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Pharm Exam 4

Total questions: 50

Worksheet time: 25mins

Name
Class
Date
1.

The nurse has administered normal saline to a patient who experienced blood loss. Before administering frozen plasma to the patient, what information will the nurse gather

a)

History of seizure

b)

History of brain injury

c)

History of osteoporosis

d)

History of thyroid problems

2.

A patient who was injured in a motor vehicle accident has hypovolemic shock due to excess blood loss. The laboratory reports show that the patient has anemia. What will the nurse expect the provider to order?

a)

Albumin

b)

Normal saline

c)

Packed red blood cells

d)

Plasma protein fraction

3.

Which assessment finding in an adult patient requires immediate nursing action?

a)

PaO2 level of 92 mm Hg

b)

Serum sodium 140 mEq/L

c)

Serum potassium of 3.8 mEq/L

d)

Urinary output of 250 mL in 24 hours

4.

For what signs and symptoms of overdose does the nurse monitor after administering a hypertonic saline solution to a patient who has severe hyponatremia?

a)

Vomiting and diarrhea

b)

Confusion and seizures

c)

Lethargy and hypotension

d)

Flushed skin and increased thirst

5.

The nurse is caring for a patient who has a deficiency in clotting factor. Which product is used in such a patient?

a)

Hetastarch

b)

Fresh frozen plasma (FFP)

c)

Plasma protein fraction (PPF)

d)

Packed red blood cells (PRBCs)

6.

A patient who has just undergone surgery exhibits tachycardia and a hemoglobin level of 9 g/100 mL. Which fluid therapy will the nurse expect to administer?

a)

50 mL of 5% albumin

b)

450 mL of whole blood

c)

100 mL of fresh frozen plasma

d)

250 mL of packed red blood cells

7.

Which food will the nurse recommend for a patient who has hypokalemia?

a)

Lean turkey

b)

Beef bouillon

c)

Mashed potatoes

d)

Cream of broccoli soup

8.

A child is prescribed methylphenidate (Ritalin) to treat attention deficit hyperactivity disorder (ADHD). The parent expresses concern about using a controlled substance to treat ADHD and asks the nurse about using a noncontrolled substance. The nurse knows ADHD can be treated with which noncontrolled substance?

a)

Methylphenidate (Concerta)

b)

Atomoxetine (Strattera)

c)

Amphetamine aspartate (Adderall)

d)

Dextroamphetamine sulfate (Dexedrine)

9.

A patient diagnosed with narcolepsy is prescribed a central nervous system (CNS) stimulant. Which statement best describes the action of CNS stimulants?

a)

CNS stimulants activate cyclic adenosine monophosphate.

b)

CNS stimulants block or reduce the activity of inhibitory neurons.

c)

CNS stimulants increase release of and block reuptake of neurotransmitters.

d)

CNS stimulants decrease the production of excitatory neurotransmitters.

10.

The nurse explains to a patient that using caffeine may exacerbate which health condition?

a)

Cardiac dysrhythmias

b)

Constipation

c)

Heart block

d)

Myelin degeneration

11.

Which instructions should the nurse discuss to reduce the gastrointestinal (GI) adverse effects of orlistat (Xenical)?

a)

Advise to take vitamin C supplement.

b)

Take the medication with an antacid.

c)

Limit dietary intake of fat.

d)

Increase fluid and fiber in the diet.

12.

The nurse has given medication instructions to a patient receiving phenytoin (Dilantin). Which statement by the patient indicates that the patient has an adequate understanding?

a)

"I will need to take extra care of my teeth and gums while on this medication."

b)

"I can go out for a beer while on this medication."

c)

"I can skip doses if the side effects bother me."

d)

"I will be able to stop taking this drug once the seizures stop."

13.

When teaching a patient about taking a newly prescribed antiepileptic drug (AED) at home, the nurse will include which instruction?

a)

"Driving is allowed after 2 weeks of therapy."

b)

"If seizures recur, take a double dose of the medication."

c)

"Antacids can be taken with the AED to reduce gastrointestinal adverse effects."

d)

"Regular, consistent dosing is important for successful treatment."

