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Pharm 2 - Review Q's
Question | Answer |
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The nurse teaches the patient relaxation techniques and guided imagery as an adjunct to medication for treatment of pain. What is the main rationale for the use of these techniques as adjuncts to analgesic medication? | They may allow lower doses of drugs with fewer adverse effects. |
The emergency department nurse is caring for a patient with a migraine. Which drug would the nurse anticipate administering to abort the patient’s migraine attack? | Sumatriptan (Imitrex) |
A patient admitted with hepatitis B is prescribed hydrocodone with acetaminophen (Vicodin) 2 tablets for pain. What is the most appropriate action for the nurse to take? | Recheck the order with the health care provider. |
The nurse administers morphine 4 mg IV to a patient for treatment of severe pain. Which of the following assessments require immediate nursing interventions? | The patient’s pain is unrelieved in 15 minutes. The patient’s respiratory rate is 10 breaths per min. The patient becomes unresponsive. |
Planning teaching needs for a patient who is to be discharged postoperatively with a prescription for oxycodone with acetaminophen (Percocet) should include which of the following? | Encourage increased fluids and fiber in the diet. |
What is the most appropriate method to ensure adequate pain relief in the immediate postoperative period from an opioid drug? | Give the drug as consistently as possible for the first 24 to 48 hours. |
The patient received lidocaine viscous before a gastroscopy was performed. Which of the following would be a priority for the nurse to assess during the postprocedural period? | Return of gag reflex |
A young patient requires suturing of a laceration to the right forearm and the provider will use lidocaine (Xylocaine) with epinephrine as the local anesthetic prior to the procedure. Why is epinephrine included in the lidocaine for this patient? | It will prolong anesthetic action at the site. |
The patient who is scheduled to have a minor in-office surgical procedure will receive nitrous oxide and expresses concern to the nurse that the procedure will hurt. Which of the following would be the nurse’s best response? | “You will not feel any pain during the procedure because the drug blocks the pain signals.” |
The patient returns to the postanesthesia recovery unit (PACU) for observation and recovery following surgery with a general anesthetic. Which of the following assessment findings may the nurse expect to find during this recovery period? | Bradycardia and Respiratory depression |
A patient is admitted to the postanesthesia recovery unit (PACU) after receiving ketamine (Ketalar) after his minor orthopedic surgery. What is the most appropriate nursing action in the recovery period for this patient? | Place the patient in a quiet area of the unit with low lights and away from excessive noise. |
A patient has received succinylcholine (Anectine, Quelicin) along with the general anesthetic in surgery. Which of the following abnormal findings in the recovery period should be reported immediately to the provider? | Temperature 38.9°C (102°F) |
A patient with a history of hypertension is to start drug therapy for rheumatoid arthritis. Which of the following drugs would be contraindicated, or used cautiously, for this patient? | Ibuprofen (Advil, Motrin), Naproxen (Aleve), Methylprednisolone (Medrol) |
The patient has been taking aspirin for several days for headache. During the assessment, the nurse discovers that the patient is experiencing ringing in the ears and dizziness. What is the most appropriate action by the nurse? | Tell the patient not to take any more aspirin. |
While educating the patient about hydrocortisone (Cortef), the nurse would instruct the patient to contact the health care provider immediately if which of the following occurs? | There is any difficulty breathing. |
A pt with rheumatoid arthritis has been taking prednisone. During the assessment, the rn observes that the pt has a very round moon-shaped face, bruising, & an abnormal contour of the shoulders. What does the rn conclude based on these findings? | These are symptoms of adverse drug effects from the prednisone. |
A 24-year-old patient reports taking acetaminophen (Tylenol) fairly regularly for headaches. The nurse knows that a patient who consumes excessive acetaminophen per day or regularly consumes alcoholic beverages should be observed for what adverse effect? | Hepatic toxicity |
The nurse is counseling a mother regarding antipyretic choices for her 8-year-old daughter. When asked why aspirin is not a good drug to use, what should the nurse tell the mother? | It increases the risk of Reye’s syndrome in children under 19 with viral infections. |
Superinfections are an adverse effect common to all antibiotic therapy. Which of the following best describes a superinfection? | The overgrowth of normal body flora or of opportunistic organisms such as viruses and yeast no longer held in check by normal, beneficial flora |
A patient will be discharged after surgery with a prescription for penicillin. When planning at-home instructions, what will the nurse include? | The entire prescription must be finished. |
A patient has been prescribed tetracycline. When providing information regarding this drug, the nurse should include what information about tetracycline? | It is contraindicated in children younger than 8 years. |
What important information should be included in the patient’s education regarding taking ciprofloxacin (Cipro)? | Any heel or lower leg pain should be reported immediately. |
A patient has been diagnosed with tuberculosis and is prescribed Rifater (pyrazinamide with isoniazid and rifampin). While the patient is on this medication, what teaching is essential? | “It is critical to continue therapy for at least 6 to 12 months.” “Two or more drugs are used to prevent tuberculosis bacterial resistance.” “These drugs may also be used to prevent tuberculosis.” |
