Pharmacology Exam 4
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| This dementia medication can still be taken with decreased renal function however the dosage needs to be lower. | Memantine
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| A patient calls the clinic one week after being prescribed Fluoxetine complaining that he is still depressed. What should the nurse do? | Inform the patient to continue taking the medication, it may take 1-3 weeks to have therapeutic effects, evaluate the patient for suicidal ideation. Causes weight gain as well.
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| A doctor orders 250mg of phenytoin (IV). The nurse should be cautious that administration of phenytoin does not exceed what value? | 50mg/min
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| A patient newly diagnosed with bipolar disorder is being discharged with a prescription for lithium. What should the nurse include in the patient teaching? | Be cautious when combining lithium with diuretics because low Na levels can cause lithium toxicity.
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| A patient who has been prescribed phenytoin or oxcarbazepine gives the nurse a list of the medications she’s currently taking. What should the nurse teach her about the oral contraceptives she has listed? | Phenytoin and oxcarbazepine (antiepileptics) decreases the effects of oral contraceptives therefore the patient needs to use a different form of birth control.
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| Donepezil should be taken when? | At bedtime because it causes drowsiness
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| A patient with bipolar disorder may be prescribed which two medications to prevent a manic episode? | Lithium and an antidepressant
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| The nurse has difficulty getting the patient to swallow her medications. When the nurse talks to the HCP, what medication should the nurse request instead of Donepezil? | Rivastigmine patch
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| If a patient taking phenytoin has a blood level of greater than 20, what should the nurse be concerned about? | Toxicity
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| The nurse would question the doctor's order for Rivastigmine if it is prescribed for a patient with what disease? | COPD
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| Which patient should not be prescribed phenytoin to minimize adverse effects? | Pregnant Women
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| A menopausal patient who is also a smoker has been prescribed hormone therapy for hot flashes and restlessness. What should the nurse include in the patient teaching? | Inform the patient that she is at risk for cardiovascular events such as MI, stroke, PE and DVT.
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| The nurse would question the doctor's order for lithium if it is prescribed for a patient with what disease? | End Stage Renal Disease
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| What organ should the nurse assess in a patient receiving lithium as a treatment for mood swings? | Kidneys
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| What is the biggest risk associated with estrogen and progestin? | Blood clots
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| What classes of medications are given for emergent acute management of status epilepticus? | Benzodiazepines to stop the seizure, Antiepileptics for control management
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| This class of antidepressants can cause cardiotoxicity and can be fatal if taken in excess. | Tricyclic Antidepressants (TCAs)
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| This medication is an adjunct to chemotherapy for treatment of breast cancer. | Tamoxifen
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| A patient taking oral contraceptives should avoid which food, drug and herb interactions? | Grapefruit, Antiepileptics and St. John's Wort
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| Which drug is better suited for a patient with moderate dementia? | Memantine
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| A patient who has been prescribed hormone therapy gives the nurse a list of medications she’s currently taking. What should the nurse teach her about the antianxiety medications she has listed? | Inform the patient that contraceptives increase the effects of antianxiety medications.
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| If a patient taking phenytoin has a blood level less than 10, what should the nurse be concerned about? | Patient is at risk of seizures
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| A patient who is breast-feeding her newborn infant is prescribed an antibiotic to take after discharge. Which statement should the nurse include when providing discharge instructions? | Take the antibiotic immediately after breast-feeding.
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| The nurse is assessing an infant delivered by a patient who is suspected of regularly using alcohol and cocaine during her pregnancy. It is most important for the nurse to observe the infant for what? | High-pitched cry, vomiting, and jitteriness
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| A cancer patient who is in remission is taking mexotrexate (Category X drug), but has hopes of becoming pregnant soon. Which statement by the nurse is accurate? | This drug has caused fetal demise.
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| A patient taking haloperidol is experiencing worm-like movements of the tongue. What should she do? | Contact HCP
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| A patient taking haloperidol admitted for symptoms such as dysrhythmias, rigidity and fluctuations in BP. The nurse can infer that these are symptoms of what syndrome? | Neuroleptic Malignant Syndrome
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| A patient taking chemotherapy may experience what side effects? | N/V and alopecia, fever
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| To decrease the risk of extravasation, the nurse should administer chemotherapy through what route? | IV central line
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| Infection, bleeding and anemia are all caused by chemotherapy's toxic affect on what? | Bone marrow suppression
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| When assessing the patient, the nurse notices that the patient's mouth is swollen. What chemotherapy agent was the patient prescribed? | Fluorouracil (5FU) or Methotrexate
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| A patient prescribed Doxorubicin is SOB, has edema and changes in her vital signs. The nurse should notice that these are all signs of what? | Cardiotoxicity
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| A patient has developed numbness, tingling and pain in the extremities. What chemotherapy agent was she prescribed? | Vincristine
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| A patient being treated for cancer is receiving medication for palliation. The nurse understands that palliative therapy is used to | relieve symptoms
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| The nurse assesses a patient who is receiving doxorubicin intravenously. The nurse determines extravasation has occurred. The first action by the nurse is to | Stop the intravenous infusion of doxorubicin.
