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WorksheetsPharmacology 3
Total questions: 86
Worksheet time: 46mins
What are the two clot medications that can be given to the patients
Heparin and Warfarin
Atropine
Morphine
oxycodone
If a patient is overdosing on heparin which drug will you give them?
Vicodin
Asprin
Protamine Sulfate
Antropine
What is the normal INR
3.9
2.7
1.8
4.8
What does HIT stand for
Homeostasis Induced thyroid
Heparin Is Thrombocytopenia
Heparin Induced Thrombocytopenia
The prevention of further clotting after PE, DVT, Diagnosis
Dalteparin
Enoxaparin
Warfarin
Oxycodone
ACE and ARBS (Linsinopril- Losartan lower what?
HR
BP
Pain
O2
When blood pressure is low?
Move the patient slow
Sit patient up
Place patient on left side
Move the patient faster
ACE AND ARBS ARE?
OLOL
ALOL
Prills
Sartan
What is Coagulation?
hemostasis that occurs when the body has heparin within
hemostasis that occurs when hypothermia sets in
Hemostasis that occurs when the body's levels become unbalanced
hemostasis that occurs due to physiologic clotting of blood
AACE inhibitors give you a
Edema
Dry Cough
Septicemia
Rheumatic
What is the rescue inhaler before the steroid inhaler:
Albruterol
Methylphredone
Steroid
Mupirocin
The nervous system is divided into two parts. Which parts?
Central and peripheral
Somatic and Autonomic
Sympathetic and Parasympathetic
Alpha and Beta
A drug that binds to and stimulates the activity of one or more receptors in the body
Medication
Antidotes
Agonist
Adrenergic
A client is receiving an IV infusion of heparin and was started on warfarin therapy the night before. Which statement is most correct?
The client is receiving a double dose of anticoagulants
The heparin therapy was ineffective, so the warfarin was started.
The heparin provides anticoagulation until therapeutic levels of warfarin are reached.
The heparin and warfarin work together synergistically to provide anticoagulation.
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?
Monitor the site for further bleeding.
Apply pressure to the site with a gauze pad.
Slow the rate of infusion of the thrombolytic drug.
Stop the infusion of the thrombolytic drug
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?
Pressure should be applied to the lump for 3 to 5 minutes
He will need to take two doses of warfarin tonight to prevent blood clotting.
He needs to be examined for possible internal bleeding from the fall.
As long as there is no bleeding, there is no concern.
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?
tachycardia
bradycardia
ectopic beats
cardiac standstill
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
Diarrhea
hypotension
Neurogenic bladder
Uncontrolled angle-closure glaucoma
The nurse is reviewing the use of anticholinergic drugs block the effect of which nervous system?
Central Nervous System
Somatic Nervous System
Sympathetic Nervous System
Parasympathetic Nervous System
A Patient has received an accidental overdose of intravenous atropine. Which drug will the nurse prepare to administer
Atenolol (Tenormin)
Bethanechol (Urecholine)
Dicyclomine
(Bentyl)
Physostigmine (Antiliruim)
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?
Drowsiness may interfere with his outdoor activities
increased salivation may occur during exercise and outside activities
Fluid volume deficits may occur as a result of an increased incidence of diarrhea
He will need to take measures to reduce the occurrence of heat stroke during his activities
The nurse will monitor for which adverse effect when administering an anticholinergic drug
Excessive urination
Diaphoresis
Dry Mouth
Pupillary constriction
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?
Irritable bowel disease
Induction of mydriasis
Urge incontinence
Reduction of secretions preoperatively
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?
the newer cholinergic blocker drugs are more effective
it helps reduce urinary retention
it can be used in patients with narrow angle glaucoma
the incidence of dry mouth is much lower with darifenacin
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
Control the heart rate
relax the patient
Reduce urinary frequency
Reduce oral and gastrointestinal secretions
In preparation for eye surgery, the nurse monitors for which desired drug effect in a patient who is receiving a cholinergic blocking eyedrop medication
Miosis
Mydriasis
Increased intraocular fluid production
Enhanced tear production
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
Angina
Chronic pain
hypertension
motion sickness
The nurse is reviewing the indications for atropine sulfate. Atropine is appropriate for which of these patients
A patient who has suddenly developed symptomatic bradycardia with a heart rate of 32 beats / minute
A patient who has suddenly developed symptomatic tachycardia with a heart rate of 180 beats/ minute
A patient with severe narrow angle glaucoma
A patient who is about to have surgery
A patient with anticholinesterases
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
3ml
4ml
1ml
5ml
A patient has a new order for the adrenergic drug doxazosin (Cardura). When providing education about this drug, the nurse will include which instructions?
weigh yourself daily and report any weight loss to your prescriber
Increase your potassium intake by eating more bananas and apricots
The impaired taste associated with this medication usually goes away in 2 to 3 weeks
Be sure to lie down after taking the first dose, because first dose hypotension may make you dizzy
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?
