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Pharmacology 3

Total questions: 86

Worksheet time: 46mins

Name
Class
Date
1.

What are the two clot medications that can be given to the patients

a)

Heparin and Warfarin

b)

Atropine

c)

Morphine

d)

oxycodone

2.

If a patient is overdosing on heparin which drug will you give them?

a)

Vicodin

b)

Asprin

c)

Protamine Sulfate

d)

Antropine

3.

What is the normal INR

a)

3.9

b)

2.7

c)

1.8

d)

4.8

4.

What does HIT stand for

a)

Homeostasis Induced thyroid

b)

Heparin Is Thrombocytopenia

c)

Heparin Induced Thrombocytopenia

5.

The prevention of further clotting after PE, DVT, Diagnosis

a)

Dalteparin

b)

Enoxaparin

c)

Warfarin

d)

Oxycodone

6.

ACE and ARBS (Linsinopril- Losartan lower what?

a)

HR

b)

BP

c)

Pain

d)

O2

7.

When blood pressure is low?

a)

Move the patient slow

b)

Sit patient up

c)

Place patient on left side

d)

Move the patient faster

8.

ACE AND ARBS ARE?

a)

OLOL

b)

ALOL

c)

Prills

d)

Sartan

9.

What is Coagulation?

a)

hemostasis that occurs when the body has heparin within

b)

hemostasis that occurs when hypothermia sets in

c)

Hemostasis that occurs when the body's levels become unbalanced

d)

hemostasis that occurs due to physiologic clotting of blood

10.

AACE inhibitors give you a

a)

Edema

b)

Dry Cough

c)

Septicemia

d)

Rheumatic

11.

What is the rescue inhaler before the steroid inhaler:

a)

Albruterol

b)

Methylphredone

c)

Steroid

d)

Mupirocin

12.

The nervous system is divided into two parts. Which parts?

a)

Central and peripheral

b)

Somatic and Autonomic

c)

Sympathetic and Parasympathetic

d)

Alpha and Beta

13.

A drug that binds to and stimulates the activity of one or more receptors in the body

a)

Medication

b)

Antidotes

c)

Agonist

d)

Adrenergic

14.

A client is receiving an IV infusion of heparin and was started on warfarin therapy the night before. Which statement is most correct?

a)

The client is receiving a double dose of anticoagulants

b)

The heparin therapy was ineffective, so the warfarin was started.

c)

The heparin provides anticoagulation until therapeutic levels of warfarin are reached.

d)

The heparin and warfarin work together synergistically to provide anticoagulation.

15.

A client is receiving an IV infusion of a thrombolytic drug during treatment for an acute MI. The nurse notices that there is a slight amount of bleeding from the antecubital area where venous lab work was drawn. What will the nurse do first?

a)

Monitor the site for further bleeding.

b)

Apply pressure to the site with a gauze pad.

c)

Slow the rate of infusion of the thrombolytic drug.

d)

Stop the infusion of the thrombolytic drug

16.

A 75-year-old man fell at home and hit his head against a table. His wife reports to their daughter that he does not have cuts or scratches, but there is a small lump on his upper scalp. She does not see any blood. He is taking warfarin and an antidysrhythmic as part of his treatment for chronic atrial fibrillation. What is the main concern at this time?

a)

Pressure should be applied to the lump for 3 to 5 minutes

b)

He will need to take two doses of warfarin tonight to prevent blood clotting.

c)

He needs to be examined for possible internal bleeding from the fall.

d)

As long as there is no bleeding, there is no concern.

17.

The nurse is about to administer a stat dose of intravenous atropine sulfate to a patient who is experiencing a symptomatic cardiac dysrhythmia. During administration of this drug, the nurse will monitor the patient closely for which adverse effect?

a)

tachycardia

b)

bradycardia

c)

ectopic beats

d)

cardiac standstill

18.

A patient has a prescription for oxybutynin (Ditropan), an anticholinergic drug. When reviewing the patients medica history, which condition, if present would be considered a contraindication

a)

Diarrhea

b)

hypotension

c)

Neurogenic bladder

d)

Uncontrolled angle-closure glaucoma

19.

