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Pharm Final Study Guide Questions ONLY

Total questions: 105

Worksheet time: 55mins

Name
Class
Date
1.

Select the normal parameters for temperature, pulse, respirations, BP, and pulse ox for an adult patient.

a)

Temperature: 36.5-37.5°C, Pulse: 60-100 bpm, Respirations: 12-20/min, BP: 120/80 mmHg, Pulse ox: 95-100%

b)

Temperature: 38-39°C, Pulse: 40-60 bpm, Respirations: 8-12/min, BP: 140/90 mmHg, Pulse ox: 85-90%

c)

Temperature: 35-36°C, Pulse: 100-120 bpm, Respirations: 20-30/min, BP: 100/60 mmHg, Pulse ox: 90-95%

d)

Temperature: 37-38°C, Pulse: 80-120 bpm, Respirations: 10-16/min, BP: 130/85 mmHg, Pulse ox: 80-85%

2.

What is the normal blood glucose range?

a)

70-110 mg/dL

b)

60-110 mg/dL

c)

40-60 mg/dL

d)

90-100 mg/dL

3.

Which of the following are signs and symptoms (S/S) of hyperglycemia?

a)

Increased thirst, frequent urination, and blurred vision

b)

Cold sweats, shakiness, and confusion

c)

Sudden weight gain, decreased appetite, and bradycardia

d)

Low blood pressure, dry skin, and slow pulse

4.

The signs and symptoms (S/S) of hypoglycemia include:

a)

Sweating, shakiness, confusion, and fatigue

b)

High fever and chills

c)

Persistent cough and sore throat

d)

Severe abdominal pain and vomiting

5.

Important information that should be included in the patient/family teaching related to growth hormone administration includes:

a)

GH must be administered before the epiphyseal plates close

b)

GH must be administered first thing in the morning before breakfast

c)

GH is only available in a pill form, children must be able to swallow large pills

d)

GH must be administered before the fontanels close

6.

Routine assessments that should be performed on a child who is taking growth hormone include:

a)

Monitoring growth velocity, thyroid function, glucose tolerance, and bone age

b)

Height and weight, pineal gland function

c)

Checking vision and hearing regularly

d)

Regular culture and sensitivity testing

7.

A complication of prolonged use of growth hormone is:

a)

Acromegaly

b)

Hypothyroidism

c)

Anemia

d)

Hypercalcemia

8.

Too much growth hormone can cause which of the following conditions if excessive GH administration is BEFORE puberty?

a)

Acromegaly

b)

Diabetes insipidus

c)

Hypothyroidism

d)

Addison's disease

e)

Gigantism

9.

Growth hormone should be administered at what time?

a)

At night

b)

In the morning

c)

In the afternoon

d)

After meals

10.

Tests performed to diagnose &/or evaluate treatment of diabetes mellitus include:

a)

Fasting blood glucose and HbA1c

b)

Diabetes can only be diagnosed via HbA1c

c)

Diabetes can only be diagnosed via fasting blood glucose check

d)

Serum calcium, lipid profile, and chest X-ray

11.

SATA: Select all of the different forms of insulin.

a)

Rapid Acting

b)

Short Acting (Regular)

c)

Long Acting

d)

Intermediate Acting (NPH)

e)

Instant Acting (Regular)

12.

SATA: Select all of the CLEAR insulin vials.

a)

Rapid Acting

b)

Short/Regular Acting

c)

Intermediate/NPH Acting

d)

Long Acting (CANNOT be mixed with cloudy insulin in the same syringe)

e)

Long Acting (CAN be mixed with cloudy insulin in the same syringe)

13.

When does each type of insulin start working to lower blood sugar?

a)

Rapid: 15 minute onset, Short/Regular: 30-60 minute onset, Intermediate/NPH: 2-4 hour onset, Long: 3-4 hour onset

b)

Rapid: 30-60 minute onset, Short/Regular: 2-4 hour onset, Intermediate/NPH: 3-4 hour onset, Long: 5-6 hour onset

c)

Rapid: 2-4 hour onset, Short/Regular: 3-4 hour onset, Intermediate/NPH: 5-6 hour onset, Long: 30-60 minute onset

d)

Rapid: 1 minute onset, Short/Regular: 15 minute onset, Intermediate/NPH: 30-60 minute onset, Long: 2-4 hour onset

14.

