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Pharm Exam3

Total questions: 50

Worksheet time: 27mins

Name
Class
Date
1.

The nurse is caring for a client receiving combination chemotherapy. The client asks why more than one drug is prescribed. Which response by the nurse would be correct?

a)

“It has better response rates than single-drug chemotherapy.”

b)

“It has fewer side effects than when given alone.”

c)

It is always more effective than surgery or radiation.”

d)

“Survival rates are always better.”

2.

A patient is scheduled to receive chemotherapy drugs that will cause myelosuppression. Which action by the nurse will be most important?

a)

Monitor for a change in temperature.

b)

Evaluate gastrointestinal function.

c)

Assess for evidence of cardiac compromise.

d)

Question the patient about changes in sense of taste.

3.

A patient is scheduled to receive high-dose cyclophosphamide via an intravenous infusion as treatment for cancer. Which will be most important for the nurse to include when teaching the patient about cyclophosphamide?

a)

An indwelling urinary catheter will be placed

b)

Drink at least 2 liters of fluid per day

c)

empty the bladder every 4-6 hours

d)

limit fluid intake during chemotherapy

4.

A patient is receiving the antitumor antibiotic doxorubicin to treat lung cancer. The patient is experiencing shortness of breath and palpitations. The nurse is concerned that the patient has developed which condition

a)

Anemia

b)

Cardiotoxicity

c)

Hypersensitivity

d)

Pulmonary infection

5.

The client has thrombocytopenia secondary to chemotherapy. Which nursing actions would be most appropriate?

a)

Apply pressure to the injection site and assess for occult bleeding

b)

Help the patient conserve energy by scheduling care.

c)

Monitor breath sounds and vital signs

d)

Provide small, frequent meals and monitor loss of fluids from diarrhea

6.

The nurse is teaching a patient who will begin receiving targeted therapy for cancer. The patient asks how targeted therapy differs from other types of chemotherapies. The nurse will explain that targeted therapy:

a)

damages cancer cell DNA to prevent cell replication.

b)

directly kills or damages cancerous cells

c)

interferes with specific molecules in cancer cells.

d)

prevents metastasis of cancer cells

7.

A patient undergoing chemotherapy for breast cancer asks why she is not receiving trastuzumab like her sister. Which response by the nurse is correct?

a)

Your breast cancer cells are estrogen-receptor positive, and targeted therapy is not needed

b)

You are much older than your sister and would not tolerate the treatment well.

c)

The drug is expensive, and your insurance does not cover it.

d)

Your cancer cells do not have the target for trastuzumab.

8.

The nurse is teaching a patient about diphenhydramine. Which instructions should the nurse include in the patient’s teaching plan? (Select all that apply.)

a)

Take medication on an empty stomach to facilitate absorption.

b)

Avoid alcohol and other central nervous system depressants.

c)

Notify a health care provider if confusion or hypotension occurs.

d)

Use sugarless candy, gum, or ice chips for temporary relief of dry mouth.

e)

Avoid handling dangerous equipment or performing dangerous activities until stabilized on the medication.

9.

A patient who has narrow-angle glaucoma asks the nurse to recommend a medication to alleviate cold symptoms such as nasal congestion and runny nose. The nurse will suggest the patient talk to the provider about which medication that is available as a nasal spray?

a)

Azelastine

b)

Cetirizine

c)

Benzonatate

d)

Dipenhydramine

10.

The patient who has nasal congestion asks the nurse to recommend a decongestant medication. The nurse performs a medication history and learns that the patient takes a beta blocker to treat hypertension. Which of the over-the-counter products below would be most appropriate to recommend?

a)

Dipehydramine

b)

Ephedrine

c)

Phenylephrine

d)

Loratadine

11.

A patient with chronic obstructive pulmonary disease is taking the leukotriene antagonist montelukast. The nurse is aware that this medication is given for which purpose?

a)

Maintenance treatment of asthma

b)

Treatment of an acute asthmatic attack

c)

reversing bronchospasm associated with COPD

d)

Treatment of inflammation in chronic bronchitis

12.

