Pharmocology

Front 1

Your patient is new on the drug captopril (Capoten), an ACE Inhibitor. When providing client education, which of the following will you include in your instruction regarding possible adverse effects of this drug?

Back 1

Persistent dry cough

Front 2

Your patient with hypertension is started on losartan (Cozaar), an angiotension II receptor blocker. This category of drugs differs from angiotensin-converting enzyme inhibitors in that they do not cause hyperkalemia or cough. (t/f)

Back 2

True

Front 3

Your patient with hypertension also has type II diabetes. Which of the following drugs is known to slow the progress of nephropathy in both the diabetic and nondiabetic population?

Back 3

Captopril (Capoten)

Front 4

The drug nifedipine (Procardia) is a good choice of drug for a patient that has both hypertension and angina pectoris. (t/f)

Back 4

True

Front 5

Mr. James is on a calcium channel blocker to control his hypertension. Prior to administering his medication you check his v/s and find that his B/P is 98/50 and his pulse is 56 and regular. Based on your assessment you will

Back 5

Hold the drug and notify her doctor

Front 6

Mr. Ferris arrives in the ER in acute anaphylactic shock. The drug of choice for treating this condition is:

Back 6

Epinephrine (Adrenalin)

Front 7

Prolonged infusion of sodium nitroprusside (Nitropress) may result in the accumulation of

Back 7

Cyanide

Front 8

Which of the following drugs is a centrally acting alpha 2 agonist that acts by suppressing sympathetic outflow to decrease sympathetic stimulation of the heart and blood vessels?

Back 8

Clonidine (Catapress)

Front 9

To avoid exacerbating a co-morbid condition, non selective beta blockers should not be administered to a patient that has

Back 9

Asthma

Front 10

"First Dose Hypotension" is commonly associated with which category of antihypertensive agents?

Back 10

Alpha Adrenergic Blockers

Front 11

Mr. Jones has had 2 myocardial infarctions (MI) and has a history of heart failure (HF) as a complication of the myocardial damage. He is admitted to the hospital with SOB, a weight gain of 9 pounds, rales, and pedal edema. You would suspect he is again in HF. Which laboratory test might help you determine HF ?

Back 11

BNP (brain natriuretic peptide)

Front 12

Mr. Curtis, 59 years old, obese, and a smoker, comes to the ER complaining of sternal chest pain radiating to his jaw. These are classic signs/symptoms of an MI. Which laboratory test will assist in R/O and MI or diagnosing properly?

Back 12

Troponin and Isoemzyme CK (MB)

Front 13

Ms. Ross, a 49 year old woman, is newly diagnosed with an elevated total cholesterol and LDL. She has a family history of hypercholesteremia and heart attacks in her family. The doctor decides to treat her with the best drugs to lower her LDL and cholesterol, with the lowest side effects, which are?

Back 13

Statins (HMG CoA Reductase Inhibitors) Lipitor

Front 14

Nitrates are ______?

Back 14

Vasodilators

Front 15

Digoxin has a narrow theraputic range. If you patients dig level came back at 0.8nmg/ml what action would you take?

Back 15

Administer digoxin as ordered. This is within the therapeutic range.

Front 16

Lidocaine is the drug of choice for management of acute ventricular dysrhythmias. (t/f)

Back 16

True

Front 17

Which of the following are adverse effects of procanamide (Pronestyl)?

Back 17

SLE-like symptoms, blood dyscrasias, cardiotoxicity, arterial embolism

Front 18

A common adverse effect of Nitroglycerine products is headache. Patients should be told that headaches usually diminish with continued drug use. (t/f)

Back 18

True

Front 19

Bile acid sequestrants are ordered in conjunction with diet and exercise to reduce elevated levels of HDL cholesterol. (t/f)

Back 19

False

Front 20

A patient who has taken 1 nitroglycerine tablet at 5 minute intervals x3 for chest pain without relief should be instructed to seek immediate medical help (i.e call 911). (t/f)

Back 20

True

Front 21

Which of the following drugs is a prostaglandin agonist used to treat glaucoma by increasing the outflow of aqueous humor?

