Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/110

Click to flip

110 Cards in this Set

  • Front
  • Back
1. A patient has been treated with ropinirole (Requip), an antiparkinsonian agent, for
approximately three months now. What therapeutic responses should you look for when
assessing this patient?
a. Decreased appetite
b. Gradual development of cogwheel rigidity
c. Occurence of side effects such as confusion, anxiety, irritability, and headache
d. Improved mental status, as well as improved ability to perform activities of daily
living (ADLs)
If you selected "d," you are a genius! Therapeutic responses to the antiparkinsonian
agents include an improved sense of well-being, an improved mental status, an increase
in appetite, an increase in ability to perform activities of daily living (ADLs), an increase
in concentration and clear thinking, and less intense parkinsonism manifestations.
2. Before beginning therapy with amitriptyline (Elavil), you would want to assess for
concurrent use of which of the following types of medications?
a. Aspirin
b. Warfarin (Coumadin)
c. Diuretics
d. Nonsteroidal antiinflammatory agents (NSAIDs)
If you selected "b," you are a wizard! Use of the tricyclic antidepressant agent,
amitriptyline (Elavil), in conjunction with warfarin (Coumadin) results in an increased
anticoagulant effect.
3. A 22-year-old female has been taking lithium (Eskalith) for six months. She comes in
for blood work every month and you assess her for signs of toxicity. What are
indications of toxicity?
a. Serum lithium level of 0.8 mEq/L and excitability
b. Serum lithium level of 1.0 mEq/L and palpitations
c. Serum lithium level of 1.5 mEq/L and hypertension
d. Serum lithium level of 2.5 mEq/L and cardiac dysrhythmias
If you selected "d," bravo! Lithium (Eskalith) levels exceeding 2.0 to 2.5 mEq/L produce
moderate to severe toxicity and cardiac dysrhythmias are possible adverse effects.
Moderate to severe pain is best treated with:
a. acetaminophen (Tylenol).
b. naloxone HCl (Narcan).
c. propoxyphene HCl (Darvon).
d. morphine sulfate.
d. morphine sulfate.
Lidocaine is frequently used for:
a. spinal anesthesia.
b. local anesthesia.
c. intravenous anesthesia.
d. general anesthesia.
B. local anesthesia
A patient who has been taking a benzodiazepine (i.e. temazepam/Restoril) for five weeks is told by his physician that he wants him to stop using the medication. The best way to discontinue the medication is to:
a. stop taking the drug immediately.
b. plan a gradual reduction in dosage.
c. overlap the initial medication with another agent.
d. take the medication with another agent.
b. plan a gradual reduction in dosage.
Which of the following is not true about intravenous infusion of phenytoin?
a. It should be injected slowly.
b. It should be injected quickly.
c. It should be followed by an injection of sterile saline.
d. Continuous infusion should be avoided.
b. It should be injected quickly.
A patient, who is taking levodopa for Parkinson's disease, wants to take a vitamin supplement. What should he be told?
a. He should not take a vitamin supplement at this time.
b. Be sure to take a supplement twice a day to ensure enough nutrients.
c. Avoid supplements that contain vitamin B6 (pyridoxine).
d. Do not take more that the recommended amount of calcium with this medication.



