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WorksheetsPharm Exam 4
Total questions: 143
Worksheet time: 1hrs 13mins
Why would a physician choose a local anesthetics over a general anesthetic?
Local anesthetic have less risk than general anesthetics
It suppresses pain without depression of entire nervous system
Local anesthetics are selective modifiers of neuronal function
Local anesthetics suppress pain by blocking axonal nerves conduction
The nurse knows that local anesthetics stop axonal conduction by blocking what?
Potassium channels in the axonal membrane
Sodium channels in the axonal membrane
Calcium channels in the axonal membrane
Protein channels in the axonal membrane
Which of the following shows the correct sequence of effect for local anesthetics?
Loss of perception of cold, deep pressure, pain, touch, and warmth
Loss of perception of pain, cold, warmth, touch, and deep pressure
Loss of perception of deep pressure, pain, touch, warmth, and cold
Loss of perception of touch, deep pressure, warmth, cold and pain
The nurse is explaining differential sensitivity to the nursing student with regard to the use of local anesthetics. The nurse explains that which perception is lost first?
Cold
Pain
Warmth
Touch
Which of these local anesthetic agents is most likely to cause an allergic response?
Procaine [Novocain]
Lidocaine [Xylocaine]
Bupivacaine [Marcaine]
Ropivacaine [Naropin]
The nurse is caring for a patient who is to receive a local anesthetic with lidocaine and epinephrine. What is the primary purpose of the epinephrine?
To reduce the risk of an allergic reaction
To improve transport of anesthetic into the axon
To delay systemic absorption of the anesthetic
To suppress excitability of the myocardium
T or F - Local Anesthetics block sensation in small, non-myelinated neurons faster than larger myelinated neurons
True
False
There are 2 classes of local anesthetics - Esters & Amides. Which of the following statements apply only to Esters
Metabolized by plasma esterases
Metabolized by hepatic enzymes
They have a very low incidence of allergic reaction
They can promote more of an allergic reaction than the other
Procaine (Novocaine) and Cocaine are examples
T or F = Local anesthetics only affect sensory neurons
True - Only sensory neurons are affected
False - Both motor and sensory neurons are affected
Which of the following best explains why epinephrine + local anesthetics should never be injected in the finger, toes, or ears?
Epinephrine can cause necrosis of the tissue
It can cause methemoglobinemia, a blood disorder that alters hemoglobin
It can cause a hypersensitivity reaction
It can result in bradycardia and CNS depression
There are 2 classes of local anesthetics - Esters & Amides. Which of the following statements apply only to Amides
Metabolized by plasma esterases
Metabolized by hepatic enzymes
They have a very low incidence of allergic reaction
They can promote more of an allergic reaction than the other
Lidocaine, Bupivacaine, and Dibucaine are examples
A patient who is allergic to Procaine (Novocaine), would most likely experience cross sensitivity with all of the following EXCEPT:
Benzocaine
Cocaine
Lidocaine
Tetracaine
Why are local anesthetics contraindicated in pregnant women?
They cross the placenta and can cause CNS depression and bradycardia in neonate.
They cause excitation then depression of the CNS
They can result in systemic toxicity
They can cause a hypersensitivity reaction
Orajel, a product used to relieve the discomfort of teething contains Benzocaine. Why should the use of benzocaine, an ester, be avoided in children less than 2 years of age?
Benzocaine can cause methemoglobinemia and result in death of the toddler.
Benzocaine can cause a hypersensitivity reaction
Benzocaine can result in bradycardia or cardiac arrest
Benzocaine can result in palpitations and hypertension
The nurse should monitor for which central nervous system (CNS) adverse effect that can result when sufficient amounts of local anesthetics are absorbed systemically?
Hallucinations and nightmares
Tremors of the lower extremities
Excitation followed by depression
Vertigo and nausea/vomiting
Which of the following are Ester-type local anesthetics?
Tetracaine
Chloroprocaine
Prilocaine
Cocaine
Mepivacaine
Which of the following are Amide-type local anesthetics?
Dibucaine
Chloroprocaine
Prilocaine
Cocaine
Mepivacaine
Lidocaine is used in patients with dysrhythmia because
It suppresses excitability in the myocardium and conducting system
it causes an array of hypersensitivity reactions rangining from allergic dermatitis to anaphylaxis
It depresses uterine contractility and maternal effort
Anesthesia with lidocaine is more rapid, intense, and prolonged than procaine
All of the following statements about Cocaine are true EXCEPT:
Cocaine causes psychological dependency and tachycardia
Cocaine helps people who are tired become more alert and energized
Cocaine can be used with people who are depressed because it instills a sense of euphoria
Cocaine can be prescribed and picked up at your local pharmacy.