Back 21

Xalatan

Front 22

Diamox is a carbonic anhydrase inhibitor that increases production of aqueous humor in the eye. (t/f)

Back 22

False

Front 23

Carbamide peroxide is an agent commonly ordered for what therapeutic purpose?

Back 23

Removing ear wax from the external canal

Front 24

Which of the following are adverse effects of cortiosteroids ( example, Prednisone):

Back 24

GI bleeding, blood sugar elevations, osteoporosis

Front 25

The most serious side effect of Plaquenil toxicity is?

Back 25

Blindness secondary to retinal damage

Front 26

A drug which may be used to manage acetaminophen toxicity is

Back 26

Mucosmyst

Front 27

Patients should be instructed to take NSAIDs with food, milk or a glass of water to reduce gastric upset. (t/f)

Back 27

True

Front 28

Which of the following are signs of Aspirin Toxicity (Salicylism)?

Back 28

tinnitus, sweating, headache, & dizziness

Front 29

To prevent Reye's Syndrome, children with chickenpox or influenza should avoid taking NSAIDS. (t/f)

Back 29

TRUE

Front 30

Epotin Alfa (Epogen) is given to increase red blood cell counts in patients with anemias of chronic disease. Patients undergoing this therapy need to be assessed for which of the common adverse effects?

Back 30

Hypertension

Front 31

Which of the following actions by a seventeen year old patient learning to self inject regular and NPH insulin would indicate a need for additional instruction?

Back 31

The patient vigorously shakes the NPH insulin to disperse the particles throughout the suspension.

Front 32

A 21 year old patient with Type 1 diabetes mellitus wants to know why he has to take a "shot" instead of a pill. The nurse's best response would be:

Back 32

"Your body does not make the insulin you need to use the foods that you eat, but the insulin would be destroyed in your stomach if you took it by mouth, so you have to take it by injection."

Front 33

A patient with type2 diabetes is placed on miglitol (Acarbose) to inhibit digestion and absorption of carbohydrates. When teaching the patient about the administration of the drug, the nurse should instruct her to take the drug.

Back 33

With every meal

Front 34

The “onset” of regular insulin is:

Back 34

½ - 1hr

Front 35

Your 46 year old male patient has diabetes mellitus Type II. In order to evaluate his diabetic compliance over a period of time, you will check lab values on a regular basis. Which of the following is the best indicator of compliance?

Back 35

glycosylated hemoglobin (hgbA1c)

Front 36

An important thing to remember about the drug Glucophage is that-

Back 36

It should be held prior to IV contrast dye studies

Front 37

The sulfonylurea, Orinase works by increasing insulin release. (t/f)

Back 37

True

Front 38

Your diabetic patient administered NPH Insulin before breakfast this morning at 8am. Based on your knowlegde of when this drug may "peak", you would expect that he may develope an hypoglycemic reaction

Back 38

4 p.m.

Front 39

Troglitazone (Rezulin) the first thiazolidineione to be approved by the FDA in the U.S. was removed from the market in 2000 secondary to reports of dealths from hepatic failure. (t/f)

Back 39

True

Front 40

Lispro Insulin is considered a rapid acting insulin and has an onset of between 30-60 minutes. (t/f)

Back 40

FALSE

Front 41

Which of the following are adverse effects of cortiosteroids ( example, Prednisone):

Back 41

GI bleeding, blood glucose elevations, osteoporosis

Front 42

Your patient has been diagnosed with hypothyroidism and the doctor has prescribed levothyroxine. The patient asks how long she will need to take this medication. The nurse's best response would be:

Back 42

"Hypothyroidism is caused by the lack of a hormone that will need replacement for life unless whatever is causing the problem is altered."

