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Pharm II Final

QuestionAnswer
Adverse systemic effects possible with miotic eye drops include: sweating, muscle weakness, and vomiting
Adverse systemic effects from a miotic eye drop can be prevented by: holding pressure at the inner canthus after instillation
Timolol maleate (Timoptic) should be used with caution in patients with: chronic lung disease
All of the following are true about the instillation of eye ointment except: following the instillation, the eye is rubbed vigorously to distribute the medication
To administer ear drops to a child under age three, the pinna of the ear should be pulled: down and back
The mechanism of action of carbonic anhydrase inhibitors (e.g. acetazolamide, Diamox) in glaucoma is: decreasing production of aqueous humor
In demonstrating the correct procedure for instilling either eye drops or ointments, the nurse: does not let the dropper/tube tip touch any surface, including the eye lashes
o S.P. comes to the clinic complaining of lt ear pain/hearing loss that have been increasing over the past 3 days. After exam, the MD prescribes polymixin B (Cortisporin). Polymixin B. is classified as what type of otic agent? Anti-infective
When teaching an adult patient how to instill ear drops, the nurse instructs him/her to: keep his head tilted toward the unaffected side for 5 minutes after instilling the drops
A drug used to assist in removing cerumen from the ear is: Debrox
Impacted cerumen can be removed from the ear canal with a(n): irrigation
When used for glaucoma, one drawback of prostaglandins is that they: change the pigmentation of the eye
Which statement is true about glaucoma? Treatment for glaucoma continues throughout a lifetime
The physician writes an order stating: "Neosynephrine 1/4%, gtt ii, OD, b.i.d. What does the abbreviation "gtt ii" stand for? 2 drops
When teaching a family member to instill eye drops for an elderly patient, you will include all except which one? Refrigerate the eye medication
L.C., 7 years old, is receiving Bactrim (trimethoprim/sulfamethoxazole) for a middle-ear infection. Nursing care for L.C. includes which of the following: encourage fluid intake
Your health teaching plan for a patient with otitis media includes all of the following except: take medication for full 10 days
Your client is to begin treatment with pilocarpine (Isopto Carpine). You should instruct her that (s)he may experience: burning and stinging
When assessing a client who is receiving pilocarpine, you will find: constricted pupils
Fluorescein sodium is used in the eye to: diagnose lesions of the eye
Dorzolamide (Trusopt) works to lower intraocular pressure by: decreasing the production of aqueous humor
Which of the following medications is converted to epinephrine in the eye? dipivefrin hydrochloride (Propine)
In which patient would the use of acetazolomide (Diamox), a carbonic anhydrase inhibitor, be contraindicated? a patient with allergy to sulfa drugs
Which group of ophthalmic drugs is used to prepare a patient's pupils for examination? mydriatics
Pt recently diagnosed with open-angle glaucoma. Intraocular pressure is controlled with miotic meds, including latanoprost (Xalatan). Wants to know if there is a permanent cure & if cont. tx will be necessary. What the pt teaching will be provided? Glaucoma is being controlled with meds, making surgery unnecessary. Will need to continue meds for the rest of his life and have regular eye exams. There is a possibility that the condition may worsen, necessitating surgery, but not at this time
An adverse reaction to prolonged use of growth hormone therapy is: diabetes mellitus because it antagonizes insulin secretion
Which of the following medications is used to control the acute symptoms of polyuria and polydypsia in patients with diabetes insipidus? desmopressin (DDAVP)
When teaching about hydrocortisone, the nurse tells the client: this medication inhibits the immune system and increases the risk for infection
When used therapeutically, hypothalamic hormones are indicated for: treatment of multiple endocrine disorders
Glucocorticoids may be prescribed for allergic reactions and also for: anti-inflammatory effects
Patient teaching for a client who has recently been diagnosed with hypothyroidism and is beginning levothyroxine (Synthroid) therapy would include: the client should report any altered sleep patterns
Which of the following should the nurse be alert for prior to administration of intranasal desmopressin (DDAVP)? rotation of nares should be documented on the medication profile
Which of the following client statements indicates that additional teaching is necessary regarding the use of glucocorticoid therapy? I will eat a diet that is high in fat and sugar while on this medication.
