Pharm 1 exam 2

The nurse provides care for a client who is admitted to the urgent care clinic for the treatment of an asthma exacerbation. The client reports feeling shaky and has a heart rate of 124 beats per minute. Which prescribed medication does the nurse suspect as being responsible for the client’s current symptoms?

• Guaifenesin

• Albuterol

• Montelukast

• Diphenhydramine

Answer explanation

Albuterol is a beta-2 adrenergic agonist that is a rescue medication that is prescribed for the treatment of acute asthma exacerbation. This medication is associated with hypokalemia, shakiness and tachycardia; therefore, the nurse suspects this pharmacotherapy is responsible for the client’s current symptoms. 

Expected SE: Tachycardia Tremors Tossing and turning at night

A client with which of the following conditions may experience a dangerous or fatal side effect of theophylline?  

• Hepatic disease

• Cardiac disorder

• Diabetes

• Renal disease

Answer explanation

A client with a heart condition may experience dangerous stimulation from this drug. Use cautiously in patients who have cardiac arrhythmias (excluding bradyarrhythmias), as it may exacerbate arrhythmias. Theophylline should be administered cautiously with all the other choices, but the consequences are most dangerous or possibly fatal for clients with heart conditions. Theophylline has a very narrow therapeutic window.

3 Ts:

• - Toxic over 20

• - Tonic clinic seizures; FIRST priority

• - Tachycardia and dysrhythmias

A nurse is providing teaching to a client who has a new prescription for doxycycline. The nurse should instruct the client to monitor for which of the following adverse effects?

• Blurred vision

• Ototoxicity

• Photosensitivity

• Constipation

What statements are true about Vancomycin?

• It can cause Red Man syndorme

• It should be administered <60 min piggyback

• It is used to treat MRSA infection

• It should be administered IV push

• It is bacteriostatic

Answer explanation

MRSA and C. diff, bactericidal, red man syndrome, ototoxic, check serum trough levels (after 3rd before 4th), IV piggyback 60 minutes or longer.

What is a contraindication for the use of Imipenem-cilastatin (Primaxin)

• History of muscle cramps

• 60 years old

• History of seizures

• Oral contraceptives

Which drug is a PCN substitute?

• Amoxicillin

• Monobactams

• Cephalosporins

• Erythromycin

What is the rate at which Gentamycin should be administered?

• 60 min IV piggyback or longer

• over 2 hours IV piggyback or longer

• 30 minutes IV piggyback or longer

• 15 min IV piggyback or longer

What is most concerning to the nurse when assessing a patient on Ciprofloxacin?

• The patient took a potassium supplement

• The patient expresses pain in the lower extremities

• The patient reports diarrhea

• The patient states they are feeling tired

What is penicillin's mechanism of action?

• Inhibits protein synthesis

• Weakens the cell wall

• Inhibits bacterial DNA synthesis

• To do nothing

Nurse Rita is giving instructions to her client who is taking antihistamine. Which of the following nurse teachings is appropriate for the client?

• Expect relief in 24 hours

• Be aware that you may have increased saliva

• Be aware that you may need to take a decongestant

• Avoid ingesting alcohol

Answer explanation

Because alcohol and antihistamines have sedating properties, concurrent administration of these drugs should be avoided. H-1 receptors and H-2 receptors. Antihistamine drugs that bind to H-1 receptors are generally used to treat allergies and allergic rhinitis. Dry mouth is a common side effect. Antihistamines and decongestants are often given together. Not all antihistamines last 24 hours