Score: 0 / 10
c. Avoid supplements that contain vitamin B6 (pyridoxine).
A 38-year-old male has come into the urgent care center with severe hip pain after falling from a ladder at work. He said he has taken several pain pills over the past few hours but cannot remember how many he has taken. He hands you an empty bottle of acetaminophen (Tylenol). What is the most serious toxic effect of acute acetaminophen overdose?
a. Tachycardia
b. Central nervous system depression
c. Hepatic necrosis
d. Nephrotic necrosis
c. Hepatic necrosis
Your patient has been given succinylcholine (Anectine) after a severe injury that necessitated controlled ventilation. The physician now wants to reverse the paralysis. You would expect to use which agent to reverse the succinylcholine (Anectine)?
a. Diazepam (Valium)
b. Caffeine (No-Doz)
c. Neostigmine (Prostigmin)
d. Vecuronium (Norcuron)
c. Neostigmine (Prostigmin)
A patient is recovering from a minor automobile accident that occurred one week ago. He is taking cyclobenzaprine for muscular pain and goes to physical therapy three times a week. Which of the following nursing diagnoses would be appropriate for him?
a. Risk for falls related to decreased sensorium
b. Risk for addiction related to psychological dependency
c. Excess fluid volume related to potential side effects
d. Disturbed sleep pattern related to the drug's interference with REM sleep
a. Risk for falls related to decreased sensorium
Your patient has been taking carbamazepine (Tegretol) for several months and is worried because the physician has increased her dose twice since beginning therapy. You explain that:
a. the initial dose was not sufficient to prevent seizures.
b. autoinduction results in lower than expected drug concentrations.
c. her seizures are difficult to manage and increase doses are needed to control them.
d. her forgetting to take the medication as prescribed led to a need for increased dosage.
b. autoinduction results in lower than expected drug concentrations.
When a patient is taking an anticholinergic, such as benztropine mesylate (Cogentin), as part of the treatment for Parkinson's disease, what is important to include in the teaching plan?
a. Avoid vitamin B6 supplements and vitamin-fortified foods.
b. Discontinue the medication immediately if side effects occur.
c. Take the medication on an empty stomach to enhance absorption.
d. Take the medication at bedtime to prevent drowsiness during the day.
d. Take the medication at bedtime to prevent drowsiness during the day.
Iatrogenic is best defined as:
A. harmful or undesireable.
B. arising from treatment.
C. persistent despite the treatment.
D. Innate in the illness.
B. arising from treatment.
The identification of adverse reactions to medication is usually imcomplete until the drug in question has been in use at least
A. one year
B. five years
C. ten years
D. 50 years
C. ten years
Side effects are best defined as:
A. helpful effects of drugs other than the specific purpose for which the drug was perscribed.
A. harmful effects of drugs other than the specific purpose for which the drug was perscribed.
B. harmful efects of drugs incidental to the specific purpose for which the drug was perscribed.
C. effects of the drug other than the specific purpose for which the drug was perscribed, both helpful and harmful.
D. effects of a drug exerted at sites other than the site at which the desired theraputic effect occurs.
C. effects of the drug other than the specific purpose for which the drug was perscribed, both helpful and harmful.
A genetically determined, unexpected response to a drug is called:
A. cumulative reaction
B. tolerance
C. idiosyncratic reaction
D. interaction
C. idiosyncratic reaction
When drugs are execreted more slowly than they are absorbed, the result is:
A. tolerance
B. cummulation
C. renal disease
D. Metabolic disorder
B. cummulation
A decreased physiologic response to a drug after repeated administration of a drug is:
A. cumulation
B. tolerance
C. toxicity
D. idiosyncrasy
B. tolerance
The ability of a drug to cause abnormal fetal development is referred to as:
A. hypersensistivity
idiosyncrasy
C. carcinogenicity
D. teratogenicity
D. teratogenicity
The pateint has been perscribed an antibiotic. About 72 hours later, the physician changes teh antibiotic. Which action should the nurse take before administering the new antibiotic?
A. obtain a blood sample for blood cultures
B. Determine the route of administration most appropriate for the new antibiotic
C. Teach the patient how to dispose of discontinued medications
D. Review the patient's medication history to detect any history of allergies by asking the patient.
D. Review the patient's medication history to detect any history of allergies by asking the patient.
