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PharmE5

Total questions: 52

Worksheet time: 36mins

Name
Class
Date
1.

If combining regular insulin with NPH insulin within a single syringe, which medication is drawn up first?

a)

Regular insulin

b)

NPH insulin

c)

this is not recommended, need to be given separately

d)

meds need to be drawn into two separate syringes, then combined into single syringe just before administration

2.

When administering an interdermal injection, the tip of needle is only inserted till bevel disappears, and at an angle of...

a)

0 - 15 degrees

b)

10-15 degrees

c)

15 -45 degrees

d)

45 - 90 degrees

3.
What element is needed to produce proper amounts of Thyronine (T3) and Thyroxine (T4)?
a)
Iodine
b)
Iron
c)
Calcium
d)
Zinc
4.

Produces the hormone insulin and glucagon, which controls the level of glucose in the blood.

a)

Thyroid Gland

b)

Pancreas

c)

Thymus Gland

d)

Pituitary Gland

5.

Which of the following are produced from the thyroid?

a)

calcitonin

b)

parathyroid hormone

c)

oxytocin

d)

aldosterone

6.

An increased level of thyroxine would cause which of the following:

a)

myxedema

b)

Grave's disease

c)

Addison's disease

d)

Cretinism

7.

Too much ANTIDIURETIC hormone will cause you to

a)

lose wight and not eat

b)

retain water and dilute sodium

c)

grow very tall in stature

d)

excrete too much calcium

8.
a)
Epi
b)
Oral glucose 
c)
Nitro 
d)
Oxygen 
9.

A client has an order for an IV of 1000 ml of lactated ringers with 20 mEq of potassium/L to infuse at 40 ml/hr. The drip factor is 15 drops/ml. The nurse calculates the flow rate to be: ­­­­­­­­­­­­­­­­­­­­­­­______ gtt/min.

a)

9 drops/min

b)

10 drops/min

c)

11 drops/min

d)

12 drops/min

10.

A client experiencing pain has been prescribed meperidine (Demerol) 30mg IM every three hours, PRN pain. The vial available is Demerol 75mg/1 mL. How much Demerol should the nurse administer?

a)

0.5 ml

b)

2.5 ml

c)

1.4 ml

d)

0.4 ml

11.

The nurse is reviewing a 24-hour log of a child with insulin-dependent diabetes blood sugars and notes a 7:30 am blood sugar of 59. The nurse suspects this is a result of:

a)

6:00 pm NPH dose is too high

b)

6:00 pm dose of rapid-acting insulin is too low.

c)

6:00 am dose of NPH is to high

d)

6:00 am dose of rapid-acting insulin is too low.

12.

The nurse is completing a health history with the parents of an insulin-dependent child. The parents state they rotate the morning injection from the thighs, to the buttocks, then to the upper back, and to the arms. The nurses next action should be:

a)

Nothing, this is an appropriate action.

b)

Perform a physical examination of the injection sites.

c)

Review blood sugars to determine absorption rate.

d)

Ask the child which site they like best.

13.

The nurse is preparing a discharge plan for a newborn diagnosed with congenital hypothyroidism. Which of the following outcomes should be included in the plan of care? Parents state:

a)

hoarse cry is a sign of overdose.

b)

poor feeding is a sign of overdose.

c)

tachycardia and tremors are signs of overdose.

d)

bradycardia and lethargy are signs of overdose.

14.

An adolescent with insulin-dependent diabetes has joined the track team and will start practice at 3:00 pm daily. What time should the nurse tell the teen to eat an extra 15-30 gram carbohydrate snack?

a)

2:00 pm

b)

2:30 pm

c)

3:00 pm

d)

3:30 pm

15.

The mother of a newly diagnosed child with insulin dependent diabetes asks the nurse why her child cannot just take Glargine once a day like her husband does. The best response by the nurse is:

a)

The medication is only for adults.

b)

The medication peaks too fast for your child's metabolism.

c)

The medication does not peak post-meals.

d)

The medication does not offer steady coverage of blood sugar.

