Pharmacology Pt.2 Pre-Quiz

The nurse gives a client NPH insulin 14 units SQ before breakfast (7:30am). At what time should the nurse be particularly alert for signs or symptoms of a potential hypoglycemic reaction?

• A. 1:30-3:30pm
• B. 8:30-11:30am
• C. 7:30-9:30pm
• D. 12:00 midnight

Answer explanation

NPH, an intermediate acting insulin, peaks within 4-12 hours after SQ injection. Review insulins & peak times!

In addition to nitrate therapy, a client is receiving nifedipine (Procardia) 10 mg PO q6h. The nurse should plan to observe for which common side effect of this treatment regimen?

• Hyperkalemia
• Hypokalemia
• Hypotension
• Seizures

Answer explanation

Nifedipine (Procardia) reduces peripheral vascular resistance and nitrates produce vasodilation, so concurrent use of both can cause hypotension with the initial administration of the drugs.

A female client who has started taking long-term corticosteroid therapy tells the nurse that she is careful to take her daily dose at bedtime with a snack of crackers and milk. What is the best response by the nurse?

• Advise the client to take the medication in the morning, rather than at bedtime.
• Teach the client that dairy products should not be taken with her medication.
• Tell the client that absorption is improved when taken on an empty stomach.
• Affirm that the client has a safe and effective routine for taking the medication.

Answer explanation

Daily doses of long-term corticosteroid therapy should be administered in the morning, to coincide with the body's normal secretion of cortisol (and to avoid insomnia).

A client receiving a continuous infusion of heparin IV starts to hemorrhage from an arterial access site. What medication should the nurse anticipate administering to prevent further heparin-induced hemorrhaging?

• Vitamin K
• Protamine Sulfate
• Warfarin Sodium (Coumadin)
• Prothrombin

Answer explanation

Protamine sulfate is the antidote for heparin and is given for episodes of acute hemorrhage.

A burn client is receiving treatments of topical mafenide acetate to the site of injury. The nurse monitors the client, knowing that which finding indicates that a systemic effect has occurred?

• Hyperventilation
• Elevated blood pressure
• Local rash at the burn site
• Local pain at the burn site

Answer explanation

Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion of acid, thereby causing acidosis.

Clients receiving this treatment should be monitored for signs of an acid-base imbalance (hyperventilation). If this occurs, the medication will probably be discontinued for 1 to 2 days.

Options 3 and 4 describe local rather than systemic effects. An elevated blood pressure may be expected from the pain that occurs with a burn injury.