NURS 6521 - Advanced Pharmacology Mid-term Exam 1. Mrs. Shawn is a 68-year-old woman who prides herself in maintaining an active lifestyle and a healthy diet that includes adequate fluid intake. Howev er, Mrs. Shawn states that she has experienced occasional constipation in recent months. What remedy should be the nurse's first suggestion? - BULK-FORMING (fiber) LAXATIVES 2. What critical piece of information is missing from the following medication order: Amoxicillin 250 mg every 8 hours? - Routes of Administration 3. The nurse practitioner orders Amoxicillin 250 mg/5 ml tid for 10 days? The nurse practitioner would expect the pharmacist to fill the prescription bottle with how many ml? - 150 ml 4. A 77-year-old woman who is 5 feet 3 inches tall and weighs 89 lbs has been admitted to the hospital with a diagnosis of failure to thrive. What action should the nurse prioritize when addressing the woman's apparent lack of nutrition? - Assess the reasons behind the patient's poor nutritional status 5. A 60-year-old African-American man lives with a number of chronic health problems. Genetic factors are likely to influence his etiology and/or treatment of - 6. A 49-year-old woman has been diagnosed with myalgia. The physician has recommended aspirin. The patient is concerned that the aspirin will upset her stomach. The nurse will encourage the patient to... - 7. A patient has recently been prescribed a drug that treats his hypertension by blocking the sympathetic receptors in his sympathetic nervous system. This action is characteristic of - 8. A patient is brought to the emergency department in hypertensive crisis. Nitroprusside is administered intravenously. The patient experiences diaphoresis and dizziness. Which of the following is the appropriate action by the nurse? - 9. A nurse is creating a plan of care for a 68-year-old woman with a recent diagnosis of unstable angina and new prescription for nitroglycerin. Which of the following nursing diagnoses should the nurse prioritize in the planning of this patient's care? - 10. A 53-year-old man has been treated for severe asthma for several years with prednisone. Recently, his physician initiated alternate-day therapy for him. The patient tells the nurse that he would rather take the medication every day to prevent confusion. Which of the following would be the best response by the nurse? - 11. A 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man's most recent visit to his care provider, routine blood work was ordered and the results indicated an unprecedented rise in the man's serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings? - 12. A nurse who provides care in a busy clinic is aware of the high incidence and prevalence of hyperlipidemia and the consequent need for antihyperlipidemics in many patients. Treatment of high cholesterol using statins would be contraindicated in which of the following patients? - 13. A woman with numerous chronic health problems has been diagnosed with a benign gastric ulcer has begun treatment with ranitidine (Zantac). Which of the following teaching points should the nurse provide to this patient? - 14. A 47-year-old woman has been diagnosed with open-angle glaucoma. Pilocarpine drops are prescribed. The nurse's assessment reveals that the patient has worn soft contact lenses for 15 years. The nurse will instruct the patient to - 15. It is determined that a patient, who is in a hepatic coma, needs a laxative. Lactulose is prescribed. Which of the following should the nurse monitor to assess the efficacy of the lactulose therapy? - 16. A nurse is a member of a research team that is exploring unique differences in responses to drugs that each individual possesses, based on genetic make-up. This area of study is called - 17. A nurse has been invited to speak to a support group for persons with movement disorders and their families. Which of the following statements by the nurse addresses the chronic nature of these diseases and the relevant drug therapies? - 18. A patient on 5-FU calls the clinic and reports that he has between five and seven loose bowel movements daily. The nurse will instruct the patient to - 19. An adult patient who has been diagnosed with a rectal tumor is scheduled to begin treatment with cisplatin. The nurse has conducted patient teaching about the possibility of nausea and vomiting. In order to reduce the patient's risk of severe nausea, the nurse should - 20. A nurse is assessing a female patient who is taking diphenoxylate HCl with atropine sulfate. Which of the following would lead the nurse to suspect that she is experiencing an allergic reaction? - 21. Following an assessment by her primary care provider, a 70-year-old