14.

A patient has a 9-year history of a seizure disorder that has been managed well with oral phenytoin (Dilantin) therapy. He is to be NPO (consume nothing by mouth) for surgery in the morning. What will the nurse do about his morning dose of phenytoin?

a)

Give the same dose intravenously.

b)

Give the morning dose with a small sip of water.

c)

Contact the prescriber for another dosage form of the medication.

d)

Notify the operating room that the medication has been withheld.

15.

A patient is experiencing status epilepticus. The nurse prepares to give which drug of choice for the treatment of this condition?

a)

diazepam (Valium)

b)

midazolam (Versed)

c)

valproic acid (Depakote)

d)

carbamazepine (Tegretol)

16.

Phenytoin (Dilantin) has a narrow therapeutic index. The nurse recognizes that this characteristic means that

a)

the safe and the toxic plasma levels of the drug are very close to each other.

b)

phenytoin has a low chance of being effective.

c)

there is no difference between safe and toxic plasma levels.

d)

a very small dosage can result in the desired therapeutic effect.

17.

A patient has been taking selegiline (Eldepryl), 20 mg/day for 1 month. Today, during his office visit, he tells the nurse that he forgot and had a beer with dinner last evening, and "felt awful." What did the patient most likely experience?

a)

Hypotension

b)

Hypertension

c)

Urinary discomfort

d)

Gastrointestinal upset

18.

A patient has been given a prescription for levodopa-carbidopa (Sinemet) for her newly diagnosed Parkinson's disease. She asks the nurse, "Why are there two drugs in this pill?" The nurse's best response reflects which fact?

a)

Carbidopa allows for larger doses of levodopa to be given.

b)

Carbidopa prevents the breakdown of levodopa in the periphery.

c)

There are concerns about drug-food interactions with levodopa therapy that do not exist with the combination therapy.

d)

Carbidopa is the biologic precursor of dopamine and can penetrate into the central nervous system.

19.

A patient has been treated with antiparkinson medications for 3 months. What therapeutic responses should the nurse look for when assessing this patient?

a)

Decreased appetite

b)

Gradual development of cogwheel rigidity

c)

Newly developed dyskinesias

d)

Improved ability to perform activities of daily living

20.

In caring for a patient experiencing ethanol withdrawal, the nurse expects to administer which medication or medication class as treatment for this condition?

a)

lithium (Eskalith)

b)

benzodiazepines

c)

buspirone (BuSpar)

d)

antidepressants

21.

Patient teaching for a patient receiving an MAOI would include instructions to the patient to avoid which food product?

a)

orange juice

b)

milk

c)

shrimp

d)

swiss cheese

22.

The nurse is giving medications to a patient. Which drug or drug class, when administered w/lithium, increases the risk for lithium toxicity?

a)

thiazides

b)

levofloxacin

c)

calcium citrate

d)

beta blockers

23.

When doing an admission drug history, the nurse notes that the patient has a prescription for lithium (Lithobid). The nurse suspects that this patient has been diagnosed with which condition?

a)

Bipolar disorder

b)

Absence seizures

c)

Paranoid schizophrenia

d)

Obsessive-compulsive disorder

24.

A patient diagnosed with depression is being discharged with a prescription for TCAs after no improvement of symptoms on an SSRI. Which instruction should the nurse include about this new medication?

a)

There are no drug or food contraindications with this

medication.

b)

There is a risk of toxicity when this medication is taken with alcohol.

c)

Take St. John's wort every day to minimize the adverse effects of the medication.

d)

This drug does not cause problems with sleep, constipation, or low blood pressure.