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| A patient receiving chemotherapy for the treatment of cancer experiences “stocking/glove” syndrome. The nurse identifies which drug as most likely associated with this adverse effect? | Vincristine
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| A patient is prescribed phenytoin [Dilantin] for epileptic seizures. Which of the following is the priority for patient teaching? | Teach the patient to avoid the abrupt cessation of treatment.
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| The nurse realizes more medication teaching is necessary when the 30-year-old patient taking lorazepam (Ativan) states | I can stop this drug after 3 weeks if I feel better.
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| A patient on Olanzapine (Zyprexa) may be at increased risk for injury due to | increased risk for falls due to orthostatic hypotension
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| Assessment findings for a patient with neuroleptic malignant syndrome (NMS) include | Rhabdomyolysis
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| A nurse caring for a patient in an outpatient setting notes that the patient is currently taking lorazepam (Ativan) for anxiety and her breath smells of alcohol. The nurse reports this to the health care provider because | taking alcohol with Ativan may increase sedative effects
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| A patient has been diagnosed with neuroleptic malignant syndrome. The nurse anticipates administration of which medication to treat this patient? | Dantrolene (Dantrium)
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| A patient taking lorazepam (Ativan) should avoid what particular herb supplement? | Kava (sleep aids) may increase sedative effects
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| A patient taking Haloperidol should stand slowly from a seated position because a side effect of this medication is what? | Orthostatic Hypotension
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| The nurse is reviewing a patient’s medication history and notes that the patient recently began taking lithium (Lithibid). What intervention is a priority for this patient? | Monitoring the patient’s intake and output
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| Which laboratory test is most important for the nurse to monitor when a patient is receiving cyclophosphamide? | Urinalysis
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| Which advice will the nurse include when teaching the patient about lithium therapy? | It may take 2 to 3 weeks before you have any benefits from taking the medication.
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| The nurse identifies which as an approved condition for induction of labor? | Preeclampsia or eclampsia
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| A patient is experiencing postpartum hemorrhage also known as uterine atony. What medication should the nurse request from the HCP? | Oxytocin
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| A patient comes to the ER at 40 weeks for a scheduled induction. What medication will be used to stimulate uterine contractions? | Oxytocin
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| What should the nurse monitor for in a patient taking Magnesium Sulfate for uterine relaxation? | DTR, Mg+ levels, renal function and fluid balance (I&O)
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| A nurse assesses the patient's deep tendon reflexes (DTR) and notices they are diminished. What could this be a sign of? | Mg+ Sulfate toxicity
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| This uterine relaxant may cause hypotension in hypovolemic patients. | Nifedipine
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| What is the preferred drug of choice for suppression of pre-term labor? | Nifedipine
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| A patient is admitted to the hospital for treatment of symptomatic bradycardia and atrioventricular (AV) heart block. Which topical medication for the eye should the nurse withhold and discuss with the healthcare provider before administration? | Beta-blockers (timolol)
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| A patient is receiving ocular injections to treat neovascular age-related macular degeneration (ARMD). The nurse should teach the patient to immediately report symptoms that indicate an eye infection. The symptoms of eye infection include what? | Redness, light sensitivity, and pain
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| A 22-year-old female patient is prescribed isotretinoin for severe acne. What statement will the nurse include in patient teaching? | Pregnancy must be avoided while taking this medication.
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| A 3-month-old infant is diagnosed with acute otitis media (AOM). The caregiver asks the nurse what the most likely course of treatment will be. The nurse should do what? | Tell the caregiver that antibiotics will be ordered.
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| The nurse is preparing the newborn patient for a circumcision. What skin medication will be used to decrease pain? | Lidocaine (Local Anesthetic)
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| Methotrexate, Glucocorticoids and Cyclosporine are all used to treat psoriasis. What do these 3 medications have in common? | They suppress the immune system.