Front 43

A patient with hyperthyroidism is started on propylthiouracil (PTU). The patient asks the nurse why the therapeutic effects of the drug may not be achieved before 2 weeks of treatment. The nurse's best response would be:

Back 43

The drug will only prevent further synthesis of the hormone, and stores may not be depleted for 2 weeks.

Front 44

When counseling a patient regarding radioactive iodine therapy,the nurse should explain that the development of full theraputic effects may take:

Back 44

2-3 months

Front 45

Adrenal hormone replacement therapy is needed for patients with:

Back 45

Addison's Disease

Front 46

How should the nurse suggest the patient take their thyroid drug (Synthroid)?

Back 46

Before breakfast on an empty stomach

Front 47

Excessive doses of the mineralocorticoid, fludrocortisone, cause which of the following adverse effects

Back 47

weight gain & edema of the lower extremities

Front 48

An FDA approved use of Growth Hormone is to increase the height of children who are short secondary to their genetic heritage. (t/f)

Back 48

False

Front 49

Your patient with diabetes insipidus is on Desmopressin, an antidiuretic hormone. Which of the following interventions will you include in teaching him about his new drug therapy?

Back 49

Monitor and record your daily intake and output of fluid

Front 50

Your patient with Addison's Disease is prescribed a replacement dose of hydrocortisone to treat his condition. When instructing him about this new drug therapy, you will inform him that with low (physiologic) doses this drug will have no adverse effects. (t/f)

Back 50

True

Front 51

Metoclopramide (Reglan) is frequently ordered post-operatively to slow GI motility. (t/f)

Back 51

False

Front 52

Ondansetron (Zofran) is classified as a "osomotic diuretic" to promote K loss from the bowel. (t/f)

Back 52

FALSE

Front 53

Carafate promotes ulcer healing by creating a protective barrier against acid and pepsin.

Back 53

TRUE

Front 54

Tagmet (cimetidine) is a histamine 2-receptor antagonists that promotes ulcer healing by supressing the secretion of gastric acid. (t/f)

Back 54

TRUE

Front 55

Omeprazole ( Prilosec) is pharmacologically classified as a proton pump-inhibitor. (t/f)

Back 55

TRUE

Front 56

Alkaline Phosphatase (ALP) isoenzymes can be used to distinguish between liver and bone diseases. (t/f)

Back 56

TRUE

Front 57

The use of atropine sulfate (Lomotil) is a good recommendation for occassional constipation (once every 2-3 months). (t/f)

Back 57

FALSE

Front 58

Colace promotes regular bowel movements by promoting GI motility (t/f)

Back 58

FALSE

Front 59

A retention enema of Sulfasalazine (Azulfidine) should be administered at bedtime and be retained all night for best results. (t/f)

Back 59

TRUE

Front 60

Amylase and Lipase levels are monitored closely when renal disease is suspected. (t/f)

Back 60

FALSE

Front 61

Mr. Ross has a DVT in his lower leg. Heparin is needed, and is started with a loading dose and then he is put on a Heparin algorithm per hospital protocol. Heparin is monitored and ordered per lab work of (A)PTT. (t/f)

Back 61

TRUE

Front 62

Mr. Ross' lab work/anticoagulation is more than double what it should be. What would you do and/or might be ordered to do?

Back 62

Stop the Heparin, and possibly give Protomine to reverse Heparin.

Front 63

Mr. Scott is in Atrial Fibrillation and is on Coumadin/Warfarin for anticoagulation. Warfarin has a long half-life compared to Heparin and is ordered by the doctor according to (PT) Prothrombin times. It is important to know and teach your patient that coumadin is subject to a lot of drug and food interactions. The antidote for Coumadin/Warfarin is Vitamin K (aqua mephyton). (t/f)

Back 63

TRUE

Front 64

Before sending a patient home on an anti-coagulant as Coumadin, it is very important that he/she understand the following:

Back 64

read OTC labels to omit aspirin, don't use a stright edge razor, check for bleeding in soft tissues

