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110 Cards in this Set
- Front
- Back
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1. A patient has been treated with ropinirole (Requip), an antiparkinsonian agent, for |
If you selected "d," you are a genius! Therapeutic responses to the antiparkinsonian |
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2. Before beginning therapy with amitriptyline (Elavil), you would want to assess for |
If you selected "b," you are a wizard! Use of the tricyclic antidepressant agent, |
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3. A 22-year-old female has been taking lithium (Eskalith) for six months. She comes in |
If you selected "d," bravo! Lithium (Eskalith) levels exceeding 2.0 to 2.5 mEq/L produce |
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Moderate to severe pain is best treated with: |
d. morphine sulfate. |
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Lidocaine is frequently used for: |
B. local anesthesia |
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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: |
b. plan a gradual reduction in dosage. |
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Which of the following is not true about intravenous infusion of phenytoin? |
b. It should be injected quickly. |
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A patient, who is taking levodopa for Parkinson's disease, wants to take a vitamin supplement. What should he be told? |
c. Avoid supplements that contain vitamin B6 (pyridoxine). |
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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? |
c. Hepatic necrosis |
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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)? |
c. Neostigmine (Prostigmin) |
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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 |
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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: |
b. autoinduction results in lower than expected drug concentrations. |
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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? |
d. Take the medication at bedtime to prevent drowsiness during the day. |
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Iatrogenic is best defined as: |
B. arising from treatment. |
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The identification of adverse reactions to medication is usually imcomplete until the drug in question has been in use at least |
C. ten years |
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Side effects are best defined as: |
C. effects of the drug other than the specific purpose for which the drug was perscribed, both helpful and harmful. |
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A genetically determined, unexpected response to a drug is called: |
C. idiosyncratic reaction |
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When drugs are execreted more slowly than they are absorbed, the result is: |
B. cummulation |
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A decreased physiologic response to a drug after repeated administration of a drug is: |
B. tolerance |
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The ability of a drug to cause abnormal fetal development is referred to as: |
D. teratogenicity |
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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? |
D. Review the patient's medication history to detect any history of allergies by asking the patient. |
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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 |
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Reactions that are characteristic of high doses of a drug are termed: |
D. toxic |
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Renal insufficiency is most likely to: |
B. lengthen serum half-life drugs taken by the patient |
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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: |
C. a return of symptoms in exaggerated form |
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When a patient develops diarrhea, the effect of medication regimines is likely to be: |
C. excretion of the drug before it can be absorbed |
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If a nurse crushed an enteric coated drug and instilled it into the stomach through a feeding tube, the result would most likely be: |
D. stomach irritation owing to gastric release of the drug |
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An example of an antineoplastic drug known to have carcinogenic potential is: |
A. cyclophosphamide |
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Which of the following statements correctly describes a manifestation of cochlear toxicity? |
C. The hearing loss progresses from higher to lower frequencies |
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A drug with multiple pharmacologic actions (such as diphenhydramine) may be administered because it causes: |
B. A known desirable effect |
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Postural (orthostatic) hypotension from a vasodilator is an example of: |
B. A predictable reaction |
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Unpredictable adverse reactions are: |
A. unusal and unexpected |
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If a patient reports a previous response to PCN, the nurse should avoid giving the patient: |
D. cephalosporins |
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Adverse drug reactions are easier to identify and pinpoint when: |
A. only one drug is being administered |
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To assess for possible organ toxicity from an ADR (adverse drug reaction), the nurse should: |
D. Monitor liver and kidney function |
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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. |
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When filing an FDA report on an adverse drug reaction, the nurse should: |
D. be as complete as possible |
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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: |
B. cross-tolerance |
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An unexpected reaction to a drug the first time it is given is: |
A. idiosyncratic response |
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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? |
B. Administration of Narcan, an opioid reversal agent |
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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? |
C. acetylcysteine (mucomyst) |
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What is the major adverse effect of nonsteriodal anti-inflammatory drugs (NSAIDS)? |
D. GI complaints, which can develop into ulcers and GI bleeding |
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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 |
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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? |
B. Benzodiazepines affect the sleep cycle, thus causing a hangover effect |
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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? |
C. "Drinking one beer may change the way my medications works" |
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After giving your 62yo patient Seconal 100mg PO at HS, the nurse should do all of the following except? |
C. Understand that this drug is being given as a hypertensive agent |
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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? |
B. Contact the physician for another dosage form of the medication |
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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? |
B. The potential decreased effectiveness of the birth control pills while taking Dilantin |
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Signs and symptoms of phenytoin toxicity include all of the following except: |
A. Euphoria |
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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: |
C. hypertension |