The nurse is reviewing the use of anticholinergic drugs block the effect of which nervous system?

a)

Central Nervous System

b)

Somatic Nervous System

c)

Sympathetic Nervous System

d)

Parasympathetic Nervous System

20.

A Patient has received an accidental overdose of intravenous atropine. Which drug will the nurse prepare to administer

a)

Atenolol (Tenormin)

b)

Bethanechol (Urecholine)

c)

Dicyclomine

(Bentyl)

d)

Physostigmine (Antiliruim)

21.

A 72 year old man has a new prescription for an anticholinergic drug. He is an active man and enjoys outdoor activities such as golfing and doing his own yard work. What will the nurse emphasize to him during the teaching session about his drug therapy?

a)

Drowsiness may interfere with his outdoor activities

b)

increased salivation may occur during exercise and outside activities

c)

Fluid volume deficits may occur as a result of an increased incidence of diarrhea

d)

He will need to take measures to reduce the occurrence of heat stroke during his activities

22.

The nurse will monitor for which adverse effect when administering an anticholinergic drug

a)

Excessive urination

b)

Diaphoresis

c)

Dry Mouth

d)

Pupillary constriction

23.

The nurse is reviewing a patients medication history and notes that the patient is taking the cholinergic blocker tolterodine (detrol). which is an indication for this medication?

a)

Irritable bowel disease

b)

Induction of mydriasis

c)

Urge incontinence

d)

Reduction of secretions preoperatively

24.

A patient has been taking tolterodine (Detrol), but today her prescriber changed her to a newer drug, darifenacin (enablex). What advantage does darifenacin have over the tolterodine?

a)

the newer cholinergic blocker drugs are more effective

b)

it helps reduce urinary retention

c)

it can be used in patients with narrow angle glaucoma

d)

the incidence of dry mouth is much lower with darifenacin

25.

The nurse working in a preoperative admitting unit administers an anticholinergic medication to a patient before surgery. What is the purpose of this drug in the preoperative setting

a)

Control the heart rate

b)

relax the patient

c)

Reduce urinary frequency

d)

Reduce oral and gastrointestinal secretions

26.

In preparation for eye surgery, the nurse monitors for which desired drug effect in a patient who is receiving a cholinergic blocking eyedrop medication

a)

Miosis

b)

Mydriasis

c)

Increased intraocular fluid production

d)

Enhanced tear production

27.

A patent has a new prescription for the transdermal form of scopolamine. The nurse knows that this form of scopolamine is used for which condition

a)

Angina

b)

Chronic pain

c)

hypertension

d)

motion sickness

28.

The nurse is reviewing the indications for atropine sulfate. Atropine is appropriate for which of these patients

a)

A patient who has suddenly developed symptomatic bradycardia with a heart rate of 32 beats / minute

b)

A patient who has suddenly developed symptomatic tachycardia with a heart rate of 180 beats/ minute

c)

A patient with severe narrow angle glaucoma

d)

A patient who is about to have surgery

e)

A patient with anticholinesterases

29.

A patient is to receive glycopyrrolate (Robinul) 4mcg/kg IM 30 minutes before a procedure. The patient weighs 110lns; the medication is available in a strength of 0.2 mg/ml. Identify how many milliliters of medication will the nurse draw up into the syringe

a)

3ml

b)

4ml

c)

1ml

d)

5ml

30.

A patient has a new order for the adrenergic drug doxazosin (Cardura). When providing education about this drug, the nurse will include which instructions?

a)

weigh yourself daily and report any weight loss to your prescriber

b)

Increase your potassium intake by eating more bananas and apricots

c)

The impaired taste associated with this medication usually goes away in 2 to 3 weeks

d)

Be sure to lie down after taking the first dose, because first dose hypotension may make you dizzy

31.

A patient with severe liver disease is receiving the angiotensin- converting enzyme (ACE) inhibitor, captopril (Capoten). The nurse is aware that the advantage of this drug for this patient is which characteristic?

a)

Captopril rarely causes first dose hypotensive effects

b)

captopril has little effect on electrolyte levels

c)

captopril is a prodrug and is metabolized by the liver before becoming active

d)

captopril is not a prodrug and does not need to be metabolized by the liver before becoming active

32.