Front 65

Mrs. Oakridge has iron deficiency anemia, which is the most common nutrition related anemia in the world. The major consequence is microcytic, hypochromic anemia, and is treated with oral ferrous sulfate or IV iron dextran. (t/f)

Back 65

TRUE

Front 66

Mrs. Wolf has been diagnosed with severe vitamin B12 deficiency. Sha has lack of intrinsic factor due to malabsorption from a gastric bypass 7 years ago. Her doctor has begun giving her vitamin B12 IM injections and adding folic acid to treat this. (t/f)

Back 66

TRUE

Front 67

Mr Adams is a 49 year old man who has a long history of alcohol abuse and has cirrhosis. He was found in his apartment after a binge (not known how long he was there), is in the hospital and is severely malnourished with anemia. What type of anemia do alcoholics typically have and what medication(s) is prescribed?

Back 67

Folic acid deficiency anemia, treat with folic acid and possibly multi-vitamin, and improve nutrition

Front 68

Your patient has had chronic renal failure for 8 years and is on dialysis 3 times per week. Typically these patients have anemia and need a medication to boast their RBC count. That medication is?

Back 68

Epoetin alfa

Front 69

Mrs. Monet has cancer and has been receiving traditional chemotherapy which is depleting her cell count. She is at high risk for a severe infection. What drug might the physician order to boast her immune infection fighting capabilities?

Back 69

Filgrastim or neupogen

Front 70

Mrs. Easter has a nonmyeloid cancer and is being given myelosupressive chemotherapy for her disease. The drug given to minimize her thrmbocytopenia is:

Back 70

Interleukin-11 (oprelvekin)

Front 71

The drugs of choice in the treatment of Parkinson’s Disease are those that have which action?

Back 71

Increase dopamine

Front 72

When analyzing the diet of a patient who is taking levodopa, the nurse finds that the patient eats three times the recommended amount of meat at each meal. The nurses best response would be to tell her:

Back 72

why it is important to decrease her meat consumption, especially while she is taking levodopa.

Front 73

A mannitol solution that contains crystals must be discarded. (t/f)

Back 73

FALSE

Front 74

Which of the following medications is considered "disease modifying " for Multiple Sclerosis?

Back 74

Copaxone

Front 75

When administering Mannitol I.V. it is important to use an inline filter. (t/f)

Back 75

TRUE

Front 76

Which of the following are common adverse effects of Solu-Medrol?

Back 76

immune suppression and hyperglycemia

Front 77

Amantadine (Symmetrel) is classified as both an an anti-parkinson's agent and

Back 77

an anti-viral agent

Front 78

Benztropine (Cogentin) is used to attain the following theraputic effect?

Back 78

reduce rigidity and tremors

Front 79

Concurrent use of Selegiline (Eldepyrl) with this drug may result in a possible fatal reaction:

Back 79

Demerol

Front 80

Bromocriptine (Parlodel) is used often used in combination with levodopa to treat Parkinson's Disease. (t/f)

Back 80

TRUE

Front 81

The physician has prescribed sumatriptan (Imitrex) for a patient's headaches. During patient assessment and teaching, the nurse must determine whether:

Back 81

The patient has taken ergotamine (Cafergot) within the past 24 hours.

Front 82

Optimal dosage of cholinesterase inhibitors for patients with myasthenia gravis is indicated by:

Back 82

ease of swallowing and increase ability to raise eyelids.

Front 83

Which of the following patients should receive ergotamine preparations (Cafergot) for their migraines?

Back 83

Females who have severe migraines during their menses.

Front 84

The plasma level for phenytoin (Dilantin) is 24mg/ml, and the next dose of the drug is now due. The nurse should:

Back 84

Withhold the drug and notify the physician.