SATA: Which medications should not be combined with insulin? Specifically in type 1 diabetes?

a)

SGLT2s

b)

Metformin

c)

Sulfonylureas

d)

Thiazolidinediones

e)

GLP-1 agonists

15.

If a patient is on IV regular insulin, what frequent assessments should be performed?

a)

BG monitoring

b)

Intake and output

c)

Daily weight checks

d)

Pulse oximetry monitoring

16.

What are the signs and symptoms (S/S) of hypoglycemia?

a)

Sweating, trembling, dizziness, mood changes, hunger, headaches, blurred vision, extreme fatigue and paleness. Coma in extreme cases.

b)

Sweating, trembling, dizziness, mood changes, hunger, headaches, blurred vision, extreme fatigue and redness. Seizure in extreme cases.

c)

Sweating, trembling, dizziness, mood changes, extreme thirst, headaches, bed wetting, extreme fatigue and paleness. Coma in extreme cases.

d)

Sweating, trembling, dizziness, mood changes, hunger, gambling, blurred vision, extreme 13-leg parlays and paleness. Catharsis in extreme cases.

17.

If a patient is prescribed two different insulins, such as regular and NPH, what would be the best practice for administration?

a)

Draw CLEAR BEFORE CLOUDY.

b)

Draw CLOUDY BEFORE CLEAR.

c)

Mix both insulins in the vial before drawing.

d)

Administer NPH first, then regular insulin.

18.

What is the treatment for mild hypoglycemia for a conscious patient without dysphagia?

a)

Oral carbohydrates such as candy and graham crackers

b)

Administering intravenous insulin

c)

Immediate administration of glucagon injection

d)

Withholding all food and fluids until symptoms resolve

19.

Does the treatment for hypoglycemia change for an unconscious patient? If yes, what should be done?

a)

Yes, if the patient is unconscious they cannot swallow, turn patient on side and administer glucagon, set up IV dextrose.

b)

No, continue to give oral glucose as usual.

c)

No, just monitor the patient until they regain consciousness.

d)

Yes, if the patient is unconscious they cannot swallow, turn patient to supine position and administer glycogen, set up IV dextrose.

20.

How does the antidiabetic medication acarbose work?

a)

Delays absorption of carbohydrates by blocking enzyme in the small intestine responsible for breaking down complex carbohydrates into monosaccharides.

b)

Stimulates insulin secretion from pancreatic beta cells.

c)

Increases glucose uptake in muscle and adipose tissue by enhancing insulin sensitivity.

d)

Inhibits hepatic glucose production by suppressing gluconeogenesis.

21.

Due to the action of acarbose, what common side effects might the patient experience?

a)

GI side effects: flatus, cramps, abdominal distention, diarrhea. Will NOT cause hypoglycemia.

b)

GI side effects: coffee ground emesis, cramps, abdominal distention, constipation, impaction. WILL cause hypoglycemia.

c)

GI side effects: flatus, cramps, abdominal distention, diarrhea. WILL cause hypoglycemia.

d)

GI side effects: coffee ground emesis, cramps, abdominal distention, constipation, impaction. Will NOT cause hypoglycemia.

22.

What should the nurse include in the patient teaching for metformin? What concurrent administration must be avoided with metformin?

a)

The nurse should teach about the risk of lactic acidosis and avoid concurrent use of IV contrast dye with metformin.

b)

The nurse should teach about the risk of hypokalemia and avoid concurrent use of aspirin with metformin.

c)

The nurse should teach about the risk of hyperglycemia and avoid concurrent use of acetaminophen with metformin.

d)

The nurse should teach about the risk of dehydration and avoid concurrent use of ibuprofen with metformin.

23.

Patient teaching for the sulfonylurea, glipizide, should include which of the following instructions?

a)

Avoid consuming alcohol while taking glipizide.

b)

Increase your intake of high-sugar foods.

c)

Skip meals to enhance the drug's effect.

d)

Take the medication only when you feel symptoms.

e)

Avoid consuming water while taking glipizide.

24.