A patient is taking furosemide. Three days later the patients serum potassium level is 3.5mEq/L. The physician perscribes a potassium supplement. This scenario describes a/an:
A. chain reaction
B. cumulative reaction
C. idiosyncratic reaction
D. toxic reaction
A. chain reaction
Reactions that are characteristic of high doses of a drug are termed:
A. adverse
B. allergic
C. idiosyncratic
D. toxic
D. toxic
Renal insufficiency is most likely to:
A. shorten serum half-life of drugs taken by a patient
B. lengthen serum half-life drugs taken by the patient
C. increase the sensitivity of the patient to drug effects
D. increase the amount of drugs entering the enterohepatic circulation
B. lengthen serum half-life drugs taken by the patient
A patient has been taking a drug over a period of time to control unpleasant symptoms. Abrupt withdrawl of the drug is likely to result in:
A. a return of normal function
B. Continued relief through placebo effect
C. a return of symptoms in exaggerated form
D. No change in the patient's status
C. a return of symptoms in exaggerated form
When a patient develops diarrhea, the effect of medication regimines is likely to be:
A. delayed absorption of the drug due to hydrochloric acid in the intestine
B. dissolution of the drug in the stomach, enabling better absorption
C. excretion of the drug before it can be absorbed
D. No change in the serum levels of teh drug
C. excretion of the drug before it can be absorbed
If a nurse crushed an enteric coated drug and instilled it into the stomach through a feeding tube, the result would most likely be:
A. rapid excretion of the drug
B. intestion rather than gastric absorptionof the drug
C. destruction of the drug in the small intestine
D. stomach irritation owing to gastric release of the drug
D. stomach irritation owing to gastric release of the drug
An example of an antineoplastic drug known to have carcinogenic potential is:
A. cyclophosphamide
B. co-triamoxazole
C. asparaginase
D. warfarin
A. cyclophosphamide
Which of the following statements correctly describes a manifestation of cochlear toxicity?
A. The patient experiences a bone conduction hearing loss
B. Most patients realize their hearing loss immediately
C. The hearing loss progresses from higher to lower frequencies
D. Tinnitus decreases as the hearing loss increases
C. The hearing loss progresses from higher to lower frequencies
A drug with multiple pharmacologic actions (such as diphenhydramine) may be administered because it causes:
A. Positive effects in certain patients
B. A known desirable effect
C. an unpredictable reaction
D. a cardiovascular reaction
B. A known desirable effect
Postural (orthostatic) hypotension from a vasodilator is an example of:
A. patient hypersensitivity
B. A predictable reaction
C. an unpredictable reaction
D. a response to toxicity
B. A predictable reaction
Unpredictable adverse reactions are:
A. unusal and unexpected
B. more likely to occur when the theraputic dose is close to the toxic range
C. related to the drug's theraputic properties
D. annoying but tolerable
A. unusal and unexpected
If a patient reports a previous response to PCN, the nurse should avoid giving the patient:
A. any antibiotic
B. aminoglycosides
C. erythromycin
D. cephalosporins
D. cephalosporins
Adverse drug reactions are easier to identify and pinpoint when:
A. only one drug is being administered
B. the patient is on a medical unit
C. only one medical diagnosis is being treated
D. the pateint has just had surgery
A. only one drug is being administered
To assess for possible organ toxicity from an ADR (adverse drug reaction), the nurse should:
A. request frequent blood levels of teh drug to establish optimal therapy
B. Administer a subtheraputic dose
C. Consult witha pharmacist
D. Monitor liver and kidney function
D. Monitor liver and kidney function
The nurse's reports to the FDA about a serious drug reactions are important because:
A. the nurse saw the reaction, so the nurse can give an accurate clinical description.
B. The nurse understands what constitutes a serious reaction
C. The nurse is fulfilling a requirement when a patient dies from a reaction
D. the nurse needs to alert the FDA to errors in perscription and administration
A. the nurse saw the reaction, so the nurse can give an accurate clinical description.
When filing an FDA report on an adverse drug reaction, the nurse should:
A. identify inappropriate use of the drug
B. include the patient's name
C. identify any administration errors
D. be as complete as possible
D. be as complete as possible
The patient, who has a long history of alcoholism, had surgery two days ago and has required large amounts of pain medication following the surgery. This may be due to:
A. idiosyncratic response
B. cross-tolerance
C. hypersensitivity
D. hepatotoxicity
B. cross-tolerance
An unexpected reaction to a drug the first time it is given is:
A. idiosyncratic response
B. cross-tolerance