25.

a newly admitted patient reports a penicillin allergy. The prescriber has ordered a second generation cephalosporin as part of the therapy. which nursing action is appropriate?

a)

call the prescriber to clarify the order because of the patients allergy

b)

give the medication and monitor for adverse effects

c)

ask the pharmacy to change the order to a first generation cephalosporin

d)

administer the drug with a NSAID drug to reduce adverse effect

26.

the nurse is reviewing the orders for a patient who has been admitted for treatment of pneumonia. The antibiotic orders include an order for doxycycline. however the patient is asked about his allergies, he lists doxycycline as one of them. what is the nurses priority action

a)

call the provider to clarify the order because of the patients allergy

b)

ask the patient to explain what happens when he has the allergic reaction

c)

ask the pharmacy to order a different antibiotic

d)

administer the drug with and antihistamine to reduce adverse effects

27.

Which adverse effect can result if tetracycline is administered to children younger than 8 years of age?

a)

Drug-induced neurotoxicity

b)

Delayed growth development

c)

Gastrointestinal (GI) and rectal bleeding

d)

Permanent discoloration of the teeth

28.

Which information should the nurse include in discharge teaching for a client prescribed doxycycline (Vibramycin)?

a)

"Keep the remainder of the medication in case of recurrence."

b)

"Take the medication until you have no fever and feel better."

c)

"Apply sunscreen or wear protective clothing when outdoors."

d)

"Take the medication with milk to minimize gastrointestinal upset."

29.

Bacterial resistance to antibiotics can occur with which situations?

a)

Antibiotics that are prescribed to treat a viral infection

b)

Taking an antibiotic and an antiviral medication at the same time

c)

Microorganisms arriving from foreign countries and overseas ports

d)

Antibiotics that are prescribed according to culture and sensitivity reports

30.

Nurse is administering IV Acyclovir (zovirax) to a patient with a viral infection. Which admin technique is correct?

a)

Infuse Acyclovir IV slowly, over at least 1 hour

b)

Infuse by rapid bolus

c)

Refrigerate Acyclovir IV

d)

Restrict oral fluids

31.

The nurse checks the patient's laboratory work prior to administering a dose of vancomycin (Vancocin) and finds that the trough vancomycin level is 24 mcg/mL. What will the nurse do next?

a)

Repeat the test to verify results.

b)

Administer the vancomycin

c)

Hold the drug, and administer 4 hours later.

d)

Hold the drug, and notify the prescriber.

32.

The nurse would monitor which laboratory values in a patient receiving intravenous gentamicin (Garamycin)?

a)

Blood urea nitrogen (BUN) and creatinine

b)

Prothrombin time (PT) and partial thromboplastin time (PTT)

c)

Hematocrit and hemoglobin

d)

Serum glutamic-oxaloacetic transaminase (SGOT) and alanine transaminase (ALT)

33.

A 79-year-old patient is receiving a quinolone as treatment for a complicated incision infection. The nurse will monitor for which adverse effect that is associated with these drugs?

a)

Neuralgia

b)

Double vision

c)

Tendonitis and tendon rupture

d)

Hypotension

34.

When a patient is on aminoglycoside therapy, the nurse will monitor the patient for which indicators of potential toxicity?

a)

Tinnitus and dizziness

b)

Fever

c)

White blood cell count of 8000 cells/mm3

d)

Decreased blood urea nitrogen (BUN) levels

A.Tinnitus and dizziness

35.

The nurse is administering a vancomycin (Vancocin) infusion. Which measure is appropriate for the nurse to implement in order to reduce complications that may occur with this drug's administration?

a)

Restricting fluids during vancomycin therapy

b)

Discontinuing the drug immediately if red man syndrome occurs

c)

Monitoring blood pressure for hypertension during the infusion

d)

Infusing the drug over at least 1 hour

36.

During antibiotic therapy, the nurse will monitor closely for signs and symptoms of a hypersensitivity reaction. Which of these assessment findings may be an indication of a hypersensitivity reaction? (Select all that apply.)

a)

Wheezing

b)

Black, hairy tongue

c)

Swelling of the tongue

d)

Itching

e)

Shortness of breath

37.