Front 85

A patient taking phenytoin (Dilantin) begins to exhibit ataxia and diplopia. As the nurse, you recognize that these are adverse effects of the drug on the CNS and notify the patient's physician. (t/f)

Back 85

TRUE

Front 86

When a patient receives an overdose of a cholinesterase inhibitor, the nurse would expect the resulting respiratory depression to be treated with:

Back 86

atropine

Front 87

A patient's family calls and tells the nurse that the patient has taken 5 times his normal dose of baclofen (Lioresal). They want to know what to give him. The nurses best response would be:

Back 87

"Call 911 immediately for help, because emergency treatment is supportive."

Front 88

I.V. Valium is a first line drug used in the treatment of prolonged seizure activity. (t/f)

Back 88

TRUE

Front 89

A medication commonly used to prevent migraine headaches is:

Back 89

Inderal

Front 90

Gingival hyperplasia is a side effect associated with which of the following drugs:

Back 90

Dilantin

Front 91

Your 73 year old female patient is started on Raloxifene (Evista) to treat her post menopausal osteoporosis. You will instruct her to discontinue the drug 72 hours prior to any period of prolonged immobilization (prolonged bedrest, surgery) to decrease the risk of:

Back 91

Thromboembolism

Front 92

Tamoxifen (Nolvadex) is an example of a selective estrogen-receptor modulator (SERM). This drug was designed with the goal of producing the same benefits that estrogen has on the bones and cholesterol levels but without the same risk for hormone related cancers. (t/f)

Back 92

TRUE

Front 93

Two drawbacks to using Teriparatide (Forteo) to treat osteoporosis is that the drug must be administed sq and that it is very expensive. (t/f)

Back 93

TRUE

Front 94

To help promote asorbtion of calcium, you should instruct your patient to take no greater than _______________ mg at one time

Back 94

600mg

Front 95

Calcitomin salmon (Micalcin) must be taken in the mornig before breakfast with a full glass of water. The patient must be instructed to remain seated or standing for at least 30 minutes before taking any other food or drink. (t/f)

Back 95

FALSE

Front 96

Alendronate (Fosamax) is a Biphosphonate indicated in both the prevention and treatment of osteoporosis. (t/f)

Back 96

TRUE

Front 97

Vitamin D induced hypercalcemia can cause irregular heart rhythms in patients taking which of the following drugs?

Back 97

Digoxin

Front 98

Current therapy for rheumatoid arthritis involves using DMARDs only after NSAIDs are no longer effective.(t/f)

Back 98

FALSE

Front 99

According to Lehne, which of the following DMARDs is considered the first choice of many rheumatologists when treating rheumatoid arthritis?

Back 99

Methotrexate

Front 100

Allopurinol is used to increase levels of uric acid in patients suffering from gout. (t/f)

Back 100

FALSE

Front 101

The doctor orders; Fursomide (Lasix) 20 mg po twice a day. To minimize nocturia you will instruct your patient to take the drug on which of the following schedules

Back 101

8am and 2 pm

Front 102

Which of the following is an adverse effect of a high ceiling (loop) diuretic?

Back 102

Ototoxicity

Front 103

Thiazide diuretics produce the greatest diuresis of all diuretics. (t/f)

Back 103

FALSE

Front 104

Hypokalemia is an adverse effect of loop and thiazide diuretics which can be minimized by

Back 104

Consuming potassium rich foods, taking a potassium supplement, using a potassium sparing diuretic

Front 105

The principle adverse effect of spironolactone (aldactone) is hypokalemia. (t/f)

Back 105

FALSE

Front 106

Sodium Bicarbonate is an alkalinizing salt used primarily to treat respiratory or metabolic alkalosis.(t/f)

Back 106

FALSE

Front 107

In a patient taking digoxin, concurrent hypokalemia is the principle cause of digoxin toxicity. (t/f)

Back 107

TRUE

Front 108

Severe hypokalemia should be promptly treated with potassium chloride in sustained release tablets. (t/f)

Back 108

FALSE

Front 109

When a patient is receiving IV Magnesium, which of the following drugs should be immediately available to counteract neuromuscular action that may be produced?