C. hypersenstitivity
D. heptatoxicity
A. idiosyncratic response
A 78yo patient is in the recovery room after having a lengthy surgery on his hip. He was gradually awakening,and he requested some pain medication. Within 10 minutes after recieving a dose of demerol, he is almost unresponsive, and his respirations are shallow with a rate of 9bpm. What may be necessary treatment at this time?
A. Administration of an agonist opioid, such as fentanyl
B. Administration of Narcan, an opioid reversal agent
C. Immediate intubation and artificial ventilation
D. Close observation of signs of opioid tolerance
B. Administration of Narcan, an opioid reversal agent
The nurse is caring for a patient in the ER who is DX with Bells Palsy. The patient has been taking Tylenol, and a Tylenol overdose is suspected. The nurse anticipates that the antidote to be prepared is?
A. auranofin (Ridaura)
B. fludarabine (Fludara)
C. acetylcysteine (mucomyst)
D. Pentostatin (Nipent)
C. acetylcysteine (mucomyst)
What is the major adverse effect of nonsteriodal anti-inflammatory drugs (NSAIDS)?
A. Dizziness
B. Lethargy
C. Jaundice
D. GI complaints, which can develop into ulcers and GI bleeding
D. GI complaints, which can develop into ulcers and GI bleeding
Mr.Jackson is to have local anestesia for the removal of a lymph node from his arm. The physician adds epiepherine to the local anesthetic during the preparation because:
A. vasoconstrictive effects keep the anesthetic at its local site of action
B. epinephrine contributes to a balanced anesthetic state
C. The anesthetic enhances the effect of the epinephrine
D. it prevents an ana[hyalactic reaction from ocuring.
A. vasoconstrictive effects keep the anesthetic at its local site of action
Ms. JOhnson has been takinf temazepam for intermittent insomnia. She calls and tells you that when she takes it, she sleeps well, but the next day she feels "so tired" what do you explain to her?
A. Benzodiazepines increase CNS activity, thus causing tiredness the next day.
B. Benzodiazepines affect the sleep cycle, thus causing a hangover effect.
C. She should take the drug every night to reduce this handpver effect
D. Long-term use results in a sedative effect
B. Benzodiazepines affect the sleep cycle, thus causing a hangover effect
A patient is discharged on phenobarbital sodium, 100mg PO BID. Which of the following statements, if made by the patient, reflects an accurate understanding of safety precautions with this medication?
A. "I must take my medication at the same time daily"
B. "Using a daily dosing system container is helpful to the prevention if an overdoes"
C. "Drinking one beer may change the way my medications works"
D. "I can take my medication with food if I need to"
C. "Drinking one beer may change the way my medications works"
After giving your 62yo patient Seconal 100mg PO at HS, the nurse should do all of the following except?
A. make periodic assessments of his respiratory rate
B. Anticipate that he may have a paradoxical response
C. Understand that this drug is being given as a hypertensive agent
D. Check periodically to validate his response to the medication.
C. Understand that this drug is being given as a hypertensive agent
Your patient has a nine year history of a seizure disorder that has been managed well with Dilantin therapy. He is to be NPO for surgery in the morning. What should be done about his morning dose of Dilantin?
A. Notify the operating room that the medication has been withheld
B. Contact the physician for another dosage form of the medication
C. Give him the morning dose with a small sip of water
D. Give him the same dose intravenously
B. Contact the physician for another dosage form of the medication
The home health nurse visits a patient who is taking Dilatin for control of seizures. During the assessment, the nurse notes that the patient is taking birth control pills. Which of the following should the nurse include in the teaching plan?
A. The increased risk for thrombophlebitis while taking Dilaton and birthcontrol pills together
B. The potential decreased effectiveness of the birth control pills while taking Dilantin
C. The patietn may stop the medication if it is causing severe GI effects
D. Pregnancy should be avoided while taking Dilantin
B. The potential decreased effectiveness of the birth control pills while taking Dilantin
Signs and symptoms of phenytoin toxicity include all of the following except:
A. Euphoria
B. Lethargy
C. Sedation
D Nystagmus
A. Euphoria
Mr. Baxter has been taking Carbex for a month and says he understands the "cheese effect" that the doctor explained to him. When you question him about it, he tells you (correctly) that the cheese effects results in:
A. GI upset
B. urinary discomfort
C. hypertension
D. Hypotension
C. hypertension