resident of an assisted living facility has begun taking daily oral doses of levothyroxine. Which of the following assessment findings should prompt the nurse to withhold a scheduled dose of levothyroxine? - 22. A 40-year-old woman with a diagnosis of fibromyalgia has been prescribed cyclobenzaprine (Flexeril) as an adjunct to her existing drug regimen. What nursing diagnosis should the nurse prioritize when updating the nursing care plan for this patient? - 23. A homeless man who is well known to care providers at the local hospital has been admitted to the emergency department after having a seizure outside a mall. The man is known to be a heavy alcohol user and is malnourished with a very low body mass index. How are this patient's characteristics likely to influence possible treatment with phenytoin? - 24. A clinic nurse is following a 9-year-old boy who is taking somatropin. Which of the following will the nurse monitor periodically? - 25. A Native American man who lives a traditional lifestyle is scheduled to have heart surgery. The tribal chief has requested that the tribe's medicine man perform a ritual before the patient goes to surgery. The nurse's response to this request should be - 26. A 30-year-old woman is taking phenelzine (Nardil) 30mg PO tid. The nurse knows that at that dosage, the patient will need to be carefully monitored for - 27. A nurse is overseeing the care of a young man whose ulcerative colitis is being treated with oral prednisone. Which of the following actions should the nurse take in order to minimize the potential for adverse drug effects and risks associated with prednisone treatment? - 28. A patient with a diagnosis of non-small cell lung cancer is currently undergoing chemotherapy. At the encouragement of a family member, the patient has announced to the nurse his intention to complement this treatment with a regimen of herbal remedies. How should the nurse respond to this patient's statement? - 29. Mr. Nguyen, age 71, will soon be discharged home from the hospital after a successful coronary artery bypass graft (CABG). During patient education about his drug regimen, Mr. Nguyen's nurse should prioritize teach about - 30. A 24-year-old factory worker has been prescribed guaifenesin for the first time. Which of the following will be a priority assessment by the nurse before the patient's first dose? - 31. A patient will begin three new medications as part of her treatment plan. The nurse practitioner understands that proper disposal of medications is key when the nurse practitioner states - 32. Several months of treatment with a statin accompanied by lifestyle modifications have failed to appreciably improve a patient's cholesterol levels. Consequently, the patient has been prescribed cholestyramine. The nurse should recognize that this drug achieves its therapeutic effect by - 33. A patient has been prescribed several drugs and fluids to be given intravenously. Before the nurse starts the intravenous administration, a priority assessment of the patient will be to note the - 34. A 58-year-old man is admitted to the emergency department. A diagnosis of severe digoxin toxicity is made. Bradycardia is present, and an electrocardiogram (ECG) confirms toxicity. The nurse will administer which of the following drugs? - 35. A 76-year-old woman has a complex medical history that includes emphysema, osteoporosis, malnutrition, and hypothyroidism. Recently, the woman fell outside her home as a result of weakness and suffered a fracture to her femoral head. The woman's subsequent hip-replacement surgery has been scheduled and the care team recognizes that the use of isoflurane will be most significantly influenced by - 36. A 75-year-old woman is prescribed magnesium hydroxide for constipation. The nurse's assessment reveals that the patient is being treated for rheumatoid arthritis and hypertension. The patient lives in assisted living and is on a low- sodium diet. Before the magnesium hydroxide therapy begins, it will be most important for the nurse to assess the patient's - 37. A clinic nurse has been assigned a 49-year-old female patient who has a history of diabetes. A recent diagnosis of hypertension has been made, and the patient has been prescribed a thiazide diuretic and labetalol. The patient will be scheduled to return to the clinic once a month for the next 6 months. A priority action by the nurse will be to - 38. A female patient calls the clinic and reports that since she has been taking dextromethorphan (Robitussin), she has been extremely drowsy and dizzy. The nurse will question the patient about which of the following? - 39. A 79-year-old woman with a medical history that includes osteoporosis