, withdraw the Humuli
Which of the following adverse reactions would the nurse expect with the administration of clomiphene?	vasomotor flushes
Which of the following sings would lead the nurse to suspect a cushingoid appearance adverse reaction in a patient taking a corticosteroid?	moon face, hirsutism
Which of the following statements, if made by the patient, would indicate a possible adverse reaction to the administration of vasopressin?	“My stomach is cramping.”
Adverse reactions to the administration of fludrocortisone include?	edema, hypertension
Which of the following assessments would be most important for the nurse to make when a child receiving GH comes to the primary health care providers office?	height and weight
What adverse reaction is most likely to occur in the early days of therapy in a patient taking a thyroid hormone?	hyperthyroidism
The nurse informs the patient that therapy with a thyroid hormone may not produce a therapeutic response for?	several weeks or more
Which of the following symptoms best indicates that serious adverse reactions are developing in a patient receiving methimazole (Tapazole)?	fever, sore throat, bleeding from an injection site
Which of the following statements made by a patient would indicate to the nurse that the patient is experiencing an adverse reaction to radioactive iodine?	“My throat hurts when I swallow.”
Which of the following food allergies is of highest concern to the patient about to take radioactive iodine?	seafood
The nurse monitors the patient taking an anabolic steroid for the more severe adverse reactions, which include?	severe mental changes
The nurse must be aware that older men taking androgens are?	at increased risk for prostate cancer
When monitoring a patient taking an oral contraceptive, the nurse would observe the patient for signs of excess progestin. Which of the following reactions would indicate to the nurse that a patient has an excess of progestin?	nausea, early breakthrough bleeding
When teaching the patient taking an oral contraceptive for the first time, the nurse emphasizes the importance of taking?	the drug at the same time each day
A patient calls the outpatient clinic and says that she missed 1 day’s dose of her birth control pills. Which of the following statements would be most appropriate for the nurse to make for the patient?	Do not take an additional tablet but resume the regular schedule today.
When oxytocin is administered over a prolonged time, which of the following adverse reactions would be most likely to occur?	water intoxication
When the patient is receiving oxytocin, the nurse would notify the primary health care provider in which of the following conditions?	uterine contractions last more than 60 seconds or contractions occur more frequently than every 2 to 3 minutes.
Which of the following adverse reactions is most indicative of ergotism?	numbness, tingling of the extremities
During administration of ritodrine, in what position would the nurse most probably place the patient?	on the left side
Intravenous oxytocic and tocolytic drugs should be administered as?	secondary or piggybacked into a primary line
When evaluating the effectiveness of acetazolamide (diamox) given for acute glaucoma, the nurse questions the patient about?	the relief of eye pain
When administering spironolactone (Aldactone), the nurse monitors the patient closely for which of the following electrolyte imbalances?	hyperkalemia
When a diuretic is being administered for HF, which of the following would be most indicative of an effective response of diuretic therapy?	daily weight loss of 2lb
Which electrolyte imbalance would the patient receiving a loop or thiazide diuretic most likely develop?	hypokalemia
Which of the following foods would the nurse most likely recommend the patient include in the daily diet to prevent hypokalemia?	bananas
When a patient taking mannitol for increased intracranial pressure is being assessed, which of the following findings would be most important for the nurse to report?	urine output of 20mL for the last 2 hours
The nurse correctly administers nitrofurantoin (Macrodantin)	with food
To avoid raising the pH when taking methanamine (Hiprex), the nurse advises the patient to?	avoid the use of antacids 1 hour before or 2 hours after taking the drug
What instruction would be most important to give a patient prescribed fosfomycin (Monurol)?	this drug comes in a one-dose packet that must be dissolved in 90ml or more of fluids.
What statements would be included in a teaching plan for a patient prescribed phenazopyridine (Pyridium)?	this drug may turn the urine dark brown. This is an indication of a serious condition and should be reported immediately.
When discussing the possibility of adverse reactions after receiving a vaccine, the nurse tells the parents of a young child that?	adverse reactions are usually mild
Which of the following statements made by the patient would alert the nurse to a possibility of an allergy to the measles vaccine?	gelatin
What type of immunity does an antivenin produce?	passive immunity
What type of immunity is produced by the hepatitis B vaccine recombinant?	artificially-acquired advice immunity
The nurse is monitoring a patient receiving an IV infusion of RSV-IGIV globulin	itching
Which of the following findings would be the most indicative to the nurse that the patient has thrombocytopenia?	easy bruising
Which of the following adverse reactions to the antineoplastic drugs is most likely to affect the patient’s body image?	alopecia
When assessing the patient for leucopenia, the nurse?	monitors the patient for fever, sore throat, chills
Which of the following interventions would be most helpful for a patient with stomatitis?	provide frequent mouth care with normal saline
Which of the following is the most common symptom of extravasation?	swelling around the injection site
Which is the most common type of anemia?	iron deficiency anemia
Which of the following substances would decrease the absorption of oral iron?	antacids
Filgrastim are contraindicated in which of the following conditions?	hypothyroidism
When monitoring a patient taking epoetin alfa, which of the following laboratory results would be most important for the nurse to report immediately?	any increase in hematocrit of 4 points within a 2 wk period
When teaching a patient about the use of vitamin b 12, the nurse would include which of the following statements?	you will require vitamin b12 injections monthly for life
Peripheral – all the nerves that emerge CNS	12 cranial nerve ; 31 spinal nerves; autonomic NS
Nonopiod Analgesics: Salicylates and Nonsalicylates	Medication to manage pain, most subjective thing out there is pain. Pain depends on who you talk to. Don’t ever underestimate how much pain people are not. It is not measurable.)