Type 2 diabetes medications that cause hypoglycemia include:

a)

Sulfonylureas

b)

Metformin

c)

DPP-4 inhibitors

d)

SGLT2 inhibitors

25.

Diabetes Insipidus is:

a)

a disorder characterized by excessive thirst and excretion of large amounts of severely diluted urine

b)

a condition caused by high blood sugar levels due to the lack or dysfunction of endogenous insulin

c)

an autoimmune disease affecting the pancreas, leading to the destruction of beta islet cells

d)

a genetic disorder leading to insulin resistance postprandially

e)

acute angiotensinogen deficiency, causing reabsorption of large amounts of severely concentrated urine

26.

Diabetes Insipidus is different from Diabetes Mellitus because:

a)

Diabetes Insipidus is caused by a deficiency of antidiuretic hormone, while Diabetes Mellitus is related to insulin problems.

b)

Diabetes Insipidus is caused by a deficiency of insulin, while Diabetes Mellitus is related to antidiuretic hormone problems.

c)

Diabetes Insipidus is caused by a deficiency of aldosterone and angiotensinogen, while Diabetes Mellitus is related to insulin problems.

d)

Diabetes Insipidus is caused by a deficiency of angiotensinogen, while Diabetes Mellitus is related to insulin problems.

27.

What would indicate that the desmopressin dose to treat Diabetes Insipidus is therapeutic?

a)

Pt's fluid output decreases dramatically

b)

Pt's blood pressure decreases significantly

c)

Pt's no longer has any fluid output

d)

Pt's urine becomes dark yellow

e)

Pt's heart rate increases dramatically

28.

What would indicate the desmopressin dose to treat Diabetes Insipidus is too high?

a)

Hypervolemia, water intoxication, hyponatremia

b)

Polyuria, hypernatremia, dehydration

c)

Bradycardia, hypotension, hypokalemia

d)

Tachycardia, fever, hyperglycemia

29.

The adrenal glands are responsible for:

a)

Producing hormones such as adrenaline and cortisol

b)

Filtering waste from the blood

c)

Regulating blood sugar by producing insulin

d)

Producing hormones such as renin and aldosterone

30.

Fill in the blank: Diabetes Mellitus relates to ______ deficiency.

a)

insulin

b)

glucagon

c)

thyroxine

d)

adrenaline

31.

Fill in the blank: Insipidus relates to ______ output while mellitus relates to insulin deficiency.

a)

urine

b)

blood

c)

saliva

d)

sweat

32.

Which hormone released by the adrenal cortex suppresses the immune system?

a)

Cortisone

b)

Adrenaline

c)

Insulin

d)

Thyroxine

33.

Which action is NOT a function of corticosteroids?

a)

Suppress the immune system

b)

Increase BG concentration

c)

Decrease sensitivity to pain

d)

Increase insulin secretion

34.

Which of the following best describes the correct approach to discontinuing prednisone, as well as its potential long-term consequences?

a)

Prednisone should be tapered gradually, over 5-10 days, and chronic use can cause osteoporosis, diabetes, and adrenal suppression.

b)

Prednisone should be stopped abruptly, and long-term use has no significant side effects.

c)

Prednisone should only be used for one day, and long-term use can cause sarcoidosis, lupus, and adrenal gland loss.

d)

Prednisone can be discontinued at any time, and chronic use prevents adrenal suppression.

e)

Prednisone should be tapered gradually, over 5-10 weeks, and chronic use can cause osteoporosis, diabetes, and adrenal suppression.

35.

The signs and symptoms of Addison's Disease include:

a)

Fatigue, weight loss, low blood pressure, and hyperpigmentation

b)

Buffalo hump, increased appetite, weight gain, and high blood pressure

c)

Moon face, jaundice, abdominal pain, and dark urine

d)

Tremors, palpitations, and excessive sweating

36.

What surgical procedures could be completed for Addison's Disease?

a)

Laparoscopic adrenalectomy

b)

Laparoscopic thyroidectomy

c)

Laparoscopic splenectomy

d)

Laparoscopic cholecystectomy

37.

Common medications used to treat Addison's Disease include which of the following?

a)

Hydrocortisone and fludrocortisone

b)

Insulin and metformin

c)

Levothyroxine and liothyronine

d)

Methotrexate and sulfasalazine

38.