Cocaine only clinical application is in eye, ear, nose, & throat clinics and surgery
Which of the following statements about cocaine is TRUE.?
Cocaine causes intense vasoconstriction.
Cocaine has no medicinal applications.
Cocaine is a poor local anesthetic.
Cocaine has no CNS effects.
Which of the following actions should be avoided when applying topical anesthetics to prevent systemic toxicity?
Applying medication to broken skin or open wounds
Doing strenuous exercise
Dressing, wrapping or binding the wound
Use only the needed amount
Avoid application to large areas
Why should a nurse aspirate a parenteral administration of a local anesthetic prior to injecting medication?
Injecting in a blood vessel can result in systemic toxicity
Because its just good nursing practice to aspirate prior to any injection
Nurses do not have to aspirate prior to giving any injection
Nurse should check to. make sure in blood vessel prior to injecting medication
Which of the following descriptions best differentiates between Epidural and Spinal anesthesia
There is no difference they are both shots received in the spine to block pain.
In an epidural the medication is injected into the epidural space and is eventually absorbed in the spinal fluid,. but in a spinal the medication is injected directly into the spinal fluid.
Spinal and epidural are both injections received in the spine, but they vary in the amount of medication needed to produce an effect.
In a spinal the medication is injected into the epidural space and is eventually absorbed in the spinal fluid,. but in an epidural the medication is injected directly into the spinal fluid.
The nurse is caring for a patient in the PACU (Post-Anesthesia Care Unit). What is the highest priority assessment by the nurse?
Breathing
Level of consciousness
Pain
Urinary Output
Which of the following is the best definition for analgesia?
Loss of pain sensation
Loss of consciousness pain, touch, temperature, and taste sensation
Loss of pain and touch sensation
Loss of touch, temperature, taste
Which of the following is the best definition for anesthesia?
Loss of pain sensation
Loss of consciousness, pain, touch, temperature, and taste sensation
Loss of pain and touch sensation
Loss of touch, temperature, taste
Which of the following is the best definition for anesthesia?
Loss of pain sensation
Loss of consciousness, pain, touch, temperature, and taste sensation
Loss of pain and touch sensation
Loss of touch, temperature, taste
All of the following statements regarding the minimum alveolar concentration (MAC) are true EXCEPT
It is the minimum concentration of drug in the alveolar air that will produce immobility in 50% of patients exposed to a painful stimulus
It determines how much anesthetic the inspired air must contain to produce anesthesia.
The lower the MAC then the more potent the anesthesia, and the smaller the amount is needed.
The higher the MAC then the more potent the anesthesia, and the greater the amount is needed.
Anesthesia has to be 1.2 to 1.5 times the MAC for it to work on all patients
The minimum alveolar concentration of several General Anesthetics is listed below. Which one would utilize the smallest amount of anesthetic?
Isoflurane (1.15%)
Enflurane (1.68%)
Desflurane (1.71%)
Sevoflurane (1.71%)
Nitrous oxide (105%)
True or False - Most inhalation anesthetics undergo very little metabolism
True - Most inhalation anesthetics are eliminated almost entirely by the lungs
False - Most inhalation anesthetics are elminated almost entirely by the liver
Which of the following statements explain how Nitrous Oxide differs from other Inhalation agents
It is the only gaseous inhalation agent at room temperature
It works by enhancing inhibitory synapses and by depressing transmission at excitatory synapses
Due to a very high MAC, it can't be used by itself as an anesthetic
It does NOT enhance GABA receptors
Which of the following adverse effects should a nurse be concerned about with all inhalation anesthetics?
Respiratory and Cardiac Depression
Sensitization of the heart to catecholamines
Hepatotoxicity - drugs cause liver disfunction
Malignant hyperthernia - Muscle rigidity/profound elevation of temperature
Which of the following statement regarding balanced anesthesia is TRUE?
Refers to a combination of drugs used to ensure that induction is smooth, rapid, and that analgesia and muscle relaxation are adequate.
Barbituates(propofol) are used for induction, Neuromuscular blockers for muscle relaxation and opioids for analgesia
Balanced anesthesia is more dangerous to patients due to the patient is taking more drugs.
Its use allows full general anesthesia at lower safer doses of inhalation anesthetics
Which of the following adverse effects of inhalation anesthetics is increased with the use of succinylcholine, a neuromuscular blocker?