A 32-year-old female has been started on amoxicillin (Amoxil, Trimox) for a severe UTI. Before sending her home with this prescription, the nurse will provide which instruction? | Ask her about oral contraceptive use and recommend an alternative method for the duration of the ampicillin course. |
Which of the following teaching points will the nurse provide to a patient with a new prescription for alendronate (Fosamax)? | Take the medication with a full glass of water 30 minutes before breakfast. |
Which assessment findings in a patient who is receiving calcitriol (Calcijex, Rocaltrol) should the nurse immediately report to the health care provider? | Bone pain, lethargy, anorexia |
The pt who is receiving allopurinol (Lopurin) for treatment of gout asks why he should avoid the consumption of alcohol. The nurse’s response is based on the knowledge that the use of alcohol along with allopurinol may result in which of the following? | It raises uric acid levels. |
A patient has been taking hydroxychloroquine (Plaquenil) for rheumatoid arthritis. Which of the following symptoms may alert the nurse to a possible toxic effect? | Blurred vision or diminished ability to read |
The nurse is explaining to a student nurse the physiological principle for how colchicine (Colcrys) achieves its effect. What response will the nurse give to the student? | It reduces the pain associated with joint inflammation by uric acid crystals. |
A 62-year-old female has received a prescription for alendronate (Fosamax) for treatment of osteoporosis. The nurse would be concerned about this order if the patient reported which condition? | She is unable to sit upright for prolonged periods because of severe back pain. She is lactose intolerant and rarely consumes dairy products. She has had trouble swallowing and has been told she has “problems with her esophagus.” |
Antimigraine drug. Should be administered asap after migraine is suspected or has begun. A/E: dizziness, warming sensation. Contraindicated in pt with renal or hepatic impairment. | Sumatriptan (Imitrex) |
Opiod analgesic. Used to relieve pain. Binds with mu & kappa receptor sites. A/E: dysphoria, nausea, constipation, dizziness, and itching. Contraindicated in pt with severe asthma, GI obstruction, and hepatic or renal impairment. | Morphine |
Treatment for opioid overdose. Opioid antagnoist. Blocks both mu and kappa receptors. A/E: increase b/p, tremors, hyperventilation, n/v, drowsiness. | Naloxone (Evzio, Narcan) |
NSAID, nonopioiod analgesic, antipyretic. Inhibits prostaglandin synthesis involved in the processes of pain and inflammation. A/E: Gastric discomfort and bleeding. Contraindicated in pt on anticoagulants. | Aspirin (Acetylsalicylic acid, ASA) |
Inhaled general anesthetic. Produces a potent level of surgical anesthesia. Muscle relaxation. A/E: mild n/v and tremors. Contraindicated in pt with malignant hyperthermia. | Isoflurane (Forane) |
Skeletal muscle paralytic drug; neuromuscular blocker. A/E: can cause complete paralysis of diaphragm & intercostal muscles, bradycardia, respiratory depression, tachycardia, hypotension, urinary retention. | Succinylcholine (Anectine, Quelicin) |
Anesthetic (local/topical); antidysrhythmic. Sodium channel blocker; amide. Acts by blocking neuronal pain impulses. Side effects are uncommon. An early symptom of toxicity is CNS excitement, leading to irritability and confusion. | Lidocaine (Xylocaine) |
reduces fever by direct action at the level of the hypothalamus and dilation of peripheral blood vessels. a/e are uncommon. causes less gastric irritation than aspirin & does not affect blood coagulation. not recommended in patients who are malnourished. | Acetaminophen |
Inflammatory drug, corticosteriod. contraindicated in pts with active viral, bacterial, fungal, or protozoan infections. A/E: hyperglycemia, fat redistribution to the shoulders & face, muscle weakness, bruising, & bones that easily fracture | Prednisone |
Hypocalcemia agent. Used to prevent or treat hypocalcemia. Can also be administered for osteoporosis, Paget’s disease, osteomalacia, chronic hypoparathyroidism, rickets, pregnancy, lactation, and rapid childhood growth. A/E: hypercalcemia | Calcium Salts |
Drug for osteoporosis. Bisphosphonate; bone resorption inhibitor. A/E: diarrhea, constipation, flatulence, n/v, metallic taste, hypocalcemia, hypophosphatemia, abdominal pain, dyspepsia, arthralgia, myalgia, headache, and rash. | Alendronate (Fosamax) |
Drug for osteoporosis prevention. It decreases bone resorption and increases bone mass and density by acting through the estrogen receptor. A/E: hot flashes, leg cramps, and weight gain. | Raloxifene (Evista) |
beta-lactam antibiotic used for the treatment and prophylaxis of bacterial infections & to treat infections of the respiratory tract, urinary tract, skin structures, biliary tract, bones, and joints. A/E: rash & diarrhea. | Cefazolin (Ancef, Kefzol) |
Antibacterial effective against a broad range of gram-positive and gram-negative organisms, including Chlamydia, Rickettsiae, and Mycoplasma. A/E: Causes superinfections & irritates the GI mucosa & may cause n/v, epigastric burning, and diarrhea. | Tetracycline (Sumycin, others) |
broad-spectrum, bactericidal antibiotic usually prescribed for serious urinary, respiratory, nervous, or GI infections when less toxic antibiotics are contraindicated. A/E: n/v and fatigue. | Gentamicin (Garamycin, others) |
antibiotic used to treat a number of bacterial infections. Common side effects include pain in the area of injection and allergic reactions. Occasionally, hearing loss, low b/p, or bone marrow suppression occur. | Vancomycin |
antibiotic used for the treatment of tuberculosis. Common side effect include increased blood levels of liver enzymes and numbness in the hands and feet. Serious side effects may include liver inflammation | Isoniazid |
decreased synthesis of cell wall; bactericidal S/E: n/v/d, allergy, superinfection; N/C: decreased effectiveness of oral birth control; dilute if IV; deep in large muscle if IM; NO warfarin/NSAIDs (increase anticoagulation); liver labs | -Cillins (bacterial) |