Captopril rarely causes first dose hypotensive effects
captopril has little effect on electrolyte levels
captopril is a prodrug and is metabolized by the liver before becoming active
captopril is not a prodrug and does not need to be metabolized by the liver before becoming active
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?
We need to monitor for drug toxicity
We must watch for increased intraocular pressure
The provider is assessing for visual changes that may occur with drug therapy
The provider is making sure the treatment is effective over the long term
A nurse is preparing for a community education program on hypertension. Which of these parameters determine the regulation of arterial blood pressure?
Cardiac output and systemic vascular resistance
Heart rate and peripheral resistance
Blood volume and renal blood flow
Myocardial contractility and arteriolar constriction
when counseling a male patient about the possible adverse effects of antihypertensive drugs the nurse will discuss which potential problem
Impotence
Bradycardia
Increased libido
Weight gain
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
Vasodilators alone
ACE inhibitors alone
Calcium Channel Blockers with thiazide diuretics
Beta blockers with thiazide diuretics
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
Diarrhea
Sexual dysfunction
Urge urinary incontinence
impaired memory
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
10 minutes
30 minutes
1 hour
24 hours
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
This therapy will take about 3 months
This therapy will take about a year
This therapy will go on until your symptoms disappear
Therapy for high blood pressure is usually lifelong
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
Beta Blockers
Angiotensin- converting enzyme (ACE) inhibitors
Angiotensin II receptor blockers (ARBS)
Calcium channel blockers
A pregnant woman is experiencing hypertension. The nurse knows that which drug is commonly used for a pregnant patient who is experiencing hypertension
Mannitol (osmitrol)
Enalapril (Vasotec)
Hydrochlorothiazide
(HydroDIURIL)
Methyldopa (Aldomet)
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
Cardioprotective effects
Renal protective effects
reduces blood pressure
promotes fluid output
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
Calcium channel blockers
Diuretics
Nonsteroidal anti-inflammatory drugs
Nitrates
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
Dry Mouth
Restlessness
Constipation
Hypotension
When teaching a patient about antihypertensive drug therapy, which statements by the nurse are correct
you need to have your blood pressure checked once a week and keep track of the readings
if you notice that the symptoms have gone away, you should be able to stop taking the drug
An exercise program may be helpful in treating hypertension, but lets check with your doctor first
Please continue taking the medication even if you are feeling better
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
5ml
1 ml
4ml
3ml
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
the oral an injection forms work synergistically
the combination of heparin and an oral anticoagulant results in fewer adverse effects than heparin use alone
oral anticoagulants are used to reach an adequate level of anticoagulation when heparin alone is unable to do so
Heparin is used to start anticoagulation so as to allow time for the blood levels of warfarin to reach adequate levels.
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
Dysrhythmaias
nausea and vomitting
anaphylactic reactions
internal and superficial bleeding
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
Vitamin E
Vitamin K
Protamine sulfate
Potassium chloride
When administering heparin subcutaneously the nurse will follow which procedure?
Aspirating the syringe before injecting the medication
massage the site after the injection
Applying heat to the injection site
Using 1/2 ti 5/8 inch 25- to 28 gauge needle
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
Aspirin needs to be taken on an empty stomach to ensure maximal absorption
Low-dose aspirin therapy rarely causes problems with bleeding
Take the medication with 6 to 8 ounces of water and with food
Coated tablets may be crushed if necessary for easier swallowing
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
To relieve chest pain
to prevent further clot formation
to dissolve the clot in the coronary artery
to control bleeding in the coronary vessels
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
Bleeding times
Activated partial thromboplastin time (aPTT)
Prothrombin time/international normalized ration (PT/INR)
Vitamin K levels
The nurse notes in the patients medication orders that the patient will be starting anticoagulant therapy. what is the primary goal of anticoagulant therapy>
stabilizing an existing thrombus
dissolving an existing thrombus
preventing thrombus formation
dilatating the vessel around a clot
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
valerian
ginkgo
soy
saw palmetto
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
the patient is not receiving enough warfarin to have a therapeutic effect
the patients warfarin dose is at therapeutic levels
the patients intravenous heparin dose is dangerously high
the patients intravenous heparin dose is at therapeutic levels
A patient has received an overdose of intravenous heparin and is showing signs of excessive bleeding. Which substance is the antidote for heparin overdose?