Respiratory and Cardiac Depression
Hepatotoxicity
Sensitization of the heart to catecholamines
Malignant Hyperthermia
Aspiration of Gastric contents
A female surgical nurse may experience which of the following side effects as a result of exposure to inhalation anesthetics?
Spontaneous abortion
Hyperthermia
Decreased alertness
Headache
Dysrhythmias
Why should the nurse working surgery be notified if a patient was given opioids prior to surgery?
Opioids can delay awakening, increase vomiting, and increase risk of respiratory arrest.
Opioids can increase the sensitivity of the heart to catecholamines
Opioids increase risk of cardiac or respiratory depression
Opioids increase risk of hepatotoxicity
What order would a nurse expect to see for a patient about to undergo surgery?
NPO
TKO
NKDA
LOC
Identify inhalation agent
I do not cause liver or kidney toxicity or sensitivity to catecholamines. I am commonly used with nitrous oxide(analgesic), opioids, or neuromuscular blocker . My bad smell makes me a poor choice for putting patients to sleep, but great for keeping them asleep
Enflurane
Desflurane
Isoflurane
Sevoflurane
Identify inhalation agent
My use is contraindicated in patients with epilepsy or seizure disorders. I cause cardiac stimulation because I have no effect on catecholamines, but be sure to. have the ventilator handy.
Enflurane
Desflurane
Isoflurane
Sevoflurane
Identify inhalation agent
I am not for the kiddies due to my stinky smell. I may trigger the Baroreflex and cause hypertension and tachychardia.
Enflurane
Desflurane
Isoflurane
Sevoflurane
Identify inhalation agent
I am perfect to put the kiddies to sleep, because I smell so sweet. But please be sure to have the garbage can handy when they awake
Enflurane
Desflurane
Isoflurane
Sevoflurane
True or False - Nitrous oxide is only a primary anesthetic in the dentist's office
True - It is primary at the dentist and used as a secondary elsewhere
False - Nitrous oxide is never a primary anesthetic
Why intravenous anesthetics used alone or to supplement inhalation agent?
To decrease the amount of inhalation agent needed
To increase the amount of inhalation agent needed
To produce effects that can not be produced by inhalation agents alone
To remove effect that the inhalation agents produce
T or F - Nitrous Oxide is a potent analgesic that can reduce the needed amount of primary anesthetic by 50%
True - Laughing gas is primarily used to supplement the analgesic effect and reduce the amount of primary anesthetic needed.
False - Nitrous Oxide is not potent and does not affect the amount of primary anesthetic
Which of the following IV anesthetics would be the best choice for a 75 year old hypertensive patient undergoing surgery?
Methohexital (Brevital)
Thiopental (Pentothal)
Diazepam (Valium)
Lorazepam (Ativan)
Midazolam (Versed)
A felon who been given the death penalty and is sentenced to die by lethal injection is most likely to receive which of the following drugs?
Methohexital (Brevital)
Thiopental (Pentothal)
Diazepam (Valium)
Lorazepam (Ativan)
Midazolam (Versed)
Midazolam (Versed) can cause conscious sedation, in which a patient experiences sedation, analgesia, amnesia, and decreased anxiety while still being able to respond to commands, when combined with which of the following?
Local anesthesia
Barbituates
Opioids
Nitrous Oxide
A nurse caring for a patient who has received propofol (Diprivan) could anticipate which of the following adverse effects?
Profound respiratory distress
Hypotension
Infusion syndrome (metabolic acidosis, cardiac failure, renal failure, rhabdomyolysis)
Urticaria (hives)
All of the following are examples of Benzodiazepines EXCEPT
Diazepam (Valium)
Larazepam (Ativan)
Midazolam (Versed)
Methohexital (Brevital)
Which of the following statements about Propofol (Diprivan) is FALSE?
It has a rapid onset (60s) and short duration (3-5 min)
It can cause hypotension, infusion syndrome, and respiratory depression
It poses no risk of bacterial infection
It is highly addictive due to it allows quick, restful sleep
T or F - One dose of Etomidate (Amidate) will result in hypotension, post-op nause & vomiting , electrolyte disturbances and oliguria
True - One dose results in the effects in 50% or more of patients
False - It takes repeated dosage to elicit effects
T or F - Ketamine is recommended for patients with psychological disorders.