Priority assessments that would indicate the medication dose is too high in a patient being treated for Addison’s Disease include:

a)

Signs of Cushing's features such as moon face and weight gain

b)

Increased skin pigmentation and hypotension

c)

Severe dehydration and electrolyte imbalance

d)

Persistent hypoglycemia and fatigue

39.

Treatment of Addison’s could lead to which condition?

a)

Cushing's syndrome

b)

Diabetes insipidus

c)

Graves' disease

d)

Hypothyroidism

40.

Every patient with Addison’s disease should have which of the following with them at all times?

a)

A steroid emergency card or injection kit

b)

A blood glucose monitor

c)

An inhaler

d)

A blood pressure cuff

41.

Identify the signs & symptoms of Cushing’s syndrome.

a)

Moon face, central obesity, purple striae, muscle weakness, buffalo hump

b)

Weight loss, hyperpigmentation, hypotension, salt craving, buffalo hump

c)

Tremors, heat intolerance, exophthalmos, tachycardia, moon face

d)

Bradycardia, cold intolerance, weight gain, dry skin, moon face

42.

Fill in the blank: A sign of Cushing’s syndrome is emotional ________.

a)

lability

b)

stability

c)

numbness

d)

detachment

43.

Fill in the blank: A physical sign of Cushing’s syndrome is a ________ hump.

a)

buffalo

b)

camel

c)

elephant

d)

giraffe

44.

Fill in the blank: Cushing’s syndrome can cause ____, benign avascular necrosis of the _______ head, and hyperglycemia.

a)

HTN, femoral

b)

DM, distal

c)

CHF, temporal

d)

COPD, auricular

45.

Fill in the blank: A facial sign of Cushing’s syndrome is a moon face with red (________) cheeks.

a)

plethoric

b)

cyanotic

c)

pale

d)

jaundiced

46.

Fill in the blank: Cushing’s syndrome can cause ________, which is a clouding of the lens in the eye.

a)

cataracts

b)

glaucoma

c)

retinopathy

d)

conjunctivitis

47.

Fill in the blank: Cushing’s syndrome can cause increased ________ fat.

a)

abdominal

b)

subcutaneous

c)

peripheral

d)

gluteal

48.

Fill in the blank: Cushing’s syndrome can cause increased appetite and ________.

a)

obesity

b)

hair loss

c)

dehydration

d)

muscle cramps

49.

What surgical procedure(s) could treat Cushing’s syndrome?

a)

Removal or radiation of tumors (preferred), Adrenalectomy (not ideal)

b)

Removal or radiation of tumors (not ideal), Adrenalectomy (preferred)

c)

Adrenalectomy ONLY

d)

Tonsillectomy

50.

What drug would you expect to administer POST-OP for a patient who had their adrenal gland removed? Why?

a)

Glucocorticoid steroids for hormone replacement therapy

b)

Levothyroxine to prevent hypoparathyroidism

c)

Insulin to manage blood sugar

d)

Anabolic steroids for muscle wasting in the cranial space

51.

What are the signs and symptoms (S/S) of Hypothyroidism?

a)

Bradycardia, lethargy, constipation, excessive fatigue and sleeping

b)

Tachycardia, weight loss, diarrhea, insomnia

c)

Increased appetite, sweating, nervousness, heat intolerance

d)

Palpitations, tremors, exophthalmos, hyperactivity

52.

What common medication is used to treat hypothyroidism?

a)

Levothyroxine

b)

Metformin

c)

Atorvastatin

d)

Omeprazole

53.

How would the nurse know whether the dose of levothyroxine is too low for a patient with hypothyroidism?

a)

Patient experiencing bradycardia, lethargy, constipation, excessive fatigue and sleeping

b)

Patient develops tachycardia, hyperexcitability, and weight loss

c)

Patient experiences increased sweating, neuromuscular agitation, and anxiety

d)

Patient reports insomnia and palpitations

54.

SATA: What are the signs and symptoms of myxedema coma?

a)

Hypoventilation

b)

Decreased LOC

c)

Severe bradycardia

d)

Severe hypotension

e)

Severe hypothermia

55.