During a follow-up visit, the health care provider examines the fundus of the patients eye. Afterward the patient asks the nurse "why is he looking at my eyes when I have high blood pressure? It does not make sense to me!" what is the best response by the nurse?

a)

We need to monitor for drug toxicity

b)

We must watch for increased intraocular pressure

c)

The provider is assessing for visual changes that may occur with drug therapy

d)

The provider is making sure the treatment is effective over the long term

33.

A nurse is preparing for a community education program on hypertension. Which of these parameters determine the regulation of arterial blood pressure?

a)

Cardiac output and systemic vascular resistance

b)

Heart rate and peripheral resistance

c)

Blood volume and renal blood flow

d)

Myocardial contractility and arteriolar constriction

34.

when counseling a male patient about the possible adverse effects of antihypertensive drugs the nurse will discuss which potential problem

a)

Impotence

b)

Bradycardia

c)

Increased libido

d)

Weight gain

35.

The nurse is reviewing drug therapy for hypertension. According to the JNC-8 guidelines antihypertensive drug therapy for a newly diagnosed hypertensive African Americant patient would most likely include which drug or drug class

a)

Vasodilators alone

b)

ACE inhibitors alone

c)

Calcium Channel Blockers with thiazide diuretics

d)

Beta blockers with thiazide diuretics

36.

The nurse is creating a plan of care for a patient with new diagnosis of hypertension. Which is a potential nursing diagnosis for the patient taking antihypertensive medications

a)

Diarrhea

b)

Sexual dysfunction

c)

Urge urinary incontinence

d)

impaired memory

37.

A patients blood pressure elevates to 270/150 and a hypertensive emergency is obvious. He is transferred to the intensive care unit and started on a sodium nitroprusside (Nipride) drip to be titrated per his response. With this medication the nurse knows that the maximum dose of this drug should be infused for how long

a)

10 minutes

b)

30 minutes

c)

1 hour

d)

24 hours

38.

A patient with primary hypertension is prescribed drug therapy for the first time. The patient asks how ling drug therapy will be needed. Which answer by the nurse is the correct response

a)

This therapy will take about 3 months

b)

This therapy will take about a year

c)

This therapy will go on until your symptoms disappear

d)

Therapy for high blood pressure is usually lifelong

39.

A patient who has been taking antihypertensive drugs for a few months complains of having a persistent dry cough. The nurse knows that this cough is an adverse effect of which class of antihypertensive drugs

a)

Beta Blockers

b)

Angiotensin- converting enzyme (ACE) inhibitors

c)

Angiotensin II receptor blockers (ARBS)

d)

Calcium channel blockers

40.

A pregnant woman is experiencing hypertension. The nurse knows that which drug is commonly used for a pregnant patient who is experiencing hypertension

a)

Mannitol (osmitrol)

b)

Enalapril (Vasotec)

c)

Hydrochlorothiazide

(HydroDIURIL)

d)

Methyldopa (Aldomet)

41.

A patient with type 2 diabetes mellitus has been found to have trace proteinuria. The prescriber writes an order for an angiotensin converting enzyme (ACE) inhibitor. What is the main reason for prescribing this class of drug for this patient

a)

Cardioprotective effects

b)

Renal protective effects

c)

reduces blood pressure

d)

promotes fluid output

42.

The nurse is reviewing the orders for a patient and notes a new order for an angiotensin-converting enzyme (ACE) inhibitor. The nurse checks the current medication orders, knowing that this drug class may have a serious interaction with what other drug class

a)

Calcium channel blockers

b)

Diuretics

c)

Nonsteroidal anti-inflammatory drugs

d)

Nitrates

43.

An older adult patient will be taking a vasodilator for hypertension. Which adverse effect is of most concern for the older adult patient taking this class of drug

a)

Dry Mouth

b)

Restlessness

c)

Constipation

d)

Hypotension

44.

When teaching a patient about antihypertensive drug therapy, which statements by the nurse are correct

a)

you need to have your blood pressure checked once a week and keep track of the readings

b)

if you notice that the symptoms have gone away, you should be able to stop taking the drug

c)

An exercise program may be helpful in treating hypertension, but lets check with your doctor first

d)

Please continue taking the medication even if you are feeling better

45.