True - The medication has no adverse reactions for psych patients
False - Medication is contraindicated in patients with psych disorders
Dissociative anesthesia where a patient feels removed from their environment and experiences sedation, immobility, analgesia, and amnesia can be produced by which of the following
Ketamine
Neuroleptic-Opioid Combo
Midazolam (Versed)
Etomidate (Amidate)
A patient recovering from surgery complains of hallucinations, disturbing dreams and delirium. This patient most likely received
Ketamine
Neuroleptic-Opioid Combo
Midazolam (Versed)
Etomidate (Amidate)
T or F - Droperidol is contraindicated in patients with Parkinson's disease because it blocks dopamine receptors.
T - It should not be given to Parkinson's patients
F - It can be given because it does not block dopamine receptors
Which of the statements regarding acne is FALSE?
Acne is more common in males than females
Increase presence of androgens can cause an increase oil production and thus acne
Can only be treated with drugs
It is a chronic skin condition that begins during puberty
T or F - A comedo (comedones) is commonly referred to as a blackhead or whitehead
True
False
Which of the following statements best distinguishes between whiteheads and blackheads?
Blackheads form when sebum and keratin combine and plug a pore that remains open, but a whitehead forms when sebum and keratin are trapped below the skin surface.
Blackheads form when sebum and keratin combine and plug a closed pore, but a whitehead forms when sebum and keratin combine in an open pore
Blackheads contain only sebum, whereas whitehead only contain keratin
Blackheads contain only keratin, whereas whitehead only contain sebum
T or F - All medications for acne can potentially cause drying, peeling, irritation, burning and photosensitivity
True - This is a rule of thumb for acne medication
False - There are some medication that cause none of these adverse effects
Non-drug treatment for acne would include all of the following EXCEPT:
Gentle cleansing 2-3x daily
Vigorous scrubbing of the skin
Avoidance of oil-based products
Comedone extraction or Dermabrasions
T or F - Etomidate is preferred to barbituates in cardiovascular patients due to has less CV side effects
True
False
Identify the drug - I am the 1st treatment for mild -moderate acne. I use oxygen to reduce inflammation and promote keratolysis.
Benzoyl Peroxide
Clindamycin or Erythromycin
Dapsone
Tretinoin
Identify the drug - We suppress growth of P. Acnes and decrease inflammation. We are often combined with B. peroxide to prevent growth of resistant strains of P. Acnes.
Benzoyl Peroxide
Clindamycin or Erythromycin
Dapsone
Tretinoin
Identify the drug - I am primarily used to treat leprosy, but now used to treat acne in people who traditional treatment does not work. Combined B. peroxide I can turn the skin yellow or orange. If you use me, you definitely WASH YOUR HANDS.
Benzoyl Peroxide
Clindamycin or Erythromycin
Dapsone
Tretinoin, Retin - A
T or F - Retinoids are acne treatments that are derived from Vitamin C
True - Retinoids are derived from Vitamin C
False - Retinoids are derived from Vitamin A
Identify the drug - I am a retinol derivative that can be harsh on the skin. My adverse effects include crusting, peeling, blistering, and edema. Patients using me should protect their skin from burning.
Benzoyl Peroxide
Clindamycin or Erythromycin
Dapsone
Tretinoin, Retin A
Which of the following statements regarding Neuroleptalanalgesia is FALSE?
Condition in which patient is Indifferent to surroundings and insensitive to pain
Patient is awake, responsive to commands, but suffers amnesion upon awakening
This state is used for dressing changes and diagnostic procedures. State can result in hypotension/respiratory distress
Patient appears asleep , but is not
Which of the following are oral acne medications
Clindamycin or Erythromycin
Retinol A
Doxycycline or Minocycline
Dapsone
Isotretinoin (Accutane
T or F - A patient who had a mild case of acne should be prescribed an oral medication
T - Oral acne medication can be used for any type
F - Patients with mild to moderate cases should use topical medication
Identify the drug - . I modulates inflammation, epithelial keratinization, and differentiation of follicular cells. Patients using me should protect their skin from burning.
Benzoyl Peroxide
Adapalene (Differin)
Dapsone
Tretinoin, Retin A
What should the nurse teach the patient who is taking antibiotics for acne?