A patient is receiving intravenous aminophylline. The nurse checks the patient's lab values and sees the serum theophylline level is 32 mcg/mL. What action should the nurse take?

a)

Assess the patient’s breath sounds for improvement.

b)

Increase the dosage per sliding-scale directions.

c)

Notify the health care provider of the level.

d)

Have the laboratory collect another sample to verify the results.

13.

What is/are the side effect(s) of long-term use of glucocorticoids? (Select all that apply.)

a)

Impaired Immune response

b)

Insomnia

c)

Hyperglycemia

d)

Vomiting

e)

Weight Loss

14.

A patient will be discharged home with albuterol (Proventil) to use for asthma symptoms. What information will the nurse include when teaching this patient about this medication?

a)

Failure to respond to the medication indicates a need for a higher dose

b)

Monitor for hypoglycemia symptoms when using this medication.

c)

Palpitations are common with this drug even at normal, therapeutic doses

d)

Overuse of this medication can result in airway narrowing and bronchospasm

15.

The nurse is caring for a patient diagnosed with COPD who has been prescribed tiotropium (Spiriva). Which statement will the nurse include in the education?

a)

Remove the capsules from the packaging and place in your 7-day med box.

b)

If you experience dry mouth, stop taking the medication immediately

c)

Use tiotropium as needed for sudden breathing problems.

d)

Tiotropium works by relaxing and dilating the bronchioles

16.

A patient who uses an inhaled glucocorticoid medication reports having a sore tongue. The nurse notes white spots on the patient’s tongue and oral mucous membranes. After notifying the provider, the nurse will remind the patient to perform which action?

a)

Avoid using a spacer with the inhaled glucocorticoid medication.

b)

Clean the inhaler with hot, soapy water after each use.

c)

Consume yogurt daily while using this medication

d)

Rinse the mouth thoroughly with water after each use

17.

The patient’s serum digoxin level is 3.0 ng/mL. What does the nurse know about this serum digoxin level?

a)

It is elevated

b)

It is low

c)

It is normal

d)

It is low-average

18.

A patient takes an initial dose of a nitrate. Which symptom(s) will the nurse expect to occur?

a)

Nausea

b)

Headaches

c)

Stomach Cramps

d)

Irregular pulse rate

19.

The nurse performs a medication history and learns that the patient takes a loop diuretic and digoxin (Lanoxin). The nurse will question the patient to ensure that the patient is also taking which medication?

a)

Cortisone

b)

Lidocaine

c)

Nitroglycerin

d)

Potassium

20.

A patient who has angina is prescribed nitroglycerin. Which are appropriate nursing interventions for nitroglycerin? (Select all that apply.)

a)

Teach the patient who has taken a tablet to call 911 in 5 minutes if chest pain persists.

b)

Have the patient sit or lie down when taking a nitroglycerin sublingual tablet.

c)

Apply the nitroglycerin patch to a hairy area to protect skin from burning.

d)

Avoid extremes in weather

e)

Warn the patient against ingesting alcohol while taking nitroglycerin.

21.

What are the signs and symptoms of digoxin toxicity? (Select all that apply)

a)

Dysuria

b)

Vomiting

c)

Tachycardia

d)

Yellow haloes in the visual field

e)

Diarrhea

22.

The beta blocker acebutolol is prescribed for dysrhythmias. What is the primary purpose of the drug?

a)

Increase beta1 and beta2 receptors in cardiac tissues

b)

Increase the flow of oxygen to cardiac tissues

c)

Block beta1-adrenergic receptors in cardiac tissues

d)

Block beta2-adrenergic receptors in cardiac tissues

23.

A patient is taking hydrochlorothiazide 50 mg/day and digoxin 0.25 mg/day. The nurse plans to monitor the patient for which potential electrolyte imbalance?

a)

Hypocalcemia

b)

Hypokalemia

c)

Hyperkalemia

d)

Hypermagnesemia

24.