A patient is to receive enalapril (vasotec) 5ml IV every 6 hours. each dose is given over 5 minutes. the mediation is available in an injectable form, 1.25mg/ml. Identify how many milliliters of medication will the nurse draw up for each dose

a)

5ml

b)

1 ml

c)

4ml

d)

3ml

46.

A patient has been prescribed warfarin (coumadin) in addition to a a heparin infusion. The patient asks the nurse why he has to be on two medications. The nurse response is based on which rationale

a)

the oral an injection forms work synergistically

b)

the combination of heparin and an oral anticoagulant results in fewer adverse effects than heparin use alone

c)

oral anticoagulants are used to reach an adequate level of anticoagulation when heparin alone is unable to do so

d)

Heparin is used to start anticoagulation so as to allow time for the blood levels of warfarin to reach adequate levels.

47.

A patient is receiving thrombolytic therapy and the nurse monitors the patient for adverse effects. what is the most common undesirable effect of thrombolytic therapy

a)

Dysrhythmaias

b)

nausea and vomitting

c)

anaphylactic reactions

d)

internal and superficial bleeding

48.

A patient who has been anticoagulated with warfarin (Coumadin) has been admitted for gastrointestinal bleeding. The history and physical examination indicates that the patient may have take too much warfarin. The nurse anticipates that the patient will receive which antidote

a)

Vitamin E

b)

Vitamin K

c)

Protamine sulfate

d)

Potassium chloride

49.

When administering heparin subcutaneously the nurse will follow which procedure?

a)

Aspirating the syringe before injecting the medication

b)

massage the site after the injection

c)

Applying heat to the injection site

d)

Using 1/2 ti 5/8 inch 25- to 28 gauge needle

50.

A oatient has been instructed to take one enteric-coated low dose asprin a day as part of therapy to prevent strokes. The nurse will provide which instruction when providing patient teaching about this medication

a)

Aspirin needs to be taken on an empty stomach to ensure maximal absorption

b)

Low-dose aspirin therapy rarely causes problems with bleeding

c)

Take the medication with 6 to 8 ounces of water and with food

d)

Coated tablets may be crushed if necessary for easier swallowing

51.

A patient will be receiving a thrombolytic drug as part of the treatment for acute myocardial infarction. The nurse explains to the patient that this drug is used for which purpose

a)

To relieve chest pain

b)

to prevent further clot formation

c)

to dissolve the clot in the coronary artery

d)

to control bleeding in the coronary vessels

52.

A patient is receiving heparin therapy as part of the treatment for pulmonary embolism. The nurse monitors the results of which labatory test to check the drugs effectiveness

a)

Bleeding times

b)

Activated partial thromboplastin time (aPTT)

c)

Prothrombin time/international normalized ration (PT/INR)

d)

Vitamin K levels

53.

The nurse notes in the patients medication orders that the patient will be starting anticoagulant therapy. what is the primary goal of anticoagulant therapy>

a)

stabilizing an existing thrombus

b)

dissolving an existing thrombus

c)

preventing thrombus formation

d)

dilatating the vessel around a clot

54.

A patient is being discharged on anticoagulant therapy. The nurse will include in the patient education conversation that it is important to avoid herbal products that contain substance

a)

valerian

b)

ginkgo

c)

soy

d)

saw palmetto

55.

A patient has had recent mechanical heart valve surgery and is receiving anticoagulant therapy. While monitoring the patients laboratory work, the nurse interprets that the patients international normalized ratio (INR) level of 3 indicates that

a)

the patient is not receiving enough warfarin to have a therapeutic effect

b)

the patients warfarin dose is at therapeutic levels

c)

the patients intravenous heparin dose is dangerously high

d)

the patients intravenous heparin dose is at therapeutic levels

56.

A patient has received an overdose of intravenous heparin and is showing signs of excessive bleeding. Which substance is the antidote for heparin overdose?

a)

Vitamin E

b)

Vitamin K

c)

Protamine Sulfate

d)

Potassium chloride

57.