They take a shorter period of time to work
They take a longer period of time to work
Medication will be switched to topical once acne is controlled
Patient will start to take an oral medication and a topical medication one the acne is controlled
T or F - Doxycycline or Minocyline are the oral antibiotic treatments of choice for acne
True
False
Patient teaching for someone prescribed Isotretinoin (Accutane) should include
Medicaion is highly teratogenic (IPledge program)
Female patients should use 2 or more forms of birth control while taking medication
Medication will be switched to topical once acne is controlled
Patient will start to take an oral medication and a topical medication one the acne is controlled
Identify the drug - I treat severe nodulocystic acne vulgaris. I am highly teratogenic and women should not get pregnant while. taking me. Patients should be assessed for depression before prescribing me. Nose bleeds and lip inflammation is common with me
Benzoyl Peroxide
Adapalene (Differin)
Isotretinoin (Accutane)
Tretinoin, Retin A
Oral contraceptives can be used to control acne ONLY in females who
Have a severe case of acne
Are 15 years of age or older
Want contraception
Have started their period
Are sexually active
Identify the drug - I cure acne by blocking the sex hormones. I am teratogenic and women should not get pregnant while. taking me. I cause menstrual irregularities, breast tenderness, and hyperkalemia.
Sprironolactone
Adapalene (Differin)
Isotretinoin (Accutane)
Tretinoin, Retin A
Solar Radiation causes
Burning
Premature Aging
Immunosuppression
Skin Cancer
UV rays able to penetrates epidermis deep into dermis
able to penetrate glass
UVA
UVB
Sun Protection Factor
Broad Spectrum
UV rays that penetrates epidermis but does not go deeper
causes burning and tanning
UVA
UVB
Sun Protection Factor
Broad Spectrum
Found by shining UV light on protected and unprotected skin and recording the time it takes for redness to develop.Calculation - divide time required for redness to develop in protected by unprotected
UVA
UVB
Sun Protection Factor
Broad Spectrum
Patients taking accutane would best be served by taking which of the following
Sunscreen that protects against UVA
Sunscreen that protects against UVB
Sunscreen that protects against UVA & UVB
All of the following statements about Psoriasis are true EXCEPT:
It is a chronic inflammatory skin disordeer
It is characterized by accelerated maturation of epidermal cells, scaling of skin, silver in color usually.
Curable with the right medication
Not Curable, but treatable
Affects skin on the Scalp, elbows, knees, palms, soles
Which of the following should be taught to patients taking Glucocorticoids: for psoriasis?
Patients should not apply potent to groin, face, axilla, genitalia → these areas can atrophy or get secondary infection
Patients can go into “remission” for long periods of time
Choice of treatment is based on severity of symptoms
Reapplication will not extend protection time
Your patient has just been prescribed a topical retinoid for their acne treatment. What will you be sure to include in your patient education?
"This medication may turn your skin orange or yellow"
"This medication can increase your risk for sunburn. Make sure you protect your skin"
"This medication is very harmful to a fetus. Make sure you are using contraception."
"This medication can cause microbial resistance, so you will need to take with Benzoyl Peroxide"
You are teaching your patient about a topical anesthetic. What about toxicity are you going to include in your instructions?
"Avoid applying a hot compress with this increased skin temperature also increases absorption."
"It is okay to engage in strenuous exercise when using this medication"
"Avoid applying an ice pack with this. Decreased skin temperature increases absorption"
"Local anesthetics do not cause toxicity. You can use as much as you want."
The CRNA is adding Nitrous Oxide to the combination of anesthesia given to the patient. What is the benefit of this?
Reduces the need for a large dose of other anesthetics
Reduces the incidence of post-op nausea and vomiting
Reduces the need for post-op opioid analgesia
This is no benefit
You are getting the OR ready for a patient who is going to be anesthetized. What 2 pieces of equipment do you need to ensure are present before and during the procedure?
Ventilator & NG Tube
Ventilator & Crash Cart
NG Tube & Crash Cart
Stethoscope & Ventilator
What are you going to teach your patient about Ustekinumab (Stelara)?
"This medication stops your body from making too many skin cells."
"This medication has to be taken every day."
"This medication will require you to expose your skin to a UV light 30 minutes after taking it."
"This medication should not be applied to groin, face, or axilla."
The medication is given every 12 weeks so it is more more convenient
Phototherapy for psoriasis patients includes all of the following EXCEPT:
Washing the coal tar off prior to UV light exposure
Coating the patient in coal tar for 8-10 hours
Leaving the coal tar on during UV light exposure
Exposure to UV light after 8-10 hours of coal tar application
When teaching your acne patient about how to take care of their skin, you will include all of the following EXCEPT:
Daily cleansing with an abrasive cleanser
Avoid oil-based moisturizers
Daily cleansing with a gentle cleanser
Changing diet does not help
Your pediatric patient has honey-colored crusty lesions around their nose and mouth. The provider has prescribed Mupirocin ointment as treatment. What common childhood illness does this patient most likely have?
Fifth's Disease
Nonbullous Impetigo
Necrotizing Fasciitis
Bullous Impetigo
What are you going to teach your patient who has just been treated with Podophyllin?