What some the signs and symptoms of hyperthyroidism such as Graves’ Disease?

a)

HEAT intolerance, bulging eyes (exophthalmos), clubbing of the fingers, weight LOSS

b)

COLD intolerance, Coarse, dry hair, amenorrhea, weight LOSS

c)

HEAT intolerance, bradycardia, excessive sleeping and fatigue, weight GAIN

d)

COLD intolerance, bulging eyes (enophthalmos), insomnia, weight GAIN

56.

Which of the medications below is a treatment option for Grave's disease?

a)

Thioamides

b)

Sulfonylureas

c)

Biguanides

d)

Glucocorticoids

e)

Levothyroxine

57.

What are the symptoms of too high thyroid hormone levels (hyperthyroidism)?

a)

Irritability, palpitations, tachycardia, diarrhea, tremors, insomnia.

b)

Weight gain, bradycardia, constipation, dry skin, hair loss.

c)

Joint pain, frequent urination, blurred vision, increased thirst.

d)

Chest pain, shortness of breath, swollen ankles, persistent cough.

58.

What should the nurse include in the patient education related medications that treat Grave's Disease?

a)

Teach patient s/s of hypothyroidism!

b)

Encourage a high-sodium diet.

c)

Advise patient to avoid all physical activity.

d)

Instruct patient to double the dose if a dose is missed.

59.

Which medication is the treatment of choice for tachycardia associated with hyperthyroidism?

a)

Propranolol

b)

Digoxin

c)

Amiodarone

d)

Verapamil

60.

What are some serious potential adverse effects of PTU?

a)

agranulocytosis, hypothyroidism

b)

hypertension, hyperglycemia

c)

weight gain, insomnia

d)

bradycardia, diarrhea

e)

infection, hyperthyroidism

61.

What is currently happening in the United States regarding antibacterial resistance?

a)

Superinfections due to overuse of antimicrobial agents

b)

Decrease in hospital-acquired infections

c)

Complete eradication of resistant bacteria

d)

Increased effectiveness of older antibiotics

62.

What would indicate that a bacterium has become resistant to an antibacterial agent?

a)

Antibacterial agent is no longer able to kill or inhibit target pathogen

b)

Bacterium grows slower in the presence of the agent

c)

Antibacterial agent changes color when applied

d)

Bacterium becomes visible under UV light

63.

What type of antibiotic would most likely cause a superinfection? Broad or Narrow spectrum?

a)

Broad spectrum

b)

Narrow spectrum

64.

If a patient is allergic to PCN, what other antibiotic might they be allergic to? (They have a potential rare cross reaction)

a)

Cephalosporins

b)

Macrolides

c)

Tetracyclines

d)

Sulfonamides

65.

Will the patient develop an allergy the first time they take PCN?

a)

It depends

b)

Yes, always

c)

No, never

d)

Only if they have a cold

66.

What interventions would the nurse implement if a pt. is having an anaphylactic reaction from taking a medication such as PCN?

a)

Stop the PCN, get ready to give epinephrine

b)

Continue the PCN and monitor for improvement

c)

Give the patient more fluids and wait for the reaction to subside

d)

Ask the patient to take deep breaths and rest

e)

Stop the PCN, get ready to give norepinephrine

67.

What is unique about administration of a z-pack, azithromycin?

a)

It is typically given as a short 5-day course with a loading dose.

b)

It must be taken with food to be effective.

c)

It is administered only by injection.

d)

It requires daily blood monitoring.

e)

It is the single most effective antibiotic in the US.

68.

What is a possible life-threatening side effect that the nurse should include in the patient teaching regarding macrolides?

a)

Macrolides can cause clostridium difficile.

b)

Macrolides can cause hypoglycemia.

c)

Macrolides can cause hypertension.

d)

Macrolides can cause fluid loss.

69.

What should the nurse teach regarding tetracycline? List at least three important points.

a)

1. Photosensitivity: skin becomes sensitive to sun.

2.. Contraindicated in children LESS than 8 years old and pregnant women.

  1. 3. NOT to be given with milk, calcium, antacids or iron containing drugs

b)
  1. 1. Tetracyclines are ONLY safe for children UNDER 8 years old.