The nurse is reviewing new medication orders for a patient who has an epidural catheter for pain relief. One of the orders is for enoxaparin (lovenox), a low -molecular-weight heparin (LMWH). What is the nurses priority action

a)

Give the LMWH as ordered

b)

double check the LMWH order with another nurse and then administer as ordered

c)

Stop the epidural pain medication and then administer the LMWH

d)

Contact the prescriber because the LMWH cannot be given if the patient has an epidural catheter

58.

A patient will be taking dabigatran (Pradaxa) as part of treatment for chronic atrial fibrillation. Which statements about dabigatran are true

a)

The dose of dabigatran is reduced in patients with decreased renal function

b)

Bleeding is the most common adverse effect

c)

potassium chloride is given asan antidote in cases of overdose

d)

Dabigatran levels are monitored by measuring prothrombin time/ international normalized ratio (PT/INR) results

e)

this drug is a prodrug and becomes activated in the liver

59.

A patient is taking intravenous aminophylline for a severe exacerbation of chronic obstructive pulmonary disease. The nurse will assess for which therapeutic response

a)

Increased sputum production

b)

increased heart rate

c)

increased respiratory rate

d)

increased ease of breathing

60.

A patient is taking a xanthine derivative as part of treatment for chronic obstructive pulmonary disease. the nurse will monitor for which adverse effects associated with the use of xanthine

a)

Diarrhea

b)

palpitations

c)

bradycardia

d)

drowsiness

61.

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 beta 2 agonist such as albuterol (Proventil)

c)

A long acting Beta 2 agonist such as salmeterol (Serevent)

d)

A corticosteroid such as fluticasone (flovent)

62.

The prescriber has changed the patients medication regimen to include the leukotriene receptor antagonist (LTRA) montelukast (singulair) to treat asthma. The nurse will emphasize which point about this medication

a)

the proper technique for inhalation must be followed

b)

The patient needs to keep it close by at all times to treat acute asthma attacks

c)

it needs to be taken every day on a continuous schedule even if symptoms improve

d)

When the asthma symptoms improve the dosage schedule can be tapered and eventually discontinued

63.

After receiving a nebulizer treatment with a beta agonist the patient complains of feeling slightly nervous and wonders if her asthma is getting worse. What is the nurse's best response

a)

This is an expected adverse effect. Let me take your pulse

b)

the next scheduled nebulizer treatment will be skipped

c)

I will notify the physician about this advers effect

d)

we will hold the treatment for 24 hours

64.

A patient has prescriptions for two inhalers. One inhaler is a bronchodilator and the other is a corticosteroid. Which instruction regarding these inhalers will the nurse give to the patient

a)

Take the corticosteroid inhaler first

b)

take the bronchodilator inhaler first

c)

take these two drugs at least 2 hours apart

d)

it does not matter which inhaler you use first

65.

When educating a patient recently placed on inhaled corticosteroids, the nurse will discuss which potential adverse effects

a)

Fatigue and depression

b)

anxiety and palpitations

c)

headache and rapid heart rate

d)

oral candidiasis and dry mouth

66.

The nurse is monitoring drug levels for patient who is receiving theophylline. The most recent theophylline level was 22mcg/ml and the nurse evaluates this level to be

a)

below the therapeutic level

b)

at a therapeutic level

c)

above the therapeutic level

d)

at toxic level

67.

When evaluating a patients use of a metered dose inhaler (MDI) the nurse notes that the patient is unable to coordinate the activation of the inhaler with her breathing. What intervention is most appropriate at this time

a)

notify the doctor that the patient is unable to use the MDI

b)

Obtain an order for peak flow meter

c)

obtain an order for a spacer device

d)

ask the prescriber if the medication can be given orally

68.

The nurse is providing instructions about the Advair inhaler (fluticasone propionate and salmeterol). Which statement about this inhaler is accurate

a)

It is indicated for the treatment of acute bronchospasms

b)

it needs to be used with a spacer for best results

c)

patients need to avoid drinking water for 1 hour after taking this drug

d)

it is used for the prevention of bronchospasms

69.

The nurse is reviewing medications for the treatment of asthma Which drugs are used for acute asthma attacks

a)

Salmeterol (Serevent) inhaler

b)

Albuterol (Proventil) nebulizer solution

c)

Epinephrine

d)

Montelukast (singulair)

e)

Fluticasone (Flovent) Rotadisk inhaler

70.