Which serum electrolyte should be closely monitored when a client is taking fludocortisone (Florinef), and oral mineralcorticoid? sodium
Bromocriptine (Parlodel) is used for: treatment of acromegaly
The patient has a history of hypothyroidism and has been on levthyroxine (Synthroid) 250mcg/day. The nurse recognizes the medication is being effective when: the patient's pulse rate increases
Glucocorticoids may be prescribed for all of these conditions except: improving athletic performance
Growth hormone drugs are administered subcutaneously or intramuscularly. Why? GH drug is inactivated by enzymes in the gastrointestinal tract
Thyroid replacement therapy is indicated for the treatment of: thyroidectomy
L.B. is found to have hyperthyroidism. The physician wants to start her on medication before performing surgery in order to prevent thyrotoxicosis. She is most likely to prescribe? propylthiouracil (PTU)
K.J. has a severe arthritic condition. The health care provider left an order to discontinue the prednisone. An appropriate and best response is: ask the healthcare provider how the prednisone dose is to be tapered
A.S. comes in with a bad case of poison ivy. She has been scratching the red, swollen area on her arm because it itches. The arm has been getting increasingly swollen over the last 3 days. The physician is most likely to order: a corticosteroid
Which of the following is an expected consequence of being treated with radioactive iodine (Iodine-131) therapy? The client will need thyroid replacement therapy eventually
L.H. has been taking prednisone for arthritis for several weeks. Pt teaching includes the following except: inform her that prednisone should be taken between meals and without food
The insulin that is least likely to cause an allergic reaction is: human insulin (Humulin)
J.S., age 39, takes NPH 30 units and regular insulin 10 units daily in the morning. When administering J.S.'s insulin, the nurse uses which of the following syringes? U100 insulin syringe
When preparing regular and NPH insulin to be administered at 0700, the nurse or client would: combine the two insulins in one injection, drawing up the regular insulin first
NPH and regular insulin can be administered together by injecting them: subcutaneously
It is important the nurse to know the peak action time of insulins. When administered at 0700, the most likely time for a hypoglycemic reaction due to NPH: 1500-1900
The only type of insulin that can be administered intravenously (IV) is: regular
An external insulin pump is programmed by the client to deliver a basal insulin dose per hour and a bolus dose at meals as needed. Which of these types of insulin can be used in insulin pumps? regular insulin
M.H., age 57, was diagnosed as having diabetes mellitus two years ago. The type of diabetes mellitus M.H. most likely has is: non-insulin dependant diabetes mellitus (NIDDM)
The patient asks the nursing student how oral antidiabetic medicines work in the body. Depending upon the specific medication, one of the responses below would be correct except: antidiabetic drugs are identical to natural human insulin
Which of the following medication orders would the nurse question in the treatment of a diabetic client? administer NPH insulin 15 minutes after breakfast
While on a home visit to a diabetic client, the nurse observes that the client's unopened insulin vials are not refrigerated; however, they are not outdated. What action would you take at this time? Have the client place the unopened vials in the refrigerator
Which of the following instructions is necessary for the nurse to include when teaching the diabetic client to administer insulin injections? It is important to only use an insulin syringe to administer injections
A diabetic pt who is taking metformin (Glucophage) is scheduled for a diagnostic test that requires them to be NPO prior to testing. The pt will be given IV contrast to perform the test. What should the nurse do with regard to admin of the pt's med? Contact the physician to obtain orders
You are teaching R.H. how to test his sugar level at home in order to determine how much insulin he is to self administer. How would you do this? You explain the use of the glucometer
Pt takes Novulin 70/30 q AM. At lunch & dinner, she uses a sliding scale w/reg insulin to control his sugar. Sliding scale is: 0-150 no insulin, 150-200 2U, 200-250 4U, and >250 6U. If his glucose level is 180, how much insulin should she inject? 2 units
The home health nurse is teaching a new diabetic how to draw up NPH insulin into a syringe. He explains that prior to drawing up the insulin the client will: roll the vial before inserting the needle
Which of these insulins should appear cloudy? NPH
Which of these insulins should be clear? regular
Which type of insulin should be administered 0-15min prior to a meal? lispro (Humalog)
Which type of insulin will be administered once a day at the same time, often at bedtime? glargine (Lantis)
The most serious toxic effect of the ankylating agents is: bone marrow depression
Which of the following is a common side effect of the antineoplastic drugs? Anemia
The antineoplastic drugs must be discontinued if which of the following develops? Aplastic anemia
Certain tumors of the reproductive system are antagonized by: hormones
J.E., a 76y.o. male, is started on estrogen for metastatic prostate cancer. Which of the following statements by the client leads you to believe he needs further teaching? "This medication will cause me to become homosexual."