What should the nurse do when a patient is taking furosemide?

a)

Instruct the patient to change positions quickly when getting out of bed.

b)

Assess blood pressure before administration.

c)

Administer the drug at bedtime for maximum effectiveness.

d)

Teach the patient to avoid fruits to prevent hyperkalemia.

25.

The patient has been receiving spironolactone 50 mg/day for heart failure. The nurse should closely monitor the patient for which condition?

a)

Hypokalemia

b)

Hyperkalemia

c)

Hypoglycemia

d)

Hypermagnesemia

26.

The nurse is administering a beta blocker to a patient. Which is the most important assessment to perform before administration?

a)

Urine output

b)

Apical pulse

c)

Potassium level

d)

Serum level of medication

27.

The nurse is caring for a patient who develops marked edema and a low urine output as a result of heart failure. Which medication will the nurse expect the provider to order for this patient?

a)

Digoxin

b)

Furosemide

c)

Hydrochlorothiazide

d)

Spironolactone

28.

The nurse knows that which diuretic is most frequently combined with an antihypertensive drug?

a)

Chlorthalidone

b)

Hydrochlorothiazide

c)

Bendfroflumethiazide

d)

Spironolactone

29.

An African American patient has developed hypertension. The nurse is aware that which group(s) of antihypertensive drugs are less effective in African American patients?

a)

Diuretics

b)

Calcium channel blockers and vasodilators

c)

Beta blockers and ACE Inhibitors

d)

Alpha blockers

30.

stion 10

10 out of 10 points

Captopril (Capoten) has been ordered for a patient. The nurse should teach the patient that the most commonly occurring side effect of an angiotensin-converting enzyme (ACE) inhibitor drug is which of the following?

a)

Nausea and vomiting

b)

Dizziness and headaches

c)

Upset stomach

d)

Constant, irritating cough

31.

A patient is prescribed losartan. The nurse teaches the patient that an angiotensin II-receptor blocker acts by doing what?

a)

Inhibiting angiotensin-converting enzyme

b)

Blocking angiotensin II from angiotensin I receptors

c)

Preventing the release of angiotensin I

d)

Promoting the release of aldosterone

32.

A patient is being changed from an injectable anticoagulant to an oral anticoagulant. Which anticoagulant does the nurse realize is administered orally?

a)

Enoxaparin

b)

Warfarin

c)

Bivalirudin

d)

Dalteparin

33.

A patient is admitted to the emergency department with an acute myocardial infarction. Which drug does the nurse expect the health care provider to order for prevention of tissue necrosis after blood clot blockage in a coronary artery?

a)

Heparin

b)

Clopidogrel

c)

Alteplase

d)

Aminocaproic acid

34.

A patient is taking clopidogrel (Plavix). When teaching this patient about dietary restrictions while taking this medication, the nurse will instruct the patient to avoid excessive consumption of which food?

a)

Garlic

b)

Grapefruit

c)

Green, leafy vegetables

d)

Red meats

35.

A patient who is taking warfarin has an international normalized ratio (INR) of 5.5. The nurse will anticipate giving which of the following?

a)

Fresh frozen plasma

b)

IV Iron

c)

Vitamin K

d)

Protamine sulfate

36.

For what severe skeletal muscle adverse reaction should the nurse observe in a patient taking atorvastatin?

a)

Myasthenia Gravis

b)

Rhabdomyloysis

c)

Dyskinesia

d)

Agranulocytosis

37.

A patient with high cholesterol is ordered to take atorvastatin (Lipitor). What information will be included in the patient teaching? (Select all that apply.)

a)

Dietary management is not a priority with this medication

b)

The medication should be taken on an empty stomach.

c)

The medicine should be taken with a full glass of water

d)

The patient should watch for body aches or gastrointestinal upset as side effects.

e)

The patient should have renal function tests frequently

38.