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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: |
B. eating a snack before taking the medication will help prevent the nausea |
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What type of glaucoma prohibits the use of levodopa? |
D. Closed-angle |
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Before beginning therapy with amitriptyline (a tricyclic antidepressant), you would want to assess for concurrent use of which of the following types of medications? |
C. Warfarin |
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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? |
B. GI dysfunctions |
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Which classification of drugs stimulates an inhibitory neurotransmitter gamma amino benzoic acid (GABA)? |
D. Benzodiazepines |
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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 |
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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 |
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Which of the following drugs has shown a neuroprotective effect when started early in therapy? |
c. Selegiline (Eldepryl) |
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The drug of choice for mania is: |
b. lithium (Eskalith) |
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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: |
c. "It may take two to four weeks before you see an improvement." |
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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? |
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. |
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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 |
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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? |
d. Improved mental status, as well as improved ability to perform activities of daily living (ADLs) |
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Before beginning therapy with amitriptyline (Elavil), you would want to assess for concurrent use of which of the following types of medications? |
b. Warfarin |
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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? |
d. Serum lithium level of 2.5 mEq/L and cardiac dysrhythmias |
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Caffeine should be used with caution in which of the following patients? |
a. A male with a history of peptic ulcers |
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When evaluating the patient who is taking sibutramine (Meridia), which of the following is an intended therapeutic effect? |
c. Suppressed appetite |
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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. |
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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. |
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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. |
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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. |
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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. |
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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. |
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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.) |
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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. |
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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. |
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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. |
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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. |
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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. |
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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. |
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Review medication routes. |
Enteral Drugs: oral medications |
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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. |
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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. |
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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 |
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Discuss the risks of anesthesia |
Age-risk (premature infants, neonates and pediatrics pateints are more affected by anesthesia) |
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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. |
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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. |
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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. |
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Any chemical that affects the processes of a living organism can broadly be defined as a |
a. drug. |
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The study or science of drugs is known as |
c. pharmacology. |
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Pharmacology is an extensive science that incorporates five interrelated sciences: pharmocokinetics, pharmocodynamics, pharmacotherapeutics, toxicology, and |
b. pharmacognosy. |
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The name that describes a drug’s chemical composition and molecular structure is known its |
a. chemical name. |
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The name given to a drug by the United States Adopted Names (USAN) council (also called nonproprietary name) is known as its |
b. generic name. |
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The final name given to a drug (also called the proprietary name) is known as its |
c. trade name. |
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The study of what the body does to the drug is known as |
b. pharmacokinetics. |
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The study of what the drug does to the body is known as |
c. pharmacodynamics. |
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Pharmacokinetics examines four characteristics of drugs in the body: drug absorption, distribution, metabolism, and |
d. excretion. |
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The study of drugs that are obtained from natural plant and animal sources is known as |
c. pharmacognosy. |
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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. |
b. 1, 2, 3, 4 |
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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 |
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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 |
d. brain. |
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The primary organ responsible for excretion is the |
d. kidney. |
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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 |
d. eight hours. |
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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? |
c. Five to ten minutes before the next dose |
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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. |
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Regarding pharmacodynamics, there are three basic ways by which drugs can exert their mechanism of action: receptor, enzyme, and |
d. nonspecific interactions. |
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Regarding pharmacotherapeutics, implementation of therapy can be: a) acute, b) maintenance, c) supplemental (or replacement), d) palliative, e) supportive, or |
True |
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Name the therapy. |
1. |
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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. |
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Acetaminophen has a FDA pregnancy category of B. This means |
b. no adverse effects in animals, no human studies available. |