The physician initiates Levodopa therapy for the patient with Parkinson's disease. A few days after the patient starts the medication, the patient complains of nausea and vomiting. The nurse's best instruction to the patient to alleviate the nausea is that:
A. this is an expected side effect
B. eating a snack before taking the medication will help prevent the nausea
C. taking antiemetic is the best measure to prevent the nausea
D. the nausea and vomiting will decrease when the dose of Levodopa is stabilized
B. eating a snack before taking the medication will help prevent the nausea
What type of glaucoma prohibits the use of levodopa?
A. chronic conjunctival
B. Transient
C. Open-angle
D. Closed-angle
D. Closed-angle
Before beginning therapy with amitriptyline (a tricyclic antidepressant), you would want to assess for concurrent use of which of the following types of medications?
A. nonsteroidal anti-inflammatory drugs
B. Diuretics
C. Warfarin
D. Aspirin
C. Warfarin
The nurse is performing a follow-up teaching session with a patient discharged one month ago. The patient is taking Prozac. What information is important for the nurse to gather, during the patient visit, regarding the adverse effects related to the medication?
A. Problems with excessive sweating
B. GI dysfunctions
C. Cardiovascular symptoms
D. Problems with mouth dryness
B. GI dysfunctions
Which classification of drugs stimulates an inhibitory neurotransmitter gamma amino benzoic acid (GABA)?
A. Anticholinergics
B. Hydantoins
C. Barbiturates
D. Benzodiazepines
D. Benzodiazepines
Robet, a 10yo, has been on Ritalin for almost 6 months. His mother reports that he seems to have stopped growing. Your response is based on the fact that:
A. tempory slowing of growth is expected with Ritalin therapy
B. Growth in 10yo children tends to be slower
C. Growth can be promoted with a high-protein diet
D. Growth will occur with the onset of puberty
A. tempory slowing of growth is expected with Ritalin therapy
Which CNS stimulant is commonly used in conjunction with supportive measures to hasten arousal and to treat respiratory depression that may occur in the post operative recovery?
A. Dopram
B. Amphetamine
C. Benzphetamine
D. Methylphenidate hydrochloride
A. Dopram
Which of the following drugs has shown a neuroprotective effect when started early in therapy?
a. Amantadine hydrochloride (Symmetrel)
b. Levodopa (L-Dopa)
c. Selegiline (Eldepryl)
d. Tolcapone (Tasmar)
c. Selegiline (Eldepryl)
*****************************
Selegiline may be somewhat beneficial as a prophylactic agent. Selegiline administration before exposure to the neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) has been shown to prevent the onset of a Parkinson's disease-like syndrome in laboratory animals, indicating a possible neuroprotective effect.
The drug of choice for mania is:
a. phenelzine sulfate (Nardil).
b. lithium (Eskalith).
c. risperidone (Risperdal).
d. amitriptyline (Elavil).
b. lithium (Eskalith)
****************************
The original drugs currently available that can alleviate the major symptoms of mania are the lithium salts. Phenelzine (Nardil) is a monoamine oxidase inhibitor (MAOI) agent, risperidone (Risperdal) is an antianxiety agent, and amitriptyline (Elavil) is a tricyclic antidepressant (TCA) agent.
Mary's husband, Joseph has been started on antidepressant therapy (bupropion/Wellbutrin). She asks you, "How long will it take for him to feel better?" Your best response should be:
a. "Well, depression rarely responds to medication therapy."
b. "He should be feeling better in a few days."
c. "It may take two to four weeks before you see an improvement."
d. "You may not see any effects for several months."
c. "It may take two to four weeks before you see an improvement."
*****************************
It may take two to four weeks to notice the full therapeutic effects of antidepressants.
Five-year-old Jeffery is taking methylphenidate hydrochloride for attention deficit hyperactivity disorder (ADHD). What specific precautions must be taken with children who are taking this drug?
a. Special precautions are not necessary with Ritalin therapy.
b. Intake and output should be monitored closely as this drug is nephrotoxic.
c. The child should be instructed to avoid tyramine-containing foods as a hypertensive crisis may occur when the child is on methylphenidate hydrochloride and consuming foods high in tyramine such as cheese, avocados, bananas, and liver.
d. The height and weight of children on methylphenidate hydrochloride should be measured and recorded before therapy is initiated and their growth rate should be plotted during therapy as this drug may retard growth.
d. The height and weight of children on methylphenidate hydrochloride should be measured and recorded before therapy is initiated and their growth rate should be plotted during therapy as this drug may retard growth.