has recently moved to a long-term care facility. Medication reconciliation indicates that the woman has been taking calcitonin, salmon for several years. The nurse should recognize that the most likely route for the administration of this drug is - 40. An older adult who lives in a long-term care facility has recently begun taking losartan (Cozaar) for the treatment of hypertension. The nurse who provides care for this resident should recognize that this change in the resident's medication regimen make create a risk for - 41. A patient with class-IV CHF has a medication regimen consisting of metoprolol (Lopressor), enalapril (Vasotec), and furosemide (Lasix). In addition to regularly assessing the patient s heart rate, the nurse should prioritize assessment of the patient's - 42. A nurse is providing education to a 56-year-old man who is admitted to the emergency department with an acute asthma attack. The nurse's initial assessment reveals that the patient has a history of pneumonia, drinks large quantities of coffee, and eats a high-calorie diet. Albuterol is prescribed for him. The important consideration when the nurse is preparing a teaching plan will be that the patient - 43. A 62-year-old man is admitted to the hospital with a diagnosis of chest pain. He has an order for 0.3 mg of sublingual nitroglycerin prn for chest pain. Which of the following actions should the nurse do first when he complains of chest pain? - 44. An expected outcome for a patient who has just taken sublingual nitroglycerin should be - 45. A patient is to take nifedipine (Procardia) 10 mg PO tid. How many milligrams will he take per dose? - 46. A nurse explains to a patient that nitroglycerin patches should be applied in the morning and removed in the evening. This medication schedule reduces the potential for ... - 47. A patient is admitted to the emergency department with severe chest pain. The emergency department physician orders intravenous nitroglycerin 5 mcg/min, titrate dose by 5 mcg/min every 3 to 5 minutes per infusion pump as needed. Before administering the nitroglycerin, the nurse should prioritize which of the following assessments? - 48. A nurse is caring for a patient with chronic angina. The patient is receiving ranolazine (Ranexa) 500 mg PO bid. Which of the following signs or symptoms would the nurse attribute to being a common adverse effect of this medication? - 49. A 45-year-old man enters the emergency department complaining of chest pain. The nurse has an order to administer amyl nitrite. The nurse will... - 50. A patient is being discharged home with a prescription for sublingual nitroglycerin. The nurse will instruct the patient and family to... - 51. A nurse has an order to apply nitroglycerin topically, twice a day. The nurse's initial action will be to... - 52. A patient calls the clinic and reports that he is having chest pain. The patient states that I’m scared that I am going to die and I've been pacing up and down my driveway. After calming the patient, the initial instruction by the nurse would be to... - 53. A recent episode of chest pain while doing yard work prompted a 70-year-old man to seek care and he has been subsequently diagnosed with chronic stable angina. The nurse should recognize what guiding principle in the treatment of this patient's angina? - 54. Frequent episodes of exercise-related chest pain have caused a 79-year-old woman to use her prescribed nitroglycerin spray several times in recent weeks. This patient's age will have what effect on her use of nitroglycerin? - 55. A nurse is creating a plan of care for a 68-year-old woman with a recent diagnosis of unstable angina and new prescription for nitroglycerin. Which of the following nursing diagnoses should the nurse prioritize in the planning of this patient's care? - 56. A man has left his most recent visit to his primary care provider with a new prescription for a transdermal nitroglycerin patch. What patient education should the nurse provide to this patient? - 57. Mr. Penny, age 67, was diagnosed with chronic angina several months ago and has been unable to experience adequate relief of his symptoms. As a result, his physician has prescribed ranolazine (Ranexa). Which of the following statements is true regarding the use of ranolazine for the treatment of this patient's angina? - 58. A patient is in the clinic for seasonal allergic rhinitis. Loratadine (Claritin) is prescribed. Which of the following statements will the nurse include when providing patient education concerning this drug? - 59. A 73-year-old woman has scheduled an appointment with her nurse practitioner to discuss her recurrent constipation. The woman states that she experiences