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| A patient diagnosed with glaucoma should avoid which anticholinergic medications because they increase intraocular pressure? | Anti-histamines, Anti-depressants and OTC cough and cold meds
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| A patient contacts the HCP complaining of extreme eye pain that developed suddenly. What condition is this patient referring to? | Angle-Closure Glaucoma (Narrow-Angle Glaucoma)
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| A patient was given an adrenergic agonist to dilate pupils for an eye exam. The nurse should monitor for what vital sign changes? | increase in HR and BP, blurred vision
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| What are important nursing considerations when administering an antibiotic in the tetracycline family? | bacteria resistance, secondary infection, food interactions and drug interactions w/ oral contraceptive
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| What should the nurse assess for in a patient taking memantine? | RBC, H&H
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| How many times does the nurse have to administer memantine to a patient with dementia? | Once a day
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| What should the nurse assess for in a patient taking Donepezil? | Bradycardia (check HR/pulse)
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| Donepezil is most effective for patients with which form of dementia? | Mild
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| A patient taking glucocorticoids long-term for a skin condition should be aware of what adverse effects? | adrenal suppression, thinning of skin, systemic toxicity, purpura, spider veins
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| Which medications might be used to treat side effects of chemotherapy agents? | Promethazine, Ondansetron, Glucocorticoids
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| This medication known as the "Red Devil" is cardiotoxic? | Doxorubicin
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| What are baseline assessments for chemotherapy? | Echocardiogram, CBC, reproductive testing
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| This medication is a beta 2 agonist given to pregnant women to relax the uterus and stop preterm labor. It can cause pulmonary edema. | Terbutaline
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| A 24-year old patient in her first trimester complains of nausea/vomiting and asks if there is a medication that can be prescribed to alleviate her symptoms. What should be the nurse's first response? | It is best to try safer options first like eating saltine crackers, bland food, and soda water.
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| A mother who is Rh negative is pregnant with an Rh positive fetus. The nurse should request what medication from the physician? | Rhogam
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| During the timeframe in which a woman's labor is stalled, what is the priority for the patient? | Administer glucocorticoids (Betamethasone) in order to develop the babies lung to increase chances of survival.
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| The nurse receives a laboratory report indicating that the phenytoin level for the patient seen in the clinic yesterday is 16 mcg/mL. Which intervention is most appropriate? | Continue as planned, because the level is within normal limits.
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| Which medication should the nurse anticipate administering to a patient in convulsive status epilepticus to halt seizure activity? | Lorazepam [Ativan] 0.1 mg/kg IV at a rate of 2 mg/min
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| The nurse is conducting discharge teaching related to a new prescription for phenytoin. Which statement is appropriate to include in the teaching for this patient and family? | “It is very important to have good oral hygiene and to visit your dentist regularly.” and“You may have some mild sedation. Do not drive until you know how this drug will affect you.”
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| The nurse suspects that a female patient is experiencing phenytoin toxicity if which manifestation is noted? | nystagmus, ataxia, confusion
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| MAOIs | Take a list of the foods patient has eaten
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| A patient contacts the HCP complaining that his antidepressant isn't working. What should be the nurse's response? | Try a non-pharmacological method until benefits occur
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| What's the priority concern for a patient taking terbutaline? | foamy mouth and sputum
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| A pregnant patient gives the nurse a list of the medications she’s currently taking. What is the nurse's primary concern? | Megadose of vitamins (NOT grapefruit juice)
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| Tocolytics are used for what? | Suppress pre-term labor
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| A patient comes to the ED with a severe asthma attack. Which medication will be administered? | short acting inhaled bronchodilator
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| Which medications should the nurse caution the client about taking with an opioid analgesic? | Benzodiazepines
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| Which symptoms are serious adverse effects of beta 2 adrenergic blockers? | Wheezing, hypotension, and AV block
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| A client is taking metronidazole 2g PO. Which teaching will the nurse provide? | Avoid alcohol while you are taking this med.
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| A client is receiving cortisone 40mg daily. Which lab result could increase due to this med? | Glucose levels
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| A patient is receiving vitamin K for a INR of 4.5. Which med dose may have been too high? | Warfarin
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| Sulcrafate is prescribed for a client with an ulcer. What is the purpose of this medication? | Produce an adherent barrier over the ulcer.
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| A client with CHF is prescribed spirinolactone. Which dietary teaching should be provided? | Decrease food high in Na
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| A patient on chemotherapy reports severe nausea. Which would be most beneficial to the patient? | Administer ondansetron
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| Nitroprusside IV is prescribed to a patient with a BP of 220/100. What is the best action by the RN? | Monitor BP continuously
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| Which laboratory reports should the nurse evaluate if the patient is administered vancomycin? | Serum creatinine
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| In which patient would a low-dose aspirin be contraindicated? | A patient with a recent abdominal surgery
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| A patient is prescribed a drug with phototoxic effects. Which of these meds causes phototoxicity? | Doxycycline and Sulfanomides
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| Which factor would increase the risk of blood clots with oral contraceptive use? | Patient over 35
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| An RN is caring for a patient with a hypoparathyroidism. Which vitamin should the RN teach about? | Vitamin D
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| A patient is scheduled to begin taking alendronate. Which instruction should the nurse provide? | After taking the medication, sit or stand for 30 mins
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| A patient is prescribed levodopa-carbidopa. Which statement indicates a need for further teaching? | I will take this med with a protein to avoid nausea
It's common to feel heart palpitations on this medication
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| A patient recently started taking an SSRI. Which question is most important to ask? | Have you had changes in your mood or thoughts of suicide?
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| The client's serum phenytoin level is 31mcg/mL. What is the nurse's best action? | Hold the medication then contact HCP
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| A patient has lispro insulin at 7AM. Which action will the RN perform when giving this med? | Make sure the patient eats breakfast immediately
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