A patient asks the nurse about using loperamide (Imodium) to treat infectious diarrhea. Which response will the nurse give?

a)

“Loperamide results in many central nervous system (CNS) side effects.”

b)

“Loperamide has no effect on infectious diarrhea.”

c)

“Loperamide is taken once daily.”

d)

“Loperamide can be used to treat diarrheal symptoms but may also slow the exit of the infectious organisms from the GI tract.”

39.

The nurse is caring for a patient who has postoperative nausea and vomiting. The surgeon has ordered promethazine. Which aspect of this patient’s health history would be of concern?

a)

Asthma

b)

Diabetes

c)

GERD

d)

Glaucoma

40.

The nurse is instructing a patient who will take psyllium to treat constipation. What information will the nurse include when teaching this patient?

a)

The importance of consuming adequate amounts of water

b)

The need to monitor for systemic side effects

c)

The onset of action of 30 to 60 minutes after administration

d)

The need to use the dry form of Metamucil to prevent cramping

41.

A patient is taking famotidine. What information should the nurse teach the patient about this drug? (Select all that apply.)

a)

The drug should be administered for 4 to 8 weeks.

b)

The drug must be administered 30 minutes before meals

c)

The drug must be administered separately from iron by at least 1 hour.

d)

Smoking should be avoided while taking this drug.

e)

Foods high in vitamin B12 should be increased in the diet.

42.

An elderly patient reports using Maalox frequently to treat acid reflux. The nurse should notify the patient’s provider to request an order for which laboratory tests?

a)

Liver enzymes and serum calcium

b)

Liver enzymes and serum magnesium

c)

renal function and serum calcium

d)

Renal function and serum magnesium

43.

Famotidine is more potent than lansoprazole

a)

True

b)

False

44.

A patient is taking famotidine to inhibit gastric secretions. Which side effects of famotidine will the nurse teach the patient? (Select all that apply.)

a)

Dizziness

b)

Headaches

c)

Hypokalemia

d)

Hyperkalemia

e)

Erectile dysfunction

45.

A patient has been prescribed clomiphene citrate therapy by her doctor. The patient asks the nurse, “How does my new medicine work?” What can the nurse say to convey the mechanism of action of clomiphene citrate therapy to this patient? (Select all that apply.)

a)

This drug stimulates the ovaries, increasing the chance of ovulation

b)

This drug increases circulating progesterone levels.

c)

This drug usually does not work on the first cycle.

d)

This drug helps the ovaries form multiple follicles.

46.

A 45-year-old woman reports cessation of menses for the past 6 months and asks the nurse if she needs to continue using contraception. The nurse will tell her:

a)

that she may discontinue using contraception.

b)

that she most likely has premature ovarian failure

c)

to begin hormone therapy to prevent menopausal symptoms

d)

to continue using contraception for at least 6 more months.

47.

Flutamide is used to treat which condition

a)

BPH

b)

Breast Cancer

c)

Male-pattern baldness

d)

Metastatic prostate cancer

48.

A male patient wants to begin taking tadalafil to treat erectile dysfunction. Which aspect of this patient’s history would be of particular concern?

a)

Angina

b)

Asthma

c)

BPH

d)

Color blindness

49.

The nurse is interviewing a man with erectile dysfunction who is interested in one of the phosphodiesterase inhibitors. Which response by the nurse is best for this patient?

a)

There are many causes of sexual dysfunction in men, so a complete history and physical is the first step in treatment.

b)

Common side effects include headache, blurred vision, photosensitivity, changes in color perception, and urinary tract symptoms.

c)

These drugs should not be used if you take nitroglycerine for angina.

d)

The onset of action varies among the different drugs in this class.

50.

What are the signs of angioedema? (Select all that apply)

a)

Peripheral edema

b)

Swelling around the eyes, cheeks, and lips

c)

Mild pain and warmth around the affected areas

d)

Pale, cool extremities