Pain Assessment Nursing role in providing contraceptive care	Need to take patients report of pain seriously Understand patient’s pain level Teach patient to rate pain 0-10
***Salicylates Drugs derive from salicyclic acid	Useful in pain management due to analgesics, antipyretic, and anti-inflammatory effects
Salicylates	3 Main Functions: Reduce fever, pain, and inflammations
Salicylates: Actions and Uses	Lower body temperature Inhibit production of prostaglandins
Aspirin: Inhibits	prostaglandin synthesis and has greater anti-inflammatory effects; prolongs bleeding time
Salicylates: Adverse Reactions	Gastrointestinal (GI) reactions Gastric upset; heartburn; nausea; vomiting; anorexia; GI bleeding; allergy
Salicylates: Adverse Reactions	Significant blood loss Allergy to salicylates manifested by: Hives, rash, angioedema, bronchospasm, anaphylactoid reactions (confused with asthma patients)
Nonsalicylates: Actions	Actions Analgesic and antipyretic activity: Same as salicylates No anti-inflammatory action
Nonsalicylates ; Uses	Uses Used to treat mild to moderate pain; reduce elevated body temperature; manage pain and discomfort – arthritic disorders
What is the difference of salicylate and nonsalicylate?	Salicylate has an anti-inflammatory response vs. nonsalicylate that doesn’t.
Nonsalicylates: Actions and Uses	Useful for people with aspirin allergy; bleeding disorders; receiving anticoagulant therapy; who had recent minor surgical procedures
Nonsalicylates: Adverse Reactons	Adverse reactions: Skin eruptions; urticaria; hemolytic anemia; pancytopenia; hypoglycemia; jaundice; hetatoxicity; hepatic failure
Nursing Process: Assessment Preadministration assessment	Asses: Type, onset, intensity, location of pain Evaluate ability to carry out activities of daily living Develop a care plan Evaluate the response to drug therapy Ongoing Asse Monitor relief of pain; reassess pain rating 30 to 60 minutes
NSAIDs: Actions and Uses	Exact mechanism action unknown; thought to work by inhibiting action of enzyme cyclooxygenase responsible for prostaglandin synthesis
NSAIDs inhibit two related enzymes.	Inhibit activity of cyclooxygenerase-1 (COX-1); Enzyme helps to maintain the stomach lining Inhibit activity of cyclooxygerase-2 (COX-2); Enzyme triggers pain and inflammation
NSAIDs are most commonly used for LONG TERM TREATMENT OF PAIN	osteoarthritis, rheumatoid arthritis
NSAIDs: Adverse Reactions	Gastrointestinal system reactions Nausea, vomiting, dyspepsia, diarrhea, constipation, epigastric pain, indigestion, abdominal distress or discomfort, intestinal ulceration,, stomatitis, jaundice, bloating, anorexia, dry mouth
Stevens-Johnson Syndrome	life threatening condition of brain problems
NSAIDS: Contraindications	Ibuprofen – hypertension, peptic ulceration, or GI bleeding Celecoxib – allergic to sulfonamides, or history of cardiac disease or stroke
NSAIDs: Precautions	Cautious use: Pregnancy (pregnancy category B), elderly patients, patients with bleeding disorders, renal disease, cardiovascular disease, hepatic impairment
Opioid Analgesics Controlled substances	Do not change tissues where pain originates Change patient’s perception of pain Treat pain centrally in the brain
Opioid Analgesics	Opiates • Morphine • Heroin • Synthetic opioids
Opioid Analgesics: Actions	Cells within central nervous system Mu and kappa receptors Agonist agents Opioid analgesic Agonist Partial agonist Agonist-antagonist Non-intended responses
Opioid Analgesics: Uses	• Treat pain • Manage opiate dependence • Decrease anxiety • Support anesthesia adjunct • Promote obstetrical analgesia • Administered intrathecally/epidurally (spinal tap) • Treats: Severe diarrhea; intesti
Opioid Analgesics: Contraindications	Patients with hypersensitivity to drugs Acute bronchial asthma, emphysema, or upper airway obstruction Patients with head injury or increased intracranial reassure Convulsive disorders; severe renal or hepatic dysfunction; acute ulcerative colitis
Opioid Analgesics: Contraindications	Not recommended in pregnancy or labor
: Opioid (Narcotic) Antagonists • Actions	has no drug activity (blocks what the opioid does)
Opioid (Narcotic) Antagonists • Uses	o Postoperative acute respiratory depression, reversal of opioid adverse effects, suspected acute opioid over dosage • Adverse reactions o Nausea, vomiting, sweating, tachycardia, increased blood pressure, tremors
Opioid (Narcotic) Antagonists Contraindications, precautions, interactions	Hypersentivity, pregnancy category B, infants of opioid-dependent mothers, patients with opioid dependency, cardiovascular disease, and lactation • Withdrawal symptoms: Opioid dependent
Are u glad that is over?	HELL YEAH! Good luck!:)

Created by: cruse36

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