  2. 2. They should always be taken with milk to improve absorption.

  3. 3. Tetracyclines can cause liver toxicity.

c)
  1. 1. Tetracyclines are best taken with food, especially dairy products.

  2. 2. Tetracyclines are ONLY safe for children UNDER 8 years old.

  3. 3. Tetracyclines are NOT safe for pregnant women

d)
  1. 1. Tetracyclines are ONLY used for viral infections.

  2. 2. They should always be taken with iron to improve absorption.

  3. 3. Tetracyclines are NOT safe for pregnant women

70.

What would you do if the doctor orders tetracycline to a young child?

a)

If the child is younger than 8 years old, hold the tetracycline until you double check with the HCP.

b)

Administer the tetracycline as ordered without any concerns.

c)

Reduce the dose and administer the medication.

d)

Ask the parent to monitor for side effects and continue the medication.

71.

Why would a patient be prescribed 1% silver sulfadiazine (Silvadene) cream?

a)

Topical agent used to treat burns

b)

Oral agent used to treat viral infection

c)

Antibiotic for systemic infections

d)

Antifungal for nail infections

72.

General guidelines for ACTIVE TB treatment recommend which of the following regarding monotherapy versus multi-drug therapy, and what is the typical duration of treatment?

a)

Multi-drug therapy is recommended for 6-24 months; monotherapy is not advised due to resistance risk.

b)

Monotherapy is preferred for 2-6 months, then switch to multi-drug therapy.

c)

Monotherapy is sufficient for all TB cases for 4-6 months.

d)

Multi-drug therapy is only used if monotherapy fails after 12 months.

73.

A culture and sensitivity test determines which antibiotics a bacteria is sensitive to and guides treatment. Should a patient take an antibiotic the bacteria is NOT sensitive to?

a)

No, because the antibiotic will not be effective against the bacteria.

b)

Yes, because any antibiotic can treat the infection.

c)

Yes, because resistance does not matter. Only vibes matter.

d)

No, because a non-specific antibiotic will ensure the eradication of normal flora.

74.

Gentamycin can cause ototoxicity. What is the first sign of this?

a)

Tinnitus

b)

Vertigo

c)

Hearing loss

d)

Nausea

75.

Gentamycin and other aminoglycosides can cause kidney injury, how would the nurse know this has happened?

a)

Proteinuria, elevated serum creatinine and BUN, decreased eGFR

b)

Increased urine output, decreased serum creatinine, elevated BUN

c)

Decreased blood pressure, increased heart rate, elevated eGFR

d)

Jaundice, elevated liver enzymes, decreased albumin

76.

The correct way to instruct a patient to take the oral suspension nystatin for thrush is:

a)

Swish the medication in the mouth for 30 seconds and then swallow it. No food or drink for 30 minutes after taking nystatin.

b)

Swallow the medication immediately without holding it in the mouth. No food or drink for 45 minutes after taking nystatin.

c)

Mix the medication with water before taking it. Swish the medication in the mouth for 10 seconds and then swallow it. No food or drink for 30 minutes after taking nystatin.

d)

Swish the medication in the mouth for 30 seconds and then spit it out. No food or drink for 45 minutes after taking nystatin.

77.

Antibiotics that potentially affect the efficacy of estrogen containing birth control pills include:

a)

Rifampin

b)

Amoxicillin

c)

Ciprofloxacin

d)

Azithromycin

78.

Which of the following best describes the difference between antibiotics and antiviral agents?

a)

Antiviral agents inhibit viral replication, while antibacterial agents can inhibit bacterial replication as well as kill bacteria.

b)

Antiviral agents kill viruses, while antibacterial agents kill bacteria.

c)

Antiviral agents and antibacterial agents both target protozoa.

d)

Antiviral agents and antibacterial agents have the same mechanism of action.

e)

Antiviral agents kill viruses, while antibacterial agents can inhibit bacterial replication as well as kill bacteria.

79.

Management of acute pain in the post-op period involves:

a)

Use of analgesics, regional anesthesia, and multimodal pain management strategies

b)

Avoiding all medications to prevent side effects

c)

Relying solely on non-pharmacological methods

d)

Delaying pain management until pain becomes severe

e)

Straight fent to the dome until the patient recovers or dies.