The nurse is providing instructions to a patient who has a new prescription for a corticosteroid metered-dose inhaler. Which statement by the patient indicates that further instruction is needed

a)

I will rinse my mouth with water after using the inhaler and then spit out the water

b)

I will gargle after using the inhaler and then swallow

c)

I will clean the plastic inhaler casing weekly by removing the canister and then washing the case in warm soapy water. I will then let it dry before reassembling

d)

I will use the inhaler for asthma attacks

e)

I will continue to use this inhaler even if I am feeling better/ I will use a peak flow meter to measure my response to therapy

71.

A patient has a metered dose inhaler that contains 200 actuations (puffs), and it does not have dose counter. He is to take two puffs two times a day. If he does not take any extra doses identify how many days will this inhaler last at the prescribed dose

a)

45 days

b)

10 days

c)

50 days

d)

32 days

72.

A patient with severe asthma with a tachycardia greater than 120 BPM tachypnea greater than 30 BPM, o2 sat less than 90% on RA peak exp flow less than 40% predicted or best is less than 150 L/min

a)

Ipratropium 2nd

b)

Albuterol 1st

c)

Methyl-predniso-lone 3rd

d)

Salmetric

73.

Which medication would you give for patient with severe asthma

a)

Albuterol Inhaler

b)

Inhaled salmeterol

c)

Nebulizer Ipratropium

d)

IV Methamphetamines

e)

IV methylprednisolone

74.

What are all of the drugs not good for asthma

a)

Naproxen

b)

Salicylate

c)

acetylsalicylic acid

d)

Ibuprofen and indomethacin

e)

Ketorolac (Toradol)

75.

what is the therapeutic range for Heparin

a)

90 to 100 PTT

b)

50 to 80 PTT

c)

46 to 70 PTT

d)

150 to 400 PTT

76.

what is the antidote for heparin

a)

More heparin

b)

Warfarin

c)

Cephalosporin

d)

protamine sulfate

77.

what is the therapeutic range for Warfarin

a)

2- 6 INR

b)

2-3 INR

c)

6-10 INR

d)

1-3 INR

78.

How many platelets must there be

a)

150,000-200,000

b)

150,000-600,000

c)

150,000-500,000

d)

150,000-400,000

79.

NO EGGGOS

a)

Vitamin E

b)

GINSENG or Garlic

c)

Ginkgo

d)

Omega 3

e)

St. Johns Warts

80.

When do you hold heparin and contact the HCP

a)

Patient has recent diagnosis of peptic ulcer

b)

Patient has a aPTT of 105

c)

Patient has an INR 4.5

d)

Patient has black tarry stools

e)

Patient has aPTT of 25

81.

Huge risk for bleeds

a)

Vitamin K

b)

Patient has INR of 4.5

c)

Patient has an aPTT of 25

d)

Patient is taking Ginkgo and Vitamin E

82.

When do you question the order of the aspirin or clopidogrel

a)

Patient has 65,000 platelets

b)

Patient with 1.5 INR

c)

Patient with 46 PTT

d)

Currently taking warfarin

e)

Regular consumption of 6 glasses of wine per night

83.

A patient is on dabigatran for A fib. which actions should the nurse initiate

a)

Place an IV line

b)

Report stools that are black and tarry

c)

Teach patient to avoid clopidogrel

d)

Administer aspirin instead

e)

Teach a patient to stop taking this med before surgery

84.

A client is receiving discharge instructions for a inhaled corticosteroid metered dose inhaler. Which teaching should the nurse include

a)

Discard the use fluticasone if albuterol provides relief

b)

Do not swallow the water as you wash your mouth after each use

c)

if taking albuterol be sure to use after the steroid

d)

Steroid inhalers should be used before beta 2 agonists

85.

Which statement by the patient requires further teaching

a)

I will use cromolyn to prevent activity induced asthma

b)

I will use montelukast to prevent asthma attacks

c)

I will use spacers to prevent oral thrush while using beclomethasone

d)

I will take cromolyn 45 minutes before physical activity

86.

What is coagulation

a)

It is the hemostasis that occurs during pregnacy

b)

is hemostasis that occurs due to physiologic clotting of blood

c)

Stops blood clots

d)

helps the heart regulate