16.

The parent of a toddler newly diagnosed with insulin dependent diabetes asks the nurse additional ways to tell her child's insulin is working besides the ordered finger sticks. The nurse states hyperglycemia may be also detected by the presence of ____________ in the urine.

a)

Leukocytes

b)

Protein

c)

Ketones

d)

Nitrates

17.

The school nurse is teaching the school staff about Glucagon. A teacher asks why the nurses office has this medication in the cabinet. The nurse should reply "Glucagon is administered:

a)

for an emergency to treat severe hypoglycemia where the child may not be able to eat.

b)

to quickly lower blood sugar if the child is progressing into ketoacidosis.

c)

to stimulate the pancreas to release more insulin in times of hyperglycemia.

d)

before physical education class to help control the sugar in the blood.

18.
What are three major classes of opioid receptors?
a)
Mu, Delta, Epsilon 
b)
Mu, Kappa, Lambda 
c)
Kappa, Delta, Kappa 
d)
Mu, Kappa, Delta
19.
What is one of the most common side effects of intrathecal opioids?
a)
micturation
b)
vomiting
c)
non-histamine pruritis
d)
infection
20.
Ofirmev is the IV version of what oral medication? what is the appropriate dose for an adult that weighs 55 kg
a)
Tylenol; 15 mg/kg IV q 6 hrs
b)
Tylenol; 1000 mg IV q 6 hrs
c)
Ibuprofen; 1000 mg q 6 hrs 
d)
Ibuprofen; 15 mg/kg q 6 hrs
21.
A patient weighs 150 lbs. What is this in kilograms?
a)
330
b)
68.18
c)
75
d)
147.8
22.
An order reads:
Give 0.3 mg of drug A and 65 mg of drug B  
The label reads:  
Drug A  0.5 mg / 1/2 cc  
Drug B  0.075 g / 1 cc  
How much fluid will you have in your syringe? 
a)
1.3 cc
b)
1.2 cc
c)
1 1/2 cc
d)
3 cc
23.
An 8 year old child with Type I diabetes actively played during recess but  presents to the school nurse with complaints of headache and feeling "Shaky" . The nurses first action should be to :
a)
Notify the child's parents
b)
Have the child lie down  for a few minutes and see if the symptoms subside.
c)
Give the child a simple carbohydrate snack
d)
Give the child a complex carbohydrate and protein snack
24.
A 10 year old with newly diagnosed  type I diabetes ask why he must take "shots" everyday, when his aunt with diabetes' gets to take pills" . The nurses best response is :
a)
"When you get older , you can take the pills too "
b)
"When your pancreas gets bigger, you will be able to stop taking the shots".
c)
"You have a different type of diabetes than your aunt does . Your type needs insuling shots everydat".
d)
"You don't understand diabetes. Have your read the pamphlet I gave you "
25.
Which characteristic
of an adolescent must the nurse first consider in order assist the teenager to deal with the diagnosis of type I diabetes ?
a)
Desire for independence
b)
Goals for the future
c)
Need to be like peers
d)
Wish to please parents
26.

Elevated TSH and Low T 4 =

a)

Hypothyroidism

b)

Hyperthyroidism

27.

The thyroid gland secretes the hormones:

a)

T4

b)

T3

c)

glucagon

d)

Calcitonin

28.

Signs and Symptoms: decreased metabolism, weight gain, lethargy/fatigue, cold intolerance, (eeyore)

a)

hypothyroidism (Hashimoto's)

b)

Hyperglycemia

c)

Hyperthyroidism (Grave's)

d)

Hypoglycemia

29.

How is the secretion of thyroid hormones controlled ?

a)

pancreas

b)

liver

c)

pituitary gland

d)

thyroid gland

30.

Signs and Symptoms: increased metabolism, weight loss, heat intolerance, exophthalmus, excitability, anxiety (tiger)

a)

hyperglycemia

b)

hyperthyroidism (Grave's)

c)

Hypothyroidism (Hashimoto's)

d)

hypocalcemia

31.

define euthyroid

a)

normal thyroid function

b)

abnormal pancreas function

c)

abnormal thyroid function

d)

normal hormone production

32.