80.

What type of pain meds are used initially for intense, post-operative pain?

a)

Strong opioids (morphine, hydromorphone, fentanyl, methadone, codeine)

b)

Topical anesthetics (lidocaine patches, capsaicin cream)

c)

NSAIDs (ibuprofen, naproxen, ketorolac)

d)

Anticonvulsants (gabapentin, pregabalin)

81.

If a patient states they are having severe pain, but doesn’t appear in distress, what therapeutic responses could be made by the nurse? What is an appropriate open-ended response?

a)

A patient's pain is what they say it is. Ask them to self-rate their pain scale, and ask them to describe their pain

b)

Tell the patient their pain is not believable without visible distress

c)

Ignore the patient's complaint and continue with the assessment

d)

Advise the patient to wait until the next scheduled medication time

e)

Suggest the patient is exaggerating their symptoms

82.

The best intervention if a patient states they are having severe pain, but doesn’t appear in distress, would be to immediately administer an opioid.

a)

No, further assessment is needed before administering an opioid.

b)

Yes, always trust the patient's report and give an opioid immediately.

c)

Yes, but only if the patient requests a specific opioid.

d)

No, opioids should never be given for severe pain.

83.

Prior to discharge, what type/route of pain med should the patient be switched to?

a)

Patient should be effectively managing pain with PO NSAIDs prior to discharge.

b)

Patient should be switched to IV opioids prior to discharge.

c)

Patient should be given IM steroids prior to discharge.

d)

Patient should be managed with transdermal fentanyl prior to discharge.

84.

What are common signs and symptoms (S/S) associated with the use of opioids? List at least three.

a)

Respiratory depression and/or arrest, orthostatic hypotension, urinary retention, constipation, bowel dysfunction, cough suppression, nausea/vomiting, elevation of ICP, sedation, sleep disorders.

b)

Increased RR, hypertension, urinary incontinence, productive expectoration, nausea/vomiting

c)

ICP elevation, respiratory depression and/or arrest, postural hypertension, bowel and bladder incontinence

d)

Respiratory depression, coma, sedation, hyperparathyroidism, Graves Disease, Addison's Disease

85.

Some side effects of opioid use include:

a)

Constipation

b)

Incontinence

c)

Hypertension

d)

Decreased intracranial pressure

e)

Diarrhea

86.

Identify the S/S (signs and symptoms) of tolerance and dependence to opioids.

a)

Increasing dose required for same effect, withdrawal symptoms on cessation

b)

Sudden onset of fever and rash

c)

Improved cognitive function and alertness

d)

Decreased risk of respiratory depression

87.

Which pain medication is contraindicated with administration of an MAOI? Why?

a)

Tramadol is contraindicated with MAOIs because it can cause hypertensive crisis.

b)

Ibuprofen is contraindicated with MAOIs because it can cause hypotensive crisis.

c)

Acetaminophen is contraindicated with MAOIs because it can cause liver toxicity.

d)

Aspirin is contraindicated with MAOIs because it can cause bleeding.

e)

Ketorolac is contraindicated with MAOIs because of increased epinephrine secretion.

88.

Some S/S (signs and symptoms) associated with an opioid overdose include:

a)

Pinpoint pupils, respiratory depression, unconsciousness

b)

Fever, rash, joint pain

c)

Increased heart rate, dilated pupils, sweating

d)

Hypertension, hyperactivity, insomnia

89.

What medication could be administered for an opioid overdose?

a)

Naloxone/Narcan.

b)

Aspirin.

c)

Ibuprofen.

d)

Acetaminophen.

90.

Can opioids be administered to elderly patients?

a)

Yes, but be careful!

b)

No, they are never allowed.

c)

Only in pediatric patients.

d)

Only in pregnant women.

91.

  Is there anything that needs to be considered regarding opioid medication administration if the pt. is elderly?

a)

Geriatrics have may have altered drug metabolism, making them more at risk for toxicity

b)

Geriatrics have been shown to have fatal consequences after single small doses of opioids

c)

Geriatrics can take as much opioids as they want because they are already about to die anyways

d)

Geriatric can only take opioids for post-surgical procedures, as it is too dangerous to give them opioids for chronic pain conditions

92.