Neurotoxicity related to antineoplastic drugs may cause all of the following except: alopecia
During chemotherapy, the client is most susceptible to infection when: the leukocyte count is low
During chemotherapy, the client is most susceptible to hemorrhage when: the platelet count is low
Nursing measures to prevent or treat nausea and vomiting related to chemotherapy include: administering the antiemetic prior to the chemotherapeutic agent
Which of the following nursing diagnoses would be the MOST appropriate for the client experiencing nausea and vomiting? alteration in nutrition related to drug therapy
J.T. is experiencing bone marrow suppression related to chemotherapy. His symptoms may include: fatigue and bruising
Hyperuricemia is treated by: Brown says: eating a low protein diet Book says: maintaining a high fluid intake
Antineoplastic drugs may be used in which of the following nonmalignant conditions? Rheumatoid arthritis
A common adverse reaction for male clients using hormone therapy for prostate cancer is: feminizing effects
Stomatitis occurring with antimetabolites can: interfere with nutrition, lead to oral infections, and cause oral bleeding
tamoxifen (Nolvadex): treats breast cancers that have estrogen receptors
The hormone, erythropoietin: stimulates the bone marrow to increase the production of erythrocytes
The therapeutic effect of epoetin alfa (Epogen) is best observed by: an increase in the patient's RBC count
Patient teaching for a patient receiving adriamycin (Doxorubicin) includes: the medication will change urine color to red.
According to Missouri Law, an IV therapy-certified LPN may: only closely monitor chemotherapy patients for evidence of side effects or toxicities
Which one of the following statements is applicable to chemotherapy-related alopecia? The extent of severity depends on a specific drug/dosage
Which nursing intervention would be appropriate by the IV therapy-certified LPN when monitoring a patient for side effects of chemotherapy? Document and report observations to the physician
Personnel handling blood, vomitus, or excreta from patients who have received chemotherapy within the previous 48hrs: should wear exam gloves and a gown.
In the event there is accidental skin exposure to a chemotherapy agent, the skin should be decontaminated by: washing thoroughly with soap and water.