*****************************
Nursing considerations for children who take methylphenidate include recording baseline height and weight before initiating drug therapy and continuing to plat height and weight in a journal during therapy as this drug may retard growth.
The physician has prescribed sumatriptan (Imitrex) for your patient. Which of the following disorders would not pose a contraindication for Imitrex therapy?
a. Irritable bowel syndrome
b. Ischemic heart disease
c. Prinzmetal's angina (an atypical form of angina pectoris thought to be due to vasospasm of otherwise normal coronary arteries; pain is experienced at rest rather than during activity)
d. Uncontrolled hypertension
a. Irritable bowel syndrome
*****************************
Sumatriptan (Imitrex) is indicated in the acute treatment of migraines. Sumatriptan is contraindicated in patients with ischemic heart disease, signs and symptoms consistent with ischemic heart disease, or Prinzmetal's angina.
A patient has been treated with ropinirole (Requip), an antiparkinsonian agent, for approximately three months now. What therapeutic responses should you look for when assessing this patient?
a. Decreased appetite
b. Gradual development of cogwheel rigidity
c. Occurrence of side effects such as confusion, anxiety, irritability, and headache
d. Improved mental status, as well as improved ability to perform activities of daily living (ADLs)
d. Improved mental status, as well as improved ability to perform activities of daily living (ADLs)
*****************************
Therapeutic responses to the antiparkinsonian agents include an improved sense of well-being, an improved mental status, an increase in appetite, an increase in ability to perform activities of daily living (ADLs), an increase in concentration and clear thinking, and less intense parkinsonism manifestations.
Before beginning therapy with amitriptyline (Elavil), you would want to assess for concurrent use of which of the following types of medications?
a. Aspirin
b. Warfarin (Coumadin)
c. Diuretics
d. Nonsteroidal antiinflammatory agents (NSAIDs)
b. Warfarin
*****************************
Use of the tricyclic antidepressant agent, amitriptyline (Elavil), in conjunction with warfarin (Coumadin) results in an increased anticoagulant effect.
A 22-year-old female has been taking lithium (Eskalith) for six months. She comes in for blood work every month and you assess her for signs of toxicity. What are indications of toxicity?
a. Serum lithium level of 0.8 mEq/L and excitability
b. Serum lithium level of 1.0 mEq/L and palpitations
c. Serum lithium level of 1.5 mEq/L and hypertension
d. Serum lithium level of 2.5 mEq/L and cardiac dysrhythmias
d. Serum lithium level of 2.5 mEq/L and cardiac dysrhythmias
*****************************
Lithium (Eskalith) levels exceeding 2.0 to 2.5 mEq/L produce moderate to severe toxicity and cardiac dysrhythmias are possible adverse effects.
Caffeine should be used with caution in which of the following patients?
a. A male with a history of peptic ulcers
b. A female with a history of migraine headaches
c. A teenager with a history of asthma
d. A male with a history of kidney stones
a. A male with a history of peptic ulcers
*****************************
Caffeine should be used with caution in patients who have a history of peptic ulcers, cardiac dysrhythmias, or individuals who have recently suffered a myocardial infarction.
When evaluating the patient who is taking sibutramine (Meridia), which of the following is an intended therapeutic effect?
a. Increased wakefulness
b. Increased appetite
c. Suppressed appetite
d. Decreased hyperactivity
c. Suppressed appetite
*****************************
Sibutramine (Meridia) is an anorexiant and is given as part of therapy for weight loss program.
Define medications error (s) and discuss measures utilized in preventing and responding to medications errors
Any preventable adverse drug event involving inappropriate medication use by a patient or health care professional; may or may not cause patient harm.
The "five rights" is essential in the nurse implementing to avoid medication errors.
Define pharmacokinetics and pharmocodynamics in relation to medication administration
Pharmacokinetics (is the study of what the body does to the drug)is defined as the study of drug distribution rates between various body compartments after a drug has entered the body. It includes the phases od absorption, distribution, metabolism, and excretion of drugs.