What drug is used to treat hypothyroidism ?

a)

scopolamine

b)

Levothyroxine (synthroid)

c)

Cimetidine

d)

Methimizole (tapazole)

33.

Which of these are the signs and symptoms of Thyrotoxicosis ("thyroid storm")

a)

extreme tachycardia

b)

high fever

c)

decreased metabolism

d)

altered mental status

34.

When should you administer the thyroid hormone for hypothyroidism ?

a)

once in the afternoon with lunch

b)

twice a day

c)

in the evening with dinner

d)

once in the morning before breakfast

35.

What anti-thyroid drug treats hyperthyroidism ?

a)

Methimazole (Tapazole)

b)

Levemir

c)

Levothyroxine (Synthroid)

d)

omeprazole

36.

How long does it take for anti-thyroid drug to reach therapeutic effect ?

a)

1-2 weeks

b)

3-4 weeks

c)

2 months

d)

1 week

37.

The potential for bleeding increases when anti-thyroid drugs are taken with:

a)

thyroid drugs

b)

anticoagulants

c)

anticholinergics

d)

antidiarrheals

38.

When should you take anti thyroid medication ?

a)

immediately after waking up then every 8 hrs afterwards

b)

before breakfast

c)

immediately after waking then every 6 hrs afterwards

d)

after lunch

39.

Patient teaching if patient is on levothyroxine:

a)

weigh yourself weekly

b)

take with meals

c)

report wt gain or loss

d)

take fsbs

40.

Adverse Reactions of levothyroxine(synthroid):

a)

increased appetite

b)

wt gain

c)

tremors

d)

irregular menses

e)

tachycardia

41.

Adverse Reactions of Methimazole (Tapazole):

a)

sore throat

b)

wt gain

c)

high metabolism

d)

agranulocytosis

e)

cold intolerance

42.

What is a thyroid drug ?

a)

lowers thyroid hormones in bloodstream

b)

hormone replacement (increases thyroid hormones)

c)

does not affect thyroid hormones at all

d)

treats thyrotoxicosis

43.

Would you give levothyroxine to a pt who is experiencing thyrotoxicosis ?

a)

Yes

b)

No

44.

What does an anti-thyroid drug do ?

a)

does not affect thyroid hormones at all

b)

increases thyroid hormones in the blood

c)

controls the pituitary gland

d)

lowers thyroid hormones in the blood

45.

Classification for ibuprofen?

a)

anticonvulsant

b)

NSAID

c)

CCB

d)

ARB

46.

Which of the following is the active ingredient in Tylenol®?

a)

Acetaminophen

b)

Acetylsalicylic Acid

c)

Ibuprofen

d)

Caffeine

47.

The most commonly used anxiolytics are:

a)

Benzodiazepines

b)

Diphenhydramine

c)

Buspirone

d)

Barbiturates

48.

What is the antidote of benzodiazepine?

a)

Theophylline

b)

Ranitidine

c)

Flumazenil

d)

Benadryl

49.

Diazepam is the drug of choice for which medical emergency?

a)

Serotonin syndrome

b)

Hypertensive crisis

c)

Status epilepticus

d)

Coma

50.

This drug is the mainstay treatment for mania.

a)

Lithium salt (Lithotabs)

b)

SSRI (Fluoxetine)

c)

Benzodiazepene (Diazepam)

d)

Tricyclic antidepressants (Imipramine)

51.

The nurse in the emergency department is caring for a patient with a suspected overdose of diazepam [Valium]. Which agent is most likely to be administered to reverse the effects of diazepam?

a)

Naloxone [Narcan]

b)

Flumazenil [Romazicon]

c)

Acetylcysteine [Mucomyst]

d)

Vitamin K

52.

The neurotransmitter dopamine is derived from which precursor:

a)

Levodopa

b)

Tyrosine

c)

Tryptophan

d)

Glutamine

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