constipation despite the fact that she takes docusate on a daily basis and performs cleansing enemas several times weekly. How should the nurse best respond to this patient's statements? - 60. A 68-year-old man complains of a chronic, nonproductive cough. He states that he has to have relief, that he has been coughing every 2 to 3 minutes, and he is worn out. Dextromethorphan is prescribed for him. Before he leaves the clinic, he asks how long it will take for the medicine to work. The nurse will advise him that he should experience therapeutic effects in - 61. A patient with seasonal allergies is exasperated by her recent nasal congestion and has expressed her desire to treat it by using pseudoephedrine. The nurse should inform the patient that - 62. A normal maintenance dose for digoxin is 0.125 to 0.5 mg/day. In which of the following patients would the nurse most likely administer a lower-than-normal maintenance dose of digoxin? - 63. A patient with diabetes has had a cough for 1 week and has been prescribed a cough syrup (an expectorant). What special instructions should the nurse include in the patient teaching for this situation? - 64. An elderly postsurgical patient has developed postoperative pneumonia in the days following abdominal surgery and is being treated with a number of medications. Which of the following medications that the nurse will administer has the slowest absorption? - 65. A 79-year-old woman who takes several medications for a variety of chronic health problems has been prescribed an oral antiplatelet aggregator that is to be taken once daily. The nurse has encouraged the woman to take the pill at the same time of day that she takes some of her other medications. What is the most likely rationale for the nurse's advice? - 66. A patient receives 25 units of NPH insulin at 7.AM. At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction - 67. A physician has ordered subcutaneous injections of morphine, a narcotic, every 4 hours as needed for pain for a motor vehicle accident victim. The nurse is aware that there is a high abuse potential for this drug and that it is categorized as a ... - 68. A 46-year-old white American has been prescribed a drug that binds to acid glycoproteins. The nurse understands that white Americans usually receive... - 69. A patient has been prescribed lovastatin for a high cholesterol level. The nurse's teaching plan will include a basic explanation of how the drug produces its therapeutic effect. The nurse will explain that lovastatin lowers cholesterol levels because it... - 70. The parents of a 7-year-old boy who has just been diagnosed with allergic asthma are being taught about their son's medication regimen by the nurse. The nurse is currently teaching the parents about the appropriate use of a "rescue drug" for acute exacerbations of their son's asthma. What drug should the nurse suggests the parents to use in these situations? - 71. Which of the following affects drug distribution throughout the body? - 72. Before the administration of morphine to a 65-year-old man who has cancer, the initial action of the nurse would be to check the patient's - 73. The lower respiratory system utilizes a number of different mechanisms that confer protection and maintain homeostasis. Which of the following physiological processes protects the lower respiratory system? - 74. The nurse's assessment of a community-dwelling adult suggests that the client may have drug allergies that have not been previously documented. What statement by the client would confirm this? - 75. For which of the following patients would a nasogastric tube most likely be considered to aid in the administration of medications? - 76. A 29-year-old woman has been prescribed alosetron (Lotronex) for irritable bowel syndrome. Before starting the drug therapy, the nurse will advise the patient about which of the following adverse effect(s)? - 77. A nurse is developing a care plan for a patient who has multiple sclerosis. An expected outcome for the patient who is receiving glatiramer would be a decrease in - 78. A diabetic patient being treated for obesity tells the nurse that he is having adverse effects from his drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which of the following adverse effects would need the nurse's immediate attention? - 79. A patient has a history of tonic-clonic seizures that have been successfully treated with phenytoin (Dilantin) for several years. Phenytoin achieves a therapeutic effect by - 80. A 90-year-old frail, elderly woman has arrived at the emergency department with a broken hip and in acute respiratory distress. Succinylcholine will be used because of the need for rapid endotracheal