Which of the following principles applies to accidental chemotherapy spills? The person performing the cleanup procedure should be gowned and double gloved
____________ disrupts normal cell function by interfering with various metabolic functions of the cell. Antimetabolites
____________ are not used for anti-infective properties, but to delay or prevent malignant cell division. Antibiotics
____________ alter the environment that promotes cancer growth. Hormones
____________ interfere with cell division and DNA structure. Alkylating agents
____________ used for treatment of thyroid cancer. Radioactive iodine
o Pt has severe abd pain: occurs approx 45-60” after eating, wakes him at night, when he eats Mexican food, or drinks alcohol. When he eats or drinks milk it improves. The MD orders tests; before they are complete, the he will probably ask the pt to take: an antacid
C.B. is diagnosed as having a duodenal ulcer. Which is likely to be the physicians drug of choice? proton pump inhibitor
Medications that prevent abdominal discomfort resulting from acid production include? H2 antagonists
A.G., a frail 67 year old nursing home patient, is brought to the clinic for a barium enema. She fails to have any bowel movements for the next few days following the procedure. The physician will probably order: a saline laxative
J.T. has undergone a cholecystectomy. During the postoperative period she is bothered by an excess of intestinal gas, producing flatus and bloating. An appropriate medication that might be ordered would be: Simethicone
What is a vital nursing consideration when infusing parenteral nutrition solutions? Initial infusions should begin slowly with incremental increases until the ordered rate is achieved
C.M.'s TPN infusion was interrupted during a trip to the radiology department. As a result, he experienced rebound hypoglycemia. Which symptoms would indicated hypoglycemia? headache, cold and clammy skin
L.P., 25 years old, is receiving TPN. With respect to changing his TPN tubing, the nurse would do all of the following EXCEPT: Place him in high Fowler's position and instruct him to pant while the tubing is changed
H.B. is receiving lipids (Liposyn II 10%). Prior to hanging the fluid, the nurse notices that the emulsion is separated into two layers. What action would be MOST appropriate? Contact the pharmacist to report the observation and request a new bottle
While receiving TPN, the client should be monitored for: elevated blood glucose levels
Pancrelipase (Viokase) is correctly administered: with each meal or snack
Injectable vitamin B12 is a specific treatment for: pernicious anemia
The use of mineral oil as a laxative is avoided when fat-soluble vitamins are used because this drug may: prevent the absorption of these vitamins
A prostaglandin analog, misoprostol (Cytotec), is effective for the prevention and treatment of peptic ulcer. This drug is effective for treating gastric distress due to: NSAID and glucocorticoid therapy
Which one of the following is not a histamine-2 receptor antagonist? cyclizine lactate (Marezine)
M.K., a 79 year old, with peptic ulcer disease, is taking cimetidine (Tagamet) and has become confused. What should you do? Hold the medication and contact his physician
Which of the following is true about emetics? They: are administer to induce vomiting only when the ingested substance is known
The ideal time to take antacids is: two hours after meals
Which of the following antacids should persons with hypertension avoid using because of its high sodium content? sodium bicarbonate (Alka-Selzer)
Health related measures which promote elimination and discourage laxative overuse include all of the following except: bland diet
K.J. is to receive polyethylene glycol-electrolyte solution (GoLYTELY) for bowel cleansing before an endoscopic procedure. Which instructions should the nurse provide? Take 8oz every 10min until the 4 liters are gone
An adverse effect of the administration of bulk-forming laxatives is: obstruction
J.L. has recently had a myocardial infarction. Which of the following would be the most effective in preventing straining? docusate sodium (Colace)
Which of the following statements my L.H. leads you to believe that he has understood how to use Metamucil? "I will drink the Metamucil as soon as I have it mixed."
A nursing assessment of a patient on laxative therapy should include all of the following EXCEPT: level of consciousness
Persons using antiemetics may experience anti-cholinergic effects which include: dry mouth, blurred vision, urinary retention
D.H. is going on an ocean cruise and is concerned about nausea and vomiting. His physician orders a scopolamine (Transderm scope) patch. Which statement by D.H. leads you to believe that he understands how to use the patch? "I will place the patch behind my ear and replace it every 3 days."
Which class of peptic ulcer medication consists of alkaline combinations of aluminum hydroxide and magnesium hydroxide? antacids
The administration set used for the infusion of TPN solutions should be changed according to what schedule? With each container of fluid
J.C. began vomiting. He mentioned how odd it is that emesis could look like "coffee grounds". What is your best response? Report this to the physician immediately
The nurse knows that ducosate (Colace) is: a stool softener
The nurse explains to the patient that milk of magnesia is: a saline cathartic
Psyllium (Metamucil) is a: bulk forming laxative
Bisacodyl (Ducolax) works by: stimulating peristalsis
A drug that forms a protective coating over a gastric ulcer is: sucralfate (Carafate)
o A pt has been diagnosed with PUD. The MD has prescribed multiple antibiotics for the treatment for the cause of his PUD, H. pylori. In addition to the antibiotics, the nurse anticipates that which of the following meds would be added? proton pump inhibitors
A drug which speeds gastric emptying is: metoclopramide (Reglan)
J.L., age 64, has been diagnosed as having Parkinson's disease. His physician orders trihexyphenidyl (Artane). Artane has anticholinergic activity. Therefore, J.L. may complain of: dry mouth and blurred vision
After a year on Artane, the physician decides to prescribe levodopa. As a nurse, you know that: the results of therapy with levodopa are best when it is combined with carbidopa (Sinemet).