"Wash this off with soap and water in a few hours"
"Be careful NOT to wash this off."
"You will need to apply this 2 more times today."
"Lie still until this medication is dry."
You are educating your clinic patient about their acne. When asked about whiteheads, you explain:
"Whiteheads are not caused by clogged pores."
"Whiteheads are formed by pores being blocked by sebum that scales below the skin's surface."
"Whiteheads are also known as open Comedones."
"Whiteheads are formed by pores blocked by sebum that are discolored by exposure to oxygen in the air."
After applying Hydrocortisone cream to relieve your itchy scalp, You notice your symptoms get worse instead of better. What is the most likely cause of this?
You may be allergic to the Hydrocortisone cream
Seborrheic Dermatitis is caused by a fungus. Topical corticosteroids can exacerbate symptoms of fungal infections.
Seborrheic Dermatitis is caused by an allergic reaction. Topical corticosteroids should help.
There is no known cause as to how this may have happened
Which is the most effective and quickest treatment for Actinic Keratosis?
Flurouracil
Adapalene (Differin)
Cryotherapy
lmiquimod (Aldera)
True or False: You are going to teach your patient to use a broad-spectrum sunscreen because it protects from both UVA and UVB rays.
True
False
Your Eczema patient has just been prescribed Tacrolimus. What side-effects are you going to tell your patient to expect?
burning, redness. & itching
burning, pallor, & stinging
numbness, redness, & swelling
stinging, redness, & pallor
lsoflurane and Desflurane are not commonly used for induction because they are both:
Not very effective for induction
Pleasantly scented but can cause respiratory irritation
Highly toxic
Very pungent and cause respiratory irritation
Which anesthetic is less likely to cause complications in patients with underlying cardiovascular disease?
Etomidate (Amidate)
Propofol (Diprivan)
Midazolam (Versed)
Sevoflurane
You are assisting in the Labor & Delivery OR, where your patient is scheduled for a C-section. The CRNA has just administered spinal anesthesia. What position are you going to place your patient in to prevent spinal headache?
Supine
High Fowlers
Prone
Reverse Trendelenberg
Cocaine. as an anesthetic. is currently used for
Dental Procedures
Teething Infants
Chronic Pain - by prescription only
Eye and Ear, Nose, & Throat Surgeries
While analgesia is defined by the loss of sensation to pain only, anesthesia is the loss of sensation to pain AND:
touch, temperature, & consciousness
touch. temperature. & taste
environment
analgesia and anesthesia are the same
You are assisting a doctor that should have retired many years ago. He orders Procaine for local anesthesia. You are assisting a doctor that should have retired many years ago. He orders Procaine for local anesthesia. Since Procaine is an ester-type, what are you going to specifically monitor your patient for?
Methemoglobinemia
Allergic Reaction
Hypertension and Tachycardia
Psychological Dependence
The year is 1989, and you are a corrections nurse at the Florida State Penitentiary where Ted Bundy is scheduled to die by lethal injection. You expect which anesthetic to be used for this procedure?
Midazolam (Versed)
Propofol (Diprivan)
Etomidate (Amidate)
Thiopental (Pentothal)
As an OR nurse, you are getting ready for your 3rd case of the day when the CRNA asks for a multi-use vial of Propofol. The vial you opened earlier has been open for 8 hours. Why are you going to discard this vial and get a new one?
So you can charge the patient for a new vial
To reduce the risk for infection since Propofol is in a lipid-based solution
To reduce the risk for infection since Propofol is in a dextrosebased solution
No need to discard. This vial will be okay until the 24 hour mark.
You are taking care of a patient who needs sutures in their Right thumb. The physician orders Lidocaine and Epinephrine for local anesthesia. Why should you question the order?
Injecting Lidocaine into a finger can cause necrosis
This order is appropriate for this patient
Lidocaine and Epinephrine are never used in combination
Injecting Epinephrine into a finger can cause necrosis
You are working in the OR and the CRNA is getting ready to administer an inhaled anesthetic that has a MAC of 1.6. After learning about MAC in pharm 1, you know which anesthetic is definitely NOT being given?
lsoflurane
Nitrous Oxide (Laughing Gas)
Enflurane
Sevoflurane
Identify the drug: I inhibit keratinocyte proliferation. My side effects include local itch, irritation, and redness
Vitamin D3 (Calcitrol)
Methotrexate
Tars
Glucocorticoids
Identify the drug: Identify the drug: I am black and sticky with a stinky odor. I cause irritation, stinging, & burning.