Back 109

Calcium

Front 110

Isotonic volume contraction should be treated with isotonic sodium chloride (0.9%). (t/f)

Back 110

TRUE

Front 111

Accolate (Zafirlukast) decreases inflammation and bronchconstriction by

Back 111

Blocking leukotriene receptors

Front 112

An oversdose of the drug Theophylline (ie theophylline level greater than 20ug/ml)can cause severe dysrhythmias and convulsions. (t/f)

Back 112

TRUE

Front 113

The most common side effects/adverse effects from the use of inhaled corticosteroids is/are:

Back 113

Oropharygeal candidiasis and dysphonia (hoarseness)

Front 114

Patient education for Accolate (Zafirlukast) includes:

Back 114

oral absorption is rapid, and should be taken on an empty stomach

Front 115

A pulse oximetery value of 88 is within normal limits and requires no nursing intervention. (t/f)

Back 115

FALSE

Front 116

Patient education is always important. You should teach a patient using inhaled corticosteroids to:

Back 116

rinse/gargle after each use, and use a spacer.

Front 117

Arterial Blood gases (ABG's) are used to monitor arterial blood pressures via an arterial line in critically ill patients. (t/f)

Back 117

FALSE

Front 118

. Suzanne, 43 years old, has a 15 year history of Asthma. She is taking her morning walk and doesn't realize that the temperature is 30 degrees out. This triggers wheezing and SOB, which she knows to be an "asthma attack". Suzanne is on 4 inhalers; which one should be used first ?

Back 118

Albuterol (B2 adrenergic agonist)

Front 119

. Which of the medications is the safest and should be used prophylactically to prevent Asthma?

Back 119

Cromolyn

Front 120

In a patient with signs and symptoms of respiratory infection, it is important to get a sputum for culture and sensitivity prior to beginning antibiotic therapy. (t/f)

Back 120

TRUE

Front 121

Malcolm is positive for Tb. The doctor explains that he has to put him on a combination of three medications, which generally include

Back 121

Isoniazide, rafampin, ethambutol

Front 122

Isoniazide (INH) is traditionally the drug of choice for Tb, but has the adverse effects of hepatotoxicity and peripheral neuropathy. (t/f)

Back 122

TRUE

Front 123

Ralph has a history of HTN and CAD (coronary heart disease). He asks you, the nurse, if it is OK to take Sudafed (pseudoephedrine). Your response would be:

Back 123

Sudafed can cause vasoconstriction, which could cause chest pain and increase your blood pressure."

Front 124

First line drugs used for allergic rhinitis, to relieve rhinorrhea and sneezing are:

Back 124

Antihistamines (H1 receptor antagonists)

Front 125

Extended use ( more than a few days) of topical nasal decongestants can cause rebound congestion. (t/f)

Back 125

TRUE

Front 126

Your patient who has been diagnosed with a "cold" is requesting that his health care provider give him a prescription for an antibiotic. How will you respond to him? Would an order to that effect be in the patient's best interest?

Back 126

No, antibiotics are ineffective against virus's. Use this time to educate your patient regarding how inappropriate use of these drugs contribute to the development of resistant bugs.

Front 127

When collecting a sputum specimen for culture the most reliable speciman is one that is collected when the patient first arises in the morning, after he brushes his teeth and rinses his mouth. (t/f)

Back 127

TRUE

Front 128

Your patient on isoniazid has orders for monthly AST levels to evaluate his liver function. If the current lab value is twice as high as his baseline value, the medications should be stopped. (t/f)

Back 128

FALSE

Front 129

Thomas has had Tb for over 1 year. He has not always taken his medications as ordered. His doctor is worried about drug resistance, mainly due to inadequate drug therapy, which kills the sensitive bacteria but allows the mutants to flourish. (t/f)

Back 129

TRUE

Front 130

To prevent emergence of resistant organisms, Tb must always be treated with at least 2 drugs, which the infecting organism is sensitive to, and usually for 6 months to two years. (t/f)

Back 130

TRUE