J.C. is admitted for a psychotic episode. He attempts to bite an orderly while he is being restrained. When you adminster IM chlorpromazine (Thorazine) to J.C., you should: demonstrate a calm, firm manner
Six weeks after starting chlorpromazine (Thorazine), the patient complains of difficulty chewing and swallowing. The nurse should: contact the physician
The nurse instructs the patient to avoid which of the following during levodopa therapy? Pyridoxine
During levodopa therapy, the nurse monitors for which side effect? Brown says: anxiety Double Key: suicidal tendencies
A patient with Parkinson's disease mentions he hopes to stop taking his medicine and be cured. What understanding would best guide the LPN's answer? Parkinson's disease requires ongoing therapy
Psychotropic drugs: affect the functioning of the mind
Which of the following foods would NOT interfere with medications for Parkinson's disease? Potato chips
Hyperkinetic movements of the face (smacking of lips, tongue protrusion, and facial grimaces) are examples of: tardive dyskinesia
Which of the following statements indicates your client has understood your teaching regarding antipsychotic medications? "Symptoms of psychosis will return if I stop the medication"
K.G. is started on amitriptyline (Elavil), a tricyclic antidepressant. Which information will the nurse include in his teaching plan? Sit on the side of your bed before getting up and stand up slowly
R.H. continues to take phenytoin (Dilantin) for her seizures. After an extended period of time on the drug, she presents to a clinic for evaluation. You would assess for which of the following dental problems: gingival hypertrophy
Long-term use of phenytoin (Dilantin) may effect: the hematopoietic system
A patient with epilepsy tells you she is tired of taking medication all the time. Your response to her is based on your knowledge that if she were to discontinue her medication abruptly, she may experience: status epilepticus
Monitoring lithium blood levels is important because lithium has: a narrow range between therapeutic and toxic doses
A client continues having occasional seizures despite taking the prescribed medication. The physician orders a benzodiazepine anticonvulsant. Which of the following anticonvulsants is a benzodiazepine? Valium
o R.D. takes 300mg of phenytoin (Dilantin) at HS every night to prevent seizures following brain surgery to remove a benign tumor. The pharmacy charges her $28.30 for 90 capsules containing 100mg each. What will her cost be for 30 days of med? $28.30
The physician has written an order to give the patient 2.5mg diazepam (Valium) IV push 15min prior to endoscopy. The available drug contains 5mg/ml. The LPN will: arrange for an RN to administer the medication
Injectable forms of barbiturates should not be combined in the same syringe with other drugs because: many of them will precipitate
Gabapentin (Neurontin) is classified as a: GABA potentiator
R.K., age 8, is placed on methylphenidate (Ritalin) for attention deficit disorder with hyperactivity. Her mother inquires about the drug and asks why a hyperactive child would need a stimulant. Your answer is based on the understanding that: the drug will have a reverse effect in children with this disorder
In teaching a mother about pemoline (Cylert), you should encourage her to remove which of the following from S.G.'s diet? caffeine
The parent of a child with ADHD tells you mornings are hectic at their household and she would rather administer the medication at bedtime. Your answer is based on the understanding that: this schedule may cause insomnia
Toxic effects of lithium can be prevented by maintaining: normal sodium levels
M.S., a student, has been using OTC stimulants containing caffeine to be alert for studying/classes and also has several cups of coffee, tea, and cola during the day. He visits a clinic for insomnia. What other symptoms would you expect him to have? Nervousness
Symptoms of serotonin syndrome include: Hypertension, sweating, and mental status changes
The nurse should teach the patient taking fluoxetine (Prozac) to avoid foods high in which amino acid? Tryptophan
Extrapyramidal effects include: dystonia, Parkinsonism, and tardive dyskinesia
Drugs that inhibit the enzyme acetylcholinesterase (AchE) will also have what effect? Increase levels of acetylcholine