Vitamin D3 (Calcitrol)
Methotrexate
Tars
Glucocorticoids
Which of the following are drugs of last resort to treat psoriasis?
Methotrexate - Cancer drug
Cyclosprorin - Nephrotoxic immunosuppressive drug
Adalimumab (Humira) - Tissue Necrosis Factor Antagonist
Flurouracil (Topical)
Ustekinumab (Stelara)
Which of the following are tissue necrosis factor antagonists used to treat psoriasis?
Etanercept (Enbrel)
Infliximab (Remicade)
Adalimumab (Humira)
Imiquimod (Aldera)
Rough, scaly red or brown papules caused by chronic sun exposure which can become squamous cell carcinomas. Usually found on the face, scalp, hands or forearms
Psoriasis
Actinic Keratosis
Eczema
Impetigo
A patient was prescribed Flurouracil (topical) for actinic keratosis. Which of the following should the patient be told
The medication takes about 3 months to become effective
Must be exposed to UV light to work
Side effects include photosensitivity, itching, burning, rash, and inflammation
You must keep your skin moisturized
Imiquimod (Aldera) is a medication that was originally used to treat venereal warts, is prescribed for actinic keratosis. Which of the following are side effects of the medication?
Redness & Swelling
Sores & Blisters
Itching & Burning
Scabbing & Crusting
Photosensitivity
Eczema is a type of atopic dermatitis caused by the abnormal activation of T-cells. It results in dry, scaly, itchy skin that causes scratching & rubbing. What information should be given to patients prescribed this medication?
Excessive scratching can lead to skin infections
Medication can result in skin cancer
Keep skin moisturized to help alleviate the itching
Wash medication off with soap and water after a few hours
Hydrocortisone should not be used groin, arm pits or elbow bends due to atrophy
Which of the following statements about Tacrolimus is False?
It is a first choice medication for the treatment of Eczema
It is an immunosuppressant and can cause skin cancer
Side effects include burning, redness, pruritis at application site
It is used primarily for patients who are unresponsive to glucocorticoids
Warts, an STI, is caused by an HPV infection. Other than being immunized by the Gardasil vaccine, Patients can also be treated with all of the following EXCEPT
Cryotherapy
Podophyllin
Bi/Trichloroacetic acid
Podofilox
Minoxidil
All of the statements regarding Podophyllin are true EXCEPT:
This medication should be administered by provider due to highly caustic
Patients should wash medication off with soap and water after a few hours
Side effects include kidney damage, peripheral neuropathy, teratogenic & blood dyscrasias
Patients using this medication should keep their skin moisturized
Causes cell death and erosion of warty tissue
Trichloroacetic acid is applied to a patient being treated for warts. Which of the following should be communicated to the patient?
This medication should not be taken with alcohol
The medication is very runny lie still until it is completely dry
The medication is photosensitive. Avoid the sun after applying.
The medication causes dryness apply a moisturizer with medication.
Podofilox is being used to treat warts. Patient education should include which of the following
Medication should be applied BID for 3 days then 4 days off
The medication is only effective for a short time
Medication does not have to be washed off
The patient should not eat grapefruit while taking this medication
T or F - Glucocorticoids are best to treat seborrheic dermatitis or dandruff caused by (fungus)
T - Glucocorticoids quickly elminate fungus
F - Glucocorticoids cause fungus to grow and get worse
A man being treated for alopecia complains decreased libido and of an inability to sustain an erection. The patient is most likely taking
Minoxidil
Finesteride
Warfarin
Podofilox
A type of impetigo caused by S. Aureus toxin characterized by rapidly spreading papules that change into large thin-walled vesicles (blisters)
Bullous
Non-bullous
A type of impetigo caused by S. Aureus or strep pyogens toxin characterized by small macule or papule rash that change into large t vesicles (blisters) with a honey colored exudate and crust
Bullous
Non-bullous
Which of the following should be recommended to a patient who wants to avoid venereal warts?
Take the Gardasil vaccine
Shower or bathe daily
Use condoms during sex
Patients should use antibacterial soap
A patient is prescribed Imiquimod (Aldera) for Actinic Keratosis. Which of the following should be included in patient teaching about the medication?
Avoid the sun when using this medication
The medication takes about 16 weeks to work, so don't expect results right away
The medication can result in a change in color of urine.
The medication can cause sleeplessness
Which of the following is a disadvantage of using phototherapy to treat psoriasis?