What is the maximum amount of acetaminophen that can be taken in a 24 hour time frame for adults?

a)

4 mg

b)

40 mg

c)

4 g

d)

40 g

e)

4 kg

93.

SATA: Select all correct statements on how acetaminophen toxicity is managed.

a)

IV drip of around 2.5 L of antidote solution

b)

IV drip is continuous

c)

Scheduled liver labs

d)

Pt should be placed in critical care unit

e)

IV drip is intermittent

94.

What are the common meds used to prevent rejection for pt. who had major organ transplant?

a)

Calcineurin Inhibitors

b)

Cytotoxic Agents

c)

NSAIDs

d)

Opioids

e)

Topical Anesthetics

95.

SATA: What are the major drug-drug interactions or drug-food interactions associated with calcineurin inhibitors?

a)

Tyramine rich foods cause toxicity

b)

Grapefruit juice causes toxicity

c)

Avoid use with nephrotoxic drugs

d)

Avoid use with diuretics

e)

Potassium rich foods cause toxicity

96.

  If a patient is on prednisone for a prolonged time frame, what would be important for the nurse to include in the patient teaching?

a)

Do NOT stop abruptly! Know the signs and symptoms of Cushing's syndrome, as chronic use of steroids can lead to this condition.

b)

Do NOT stop abruptly! Know the signs and symptoms of hypothyroidism, as chronic use of steroids can lead to this condition.

c)

Do NOT stop abruptly! Know the signs and symptoms of Addison's syndrome, as chronic use of steroids can lead to this condition.

d)

Do NOT stop abruptly! Know the signs and symptoms of Reye's syndrome, as chronic use of steroids can lead to this condition.

97.

What are the common side effects of NSAIDs?

a)

GI upset, peptic ulcers, increased clotting time, peripheral edema

b)

Respiratory depression, dilated pupils, orthostatic hypotension

c)

GI dysfunction, decreased clotting time, peripheral edema

d)

NSAIDs do not have any side effects

98.

SATA: Select all of the complications that can occur with aspirin/ASA toxicity.

a)

Excess bleeding

b)

Salicylism

c)

Reye's Syndrome

d)

Cushing's syndrome

e)

Hypertensive crisis

99.

What is the treatment of aspirin/ASA toxicity?

a)

IV sodium bicarbonate

b)

IV sodium chloride

c)

PO sodium bicarbonate

d)

PO sodium chloride

100.

SATA: What makes ketorolac a unique NSAID?

a)

Same analgesic effect as morphine without any opioid side effects

b)

Same analgesic effect as dilaudid without any opioid side effects

c)

Use must be limited to no more than 5 consecutive days

d)

Use must be limited to no more than 2 consecutive days

e)

NOT to be given with other NSAIDs

101.

What is the antidote for acetaminophen toxicity?

a)

acetylcysteine

b)

naloxone

c)

sodium bicarbonate

d)

levothyroxine

102.

Why would cannabis be recommended for a patient with cancer who lives in CO?

a)

Helps alleviate S/S of chemotherapy (pain, tremors, lack of appetite, n/v). In CO, cancer is a qualifying condition for a medical card, and there are many CO programs aimed at distributing cannabis to cancer patients who need it.

b)

Helps alleviate S/S of chemotherapy (overeating, hepatomegaly, moon face, buffalo hump). In CO, cancer is a qualifying condition for a medical card, and there are many CO programs aimed at distributing cannabis to cancer patients who need it.

c)

Colorado has really good weed.

d)

With enough weed, preferably dabs, cancer can go into remission.

103.

SATA: Select the signs and symptoms of Salicylism.

a)

Tinnitus

b)

Diaphoresis

c)

GI bleed (stool and emesis)

d)

Angioedema

e)

Bradycardia

104.

Most NSAIDs are ________ COX ______.

a)

nonselective, inhibitors

b)

selective, inhibitors

c)

nonselective, agonists

d)

selective, agonists

105.

Acetylcysteine is most effective when given shortly after acetaminophen overdose, but can still provide some protection if given within 24 hours of overdose.

a)

True

b)

False