intubation, and then the woman will be sent to surgery. Due to the woman's frail condition, she is at risk for skin breakdown. Which of the following nursing diagnoses would be most appropriate? - 81. A nurse is the cardiac care unit is preparing to hang an intravenous dose of dofetilide (Tikosyn) for a patient who has just been admitted. What is the most likely goal of this intervention? - 82. A nurse is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which of the following instructions? - 83. A nurse practitioner understands when prescribing a medication that there are certain questions to address. Check all that apply. - 84. An elderly patient with a history of congestive heart failure has been admitted to hospital with failure to thrive and admission blood work reveals a hemoglobin level of 6.9 g/dL. The care team has consequently administered two units of packed red blood cells, but auscultation of the client's lungs now reveals diffuse crackles. Administration of what drug is likely to resolve the patient's pulmonary edema? - 85. In order to promote therapeutic drug effects, the nurse should always encourage patients to - 86. The nurse practitioner orders Amoxicillin 500 mg tid? What is the total amount of medication patient will take per day? - 87. A patient with mild low back pain has been advised to take acetaminophen. The nurse will inform him that excessive intake of acetaminophen may result in - 88. A nurse is teaching an older adult patient about polypharmacy. Which of the following statements best describe this term? - 89. A nurse is aware that diphenoxylate HCl with atropine sulfate is an effective adjunct in the treatment of diarrhea. For which of the following patients could the administration of this drug be potentially harmful? - 90. A 70-year-old patient has just started taking lorazepam 10 days ago for anxiety issues related the death of her husband. She is staying with her daughter for a couple of weeks. The patient's daughter has noticed that her mother is having difficulty walking and seems to be confused at times and calls the clinic to report this to the nurse. The nurse will inform the daughter that... - 91. An elderly woman is slated for a hemiarthroplasty (hip replacement surgery) after falling and breaking her hip on the stairs outside her home. The woman's pain in the time since her injury has been severe, and her care team has been treating it with morphine. Which of the following administration schedules is most likely to control the patient's pain? - 92. A 67-year-old man is admitted to the hospital with pneumonia. He reports to the nurse that he has chronic arthritis and circulation problems. Further assessment by the nurse reveals that the patient has a history of mild hypertension. He explains that he owns a business and lives alone. The nurse determines that he is within the normal weight range for his height and age but has a fondness for spicy foods and sweets. Which of the mentioned patient variables will have the greatest impact on the effectiveness of the patient's drug therapy? - 93. A patient is admitted to the emergency department with severe chest pain. The emergency department physician orders intravenous nitroglycerin 5 cg/min, titrate dose by 5 mcg/min every 3 to 5 minutes per infusion pump as needed. Before administering the nitroglycerin, the nurse should prioritize which of the following assessments? - 94. Prior to administering a dose of 5-FU to a patient with pancreatic cancer, the nurse is conducting the necessary drug research. The nurse is aware that 5-FU is a cell cycle-specific chemotherapeutic agent. Which of the following statements best describes cell cycle-specific drugs? - 95. Which of the following would be the most important safety-related instruction for a nurse to give to a patient taking baclofen (Lioresal)? - A nurse is assessing a patient who has come to the emergency department complaining of back spasms. The patient states that he has a history of opioid addiction and does not want to take any drug that "puts me at risk of becoming physically dependent." Which of the following medications would the nurse question, if ordered? - 97. A patient with bronchial asthma is prescribed a sustained-release preparation of theophylline. To help minimize the adverse effects of the drug, which of the following should the nurse suggest? - 98. A middle-aged patient was diagnosed with major depression after a suicide attempt several months ago and has failed to respond appreciably to treatment with SSRIs. As a result, his psychiatrist has prescribed phenelzine. When planning this patient's subsequent care, what nursing diagnosis should the nurse prioritize? - R Show Less