It takes 30 or more treatments
It is clean and pleasant process
It does not have to be washed off
It is an inexpensive treatment
Identify the drug - I was originally used to treat hypertension, but they discovered I can regrow hair. I cause itching and in some, an allergic reaction
Minoxidil
Warfarin
Finesteride
Bichloracetic acid
Which of the following statements regarding Pulmonary Arterial Hypertension are True?
It is caused by vasoconstriction of pulmonary vascular system and vascular remodeling of continuous dividing cells
Diuretis - reduce fluid/alleviate shortness of breath/edema
Treated with warfarin to prevent thrombosis
Ca Channel blockers for vasodilation
Why is Sildenafil prescribed for patients with Pulmonary Arterial Hypertension (PAH)?
It reduces fluid overload
It prevents thrombosis
It helps with alleviate the shortness of breath
It causes vasodilation of constricted pulmonary arteries
Which of the following statements regarding surfactants is false?
Surfactants reduces surface tension on alveolar surface
It develops at 34-36 weeks gestation
Inadequate amounts can result in alveolar collapse, edema, hypoxia, respiratory failure
It can only be given to babies before they are born
All of the follow about Betamethasone is true EXCEPT:
Is given to expectant mother
Should be given for weeks 24-34 of the pregnancy
Is administered to the pre-term baby
It is given as an injection prenatally
A pre-term baby experiencing respiratory distress is administered a postnatal lung surfactant via the trachea. Which of the following statements apply
The medication will lower the surface tension that causes alveolar collapse
The medication will rapidly increase oxygenation and reduce need for ventilator
The nurse should be monitor for vagal stimulation and decr. O2 saturation
The nurse should monitor for nausea, vomiting and a skin rash
All of the following statements regarding cystic fibrosis are true EXCEPT:
Lung tissue destruction is the most common cause of death
The disease primarily damages lungs, pancreas, sweat glands, liver
Thickened lung mucus secretions caused by excess water reabsorption blocks airways and lead to infections
Tobramycin, Azetreonam, and Hydroxurea are common medications used to treat disorder
Tobramycin & Aztreonam are both commonly used to treat Cystic Fibrosis. Whereas both medications will cause coughing and wheezing,
Tobramycin causes hoarseness and tinnitus, but aztreonam causes nasal congestion
Aztreonam causes hoarseness and tinnitus, but Tobramycin causes nasal congestion
The nebulizer medication Dornase Alfa is used to decrease the viscosity of sputum in Cystic fibrosis. Patients taking this medication should expect which of the following side effects?
Hoarseness, Laryngitis, or pharnygitis
Chest pain
Rash
Conjunctivitis
Hypercalcemia
Which of the following statements regarding Sickle Cell Anemia are FALSE?
The hemoglobin(HgB) is over-oxygenated which causes the RBC to collapse and form the shape of sickle and form log rigid chains
The HgB is deoxygenated, which causes the RBC to form a sickle shape and attach end to end with other RBC to form rigid chains
Sickle shaped cells live longer 130-140 days longer normal RBC (120)
Sickle shaped cells die quicker (10-20 days) than normal RBC (120)
Sickle shaped cells clog tiny blood vessels cause ischemia & hypoxia resulting in tissue death & organ damage
Why are glucocorticoids and analgesics given to patients in sickle cell crisis?
Glucocorticoid shorten duration of sickle cell crisis and analgesics manage the pain
Analgesics shorten duration of sickle cell crisis and Glucocorticoid manage the pain
Why is Hydroxyurea prescribed for sickle cell patients?
it causes body to produce fetal hemoglobin
It decreases the sickling and prolongs life of RBC
It reduces RBC adhesion to blood vessels
It shortens duration of sickle cell crisis
A female with sickle cell on Hydroxyurea recently discovered she was pregnant. Why should this medication be discontinued for this patient?
Medication cause severe mylelosuppression and can harm developing fetus
Medication intensifies symptoms of morning sickness
Medication will cause restlessness and bad dreams. Pregnant ladies need their sleep
In addition to binding phosphate in dialysis patients, Sevelamer will also
Decrease cholesterol synthesis
Increase RBC production
Shorten the crisis in a sickle cell patient
Provide protective heart benefits in cardiovascular patients
T or F - Phosphate binders should be given with food to encourage excretion via the GI tract rather than the kidneys
True - It prevents hypercalcemia because dialysis patients can efficiently get rid of calcium via urine
False - Phosphate binders can be given with or without food
T or F - Ca-based phosphate binders should be given to patients with high calcium levels
True - The medication uses the calcium in the blood to bind the phosphate
False - Ca based phosphate binders should only be used with patients with normal calcium levels