o L.P. comes to the clinic complaining of LBP. He has reported feeling spasms in his low back area following a game of basketball when he was knocked to the floor. He takes no meds and has no chronic disease. Xrays are neg. The MD is likely to order: a muscle relaxant
o A.G. has had RA for 17yrs & has taken a variety of antiinflammatory meds. Still has had progressive deterioration of the rt hip, causing pain, limiting motion, and confining her to a wheelchair. The MD decides to try her on Plaquenil. This drug is a: disease modifying drug
After taking Plaquenil for one week, R.K. has not noticed any improvement in her arthritis pain. The nurse explains that: therapeutic effects may not be seen for several more months
S.G. recently fell while she was out jogging and has severely sprained her left ankle. She asks why OTC ibuprofen will not reduce her symptoms, the nurse explains: large doses of NSAIDs may be necessary to achieve an antiinflammatory response
L.H., an overweight 53y.o. woman, complains of severe pain in her right great toe. She has never had a problem like this before. Aspiration of the joint reveals uric acid crystals. The nurse anticipates a prescription for: colchicine
Pain that originates from the skeletal muscles, ligaments, or joints is called: somatic pain
A common side effect of NSAID therapy is: GI distress
Contraindications for the use of NSAIDs include: bleeding disorders
A 23y.o. has been taken to the ER for a suspected overdose of morphine tablets that he obtained from his grandmother's home following her total knee replacement. Which agent may be used to treat this overdose? naloxone HCl (Narcan)
Following an intramedullary rod insertion, the patient has severe acute pain above a level of 7 on a 10 point scale. This is best treated with: morphine sulfate
Which of the following is NOT necessary to include in an assessment before giving an opioid analgesic? blood clotting times
Antiinflammatory drugs are prescribed to prevent chronic excessive joint inflammation because this can lead to: tissue destruction
Muscle spasticity is the result of: damage to neurons within the CNS
A muscle spasm often results from: an injury to the musculoskeletal system
Narcotics are drugs that react with opioid receptors throughout the body and are NOT associated with: hypnosis
When asked why NSAIDs are better than acetaminophen (Tylenol) for rheumatoid arthritis, the healthcare provider responds, "Compared to aspirin, acetaminophen has": no antiinflammatory activity
A mother asks why aspirin should NOT be given to children and teens. The appropriate reaction by the healthcare provider is based on the actions of aspirin, which can cause which of the following? Increase in the risk of Reye's syndrome
A client comes to the ER with an overdose of morphine. The nurse's greatest concern would be: depressed respiration
M.K. is receiving meperdine (Demerol) continuously via a PCA pump following spinal fusion surgery. When assessing for side effects of the meperdine, to which vital signs will the nurse give particular attention? pain level, respirations, blood pressure
A client with rheumatoid arthritis has been taking prednisone (Meticorten) for two years. Which statement by the client indicates a need for further teaching? "I should not restrict sweets while on this medication"
Selective estrogen receptor modulators (SERMs) acre contraindicated in patients with all of the following conditions except which one? Postmenopause
Methotrexate can be used to treat rheumatoid arthritis. What other condition is it used for? Cancer
Patient teaching about vitamin D therapy includes all except which one? Avoid calcium while taking this drug
Sodium hyaluronate (Hyalgan) is a potential therapy for patients with moderate osteoarthritis. Which statement about this drug is false? It is used prior to other drug treatments
baclofen (Lioresal) is an example of a: central acting antispasmodic
The client has been using a calcium replacement nasal spray. What will the nurse teach the patient about continuing this medication at home? Contact the prescriber if the nose starts to bleed
An antianxiety drug that is also used as a muscle relaxant is: diazepam (Valium)
botulinum toxin A (Botox) is an example of: a direct acting antispasmodic
The most effective drug for treating an acute attack of gout would be colchicine (Colrys)
Created by: kthoma
 

 



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