Pharmocodynamics (is the study of what the drug does to the body) is defined as the study of biochemical and physiologic interactions of drugs. It examines the physiochemical properties of drugs and their pharmacologic interactions with suitable body receptors.
Discuss the nursing process (assessment, nursing diagnosis, planning, implementation, and evaluation) and medication administration.
An organizational framework for the practice of nursing. It encompasses all steps taken by the nurse incaring for a patient: assessment, nursing diagnosis, planning (with outcome criteria), implementation of the plan (with patient teaching), and evaluation. The rationale for each step is founded on nursing theory.
Define the first-pass effect.
The first-pass effect is the initial metabolism in the liver of the drug absorbed from the GI tract, before the drug reaches systemic circulation through the blood stream.
Explain and give an example of polypharmacy.
The use of many different drugs in treating a patient who may have one or several health problems.
*****************************
Perscriptions from many physicians as well as OTC medications.
Discuss measures utilized in accurate pediatric medication calculation/administration.
Pediatric patients play a significant role in dosage calculation, characteristics in this are: Skin is thin and permeable, stomach lacks acid to kill bacteria, lungs lack mucus barriers, temperature is poorly regulated and dehydration occurs easily.
Many formulas for pediatric dose calculation have been used throughout the years. Formulas involving age, weight, and body surface area (BSA)are most commonly used as the basis of calculations. BSA is the most accurate of these dosing formulas.
Discuss controlled substances, noting categories (i.e. C-I, C-II, C-III, C-IV, and C-V), dispensing restrictions, and examples
C-I Only with approved protocol (heroin, LSD, marajuana, etc.)
C-II Written perscription only (if telephoned in, need written perscription within 24 hours) No perscription refills and container must have warning label. (Codeine, cocaine, moraphine, etc.)
C-III Written or oral perscription that expires in 6 months. No more than 5 refills in a six month period Container must have a warning label (Codeine, hydrocodone, etc.)
C-IV Written or oral perscription that expires in 6 months. No more than 5 refills in a six month period. Container must have warning label. (Phenobarbital, chloral hydrate, diazepam, etc.)
C-V Written perscription or OTC varies with each state law. (Medications generally for relief of coughs or dirrhea containing limited quantities of certain opioid-controlled substances)
Review cultural considerations and medication administration
The nurse needs to to acknowledge and accept the influences of a patient's cultural beliefs, values, and customs to prevent a conflict from arising between the goals of nursing and the health care and the dictates of a patient's cultural background.
Define placebo
An inactive (inert) substance (saline, distilled water, starch, sugar); a less-than-experimental drug study to compare teh "effects" of the inactive substance witht eh bona fide effeects of teh experimental drug. Placebos are also prescribed to satisfy the quests of patients who cannot be given the medication they request or who, in the judgement of the health care provider, do not need this medication.
Discuss the safety of the over-the-counter drugs and herbal products
Over-the-counter drugs are drugs that are available to consumers without a prescription. Herbal medicine is the practice of using herbs to heal. Herbal medicine are often percieved as being natural and therefore harmless, however, this is not the case. Many examples exist of allegic ractions, toxic reactions, and adverse effects related to herbs.Herbs have been shown to have possible mutagenic effects, and drug interactions.
Review heroin addiction and naltrexone (ReVia).
ReVia is perscribed for opioid abuse or dependence. Revia ia an opioid antagonist, it works by blocking the opioid receptors so that the use of opioid drug does not produce euphoria. It is also used for alcohol-dependence. This helps cease craving for alcohol and reduces the liklihood of a full relapse if a sip occurs.
Review ethanol abuse and disulfiram (Antabuse).
Antabuse is not a cure for alcoholism; it helps a patient who has a sincere desire to stop drinking. The rationale for its use is that patients know that if they are to avoid the devastating experience of the acetaldehyde syndrome, they cannot drink for at least 3-4 days after taking Antabuse. These side effects are obviously very uncomfortable and even potentially dangerous for someone with any other major illnesses.
Discuss amphetamine use/abuse and the nursing process
Some of the effcts of amphetamine asre that they have led to their abuse is elevation in mood, reduction in fatique, sense of increased alertness, and invigorating aggressiveness.
Review medication routes.
Enteral Drugs: oral medications
NG administration
Rectal administration
Parenteral drug administration
Topical eye medications
Administering ear drops
administering nasal spray
administering inhaled drugs
administering medications to the skin
administering vaginal medications
Discuss the purpose of naloxene (Narcan).
Narcan is a pure opioid antagoinist because it possess no agonist moraphine-like properties and works as a blocking agent to the opioid drugs. Accordingly, the drug does not produce analgesia or respiratory depression. Narcan is the drug of choice for the complete or partial reversal of opioid induces depression,it is also indicated for opioid overdose.
Review the nursing process in pain management.
It is best to maintain comfort from pain around the clock..as to trying to control pain once escaled to higher degree. Nurses need to adequately and accurately assess the nature of the patients pain. The RN must also evaluate and monitor the patients rsponse to the analgecics.
Discuss the purpose of the co administration if epinephrine with a local anesthetic.
The epinephrine causes vasoconstriction and when administered with the local can keep the local more "localized" in the tissues with less circulation
Discuss the risks of anesthesia
Age-risk (premature infants, neonates and pediatrics pateints are more affected by anesthesia)
Smoker vs. Non smoker
Other disease process present
Discuss the mechanism of action and drug effects, indications, contraindications, side effects and adverse effects (including toxicity and management of overdose), interactions, and dosages for Phenobarbital.
Phenobarbitol is the most commonly perscribed barbiturate, either alone or in combination with other drugs. It is considered the prototypical barbituate and is classified as a long-acting agent. Phenobarbitol is used for the prevention of grand mal seizures and fever-induced convulsions. In, addition, it has been useful in treatment of hyperbilirubinemia in neonates. It has also been used in Gilbert syndrome. It is only rarely used today for sedative-hypnotic agent. Pregnancy category D.
Discuss the nursing process (assessment, nursing diagnoses, planning, implementation, and evaluation) and secobarbital (Seconal) overdose.
Seconal is used primarily as a hypnotic agent to induce sleep. It is now used much less commonly than before because of the availability of the hypnotic benzodiazepines. It may be administered intravenously to control status epilepticus or acute seizures, similar to the way in which penobarbital is used. It may also be used to maintain a steady state of unconsciousness during general, spinal, or regional anesthesia or to facilitate intubation procedures. Pregnancy category D.
List the common adverse effects of the benzodiazepines and the management of stated adverse effects.
As a class, benzodiazepines have a relatively safe side effect profile. The side effects and adverse effects associated with their use are usually mild and they primarily involve CNS. The more commonly reported undesireable effects are headache, drowsiness, parradoxical excitement or nervousness, dizziness or vertigo, cognitive impairment, and lethargy. However they can create a significant fall hazard in frail geriatric patients and should be avoided when possible in this population.
Any chemical that affects the processes of a living organism can broadly be defined as a