Vitamin E
Vitamin K
Protamine Sulfate
Potassium chloride
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
Give the LMWH as ordered
double check the LMWH order with another nurse and then administer as ordered
Stop the epidural pain medication and then administer the LMWH
Contact the prescriber because the LMWH cannot be given if the patient has an epidural catheter
A patient will be taking dabigatran (Pradaxa) as part of treatment for chronic atrial fibrillation. Which statements about dabigatran are true
The dose of dabigatran is reduced in patients with decreased renal function
Bleeding is the most common adverse effect
potassium chloride is given asan antidote in cases of overdose
Dabigatran levels are monitored by measuring prothrombin time/ international normalized ratio (PT/INR) results
this drug is a prodrug and becomes activated in the liver
A patient is taking intravenous aminophylline for a severe exacerbation of chronic obstructive pulmonary disease. The nurse will assess for which therapeutic response
Increased sputum production
increased heart rate
increased respiratory rate
increased ease of breathing
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
Diarrhea
palpitations
bradycardia
drowsiness
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
An Anticholinergic such as ipratropium (Atrovent)
A short- acting beta 2 agonist such as albuterol (Proventil)
A long acting Beta 2 agonist such as salmeterol (Serevent)
A corticosteroid such as fluticasone (flovent)
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
the proper technique for inhalation must be followed
The patient needs to keep it close by at all times to treat acute asthma attacks
it needs to be taken every day on a continuous schedule even if symptoms improve
When the asthma symptoms improve the dosage schedule can be tapered and eventually discontinued
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
This is an expected adverse effect. Let me take your pulse
the next scheduled nebulizer treatment will be skipped
I will notify the physician about this advers effect
we will hold the treatment for 24 hours
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
Take the corticosteroid inhaler first
take the bronchodilator inhaler first
take these two drugs at least 2 hours apart
it does not matter which inhaler you use first
When educating a patient recently placed on inhaled corticosteroids, the nurse will discuss which potential adverse effects
Fatigue and depression
anxiety and palpitations
headache and rapid heart rate
oral candidiasis and dry mouth
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
below the therapeutic level
at a therapeutic level
above the therapeutic level
at toxic level
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
notify the doctor that the patient is unable to use the MDI
Obtain an order for peak flow meter
obtain an order for a spacer device
ask the prescriber if the medication can be given orally
The nurse is providing instructions about the Advair inhaler (fluticasone propionate and salmeterol). Which statement about this inhaler is accurate
It is indicated for the treatment of acute bronchospasms
it needs to be used with a spacer for best results
patients need to avoid drinking water for 1 hour after taking this drug
it is used for the prevention of bronchospasms
The nurse is reviewing medications for the treatment of asthma Which drugs are used for acute asthma attacks
Salmeterol (Serevent) inhaler
Albuterol (Proventil) nebulizer solution
Epinephrine
Montelukast (singulair)
Fluticasone (Flovent) Rotadisk inhaler
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
I will rinse my mouth with water after using the inhaler and then spit out the water
I will gargle after using the inhaler and then swallow
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
I will use the inhaler for asthma attacks
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
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
45 days
10 days
50 days
32 days
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
Ipratropium 2nd
Albuterol 1st
Methyl-predniso-lone 3rd
Salmetric
Which medication would you give for patient with severe asthma
Albuterol Inhaler
Inhaled salmeterol
Nebulizer Ipratropium
IV Methamphetamines
IV methylprednisolone
What are all of the drugs not good for asthma
Naproxen
Salicylate
acetylsalicylic acid
Ibuprofen and indomethacin
Ketorolac (Toradol)
what is the therapeutic range for Heparin
90 to 100 PTT
50 to 80 PTT
46 to 70 PTT
150 to 400 PTT
what is the antidote for heparin
More heparin
Warfarin
Cephalosporin
protamine sulfate
what is the therapeutic range for Warfarin
2- 6 INR
2-3 INR
6-10 INR
1-3 INR
How many platelets must there be
150,000-200,000
150,000-600,000
150,000-500,000
150,000-400,000
NO EGGGOS
Vitamin E
GINSENG or Garlic
Ginkgo
Omega 3
St. Johns Warts
When do you hold heparin and contact the HCP
Patient has recent diagnosis of peptic ulcer
Patient has a aPTT of 105
Patient has an INR 4.5
Patient has black tarry stools
Patient has aPTT of 25
Huge risk for bleeds
Vitamin K
Patient has INR of 4.5
Patient has an aPTT of 25
Patient is taking Ginkgo and Vitamin E
When do you question the order of the aspirin or clopidogrel
Patient has 65,000 platelets
Patient with 1.5 INR
Patient with 46 PTT
Currently taking warfarin
Regular consumption of 6 glasses of wine per night
A patient is on dabigatran for A fib. which actions should the nurse initiate
Place an IV line
Report stools that are black and tarry
Teach patient to avoid clopidogrel
Administer aspirin instead
Teach a patient to stop taking this med before surgery
A client is receiving discharge instructions for a inhaled corticosteroid metered dose inhaler. Which teaching should the nurse include
Discard the use fluticasone if albuterol provides relief
Do not swallow the water as you wash your mouth after each use
if taking albuterol be sure to use after the steroid
Steroid inhalers should be used before beta 2 agonists
Which statement by the patient requires further teaching
I will use cromolyn to prevent activity induced asthma
I will use montelukast to prevent asthma attacks
I will use spacers to prevent oral thrush while using beclomethasone
I will take cromolyn 45 minutes before physical activity
What is coagulation
It is the hemostasis that occurs during pregnacy
is hemostasis that occurs due to physiologic clotting of blood
Stops blood clots
helps the heart regulate