When reviewing the allergy history of a patient, the nurse notes that the patient is allergic to penicillin. Based on this finding, the nurse would question an order for which class of antibiotics?

a)

Sufonamides

b)

Tetracyclines

c)

Quinolones

d)

Cephalosporins

38.

What are important for the nurse to monitor in a client receiving an antifungal medication? (Select all that apply.)

a)

Creatinine

b)

Daily weights

c)

Mental status

d)

Intake and output

e)

Blood urea nitrogen

39.

The nurse is giving medications to a patient. Which drug or drug class, when administered w/lithium, increases the risk for lithium toxicity?

a)

thiazides

b)

levofloxacin

c)

calcium citrate

d)

beta blockers

40.

An intravenous dose of midazolam (Versed) has been prescribed for a patient before a colonoscopy. The nurse informs the patient that one of the most common adverse effects of this medication is what effect?

a)

Amnesia

b)

Dry mouth

c)

Chest pain

d)

Constipation

41.

A hospitalized patient is complaining of having difficulty sleeping. Which action will the nurse take first to address this problem?

a)

administer a sedative-hypnotic drug if ordered

b)

offer tea made with the herbal preparation valerian

c)

encourage the patient to exercise by walking up and down the halls a few times if tolerated

d)

provide an environment that is restful, and reduce loud noises

42.

A patient has been admitted to the ER because of an overdose of an oral benzodiazepine. He is very drowsy but still responsive. The nurse will prepare for which immediate intervention?

a)

hemodialysis to remove the medication

b)

administration of flumazenil

c)

administration of naloxone

d)

intubation and mechanical ventilation

43.

What is another approved and indicated use for bupropion (Zyban), A second-generation antidepressant?

a)

orthostatic hypotension

b)

smoking cessation

c)

anorexia in patients undergoing chemotherapy

d)

nocturnal enuresis and children

44.

The patient diagnosed with depression is started on a TCA after failure to improve symptoms on an SSRI. The nurse should include which teaching point when educating the patient about the new medication?

a)

there are no conscience occasions to this medication

b)

the medication is safe; it is been used longer than the many others

c)

this class of medications has no other use and is only for depression

d)

there is a risk of toxicity when this medication is taken without alcohol

45.

The nurse notes lithium on a patient's drug history upon admission. Which condition with the nurse suspect that this patient has been diagnosed with?

a)

obsessive-compulsive disorder

b)

absence seizures

c)

bipolar disorder

d)

paranoid schizophrenia

46.

While completing discharge activity for patients prescribed and antiepileptic drug, the nurse instructs patient that what potential complication could occur if he abruptly stopped taking antiepileptic drug?

a)

rebound seizure activity

b)

acute withdrawal syndrome

c)

hypotension

d)

Confusion and delirium

47.

The nurse explains to a patient that using caffeine may exacerbate which health condition?

a)

Cardiac dysrhythmias

b)

Constipation

c)

Heart block

d)

Myelin degeneration

48.

A patient with narcolepsy is prescribed methylphenidate (Ritalin). Which adverse effects should the nurse include in the teaching of this drug? (Select all that apply.)

a)

Insomnia

b)

Headache

c)

Weight Loss

d)

Decreased blood pressure

e)

Increased appetite

49.

The nurse is reviewing the history of a patient who will be starting the triptan sumatriptan (Imitrex) as part of a treatment for migraine headaches. Which condition, if present, may be a contraindication to triptan therapy?

a)

Cardiovascular disease

b)

Chronic bronchitis

c)

History of renal calculi

d)

Diabetes mellitus type 2

50.

A patient is in an urgent care center with an acute asthma attack. The nurse expects that which medication will be used for initial treatment?

a)

An anticholinergic such as ipratropium (Atrovent)

b)

A short-acting beta2 agonist such as albuterol (Proventil)

c)

A long-acting beta2 agonist such as salmeterol (Serevent)

d)

A corticosteroid such as fluticasone (Flovent)