a. drug.

b. side effect.

c. synergistic effect.

d. therapeutic index.
a. drug.
The study or science of drugs is known as

a. pharmacokinetics.

b. pharmacodynamics.

c. pharmacology.

d. toxicology.
c. pharmacology.
Pharmacology is an extensive science that incorporates five interrelated sciences: pharmocokinetics, pharmocodynamics, pharmacotherapeutics, toxicology, and

a. iatrogenic responses.

b. pharmacognosy.

c. therapeutic effect.

d. therapeutic index.
b. pharmacognosy.
The name that describes a drug’s chemical composition and molecular structure is known its

a. chemical name.

b. generic name.

c. trade name.

d. therapeutic index.
a. chemical name.
The name given to a drug by the United States Adopted Names (USAN) council (also called nonproprietary name) is known as its

a. chemical name.

b. generic name.

c. trade name.

d. steady state.
b. generic name.
The final name given to a drug (also called the proprietary name) is known as its

a. chemical name.

b. generic name.

c. trade name.

d. restricted name.
c. trade name.
The study of what the body does to the drug is known as

a. pharmaceutics.

b. pharmacokinetics.

c. pharmacodynamics.

d. toxicology.
b. pharmacokinetics.
The study of what the drug does to the body is known as

a. pharmaceutics.

b. pharmacokinetics.

c. pharmacodynamics.

d. toxicology.
c. pharmacodynamics.
Pharmacokinetics examines four characteristics of drugs in the body: drug absorption, distribution, metabolism, and

a. adverse drug events.

b. adverse drug reactions.

c. dissolution.

d. excretion.
d. excretion.
The study of drugs that are obtained from natural plant and animal sources is known as

a. pharmaceutics.

b. pharmacology.

c. pharmacognosy.

d. toxicology.
c. pharmacognosy.
Rank the absorption of the following various preparations from fastest to slowest: 1) liquids, elixirs, and syrups, 2) powders, 3) capsules, and 4) enteric-coated tablets.

a. 4, 3, 2, 1

b. 1, 2, 3, 4

c. 2, 3, 1, 4

d. 3, 4, 2, 1
b. 1, 2, 3, 4
Parenteral doses of drugs with a high first-pass effect are much __________ than enterally administered oral doses, yet they produce the same pharmacologic response.

a. smaller

b. larger
a. smaller
The areas where the drug is distributed first are those that are most extensively supplied with blood. Areas of rapid distribution are the heart, liver, kidneys, and

a. muscle.

b. skin.

c. fat.

d. brain.


The organ most responsible for the biotransformation or metabolism of drugs is the

a. liver.

b. kidneys.

c. lungs.

d. plasma.
d. brain.
The primary organ responsible for excretion is the

a. liver.

b. bowel.

c. plasma.

d. kidney.
d. kidney.
If the maximum level that a particular dosage could achieve in the body is 250 mg/L, and in eight hours the measured drug level is 125 mg/L, the estimated half-life for that drug is

a. two hours.

b. four hours.

c. six hours.

d. eight hours.
d. eight hours.
Peak and trough levels are important monitoring parameters for some medications. Your patient is receiving vancomycin 500 mg q 8 hr IV for a resistant staphylococcal infection and the physician ordered a peak and trough level. When would the trough level be drawn?

a. One hour before the next dose

b. One hour after the next dose

c. Five to ten minutes before the next dose

d. Five to ten minutes after the next dose
c. Five to ten minutes before the next dose
An adverse side effect of vancomycin therapy (symptoms include one or more of the following: pruritus, erythema and flushing of the upper torso, angioedema and rarely, cardiac decompression) is known as

a. red-man syndrome.

b. red-out syndrome.

c. red precipitate syndrome.

d. red rash syndrome.
a. red-man syndrome.
Regarding pharmacodynamics, there are three basic ways by which drugs can exert their mechanism of action: receptor, enzyme, and

a. affinity.

b. agonists.

c. antagonists.

d. nonspecific interactions.
d. nonspecific interactions.
Regarding pharmacotherapeutics, implementation of therapy can be: a) acute, b) maintenance, c) supplemental (or replacement), d) palliative, e) supportive, or

f) prophylactic.
True
Name the therapy.

1) Administration of vasopressors to maintain blood pressure and cardiac output after open heart surgery

2) IV antibiotic therapy may be used to prevent infections in a high-risk surgery

3) The use of high-dose opioid analgesics to relieve pain in the final stages of cancer

4) The use of oral contraception for birth control

5) The administration of insulin to diabetic patients

6) Providing fluids and electrolytes to prevent dehydration in a patient with influenza who is vomiting and has diarrhea

Antagonistic effects are experienced when antacids are given with tetracycline resulting in decreased absorption of tetracycline. Your patient is prescribed tetracycline 500 mg PO qid x 7 days and aluminum hydroxide 600 mg PO 1 hr pc and hs. Both medications are scheduled for 0900 – 1300 – 1800 – 2100. Would you administer these medications simultaneously? Why or why not?
1.
2.
3. Palative
4.
5.Suplemental
6. Supportive
A common pharmacologic disorder is glucose-6-phosphate dehydrogenase (G6PD) deficiency. Individuals who lack proper levels of G6PD have idiosyncratic reactions to a wide range of drugs and all produce varying degrees of

a. drug-induced hemolysis.

b. hives.

c. renal damage.

d. hepatic toxicity.
a. drug-induced hemolysis.
Acetaminophen has a FDA pregnancy category of B. This means

a. no risk demonstrated to the fetus in any trimester.

b. no adverse effects in animals, no human studies available.

c. only given after risks to the fetus are considered; animal studies have shown adverse reactions, no human studies available.

d. definite fetal risks, may be given in spit of

risks if needed in life-threatening conditions.

e. absolute fetal abnormalities; not to be used

anytime during pregnancy.
b. no adverse effects in animals, no human studies available.